Digestive System Diseases Commons^™

A Rare Cause Of Pneumoperitoneum, Robert Zusman, George Michael, Anna E. Augustin, My Myers, Dudith Pierre-Victor

West Florida Division GME Research Day 2020

Pneumoperitoneum is most commonly associated with a perforated viscus. When free air is seen on imaging, the most common course of action is an emergent exploratory laparotomy. However, pneumoperitoneum may not always be indicative of a perforated bowel. In the case described below, we will discuss a patient who developed acute peritonitis and pneumoperitoneum after undergoing chest compressions during cardiopulmonary resuscitation (CPR) and positive pressure mechanical ventilation.

Ctrp3 And Alcoholic Liver Disease In Female Mice, Callie Root

Undergraduate Honors Theses

C1q TNF Related Protein 3 (CTRP3), is a cytokine that is primarily secreted from adipose tissue, which classifies it as an adipokine. Our previous research has shown that CTRP3 prevents alcoholic fatty liver disease (ALD) in male mice. However, even when accounting for confounding factors such as absolute and relative alcohol intake, females are more sensitive to the effects of consumption compared to male mice. Therefore, the goal of this project was to determine whether CTRP3 prevented ALD in female mice. Methods: Female wild type (WT) and female CTRP3 transgenic over expressing (Tg) mice were fed an ethanol containing liquid …

Ubiquitination Of The Dna-Damage Checkpoint Kinase Chk1 By Traf4 Is Required For Chk1 Activation, Xinfang Yu, Wei Li, Haidan Liu, Qipan Deng, Xu Wang, Hui Hu, Zijun Y Xu-Monette, Wei Xiong, Zhongxin Lu, Ken H Young, Wei Wang, Yong Li

Faculty, Staff and Students Publications

BACKGROUND: Aberrant activation of DNA damage response (DDR) is a major cause of chemoresistance in colorectal cancer (CRC). CHK1 is upregulated in CRC and contributes to therapeutic resistance. We investigated the upstream signaling pathways governing CHK1 activation in CRC.

METHODS: We identified CHK1-binding proteins by mass spectrometry analysis. We analyzed the biologic consequences of knockout or overexpression of TRAF4 using immunoblotting, immunoprecipitation, and immunofluorescence. CHK1 and TRAF4 ubiquitination was studied in vitro and in vivo. We tested the functions of TRAF4 in CHK1 phosphorylation and CRC chemoresistance by measuring cell viability and proliferation, anchorage-dependent and -independent cell growth, and mouse …

The Role Of Nutrition In Promoting Gut Health And Treating Chronic Illness Through The Attenuation Of Inflammation, Allison Dalton

HCA Healthcare Journal of Medicine

Over the millennia, the human body and microorganisms such as bacteria, viruses, archaea, protozoa and parasites have coevolved together forming an intimate relationship. These microorganisms are found on the skin, in the mouth, genitourinary tract and most abundantly in the large intestine of the digestive tract. States of microbial dysbiosis contribute to chronic inflammation, which can lead to the pathogenesis and progression of numerous diseases. Micro- and macro-nutrients as well as dietary patterns like the Mediterranean diet can help improve health outcomes.

The Inflammatory Bowel Disease Questionnaire In Randomized Controlled Trials Of Treatment For Ulcerative Colitis: Systematic Review And Meta-Analysis, Aaron Yarlas, Stephen Maher, Martha Bayliss, Andrew Lovley, Joseph C. Cappelleri, Andrew G. Bushmakin, Marco D. Dibonaventura

Journal of Patient-Centered Research and Reviews

Purpose: The 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32) is the most frequently used instrument to capture disease-specific quality of life in randomized clinical trials for ulcerative colitis. This review and meta-analysis provides the first synthesis of evidence regarding the sensitivity of IBDQ-32 total and domain scores to treatment efficacy.

