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Authors Lin Chang, MD Jennifer Christie, MD Rosemarie Fisher, MD Rebekah Gross, MD Amy Foxx-Orenstein, MD Asma Khapra, MD Caroline Loeser, MD Suwebatu.

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Presentation on theme: "Authors Lin Chang, MD Jennifer Christie, MD Rosemarie Fisher, MD Rebekah Gross, MD Amy Foxx-Orenstein, MD Asma Khapra, MD Caroline Loeser, MD Suwebatu."— Presentation transcript:

1 Authors Lin Chang, MD Jennifer Christie, MD Rosemarie Fisher, MD Rebekah Gross, MD Amy Foxx-Orenstein, MD Asma Khapra, MD Caroline Loeser, MD Suwebatu T. Odunsi, MD Lin Chang, MD Jennifer Christie, MD Rosemarie Fisher, MD Rebekah Gross, MD Amy Foxx-Orenstein, MD Asma Khapra, MD Caroline Loeser, MD Suwebatu T. Odunsi, MD Ann Ouyang, MBBS S. Devi Rampertab, MD Robin Rutherford, MD Pratima Sharma, MD, MS Grace L. Su, MD Trinh Truong, MD Jacqueline Wolf, MD Rebecca Van Dyke, MD Ann Ouyang, MBBS S. Devi Rampertab, MD Robin Rutherford, MD Pratima Sharma, MD, MS Grace L. Su, MD Trinh Truong, MD Jacqueline Wolf, MD Rebecca Van Dyke, MD Senior Author Suzanne Rose, MD, MSEd Professor of Medical Education and Medicine Mount Sinai School of Medicine GASTROSLIDES Project Director Jean-Pierre Raufman Professor of Medicine University of Maryland School of Medicine GASTROSLIDES Project Director Jean-Pierre Raufman Professor of Medicine University of Maryland School of Medicine GASTROSLIDES Art Director Jerry Schoendorf, MAMS Duke University Medical Center GASTROSLIDES Art Director Jerry Schoendorf, MAMS Duke University Medical Center Digestive Health and Disease in W men

2 Pathophysiology of GERD Castell Do et al. Aliment Pharmacol Ther 2004; 20 (Suppl 9):14 Lower esophageal sphincter (LES) Decreased salivation Impaired esophageal acid clearance Impaired tissue resistance Decreasing resting tone of LES Delayed gastric emptying Transient LES relaxation Duodenum GERD / Dyspepsia II-4

3 Anorectal angle Descent of pelvic floor Straining to defecate Symphysis pubis Symphysis pubis Anorectal angle Coccyx External anal sphincter Puborectalis Rectum At rest Pelvic Floor Musculature Constipation IV-9

4 Chapron C et al. Human Reproduction 2006: 21:1839 Deeply Infiltrating Endometriosis of the Digestive Tract: Anatomical Distribution Omentum1.7% Omentum1.7% Cecum andileocecal junction4.1% Cecum andileocecal junction4.1% Appendix6.4% Appendix6.4% Small bowel4.7% Small bowel4.7% Sigmoid colon17.4% Sigmoid colon17.4% Rectosigmoidjunction and rectum65.7% Rectosigmoidjunction and rectum65.7% V-54

5 Effects of Estrogens/Pregnancy on Transporters Involved in Cholesterol Excretion Cholesterol Sinusoid to bile duct Liver Gall bladder Common bile duct Hepatocyte NTCP OATPs Bilirubin Bile Acids Na + ABC C2 ABC B11 ABC G5/G8 ABC B4 Phosphatidylcholine (PC) Pregnancy and Liver Disease Geier A, et al. BBA 2007; 1773:283 VII-79

6 Mitochondrial  -Oxidation and Oxidative Phosphorylation Outer membrane Inner membrane CO 2 O2O2 O2O2  oxidation Citric acid cycle Acetyl Co-A Fatty acids NADH e - ATP H2OH2O H2OH2O H+H+ H+H+ H+H+ H+H+ H+H+ H+H+ H+H+ H+H+ ADP+P i VIII-61 Mitochondrial  -Oxidation and Oxidative Phosphorylation

7 Barriers to Successful Colonoscopy in Women  Completion Rates  Women88-96%  Men %  Anatomical differences  Low BMI  Previous pelvic surgery  Hysterectomy  Diverticulosis in women  Completion Rates  Women88-96%  Men %  Anatomical differences  Low BMI  Previous pelvic surgery  Hysterectomy  Diverticulosis in women Church JM. American Journal of Gastroenterology 1994; 89(4):556 Anderson JC et al. Gastrointestinal Endoscopy 2001; 54(5):558 Church JM. American Journal of Gastroenterology 1994; 89(4):556 Anderson JC et al. Gastrointestinal Endoscopy 2001; 54(5):558 Special Issues - Colon Cancer IX-12

8 Nutrition X-3 Diet vitamin D 3 and D 2 Vitamin D 3 7-dehydroxycholesterol Vitamin D 3 7-dehydroxycholesterol UVB Vitamin D 3 + VDBP or albumin Enterocyte Chylomicron + vitamin D Enterocyte Chylomicron + vitamin D 25-hydroxylase 25-OHD 1  hydroxylase 1,25-(OH) 2 vitamin D Active form of vitamin D 1,25-(OH) 2 vitamin D Active form of vitamin D Terminal ileum Reabsorption of bile salts and conjugated vitamin D metabolites Bile salts and conjugated vitamin D Skin Small intestine Vitamin D Absorption


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