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Gastroenterology Report 2019年第2期7卷 107-114,I0002页

作者： Fares Ayoub Amir Y.Kamel ahmed Ouni Naueen Chaudhry Yan Ader Sanda Tan atif Iqbal Ellen M.Zimmermann Sarah C.Glover Department of Medicine University of FloridaGainesvilleFLUSA Department of Pharmacy University of FloridaGainesvilleFLUSA Division of Gastroenterology Hepatology&NutritionDepartment of MedicineUniversity of FloridaGainesvilleFLUSA Department of Surgery University of FloridaGainesvilleFLUSA

背景:尽管克罗恩病(CD)的药物治疗取得了重大进展,但仍有相当一部分患者在诊断后5年内需要接受外科手术治疗。营养不良是胃肠手术疗效欠佳的独立危险因素。术前全胃肠外营养(TPN)在CD患者中的应用价值,各项研究数据并不一致,而且缺少生... 详细信息

背景:尽管克罗恩病(CD)的药物治疗取得了重大进展,但仍有相当一部分患者在诊断后5年内需要接受外科手术治疗。营养不良是胃肠手术疗效欠佳的独立危险因素。术前全胃肠外营养(TPN)在CD患者中的应用价值,各项研究数据并不一致,而且缺少生物治疗时代的相关研究数据。本研究旨在明确TPN在CD手术患者中的应用价值。方法:这是一项在一家三级转诊中心完成的回顾性队例研究。纳入接受主要腹部手术的CD患者,按术前有无接受TPN治疗分为TPN组与非TPN组。比较两组患者术后30天感染性与非感染性并发症发生率。结果:纳入2007年3月至2017年3月间行主要腹部手术的144例CD患者,其中55例接受术前TPN治疗,非TPN组89例。21例(14.6%)患者术后出现感染性并发症,其中TPN组与非TPN组发生率分别为18.2%和12.3%(P=0.34);23例(15.9%)术后发生非感染性并发症,其中TPN组与非TPN组发生率分别为14.5%和16.9%(P=0.71)。采用多因素分析校正两组间基线疾病严重度和营养不良程度的差异后,术前TPN治疗≥60天的患者,其术后发生非感染性并发症的风险显著降低(OR=0.07,95%CI:0.01-0.80,P=0.03)。近6个月内体重下降>10%则是术后并发症的危险因素。结论:对于营养不良的CD患者,TPN是安全的,而且可以使其获得与营养正常CD患者相当的手术疗效。术前行≥60天TPN治疗可减少术后非感染性并发症的发生,而且并不会增加感染性并发症的发生概率。

关键词： Crohn’s disease total parenteral nutrition pre-operative malnutrition post-operative complications

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Neuroblastoma in Saudi Children: A Single Center Experience (2006-2014)

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Journal of Cancer Therapy 2015年第10期6卷 896-905页

作者： Zaid Al Naqib atif A. ahmed Musa Al Harbi Fahad Al Manjomi Zaheer Ullah Khan Awatif Alanazi Othman Mosleh Walid Ballourah Mohammed Rayis Pediatric Hematology/Oncology Division King Fahad Medical City Riyadh Saudi Arabia Department of Pathology and Laboratory Medicine Children’s Mercy Hospital Kansas City USA

Introduction: Neuroblastoma is the most common extracranial solid tumor in childhood and survival rate has improved during the last few decades. Only a few studies, related to Neuroblastoma in Saudi Arabian children, have been performed. We report epidemiologic data and our clinical experience from the department of Pediatric Hematology Oncology (PHO), King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. Method: A retrospective observational study of all patients, with diagnosis of Neuroblastoma, who attended PHO-KFMC from July 2006 to June 2014 was performed. The survival periods (overall survival and disease-free survival) and the final outcomes for patients treated and followed at KFMC were recorded. The survival data were statistically correlated with the clinical, pathological and biological features of patients and tumors and compared to national and international cohorts. Results: Eight-year data were available for the 42 patients of which 22 (52.4%) were male and 20 (47.6%) were females. Age at diagnosis ranged 0 - 91 months with a mean and median of 26.3 and 18.5 months respectively. 16 (38.1%) patients were under one year and 26 (61.9%) above 1 year of age. The event-free survival (EFS) and overall survival (OS) rates were 66.5% and 71.5% respectively. EFS and OS among those who were <1 year age at presentation was 75% and 82%, whereas ≥1 yr age group had 59% and 62% survival rates respectively. Patients with tumors in the adrenal had considerably lower EFS (59%) and OS (63%);in comparison to patients with tumors sites other than the adrenal who had EFS and OS of 85% and 89% respectively. Both EFS and OS survival rates at the end of follow-up interval were 100.0%, in the low and intermediate risk groups. In contrast, patients in the high risk group had EFS and OS rates of 44% and 48% respectively. This difference was statistically significant (p < 0.05). Conclusion: Our results are very encouraging and comparable with known published international cohorts

