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Evaluation of the safety and effectiveness of direct oral anticoagulants and low molecular weight heparin in gastrointestinal cancer-associated venous thromboembolism

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World journal of Gastrointestinal Oncology 2019年第10期11卷 866-876页

作者： Alejandro Recio-Boiles Sumana Veeravelli jessica Vondrak Hani M Babiker Aaron j Scott Rachna T Shroff Hitendra patel Emad Elquza Ali McBride Department of Medicine Hematology and Medical OncologyUniversity of Arizona Cancer CenterTucsonAZ 85724United States Department of Medicine Internal Medicine Residency ProgramUniversity of ArizonaTucsonAZ 85725United States UC San Diego Health Moores Cancer Center La JollaCA 92093United States University of Arizona College of Pharmacy TucsonAZ 85725United States

BACKGROUND Gastrointestinal cancer(GICA)is associated with a higher incidence of venous thromboembolism(VTE)compared to other solid tumors,moreover,recurrent VTE and major bleeding(MB)complications during anticoagulation treatment have an associated increase ***-VTE remains a challenging clinical scenario with MB concerns for utilization of direct oral anticoagulants(DOAC),especially with active cancer *** To evaluate patient risk factors,effectiveness(VTE)and safety(MB)of DOACs and low molecular weight heparin(LMWH)in patients with active *** A retrospective chart review of patients receiving DOACs and LMWH with GICA and symptomatic or incidental VTE treated at comprehensive cancer center from November 2013 to February 2017 was *** criteria included active GI cancer diagnosed at any stage or treatment+/-6 mo of VTE diagnosis,whom were prescribed 6 mo or more of DOACs or *** Chi-squared test was used for overall and the Fisher exact test for pairwise comparisons of the proportions of patients experiencing recurrent VTE and MB *** ratios were used to compare the relative odds of the occurrence of the outcome given exposure to the risk *** A total of 144 patients were prescribed anticoagulation,in which 106 fulfilled inclusion criteria apixaban(27.3%),rivaroxaban(34.9%)and enoxaparin(37.7%),and 38 were *** median age was 66.5 years at GICA diagnosis and 67 years at CAVTE event,with 62%males,80%Caucasian,70%stage IV,pancreatic cancer(40.5%),30%Khorana Score(≥3 points),and 43.5%on active ***-four percent of patients completed anticoagulation therapy(range 1 to 43 mo).Recurrent VTE at 6 mo was noted in 7.5%(n=3),6.8%(n=2)and 2.7%(n=1)of patients on enoxaparin,apixaban and rivaroxaban,respectively(all P=NS).MB at 6 mo were 5%(n=2)for enoxaparin,6.8%(n=2)for apixaban and 21.6%(n=8)for rivaroxaban(overall P=0.048;vs LMWH P=0.0423;all other P=NS).Significant predictors of a prim

关键词： Direct oral anticoagulants Low molecular weight heparin Gastrointestinal cancer Venous thromboembolism Cancer associated thrombosis Clinical risk

Albumin as a prognostic marker for ulcerative colitis

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World journal of Gastroenterology 2017年第45期23卷 8008-8016页

作者： Nabeel Khan Dhruvan patel Yash Shah Chinmay Trivedi Yu-Xiao Yang Section of Gastroenterology University of Pennsylvania Perelman School of Medicine Section of Gastroenterology Corporal Michael J. Crescenz VA Medical Center Department of Gastroenterology Drexel University College of Medicine Department of Internal Medicine Icahn School of Medicine at Mount SinaiJames J. Peters VA Medical Center

