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Article ; Online: Perceptions Toward Established and Novel Dietary Therapies for Crohn's Disease Management Among Adult Patients: Results From a Questionnaire Survey.

Jatkowska, Aleksandra / White, Bernadette / Jaskolski, Paige / Nichols, Ben / Brownson, Emily / Clowe, Jennifer / Seenan, John Paul / Gerasimidis, Konstantinos / MacDonald, Jonathan

Crohn's & colitis 360

2024 Volume 6, Issue 1, Page(s) otae008

Abstract: Background: Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) remain the only established dietary therapies in Crohn's disease (CD) management. We conducted a questionnaire survey to evaluate the perceptions of adults with CD toward ... ...

Abstract	Background: Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) remain the only established dietary therapies in Crohn's disease (CD) management. We conducted a questionnaire survey to evaluate the perceptions of adults with CD toward established and emerging food-based dietary therapies. Methods: A 26-question anonymous survey was mailed to 300 adults receiving biologic treatment. Two researchers independently conducted a thematic analysis of open-ended responses. Machine learning with the Random Forest-Recursive Feature Elimination algorithm identified predictors of willingness to try dietary therapies. Results: One hundred and sixty patients (53% female) completed and returned the survey. Forty-two percent were following some form of exclusion diet, with low-spice and low-fiber diets being the most popular. Although only a quarter of patients believed that EEN/PEN could help with their CD, more than half believed that diet could help, with another 13% already using diet for CD management. While half of the patients were willing to try EEN, the majority were willing to try PEN instead (51% vs. 79%; Conclusions: Most adults preferred to follow a food-based dietary therapy over EEN/PEN. The majority would try PEN though which allows for more flexibility to incorporate in habitual diet and may be easier to comply with than the EEN.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ISSN	2631-827X
ISSN (online)	2631-827X
DOI	10.1093/crocol/otae008
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Article ; Online: Micronutrient Status and Prediction of Disease Outcome in Adults With Inflammatory Bowel Disease Receiving Biologic Therapy.

Brownson, Emily / Saunders, Jayne / Jatkowska, Aleksandra / White, Bernadette / Gerasimidis, Konstantinos / Seenan, John Paul / Macdonald, Jonathan

Inflammatory bowel diseases

2023

Abstract: Background and aims: Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD), but whether they relate to disease outcomes remains unknown. This study assessed the micronutrient status of adults with IBD on treatment with ... ...

Abstract	Background and aims: Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD), but whether they relate to disease outcomes remains unknown. This study assessed the micronutrient status of adults with IBD on treatment with biologic therapies and explored predictive relationships with disease outcomes. Methods: Seventeen micronutrients were measured in the blood of 216 adults with IBD on biologic therapy. Of these, 127 patients (58%) had Crohn's disease (CD), and the majority (70%) received treatment with infliximab. Patients were followed for 12 months and onset of adverse clinical outcomes (eg, requirement for treatment with corticosteroids, hospitalization, or surgical intervention) was recorded, and related to micronutrient status. Results: Among all patients, the most common deficiencies were for vitamin C (n = 35 of 212 [16.5%]), ferritin (n = 27 of 189 [14.3%]), folate (n = 24 of 171 [14.0%]), and zinc (n = 27 of 210 [12.9%]). During follow-up, 22 (10%) of the 216 patients developed 1 or more adverse clinical outcomes. Patients with CD and zinc deficiency were significantly more likely to require surgery (P = .002) or treatment with corticosteroids (P < .001). In contrast, patients with ulcerative colitis and selenium deficiency were significantly more likely to have a clinical flare of disease (P = .001), whereas those with CD were not. This relationship with selenium remained significant after adjustment for confounders. Conclusions: A substantial proportion of adults with IBD present deficiencies for certain micronutrients, with selenium and zinc deficiency predicting adverse disease outcomes. For other micronutrients, deficiencies were less common and should not warrant routine screening. Intervention studies should explore the effect of micronutrient supplementation in modifying disease outcomes in IBD.
Language	English
Publishing date	2023-08-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izad174
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Article ; Online: Unusual case of adult familial Menetrier disease in siblings.

