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Anatomy of the Gastrointestinal System01:26

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Gastrointestinal Motility Disorders01:20

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Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
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Histology of the Gastrointestinal (GI) Tract01:20

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The GI tract, from beginning to end, is made up of four continuous tissue layers that adjust their structure according to their specific roles. These layers, from innermost to outermost, are known as the mucosa, submucosa, muscularis, and serosa, which are continuous with the mesentery.
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The gastrointestinal (GI) tract, extending from the mouth to the anus, plays a pivotal role in the digestion and absorption of nutrients. This process involves both mechanical and chemical actions facilitated by various enzymes.
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Physiology of the Gastrointestinal System III: Elimination01:26

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The gastrointestinal elimination process involves a complex interplay of neural and hormonal mechanisms that coordinate the final waste removal from the body. This intricate operation encompasses the absorption of water and electrolytes, vital for transforming the remaining indigestible food matter into feces. The large intestine is pivotal in water and electrolyte absorption, forming feces from unabsorbed minerals, undigested food, bacteria, bile pigments, and shed epithelial cells. Essential...
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Genome-Wide Analysis of DNA Methylation in Gastrointestinal Cancer
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Perioperative Mortality Does Not Explain Racial Disparities in Gastrointestinal Cancer.

J Bliton1, P Muscarella1, P Friedmann1,2

  • 1Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|January 18, 2019
PubMed
Summary

Racial disparities in gastrointestinal cancer survival are not explained by perioperative mortality. Focus on screening, socioeconomic factors, and access to care to address cancer disparities.

Keywords:
CancerDisparitiesOutcomesPerioperative mortalitySocioeconomic status

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Area of Science:

  • Oncology
  • Health Services Research
  • Health Disparities

Background:

  • Racial minorities with gastrointestinal cancer experience worse survival rates.
  • Existing research indicates significant disparities in overall and disease-specific survival.
  • This study investigates if these disparities extend to the perioperative period.

Purpose of the Study:

  • To examine the relationship between race/ethnicity and mortality in patients undergoing gastrointestinal cancer surgery.
  • To determine if racial disparities in mortality are present during the perioperative period.
  • To identify factors associated with perioperative mortality in gastrointestinal cancer patients.

Main Methods:

  • Utilized the Nationwide Inpatient Sample (NIS) database from 2008-2012.
  • Included patients undergoing surgery for esophagus, stomach, pancreas, colon, and rectal cancers.
  • Employed logistic regression to assess race/ethnicity's association with perioperative mortality, adjusting for covariates.

Main Results:

  • Analysis included 110,044 patients: 75.8% White, 10.5% Black, 7.2% Hispanic, 3.1% Asian/Pacific Islander.
  • No increased perioperative mortality was observed for racial minorities after adjusting for clinical and demographic factors.
  • Higher comorbidity scores, lower income regions, male sex, and lack of private insurance were associated with worse outcomes.

Conclusions:

  • Racial minorities do not face higher perioperative mortality rates for gastrointestinal cancer surgeries when controlling for clinical and demographic factors.
  • Cancer disparities are driven more by comorbidities than race in the perioperative setting.
  • Future interventions should target cancer screening, surveillance, socioeconomic factors, and access to care to reduce disparities.