Endoscopic ultrasound-guided celiac plexus block for painful chronic pancreatitis: A systematic review and meta-analysis.

Background: The efficacy of endoscopic ultrasound-guided celiac plexus block (EUS-CPB) for treatment of pain in chronic pancreatitis (CP) is unclear. Therefore, we aimed to assess this outcome using a systematic review and meta-analysis.

Methods: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane Central for evaluating the efficacy of EUS-CPB for pain in CP.

Endoscopic Management of Portal Hypertension and Varices.

Chronic liver disease as well as various other conditions can change vascular resistance in the portal system thereby leading to portal hypertension. Acute gastroesophageal variceal bleeding is a dreaded complication of portal hypertension associated with high morbidity and mortality. Historically, endoscopy in the management of portal hypertension was limited to the prevention and treatment of esophageal varices.

Qualitative Assessment of a Novel Intervention to Reduce Hospital Readmission Risk Among People with Diabetes.

Purpose: To qualitatively assess a novel intervention, the Diabetes Transition of Hospital Care (DiaTOHC) Program, designed to reduce hospital readmissions within 30 days of discharge among people with diabetes.

Methods: In a separately reported randomized controlled trial of the DiaTOHC intervention, hospitalized people with diabetes were identified as high risk for 30-day hospital readmission using the Diabetes Early Readmission Risk Indicator (DERRI). Of these, 58 participants were randomized to the intervention.

A pathway-based genetic score for inflammation: An indicator of vulnerability to phthalate-induced adverse neurodevelopment outcomes.

Introduction: Phthalates, chemical additives used to enhance plastic products' flexibility, are easily released into the environment, and can harm the brain development through various mechanisms including inflammation. Genetic variation influencing an individual's susceptibility to inflammation may play a role in the effects of phthalate exposure on neurodevelopment however there is no summary measure developed for genetic susceptibility to inflammation.

Methods: We developed a genetic pathway function score for inflammation (gPFS), based on the transcriptional activity of the inflammatory response pathway in the brain and other tissues.

Variation and covariation of external shape and cross-sectional geometry in the human metacarpus.

Objectives: Analyses of external bone shape using geometric morphometrics (GM) and cross-sectional geometry (CSG) are frequently employed to investigate bone structural variation and reconstruct activity in the past. However, the association between these methods has not been thoroughly investigated. Here, we analyze whole bone shape and CSG variation of metacarpals 1-5 and test covariation between them.

Gastrointestinal-Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life.

Background: Gastrointestinal (GI)-specific anxiety has been identified as a treatment target in irritable bowel syndrome. However, GI-specific anxiety has been understudied in other GI functional/motility disorders. Among adults with gastroparesis, we aimed to: (1) initially validate a measure of GI-specific anxiety, the Visceral Sensitivity Index (VSI); and (2) evaluate the relationship between GI-specific anxiety and gastroparesis symptom severity and quality of life, compared to measures of anxiety, depression, and somatization.

Clinical Characteristics of Patients With Ineffective Esophageal Motility by Chicago Classification Version 4.0 Compared to Chicago Classification Version 3.0.

Background/aims: Chicago classification version 4.0 (CCv4.0) of esophageal motility disorders developed a more stringent diagnostic criteria for ineffective esophageal motility (IEM) than version 3.

Trends in Gastroparesis Management: A United States Population-based Study From 2010 to 2020.

Background: There is little consensus on the medical management of gastroparesis, a disorder characterized by delayed gastric emptying with symptoms of early satiety, nausea, vomiting, and upper abdominal pain.

Goals: We utilized population-level data to: (1) describe the prevalence of different pharmacological and nonpharmacological therapies in patients with gastroparesis; and (2) trend the prevalence of these therapies from 2010 to 2020.

Study: More than 59 million unique medical records across 26 US-based major health care systems were surveyed using the Explorys platform to identify a cohort of adults with gastroparesis who completed both a gastric emptying study and upper endoscopy or upper gastrointestinal tract imaging.

A Case of Upper Gastrointestinal Bleeding Due to Metastatic High-Grade B-Cell Lymphoma Successfully Treated With Chemotherapy.

Upper gastrointestinal bleeding (UGIB) is a common and potentially life-threatening condition. Metastatic disease is an exceedingly rare cause of UGIB. We report the case of a 73-year-old man with high-grade B-cell lymphoma (HGBL) who presented for the initiation of chemotherapy and was found to be acutely anemic due to UGIB.

A Pathway-Based Genetic Score for Oxidative Stress: An Indicator of Host Vulnerability to Phthalate-Associated Adverse Neurodevelopment.

The developing brain is highly sensitive to environmental disturbances, and adverse exposures can act through oxidative stress. Given that oxidative stress susceptibility is determined partly by genetics, multiple studies have employed genetic scores to explore the role of oxidative stress in human disease. However, traditional approaches to genetic score construction face a range of challenges, including a lack of interpretability, bias towards the disease outcome, and often overfitting to the study they were derived on.

