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Endoscopy during COVID-19 pandemic: An overview of infection control measures and practical application

World Journal of Gastrointestinal Endoscopy 2020年第9期12卷 256-265页

作者： Margaret Teng Si Ying Tang calvin jianyi koh Gastroenterology and Hepatology National University HospitalSingapore 119228Singapore Division of Gastroenterology and Hepatology National University Health SystemSingapore 119074Singapore

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in coronavirus disease 2019(COVID-19)which has affected more than 4.5 million people in 213 countries,and has been declared a pandemic by World Health Organization on March 11,*** transmission of SARS-CoV-2 has been reported to occur primarily through direct contact or *** have also been reports that SARS-CoV-2 can be detected in biopsy and stool specimens,and it has been postulated that there is potential for fecal–oral transmission as *** symptoms have been reported in 17.6%of COVID-19 patients and transmission can potentially occur through gastrointestinal secretions in this group of ***,transmission can also occur in asymptomatic carriers or patients with viral shedding during the incubation *** procedures hence may pose significant risks of transmission(even for those not directly involving confirmed COVID-19 cases)as endoscopists and endoscopy staff are in close contact with patients during these aerosol generating *** could result in inadvertent transmission of infection at time of endoscopy.

关键词： Coronavirus Endoscopy Infection control Personal protective equipment Guidelines Gastroenterology

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Dental trauma in endoscopy:A systematic review and experience of a tertiary endoscopy centre

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World Journal of Gastrointestinal Endoscopy 2023年第8期15卷 518-527页

作者： Chelsea Qiu Lin Tan Gabrielle Yi Wen Loh Tay Wei Rong Benjamin calvin jianyi koh John Shao Rong Mok Juanda Leo Hartono Kai Ting Cheryl Chua Hee Hon Tan Kewin Tien Ho Siah Yong Loo Lin School of Medicine National University of SingaporeSingapore 117594Singapore Division of Gastroenterology and Hepatology National University Health SystemSingapore 119074Singapore Department of Medicine Ng Teng Fong General HospitalSingapore Division of Prosthodontics National University Centre for Oral HealthSingapore 119074Singapore

BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of *** To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of *** Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of *** of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be ***-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time *** retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific *** Dental complications occur in approximately 1 in 300 of upper endoscopy *** are easily preventable by pre-endoscopy *** to mitigate dental injury are also suggested.

关键词： Teeth Dental trauma Endoscopy Digestive system

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Validation of genetic variants associated with metabolic dysfunctionassociated fatty liver disease in an ethnic Chinese population

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World Journal of Hepatology 2020年第12期12卷 1228-1238页

作者： Guan Huei Lee Wah Wah Phyo Wai Mun Loo Raymond Kwok Taufique Ahmed Asim Shabbir Jimmy So calvin jianyi koh Juanda Leo Hartono Mark Muthiah Kieron Lim Poh Seng Tan Yin Mei Lee Seng GeeLim Yock Young Dan Division of Gastroenterology and Hepatology Department of MedicineNational University Health SystemSingapore 119228Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine Khoo Teck Puat HospitalSingapore 768828Singapore Department of Surgery National University Health SystemSingapore 119228Singapore

