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13


It's All in the History: Infectious Mimics of Inflammatory Bowel Disease [Meeting Abstract]

Quarta, Giulio; Lopatin, Sarah; Betesh, Andrea; Malter, Lisa; Gamagaris, Zoi
ISI:000395764603028
ISSN: 1572-0241
CID: 2492602

Sensorimotor Neuropathy Associated with Mesalamine Use in a Patient with Ulcerative Colitis: A Case Report [Meeting Abstract]

Chugh, Priyanka; Razavi, Farid; Gamagaris, Zoi; Malter, Lisa
ISI:000330178101556
ISSN: 0002-9270
CID: 816062

Lap-band impact on the function of the esophagus

Gamagaris, Zoi; Patterson, Carlie; Schaye, Verity; Francois, Fritz; Traube, Morris; Fielding, Christine J; Fielding, George A; Youn, Allison Heekoung; Weinshel, Elizabeth H
BACKGROUND: The laparoscopic adjustable gastric band (LAGB) has been widely used to treat morbid obesity. There is conflicting data on its long-term effect on esophageal function. Our aim was to assess the long-term impact of the LAGB on esophageal motility and pH-metry in patients who had LAGB who had normal and abnormal esophageal function at baseline. METHODS: Consecutive patients referred for bariatric surgery were prospectively enrolled. A detailed medical history was obtained, and esophageal manometric and 24-h pH evaluations were performed in standard fashion preoperatively and 6 and 12 months postoperatively; patients served as their own controls. RESULTS: Twenty-two patients completed manometric evaluation. Ten patients had normal manometric parameters at baseline; at 6 months, mean lower esophageal sphincter (LES) residual pressure increased significantly from baseline (3.9 +/- 2 vs. 8.9 +/- 4 mmHg, p = 0.014). At 12 months, the mean peristaltic wave duration increased from 3.6 +/- 1 at baseline to 6.8 +/- 2 s, p = 0.025 and wave amplitude decreased during the same period (98.7 +/- 22 vs. 52.3 +/- 24, p = 0.013). LES pressure and percent peristalsis did not differ significantly pre- and post-LAGB. Twelve patients had one or more abnormal manometric findings at baseline; at 12 months, LES pressure in these 12 patients decreased significantly (31.1 +/- 10 vs 23.6 +/- 7, p = 0.011) and wave amplitude was significantly reduced (125.9 +/- 117 vs 103 +/- 107, p = 0.039). LES residual pressure did not change significantly pre- and post-LAGB. Twenty-two individuals were evaluated for impact of Lap-Band on esophageal acid exposure. Sixteen of these patients had normal esophageal pH-metry values at baseline and had no significant changes in 12 months in any pH-metry measurement. Six patients had abnormal pH-metry values at baseline. Among these patients, time with pH < 4.0 and Johnson/DeMeester score did not change significantly during follow-up. There was a significant decrease in the number of reflux episodes from baseline to 6 months (159 +/- 48 vs. 81 +/- 61, p = 0.016). CONCLUSIONS: Abnormal manometric findings are frequently encountered post-LAGB. Increases in LES residual pressure and peristaltic wave duration were the most significant changes. LAGB is not associated with an increase in total esophageal acidification time. Further evaluation of the clinical significance of manometric abnormalities is warranted
PMID: 18663546
ISSN: 0960-8923
CID: 91869

The Effect of Laparoscopic Gastric Banding Surgery on Plasma Levels of Appetite-Control, Insulinotropic, and Digestive Hormones

Shak, Joshua R; Roper, Jatin; Perez-Perez, Guillermo I; Tseng, Chi-hong; Francois, Fritz; Gamagaris, Zoi; Patterson, Carlie; Weinshel, Elizabeth; Fielding, George A; Ren, Christine; Blaser, Martin J
BACKGROUND: We hypothesized that laparoscopic adjustable gastric banding (LAGB) reduces weight and modulates ghrelin production, but largely spares gastrointestinal endocrine function. To examine this hypothesis, we determined plasma concentrations of appetite-control, insulinotropic, and digestive hormones in relation to LAGB. METHODS: Twenty-four patients undergoing LAGB were prospectively enrolled. Body mass index (BMI) was measured and blood samples obtained at baseline and 6 and 12 months post-surgery. Plasma concentrations of leptin, acylated and total ghrelin, pancreatic polypeptide (PP), insulin, glucose-dependent insulinotropic peptide (GIP), active glucagon-like peptide-1 (GLP-1), gastrin, and pepsinogens I and II were measured using enzyme-linked immunoassays. RESULTS: Median percent excess weight loss (%EWL) over 12 months was 45.7% with median BMI decreasing from 43.2 at baseline to 33.8 at 12 months post-surgery (p < 0.001). Median leptin levels decreased from 19.7 ng/ml at baseline to 6.9 ng/ml at 12 months post-surgery (p < 0.001). In contrast, plasma levels of acylated and total ghrelin, PP, insulin, GIP, GLP-1, gastrin, and pepsinogen I did not change in relation to surgery (p > 0.05). Pepsinogen II levels were significantly lower 6 months after LAGB but returned to baseline levels by 12 months. CONCLUSIONS: LAGB yielded substantial %EWL and a proportional decrease in plasma leptin. Our results support the hypothesis that LAGB works in part by suppressing the rise in ghrelin that normally accompanies weight loss. Unchanged concentrations of insulinotropic and digestive hormones suggest that gastrointestinal endocrine function is largely maintained in the long term
PMCID:3743550
PMID: 18408980
ISSN: 0960-8923
CID: 78623