AIM To evaluate the role of albumin at the time of ulcerative colitis(UC) diagnosis in predicting the clinical course of *** Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified and divided into two categories: hypoalbuminemia(i.e.,≤ 3.5 gm/dl) or normal albumin levels(i.e.,> 3.5 gm/dl) at the time of UC diagnosis. The exposure of interest was presence of hypoalbuminemia defined asalbumin level ≤ 3.5 g/dl at the time of UC diagnosis. Patients were then followed over time to identify the use of ≥ 2 courses of corticosteroids(CS),thiopurines,anti-TNF medications and requirement of colectomy for UC management. RESULTS The eligible study cohort included 802 patients,but 92(11.4%) patients did not have their albumin levels checked at the time of UC diagnosis,and they were excluded. A total of 710 patients,who had albumin levels checked at time of UC diagnosis,were included in our study. Amongst them,536 patients had a normal albumin level and 174 patients had hypoalbuminemia. Patients with hypoalbuminemia at diagnosis had a higher likelihood of ≥ 2 courses of CS use(adjusted HR = 1.7,95%CI: 1.3-2.3),higher likelihood of thiopurine or anti-TNF use(adjusted HR = 1.72,95%CI: 1.23-2.40) than patients with normal albumin level at diagnosis. There was a trend of higher likelihood of colectomy in hypoalbuminemic patients,but it was not statistically significant(Adjusted HR = 1.7,95%CI: 0.90-3.25).CONCLUSION Hypoalbuminemia at disease diagnosis can serve as a prognostic marker to predict the clinical course of UC at the time of diagnosis.

关键词： Prognostic marker Albumin Ulcerative colitis Disease course Colectomy

Atrial fibrillation in the elderly: the potential contribution of reactive oxygen species

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journal of Geriatric Cardiology 2012年第4期9卷 379-388页

作者： Kurt j. Schillinger Vickas V. patel Penn Cardiovascular Institute and Section of Cardiac Electrophysiology University of Pennsylvania Philadelphia PA 19104 USA

Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia, and is a significant source of healthcare expenditures throughout the world. It is an arrhythmia with a very clearly defined predisposition for individuals of advanced age, and this fact has led to intense study of the mechanistic links between aging and AF. By promoting oxidative damage tomultiple subcellular and cellular structures, reactive oxygen species (ROS) have been shown to induce the intra- and extra-cellular changes necessary to promote the pathogenesis of *** addition, the generation and accumulation of ROS have been intimately linked to the cellular processeswhich underlie aging. This review begins with an overview of AF pathophysiology, and introduces the critical structures which, when damaged, predispose an otherwise healthy atrium toAF. The available evidence thatROS can lead to damage of these critical structures is then reviewed. Finally, the evidence linking the process of aging to the pathogenesis of AF is discussed.

关键词： Aging Arrhythmia Atrial fibrillation Cardiac Free radicals Oxidative stress Redox

无动脉粥样硬化性心血管疾病的糖尿病成人患者预测和预防心力衰竭风险的最佳筛查方法:汇总队列分析

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中华高血压杂志 2024年第1期32卷 7-7页

作者： patel KV Segar MW Klonoff DC Khan MS Usman MS Lam CSP Verma S.DeFlilippis AP Nasir K Bakker SjL Westenbrink BD Dullaart RPF Butler j Vaduganathan M Pandey A 袁源(译) 郑武洪(审校) 不详

尚无最佳筛查方法识别发展为心力衰竭的高风险糖尿病个体,以制定预防治疗措施,特别是对于未患动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)的糖尿病个体。方法:研究纳入7项社区队列、基线时患有糖尿病但未... 详细信息

尚无最佳筛查方法识别发展为心力衰竭的高风险糖尿病个体,以制定预防治疗措施,特别是对于未患动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)的糖尿病个体。方法:研究纳入7项社区队列、基线时患有糖尿病但未患心力衰竭的成年人。

关键词：动脉粥样硬化性心血管疾病筛查方法成人患者预防治疗措施队列分析心力衰竭糖尿病高风险

Floodplain Delineation Using HECRAS Model—A Case Study of Surat City

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Open journal of Modern Hydrology 2016年第1期6卷 34-42页

作者： Chandresh G. patel Pradip j. Gundaliya Department of Civil Engineering UVPCE Ganpat University Kherva India Lalbhai Dalpatbhai College of Engineering Ahmedabad India

Surat city, the commercial capital of Gujarat state, India is situated at latitude 21°06’ to 21°15’ N and longitude 72°45' to 72°54'E on the bank of river Tapi and is affected by flood once in every five years since last hundred years. Present study describes the application of HEC-RAS model with integration of GIS for delineation of flood plain. Digital Elevation Model (DEM) of Surat city is used as main input for flood inundation mapping. River section near Nehru Bridge is used as sample case to simulate flood flow. Discharges equal to food return period for 25 and 32 (worst flood year) have been used for investigation of flood scenario. Outcome of the research clearly indicates that most of the area of the Surat city is submerged for a depth of 2.5 to 4.0 m when the discharge released from Ukai dam equals to return period of 32 years (25768.09 Cumecs).