Brownson, Emily / Stanley, Adrian J / Konanahalli, Prakash / Seenan, John P

BMJ case reports

2019 Volume 12, Issue 10

Abstract: Menetrier disease is a rare disease characterised by hyperplasia of the gastric epithelium and large gastric folds. We present a case of a 58-year-old woman who was referred with iron deficiency anaemia, with a family history of a sibling who had ... ...

Abstract	Menetrier disease is a rare disease characterised by hyperplasia of the gastric epithelium and large gastric folds. We present a case of a 58-year-old woman who was referred with iron deficiency anaemia, with a family history of a sibling who had undergone gastrectomy for presumed gastric malignancy. Endoscopy showed prominent gastric mucosal folds and biopsies showed hyperplastic gastric mucosa, with prominent foveolar hyperplasia suggestive of Menetrier disease. Further information about her brother's diagnosis was sought, and it was found that his pathology after gastrectomy showed diffuse glandular hyperplasia also in keeping with Menetrier disease. Adult familial Menetrier disease has so far been a rarity in the literature-review elicits five previous cases of this presentation in siblings.
MeSH term(s)	Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa/pathology ; Gastritis, Hypertrophic/diagnosis ; Gastritis, Hypertrophic/genetics ; Gastritis, Hypertrophic/pathology ; Humans ; Hyperplasia/pathology ; Male ; Middle Aged ; Rare Diseases ; Siblings
Language	English
Publishing date	2019-10-23
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2019-231175
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Article ; Online: Experiences of Alaska Native people living with burn injury and opportunities for health system strengthening.

Smith, Mallory B / Brownson, Elisha / Newman, Andrea K / Madison, Christopher / Fuentes, Molly / Amtmann, Dagmar / Carrougher, Gretchen J / Gibran, Nicole S / Stewart, Barclay T

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1260

Abstract: Background: Injuries are a leading cause of death and disability for Alaska Native (AN) people. Alaska Native Tribal Health Consortium (ANTHC) is supporting the development of a burn care system that includes a partnership between Alaska Native Medical ... ...

Abstract	Background: Injuries are a leading cause of death and disability for Alaska Native (AN) people. Alaska Native Tribal Health Consortium (ANTHC) is supporting the development of a burn care system that includes a partnership between Alaska Native Medical Center (ANMC) in Anchorage, AK and UW Medicine Regional Burn Center at Harborview Medical Center (HMC) in Seattle, WA. We aimed to better understand the experiences of AN people with burn injuries across the care continuum to aid development of culturally appropriate care regionalization. Methods: We performed focus groups with twelve AN people with burn injury and their caregivers. A multidisciplinary team of burn care providers, qualitative research experts, AN care coordinator, and AN cultural liaison led focus groups to elicit experiences across the burn care continuum. Transcripts were analyzed using a phenomenological approach and inductive coding to understand how AN people and families navigated the medical and community systems for burn care and areas for improvement. Results: Three themes were identified: 1-Challenges with local burn care in remote communities including limited first aid, triage, pain management, and wound care, as well as long-distance transport to definitive care; 2-Divergence between cultural values and medical practices that generated mistrust in the medical system, isolation from their support systems, and recovery goals that were not aligned with their needs; 3-Difficulty accessing emotional health support and a survivor community that could empower their resilience. Conclusion: Participants reported modifiable barriers to culturally competent treatment for burn injuries among AN people. The findings can inform initiatives that leverage existing resources, including expansion of the Extension for Community Healthcare Outcomes (ECHO) telementoring program, promulgation of the Phoenix Society Survivors Offering Assistance in Recovery (SOAR) to AK, coordination of regionalized care to reduce time away from AK and provide more comfortable community reintegration, and define rehabilitation goals in terms that align with personal goals and subsistence lifestyle skills. Long-distance transport times are non-modifiable, but better pre-hospital care could be achieved by harnessing existing telehealth services and adapting principles of prolonged field care to allow for triage, initial care, and resuscitation in remote environments.
MeSH term(s)	Humans ; Alaska ; Focus Groups ; Qualitative Research ; Population Groups
Language	English
Publishing date	2023-11-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10243-x
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Article ; Online: Development and Validation of the Glasgow Exclusive Enteral Nutrition Index of Compliance.

