Gastroenterology Commons^™

Limosilactobacillus Reuteri Ameliorates Maternal Separation Stress In Newborn Mice And Alters Subsequent Adult Behaviour, Z. M. Saleh, B. Okeugo, V. R. Venna, F. W. Blixt, V. A. Quaicoe, E. S. Park, S. Giorgberidze, Meng Luo, Christopher M. Taylor, J. M. Rhoads, Y. Liu

School of Medicine Faculty Publications

Maternal separation (MS) in mice results in behavioral deficits and gut microbiota dysbiosis that all persist into adulthood. Limosilactobacillus reuteri DSM 17938 modulates gut microbiota, alters systemic metabolites, and facilitates immune regulation. To assess the effect of DSM 17938 on biochemical and behavioural stress-associated changes, newborn mice were exposed to unpredictable MS (MSU) daily from day 7 to day 20 of life, with intragastric administration of DSM 17938 or PBS as control. Body weight, brain levels of cholecystokinin (CCK), glial fibrillary acidic protein (GFAP), corticosterone, and stool microbiota were assessed at day 21. Behaviour tests including Y-maze (YMT), Tail Suspension …

Hyperemesis Gravidarum Leading To Thiamine Deficiency And Infantile Hypotonia, Christina Sanchez, Lauren Lazar, Michele Alkalay, Kelsie Matthews

2024

No abstract provided.

Disparities In The Prevalence Of Hospitalizations And In-Hospital Mortality Due To Acute Myocardial Infarction Among Patients With Non-Alcoholic Fatty Liver Disease: A Nationwide Retrospective Study, Umar Hayat, Faisal Kamal, Muhammad Kamal, Wasique Mirza, Tariq Ahmad, Manesh Gangwani, Dushyant Dahiya, Hassam Ali, Shiva Naidoo, Sara Humayun, Hayrettin Okut, Muhammad Aziz

Division of Gastroenterology and Hepatology Faculty Papers

Background: Non-alcoholic liver disease (NAFLD) may be associated with cardiovascular diseases; however, only a few studies have analyzed this relationship. We aimed to assess the epidemiologic data and the association between NAFLD and acute myocardial infarction (AMI) in the United States. Methods: The National Inpatient Sample (NIS) database 2016-2019 was queried using ICD10-CM diagnostic codes to identify hospitalizations of AMI + NAFLD. Essential demographic variables were analyzed to determine the disparities in the prevalence of AMI hospitalizations and deaths among NAFLD patients. Univariate and multivariate logistic regression models determined the association between NAFLD and AMI hospitalizations and death. …

The Use Of Real-World Evidence To Generate Cost Analysis Of Antibiotic Susceptibility Testing (Ast) In Patients With Elicobacter Pylori Treatment Failure In Thailand: A Large Population-Based Study, Natsuda Aumpan, Pornpen Gamnarai, Arti Wongcha-Um, Muhammad Miftahussurur, Yoshio Yamaoka, Ratha-Korn Vilaichone

Faculty, Staff and Students Publications

BACKGROUND:H. pylori eradication is effective for gastric cancer prevention. Treatment failure is caused by increased antibiotic resistance. This study aimed to determine eradication rates and perform cost analysis between susceptibility-guided therapy and empirical treatment in patients with H. pylori treatment failure.

METHODS: This retrospective cohort study included patients with dyspepsia undergoing gastroscopy at tertiary care center in Thailand from March 2014 to October 2021. Treatment failure was defined as persistent H. pylori infection after ≥1 regimen completion. Early AST was defined as AST performed shortly after first-line treatment failure. Demographic data, AST results, eradication regimens, and medication costs were …

Systematic Review Of Immune Checkpoint Inhibitor-Related Gastrointestinal, Hepatobiliary, And Pancreatic Adverse Events, Malek Shatila, Hao Chi Zhang, Anusha Shirwaikar Thomas, Antonio Pizuorno Machado, Sidra Naz, Nitish Mittal, Christine Catinis, Krishnavathana Varatharajalu, Carolina Colli Cruz, Eric Lu, Deanna Wu, Julie R Brahmer, Franck Carbonnel, Stephen B Hanauer, Bret Lashner, Bryan Schneider, John A Thompson, Michel Obeid, David P Farris, Yinghong Wang

Faculty, Staff and Student Publications

Gastrointestinal immune-related adverse events (GI irAEs) are common manifestations of immune checkpoint inhibitor (ICI) toxicity. We present a comprehensive systematic review of the incidence, management, and clinical course of irAEs across the entire GI system, including the luminal GI tract, liver, and pancreas. MEDLINE, Embase, Web of Science Core Collection, and Cochrane Library were used to conduct this review. All studies pertaining to GI irAEs were included. Both abstracts and full manuscripts were eligible if they included human subjects and were written in the English language. Articles not available in English, animal studies, or research not specific to GI toxicity …

