Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Esophageal pseudodiverticulosis presenting with massive gastrointestinal bleed

Abstract: Purpose: Introduction: Esophageal intramural pseudodiverticulosis (EIP) is a rare benign disease of uncertain significance. We report a case of EIP which presented with massive self-limiting gastrointestinal bleed. Case: A 63 year old male presented to the emergency department with hematemesis and postural dizziness. His medical history was significant for coronary artery disease, diabetes mellitus, hypertension, esophageal candidiasis, alcohol and tobacco abuse. His heart rate was 111 per minute and BP was 104/70 mmHg without orthostasis. Abdominal examination did not reveal any significant abnormality. His hemoglobin was 12.7 gm/dl and hematocrit 40.2% compared to baseline values of 13.7 gm/dl and 44% respectively. In the emergency department he had two bouts of hematemesis with clots and a significant decline in hematocrit. He was volume resuscitated, started on esomeprazole infusion and transfused two units of packed RBC. After stabilization EGD was performed which revealed extensive pseudodiverticulosis of the esophagus from about 25 cm down to the distal esophagus. Erosive non-bleeding reflux induced distal esophagitis was also seen (Los Angeles Grade B). He remained stable during hospital stay without any recurrence of bleeding and was subsequently discharged on oral omeprazole. Discussion: EIP is a rare disease characterized by small sac like out pouching of the esophageal wall. Men between the ages of 50-70 years are most commonly affected and reflux esophagitis, diabetes mellitus and chronic alcoholism are well known associations. This benign esophageal disease is also known to be associated with candidial, herpetic and eosinophilic esophagitis. Our patient had a history of esophageal candidiasis which along with multiple other risk factors may have contributed to the pathogenesis of pseudodiverticuli. The pathophysiology of EIP remains unclear. The most widely accepted hypothesis is based on chronic mucosal inflammation resulting in squamous metaplasia of glandular epithelium with ductal dilatation and formation of pseudodiverticuli. Although esophagitis is a very commonly observed endoscopic finding, pseudodiverticulosis is extremely rare and this paradox is difficult to explain. Most patients present with dysphagia, odynophagia or chest tightness, hematemesis is rare. There are only two reported cases of EIP presenting with gastrointestinal bleeding. Endoscopy is the diagnostic test of choice and these small diverticular openings can be missed in the absence of detailed examination with adequate air insufflation. Treatment is aimed at relieving obstructive symptoms when present or treating underlying causes such as esophagitis in our case.

SGLT2 inhibitors reduce adverse renal and CV outcomes in patients with or without diabetes

Abstract: Nuffield Department of Population Health Renal Studies Group; SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists' Consortium. Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet. 2022;400:1788-801. 36351458.

Haemoglobin A1c as a screening tool to identify pre‐diabetes and diabetes in postpartum women with gestational diabetes

Abstract: The primary objective of this study was to determine the right test and time for postpartum screening of women with gestational diabetes to identify diabetes mellitus or impaired glucose tolerance. Retrospective data were collected on women with gestational diabetes followed at the Center for Diabetes and Metabolic Care at Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA. Of the 150 women included in this study, blood work was completed in 42 (28%) of the subjects. Of the women completing laboratory tests, 23 of them (56.1%) had an abnormal test result. Using the standard tests, 15 (41.7%) of the women tested positive based on HbA1c ≥5.7% (39 mmol/mol), six (16.7%) based on fasting glucose ≥100 mg/dl (5.6 mmol/L), and 10 (27%) based on 2-hour 75 g oral glucose tolerance test (OGTT) ≥140 mg/dl (7.8 mmol/L). However, due to better negative predictive value, HbA1c was more accurate than 2-hour OGTT. Of the standard testing available, HbA1c alone identified the majority of the subjects with an abnormal test. Copyright © 2016 John Wiley & Sons.

Memory, Identity, and Community: A Creatively Faithful Approach to the Formation of a Theology of Interment.

Abstract: While the die is cast regarding the valid inclusion of cremation in Catholic funeral rites and liturgies given that certain required criteria are met, recent years have given rise to a new problematic regard the treatment of cremains, in particular the assignment of a final resting place. Recent statistics attest that approximately two-thirds of cremains are not interred by the family members too whom their care is entrusted. Failure to bury the ashes may not imply a malicious intent on the the part of the faithful who remain; however, such inadvertence implies a lacuna in contemporary thought to articulate a clear theology of interment with sigificant attention to cremains. Specifically, disregard for the importance of the burial of cremains indicates something of a theological void in three specific areas. First, casual treatment of the deceased's ashes indicates a failure to be aware of and understand the connection between Christ's burial and our own, most notably in the theological meaning of Christ's rest in the tomb on Holy Saturday. Second, a covert yet telling misunderstanding of the symbolic role of interment in the theology of the resurrection of the body is subtly communicated by this neglect in the obsequy. Third, failure to inter a loved one's ashes may supplant the ultimate connection of all the members of the Communion of Saints with the need for a proximate connection of the physical possession of remains. Accordingly, the present study will suggest anamnesis of Holy Saturday, awareness of the intricacies of the tomb in the theological dynamic of the resurrection of the dead, specifically the contours of resurrected identity , and a refined understanding of the various metaphysical components of the Communion of Saints as a both a pyschological and theological corrective to the need for physical connectedness through personal retention of cremains. Such an amendatory approach will serve as the foundation for the fuller development of a Catholic Theology of Interment and better understanding of the eschatological context of Catholic funerary practices. Inteneded Audience and Goal of Article: Graduate Students, Clergy, and Professional Pastoral Ministers who teach, catechize, and minister in the areas of eschatology, liturgy, and bereavement.