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Article ; Online: Fecal Microbiota Transplant: Treatment Options for Clostridium difficile Infection in the Intensive Care Unit.

Han, Samuel / Shannahan, Sarah / Pellish, Randall

2016 Volume 31, Issue 9, Page(s) 577–586

Abstract: Clostridium difficile infection (CDI) has steadily increased in incidence since the 1990s, with an associated increase in recurrence and severity, which has in turn lead to more intensive care unit (ICU) admissions. The development of recurrent CDI, in ... ...

Abstract	Clostridium difficile infection (CDI) has steadily increased in incidence since the 1990s, with an associated increase in recurrence and severity, which has in turn lead to more intensive care unit (ICU) admissions. The development of recurrent CDI, in particular, has been associated with increasing patient morbidity and mortality as well as an immense financial burden on the health care system. Recently, fecal microbiota transplantation (FMT) has received much publicity as an effective means of treatment for recurrent CDI. The goal of this review is to provide evidence-based recommendations for the diagnosis and management of CDI, with a particular focus on FMT and its utilization in the ICU.
MeSH term(s)	Aminoglycosides/therapeutic use ; Anti-Infective Agents/therapeutic use ; Clostridium difficile/isolation & purification ; Clostridium difficile/pathogenicity ; Enterocolitis, Pseudomembranous/microbiology ; Enterocolitis, Pseudomembranous/therapy ; Fecal Microbiota Transplantation/methods ; Humans ; Intensive Care Units ; Practice Guidelines as Topic ; Randomized Controlled Trials as Topic ; Recurrence ; Rifamycins/therapeutic use ; Treatment Outcome
Chemical Substances	Aminoglycosides ; Anti-Infective Agents ; Rifamycins ; rifaximin (L36O5T016N) ; lipiarmycin (Z5N076G8YQ)
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632828-3
ISSN	1525-1489 ; 0885-0666
ISSN (online)	1525-1489
ISSN	0885-0666
DOI	10.1177/0885066615594344
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Article ; Online: Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: Pilot study.

Olendzki, Barbara / Bucci, Vanni / Cawley, Caitlin / Maserati, Rene / McManus, Margaret / Olednzki, Effie / Madziar, Camilla / Chiang, David / Ward, Doyle V / Pellish, Randall / Foley, Christine / Bhattarai, Shakti / McCormick, Beth A / Maldonado-Contreras, Ana

Gut microbes

2022 Volume 14, Issue 1, Page(s) 2046244

Abstract: Diet is a modifiable, noninvasive, inexpensive behavior that is crucial in shaping the intestinal microbiome. A microbiome "imbalance" or dysbiosis in inflammatory bowel disease (IBD) is linked to inflammation. Here, we aim to define the impact of ... ...

Abstract	Diet is a modifiable, noninvasive, inexpensive behavior that is crucial in shaping the intestinal microbiome. A microbiome "imbalance" or dysbiosis in inflammatory bowel disease (IBD) is linked to inflammation. Here, we aim to define the impact of specific foods on bacterial species commonly depleted in patients with IBD to better inform dietary treatment. We performed a single-arm, pre-post intervention trial. After a baseline period, a dietary intervention with the IBD-Anti-Inflammatory Diet (IBD-AID) was initiated. We collected stool and blood samples and assessed dietary intake throughout the study. We applied advanced computational approaches to define and model complex interactions between the foods reported and the microbiome. A dense dataset comprising 553 dietary records and 340 stool samples was obtained from 22 participants. Consumption of prebiotics, probiotics, and beneficial foods correlated with increased abundance of
MeSH term(s)	Diet ; Dysbiosis/therapy ; Gastrointestinal Microbiome ; Humans ; Inflammatory Bowel Diseases/microbiology ; Pilot Projects ; Prebiotics
Chemical Substances	Prebiotics
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1949-0984
ISSN (online)	1949-0984
DOI	10.1080/19490976.2022.2046244
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Article ; Online: Tamoxifen-associated portal vein thrombosis causing severe oesophageal variceal bleeding.

