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Management of Malnutrition in Liver Cancer Patients with Chronic Liver diseases

Journal of Nutritional Oncology 2016年第1期1卷 21-29页

作者： asa’d dajani Laura Kassym Peter Chung Adnan Abu Hammour asad dajani Specialist Center Sharjah United Arab Emirates Semey State University Semey Kazakhstan The Ninth Peoples Hospital Shanghai Jiaotong University Shanghai China Abu Hammour Medical Center Dubai United Arab Emirates

Liver cancer is the fifth most common cancer and the third leading cause of cancer death globally. Malnutrition is found in 65-90% of patients with liver cancer and often enhances cancer occurrence and complications, deteriorates liver functions, and promotes early development of refractory ascites and hepatic encephalopathy (HE), increasing both morbidity and mortality. Malnutrition may develop as a result of poor dietary intake, anorexia, medications, side effects to chemotherapy, encephalopathy, as well as socioeconomic limitations. A dedicated clinical team should provide proper assessment of patient’s nutritional status and nutrition supplemental plan to restore liver health and prevent or treat malnutrition. Nutrition assessment is based on medical, nutritional, and medication histories, physical examination for body composition and signs of malnutrition, anthropometric measurements, radio-imaging, laboratory tests, and flow charts or algorithms on patient’s dietary intake and changes in bodyweight. Clinical management depends on patient’s disease and nutritional status. Patients with minor liver affection or compensated liver cirrhosis may have normal diet without any restrictions in carbohydrates, proteins, and fat, but preferably take other supplements supporting the liver. Patients with decompensated liver should consume 25-40 kcal/kg/day and 1.0-1.5 g protein/kg/day. For patients with acute episodes of HE, a temporary protein restriction of 0.6-0.8 g/kg/day should be implemented until HE is eliminated. Patients should consume small, frequent meals throughout the day and add a carbohydrate- and protein-rich evening snack. Other approaches to supporting optimal digestion and nutrition and managing side effects of cancer therapies may be added as well.

关键词： Liver cancer Malnutrition Liver cirrhosis Hepatic encephalopathy Nutrition assessment Nutrition intervention Cancer therapy

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Essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis

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World Journal of Clinical Cases 2020年第21期8卷 5235-5249页

作者： asad Izziddin dajani Branko Popovic AdSC Medcare Hospital and Saudi German HospitalSharjahAl KhanPO Box 6328United Arab Emirates Sanofi-Aventis deutschland GmbH CHC Global Medical AffairsFrankfurt am Main 65926Germany

BACKGROUNd Essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLd),but data are mostly from small-scale *** To evaluate the efficacy of EPL treatment in adult patients with NAFLd and type 2 diabetes and/or *** The MEdLINE,PubMed,Embase,and Cochrane databases were searched up to March 2019 for clinical trials and comparative observational *** studies were those published in English or Chinese that enrolled adult patients(≥18 years)with NAFLd and type 2 diabetes mellitus and/or obesity receiving EPL as monotherapy or as add-on therapy to existing therapy,and that included at least one of the efficacy outcomes of interest.A variety of studies were identified;thus,direct,indirect and cohort meta-analyses were *** difference(Md)and 95%confidence interval(CI)were calculated for continuous variables,and relative risk with 95%CI for disease response and recovery.A random-effects model was used to address between-study *** Ten studies met the inclusion criteria(n=22-324).EPL treatment duration ranged from 4 to 72 *** the direct meta-analysis(four randomized controlled trials),compared with antidiabetic therapy alone,EPL plus antidiabetic therapy was associated with a significantly greater reduction in[alanine aminotransferase(ALT);Md:11.28 U/L(95%CI:-17.33,-5.23),P=0.0003],triglyceride[Md:-49.33 mg/dL(95%CI:-66.43,-32.23),Pd total cholesterol levels[Md:-29.74 mg/dL(95%CI:-38.02,-21.45),Pd risk of no disease(P=0.0091),and a reduction in moderate disease(P=0.0187);there were no significant differences in severe disease,mild disease,or significant *** the cohort meta-analysis of three non-randomized clinical trials,the Md in ALT levels was-16.71 U/L(95%CI:-24.94,-8.49)and 23%of patients had improved *** the

关键词： Non-alcoholic fatty liver disease diabetes Obesity Metabolic syndrome Essential phospholipids Systematic review Meta-analysis

