|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Biliary complications following liver transplantation显示文摘Biliary tract complications are the most common complications after liver transplantation.These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients.Biliary complications remain a major source of morbidity in liver transplant patients,with an incidence of 5%-32%.Post liver transplantation biliary complications include strictures(anastomotic and non-anastomotic),leaks,stones,sphincter of Oddi dysfunction,and recurrence of primary biliary disease such as primary sclerosing cholangitis and primary biliary cirrhosis.The risk of occurrence of a specific biliary complication is related to the type of biliary reconstruction performed at the time of liver transplantation.In this article we seek to review the major biliary complications and their relation to the type of biliary reconstruction performed at the time of liver tranplantation. | Gursimran Kochhar Jose Mari Parungao Ibrahim A Hanouneh Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，19： | 41 |
| 2 | Old vs new: Risk factors predicting early onset colorectal cancer显示文摘BACKGROUND Colorectal cancer(CRC)is the second leading cause of all cancer related deaths in the United States and Europe.Although the incidence has been decreasing for individuals’≥50,it has been on the rise for individuals<50.AIM To identify potential risk factors for early-onset CRC.METHODS A population-based cohort analysis using a national database,Explorys,screened all patients with an active electronic medical record from January 2012 to December 2016 with a diagnosis of CRC.Subgroups were stratified based on age(25–49 years vs≥50 years).Demographics,comorbidities,and symptom profiles were recorded and compared between both age groups.Furthermore,the younger group was also compared with a control group consisting of individuals aged 25-49 years within the same timeframe without a diagnosis of CRC.Twentydata points for CRC related factors were analyzed to identify potential risk factors specific to early-onset CRC.RESULTS A total of 68860 patients were identified with CRC,of which 5710(8.3%)were younger than 50 years old,with 4140(73%)between 40-49 years of age.Multivariable analysis was reported using odds ratio(OR)with 95%CI and demonstrated that several factors were associated with an increased risk of CRC in the early-onset group versus the later-onset group.These factors included:African-American race(OR 1.18,95%CI:1.09-1.27,P<0.001),presenting symptoms of abdominal pain(OR 1.82,95%CI:1.72-1.92,P<0.001),rectal pain(OR 1.50,95%CI:1.28-1.77,P<0.001),altered bowel function(OR 1.12,95%CI:1.05-1.19,P=0.0005),having a family history of any cancer(OR 1.78,95%CI:1.67-1.90,P<0.001),gastrointestinal(GI)malignancy(OR 2.36,95%CI:2.18-2.55,P<0.001),polyps(OR 1.41,95%CI:1.08-1.20,P<0.001),and obesity(OR 1.14,95%CI:1.08-1.20,P<0.001).Comparing the early-onset cohort versus the control group,factors that were associated with an increased risk of CRC were:male gender(OR 1.34,95%CI:1.27-1.41),P<0.001),Caucasian(OR 1.48,95%CI:1.40-1.57,P<0.001)and African-American race(OR 1.25,95%CI:1.17-1.35,P<0.001),presenting symptoms of abdominal pain(OR 4.73,95%CI:4.49-4.98,P<0.001),rectal pain(OR 7.48,95%CI:6.42-8.72,P<0.001),altered bowel function(OR 5.51,95%CI:5.19-5.85,P<0.001),rectal bleeding(OR 9.83,95%CI:9.12-10.6,P<0.001),weight loss(OR 7.43,95%CI:6.77-8.15,P<0.001),having