Jatkowska, Aleksandra / White, Bernadette / Nichols, Ben / Svolos, Vaios / Gkikas, Konstantinos / Hansen, Richard / Russell, Richard K / Gaya, Daniel / Brownson, Emily / Seenan, John Paul / Milling, Simon / MacDonald, Jonathan / Gerasimidis, Konstantinos

Journal of Crohn's & colitis

2023 Volume 17, Issue 9, Page(s) 1426–1435

Abstract: Background and aims: Treatment adherence is key to the efficacy of exclusive enteral nutrition [100% EN] in active Crohn's disease [CD], but there are no biomarkers to objectively estimate this. We explored faecal parameters as biomarkers of compliance ... ...

Abstract	Background and aims: Treatment adherence is key to the efficacy of exclusive enteral nutrition [100% EN] in active Crohn's disease [CD], but there are no biomarkers to objectively estimate this. We explored faecal parameters as biomarkers of compliance with 100% EN, and subsequently developed and validated the Glasgow Exclusive Enteral Nutrition Index of Compliance [GENIE]. Methods: Healthy adults replaced all [100% EN] or part [85% EN, 50% EN, 20% EN] of their diet with a formula for 7 days. Faecal pH, water content, short chain fatty acids, and branched chain fatty acids [BCFAs] were measured before [D0] and after [D7] each intervention. Optimal biomarkers and threshold values were derived using receiver operating characteristic curve analyses and machine learning to develop the GENIE. The GENIE was then validated in 30 CD children, during and after 100% EN. Results: In all, 61 adults were recruited. D7 faecal pH and the ratios of BCFAs to either acetate or butyrate performed the best to differentiate between patients on 100% EN from <100% EN. Two models were generated; one included faecal metabolites (Laboratory GENIE, L-GENIE; sensitivity, specificity, and positive predictive value [PPV] of 88%, 94%, and 92%) and a second one [Clinical Genie, C-GENIE] which considers only faecal pH [sensitivity, specificity, and PPV of 84%, 86%, and 81%]. Validation of GENIE in CD children found that C-GENIE outperformed L-GENIE, producing a sensitivity, specificity, and PPV of 85%, 88%, and 88%, respectively. Conclusions: GENIE can help predict adherence to 100% EN and may complement current conventional dietary assessment.
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjad063
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Zs.A 6634: Show issues

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Article: Cocaine-associated hemoperitoneum following atraumatic splenic rupture: a case report and literature review.

Azar, Faris / Brownson, Elisha / Dechert, Tracey

World journal of emergency surgery : WJES

2013 Volume 8, Issue 1, Page(s) 33

Abstract: Introduction: Splenic hematoma or rupture of the spleen is rare in the absence of trauma. This case report with a brief review of the literature is intended to raise awareness of splenic bleeding as an etiology of abdominal pain; it highlights the ... ...