Hsu, Andrew / Belkin, Edward / Han, Samuel / Pellish, Randall

BMJ case reports

2015 Volume 2015

Abstract: A 46-year-old woman with medical history of breast cancer on tamoxifen presented with syncope. On arrival to the hospital, the patient developed massive haematemesis and a subsequent esophagogastroduodenoscopy revealed oesophageal varices without any ... ...

Abstract	A 46-year-old woman with medical history of breast cancer on tamoxifen presented with syncope. On arrival to the hospital, the patient developed massive haematemesis and a subsequent esophagogastroduodenoscopy revealed oesophageal varices without any known history of liver disease. Further evaluation identified portal vein thrombosis probably caused by tamoxifen use.
MeSH term(s)	Antineoplastic Agents, Hormonal/adverse effects ; Blood Transfusion ; Breast Neoplasms/drug therapy ; Breast Neoplasms/prevention & control ; Chemotherapy, Adjuvant/adverse effects ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/chemically induced ; Esophageal and Gastric Varices/complications ; Esophageal and Gastric Varices/pathology ; Female ; Gastrointestinal Hemorrhage/chemically induced ; Humans ; Middle Aged ; Portal Vein ; Syncope/etiology ; Tamoxifen/adverse effects ; Treatment Outcome ; Venous Thrombosis/chemically induced ; Venous Thrombosis/complications ; Venous Thrombosis/pathology
Chemical Substances	Antineoplastic Agents, Hormonal ; Tamoxifen (094ZI81Y45)
Language	English
Publishing date	2015-08-27
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2015-209988
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Article: The conundrum of indeterminate QuantiFERON-TB Gold results before anti-tumor necrosis factor initiation.

Hakimian, Shahrad / Popov, Yevgeniy / Rupawala, Abbas H / Salomon-Escoto, Karen / Hatch, Steven / Pellish, Randall

Biologics : targets & therapy

2018 Volume 12, Page(s) 61–67

Abstract: Background: Tumor necrosis factor alpha (TNFα) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFα medications result in an ... ...

Abstract	Background: Tumor necrosis factor alpha (TNFα) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFα medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI. Methods: We conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications. Results: We included 107 and 89 patients with IBD and RA, respectively. We found that a higher proportion of IBD patients had indeterminate QFT-GIT result compared to RA patients. Furthermore, we found that the majority of patients with indeterminate results were tested during an acute flare of IBD (88%) and while taking corticosteroids. Of all patients receiving ≥20 mg equivalent prednisone dose (n=32), 63% resulted in indeterminate QFT-GIT, compared to only 6% indeterminate testing in patients receiving <20 mg of equivalent prednisone dose (n=164, Conclusion: We observed that high-dose corticosteroids may affect QFT-GIT outcomes leading to a high proportion of indeterminate results. We propose that IBD patients should be tested prior to initiation of corticosteroids to avoid equivocal results and prevent potential delays in initiation of anti-TNF medications.
Language	English
Publishing date	2018-02-27
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2415708-9
ISSN	1177-5491 ; 1177-5475
ISSN (online)	1177-5491
ISSN	1177-5475
DOI	10.2147/BTT.S150958
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Article ; Online: S0791 Transition to Home Biologic Infusions in Inflammatory Bowel Disease (IBD) Patients During the COVID-19 Pandemic

Farhoud, Adel / Pasam, Ravi Teja / Gadupudi, Salini / Pellish, Randall / Chaudrey, Khadija

American Journal of Gastroenterology

2020 Volume 115, Issue 1, Page(s) S405–S405

Keywords	Hepatology ; Gastroenterology ; covid19
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publishing country	us
Document type	Article ; Online
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/01.ajg.0000705212.90161.9d
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Article ; Online: The conundrum of indeterminate QuantiFERON-TB Gold results before anti-tumor necrosis factor initiation

Hakimian S / Popov Y / Rupawala AH / Salomon-Escoto K / Hatch S / Pellish R

Biologics: Targets & Therapy, Vol Volume 12, Pp 61-

2018 Volume 67

Abstract: Shahrad Hakimian,1 Yevgeniy Popov,1 Abbas H Rupawala,2 Karen Salomon-Escoto,3 Steven Hatch,4 Randall Pellish1,2 1Department of Medicine, 2Division of Gastroenterology, 3Division of Rheumatology, 4Division of Infectious Disease, UMass Memorial Medical ... ...