Emerging Diagnostics And Therapeutics For Non-Alcoholic Fatty Liver Disease, Kiarra Krulikowski, Jake Darbhanga, Suzanne Riskin

HCA-NSU MD Research Day

Introduction: The obesity epidemic has pushed fatty liver disease to the forefront of the 21st century. Disease identification can be done invasively with a liver biopsy or noninvasively through elastography and measurements of biomarkers. Presently, there are no FDA-approved drugs on the market to treat the disease. Alternative medicinal treatments have been investigated, which include altering the intestinal microbiota and consuming anti-inflammatory, herbal-based, vitamin-based, and plant-based medications. Methods: In this study, multiple databases were used to identify articles pertaining to fatty liver disease (FLD). All articles gathered from the databases were peer-reviewed and less than 10 years old to ensure …

When Aml Strikes Twice: A Case Of Acute Myeloid Leukemia With Concurrent Myopericarditis And Acute Pancreatitis, Veronica Benitez, Gabriella A. Morey, Veronica Benitez, Roberto H. Ruiz

HCA-NSU MD Research Day

Introduction: Acute myeloid leukemia (AML) is a hematological malignancy characterized by the proliferation of undifferentiated hematopoietic stem cells, leading to symptoms like fatigue, fever, and bleeding. While AML can infiltrate various organs, myocardial and pancreatic involvement are extremely rare, with myopericarditis and acute pancreatitis being particularly uncommon. Case Description: A 72-year-old hispanic female with a history of pancreatitis and autoimmune disorders presented with worsening lower abdominal pain, dysuria, nausea, and vomiting. Her pancreatitis resolved, but she subsequently developed chest pain and was diagnosed with acute pericarditis. Her elevated white blood cell count, predominantly monocytic, led to the diagnosis of AML …

Could Sigmoid Diverticulitis, Drug-Induced Liver Injury, And Drug-Induced Pancreatitis Co-Occur?, Rutwik Pradeep Sharma, Ryan Tam, Michael Labuzetta, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Sigmoid diverticulitis is a leading cause of gastrointestinal pathology etiology, which causes hospital admissions in Western society. Recent studies have shown its prevalence to be 1-4%. Drug-induced liver injury (DILI) is a primary cause of acute liver failure in the West^. The incidence of DILI is between 14-19 cases per 100,000 population. The prevalence of drug-induced pancreatitis (DIP) is 2-5%, although this is hard to estimate given the lack of large-scale studies. Sulfasalazine is a disease-modifying antirheumatic drug that is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis and ulcerative colitis. It has been associated …

Sevelamer-Induced Gastrointestinal Mucosal Injury: A Critical Review For Clinicians, Lefika Bathobakae, Phenyo Phuu, Saif Yasin, Rammy Bashir, Jessica Escobar, Ruhin Yuridullah, Gabriel Melki, Mohamed Elagami, Yana Cavanagh, Walid Baddoura

Journal of Community Hospital Internal Medicine Perspectives

Sevelamer is a non-absorbable polymer used to treat hyperphosphatemia in individuals with end-stage renal disease (ESRD) undergoing hemodialysis. The deposition of sevelamer crystals in the gastrointestinal (GI) tract, especially in the colon, can cause mucosal inflammation, pseudopolyps, ulceration, ischemia, or necrosis. Owing to its rarity and lack of physician awareness, the actual incidence and prevalence of sevelamer-induced gastrointestinal mucosal injury (SIGMI) remain unknown. The current evidence is retrospective, in the form of observational studies. This systematic review of case reports provides an overview of SIGMI, with a focus on its etiology, signs and symptoms, pathogenesis, diagnosis, and management. Electronic databases, …

Rectovaginal Fistula Due To Undiagnosed Rectal Tuberculosis In A Nulliparous Young Woman: A Case Report, Daudi Gidion, Brenda Moshi, Gregory Ntiyakunze, James Chapa, Peter Majinge, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction: Rectovaginal fistulas (RVFs) can arise from various etiologies, the most common cause especially in developing countries is obstetric injury. Uncommonly, rectal tuberculosis can present as RVF, posing a diagnostic and treatment challenge especially in a patient without established risk factors. The first case of rectal tuberculosis was reported by Davis et al., in 1957, and a 2022 systematic review identified only 28 cases reported since then.