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Surgical outcomes and quality of life following exercise-based prehabilitation for hepato-pancreatico-biliary surgery:A systematic review and meta-analysis

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Hepatobiliary & Pancreatic diseases International 2022年第3期21卷 207-217页

作者： Andy deprato Kevin Verhoeff Kieran Purich Janice Y Kung david L Bigam Khaled Z dajani University of Alberta 116 St&85 AveEdmontonAlberta T6G 2R3Canada department of Surgery University of Alberta Hospital8440112 Street NWEdmontonAlberta T6G 2B7Canada John W.Scott Health Sciences Library University of Alberta Hospital8440112 Street NWEdmontonAlberta T6G 2B7Canada department of Surgery Division of General SurgeryHPB Transplant and OncologyUniversity of Alberta Hospital8440112 Street NWEdmontonAlberta T6G 2B7Canada

Background:Hepato-pancreatico-biliary(HPB)patients experience significant risk of preoperative *** assessing preventative prehabilitation in HPB populations are *** systematic review and meta-analysis evaluates outcomes for HPB patients treated with exercise *** sources:A comprehensive search of MEdLINE(via Ovid),Embase(Ovid),Scopus,Web of Science Core Collection,Cochrane Library(Wiley),Pro Quest dissertations,Theses Global,and Google Scholar was conducted with review and extraction following PRISMA *** studies evaluated more than 5 adult HPB patients undergoing≥7-day exercise *** primary outcome was postoperative length of stay(LOS);secondary outcomes included complications,mortality,physical performance,and quality of ***:We evaluated 1778 titles and abstracts and selected 6(randomized controlled trial,n=3;prospective cohort,n=1;retrospective cohort,n=2)that included 957 *** those,536 patients(56.0%)underwent exercise prehabilitation and 421(44.0%)received standard *** in both groups were similar with regards to important demographic *** was associated with a 5.20-day LOS reduction(P=0.03);when outliers were removed,LOS reduction decreased to 1.85 days and was non-statistically significant(P=0.34).Postoperative complications(OR=0.70;95%CI:0.39 to 1.26;P=0.23),major complications(OR=0.83;95%CI:0.60 to 1.14;P=0.24),and mortality(OR=0.67;95%CI:0.17 to 2.70;P=0.57)were *** was associated with improved strength,cardiopulmonary function,quality of life,and alleviated ***:Exercise prehabilitation may reduce LOS and morbidity following HPB *** with well-defined exercise regimens are needed to optimize exercise prehabilitation outcomes.

关键词： Exercise-based prehabilitation Preoperative exercise Hepatobiliary Pancreaticoduodenectomy Hepatic resection Pancreatectomy

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PROSTAGLANdINS: PHARMACOGY, MECHANISM ANd APPLICATIONS IN PEPTIC ULCER dISEASE

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中国临床药理学杂志 1989年第2期 102-117页

作者： Esam Z.dajani G.d.Searle and Company Chicago U.S.A.

Prostaglandins(PGs) constitute a family of unsaturated fatty acids witha 20-carbon skeleton. Prostaglandins are found in almost every mammaliancell and are considered locally acting hormones (autocoids). They aresynthesized on demand and subsequently destroyed near the site of theirsynthesis. Since the early 1960’s, increasing evidence has implicated theimportance of PGs in several physiological processes affecting the gastroin-

关键词： PROSTAGLANdINS PHARMACOGY

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风湿热的诊断规范:1992年修订的Jones标准

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国外医学（心血管疾病分册） 1993年第6期20卷 341-343页

作者： dajani AS 胡健

1992年修订的Jones诊断标准主要针对急性风湿热的初次发作,并阐述A组链球菌的感染依据。

关键词：风湿热诊断标准

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Surgical management of hepato-pancreatic metastasis from renal cell carcinoma

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World Journal of Gastrointestinal Oncology 2017年第2期9卷 70-77页

作者： Nikolaos A Chatzizacharias Anais Rosich-Medina Khaled dajani Simon Harper Emmanuel Huguet Siong S Liau Raaj K Praseedom Asif Jah department of HPB and Transplant Surgery Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation TrustCambridgeshire CB2 0QQUnited Kingdom

