Gastroenterology Commons^™

X-Aptamers Targeting Thy-1 Membrane Glycoprotein In Pancreatic Ductal Adenocarcinoma, Hongyu Wang, Xin Li, Lisa A Lai, Teresa A Brentnall, David W Dawson, Kimberly A Kelly, Ru Chen, Sheng Pan

Faculty, Staff and Students Publications

Modified DNA aptamers incorporated with amino-acid like side chains or drug-like ligands can offer unique advantages and enhance specificity as affinity ligands. Thy-1 membrane glycoprotein (THY1 or CD90) was previously identified as a biomarker candidate of neovasculature in pancreatic ductal adenocarcinoma (PDAC). The current study developed and evaluated modified DNA X-aptamers targeting THY1 in PDAC. The expression and glycosylation of THY1 in PDAC tumor tissues were assessed using immunohistochemistry and quantitative proteomics. Bead-based X-aptamer library that contains 108 different sequences was used to screen for high affinity THY1 X-aptamers. The sequences of the X-aptamers were analyzed with the next-generation sequencing. …

Intestinal Stem Cell-Derived Enteroids From Morbidly Obese Patients Preserve Obesity-Related Phenotypes: Elevated Glucose Absorption And Gluconeogenesis, Nesrin M Hasan, Kelli F Johnson, Jianyi Yin, Nicholas W Baetz, Lea Fayad, Vadim Sherman, Sarah E Blutt, Mary K Estes, Vivek Kumbhari, Nicholas C Zachos, Olga Kovbasnjuk

Faculty, Staff and Students Publications

OBJECTIVE: The mechanisms behind the efficacy of bariatric surgery (BS) for treating obesity and type 2 diabetes, particularly with respect to the influence of the small bowel, remain poorly understood. In vitro and animal models are suboptimal with respect to their ability to replicate the human intestinal epithelium under conditions induced by obesity. Human enteroids have the potential to accelerate the development of less invasive anti-obesity therapeutics if they can recapitulate the pathophysiology of obesity. Our aim was to determine whether adult stem cell-derived enteroids preserve obesity-characteristic patient-specific abnormalities in carbohydrate absorption and metabolism.

METHODS: We established 24 enteroid lines …

Rising Trend Of Women In Gastroenterology: A Paradigm Shift, Lubna Kamani, Jeanin E Van Hooft

Section of Gastroenterology

No abstract provided.

Prevalence Of Gastric Intestinal Metaplasia In A Multiethnic Us Veterans Population, Theresa H Nguyen, Mimi C Tan, Yan Liu, Massimo Rugge, Aaron P Thrift, Hashem B El-Serag

Faculty, Staff and Students Publications

BACKGROUND & AIMS: There is a need to identify individuals with gastric intestinal metaplasia, a precursor to gastric cancer, so they can be offered screening and surveillance. We examined the prevalence of gastric intestinal metaplasia, detected by upper endoscopy biopsy analysis, in different race and ethnic subgroups. We also investigated the extent to which Helicobacter pylori infection, with or without acute and chronic gastritis, accounts for observed associations between race or ethnicity and risk of gastric intestinal metaplasia.

METHODS: We used data from a cross-sectional study of consecutively recruited patients at the Michael E. DeBakey Veterans Affairs Medical Center in …

Prevalence Of Barrett’S Esophagus And Performance Of Societal Screening Guidelines In An Unreferred Primary Care Population Of Us Veterans, Theresa H Nguyen, Aaron P Thrift, Massimo Rugge, Hashem B El-Serag

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: Less than 10% of patients diagnosed with esophageal adenocarcinoma have a pre-existing Barrett's esophagus (BE) diagnosis, possibly because of suboptimal performance of guidelines. We examined the prevalence of BE in a previously unscreened primary care population and the potential yield of practice BE screening guidelines.

