17 results on '"Robert Bulat"'
Search Results
2. S1575 The Use of Post-Prandial Breath Hydrogen to Monitor Antibiotic-Induced Changes in the Activity of the Gut Microbiome
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Guillermo Barahona, Aine Moran, Barry McBride, Kedrick Harrison, Luisa Villatoro, Robert Burns, Bo Konings, Robert Bulat, Megan McKnight, Claire Shortt, and Pankaj Jay Pasricha
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Hepatology ,Gastroenterology - Published
- 2022
3. Postprandial symptoms in patients with symptoms of gastroparesis: roles of gastric emptying and accommodation
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Henry P. Parkman, Mark L. Van Natta, Alan H. Maurer, Kenneth L. Koch, Madhusudan Grover, Zubair Malik, Irene Sarosiek, Thomas L. Abell, Robert Bulat, Braden Kuo, Robert J. Shulman, Gianrico Farrugia, Laura Miriel, James Tonascia, Frank Hamilton, Pankaj J. Pasricha, and Richard W. McCallum
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Gastroparesis ,Hepatology ,Gastric Emptying ,Physiology ,Physiology (medical) ,Gastroenterology ,Diabetes Mellitus ,Humans ,Water ,Nausea ,Research Article ,Abdominal Pain - Abstract
Patients often are evaluated for gastroparesis because of symptoms occurring with meals. Gastric emptying scintigraphy (GES) is used for gastroparesis diagnosis, although results are not well correlated with gastroparesis symptoms. The aim of this study is to assess relationships between gastroparesis symptoms, gastric emptying (GE), and gastric accommodation (GA). Patients with symptoms of gastroparesis completed the Patient Assessment of Upper GI Symptoms (PAGI-SYM) and recorded symptoms during GES and water load satiety test (WLST), an indirect assessment for GA. A total of 109 patients with gastroparesis symptoms were assessed. Symptom severity increased after GES meal for stomach fullness, belching, nausea, abdominal burning, and abdominal pain. There was no difference in symptoms after meal between patients with delayed (n = 66) and normal (n = 42) GE. Diabetic patients (n = 26) had greater gastric retention than idiopathic patients (n = 78), but idiopathic patients had greater postprandial nausea, stomach fullness, and abdominal pain. Water consumed during WLST averaged 421 ± 245 mL. Idiopathic patients had greater nausea scores during WLST than diabetic patients. In comparison to those with normal water consumption (≥238 mL; n = 80), patients with impaired water ingestion (
- Published
- 2022
4. Improving the Diagnosis of SIBO Using an At-Home Handheld App Connected Breath Analysis Device (AIRE)
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Guillermo Barahona, Barry Mc Bride, Áine Moran, Sahar Hawamdeh, Luisa Villatoro, Robert Burns, Bo Konings, Robert Bulat, Megan McKnight, Claire Shortt, and Pankaj J. Pasricha
- Abstract
INTRODUCTIONSmall Intestinal Bacterial Overgrowth (SIBO) is a common yet underdiagnosed condition. Lactulose hydrogen breath tests (LHBT) are typically used to detect SIBO; however, current breath testing methods require specialised, expensive equipment and technical support and are either done at a point-of-care facility and/or have to be mailed to a central laboratory. To address these issues a novel hand-held breath analyzer (AIRE®, FoodMarble) was tested. The aims of this study were first, to perform a technical assessment of the AIRE device, second to compare the performance of the AIRE device against a commercially available mail-in LHBT kit using a zero-inflated negative binomial mixed effect model.METHODSThree AIRE devices were tested with certified test gases covering a diagnostically meaningful range (hydrogen mixed with air at 3 ppm, 10 ppm and 50 ppm). For the clinical study, 36 patients suspected to have SIBO presenting to a tertiary level clinic were provided with an AIRE device and performed concurrent LHBTs at home with a mail-in LHBT kit.RESULTSThe overall average readings (mean ± SD) for the AIRE devices tested at 3 ppm, 10 ppm and 50 ppm H2 were: 3.5 ± 0.7 ppm; 10.7 ± 1.1 ppm and 49.5 ± 2.6 ppm respectively. The overall mean absolute error across the tested devices was 1.2 ppm. A significant positive correlation (r = 0.78, p < 0.001) was demonstrated between AIRE and mail-in kit H2 values.DISCUSSIONThe AIRE device is a compelling alternative to mail-in LHBT kits for the diagnosis of SIBO. The AIRE device may also offer advantages over other traditional breath testing methods.