BACKGROUND Genetic factors play an important role in the pathogenesis and development of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To study the association of single nucleotide polymorphisms(SNPs),previously identified in Western populations,with the risk of MAFLD in a Singapore Chinese population and their interactions with environmental and medical risk *** A retrospective case-control study was conducted with 72 MAFLD cases and 72 controls with no hepatic steatosis on computed tomography,magnetic resonance imaging,or controlled attenuation parameter *** were recruited from two tertiary *** alleles such as NCAN,GCKR,LYPLAL1,PNPLA3,PPP1R3B,FDFT1,COL13A1,EFCAB4B,PZP,and TM6SF2 were genotyped using the TaqMan®Predesigned SNP Genotyping *** Weight and body mass index(BMI)were 1.2-times higher in patients(70.6 kg,95%confidence interval[CI]:57.1-84.1 vs 60.8 kg,95%CI:48.5-73.1,P<0.001 and 26.9 kg,95%CI:23-40.8 vs 23.3 kg 95%CI:19-27.6,P<0.001 respectively).The prevalence of diabetes mellitus in patients was 40.3%and 20.8%in controls(P=0.011).Patients had higher mean triglycerides than controls(P<0.001).PNPLA3 GG was more likely to be associated with MAFLD(43.4%CC vs 69.7%GG,P=0.017,and 44.8%CG vs 69.7%GG,P=0.022).In multivariable analysis,hypertriglyceridemia(odds ratio[OR]:2.0495%CI:1.3-3.1,P=0.001),BMI(OR:1.295%CI:1.1-1.4,P<0.001)and PNPLA3 GG(OR:3.495%CI:1.3-9.2,P=0.014)were associated with MAFLD(area under the receiver operating characteristic curve of 0.823).CONCLUSION Among the Chinese population of Singapore,PNPLA3 homozygous GG allele is a strong predictor of MAFLD,whereas LYPLAL1,GCKR,FDFT1,COL13A1,PZP,and TM6SF2 are not significantly ***,high BMI,and PNPLA3 GG are independent predictors of MAFLD.

关键词： Single nucleotide polymorphism PNPLA3 Genotyping Metabolic dysfunction-associated fatty liver disease Non-alcoholic steatohepatitis Hypertriglyceridemia Body mass index Waist-hip ratio,Screening Hepatic steatosis

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Risk factors for ribavirin treatment failure in Asian organ transplant recipients with chronic hepatitis E infection

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World Journal of Hepatology 2019年第6期11卷 553-561页

作者： En Xian Sarah Low Edhel Tripon Kieron Lim Poh Seng Tan How Cheng Low Yock Young Dan Yin Mei Lee Mark Muthiah Wai Mun Loo calvin jianyi koh Wah Wah Phyo JunXiong Pang Seng Gee Lim Guan-Huei Lee Department of Medicine Ng Teng Fong General HospitalNational University Health SystemSingapore 609606Singapore Centre for Liver Disease Management and Transplant of Medical City Manila 1605Philippines Mount Elizabeth Medical Centre Singapore 228510Singapore Division of Gastroenterology and Hepatology National University Health SystemSingapore 119228Singapore Department of Medicine National University of SingaporeSingapore 119077Singapore Centre for Infectious Disease Epidemiology and Research National University of SingaporeSingapore 117549Singapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore

BACKGROUND Hepatitis E virus(HEV)infection is a cause of chronic hepatitis in immunosuppressed *** virologic response rates to a 12-wk course of ribavirin therapy were reported to be>70%in the *** study describes the outcome of HEV treatment in a transplant center in *** To study the outcome of ribavirin treatment in a series of chronic HEV patients,and the cause of treatment *** We studied all of the transplant recipients who were diagnosed with HEV infection between 2012 to *** outcome of therapy and virologic relapse are monitored for three years after the end of *** Ten transplant recipients(4 liver,5 kidney,and 1 bone marrow transplantation)with positive HEV RNA were *** patients received at least 12 wk of ribavirin therapy,and the remaining patient resolved after reducing immunosuppression *** subjects had prolonged viremia that lasted more than one year,despite continuous ribavirin *** ribavirin-treated patients(44.4%)had HEV RNA relapse after achieving a virologic response by the end of *** overall failure rate is 66.7%.Being a kidney transplant recipient is the strongest risk factor for not achieving an initial sustained virologic response(0/5 treated,Chi-Square test,P<0.05).The most common side effect of ribavirin is anemia(100%)(haemoglobin reduction of 3-6.2 g/dL).Seven patients required either a blood transfusion or erythropoietin *** The sustained virologic response rate of 12-wk ribavirin therapy for HEV infection in this Asian series was lower than *** transplant recipients had a higher rate of treatment failure due to higher immunosuppression requirements and adverse effects.

关键词： Toxicity Antiviral agents Hepatitis E virus Virus classification Systemic immunity Immune responses Persistent infection

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