METHODS: This was a retrospective analysis of a prospective cross-sectional study of consecutively recruited unreferred patients from primary care clinics who underwent study upper endoscopy. We examined the performance of BE screening guidelines of the European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), American Society for Gastrointestinal Endoscopy (ASGE), …

Elevated Liver Enzymes Portends A Higher Rate Of Complications And Death In Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2), Emily E. Currier, Mohamed Dabaja Do, Syed-Mohammed Jafri Md

Medical Student Research Symposium

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, has infected millions worldwide since its discovery in December 2019, but little is still known about the disease process. Preliminary research in China notes liver function test (LFTs) abnormalities are common in COVID-19 patients, suggesting decreased hepatic function, and that abnormalities in LFTs are related to complicated disease course and negative outcomes. However, there has been limited large-scale data assessing COVID-19’s association with liver dysfunction and negative outcomes.

Aim: The significance of this research is to investigate how COVID-19 affects the liver function and disease course in patients infected with …

A Younger Demographic Defines Hepatitis C Patient Profiles In The Recent Direct-Acting Antiviral Era, Ria Minawala, Paul H. Naylor Phd, Murray N. Ehrinpreis Md, Milton G. Mutchnik Md

Medical Student Research Symposium

A Younger Demographic Defines Hepatitis C Patient Profiles in the Recent Direct-Acting Antiviral Era

Authors: Minawala, Ria1; Naylor, Paul H.2; Ehrinpreis, Murray N.2; Mutchnick, Milton G.2

Institutions: 1. Wayne State University School of Medicine, Detroit, MI, United States. 2. Wayne State University School of Medicine, Division of Gastroenterology, Detroit, MI, United States.

Background:

Highly effective and safe direct-acting antivirals (DAAs) against hepatitis C virus (HCV) combined with U.S. Preventive Services Task Force recommendation to screen for HCV in individuals born between 1945 and 1965 (age cohort; 54-79 years of age in 2019) was expected to reduce the number of actively …

Mucosal Genomics Implicate Lymphocyte Activation And Lipid Metabolism In Refractory Environmental Enteric Dysfunction, Najeeha Talat Iqbal, Najeeb Rahman, Kamran Sadiq, Zubair Ahmad, Romana Idress, Junaid Iqbal, Sheraz Ahmed, Aneeta Hotwani, Fayyaz Umrani, Sana Syed, Syed Asad Ali

Department of Paediatrics and Child Health

Background & aims: Environmental enteric dysfunction (EED) limits the Sustainable Development Goals of improved childhood growth and survival. We applied mucosal genomics to advance our understanding of EED.
Methods: The Study of Environmental Enteropathy and Malnutrition (SEEM) followed 416 children from birth to 24 months in a rural district in Pakistan. Biomarkers were measured at 9 months and tested for association with growth at 24 months. The duodenal methylome and transcriptome was determined in 52 undernourished SEEM participants and 42 North American controls and celiac disease patients.
Results: After accounting for growth at study entry, circulating IGF-1 and ferritin predicted …

New Insights And Enhanced Human Norovirus Cultivation In Human Intestinal Enteroids, Khalil Ettayebi, Victoria R Tenge, Nicolas W Cortes-Penfield, Sue E Crawford, Frederick H Neill, Xi-Lei Zeng, Xiaomin Yu, B Vijayalakshmi Ayyar, Douglas Burrin, Sasirekha Ramani, Robert L Atmar, Mary K Estes

Faculty, Staff and Students Publications

Human noroviruses (HuNoVs) are the leading cause of epidemic and sporadic acute gastroenteritis worldwide. We previously demonstrated human intestinal stem cell-derived enteroids (HIEs) support cultivation of several HuNoV strains. However, HIEs did not support virus replication from every HuNoV-positive stool sample, which led us to test and optimize new medium conditions, identify characteristics of stool samples that allow replication, and evaluate consistency of replication over time. Optimization of our HIE-HuNoV culture system has shown the following: (i) a new HIE culture medium made with conditioned medium from a single cell line and commercial media promotes robust replication of HuNoV strains …

Self-Expanding Metal Stent (Sems) Placement To Treat Bleeding From Late Radiation Esophagitis, Inayat Gill, Bana Antonios, Zaid Imam, Gahad Ghaith

Articles

Radiation esophagitis is a serious complication occurring in patients receiving radiotherapy for head and neck cancers. Current treatment with proton pump inhibitors and mucosal protectants provides symptomatic relief with few studies showing improvement in erosive esophagitis or ulceration. Use of self-expandable metal stents (SEMS) in cases of erosive radiation esophagitis refractory to medical therapy has not been studied. We report a case of a patient presenting with recurrent hematemesis from late (chronic) radiation esophagitis with bleeding esophageal ulceration successfully treated with SEMS placement after failure of conservative medical management, proposing a possible utility for SEMS in this setting.