Inhibitors of HIV-1 Nef-Mediated Activation of the Myeloid Src-Family Kinase Hck Block HIV-1 Replication in Macrophages and Disrupt MHC-I Downregulation.

HIV-1 Nef is an attractive target for antiretroviral drug discovery because of its role in promoting HIV-1 infectivity, replication, and host immune system avoidance. Here, we applied a screening strategy in which recombinant HIV-1 Nef protein was coupled to activation of the Src-family tyrosine kinase Hck, which enhances the HIV-1 life cycle in macrophages. Nef stimulates recombinant Hck activity , providing a robust assay for chemical library screening.

Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation.

Patients with chronic constipation who do not respond to initial treatments often need further evaluation for dyssynergic defecation (DD) and slow transit constipation (STC). The aims of this study are to characterize the prevalence of DD and STC in patients referred to a motility center with chronic constipation and correlate diagnoses of DD and STC to patient demographics, medical history, and symptoms. High-resolution ARM (HR-ARM), balloon expulsion testing (BET) and whole gut transit scintigraphy (WGTS) of consecutive patients with chronic constipation were reviewed.

Impact of patient position on esophageal motility disorders using high-resolution esophageal manometry with impedance (HREMI): supine versus upright swallows.

Background: High-resolution esophageal manometry with impedance (HREMI) performed with supine patient positioning is used to evaluate patients for esophageal dysmotility. However, most patients experience symptoms related to esophageal dysmotility when eating or drinking upright. The aims of this study are to: (1) compare HREMI metrics in supine versus upright position; and (2) determine if upright position alters motility characterization of patients.

Common sampling and modeling approaches to analyzing readmission risk that ignore clustering produce misleading results.

Background: There is little consensus on how to sample hospitalizations and analyze multiple variables to model readmission risk. The purpose of this study was to compare readmission rates and the accuracy of predictive models based on different sampling and multivariable modeling approaches.

Methods: We conducted a retrospective cohort study of 17,284 adult diabetes patients with 44,203 discharges from an urban academic medical center between 1/1/2004 and 12/31/2012.

Characterizing the proximal esophageal segment in patients with symptoms of esophageal dysmotility.

Background: Proximal esophageal striated muscle contractility may be abnormal in patients with esophageal symptoms, but is not assessed in the Chicago Classification (CC) v3.0. We aimed to (a) determine the prevalence of abnormal proximal esophageal contractility in patients with esophageal symptoms; (b) compare proximal esophageal contractility in patients with different esophageal motility disorders; (c) assess the association of abnormal proximal esophageal contractility with esophageal symptoms.

Vascular pressure bands on high-resolution esophageal manometry with impedance studies.

Horizontal pressure bands on high-resolution esophageal manometry with impedance (HREMI) tracings are often seen and thought to be due to cardiovascular structures compressing the esophagus. The aim of this study was to determine the prevalence and location of vascular pressure bands on HREMI studies and correlate these pressure bands to bolus clearance. HREMI studies in supine and upright positions from patients and normal volunteers were reviewed.

Influence of Mechanical Unloading on Articular Chondrocyte Dedifferentiation.

Due to the limited self-repair capacity of articular cartilage, the surgical restoration of defective cartilage remains a major clinical challenge. The cell-based approach, which is known as autologous chondrocyte transplantation (ACT), has limited success, presumably because the chondrocytes acquire a fibroblast-like phenotype in monolayer culture. This unwanted dedifferentiation process is typically addressed by using three-dimensional scaffolds, pellet culture, and/or the application of exogenous factors.

Discovery and evaluation of nNa1.5 sodium channel blockers with potent cell invasion inhibitory activity in breast cancer cells.

Voltage-gated sodium channels (VGSC) are a well-established drug target for anti-epileptic, anti-arrhythmic and pain medications due to their presence and the important roles that they play in excitable cells. Recently, their presence has been recognized in non-excitable cells such as cancer cells and their overexpression has been shown to be associated with metastatic behavior in a variety of human cancers. The neonatal isoform of the VGSC subtype, Na1.

Rapid adaptation to microgravity in mammalian macrophage cells.

Despite the observed severe effects of microgravity on mammalian cells, many astronauts have completed long term stays in space without suffering from severe health problems. This raises questions about the cellular capacity for adaptation to a new gravitational environment. The International Space Station (ISS) experiment TRIPLE LUX A, performed in the BIOLAB laboratory of the ISS COLUMBUS module, allowed for the first time the direct measurement of a cellular function in real time and on orbit.

Calcium-dependent deceleration of the cell cycle in muscle cells by simulated microgravity.

Of all our mechanosensitive tissues, skeletal muscle is the most developmentally responsive to physical activity. Conversely, restricted mobility due to injury or disease results in muscle atrophy. Gravitational force is another form of mechanical input with profound developmental consequences.