Abstract	Introduction: Splenic hematoma or rupture of the spleen is rare in the absence of trauma. This case report with a brief review of the literature is intended to raise awareness of splenic bleeding as an etiology of abdominal pain; it highlights the importance of a detailed social history. Presentation of case: This report of an otherwise healthy 42-year old man details hemoperitoneum with splenic rupture as a cause for hemorrhage following cocaine use. The patient was managed non-operatively in the surgical intensive care unit. He did not require transfusion and was discharged home on hospital day four with close follow-up. Discussion: While splenic pathology associated with cocaine use has been described, this case illustrates a novel report of cocaine-associated splenic hemorrhage. A plausible mechanism is transient vasospasm with subsequent bleeding into the infarcted area. Conclusion: Although uncommon, atraumatic splenic rupture should be recognized early because it is potentially fatal. This case is the first to describe hemoperitoneum of splenic etiology following cocaine use.
Language	English
Publishing date	2013-08-28
Publishing country	England
Document type	Journal Article
ISSN	1749-7922
ISSN	1749-7922
DOI	10.1186/1749-7922-8-33
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Article ; Online: University students' notebook computer use: lessons learned using e-diaries to report musculoskeletal discomfort.

Jacobs, K / Foley, G / Punnett, L / Hall, V / Gore, R / Brownson, E / Ansong, E / Markowitz, J / McKinnon, M / Steinberg, S / Ing, A / Wuest, Ellen / Dibiccari, Leah

Ergonomics

2011 Volume 54, Issue 2, Page(s) 206–219

Abstract: The objective of this pilot study was to identify if notebook accessories (ergonomic chair, desktop monitor and notebook riser) combined with a wireless keyboard, mouse and participatory ergonomics training would have the greatest impact on reducing self- ...

Abstract	The objective of this pilot study was to identify if notebook accessories (ergonomic chair, desktop monitor and notebook riser) combined with a wireless keyboard, mouse and participatory ergonomics training would have the greatest impact on reducing self-reported upper extremity musculoskeletal discomfort in university students. In addition to pre-post computing and health surveys, the Ecological Momentary Assessment was used to capture change in discomfort over time using a personal digital assistant (PDA) as the e-diary. The PDA was programmed with a survey containing 45 questions. Four groups of university students were randomised to either intervention (three external computer accessories) or to control. Participants reported less discomfort with the ergonomic chair and notebook riser based on the pre-post survey data and the e-diary/PDA ANOVA analysis. However, the PDA data, adjusted for the effect of hours per day of computer use, showed no benefit of the chair and limited benefit from the riser. Statement of Relevance:University students' use of notebook computers has increased. This study found evidence of a positive effect of an adjustable chair or notebook riser when combined with ergonomic training on reducing discomfort. Daily notebook computer use of 4 h was confirmed as a risk factor. Without some form of ergonomic intervention, these students are likely to enter the workforce with poor computing habits, which places them on the road to future injuries as technology continues to play a dominant role in their lives.
MeSH term(s)	Adolescent ; Analysis of Variance ; Boston ; Computer Peripherals ; Computers, Handheld ; Ergonomics ; Female ; Health Surveys ; Humans ; Male ; Medical Records ; Musculoskeletal Diseases/etiology ; Pain/etiology ; Posture/physiology ; Prevalence ; Risk Factors ; Self Report ; Students ; Surveys and Questionnaires ; Time Factors ; Universities ; Upper Extremity ; User-Computer Interface ; Young Adult
Language	English
Publishing date	2011-02
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1920-3
ISSN	1366-5847 ; 0014-0139
ISSN (online)	1366-5847
ISSN	0014-0139
DOI	10.1080/00140139.2010.544764
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Article: A highly reproducible method for two-dimensional thin-layer chromatography of multiple ganglioside samples.

Brownson, E / Irwin, L

Journal of neuroscience methods

1982 Volume 5, Issue 3, Page(s) 305–307

MeSH term(s)	Chromatography, Thin Layer/methods ; Gangliosides/analysis
Chemical Substances	Gangliosides
Language	English
Publishing date	1982-03
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	282721-9
ISSN	1872-678X ; 0165-0270
ISSN (online)	1872-678X
ISSN	0165-0270
DOI	10.1016/0165-0270(82)90082-6
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Zs.A 1486: Show issues

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Article: DepoFoam technology: a vehicle for controlled delivery of protein and peptide drugs.