Presentation of Case: we report the case of a 25-year-old college woman who presented with a 3-month history of lower abdominal pain and fecal passage per vagina. She had undergone a failed …

Preventing Migration Of Esophageal Silicone Covered Self-Expanding Metal Stent Using Dental Floss In A Pediatric Patient, Sofia Colon Guzman, Nadia Ibrahimi, Amornluck Krasaelap

Presentations

Temporary esophageal stents are an important and effective treatment for benign esophageal strictures, such as those caused by caustic ingestions. Fully covered self-expanding metal stents (FCSEMS) provide the benefit of continuous dilation pressure over longer periods of time compared to bougie or balloon dilation. However, stent migration is the most common complication and can be observed in up to 40% of patients, especially with FCSEMS and in refractory strictures. Typically, the stent is secured by using clips or suturing devices. However, we present a case where traditional methods of securing a stent were not possible due to the location of …

Terminal Ileal Intubation In Retroflexion In A Pediatric Patient, Lakshmi Kunam, Antonia Fernandez Ovalle, Thomas M. Attard

Posters

Background: Terminal ileum (TI) intubation is integral to complete diagnostic ileocolonoscopy in children. It is necessary to determine terminal ileal involvement in patients with a broad spectrum of pathologic processes. In some cases the standard method of intubation does not lead to success and retroflexion is needed. Here we describe the case of terminal ileal intubation in retroflexion on a 14 year old female. Case description: 14 year-old female patient with a past medical history of chronic abdominal pain, NAFLD, anxiety, vulvovaginitis, lichen sclerosus, depression, constipation, delayed menses, and GERD who was admitted for 2 weeks of escalating symptoms and …

Neighborhood-Level Deprivation Mediates Racial And Ethnic Disparities In Hcc Diagnosis In Texas, Itunu O Sokale, Aaron P Thrift, Hashem B El-Serag, Abiodun O Oluyomi

Faculty, Staff and Students Publications

BACKGROUND: Texas has the highest HCC rates in the United States, and the greatest burden is among Hispanics. Racial and ethnic disparities in HCC incidence have multiple underpinning factors. We conducted a mediation analysis to examine the role of neighborhood disadvantage (Area Deprivation Index) as a potential mediator of the association between neighborhood race and ethnicity distribution and neighborhood HCC case counts in Texas.

METHODS: The primary outcome measure was counts of new HCC diagnoses per census tract based on Texas Department of State Health Services Texas Cancer Registry data. The primary exposure of interest was the race and ethnicity-based …

Lack Of Detection Of Norwalk Virus In Saliva Samples From A Controlled Human Infection Model, Robert L Atmar, Frederick H Neill, Nicole M Hayes, Antone R Opekun, David Y Graham, Mary K Estes, Sasirekha Ramani

Faculty, Staff and Students Publications

Following recent reports of norovirus replication in salivary gland cells, we examined whether the prototype norovirus strain, Norwalk virus (GI.1), could be detected in the saliva of 21 experimentally infected persons. Viral RNA was not detected in saliva 2 and 7 days after challenge despite high levels being present in feces.

An Ancient Ecospecies Of Helicobacter Pylori, Elise Tourrette, Roberto C Torres, Sarah L Svensson, Takashi Matsumoto, Muhammad Miftahussurur, Kartika Afrida Fauzia, Ricky Indra Alfaray, Ratha-Korn Vilaichone, Vo Phuoc Tuan, Helicobacter Genomics Consortium, Difei Wang, Abbas Yadegar, Lisa M Olsson, Zhemin Zhou, Yoshio Yamaoka, Kaisa Thorell, Daniel Falush

Faculty, Staff and Students Publications

Helicobacter pylori disturbs the stomach lining during long-term colonization of its human host, with sequelae including ulcers and gastric cancer1,2. Numerous H. pylori virulence factors have been identified, showing extensive geographic variation1. Here we identify a ‘Hardy’ ecospecies of H. pylori that shares the ancestry of ‘Ubiquitous’ H. pylori from the same region in most of the genome but has nearly fixed single-nucleotide polymorphism differences in 100 genes, many of which encode outer membrane proteins and host interaction factors. Most Hardy strains have a second urease, which uses iron as a cofactor rather than …

Trends In The Use Of Biologic Disease-Modifying Antirheumatic Drugs In Patients With Rheumatoid Arthritis And Recently Diagnosed Colorectal, Lung, Or Prostate Cancer, Maria E Suarez-Almazor, Juan I Ruiz, Xiudong Lei, Chi-Fang Wu, Hui Zhao, Suja S Rajan, Sharon H Giordano

Faculty, Staff and Student Publications

INTRODUCTION: Biologic disease-modifying antirheumatic drugs (bDMARD) are often discontinued when a patient with rheumatoid arthritis (RA) is diagnosed with cancer. Our aim was to determine trends in bDMARD utilization in patients with RA and recently diagnosed cancer.