a family history of cancer(OR 11.66,95%CI:10.97-12.39,P<0.001),GI malignancy(OR 28.67,95%CI:26.64-30.86,P<0.001),polyps(OR 8.15,95%CI:6.31-10.52,P<0.001),tobacco use(OR 2.46,95%CI:2.33-2.59,P<0.001),alcohol use(OR 1.71,95%CI:1.62-1.80,P<0.001),presence of colitis(OR 4.10,95%CI:3.79-4.43,P<0.001),and obesity(OR 2.88,95%CI:2.74-3.04,P<0.001).CONCLUSION Pending further investigation,these potential risk factors should lower the threshold of suspicion for early CRC and potentially be used to optimize guidelines for early screening. | Aslam R Syed Payal Thakkar Zachary D Horne Heitham Abdul-Baki Gursimran Kochhar Katie Farah Shyam Thakkar | 2019 | World Journal of Gastrointestinal Oncology2019，11，11： | 6 |
| 3 | Functional analysis and drug response to zinc and D-penicillamine in stable ATP7B mutant hepatic cell lines显示文摘AIM: To study the effect of anti-copper treatment for survival of hepatic cells expressing different ATP7 B mutations in cell culture. METHODS: The most common Wilson disease(WD) mutations p.H1069 Q, p.R778 L and p.C271*, found in the ATP7 B gene encoding a liver copper transporter, were studied. The mutations represent major genotypes of the United States and Europe, China, and India, respectively. A human hepatoma cell line previously established to carry a knockout of ATP7 B was used to stably express WD mutants. m RNA and protein expression of mutant ATP7 B, survival of cells, apoptosis, and protein trafficking were determined.RESULTS: Low temperature increased ATP7 B protein expression in several mutants. Intracellular ATP7 B localization was significantly impaired in the mutants. Mutants were classified as high, moderate, and no survival based on their viability on exposure to toxic copper. Survival of mutant p.H1069 Q and to a lesser extent p.C271* improved by D-penicillamine(DPA) treatment, while mutant p.R778 L showed a pronounced response to zinc(Zn) treatment. Overall, DPA treatment resulted in higher cell survival as compared to Zn treatment; however, only combined Zn + DPA treatment fully restored cell viability. CONCLUSION: The data indicate that the basic impact of a genotype might be characterized by analysis of mutant hepatic cell lines. | Gursimran Chandhok Judit Horvath Annu Aggarwal Mohit Bhatt Andree Zibert Hartmut HJ Schmidt | 2016 | World Journal of Gastroenterology2016，22，16： | 3 |
| 4 | Comparative study of endoscopy vs.transjugular intrahepatic portosystemic shunt in the management of gastric variceal bleeding显示文摘Background and Aim:Gastric varices are associated with high mortality.There have been conflicting reports on whether endoscopic treatment with cyanoacrylate or the placement of a transjugular intrahepatic portosystemic shunt(TIPS)is more effective in the treatment of gastric varices.We compared the outcomes of patients treated with cyanoacrylate glue or TIPS for the management of acute gastric variceal bleeding.Methods:The study was designed as a retrospective cohort analysis of patients undergoing either TIPS or endoscopic treatment with cyanoacrylate for acute gastric variceal bleeding at our institution from 2001 to 2011.Primary compared to studied between the two treatment modalities were the short-term treatment outcomes,including re-bleeding within 30 days,length of hospital stay and in-hospital mortality.Kaplan-Meier survival analysis was performed to assess factors associated with in-hospital mortality.Results:A