The effect of laparoscopic gastric banding surgeryon plasma levels of appetite-control, insulinotropic, and digestive hormones (Obesity Surgery DOI: 10.1007/s11695-008-9454-6)

Shak, J R; Roper, J; Perez-Perez, G I; Tseng, C -H; Francois, F; Gamagaris, Z; Patterson, C; Weinshel, E; Fielding, G A; Ren, C; Blaser, M J
EMBASE:50180205
ISSN: 0960-8923
CID: 4024662

The impact of adjustable laparoscopic gastric banding on esophageal motility [Meeting Abstract]

Gamagaris, Z; Patterson, C; Francois, F; Ren, C; Youn, H; Weinshel, E
ISI:000240656100082
ISSN: 0002-9270
CID: 69308

Pemphigoid associated esophagitis dessicans superficialis complicated by acquired hemophilia A [Meeting Abstract]

Francois, F; Faroozi, B; Adams, J; Gamagaris, Z
ISI:000178230400045
ISSN: 0002-9270
CID: 32553

Endoscopic band ligation of bleeding rectal varices [Case Report]

Firoozi, Babak; Gamagaris, Zoi; Weinshel, Elizabeth H; Bini, Edmund J
PMID: 12141807
ISSN: 0163-2116
CID: 32475

Comparison of duodenal with jejunal biopsy and aspirate in chronic human immunodeficiency virus-related diarrhea

Bini EJ; Weinshel EH; Gamagaris Z
OBJECTIVES: In human immunodeficiency virus (HIV)-infected patients with chronic unexplained diarrhea, upper endoscopy with small bowel biopsy and aspirate is often performed to identify treatable pathogens. The purpose of this study was to compare the diagnostic yield of duodenal with jejunal biopsy and aspirate. METHODS: All HIV-infected patients with chronic unexplained diarrhea who were evaluated by upper endoscopy at Bellevue Hospital Center between January 1992 and January 1997 were identified. Data were collected by reviewing patient charts, endoscopy reports, and pathology records. RESULTS: During the 5-yr study period, 442 patients underwent upper endoscopy with sampling of the duodenum (N=173) or jejunum (N=269). A pathogen was identified in 123 patients (27.8%). Microsporidia was the most common organism detected (12.2%). The diagnostic yield of jejunal biopsy and aspirate was significantly higher than that obtained from the duodenum (32.3% vs 20.8%, p=0.009). Small bowel aspirates detected a pathogen in only 1.8% of patients evaluated, and there was no difference in the yield of duodenal and jejunal aspirates (1.3% vs 2.1%, p=0.7). Patients with a CD4 count of < 100 cells/mm3 were significantly more likely to have a pathogen identified than those with higher CD4 counts (38.8% vs 7.1%,p < 0.0001). CONCLUSIONS: Upper endoscopy with small bowel biopsy and aspirate identifies a pathogen in 27.8% of individuals with HIV-related chronic unexplained diarrhea. In this patient population, jejunal biopsies acquired by enteroscopy are superior to those obtained from the duodenum. Small bowel aspirates are of little value in the workup of chronic HIV-related diarrhea
PMID: 9772041
ISSN: 0002-9270
CID: 7501

The effects of prenatal exposure to delta-9-tetrahydrocannabinol on the rest-activity cycle of the preweanling rat

Hutchings, D E; Gamagaris, Z; Miller, N; Fico, T A
Either 15 or 50 mg/kg of delta-9-tetrahydrocannabinol (delta-9-THC) was administered from Day 2 through Day 22 of gestation. Pair-fed (0 mg/kg) and nontreated groups served as controls and all treated and control litters were fostered at birth to untreated dams. To examine whether delta-9-THC produces effects on the rest-activity cycle of the offspring, groups of 3 littermates from each of the treated and control groups were tested for an 8 hr observation period on electronic activity monitors at 17, 22 and 30 days of age. Whereas all treated and control groups showed age-dependent changes in activity, neither activity level nor the rest-activity pattern were affected by delta-9-THC. These findings are discussed in relation to neurobehavioral studies of activity changes following prenatal exposure to cannabis
PMID: 2552274
ISSN: 0892-0362
CID: 68398