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- 2022
5. Progress in Gastroparesis - A Narrative Review of the Work of the Gastroparesis Clinical Research Consortium
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Pankaj J. Pasricha, Madhusudan Grover, Katherine P. Yates, Thomas L. Abell, Kenneth L. Koch, Richard W. McCallum, Irene Sarosiek, Cheryl E. Bernard, Braden Kuo, Robert Bulat, Robert J. Shulman, Bruno P. Chumpitazi, James Tonascia, Laura A. Miriel, Laura A. Wilson, Mark L. Van Natta, Emily Mitchell, Frank Hamilton, Gianrico Farrugia, and Henry P. Parkman
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Gastroparesis ,Treatment Outcome ,Hepatology ,Gastric Emptying ,Gastroenterology ,Humans ,Multicenter Studies as Topic - Abstract
The Gastroparesis Clinical Research Consortium is a multicenter coalition created and funded by the National Institutes of Diabetes and Digestive and Kidney Disorders, with a mission to advance understanding of the pathophysiology of gastroparesis and develop an effective treatment for patients with symptomatic gastroparesis. In this review, we summarize the results of the published Gastroparesis Clinical Research Consortium studies as a ready and convenient resource for gastroenterologists and others to provide a clear understanding of the consortium's experience and perspective on gastroparesis and related disorders.
- Published
- 2021
6. List of Contributors
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Thomas Abell, Nitin K. Ahuja, M. Showkat Ali, Sreerup Banerjee, Mohammad Bashashati, Laren Becker, Meagan Bridges, Robert Bulat, Michael Camilleri, David J. Cangemi, Florencia Carbone, Lakshmikanth L. Chikkamenahalli, John O. Clarke, Brian R. Davis, Maryangela DeGrazia-DiTucci, Jesus Diaz, Yellowlees Douglas, Mohamed Elmasry, Liz Febo-Rodriguez, Reid Fletcher, Mark Fox, Marvin I. Friedman, Mahesh Gajendran, Prianka Gajula, Zorisadday Gonzalez, Madhusudan Grover, Gulara Hajiyeva, Ciel Harris, William L. Hasler, Carissa Haston, Michael Horowitz, MariaLisa Itzoe, Safwan Jaradeh, Karen L. Jones, Anthony N. Kalloo, Joyce E. King, Kenneth L. Koch, Braden Kuo, Brian E. Lacy, Allen Lee, Linda A. Lee, Ta-ya Lee, Marissa Lombardi, Luca Marciani, Alan H. Maurer, Richard McCallum, Richard W. McCallum, Baha Moshiree, Saowanee Ngamruengphong, Helen Parker, Henry P. Parkman, Eamonn M.M. Quigley, Christopher K. Rayner, Dennis Revicki, Ceciel Rooker, Irene Sarosiek, Ron Schey, Jolien Schol, Robert J. Shulman, Malorie Simons, Dong In Sinn, Samantha Smith, Terence K. Smith, William J. Snape, Estelle T. Spear, Lee L. Swanström, Jan Tack, Aylin Tansel, Glenn J. Treisman, Melissa Adams VanHouten, Christopher David Vélez, and John M. Wo
- Published
- 2021
7. Functional Dyspepsia and Gastroparesis in Tertiary Care are Interchangeable Syndromes With Common Clinical and Pathologic Features
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Pankaj J. Pasricha, Madhusudan Grover, Katherine P. Yates, Thomas L. Abell, Cheryl E. Bernard, Kenneth L. Koch, Richard W. McCallum, Irene Sarosiek, Braden Kuo, Robert Bulat, Jiande Chen, Robert J. Shulman, Linda Lee, James Tonascia, Laura A. Miriel, Frank Hamilton, Gianrico Farrugia, Henry P. Parkman, Pankaj Jay Pasricha, Robert Burns, Guillermo Barahona Hernandez, Megan McKnight, April Mendez, Kyle Staller, Andrea Thurler, Christopher Velez, Casey Silvernale, Zubair Malik, Alan Maurer, Amiya Palit, Natalia Vega, Denise Vasquez, Sean Connery, Karina Espino, Marvin Friedman, Thomas Abell, Abigail Stocker, Bridget Cannon, Lindsay McElmurray, Kelly Cooper, Catherine McBride, Kenneth Koch, Lynn Baxter, Anya Brown, Paula Stuart, Amirah Abdullah, William Snape, Nata DeVole, Karen Earle, Kjersti Kirkeby, Candice Lee, Mimi Lin, Doug Troyer, Anna von Bakonyi, Robert Shulman, Bruno Chumpitazi, Liz Febo-Rodriguez, John Hollier, Cynthia Bouette, Heather Charron, Samuel Nurko, Stephanie Wall, Madeline Kane, Kent Williams, Lina Yossef-Salameh, Frederick Woodley, Cheryl Bernard, Jose Serrano, Sherry Hall, Stephen James, Rebecca Torrance, Margaret Adamo, Patricia Belt, John Dodge, Michele Donithan, Milana Isaacson, Jill Meinert, Laura Miriel, Emily Sharkey, Jacqueline Smith, Michael Smith, Alice Sternberg, Mark Van Natta, Annette Wagoner, Laura Wilson, Goro Yamada, and Katherine Yates