Abstract	Shahrad Hakimian,1 Yevgeniy Popov,1 Abbas H Rupawala,2 Karen Salomon-Escoto,3 Steven Hatch,4 Randall Pellish1,2 1Department of Medicine, 2Division of Gastroenterology, 3Division of Rheumatology, 4Division of Infectious Disease, UMass Memorial Medical Center, Worcester, MA, USA Background: Tumor necrosis factor alpha (TNFα) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFα medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI. Methods: We conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications. Results: We included 107 and 89 patients with IBD and RA, respectively. We found that a higher proportion of IBD patients had indeterminate QFT-GIT result compared to RA patients. Furthermore, we found that the majority of patients with indeterminate results were tested during an acute flare of IBD (88%) and while taking corticosteroids. Of all patients receiving ≥20mg equivalent prednisone dose (n=32), 63% resulted in indeterminate QFT-GIT, compared to only 6% indeterminate testing in patients receiving <20mg of equivalent prednisone dose (n=164, P<0.001). There was no correlation between indeterminate results and age, gender, disease duration, or distribution, or smoking status within each population. Conclusion: We observed that high-dose corticosteroids may affect QFT-GIT outcomes leading to a high proportion of indeterminate results. We propose that IBD patients should be tested prior to initiation of corticosteroids to avoid equivocal results and prevent potential delays in initiation of anti-TNF medications. Keywords: indeterminate QuantiFERON-TB Gold, ...
Keywords	Indeterminate Quantiferon Gold ; Latent TB infection ; Inflammatory Bowel Disease ; Rheumatoid Arthritis ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2018-02-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Inclusion of Radiation Environment Variability in Total Dose Hardness Assurance Methodology.

Xapsos, M A / Stauffer, C / Phan, A / McClure, S S / Ladbury, R L / Pellish, J A / Campola, M J / LaBel, K A

IEEE transactions on nuclear science

2017 Volume 64, Issue 1, Page(s) 325–331

Abstract: Variability of the space radiation environment is investigated with regard to parts categorization for total dose hardness assurance methods. It is shown that it can have a significant impact. A modified approach is developed that uses current ... ...

Abstract	Variability of the space radiation environment is investigated with regard to parts categorization for total dose hardness assurance methods. It is shown that it can have a significant impact. A modified approach is developed that uses current environment models more consistently and replaces the radiation design margin concept with one of failure probability during a mission.
Language	English
Publishing date	2017-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	218510-6
ISSN	0018-9499
ISSN	0018-9499
DOI	10.1109/TNS.2016.2607021
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Article ; Online: Review article: RNA interference--potential therapeutic applications for the gastroenterologist.

Pellish, R S / Nasir, A / Ramratnam, B / Moss, S F

Alimentary pharmacology & therapeutics

2008 Volume 27, Issue 9, Page(s) 715–723

Abstract: Background: A new technique of gene regulation, termed RNA interference, has emerged recently. RNA interference utilizes short double-stranded RNA to inhibit selectively gene expression of complementary RNA nucleotide sequences after transcription, but ... ...