Association Of Presenting Symptoms With Abnormal Laboratory Values For Vector-Borne Illness — Experience In An Urban Gastroenterology Practice, Michael D. Erdman, Niloofar Kossari, Jessica Ye, Kristen H. Reynolds, Emily Blodget, B. Robert Mozayeni, Farshid Sam Rahbar

Journal of Patient-Centered Research and Reviews

Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI).

Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, …

Eus-Guided Pelvic Drainage: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Yassin Naga, Syed Mohsin Saghir, Amaninder Dhaliwal, Daryl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Adler

School of Medicine Faculty Research

Background and Objectives: EUS-guided pelvic abscess drainage (EUS-PAD) is a procedure that utilizes an echoendoscope to visualize an area of interest for needle insertion and placement of a stent, catheter, or both for drainage of the target abscess. The aim of this study was to perform a systematic review and meta-analysis for the safety and efficacy of EUS-PAD. Materials and Methods: We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to February 2020). The primary outcomes for this study were the technical and clinical …

Plasmid-Based Reverse Genetics For Probing Phosphorylation-Dependent Viroplasm Formation In Rotaviruses, Jeanette M Criglar, Sue E Crawford, Mary K Estes

Faculty, Staff and Students Publications

Rotavirus (RV) replication occurs in cytoplasmic compartments, known as viroplasms, that are composed of viral and cellular proteins. Viroplasm formation requires RV nonstructural proteins NSP2 and NSP5 and cellular lipid droplets (LDs); however, the mechanisms required for viroplasm assembly remain largely unknown. We previously identified two conformationally-distinct forms of NSP2 (dNSP2, vNSP2) found in RV-infected cells that interact differentially with hypo- and hyperphosphorylated NSP5, respectively, and indicate a coordinated phosphorylation-dependent mechanism regulating viroplasm assembly. We also reported that phosphorylation of dNSP2 on serine 313 by the cellular kinase CK1α triggers the localization of vNSP2 to sites of viroplasm assembly and …

Performance Improvement Leadership Rounding Implementation, Dena Walz

Nursing Posters

To improve patient experience scores and address patient concerns in real time.

A proactive behavior that facilitates leaders building relationships with patients and families, managing expectations, and achieving and validating consistency of key behaviors.

A member of leadership will conduct a purposeful conversation with a chosen patient three days a week regarding the care provided during their procedural appointment.

Potential Counter Regulatory Effects Of A Gut Microbiota Metabolite In Alleviating Down-Regulation Krüppel-Like Factor 4 In Intestinal Inflammation, Ylva Forslund

Theses, Dissertations and Capstones

Inflammatory bowel disease (IBD) is a medical condition characterized by chronic inflammation of the intestinal epithelium. Krüppel-like factor 4 (KLF4), a zinc finger transcription factor, is vital for maintaining intestinal epithelial homeostasis. KLF4 promotes differentiation of goblet cells that generate the protective mucus layer. Reduced goblet cell number and defective mucus layer are associated with IBD. Shortchain fatty acids (SCFA) are known to play an important role in the maintenance of a strong and healthy intestinal epithelial layer and also in goblet cell differentiation. However, whether the positive effects of SCFAs on goblet cells are mediated, at least partly, via …

Endobariatric Procedures For Obesity: Clinical Indications And Available Options., Hemant Goyal, Jonathan Kopel, Abhilash Perisetti Md, Rupinder Mann, Aman Ali, Benjamin Tharian, Shreyas Saligram, Sumant Inamdar