Methods: A systematic literature search and risk-of-bias assessment yielded 14 articles that were included in the primary analysis. Treatments were categorized as efficacious if they met the primary efficacy endpoint (which was not the IBDQ-32); otherwise they were categorized as non-efficacious. A continuous measure of treatment efficacy was calculated for …

A Systematic Search And Review On The Efficacy, Safety, And Cost-Effectiveness Of Utilizing Lactobacillus Probiotics In Concurrence With Prescribing Antibiotics To Reduce Clostridium Difficile Infection Rates In Hospitalized Patients, Laura Sheehan

Nursing Masters Papers

Incidence of Clostridium difficile infection, (CDI) in patients receiving antibiotics is significant. In 2017, there were approximately 223,900 cases of CDI in hospitalized patients alone (Center for Disease Control [CDC], 2017). Despite enhanced infection control measures, CDI rates remain prevalent and are associated with increased costs to healthcare. An integrative literature review and synthesis was performed. Studies were analyzed to delineate if Lactobacillus containing probiotics, when administered concurrently with high risk antibiotics, decrease CDI rates for patients in the inpatient hospital setting. Additional analysis of probiotic safety and a cost versus benefit analysis was researched. The purpose of the review …

Novel Method Of Supplementing Current Depression Treatments: Using Autonomous Sensory Meridian Response-Centered Therapy To Improve Constipation-Associated Comorbidity Of Depression, Shivam Patel

Virginias Collegiate Honors Council Conference

One-third of individuals struggling with constipation also suffer chronically from comorbid depression, but the evidently shared etiology has remained relatively ambiguous. This proposed study aims to analyze the role of Autonomous Sensory Meridian Response (ASMR), a newly recorded neural phenomenon that causes relaxing “tingles” from unique “triggers” in a subset of individuals, in altering serotonin (5-HT) levels within the ENS to aid with both depression and constipation. In depressed individuals, reduced 5-HT has been clinically accepted as a key symptom and is frequently treated with ineffective SSRIs. Prospective alternative methods of non-invasive treatment, such as ASMR, would not only aid …

Provider Attitudes And Practice Patterns For Direct-Acting Antiviral Therapy For Patients With Hepatocellular Carcinoma, Nicole E Rich, Ju Dong Yang, Ponni V Perumalswami, Naim Alkhouri, Whitney Jackson, Neehar D Parikh, Neil Mehta, Reena Salgia, Andres Duarte-Rojo, Laura Kulik, Mina Rakoski, Adnan Said, Omobonike Oloruntoba, George N Ioannou, Maarouf A Hoteit, Andrew M Moon, Amol S Rangnekar, Sheila L Eswaran, Elizabeth Zheng, Janice H Jou, James Hanje, Anjana Pillai, Ruben Hernaez, Robert Wong, Steven Scaglione, Hrishikesh Samant, Devika Kapuria, Shaun Chandna, Russell Rosenblatt, Veeral Ajmera, Catherine T Frenette, Sanjaya K Satapathy, Parvez Mantry, Prasun Jalal, Binu V John, Oren K Fix, Michael Leise, Christina C Lindenmeyer, Avegail Flores, Nayan Patel, Z Gordon Jiang, Nyan Latt, Renumathy Dhanasekaran, Mobolaji Odewole, Sofia Kagan, Jorge A Marrero, Amit G Singal

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Direct-acting antivirals (DAAs) are effective against hepatitis C virus and sustained virologic response is associated with reduced incidence of hepatocellular carcinoma (HCC). However, there is controversy over the use of DAAs in patients with active or treated HCC and uncertainty about optimal management of these patients. We aimed to characterize attitudes and practice patterns of hepatology practitioners in the United States regarding the use of DAAs in patients with HCC.

