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  1. Article ; Online: Bowel Preparation for Colonoscopy in 2020: A Look at the Past, Present, and Future.

    Millien, Valentine Ongeri / Mansour, Nabil M

    Current gastroenterology reports

    2020  Volume 22, Issue 6, Page(s) 28

    Abstract: Purpose of this review: Colorectal cancer is the third most common cancer in the USA. Colonoscopy is considered the gold standard for colorectal cancer screening and can offer both diagnosis and therapy. The bowel preparation remains a significant ... ...

    Abstract Purpose of this review: Colorectal cancer is the third most common cancer in the USA. Colonoscopy is considered the gold standard for colorectal cancer screening and can offer both diagnosis and therapy. The bowel preparation remains a significant barrier for patients who need to undergo colonoscopy and is often cited as the most dreaded aspect of the colonoscopy process. Inadequate bowel preparations still occur in 10-25% of colonoscopies, and this in turn can lead to increased procedural times, lower cecal intubation rates, and shorter interval between colonoscopies. From a quality standpoint, it is imperative that we do what we can to decrease the rate of inadequate bowel preparations. This review will focus on recent data regarding bowel preparation and offers a glimpse into what may be coming in the future.
    Recent findings: Recent advances in the field have been made to improve tolerability of bowel preparations and allow for more adequate colonoscopies. Newer, lower volume, flavored preparations, the use of adjuncts, and using split-dose preparations all can help with tolerability, compliance, and, in turn, preparation quality. Edible bowel preparations may become available in the near future. Early data on the use of artificial intelligence for assessment of preparation quality has been promising. Additionally, utilization of smartphone technology for education prior to the bowel preparation has also been shown to improve the adequacy of bowel preparations.
    Conclusions: Ongoing efforts to improve the tolerability and palatability of colonoscopy bowel preparations are important from a quality improvement standpoint to ensure the adequacy of colonoscopy. Incorporating patient-specific factors and comorbidities is also an essential aspect of improving the quality of bowel preparation. Leveraging technology to better communicate with and educate patients on the bowel preparation process is likely to play a larger role in the coming years.
    MeSH term(s) Artificial Intelligence ; Cathartics/administration & dosage ; Colonoscopy/standards ; Colonoscopy/trends ; Colorectal Neoplasms/diagnosis ; Diet ; Early Detection of Cancer/standards ; Early Detection of Cancer/trends ; Humans ; Patient Compliance ; Patient Education as Topic ; Preoperative Care/standards ; Preoperative Care/trends ; Quality Improvement ; Smartphone
    Chemical Substances Cathartics
    Language English
    Publishing date 2020-05-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2041376-2
    ISSN 1534-312X ; 1522-8037
    ISSN (online) 1534-312X
    ISSN 1522-8037
    DOI 10.1007/s11894-020-00764-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Colorectal cancer screening in African Americans: are we following the guidelines?

    Millien, Valentine Ongeri / Levine, Phillip / Suarez, Milena Gould

    Cancer causes & control : CCC

    2021  Volume 32, Issue 9, Page(s) 943–951

    Abstract: Purpose: The age at onset, incidence, and mortality rate of colorectal cancer varies among racial groups being highest in African Americans. This increased risk led to the recommendation to begin screening at the age of 45 years. Whether the ... ...

    Abstract Purpose: The age at onset, incidence, and mortality rate of colorectal cancer varies among racial groups being highest in African Americans. This increased risk led to the recommendation to begin screening at the age of 45 years. Whether the recommendation for screening of African Americans at an earlier age was implemented is unknown.
    Methods: We used data from the Cancer Control Supplement of National Health Interview Survey (NHIS) conducted in the years 2005, 2010, and 2015 to analyze demographic data and use of colorectal screening (colonoscopy, stool heme testing, sigmoidoscopy, computed tomographic colonography) among the US population between the ages of 45-49 years.
    Results: Data on colorectal screening was available from 6740 individuals; 16.5% were African Americans. Screening test use among African Americans in 2005, 2010, and 2015 was similar to use in Whites (i.e., 15.4% (95% CI 11.4-19.4), 28.4% (95% CI 19.3-30.4) and 20.2% (95% CI 14.8-25.5) vs. 16.9% (95% CI 15.1-18.6), 19.3% (95% CI 16.9-21.7), and 21.4% (95% CI 18.6-24.2) in 2005, 2010 and 2015, respectively. Observed screening test use rates may largely be accounted for by diagnostic exams.
    Conclusion: The recommendation for earlier colorectal screening of African Americans has not yet resulted in increased test utilization. These results emphasize the need for multidisciplinary actions to inform and implement public health policy.
    MeSH term(s) African Americans ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Early Detection of Cancer ; Humans ; Mass Screening ; Middle Aged ; Occult Blood
    Language English
    Publishing date 2021-06-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1064022-8
    ISSN 1573-7225 ; 0957-5243
    ISSN (online) 1573-7225
    ISSN 0957-5243
    DOI 10.1007/s10552-021-01448-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Rare Collision Tumor of the Biliary Tract.