Abstract	Background: A new technique of gene regulation, termed RNA interference, has emerged recently. RNA interference utilizes short double-stranded RNA to inhibit selectively gene expression of complementary RNA nucleotide sequences after transcription, but prior to translation. Gastrointestinal and hepatic disorders may be particularly amenable to therapeutic RNA interference intervention because of the relative ease of delivery of drugs to the gastrointestinal tract and liver. Aim: To examine the published literature for potential clinical uses of RNA interference in gastroenterology and speculate on future therapies for luminal disease. Methods: Reports were identified using PubMed and the search term 'RNA interference', focusing on therapeutic uses related to gastrointestinal and liver disease. Results: Cellular and animal models demonstrate the potential application of short-interfering RNA-based therapies for viral hepatitis and inflammatory bowel disease. With validation of specific targets and better in vivo delivery of short-interfering RNA, RNA interference may represent a new frontier for molecular-targeted therapy in gastroenterology and hepatology. Conclusions: Short-interfering RNA provides a novel and specific means to inhibit gene expression. Translation to the clinical arena will require further definition of side-effects, off-target effects and delivery systems. Ultimately, mucosally applied or endoscopically delivered short-interfering RNA could be one of the earliest clinical uses of short-interfering RNA therapy.
MeSH term(s)	Animals ; Cells, Cultured ; Gastrointestinal Diseases/therapy ; Gene Expression Regulation/physiology ; Genetic Therapy/methods ; Humans ; Liver Diseases/therapy ; Neoplasms/therapy ; RNA Interference/physiology ; RNA, Small Interfering/therapeutic use
Chemical Substances	RNA, Small Interfering
Language	English
Publishing date	2008-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/j.1365-2036.2008.03634.x
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Article ; Online: Efficacy and safety of natalizumab in Crohn's disease patients treated at 6 Boston academic hospitals.

Juillerat, Pascal / Wasan, Sharmeel K / Fowler, Sharyle A / Friedman, Sonia / Pabby, Vikas K / Coukas, Jennifer A / Barto, Amy E / Pellish, Randall / Germansky, Katharine A / Cheifetz, Adam S / Korzenik, Joshua R / Farraye, Francis A / Yajnik, Vijay

Inflammatory bowel diseases

2013 Volume 19, Issue 11, Page(s) 2457–2463

Abstract: Background: Despite trials demonstrating its efficacy, many physicians harbor concerns regarding the use of natalizumab in the treatment of patients with refractory Crohn's disease (CD). The purpose of this study was to perform a descriptive analysis of ...

Abstract	Background: Despite trials demonstrating its efficacy, many physicians harbor concerns regarding the use of natalizumab in the treatment of patients with refractory Crohn's disease (CD). The purpose of this study was to perform a descriptive analysis of a series of CD patients not currently enrolled in a clinical trial. Methods: A retrospective case review of patients treated with natalizumab at 6 sites in Massachusetts: Boston Medical Center, Beth Israel Deaconess Medical Center, Brigham & Women's Hospital, Lahey Clinic, Massachusetts General Hospital, and UMass Medical Center. Results: Data on 69 CD patients on natalizumab were collected. At the start of treatment, patients' disease duration was 12 years. A high proportion of patients were women (68%), presented with perianal disease (65%) and upper gastrointestinal tract involvement (14%). Prior nonbiologic therapies were steroids (96%), thiopurines (94%), antibiotics (74%), methotrexate (58%), and at least two anti-tumor necrosis factor agent failures (81%). Sixty-nine percent (44 of 64 patients) with available medical evaluation had a partial or complete clinical response. Loss of response was 13% after an average of 1 year of treatment. Adverse events were infusion reactions, headaches, fever, and infections. No case of progressive multifocal leukoencephalopathy was observed. Conclusions: In our clinical experience outside the context of a clinical trial, natalizumab is largely reserved for CD patients with extensive ileocolonic disease who have failed conventional immunosuppressants and of at least 2 anti-tumor necrosis factor agents. This drug is, however, well tolerated and offers significant clinical improvement for more than a year in one-third of these difficult-to-treat CD patients.
MeSH term(s)	Adult ; Antibodies, Monoclonal, Humanized/therapeutic use ; Boston ; Crohn Disease/drug therapy ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/therapeutic use ; Integrin alpha4/chemistry ; Integrin alpha4/immunology ; Male ; Natalizumab ; Prognosis ; Remission Induction ; Retrospective Studies ; Safety
Chemical Substances	Antibodies, Monoclonal, Humanized ; Immunosuppressive Agents ; Natalizumab ; Integrin alpha4 (143198-26-9)
Language	English
Publishing date	2013-05-21
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1097/MIB.0b013e3182a32a0d
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