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Gastroparesis ,Vomiting ,Gastroenterology ,Tertiary care ,Severity of Illness Index ,Tertiary Care Centers ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Internal medicine ,medicine ,Upper gastrointestinal ,Humans ,Registries ,Dyspepsia ,Hepatology ,Gastric emptying ,Adult patients ,business.industry ,Stomach ,Nausea ,Middle Aged ,medicine.disease ,Interstitial Cells of Cajal ,Pathophysiology ,Interstitial cell of Cajal ,Abdominal Pain ,030104 developmental biology ,medicine.anatomical_structure ,Gastric Emptying ,Case-Control Studies ,symbols ,030211 gastroenterology & hepatology ,Female ,Symptom Assessment ,business - Abstract
Background The aim of this study was to clarify the pathophysiology of functional dyspepsia (FD), a highly prevalent gastrointestinal syndrome, and its relationship with the better-understood syndrome of gastroparesis. Methods Adult patients with chronic upper gastrointestinal symptoms were followed up prospectively for 48 weeks in multi-center registry studies. Patients were classified as having gastroparesis if gastric emptying was delayed; if not, they were labeled as having FD if they met Rome III criteria. Study analysis was conducted using analysis of covariance and regression models. Results Of 944 patients enrolled during a 12-year period, 720 (76%) were in the gastroparesis group and 224 (24%) in the FD group. Baseline clinical characteristics and severity of upper gastrointestinal symptoms were highly similar. The 48-week clinical outcome was also similar but at this time 42% of patients with an initial diagnosis of gastroparesis were reclassified as FD based on gastric-emptying results at this time point; conversely, 37% of patients with FD were reclassified as having gastroparesis. Change in either direction was not associated with any difference in symptom severity changes. Full-thickness biopsies of the stomach showed loss of interstitial cells of Cajal and CD206+ macrophages in both groups compared with obese controls. Conclusions A year after initial classification, patients with FD and gastroparesis, as seen in tertiary referral centers at least, are not distinguishable based on clinical and pathologic features or based on assessment of gastric emptying. Gastric-emptying results are labile and do not reliably capture the pathophysiology of clinical symptoms in either condition. FD and gastroparesis are unified by characteristic pathologic features and should be considered as part of the same spectrum of truly "organic" gastric neuromuscular disorders. ClinicalTrials.gov Identifier NCT00398801, NCT01696747
- Published
- 2020
8. Strongyloides stercoralis Hyperinfection Syndrome as a Cause of Fatal Gastrointestinal Hemorrhage
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Helen Tsai, Shanti Rao, Yukihiro Nakanishi, Robert Bulat, and Eugenia Tsai
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Abdominal pain ,medicine.medical_specialty ,biology ,medicine.diagnostic_test ,Exploratory laparotomy ,business.industry ,Esophagogastroduodenoscopy ,medicine.medical_treatment ,Case Report ,General Medicine ,Bleed ,biology.organism_classification ,Gastroenterology ,Small Bowel ,Strongyloides stercoralis ,medicine.anatomical_structure ,Internal medicine ,medicine ,Duodenum ,Embolization ,Neurosurgery ,medicine.symptom ,business - Abstract
Strongyloides stercoralis is a small intestinal nematode that is widespread in regions with poor sanitation. We present a 57-year-old man from Colombia who was undergoing corticosteroid therapy for a meningioma who presented after neurosurgery with abdominal pain and a profound gastrointestinal (GI) bleed. The patient underwent an esophagogastroduodenoscopy (EGD), an attempted embolization, and an exploratory laparotomy to remove the necrosed duodenum. His pathology examination revealed Strongyloides infection of the duodenum, and he died of profound blood loss. This rare diagnosis displays the importance of screening patients at a high risk of Strongyloides infection before starting glucocorticoid therapy.
