Rejected

Gadolinium (Gd) usage in the Veterans Health Administration is increasing and patients with renal disease are frequently exposed. Gd is not entirely eliminated within 24 hours after administration, which may pose long-term adverse effects.

colitis is an inflammation of the colon due to toxins produced by a gram-positive bacterium called (also known as ). colitis is associated with an increased risk of morbidity and mortality in elderly patients. The infection develops because of the disruption of the microbiome that usually suppresses the overgrowth of . Testing for infection is routinely recommended in patients with at least three loose bowel movements in a day. We present an unusual case of a 74-year-old woman on chronic opioids who presented with a three-day history of lower abdominal pain, constipation, hematochezia, with no diarrhea. Radiologic imaging showed evidence of colitis, and the patient was found to have colitis.

To evaluate the clinical and radiological outcomes of aseptic revision of total knee arthroplasty (TKA) using the Vanguard 360 Revision Knee System with the hybrid cementation technique.

In most cases, diagnosing pancreatic cancer (PC) in a timely manner is challenging owing to the lack of a specific set of symptoms, especially for cancer originating in the pancreatic tail. A patient presented to our hospital with the primary complaint of bilateral scrotal pain caused by metastatic pancreatic tail cancer. Although he had a family history of PC, there were no other risk factors. Here, we discuss the challenges associated with early diagnosis of malignant PC, particularly when it presents in the tail of the organ, and spermatic cord metastasis caused by pancreatic tail cancer.

To measure postoperative pain relief following the use of rectal diclofenac combined with intramuscular pentazocine compared with intramuscular pentazocine alone in patients undergoing a caesarean delivery.

Superior labrum from anterior to posterior (SLAP) lesions represent a significant cause of shoulder pain and disability among active duty members of the US military. However, few data exist regarding the surgical management of type VIII SLAP lesions.

Small-fiber neuropathies are a heterogeneous group of disorders affecting thinly myelinated Aδ and unmyelinated C fibers. Patients generally present with neuropathic pain, while dysesthesia, allodynia, pain, burning sensations, and cold sensations are frequently present in a length-dependent pattern. Additional autonomic features of the gastrointestinal, urinary, or cardiovascular systems are frequently observed. Deep-tendon reflexes and nerve conduction tests yield normal results. Skin biopsy is useful for the diagnosis, and can demonstrate the loss of intraepidermal nerve fibers in small-fiber neuropathy and has a diagnostic sensitivity of 80%. Although many causes of small-fiber neuropathy have been reported, the cause remains unknown in 30-50% of the cases. Treatment is directed at the underlying etiology and is supported with symptomatic treatment.

Transient receptor potential melastatin 2 (TRPM2) is a sub family of TRP channels which plays a central role in producing neuro pathophysiological diseases such as Alzheimer's, Parkinson's and other neuropathic pain which are major health concern worldwide. However, their pharmacological pathway has not been fully characterized which is a significant gap in our knowledge. TRPM2 is mainly expressed in brain, bone merrow, endocrine and endothelia cells. Under oxidative stress, TRPM2 increases intracellular Ca ions due to protein oxidation that causes several neurological disorders. Reactive oxygen species (ROS) production and oxidative stress are the primary cause of many pathological disease processes. Natural compounds with medicinal properties are useful and effective source for the treatment of various diseases since ancient times. Caffeic acid and its analogs, such as caffeic, chlorogenic, salvianolic A & B, and rosmarinic acid have anti-inflammatory, antimicrobial, antioxidant, anesthetic, and cytotoxic properties. There is a critical need for new drug planning that focuses on oxidative interaction in targeted TRPM2 ion channels and intracellular ion signaling, which will regulate neuropathological diseases by interacting other TRP channels. Our ongoing experiment demonstrate that increase in ROS was decreased by caffeic acid analogs salvianolic, and rosmarinic acid more than caffeic and chlorogenic acid which was reflected by GST inhibition activity assay. Our experiments also evaluate the analgesic effects of caffeic acid analogs on TRPM2 channel by measuring intracellular calcium. Therefore, this pilot project aims to identify caffeic acid analogs as lead compounds that target TRPM2 which is one of the key pathway players for controlling various neurodegenerative diseases.

Eosinophilic esophagitis (EoE) is a chronic immune mediated disease that affects populations of all ages. It is characterized by eosinophilic inflammation of the esophageal mucosa, decreased epithelial integrity, and lamina propria fibrosis. Clinically, the symptoms of EoE can range from mild (dysphagia, abdominal pain, vomiting), to severe (food impaction, inability to thrive), to complete loss of esophageal function in extreme cases. This disease, first described in 1993, is rising in incidence and prevalence. Unfortunately, the reason for disease emergence is unknown and environmental triggers have been postulated as a potential source. The role of environmental toxins, specifically herbicides, has never been examined in the pathophysiology of atopic disease. Glyphosate, the active ingredient in Roundup, is the most used herbicide in the United States, and is frequently used as a desiccant prior to harvest. Residual amounts can be detected in harvested crops and downstream food products, potentially leading to a diet of chronic exposure. Herein we sought to determine the effects of early life glyphosate treatment and the consequences of exposure on the development of eosinophilic esophagitis and the maintenance of epithelial integrity. We exposed mice to physiologic levels of glyphosate in utero and throughout their life cycle to simulate glyphosate consumption in the typical American diet. We then induced EoE in mice using our established protocol and evaluated epithelial integrity and inflammation. Interestingly, we found that chronic glyphosate treatment alone induced a 2-fold increase in esophageal eosinophils over baseline, similar to mice undergoing EoE. Secondarily, we exposed primary human esophageal and intestinal organoids to short term glyphosate treatment. We observed no changes in the esophageal organoids. However, we found increased gene expression of mucin 2 (MUC2) in organoids derived from terminal ileum and proximal colon. Taken together these results suggest that there is increased inflammation in the glyphosate treated mice and this may be due, in part, to a response generated in the small intestine by glyphosate exposure.

Endometriosis, an estrogen dependent disease, is a gynecological disorder characterized by the growth of endometrial tissue outside the uterine cavity resulting in pain and discomfort. Estrogen plays an important role in the growth and persistence of endometriotic tissue along with inflammation. Estrogen receptor alpha (ERα) expression is significantly higher than estrogen receptor beta (ERβ) in normal endometrium. Endometriosis patients have increased abdominal fat which might contribute to a local endometriotic inflammatory environment characterized by infiltration of macrophages and secretion of proinflammatory cytokines. Furthermore, there is a dysregulation in this ratio, where lesions show increased expression of the ERβ and reduced expression of ERα. These receptors are also present in visceral fat and dysregulation of their function is known to correlate with increased adipose tissue. Preliminary data in our lab found increased mesenteric fat and serum leptin levels in endometriosis animals, which are decreased by exercise. However, it is still unclear how exercise modulates ER expression and whether it can improve endometriosis in an animal model.