关键词： Surat Flood River Tapi Return Period HEC-RAS

An Evaluation of Air Pollution Tolerance Index and Anticipated Performance Index of Some Tree Species Considered for Green Belt Development: A Case Study of Nandesari Industrial Area, Vadodara, Gujarat, India

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Open journal of Air Pollution 2018年第1期7卷 1-13页

作者： Dhruti patel j. I. Nirmal Kumar Department of Environmental Science & Technology (DEST) Institute of Science and Technology for Advanced Studies & Research (ISTAR) Vallabh Vidyanagar India

It is well renowned that trees have capacity to reduce the air pollution. It is mandatory to expand tree plantation in industrial area to minimize the threat of pollutants. For green belt development, it is necessary to use plants that are tolerant to air pollution. The present study includes Air pollution tolerance index (APTI) of selected plant species with the help of biochemical analysis. On the basis of APTI and some other socioeconomic and biological parameters of plants, Anticipated Performance Index (API) was calculated. Out of twelve species, Ficus benghalensis showed to be the most efficient among others. As per classification of API, Ficus religiosa tree species is classified into the moderate category. Based on the APTI and API, appropriate plant species for green belt development in industrial area were identified and recommended for mitigating the pollution.

关键词： Air Pollution APTI API Nandesari Green Belt

Long-term, in vivo therapeutic effects of a single dose of miR-145 micelles for atherosclerosis

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Bioactive Materials 2023年第9期27卷 327-336页

作者： Deborah D.Chin Neil patel Woori Lee Sonali Kanaya jackson Cook Eun ji Chung Department of Biomedical Engineering University of Southern CaliforniaLos AngelesCA90089United States Division of Vascular Surgery and Endovascular Therapy Department of SurgeryKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States Mork Family Department of Chemical Engineering and Materials Science University of Southern CaliforniaLos AngelesCA90089United States Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States Division of Nephrology and Hypertension Department of MedicineKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States Norris Comprehensive Cancer Center Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90089United States

Atherosclerosis is a chronic inflammatory disease that is characterized by the build-up of lipid-rich plaques in the arterial walls. The standard treatment for patients with atherosclerosis is statin therapy aimed to lower serum lipid levels. Despite its widespread use, many patients taking statins continue to experience acute events. Thus, to develop improved and alternative therapies, we previously reported on microRNA-145 (miR-145 micelles) and its ability to inhibit atherosclerosis by targeting vascular smooth muscle cells (VSMCs). Importantly, one dose of miR-145 micelles significantly abrogated disease progression when evaluated two weeks post-administration. Thus, in this study, to evaluate how long the sustained effects of miR-145 micelles can be maintained and towards identifying a dosing regimen that is practical for patients with chronic disease, the therapeutic effects of a single dose of miR-145 micelles were evaluated for up to two months in vivo. After one and two months post-treatment, miR-145 micelles were found to reduce plaque size and overall lesion area compared to all other controls including statins without causing adverse effects. Furthermore, a single dose of miR-145 micelle treatment inhibited VSMC transdifferentiation into pathogenic macrophage-like and osteogenic cells in plaques. Together, our data shows the long-term efficacy and sustained effects of miR-145 micelles that is amenable using a dosing frequency relevant to chronic disease patients.