    Millien, Valentine Ongeri / Sharma, Ashish / Jain, Shilpa / Sealock, Robert J

    ACG case reports journal

    2018  Volume 5, Page(s) e46

    Abstract: Malignancies of the gallbladder are uncommon in the developed world. Collision tumors are also extremely rare neoplastic phenomena. Given their scarcity, there are no guidelines for treatment, and prognosis is based on the more aggressive tumor type. We ... ...

    Abstract Malignancies of the gallbladder are uncommon in the developed world. Collision tumors are also extremely rare neoplastic phenomena. Given their scarcity, there are no guidelines for treatment, and prognosis is based on the more aggressive tumor type. We present a patient with a collision tumor consisting of signet-ring cholangiocarcinoma and large-cell neuroendocrine gallbladder carcinoma of the biliary tract, and we review the literature pertaining to biliary tract collision tumors and their management.
    Language English
    Publishing date 2018-06-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.2018.46
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Airway fibrinogenolysis and the initiation of allergic inflammation.

    Millien, Valentine Ongeri / Lu, Wen / Mak, Garbo / Yuan, Xiaoyi / Knight, J Morgan / Porter, Paul / Kheradmand, Farrah / Corry, David B

    Annals of the American Thoracic Society

    2014  Volume 11 Suppl 5, Page(s) S277–83

    Abstract: The past 15 years of allergic disease research have produced extraordinary improvements in our understanding of the pathogenesis of airway allergic diseases such as asthma. Whereas it was previously viewed as largely an immunoglobulin E-mediated process, ...

    Abstract The past 15 years of allergic disease research have produced extraordinary improvements in our understanding of the pathogenesis of airway allergic diseases such as asthma. Whereas it was previously viewed as largely an immunoglobulin E-mediated process, the gradual recognition that T cells, especially Type 2 T helper (Th2) cells and Th17 cells, play a major role in asthma and related afflictions has inspired clinical trials targeting cytokine-based inflammatory pathways that show great promise. What has yet to be clarified about the pathogenesis of allergic inflammatory disorders, however, are the fundamental initiating factors, both exogenous and endogenous, that drive and sustain B- and T-cell responses that underlie the expression of chronic disease. Here we review how proteinases derived from diverse sources drive allergic responses. A central discovery supporting the proteinase hypothesis of allergic disease pathophysiology is the role played by airway fibrinogen, which in part appears to serve as a sensor of unregulated proteinase activity and which, when cleaved, both participates in a novel allergic signaling pathway through Toll-like receptor 4 and forms fibrin clots that contribute to airway obstruction. Unresolved at present is the ultimate source of airway allergenic proteinases. From among many potential candidates, perhaps the most intriguing is the possibility such enzymes derive from airway fungi. Together, these new findings expand both our knowledge of allergic disease pathophysiology and options for therapeutic intervention.
    MeSH term(s) Allergens/immunology ; Asthma/immunology ; Asthma/metabolism ; Cytokines/metabolism ; Fibrinogen/metabolism ; Humans ; Hypersensitivity/immunology ; Hypersensitivity/metabolism ; Immunity, Cellular ; Inflammation/immunology ; Inflammation/metabolism ; Respiratory System/immunology ; Th2 Cells/immunology
    Chemical Substances Allergens ; Cytokines ; Fibrinogen (9001-32-5)
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201403-105AW
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cleavage of fibrinogen by proteinases elicits allergic responses through Toll-like receptor 4.

    Millien, Valentine Ongeri / Lu, Wen / Shaw, Joanne / Yuan, Xiaoyi / Mak, Garbo / Roberts, Luz / Song, Li-Zhen / Knight, J Morgan / Creighton, Chad J / Luong, Amber / Kheradmand, Farrah / Corry, David B

    Science (New York, N.Y.)