total of 169 patients were included in the analysis.The TIPS arm contained 140 patients and the cyanoacrylate arm contained 29 patients.There was no evidence to suggest any significant differences in demographics or disease severity.There were no differences between the TIPS arm and the cyanoacrylate armtwo groups in treatment outcomes including re-bleeding within 30 days(17.4%vs.17.2%;P=0.98),median length of stay in the hospital(4.5 days vs.6.0 days;P紏0.35)or in-hospital mortality(9.0%vs.11.1%;P=0.74).In-hospital mortality was evaluated for 149 patients and lower albumin(P=0.015),higher MELD score(P<0.001),higher CTP score(P=0.005)and bleeding(P=0.008)were all significantly associated with in-hospital death.Conclusion:These findings suggest that both treatments are equally effective.Cyanoacrylate offers a safe,effective alternative to TIPS for gastric varices,and physician may choose the best therapy for each patient,factoring in the availability of TIPS or cyanoacrylate,the individual patient’s presentation,and cost. | Gursimran Singh Kochhar Udayakumar Navaneethan Jason Hartman Jose Mari Parungao Rocio Lopez Ranjan Gupta Baljendra Kapoor Paresh Mehta Madhu Sanaka | 2015 | Gastroenterology Report2015，3，1： | 2 |
| 5 | Duration and severity of primary sclerosing cholangitis is not associated with risk of neoplastic changes in the colon in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Gursimran Kochhar Preethi G.K. Venkatesh Brian Lewis Bret A. Lashner Feza H. Remzi Bo Shen Ravi P. Kiran | 2012 | Gastrointestinal Endoscopy2012，，5： | 1 |
| 6 | Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in inflammatory bowel disease patients显示文摘 | Udayakumar Navaneethan Gursimran Kochhar Hardeep Phull Preethi GK Venkatesh Feza H. Remzi Ravi P. Kiran Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，4： | 1 |
| 7 | 常规粪便病原菌培养对有症状的回肠储袋患者的评估价值显示文摘背景:对于有症状的回肠储袋患者,临床上经常会进行粪便培养以明确肠道病原菌。本研究旨在探究常规粪便培养对于有症状的回肠储袋患者的评估价值,以及找到肠道病原菌对于这些患者的临床意义。方法:检索我们储袋数据库中2002-2015年间的2283例病例资料,筛选出其中有症状(提示储袋炎)且进行了粪便培养的病例纳入研究。将粪便培养结果阳性的患者作为研究组,并按1:4的比例进行匹配,选取粪便培养结果阴性的有症状患者作为对照。比较两组患者粪便培养1个月和3个月后的抗生素治疗反应、复发率和入院率。结果:共计643例(28%)患者出现储袋炎症状且进行了粪便培养,其中只有1.7%(11/643)的患者培养结果阳性。空肠弯曲杆菌(45%)是最常见的致病菌,其次是气单胞菌(36%)。不抽烟和近3个月未使用任何抗生素的患者,其培养结果阳性率更高(P<0.001和P¼0.023)。具有病原菌(培养结果阳性)的患者急性肾衰风险(27.3%vs.4.5%,P¼0.049)、3个月内住院率(36.4%vs.6.8%,P¼0.009)以及病死率(18.2%vs.0%,P¼0.040)均显著高于对照组。然而,对于培养结果阳性的患者,基于病原菌的针对性治疗后,其临床疗效与对照组相比并无显著改善。结论:我们发现对有症状的储袋患者进行粪便培养,其病原菌检出率极低,而且针对病原菌的治疗对储袋炎的疾病进程影响甚微。因此,对于这些患者是否有必要进行常规粪便培养需进一步研究。 | Amandeep Singh Jean Ashburn Gursimran Kochhar Rocio Lopez Tracy L.Hull Bo Shen | 2018 | Gastroenterology Report2018，6，2： | 0 |
| 8 | 维多株单抗治疗老年炎症性肠病患者的有效性和安全性:一项匹配病例对照研究显示文摘背景:多个临床研究显示,维多株单抗治疗成人中重度活动期炎症性肠病(IBD)安全有效。但其用于老年患者的安全性和有效性相关数据甚是有限。方法:本研究为病例对照研究,比较维多株单抗用于老年组(≥65岁)和对照组(<65岁)IBD患者的有效性(黏膜愈合率和需要外科干预)及安全性。两组病例基于性别和疾病分型进行1:4匹配。采用条件逻辑回归方法进行分层分析,计算比值比和可信区间。结果:25例老年病例和100例匹配病例纳入研究。80例克罗恩病,45例溃疡性结肠炎。两组基线资料具有可比性,包括IBD病程、抗TNF治疗史、IBD手术史等。老年组和对照组黏膜例愈合率的差异无统计学意义(50%vs 53%,P=0.507)。尽管似乎有更多的老年组病例在维多株单抗治疗期间需要外科干预,但差异未达到统计学意义(40%vs 19%,P=0.282)。维多株单抗治疗相关不良反应(如皮疹、关节痛、感染、输液反应和呼吸困难)两组相当(均P>0.05)。结论:在真实世界中,维多株单抗用于老年IBD患者的治疗同样安全有效。 | Preeti Shashi Dharmesh Gopalakrishnan Malav P.Parikh Bo Shen Gursimran Kochhar | 2020 | Gastroenterology Report2020，8，4： | 0 |
