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- 저자 : Jessica Kirby (검색결과 4 건)
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Jessica A. Paynter,Kirby R.Qin,Georgia Seamer,Ruchira Fernando,Janelle Brennan,Chun Hin Angus Lee 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.3
Colitis caused by vasculitis is a rare and poorly understood pathology. Little evidence exists on its clinical presentation, path to diagnosis, and surgical management. In this report, we present a case report and literature review. A healthy 20-year-old male patient presented with hemorrhagic colitis requiring total colectomy with end ileostomy. Pathological examination showed pancolitis with multiple ulcers, transmural inflammation, hemorrhage, and microvascular thrombosis. Extensive serological testing revealed elevated cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and eosinophilia, leading to a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) and vasculitis-induced colitis. A literature review was subsequently conducted. Nineteen studies were found documenting vasculitis-induced colitis in the absence of inflammatory bowel disease (IBD). Systemic signs of vasculitis, hemorrhagic colitis, and progression to fulminant colitis were present. Of all patients, 40.0% required colorectal surgery and 62.5% of those patients received a stoma; 25% underwent emergency surgery following failed immunosuppression. All cases relied on clinical correlation with serology and/or histopathology to reach a final diagnosis. We report a case of vasculitis-induced colitis caused by c-ANCA−positive EGPA. The review shows that vasculitis-induced colitis without IBD is an important differential that clinicians should be aware of in patients presenting with colitis.
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Paynter Jessica A.,Qin Kirby R.,Situ Dongrong,Lee Chun Hin Angus 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.5
Purpose: A patient presented to a regional surgical center with Fournier gangrene (FG) and concurrent multifocal necrotizing fasciitis (NF). Given the rarity, it was decided to undertake a systematic review to investigate the incidence and prevalence of FG with multifocal NF and consequently determine the treatment and approach to management of such presentation. Methods: Firstly, the report of the 56-year-old male patient is discussed regarding his surgical management. Secondly, a systematic review was undertaken according to PRISMA guidelines using MEDLINE, Scopus, and Embase databases. Searches used the following MeSH terms: (“fournier’s gangrene”) AND ((necrotising fasciitis) OR (necrotising soft tissue infection)). Once the search results were obtained, duplicate articles were removed. Titles, abstracts, and articles were reviewed by 2 authors. Results: The search strategy using the 3 databases revealed a total of 402 studies. Fifty-seven studies were removed due to duplication. A total of 345 records were screened via title and abstract, of which 115 were excluded. Two hundred and thirty studies were reviewed for eligibility. A total of all 230 studies were excluded; 169 were excluded as they included the incorrect patient population (patients suffered from FG or NF, but not both collectively), 60 studies were excluded due to incorrect study designs, and 1 report occurred in the wrong setting. Conclusion: This highlights that while being a relatively known, uncommon infection both FG and NF are well documented separately within the literature. However, FG with concurrent multifocal NF has not been documented within the literature.
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Cynthia Baker,Jessica B. Kirby,Jack O’Connor,Keston G. Lindsay,Andrea Hutchins,Margaret Harris 한국식품영양과학회 2022 Journal of medicinal food Vol.25 No.12
Stress, anxiety, and depression, along with feeling overwhelmed and exhausted have been widely reported by college students as factors that negatively impact their academic performance, and overall well-being. Ashwagandha is an Ayurvedic herb that has been used historically to support healthy responses to stressors, but has recently gained popularity in the United States for its ability to support well-being for populations who experience chronic stress. To our knowledge, there have not been any human trials evaluating the efficacy of ashwagandha on stress in the United States. No studies to date have used qualitative research methods to consider the experiential impact of ashwagandha supplementation. Our purpose was to explore the lived experiences of college students participating in a double-blind randomized control trial evaluating the impact of ashwagandha as an intervention to support college students' well-being. Participants were college students (N = 60) age 18–50 years, who were randomized to either intervention or placebo group to take one capsule twice a day for 30 days. Intervention group participants took 700 mg of full spectrum extract of ashwagandha root per day, whereas those in the placebo group took glycerol capsules. Qualitative data included daily affect check-ins and focus groups. Data were analyzed using Dedoose qualitative coding software and thematic analysis. Four themes resulted regarding energy levels, mental clarity, sleep dynamics, and stress. Our findings demonstrated that ashwagandha increased college students' perceived well-being through supporting sustained energy, heightened mental clarity, and enhanced sleep quality, through a moderate dose of ashwagandha for the course of 30 days. Clinical Trial Registration number: NCT05430685.
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Jack O’Connor,Keston Lindsay,Cynthia Baker,Jessica Kirby,Andrea Hutchins,Margaret Harris 한국식품영양과학회 2022 Journal of medicinal food Vol.25 No.12
The purpose of this study was to examine the impact of ashwagandha (ASH) (Withania somnifera) on sleep, perceived stress, and cravings in a college student population. Sixty healthy students were screened/enrolled into a 30-day double-blinded placebo (PLA)-controlled intervention (700 mg daily, full spectrum extract of ASH root). Anthropometrics, demographics, and validated questionnaires assessing physical activity, restorative sleep, perceived stress, and food cravings were assessed before and after the study. Descriptive statistics, Pearson's correlations, and point biserial correlations were used to screen the data. For sleep and stress, a nonsignificant mixed (group × time) multivariate analysis of variance (MANOVA) was followed by one-way MANOVA (time on sleep/stress) and one-way multivariate analysis of covariance (MANCOVA) (group on sleep/stress, using initial sleep as a covariate) as follow-up tests. Further follow-up tests for this MANCOVA showed group membership affected final sleep (58.4 ± 12.4 vs. 48.2 ± 15.0 ASH vs. PLA respectively, P < .05) using initial sleep as a covariate. Initial sleep (confounder) affected final stress, but not final sleep. Mixed analysis of variance (group × time) showed an interaction effect on food cravings, where the ASH group experienced lower cravings than the PLA group over time at end of study. The 30-day intervention was shorter than most other studies where more pronounced stress differences were seen at six weeks, indicating ASH may need the longer time period to show more pronounced stress relieving differences. ASH can be an effective safe intervention in young adult populations to help manage stress and its detrimental impacts on sleep and satiety in as little as 30 days. Clinical Trial Registration number-NCT05430685.
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