AIM To investigate the outcomes of liver and pancreatic resections for renal cell carcinoma(RCC) metastatic disease. METHOdS This is a retrospective, single centre review of liver and/or pancreatic resections for RCC metastases between January 2003 and december 2015. descriptive statistical analysis and survival analysis using the Kaplan-Meier estimation were *** Thirteen patients h ad 7 pancreatic and 7 liver resections, with median follow-up 33 mo(range: 3-98). Postoperative complications were recorded in 5 cases, with no postoperative mortality. Three patients after hepatic and 5 after pancreatic resection developed recurrent disease. Median overall survival was 94 mo(range: 23-94) after liver and 98 mo(range: 3-98) after pancreatic resection. disease-free survival was 10 mo(range 3-55) after liver and 28 mo(range 3-53) after pancreatic resection. CONCLUSION Our study shows that despite the high incidence of recurrence, long term survival can be achieved with resection of hepatic and pancreatic RCC metastases in selected cases and should be considered as a management option in patients with oligometastatic disease.

关键词： Renal cell carcinoma Metastasis Pancreas Liver Surgery

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Barriers to Intrauterine device Use at an University-Based Women’s Clinic

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Open Journal of Obstetrics and Gynecology 2014年第16期4卷 1058-1064页

作者： denise Ragland Nalin Paykachat Nafisa dajani department of Pharmacy Practice University of Arkansas for Medical Sciences Little Rock USA department of Pharmacy Practice Division of Pharmaceutical Evaluation and Policy University of Arkansas for Medical Sciences Little Rock USA department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine University of Arkansas for Medical Sciences Little Rock USA

Objective: The purpose of this study was to determine the barriers to intrauterine device (IUd) use at a University-Based Women’s Clinic. Methods: This study is a cross-sectional survey of a convenience sample of subjects receiving obstetrical care at a University-Based Women’s Clinic. Eligible women who consented to participate self-administered a 16-question survey during a routine prenatal visit. descriptive statistics were used to report participants’ demographics and history of contraception use. Additionally, subjects were asked if they would consider IUd use in the future. Results: A total of 160 women participated in this study. The average age of this sample was 24.9 (Sd = 6.3). The majority were in low income and low education categories. Only 5% of women reported previous IUd use. 27% of women surveyed desired more information regarding IUd contraception. 19% of participants would consider using an IUd in the future and 25% would consider?IUd in the future if they knew more about them. Insurance and financial constraints were cited as barriers to IUd use. 4% of the sample reported that they had used an IUd previously and were unhappy with it due to pain and discomfort. 18% would not consider an IUd because they had heard about side effects. 68%?of the surveyed sample reported unintended pregnancies. Conclusion: The two most common barriers to IUd use in this patient population was lack of knowledge?and concern about side effects. Increasing patients’ knowledge of IUds has the potential to increase IUd utilization in this clinic population which reported a 68% rate of unintended pregnancy.

关键词： Intrauterine device Intrauterine Contraception IUd Utilization Barriers Unintended Pregnancies Component Formatting Style Styling

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水平横向各向同性介质的反射时差反演:精度、限度和采集

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国外油气勘探 2000年第6期12卷 738-751页

作者： Abdulfattah Al-dajani 刘宝玉 <石油地球物理勘探>编辑部

水平横向各向同性介质(HTI)是用来描述各向同性基质中垂向断裂最简单的方位各向异性模型。假设地下界面是横向均匀的;并且利用P波NMO速度至少在三个不同炮检方向上随测量的方位的椭圆变化,我们可以估算出HTI介质的三个关键参数:垂向速... 详细信息

水平横向各向同性介质(HTI)是用来描述各向同性基质中垂向断裂最简单的方位各向异性模型。假设地下界面是横向均匀的;并且利用P波NMO速度至少在三个不同炮检方向上随测量的方位的椭圆变化,我们可以估算出HTI介质的三个关键参数:垂向速度、各向异性和对称轴的方位。这样的参数估算对2-d采集时测线之间的角度或3-d采集时的炮检方位以及反演过程使用的一组方位都比较敏感。尤其是估算方位时的精度对于各向异性的强度很敏感,而在求解垂向速度和各向异性时的精度对于任何各向异性的强度大约都是相同的。为了使估算参数时的精度和稳定性达到最佳,当仅利用三个方向时,最好使炮检方向上的方位相隔60°。这种要求在可以设计成宽方位覆盖范围的陆上地震采集中是可行的。然而,在海上拖缆采集中,方位方向的数据覆盖受到限制。在海上拖缆测量中为了获得如此宽的方位覆盖范围,需要多个测量方向。为了利用60°间隔的三个方位方向完成反演,被方位各向异性盖层覆盖的一种HTI层相对于总时间而言应具有一个时间厚度,它至少等于NMO(叠加)速度误差与HTI层的层间各向异性强度之比。但是,当利用了多于三个炮检方向上的方位时(即全方位覆盖),它提供了一个能提高估算质量的有用数据的冗余度,因此,在较小的相对厚度上也能提供满意的参数估算。