METHOD: We examined two national claims databases to identify adults with RA and recently diagnosed colorectal, lung, or prostate cancer (Optum's de-identified Clinformatics® Data Mart Database 2008-2022, and Surveillance, Epidemiology, and End Results Program (SEER) Medicare-linked 2008-2017). We determined time trends in bDMARD and tumor necrosis factor inhibitor (TNFi) prescriptions during the first 3 years after cancer with Cochram-Armitage tests and multivariable logistic …

Circulating Galectin-3: A Prognostic Biomarker In Hepatocellular Carcinoma, Shadi Chamseddine, Betul Gok Yavuz, Yehia I Mohamed, Sunyoung S Lee, James C Yao, Zishuo Ian Hu, Michael Lapelusa, Lianchun Xiao, Ryan Sun, Jeffrey S Morris, Rikita I Hatia, Manal Hassan, Dan G Duda, Maria Diab, Amr Mohamed, Ahmed Nassar, Hesham M Amin, Ahmed Omar Kaseb

Faculty, Staff and Student Publications

INTRODUCTION: Galectin-3 plays critical roles in the adhesion, proliferation, and differentiation of tumor cells. Recent data have suggested that galectin-3 plays a role in the development of hepatocellular carcinoma (HCC); however, its prognostic value has not been validated. The aim of our study was to evaluate the clinical and prognostic value of galectin-3 in patients with HCC.

METHODS: We prospectively enrolled and collected clinicopathologic data and serum samples from 767 patients with HCC between 2001 and 2014 at The University of Texas MD Anderson Cancer Center. Two hundred patients without HCC were also enrolled and had data collected. The Kaplan-Meier …

Serum Levels Of Total Bile Acids Are Associated With An Increased Risk Of Hcc In Patients With Cirrhosis, Hashem B El-Serag, Aaron P Thrift, Hao Duong, Jing Ning, Saira Khaderi, Amit G Singal, Sumeet K Asrani, Jorge A Marrero, Hannah Powell, Kinza Rizwan, Omar Najjar, Christopher I Amos, Michelle Luster, Abeer Al-Sarraj, Emad Salem, Michael E Scheurer, Jagpreet Chhatwal, Salma Kaochar, Fasiha Kanwal

Faculty, Staff and Students Publications

BACKGROUND: Previous studies have reported higher circulating bile acid levels in patients with HCC compared to healthy controls. However, the association between prediagnostic bile acid levels and HCC risk among patients with cirrhosis is unclear.

METHODS: We measured total BA (TBA) concentration in serum samples collected from a prospective cohort of patients with cirrhosis who were followed until the development of HCC, death, or last study date. Competing risk proportional hazard-adjusted models were used to estimate the association between tertiles of serum TBA levels and the risk of developing HCC. We quantified the incremental predictive value of serum bile acid …

Glp-1 Receptor Agonists And Risk For Cirrhosis And Related Complications In Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease, Fasiha Kanwal, Jennifer R Kramer, Liang Li, Yu-Xiao Yang, Yumei Cao, Xian Yu, Ronald Samuel, Basim Ali, Roxanne Desiderio, George Cholankeril, Mandeep Bajaj, Hashem B El-Serag, Steven M Asch

Faculty, Staff and Students Publications

IMPORTANCE: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasing cause of cirrhosis. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are effective in improving liver inflammation in patients with MASLD.

OBJECTIVE: To determine whether use of GLP-1 RAs is associated with lower risk of developing cirrhosis and its complications, including decompensation and hepatocellular cancer (HCC), among patients with MASLD.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study with an active comparator, new-user design used data from the national Veterans Health Administration Corporate Data Warehouse and Central Cancer Registry. Patients with MASLD and diabetes who were seen at 130 Veterans Health …

Increased Gremlin1 Expression In Pancreatic Ductal Adenocarcinoma Promotes A Fibrogenic Stromal Microenvironment, Rachel R Tindall, Erika Y Faraoni, Jiajing Li, Yinjie Zhang, Shun-Ming Ting, Beanna Okeugo, Xiurong Zhao, Yuying Liu, Mamoun Younes, Qiang Shen, Jennifer M Bailey-Lundberg, Yanna Cao, Tien C Ko

Faculty, Staff and Student Publications

Objective: Pancreatic ductal adenocarcinoma (PDAC) microenvironment is primarily composed of cancer-associated fibroblasts and immune cells. Gremlin1 (Grem1) is a profibrogenic factor that promotes tumorigenesis in several cancers. However, the role of Grem1 in the PDAC microenvironment is not defined.

Materials and methods: We correlated Grem1 levels with activated stroma and immune cells in human PDAC using The Cancer Genome Atlas RNA-sequencing data and characterized expression of Grem1 transcripts and isoforms in pancreatic cell lines and PDAC tissues. We assessed the role of Grem1 in the microenvironment by in vitro studies.

Results: Grem1 expression is associated with an activated stroma and …