METHODS: We conducted a survey of hepatology providers at 47 tertiary care centers in 25 states. Surveys were sent to 476 providers and we received 279 responses …

Hepatitis B Virus Hbx Protein Mediates The Degradation Of Host Restriction Factors Through The Cullin 4 Ddb1 E3 Ubiquitin Ligase Complex, Marissa M Minor, F Blaine Hollinger, Adrienne L Mcnees, Sung Yun Jung, Antrix Jain, Joseph M Hyser, Karl-Dimiter Bissig, Betty L Slagle

Faculty, Staff and Students Publications

The hepatitis B virus (HBV) regulatory HBx protein is required for infection, and its binding to cellular damaged DNA binding protein 1 (DDB1) is critical for this function. DDB1 is an adaptor protein for the cullin 4A Really Interesting New Gene (RING) E3 ubiquitin ligase (CRL4) complex and functions by binding cellular DDB1 cullin associated factor (DCAF) receptor proteins that recruit substrates for ubiquitination and degradation. We compared the proteins found in the CRL4 complex immunoprecipitated from uninfected versus HBV-infected hepatocytes from human liver chimeric mice for insight into mechanisms by which HBV and the cell interact within the CRL4 …

Quality Improvement In Ibd Care: The Influence Of A Qi Specific Conference For Fellows, Olayinka Afolabi, Alexis Faber, Raya Kutaimy, Paul Naylor, Murray Ehrinpreis

Medical Student Research Symposium

Given the complexity of management of inflammatory bowel disease (IBD), medical societies such as the American Gastroenterological Association (AGA) and Crohn’s and Colitis Foundation of America (CCFA) have established measures aimed at defining quality of care. In 2011, the AGA proposed 10 quality metrics for IBD, eight of these measures relate to outpatient management and two focus on inpatient management. Our objective was to evaluate compliance with these measures in our own general GI practice and determine whether a GI conference discussing quality improvement (QI) in 2017 was effective.

Gut Microbial Protein Expression In Response To Dietary Patterns In A Controlled Feeding Study: A Metaproteomic Approach, Sheng Pan, Meredith A J Hullar, Lisa A Lai, Hong Peng, Damon H May, William S Noble, Daniel Raftery, Sandi L Navarro, Marian L Neuhouser, Paul D Lampe, Johanna W Lampe, Ru Chen

Faculty, Staff and Students Publications

Although the gut microbiome has been associated with dietary patterns linked to health, microbial metabolism is not well characterized. This ancillary study was a proof of principle analysis for a novel application of metaproteomics to study microbial protein expression in a controlled dietary intervention. We measured the response of the microbiome to diet in a randomized crossover dietary intervention of a whole-grain, low glycemic load diet (WG) and a refined-grain, high glycemic load diet (RG). Total proteins in stools from 9 participants at the end of each diet period (

Methyl-Sensing Nuclear Receptor Liver Receptor Homolog-1 Regulates Mitochondrial Function In Mouse Hepatocytes, Sungwoo Choi, Bingning Dong, Chih-Chun Janet Lin, Mi Jeong Heo, Kang Ho Kim, Zhen Sun, Martin Wagner, Nagireddy Putluri, Jae Myoung Suh, Meng C Wang, David D Moore

Faculty, Staff and Students Publications

Liver receptor homologue-1 (LRH-1; NR5A2) is a nuclear receptor that regulates metabolic homeostasis in the liver. Previous studies identified phosphatidylcholines as potential endogenous agonist ligands for LRH-1. In the liver, distinct subsets of phosphatidylcholine species are generated by two different pathways: choline addition to phosphatidic acid via the Kennedy pathway, or trimethylation of phosphatidylethanolamine via Phosphatidylethanolamine N-methyl Transferase (PEMT). Here we report that a PEMT - LRH-1 pathway specifically couples methyl metabolism and mitochondrial activities in hepatocytes. We show that the loss of Lrh-1 reduces mitochondrial number, basal respiration, beta-oxidation and ATP production in hepatocytes, and decreases expression of mitochondrial …

Comparison Of Microneutralization And Histo-Blood Group Antigen-Blocking Assays For Functional Norovirus Antibody Detection, Robert L Atmar, Khalil Ettayebi, B Vijayalakshmi Ayyar, Frederick H Neill, Ralph P Braun, Sasirekha Ramani, Mary K Estes

Faculty, Staff and Students Publications

BACKGROUND: The development of an in vitro cultivation system for human noroviruses allows the measurement of neutralizing antibody levels.