Other Specialties

Obesity remains a growing public health epidemic that has increased healthcare costs and related comorbidities. Current treatment guidelines encourage a multidisciplinary approach starting from patient selection, interventions, and long-term follow-up to maintain weight loss. However, these conservative interventions are largely ineffective at reducing body weight due to low adherence to the treatment regimen. Recently, endoscopic bariatric therapies have become an attractive alternative to traditional invasive bariatric surgeries due to their improved efficacy, safety, and cost-effectiveness. Endoscopic bariatric therapies include intragastric balloon placement, endoscopic sleeve gastroplasty, gastric bypass revision, and aspiration therapy. These procedures fall into two separate categories depending on …

Covid-19 And Acute Esophageal Obstruction Management In The Emergency Department: An U.S. Multicenter Research Network Propensity-Matched Analysis, Hemant Goyal Md Facp, Abhilash Perisetti Md Facp, Mahesh Gajendran Md Mph Facp, Aman Ali Md, Neil Sharma Md

Other Specialties

Introduction- The Coronavirus Disease-2019 (COVID-19) caused by the novel SARS-CoV-2 led to significant strain on the Emergency Department (ED) visits worldwide. Multiple stay-at-home orders were issued during the pandemic unless medical treatment was urgently needed1 . Acute esophageal obstruction (AEO) due to food/ foreign body impaction usually present to the ED, given its severe symptoms. Most esophageal foreign bodies pass through the gastrointestinal (GI) tract uneventfully, and related mortality is very low. Still, most of these patients receive endoscopic interventions (up to 76%)2 . The number of non-urgent endoscopies plummeted sharply during the pandemic to reduce exposure and preserve personal …

Predictors And Outcomes Of Acute Respiratory Failure In Hospitalised Patients With Acute Pancreatitis., Mahesh Gajendran, Bharat Prakash, Abhilash Perisetti Md, Chandraprakash Umapathy, Vineet Gupta, Laura Collins, Prashanth Rawla, Priyadarshini Loganathan, Alok Dwivedi, Christopher Dodoo, Fortune Unegbu, Dan Schuller, Hemant Goyal, Shreyas Saligram

Other Specialties

Background and aim: Acute pancreatitis (AP) is associated with organ failures and systemic complications, most commonly acute respiratory failure (ARF) and acute kidney injury. So far, no studies have analysed the predictors and hospitalisation outcomes, of patients with AP who developed ARF. The aim of this study was to measure the prevalence of ARF in AP and to determine the clinical predictors for ARF and mortality in AP.

Methods: This is a retrospective cohort study using the Nationwide Inpatient Sample database from the year 2005-2014. The study population consisted of all hospitalisations with a primary or secondary discharge diagnosis of …

Outcomes In Children And Adolescents Undergoing Cholecystectomies With A High Ejection Fraction, Salony Dighamber, Karen Herzing, Arturo Aranda, Jeffrey C. Pence, Sean Barnett

Scholarship in Medicine - All Papers

Background

Cholecystectomy is commonly performed electively for symptomatic cholelithiasis and biliary hypokinesia with an ejection fraction (EF) less than 35%. Recent literature has shown that cholecystectomy in adults for biliary hyperkinesia (EF>65%) can provide resolution of symptoms (primarily pain) for the majority of patients. We seek to determine whether cholecystectomy is efficacious in the treatment of symptomatic biliary hyperkinesia in the pediatric population.

Method

The charts of over 100 patients aged 7 to 21 in the last 10 years (2008 to 2018) who had cholecystectomies were reviewed to determine ejection fraction, BMI, race, pain with CCK-HIDA, complications, and resolution …

Impact Of Bowel Management Guidelines On Documentation And Patient Outcomes In The Intensive Care Unit, Alana Trottier, Paul Blakeslee, Kristiina Hyrkas

Costas T. Lambrew Research Retreat 2021

Introduction

• Bowel management (BM) is an inadvertently overlooked aspect of patient care for critically ill patients who have complex, immediate life-threatening health issues.

• Bowel dysfunction is common with the reported incidence of diarrhea between 3.3%-78% and constipation between 20-83%

• Studies suggest that BM guidelines can standardize care, improve documentation, and impact patient outcomes

• Use of BM guidelines has remained low, probably influenced by clinicians’ resistance to change, resulting in small to moderate improvements and difficulties sustaining new practices

• We anticipated that sustained changes require recognizing clinicians’ current practice, integrating modifications into existing workflow, and engaging …