Katherine Garman

Overview:

My research focuses on injury, repair, and cancer development in the gastrointestinal tract. My laboratory performs translational research with the goal of improving health of the gastrointestinal tract. Our work is based in observations from human clinical research. We use databases of esophageal and colon disease to learn more about clinical risk factors for disease. We also use pathology samples of tumors to study the gastrointestinal tract in different states: healthy, inflamed or damaged, and with cancer.

Positions:

Associate Professor of Medicine

Medicine, Gastroenterology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Member of Duke Molecular Physiology Institute

Duke Molecular Physiology Institute
School of Medicine

Affiliate of the Duke Regeneration Center

Regeneration Next Initiative
School of Medicine

Education:

M.D. 2002

Duke University

Medical Resident, Medicine

Duke University

Fellow in Gastroenterology, Medicine

Duke University

Chief Resident, Medicine

Duke University School of Medicine

Fellow in Gastroenterology, Medicine

Duke University

Grants:

Epigenetic Control of Intestinal Inflammation

Administered By
Basic Science Departments
Awarded By
Kenneth Rainin Foundation
Role
Collaborator
Start Date
End Date

Epigenetic control of intestinal inflammation

Administered By
Basic Science Departments
Awarded By
Kenneth Rainin Foundation
Role
Collaborator
Start Date
End Date

Submucosal esophageal structures as a progenitor niche for esophageal repair

Administered By
Medicine, Gastroenterology
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Development of a Porcine Model of Esophageal Injury and Repair

Administered By
Medicine, Gastroenterology
Awarded By
University of North Carolina - Chapel Hill
Role
Principal Investigator
Start Date
End Date

Role of CAV3 Mutation in the Pathogenesis of Barrett's Esophagus

Administered By
Medicine, Gastroenterology
Awarded By
Case Western Reserve University
Role
Principal Investigator
Start Date
End Date

Publications:

Individualized ergonomic wellness approach for the practicing gastroenterologist (with video).

BACKGROUND AND AIMS: The prevalence and burden of ergonomic-related musculoskeletal injury are well established in the literature, but data are scarce on techniques that can be used to avoid injury. This pilot study aimed to develop a new method of endoscopist wellness assessment. The technique presented here is an intervention by a physical therapist assessing ergonomic position and posturing during endoscopy to create an individualized wellness plan. METHODS: Volunteer endoscopists were identified in a single ambulatory surgical center. Demographics, previous injury, current pain, and posture were evaluated. A comprehensive assessment was developed by the physical therapist while observing endoscopists performing at least 2 colonoscopies and while working at their computer workspace. The detailed personalized wellness program included recommendations for individualized exercises, static and dynamic posture re-education during and between procedures, optimization of procedure suite setup, pain education, and an opportunity for follow-up 1-on-1 sessions with the physical therapist. Endoscopists were later interviewed regarding their perception of and compliance with the wellness plan. Specific outcomes evaluated included changes in musculoskeletal pain, acceptance, and incorporation of wellness recommendations and procedure suite alterations into clinical practice. RESULTS: As we developed this new method of endoscopic wellness assessment, 8 endoscopists representing a wide range of ages and clinical experience were assessed. Twenty-two pain sites were identified among 5 subjects, with back and neck pain the most common pain sites. A variety of ergonomic inefficiencies and suboptimal movement patterns was observed, resulting in highly variant wellness plans. By the end of the study, 63% of pain sites were reduced in intensity or resolved, whereas 32% of pain sites were unchanged and 4% increased in intensity. Seven of 8 participants found the pictures depicting their posture that supported their movement analysis helpful, and 3 participants requested reassessment by the physical therapist. All participants reported static and dynamic postural education and procedure suite setup recommendations to be impactful to their ergonomic performance. CONCLUSIONS: Ergonomic assessment and instruction by a physical therapist was well received and resulted in improvement of musculoskeletal complaints among a cohort of endoscopists reporting baseline pain associated with performing endoscopy. In addition, this intervention provided ergonomic education that can be carried forward throughout their professional endoscopic career. We believe that ongoing individualized assessment and optimization of ergonomics is necessary because generalized wellness programs or even modifications to endoscopic equipment would not target all the unique ergonomic challenges faced by each physician. Ergonomic programs using the new method presented here could potentially contribute to career longevity, decrease burnout, reduce lost days of work, and, most importantly, reduce pain and fatigue among practitioners.
Authors
Markwell, SA; Garman, KS; Vance, IL; Patel, A; Teitelman, M
MLA Citation
Markwell, Stacy A., et al. “Individualized ergonomic wellness approach for the practicing gastroenterologist (with video).Gastrointest Endosc, vol. 94, no. 2, Aug. 2021, pp. 248-259.e2. Pubmed, doi:10.1016/j.gie.2021.01.045.
URI
https://scholars.duke.edu/individual/pub1473643
PMID
33561486
Source
pubmed
Published In
Gastrointest Endosc
Volume
94
Published Date
Start Page
248
End Page
259.e2
DOI
10.1016/j.gie.2021.01.045

Drivers of Esophageal Adenocarcinoma and Opportunities for Cancer Interception.