关键词： MicroRNA-145 Atherosclerosis Vascular smooth muscle cell Nanoparticle Gene therapy

Robot-assisted retroperitoneal lymphadenectomy:The state of art

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Asian journal of Urology 2021年第1期8卷 27-37页

作者： Gilberto j.Rodrigues Giuliano B.Guglielmetti Marcelo Orvieto Kulthe Ramesh Seetharam Bhat Vipul R.patel Rafael F.Coelho Sao Paulo State Cancer Institute University of Sao Paulo School of MedicineSao PauloBrazil Clı´nica Alemana SantiagoChile Department of Urology AdventHealth Global Robotics InstituteCelebrationFLUnited States

Objective:To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy(R-RPLND)in the management of testicular ***:A PubMed search for all relevant publications regarding the R-RPLND series up until August 2019 was *** largest series were identified,and weighted means calculated for outcomes using the number of patients included in each study as the weighting ***:Fifty-six articles of R-RPLND were identified and eight series with more than 10 patients in each were *** weighted mean age was 31.12 years;primary and post chemotherapy R-RPLND were performed in 50.59%and 49.41%of *** clinical stage was I,II and III in 47.20%,39.57%and 13.23%of patients.A modified R-RPLND template was used in 78.02%of patients,while 21.98%underwent bilateral full *** weighted mean node yield,operative time and estimated blood loss were,respectively,22.15 nodes,277.35 min and 131.94 *** weighted mean length of hospital stay was 2 days and antegrade ejaculation was preserved in 92.12%of *** post-operative complications(Clavien III or IV)occurred in 5.34%.Positive pathological nodes were detected in 24.54%,while the recurrence free survival was 95.77%with a follow-up of 21.81 ***:R-RPLND has proven to be a reproducible and safe approach in experienced centers;short-term oncologic outcomes are similar to the open approach with less morbidity and shorter convalescence related to its minimal ***,longer follow-up and new trials comparing head-to-head both techniques are expected.

关键词： Testicular neoplasms Lymphadenectomy Robotic surgical procedures

Genetic diseases conferring resistance to infectious diseases

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Genes & Diseases 2015年第3期2卷 247-254页

作者： Isabelle C.Withrock Stephen j.Anderson Matthew A.jefferson Garrett R.McCormack Gregory S.A.Mlynarczyk Aron Nakama jennifer K.Lange Carrie A.Berg Sreemoyee Acharya Matthew L.Stock Melissa S.Lind K.C.Luna Naveen C.Kondru Sireesha Manne bhavika B.patel Bierlein Mde la Rosa Kuei-Pin Huang Shaunik Sharma Hilary Z.Hu Sri Harsha Kanuri Steve A.Carlson Department of Biomedical Sciences Iowa State University College of Veterinary MedicineAmesIA 50011USA Department of Psychology Iowa State University College of Liberal Arts and SciencesAmesIA 50011USA Department of Kinesiology Iowa State University College of Liberal Arts and SciencesAmesIA 50011USA Department of Genetics Developmental and Cell BiologyIowa State University College of Liberal Arts and SciencesAmesIA 50011USA Neuroscience Interdepartmental Program Iowa State UniversityAmesIA 50011USA

This review considers available evidence for mechanisms of conferred adaptive advantages in the face of specific infectious *** short,we explore a number of genetic conditions,which carry some benefits in adverse circumstances including exposure to infectious *** examples discussed are conditions known to result in resistance to a specific infectious disease,or have been proposed as being associated with resistance to various infectious *** infectious diseasedgenetic disorder pairings include malaria and hemoglobinopathies,cholera and cystic fibrosis,tuberculosis and Tay-Sachs disease,mycotic abortions and phenylketonuria,infection by enveloped viruses and disorders of glycosylation,infection by filoviruses and NiemannePick C1 disease,as well as rabies and myasthenia *** also discuss two genetic conditions that lead to infectious disease hypersusceptibility,although we did not cover the large number of immunologic defects leading to infectious disease *** of the resistance-associated pairings(malaria/hemogloginopathies,cholera/cystic fibrosis,tuberculosis/Tay-Sachs,and mycotic abortions/phenylketonuria)appear to be a result of selection pressures in geographic regions in which the specific infectious agent is *** other pairings do not appear to be based on selection pressure and instead may be ***,research investigating these relationships may lead to treatment options for the aforementioned diseases by exploiting established mechanisms between genetically affected cells and infectious *** may prove invaluable as a starting point for research in the case of diseases that currently have no reliably curative treatments,e.g.,HIV,rabies,and Ebola.

关键词： Disease Infectious Pathogen Polymorphism Resistance Susceptibility