| 9 | Impact of transjugular intrahepatic portosystemic shunt on post-colectomy complications in patients with ulcerative colitis and primary sclerosing cholangitis显示文摘Objective:Primary sclerosing cholangitis(PSC)occurs in approximately 5%of patients with ulcerative colitis(UC).The risk of colon cancer is higher in patients undergoing colectomy,who have simultaneous PSC&UC.Our aim was to study the impact,in terms of post-colectomy survival and complications,of transjugular intrahepatic portosystemic shunt(TIPS)before colectomy in these patients.Methods:In this retrospective,case-control study,information was obtained on demographics,disease characteristics,TIPS characteristics,and post-colectomy complications.Nine patients with PSC and UC who underwent TIPS prior to colectomy(the Study group)and 37 patients with PSC and UC who underwent only colectomy without TIPS(the Control group)were included.Either an analysis of variance or the non-parametric Kruskal-Wallis test were used for continuous variables and Fisher’s Exact test or Pearson’s chi-squared test was used for categorical factors.Results:There was no difference in themean age between the two groups;however patients in the Study group had lower platelet count(P=0.005)as well as higher Model for End-Stage Liver disease(MELD)scores(P<0.001).Also,patients in the Study group had increased PSC severity as determined by Mayo PSC Risk Scores(1.50 vs.0.20)(P=0.001).Total bilirubin levels were higher in the Study group(2.3 vs.0.8mg/dL)(P=0.011).Comparing the post-operative complication rates without adjusting for disease severity,the Study group hadmore wound infections(P=0.034),more wound dehiscence(P=0.022),and a higher re-admission rate within 30 days(P=0.032);however,the post-operativemortality was not significantly different.Conclusion:Patients with PSC and UC who underwent TIPS prior to colectomy had higher rates of complications;however,this was probably due to the greater severity of cirrhosis and PSC in this population. | Gursimran Kochhar Udayakumar Navaneethan Jose Mari Parungao Jason Hartman Ranjan Gupta Rocio Lopez Arthur J McCullough Baljiendra Kapoor Bo Shen | 2015 | Gastroenterology Report2015，3，3： | 0 |
| 10 | 内镜下高渗葡萄糖治疗结直肠吻合口血肿显示文摘Anastomotic dehiscence and leak are dreaded complications after a colorectal resection and can often present with rectal bleeding and pelvic abscess or sepsis.Although most cases of bleeding after gastrointestinal anastomoses are minor and self-limited,major bleeding,as defined by hemodynamic instability or the need for blood transfusions,poses a significant challenge for management.Here we report a case in which a patient presenting with profuse rectal bleeding and pelvic hematoma secondary to a colorectal anastomotic leak was treated endoscopically with 50%dextrose spray then enema. | Preeti Shashi Gursimran Kochhar Bo Shen | 2019 | Gastroenterology Report2019，7，6： | 0 |
| 11 | 原发性硬化性胆管炎会进一步导致回肠储袋肛管吻合患者维生素D缺乏显示文摘目的:溃疡性结肠炎(UC)患者回肠储袋肛管吻合(IPAA)术后常出现维生素D缺乏。IPAA患者出现原发性硬化性胆管炎(PSC)后维生素D水平是否会进一步降低,目前仍不明了。本研究的目的是评估PSC是否是UC患者IPAA术后维生素D缺管的一个危险因素。方法:在该病例对照研究中,74例出现PSC的IPAA患者纳入研究组,79例未出现PSC的IPAA患者作为对照组。44项指标被纳入多因素逻辑回归模型中进行分析。结果:153例患者入组研究,其中研究组74例(48.4%),对照组79例(51.6%)。研究组维生素D水平是(18.961.4)ng/dL,明显低于对照组的(30.361.7)ng/dL(P=0.011)。共有65例(42.5%)患者出现维生素D缺乏,其中49例(75.4%)合并PSC。多因素分析显示,PSC的出现(OR=7.56,95%CI:2.29-24.08;P=0.001)和维生素D的补充(OR=2.58,95%CI:1.57-9.19;P=0.018)与维生素D缺乏密切相关。结论:PSC的出现是UC患者IPAA术后维生素D缺乏的独立危险因素。这些患者应该被筛查出来,以对其维生素D水平进行严密监测。 | Andre Fialho Andrea Fialho Gursimran Kochhar Bo Shen | 2016 | Gastroenterology Report2016，4，4： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员