- Published
- 2019
9. Occamʼs Razor or Hickamʼs Dictum?
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Eugenia Tsai, Adam Greenwod, Christopher Ducoin, and Robert Bulat
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Hepatology ,Gastroenterology - Published
- 2016
10. Oropharyngeal dysphagia
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Roy C. Orlando and Robert Bulat
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Pediatrics ,medicine.medical_specialty ,Neuromuscular disease ,business.industry ,Multiple sclerosis ,Gastroenterology ,Disease ,Aspiration pneumonia ,medicine.disease ,Dysphagia ,medicine.anatomical_structure ,otorhinolaryngologic diseases ,medicine ,Etiology ,medicine.symptom ,Esophagus ,business ,Oropharyngeal dysphagia - Abstract
Oropharyngeal dysphagia is not a single disease but a symptom complex that is recognized by difficulty in transfer of a food bolus from mouth to esophagus or by signs and symptoms of aspiration pneumonia or nasal regurgitation. Its etiologies are legion, with the most common result of underlying neuromuscular disease, including cerebrovascular accidents, Parkinson's disease, multiple sclerosis, and muscular dystrophy. There are two methods of treatment for oropharyngeal dysphagia; one is specific and directed at the underlying disease and the other is general (supportive) and designed to preserve oral intake for nutrition while preventing aspiration pneumonia. Following a general discussion of the etiology and clinical presentation of orophyarngeal dysphagia, a description of the methods for supportive care is presented as well as the approach to the treatment of cricopharyngeal dysfunction and Zenker's diverticulum.
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- 2005
11. Butter Blood
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Camille S. Thélin, Justin Miller, and Robert Bulat
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Hepatology ,Traditional medicine ,business.industry ,Gastroenterology ,Medicine ,business - Published
- 2016
12. Effects of Esophageal Stimulation in Patients With Functional Disorders of the Gastrointestinal Tract
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G. Shine, Gervais Tougas, Stephan Hollerbach, D. Fitzpatrick, Absar Bajwa, Robert Bulat, Ernest L. Fallen, Markad V. Kamath, Adrian R.M. Upton, and Andrew May
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Adult ,Chest Pain ,medicine.medical_specialty ,Adolescent ,Gastrointestinal Diseases ,Biomedical Engineering ,Stimulation ,Chest pain ,Esophagus ,Diabetic Neuropathies ,Heart Rate ,Evoked Potentials, Somatosensory ,Internal medicine ,Heart rate ,medicine ,Humans ,Heart rate variability ,Evoked potential ,Child ,Cerebral Cortex ,Esophageal disease ,business.industry ,Reproducibility of Results ,medicine.disease ,Event-Related Potentials, P300 ,Electric Stimulation ,Vagus nerve ,Autonomic nervous system ,Endocrinology ,Case-Control Studies ,Cardiology ,Perception ,medicine.symptom ,business - Abstract
We studied the effects of esophageal electrical stimulation on cortical-evoked potentials (EPs) and power spectrum of heart rate variability (PS/HRV) in patients with diabetes and non-cardiac chest pain (NCCP). We also recorded cognitive-evoked potentials (P300 EPs) in response to an odd-ball stimulation in patients with NCCP. Diabetic patients did not yield reproducible cortical EPs. Their power spectra of heart rate variability (PS/HRV) showed an increased vagal modulation during stimulation. In patients with NCCP the P300 EPs were of greater amplitude (17 +/- 3 microV vs. 12 +/- 1 microV in controls, p0.04), while peak latencies were slightly elongated in patients (382 +/- 22 ms vs. 354 +/- 12 ms in controls). The PS/HRV in these patients also showed an increased vagal modulation of the sinus node activity. Our results suggest the following: (1) in patients with diabetes, afferent pathways and processing of sensory signals are likely to be impaired; (2) an increased perception of esophageal stimulation reflects an exaggerated brainstem response and altered cortical processing of visceral sensation in patients with NCCP.