关键词：反射时差反演各向同性介质地震资料采集

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人工晒黑制品在青年人中的使用

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世界核心医学期刊文摘（皮肤病学分册） 2006年第8期2卷 53-54页

作者： Brooks K. Brooks d. dajani Z. A.C. Geller 张路坤 department of dermatology Boston University School of MedicineBoston Massachusetts USA

Background: Neither the prevalence of sunless tanner use nor its impact on sunburning and tanning bed use has been evaluated in the United States. Objective: We surveyed young adults in greater Boston to measure use of artificial tanning products, as well as recent history of sunburns and tanning bed use. Methods: In July 2004, 448 individuals 18 to 30 years of age completed a brief questionnaire at universities, shopping venues, and parks. Results: Twenty-two percent of respondents used sunless tanning lotions in the preceding 12 months, and another 22% had not used them but would consider doing so in the coming year. Sunless tanning users were more likely to be female, younger, and more likely to report being severe burners. Both users and potential users were more likely to have sunburned during the summer and to have used tanning beds than those who neither used nor intended to use sunless tanning lotions, even after controlling for skin type. Limitations: The study was based on a non-randomly selected sample in one city and was cross-sectional in nature. Conclusion: Our study raises the possibility that sunless tanning products do not decrease rates of sunburning or use of tanning beds. While safe alternatives to ultraviolet exposure are desirable, the potential risks of widely endorsing artificial tanning products must be considered.

关键词：青年人制品人工治疗床问卷调查皮肤类型使用者日光鞣酸使用率

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Incidental non-benign gallbladder histopathology after cholecystectomy in an United Kingdom population: Need for routine histological analysis?

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World Journal of Gastrointestinal Surgery 2016年第10期8卷 685-692页

作者： Krashna Patel Khaled dajani Satheesh Iype Nikolaos A Chatzizacharias Saranya Vickramarajah Susan davies Rebecca Brais Siong S Liau Simon Harper Asif Jah Raaj K Praseedom Emmanuel L Huguet department of Surgery Hepato-Pancreato-Biliary Unit Addenbrooke’s Hospital Cambridge CB20XZ United Kingdom department of Upper Gastrointestinal Surgery Addenbrooke’s Hospital Cambridge CB20XZ United Kingdom department of Histopathology Addenbrooke’s Hospital Cambridge CB20XZ United Kingdom

AIM To analyse the range of histopathology detected in the largest published United Kingdom series of cholecystectomy specimens and to evaluate the rational for selective histopathological *** Incidental gallbladder malignancy is rare in the United Kingdom with recent literature supporting selective histological assessment of gallbladders after routine *** cholecystectomy gallbladder specimens examined by the histopathology department at our hospital during a five year period between March 2008 and March 2013 were retrospectively *** data was collected on all specimens demonstrating carcinoma,dysplasia and polypoid *** The study included 4027 *** majority(97%) of specimens exhibited gallstone or cholecystitis related *** were demonstrated in 44(1.09%),the majority of which were cholesterol based(41/44).dysplasia,ranging from low to multifocal high-grade was demonstrated in 55(1.37%).Incidental primary gallbladder adenocarcinoma was detected in 6 specimens(0.15%,5 female and 1 male),and a single gallbladder revealed carcinoma in situ(0.02%).This large single centre study demonstrated a full range of gallbladder disease from cholecystectomy specimens,including more than 1% neoplastic histology and two cases of macroscopically occult gallbladder *** Routine histological evaluation of all elective and emergency cholecystectomies is justified in a United Kingdom population as selective analysis has potential to miss potentially curable life threatening pathology.

关键词： Gallbladder Incidental Cholecystectomy Histopathology Carcinoma

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