    2013  Volume 341, Issue 6147, Page(s) 792–796

    Abstract: Proteinases and the innate immune receptor Toll-like receptor 4 (TLR4) are essential for expression of allergic inflammation and diseases such as asthma. A mechanism that links these inflammatory mediators is essential for explaining the fundamental ... ...

    Abstract Proteinases and the innate immune receptor Toll-like receptor 4 (TLR4) are essential for expression of allergic inflammation and diseases such as asthma. A mechanism that links these inflammatory mediators is essential for explaining the fundamental basis of allergic disease but has been elusive. Here, we demonstrate that TLR4 is activated by airway proteinase activity to initiate both allergic airway disease and antifungal immunity. These outcomes were induced by proteinase cleavage of the clotting protein fibrinogen, yielding fibrinogen cleavage products that acted as TLR4 ligands on airway epithelial cells and macrophages. Thus, allergic airway inflammation represents an antifungal defensive strategy that is driven by fibrinogen cleavage and TLR4 activation. These findings clarify the molecular basis of allergic disease and suggest new therapeutic strategies.
    MeSH term(s) Animals ; Aspergillus niger/growth & development ; Aspergillus niger/immunology ; Aspergillus oryzae/enzymology ; Bronchoalveolar Lavage Fluid/cytology ; Epithelial Cells/immunology ; Epithelial Cells/metabolism ; Fibrinogen/metabolism ; Immunity, Innate ; Ligands ; Macrophage Activation ; Macrophages/immunology ; Macrophages/metabolism ; Macrophages/microbiology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Peptide Hydrolases/immunology ; Peptide Hydrolases/metabolism ; Respiratory Hypersensitivity/immunology ; Respiratory Hypersensitivity/metabolism ; Respiratory Mucosa/cytology ; Respiratory Mucosa/immunology ; Respiratory Mucosa/metabolism ; Th2 Cells/immunology ; Toll-Like Receptor 4/genetics ; Toll-Like Receptor 4/metabolism
    Chemical Substances Ligands ; Tlr4 protein, mouse ; Toll-Like Receptor 4 ; Fibrinogen (9001-32-5) ; Peptide Hydrolases (EC 3.4.-)
    Language English
    Publishing date 2013-08-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 128410-1
    ISSN 1095-9203 ; 0036-8075
    ISSN (online) 1095-9203
    ISSN 0036-8075
    DOI 10.1126/science.1240342
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Cleavage of Fibrinogen by Proteinases Elicits Allergic Responses Through Toll-Like Receptor 4

    Millien, Valentine Ongeri / Amber Luong / Chad J. Creighton / David B. Corry / Farrah Kheradmand / Garbo Mak / J. Morgan Knight / Joanne Shaw / Li-Zhen Song / Luz Roberts / Wen Lu / Xiaoyi Yuan

    Science. 2013 Aug. 16, v. 341, no. 6147

    2013  

    Abstract: ... invading microbes, drive allergic inflammation. Millien et al. (p. 792) shed light on this puzzle ...

    Abstract Allergy Induction Proteinases found in fungi and other allergens elicit allergic inflammation, but how they do so is far from clear. It is also unclear how pattern recognition receptors, which detect invading microbes, drive allergic inflammation. Millien et al. (p. 792) shed light on this puzzle by showing that, in mice, induction of allergic inflammation requires proteinase-dependent cleavage of the clotting factor fibrinogen, leading to generation of a ligand that activates the pattern-recognition receptor, Toll-like receptor 4 (TLR4). Cleaved fibrinogen signals through TLR4 to activate the innate immune system and recruit cells to the airway, which drives both allergic responses and antifungal immunity.
    Keywords allergens ; fibrinogen ; fungi ; hypersensitivity ; inflammation ; innate immunity ; ligands ; mice ; proteinases ; Toll-like receptor 4
    Language English
    Dates of publication 2013-0816
    Size p. 792-796.
    Publishing place American Association for the Advancement of Science
    Document type Article
    ZDB-ID 128410-1
    ISSN 1095-9203 ; 0036-8075
    ISSN (online) 1095-9203
    ISSN 0036-8075
    DOI 10.1126/science.1240342
    Database NAL-Catalogue (AGRICOLA)

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