Comparison of Post-Hemorrhoid Surgery Pain Profiles in Older and Younger Adults.

Introduction: Older and younger adults are offered similar analgesic options after hemorrhoid surgery (HS), but the differences in pain between the two populations are unknown. This study aims to compare postoperative pain outcomes after HS in older and younger individuals.

Methods: This is a retrospective analysis of electronic medical records of patients who underwent HS between 2018 and 2023.

Adjuvant chemotherapy in stage 1 colon cancer: Patient characteristics and survival analysis from the national cancer database.

Background: A subset of patients in ACS-NCDB with stage-1 colon cancer received adjuvant chemotherapy (AC), in contrast to national guidelines. This study aimed to define this population and evaluate associations between AC and survival.

Methods: Patients with T1-2N0 colon cancer from 2004 to 2016 were separated into AC and non-AC groups.

Gender and Racial Diversity Among Colon and Rectal Surgery Trainees and Leaders.

Background: Despite recent changes in women and underrepresented minorities in medicine, there still exists large gender and racial gaps in surgical training and leadership.

Objective: We hypothesize that gender and racial representation have improved among general and colorectal surgical trainees and leadership over the past 20 years.

Design: This cross-sectional study examines gender and racial representation of general and colorectal surgery residents, colorectal faculty members, and the American Society of Colon and Rectal Surgeons Executive Council.

Understanding the Well-Being of General Surgery Residents.

Background: In 2017, the Accreditation Council for Graduate Medical Education program guidelines changed to include a section that requires programs to optimize resident and faculty member well-being. There is still a poor understanding of general surgery resident wellness, and there are few well-established wellness programs.

Methods: We created a novel 50-question anonymous survey to assess burnout, depression, and wellness that was distributed to the general surgery residents as part of a pilot study.

Femoral Neck Shortening After Hip Fracture Fixation Is Associated With Inferior Hip Function: Results From the FAITH Trial.

Objective: To describe the distribution of femoral neck shortening after internal fixation and to determine whether shortening is associated with inferior hip function at 24 months after a hip fracture in patients 50 years of age or older.

Design: Retrospective cohort study.

Setting: A secondary analysis of data from 81 clinical centers included in the Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH) trial.

Staple Line Treatment and Bleeding After Laparoscopic Sleeve Gastrectomy.

Background And Objectives: Staple line treatment during laparoscopic sleeve gastrectomy (LSG) remains a controversial issue among bariatric surgeons. The objective of this study was to compare rates of postoperative bleeding (POB) among various methods of staple line reinforcement.

Methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 dataset was queried for patients undergoing an LSG.

A F magnetic resonance imaging-based diagnostic test for bile acid diarrhea.

In up to 50% of people diagnosed with a common ailment, diarrhea-predominant irritable bowel syndrome, diarrhea results from excess spillage of bile acids into the colon-data emerging over the past decade identified deficient release of a gut hormone, fibroblast growth factor 19 (FGF19), and a consequent lack of feedback suppression of bile acid synthesis as the most common cause. Selenium homotaurocholic acid (SeHCAT) testing, considered the most sensitive and specific means of identifying individuals with bile acid diarrhea, is unavailable in many countries, including the United States. Other than SeHCAT, tests to diagnose bile acid diarrhea are cumbersome, non-specific, or insufficiently validated; clinicians commonly rely on a therapeutic trial of bile acid binders.

Attenuated Accumulation of Novel Fluorine (F)-Labeled Bile Acid Analogues in Gallbladders of Fibroblast Growth Factor-15 (FGF15)-Deficient Mice.

Our work has focused on defining the utility of fluorine (F)-labeled bile acid analogues and magnetic resonance imaging (MRI) to identify altered bile acid transport in vivo. In the current study, we explored the ability of this approach to differentiate fibroblast growth factor-15 (FGF15)-deficient from wild-type (WT) mice, a potential diagnostic test for bile acid diarrhea, a commonly misdiagnosed disorder. FGF15 is the murine homologue of human FGF19, an intestinal hormone whose deficiency is an underappreciated cause of bile acid diarrhea.

Postoperative bleeding after laparoscopic Roux en Y gastric bypass: predictors and consequences.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common, safe and effective bariatric procedure. Bleeding is a significant source of postoperative morbidity. We aimed to determine the incidence, outcomes, and predictors of postoperative bleeding after LRYGB.

Diminished gallbladder filling, increased fecal bile acids, and promotion of colon epithelial cell proliferation and neoplasia in fibroblast growth factor 15-deficient mice.

Fibroblast growth factor-19 (human FGF19; murine FGF15) suppresses bile acid synthesis. In FGF19 deficiency, diarrhea resulting from bile acid spillage into the colon mimics irritable bowel syndrome. To seek other consequences of FGF19/15 deficiency, we used and wild-type (WT) mice to assess gallbladder filling, the bile acid pool, fecal bile acid levels, and colon neoplasia.

Targeting M3 Muscarinic Receptors for Colon Cancer Therapy.

Background: Expression and activation of subtype-3 muscarinic receptors (M3R) plays an important role in the progression of colorectal neoplasia.

Method: Herein, we describe the role of muscarinic receptors in colon cancer, focusing specifically on M3R, illustrate how M3R over-expression and activation of post-receptor signaling pathways potentiates tumor progression, and explore the efficacy and safety of a variety of therapeutic approaches that can target the molecules involved.

Results: Colon cancers overexpress M3R mRNA (CHRM3) and protein, and post-M3R signaling stimulates cell proliferation.

Two sides to colon cancer: mice mimic human anatomical region disparity in colon cancer development and progression.

Aim: Strong evidence reveals important differences between cancers in the proximal . distal colon. Animal models of metastatic colon cancer are available but with varying degrees of reproducibility and several important limitations.

Exponential decay modeling can define parameters of weight loss trajectory after laparoscopic Roux-en-Y gastric bypass.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) produces durable and clinically significant weight loss. We aim to characterize the trajectory of weight loss, and demonstrate the predictive ability of three-month performance on final weight loss.

Methods: Retrospective analysis of 1097 consecutive LRYGB patients allowed for assessment of conformity of various weight loss trajectory models.

Pelvic floor disorders in women with gynecologic malignancies: a systematic review.

Introduction And Hypothesis: Pelvic floor disorders (PFDs) negatively affect quality of life in the general population, and their prevalence in gynecologic cancer survivors has not been systematically described. This study aimed to determine the prevalence of PFDs in cancer survivors. We hypothesized that the prevalence of PFDs in the gynecologic cancer population would be higher than in the general female population.

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport.

Along with their traditional role as detergents that facilitate fat absorption, emerging literature indicates that bile acids are potent signaling molecules that affect multiple organs; they modulate gut motility and hormone production, and alter vascular tone, glucose metabolism, lipid metabolism, and energy utilization. Changes in fecal bile acids may alter the gut microbiome and promote colon pathology including cholerrheic diarrhea and colon cancer. Key regulators of fecal bile acid composition are the small intestinal Apical Sodium-dependent Bile Acid Transporter (ASBT) and fibroblast growth factor-19 (FGF19).