METHODS: Serum neutralizing antibody levels were determined using a GII.4/Sydney/2012-like virus in human intestinal enteroids in samples collected before and 4 weeks after administration of an investigational norovirus vaccine and were compared with those measured in histo-blood group antigen (HBGA)-blocking assays.

RESULTS: Neutralizing antibody seroresponses were observed in 71% of 24 vaccinated adults, and antibody levels were highly correlated (r = 0.82, P < .001) with those measured by HBGA blocking.

CONCLUSIONS: HBGA-blocking antibodies are a surrogate for neutralization in human noroviruses.

Budd-Chiari Syndrome From A Tunneled-Dialysis Catheter?, Ifrah Butt Md, Kairavee D. Dave Md, Lucas Rindy Do, Arash Zarrin Do, Livasky Concepcion Md, Daniel Heller Md, Franklin Kasmin Md, Steven Kaplan Md, John Rivas Md

Internal Medicine

No abstract provided.

A Rare Case Of Perforated Jejunal Diverticulitis, Mohamed Nagi Md, Stanley Deturris Md, Ang Darwin

General Surgery

Introduction: Jejunal diverticulosis is a rare condition with clinical incidence of 0.5%. It is less common than colonic and duodenum diverticulosis. It is usually asymptomatic and diagnosed incidentally but it may cause chronic symptoms and acute complications. The aim of the case report to increase the awareness about the disease Case Report: This is a 56-year-old Caucasian male who presented with abdominal pain and fever and was diagnosed with transverse colon diverticulitis with microperforation on CT scan. Patient was treated nonoperatively with antibiotics and was discharged home. Two months later, he presented with similar recurrent abdominal pain and was found …

General Surgery Residency And Emergency General Surgery Service Reduces Readmission Rates And Length Of Stay In Non-Operative Small Bowel Obstruction, Sarah Waterman Manning Md, Katherine S. Mastriani

General Surgery

No abstract provided.

The Overall Poor Specificity Of Mrcp In The Preoperative Evaluation Of The Jaundiced Patient Will Increase The Incidence Of Non-Therapeutic Ercp, Andrew M. O'Neill Md, Keith Anderson Md, Lorinda K. Baker, Michaal Schurr Md

General Surgery

See additional files.

The Role Of Noninvasive Tests For Differentiating Nash From Nafl And Diagnosing Advanced Fibrosis Among Patients With Nafld, Maya Balakrishnan, Rohit Loomba

Faculty, Staff and Students Publications

Assessing for the presence of non-alcoholic steatohepatitis (NASH) and the presence of advanced fibrosis is vital among patients with non-alcoholic fatty liver disease (NAFLD) as each is predictive of disease outcomes. A liver biopsy is the gold standard method for doing so but is impossible to perform among all patients with NAFLD. Reliable methods for noninvasively detecting for the presence of NASH and advanced fibrosis are thus a pressing need. The search for noninvasive tests has been more successful for advanced fibrosis than for NASH. Clinical prediction models and elastography have acceptable accuracy for ruling out advanced fibrosis; when used …

Isolated Gallbladder Injury From Blunt Abdominal Trauma: A Rare Co-Incidence, Muhammad Rizwan Khan, Saleema Begum

Section of General Surgery

Gallbladder injury resulting from blunt abdominal trauma is a rare entity and generally associated with other intra-abdominal injuries. Incidence of isolated gallbladder injury has not been reported yet. The most common mechanism of injury reported is road traffic accident. Diagnosis is usually made on imaging as clinical presentation may vary from no symptoms to peritonitis due to extravasation of bile in the abdominal cavity. Cholecystectomy is the treatment of choice and minimally invasive approach can be considered in haemodynamically stable patients.

Metastatic Leiomyosarcoma Presenting As Polycystic Liver Disease, Michael Burkholz Do, Apurva Modi Md

Gastroenterology

No abstract provided.