Ye, Q / Asherman, J / Stevenson, M / Brownson, E / Katre, N V

Journal of controlled release : official journal of the Controlled Release Society

2000 Volume 64, Issue 1-3, Page(s) 155–166

Abstract: A major challenge in the development of sustained-release formulations for protein and peptide drugs is to achieve high drug loading sufficient for prolonged therapeutic effect coupled with a high recovery of the protein/peptide. This challenge has been ... ...

Abstract	A major challenge in the development of sustained-release formulations for protein and peptide drugs is to achieve high drug loading sufficient for prolonged therapeutic effect coupled with a high recovery of the protein/peptide. This challenge has been successfully met in the formulation of several peptide and protein drugs using the DepoFoam, multivesicular lipid-based drug delivery system. DepoFoam technology consists of novel multivesicular liposomes characterized by their unique structure of multiple non-concentric aqueous chambers surrounded by a network of lipid membranes. The objective of this paper is to demonstrate that DepoFoam technology can be used to develop sustained-release formulations of therapeutic proteins and peptides with high loading. DepoFoam formulations of a protein such as insulin, and peptides such as leuprolide, enkephalin and octreotide have been developed and characterized. The data show that these formulations have high drug loading, high encapsulation efficiency, low content of free drug in the suspension, little chemical change in the drug caused by the formulation process, narrow particle size distribution, and spherical particle morphology. Drug release assays conducted in vitro in biological suspending media such as human plasma indicate that these formulations provide sustained release of encapsulated drug over a period from a few days to several weeks, and that the rate of release can be modulated. In vivo pharmacodynamic studies in rats also show a sustained therapeutic effect over a prolonged period. These results demonstrate that the DepoFoam system is capable of efficiently encapsulating therapeutic proteins and peptides and effectively providing controlled delivery of these biologically active macromolecules.
MeSH term(s)	Animals ; Blood Proteins/analysis ; Chromatography, High Pressure Liquid ; Delayed-Action Preparations/pharmacokinetics ; Drug Delivery Systems/methods ; Drug Stability ; Enkephalins/administration & dosage ; Enkephalins/blood ; Enkephalins/chemistry ; Escherichia coli/genetics ; Humans ; In Vitro Techniques ; Insulin/administration & dosage ; Insulin/blood ; Insulin/chemistry ; Leuprolide/administration & dosage ; Leuprolide/blood ; Leuprolide/chemistry ; Liposomes/chemistry ; Liposomes/pharmacokinetics ; Microscopy, Confocal ; Octreotide/administration & dosage ; Octreotide/blood ; Octreotide/chemistry ; Particle Size ; Peptides/administration & dosage ; Peptides/blood ; Peptides/chemistry ; Proteins/administration & dosage ; Proteins/chemistry ; Rats ; Recombinant Proteins ; Time Factors
Chemical Substances	Blood Proteins ; Delayed-Action Preparations ; Enkephalins ; Insulin ; Liposomes ; Peptides ; Proteins ; Recombinant Proteins ; Leuprolide (EFY6W0M8TG) ; Octreotide (RWM8CCW8GP)
Language	English
Publishing date	2000-02-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	632533-6
ISSN	1873-4995 ; 0168-3659
ISSN (online)	1873-4995
ISSN	0168-3659
DOI	10.1016/s0168-3659(99)00146-7
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Zs.A 2055: Show issues

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Article: Conformationally constrained peptide drugs targeted at the blood-brain barrier.

Davis, T P / Abbruscato, T J / Brownson, E / Hruby, V J

NIDA research monograph

1995 Volume 154, Page(s) 47–60

MeSH term(s)	Amino Acid Sequence ; Animals ; Biological Transport ; Blood-Brain Barrier ; Humans ; Molecular Sequence Data ; Peptides/pharmacokinetics ; Permeability ; Protein Conformation ; Solubility
Chemical Substances	Peptides
Language	English
Publishing date	1995
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Review
ISSN	1046-9516
ISSN	1046-9516
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