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- 2000
13. Delayed gastric emptying and glucose control in early type 2 diabetes
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Robert Bulat
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medicine.medical_specialty ,Gastroparesis ,Glucose control ,Gastric emptying ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Gastroenterology ,Early type ,Endocrinology ,Diabetes Mellitus, Type 2 ,Gastric Emptying ,Internal medicine ,Diabetes mellitus ,Asymptomatic Diseases ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Female ,business - Published
- 2012
14. Double endoscopic technique for operative dilation of esophageal strictures resistant to conventional therapy
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Stephanie D, Malliaris, Andrew J, Nemechek, Robert, Bulat, and Bernard M, Jaffe
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Adult ,Gastrostomy ,Male ,Esophageal Neoplasms ,Endoscopy, Gastrointestinal ,Esophageal Stenosis ,Gastroesophageal Reflux ,Esophagitis ,Humans ,Female ,Esophagoscopy ,Treatment Failure ,Deglutition Disorders ,Aged - Abstract
Esophageal strictures are a common problem causing significant morbidity for affected patients. Most can be treated safely and successfully with esophageal dilation. We have treated two patients with post-radiation esophageal strictures so tight that standard dilation technique failed even with an aggressive approach. We utilized a technique for operative dilation of these strictures using both antegrade and retrograde endoscopes. This approach for refractory esophageal strictures has only twice been previously reported. In both patients, a gastrostomy was placed and an endoscope was subsequently passed from the stomach retrograde up to the level of the stricture. Another endoscope was passed from above down to the proximal portion of the stricture. Illuminating the stricture, using fluoroscopy, carefully passing a wire, and grasping and pulling the wire with forceps from the opposite endoscope allowed for safe passage through the stricture. Savary dilators were utilized to effectively dilate the strictures. A method for protection of the lumen for subsequent dilations by passing a small catheter through the stricture was also developed. This technique offers an option for patients with otherwise untreatable strictures, with the major advantage of visualization from above and below.
- Published
- 2007
15. Pill Esophagitis
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Robert Bulat and Nathaniel S. Winstead
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Esophagogastroduodenoscopy ,medicine.medical_treatment ,Gastroenterology ,Disease ,Discontinuation ,Sucralfate ,Therapeutic endoscopy ,Intervention (counseling) ,medicine ,Bougienage ,Pill esophagitis ,Intensive care medicine ,business ,medicine.drug - Abstract
Pill esophagitis is a preventable cause of morbidity. Simple advice on how and when to take medication could probably prevent most cases of the illness. Avoidance of implicated medications in patients with significant risk factors for developing pill esophagitis could prevent additional cases. When the disease presents despite these preventive measures, the mainstays of treatment are immediate discontinuation of the offending agent and supportive care. If the diagnosis is in question, the principle diagnostic modalities are double-contrast barium esophagogram and esophagogastroduodenoscopy. Medical management of moderate to severe cases includes sucralfate to coat, protect, and promote healing of ulcerated esophageal mucosa, and acid-suppressing therapy if gastroesophageal reflux disease is felt to have played a role in the pathogenesis of the illness. Rare cases may require therapeutic endoscopy or surgical intervention early in the disease course. Late complications include esophageal strictures that may require therapeutic endoscopy or bougienage.
- Published
- 2004
16. Factors Influencing Choice of Alternative Feeding Method in Patients with Refractory Gastroparesis
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Robert Bulat, Christopher Hodnette, and Monika Kowalczyk
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medicine.medical_specialty ,Hepatology ,Refractory ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,In patient ,Gastroparesis ,medicine.disease ,business - Published
- 2013
17. Clinical Outcomes in Wireless Capsule Endoscopy on Occult Gastrointestinal Bleeding at Tulane University Hospital and Clinic from 2003 to Hurricane Katrina
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Geoffrey Kitzman, Robert Bulat, and Scott Pollack
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Gastrointestinal bleeding ,medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,medicine.disease ,University hospital ,Occult ,law.invention ,Hurricane katrina ,Capsule endoscopy ,law ,medicine ,business - Published
- 2009
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