Authors
MLA Citation
Garman, Katherine S. “Drivers of Esophageal Adenocarcinoma and Opportunities for Cancer Interception.Cell Mol Gastroenterol Hepatol, vol. 12, no. 2, 2021, pp. 787–88. Pubmed, doi:10.1016/j.jcmgh.2021.04.018.
URI
https://scholars.duke.edu/individual/pub1483007
PMID
34029533
Source
pubmed
Published In
Cellular and Molecular Gastroenterology and Hepatology
Volume
12
Published Date
Start Page
787
End Page
788
DOI
10.1016/j.jcmgh.2021.04.018

Effect of Outpatient Status on Practice Management of H. pylori-associated Peptic Ulcer Disease

Authors
Feder, R; Posner, S; Qin, Y; Zheng, J; Chow, S-C; Garman, KS
MLA Citation
Feder, Rachel, et al. “Effect of Outpatient Status on Practice Management of H. pylori-associated Peptic Ulcer Disease.” American Journal of Gastroenterology, vol. 112, Ovid Technologies (Wolters Kluwer Health), 2017, pp. S598–S598. Crossref, doi:10.14309/00000434-201710001-01094.
URI
https://scholars.duke.edu/individual/pub1339285
Source
crossref
Published In
American Journal of Gastroenterology
Volume
112
Published Date
Start Page
S598
End Page
S598
DOI
10.14309/00000434-201710001-01094

Sa1758 Colonic Tattooing: Differences in Reported and Actual Practices at a Tertiary Medical Center

Authors
Spaete, JP; Chow, S-C; Burbridge, RA; Garman, KS
MLA Citation
Spaete, Joshua P., et al. “Sa1758 Colonic Tattooing: Differences in Reported and Actual Practices at a Tertiary Medical Center.” Gastrointestinal Endoscopy, vol. 83, no. 5, Elsevier BV, 2016, pp. AB289–AB289. Crossref, doi:10.1016/j.gie.2016.03.453.
URI
https://scholars.duke.edu/individual/pub1241393
Source
crossref
Published In
Gastrointestinal Endoscopy
Volume
83
Published Date
Start Page
AB289
End Page
AB289
DOI
10.1016/j.gie.2016.03.453

Prior tonsillectomy is associated with an increased risk of esophageal adenocarcinoma.

BACKGROUND: Esophageal cancer is a deadly cancer with 5-year survival <20%. Although multiple risk factors for esophageal adenocarcinoma (EAC) including obesity, GERD and smoking have been identified, these risk factors do not fully explain the rising incidence of EAC. In this study, we evaluated the association between prior history of tonsillectomy and EAC. Our goal was to determine whether tonsillectomies were more frequent in patients with EAC (cases) than in our thoracic surgery controls. METHODS: Cases included 452 esophagectomy cases, including 396 with EAC and 56 who underwent esophagectomy for Barrett's esophagus (BE) with high grade dysplasia (HGD). 1,102 thoracic surgery patients with surgical indications other than dysplastic BE or esophageal cancer represented the controls for our analysis. The association of tonsillectomy and HGD/EAC were primarily evaluated by using univariate tests and then verified by logistic regression analysis. Baseline demographics, medical history, and thoracic surgery controls were compared by using χ2 tests or 95% CIs. Significant risk factors were considered as covariates in the multivariate models while evaluating the association between tonsillectomy and HGD/EAC. P-values or odds ratios were estimated with 95% confidence limits to identify significances which was more appropriate. RESULTS: Tonsillectomy was more common in cases than controls and was found to have a significant association with esophageal cancer (19.9% vs. 12.7%; p-value = 0.0003). This significant association persisted after controlling for other known risk factors/covariates. CONCLUSION: A prior history of tonsillectomy was significantly associated with HGD/EAC and may represent an independent risk factor for the development of EAC. However, the underlying biology driving this association remains unclear.
Authors
Garman, KS; Ajayi, TA; Boutte, HJ; Chiu, S-T; von Furstenberg, RJ; Lloyd, BR; Zhang, C; Onaitis, MW; Chow, S-C; McCall, SJ
MLA Citation
Garman, Katherine S., et al. “Prior tonsillectomy is associated with an increased risk of esophageal adenocarcinoma.Plos One, vol. 15, no. 7, 2020, p. e0235906. Pubmed, doi:10.1371/journal.pone.0235906.
URI
https://scholars.duke.edu/individual/pub1452502
PMID
32697782
Source
pubmed
Published In
Plos One
Volume
15
Published Date
Start Page
e0235906
DOI
10.1371/journal.pone.0235906

Research Areas:

Adenocarcinoma
Barrett Esophagus
Barrett's esophagus
Consumer behavior
Epithelial Cells
Esophageal Neoplasms
Mutation
Proteome