关键词： Children Neuroblastoma Saudi Arabia Survival

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Prevalence of unsuspected thyroid nodules in adults on contrast enhanced 16-and 64-MDCT of the chest

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World Journal of Radiology 2012年第7期4卷 311-317页

作者： Sameer ahmed Pamela T Johnson Karen M Horton atif Zaheer Saline Tsai Elliot K Fishman Russell H Morgan Department of Radiology and Radiological Science Johns Hopkins Hospital Baltimore MD 21212 United States

AIM: To determine the prevalence of unsuspected thyroid nodules on contrast enhanced 16and 64-modified discrete cosine transform (MDCT) of the chest, in a population of adult outpatients imaged for indications other than thyroid disease. METHODS: This retrospective study involved review of intravascular contrast-enhanced MDCT scans of the chest from 3077 consecutive adult outpatients, to identify unsuspected thyroid nodules. Exclusion criteria included history of thyroid cancer, known thyroid nodules or thyroid disease and risk factors for thyroid cancer, as evidenced by their medical records. One of 9 radiologists recorded number of nodules, location and bidirectional measurement of largest nodule, as well as amount of thyroid visualized on the chest computed tomography (CT). Presence of nodule was correlated with age, gender, race and percentage of thyroid imaged. RESULTS: A total of 2510 (2510/3077 or 81.6%) study subjects were included in the data analysis; among them,one or more nodules were identified in 629 subjects (629/2510 or 25.1%), with 242 (242/629 or 38.5%) having multiple nodules. Patients with nodule(s) were significantly older than those without (64 ± 13 years vs 58 ± 14 years, P < 0.0001), and female gender was associated with presence of nodule(s) (373/1222 or 30.5% vs 256/1288 or 19.9%, P < 0.0001). Women were also more likely having multiple nodules (167/373 or 44.8%) compared to men (75/256 or 29.3%, P < 0.0001). The majority of nodules (427/629 or 67.9%) were less than 1 cm. CONCLUSION: This retrospective review revealed a prevalence of 25.1% for unsuspected thyroid nodules on contrast-enhanced chest CT.

关键词： Thyroid nodule Thyroid cancer Multidetector cosine transform Incidental finding Chest computed tomography

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How does epidemiological and clinicopathological features affect survival after gastrectomy for gastric cancer patientssingle Egyptian center experience

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World Journal of Gastrointestinal Surgery 2016年第6期8卷 444-451页

作者： Ehab El Hanafy Ayman El Nakeeb Helmy Ezzat Emad Hamdy Ehab atif Tharwat Kandil Amgad Fouad Mohamed Abdel Wahab ahmed Monier Gastroenterology Surgical Center Mansoura University

AIM:To investigate the clinicopathological features and the significance of different prognostic factors which predict surgical overall survival in patients with gastric ***:This retrospective study includes 80 patients diagnosed and treated at gastroenterology surgical center,Mansoura University,Egypt between February 2009 to February *** factors were assessed by cox proportional hazard ***:There were 57 male and 23 *** median age was 57 years(24-83).One,3 and 5 years survival rates were 71%,69% and 46% *** median survival was 69.96 *** the follow-up period,13 patients died(16%).Hospital morbidity was reported in 10 patients(12.5%).The median number of lymph nodes removed was 22(4-41).Lymph node(LN) involvement was found in 91% of *** R0 resection,depth of wall invasion,LN involvement and the number(> 15) of retrieved LN,LN ratio and tumor differentiation predict *** multivariable analysis,tumor differentiation,curability of resection and a number of resected LN superior to 15 were found to beindependent prognostic ***:Surgery remains the cornerstone of *** differentiation,curability of resection and a number of resected LN superior to 15 were found to be independent prognostic *** LN dissection does not increase the morbidity or mortality rate but markedly improves long term survival.

关键词： Cancer stomach Prognostic factors Lymph node metastasis Recurrence after gastrectomy Lymph node ratio

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