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A rare cause of gastro-intestinal hemorrhage in a patient with a Roux-en-Y gastric bypass

Gastroenterology Report 2016年第1期4卷 84-86,I0003页

作者： Richard H.Cartabuke Paresh P.Mehta Kevin El-Hayek J.Michael Henderson carol a.burke Department of Internal Medicine Cleveland ClinicClevelandOhioUSA Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOhioUSA Department of General Surgery Cleveland ClinicClevelandOhioUSA

This case illustrates a rare cause of gastro-intestinal bleeding following bariatric *** it is essential to rule out common causes of variceal formation accompanied by intermittent,profuse bleeding,there should be a high degree of suspicion of this rare etiology in patients who have previously undergone alteration of their anatomy,especially Roux-en-Y gastric bypass(RYGB).The case emphasizes the need for a multidisciplinary medical-surgical team in evaluating and treating patients who present with complex intra-abdominal pathology.

关键词： gastro-intestinal bleeding superior mesenteric venous thrombosis Roux-en-Y gastric bypass

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Ecological factors influencing the beneficial endosymbionts of the hemlock woolly adelgid (Hemiptera:Adelgidae)

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Insect Science 2019年第1期26卷 97-107页

作者： Angela M.Mech Sherilyn J.Harper Nathan P.Havill carol D.von Dohlen Gaelen R.burke Department of Entomology University of GeorgiaAthensGeorgiaUSA School of Environmental and Forest Sciences University of WashingtonSeattleWashingtonUSA USDA Forest Service Northern Research StationHamdenConnecticutUSA Department of Biology Utah State UniversityLoganUtahUSA

Bacterial endosymbionts of sap-sucking insects provide their host with a num- ber of beneficial qualities,including the supply of nutrition,defense against parasitoids, and protection from heat *** to these bacterial associates can therefore have a negative impact on the fitness of their insect *** evaluated observational and experi- mental factors regarding the normative hemlock woolly adelgid (Adelges tsugae Annand) (Hemiptera:Adelgidae)to help understand the roles of its three recently identified symbionts,including under heat stress *** prevalence of ***'s facultafive symbiont (Serratia symbiotica)was examined at different spatial scales to determine how variable infection rates are for this *** was no significant difference found in infection rates between adelgids on a tree,within a plot,or within a ***, significantly more adelgids in Georgia (95%)had *** compared to those in New York (68%).Microsatellite genotyping of the adelgids found that this difference was most likely not the result of a second introduction *** into eastern North *** *** proportions between first and fourth instars showed that symbiont absence did not affect the ability *** to survive *** of sym- biont densities within each adelgid found that when *** was absent,the density of obligate symbionts was significantly *** to heat stress (32.5℃)was not consistently correlated with changes in symbiont densities over a 4-d ***,we have shown that symbiont prevalence and densities vary within the broad population of *** in eastern North America,with potentially significant effects upon the ecology of this important pest.

关键词： Adelges tsugae Anncindia adelgestsuga bacterial endosymbionts Serratia symbiotica Pseudomonas adelgestsugas

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Association of cancer with comorbid inflammatory conditions and treatment in patients with Lynch syndrome

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World Journal of Clinical Oncology 2022年第1期13卷 49-61页

作者： Muhammad S Faisal carol a.burke David Liska Amy L Lightner Brandie Leach Margaret O’Malley Lisa LaGuardia Benjamin Click JP Achkar Matthew Kalady JM Church Gautam Mankaney Department of Internal Medicine Cleveland Clinic FoundationClevelandOH 44195United States Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOH 44195United States Department of Colorectal Surgery Cleveland ClinicClevelandOH 44195United States Center for Personalized Genetic Healthcare Genomic Medicine InstituteClevelandOH 44195United States Department of Gastroenterology Hepatology&NutritionCleveland ClinicClevelandOH 44195United States Center for Inflammatory Bowel Disease Department of GastroenterologyHepatology and NutritionCleveland ClinicClevelandOH 44195United States Department of Colorectal Surgery Ohio State UniversityColumbusOH 43210United States Department of Gastroenterology and Hepatology Virginia Mason Franciscan HealthSeattleWA 98101United States

BACKGROUND Individuals with Lynch syndrome(LS)and hereditary non-polyposis colorectal cancer(HNPCC)are at increased risk of both colorectal cancer and other *** interplay between immunosuppression,a comorbid inflammatory condition(CID),and HNPCC on cancer risk is *** To evaluate the impact of CIDs,and exposure to monoclonal antibodies and immunomodulators,on cancer risk in individuals with *** Individuals prospectively followed in a hereditary cancer registry with LS/HNPCC with the diagnosis of inflammatory bowel disease or rheumatic disease were *** compared the proportion of patients with cancer in LS/HNPCC group with and without a *** also compared the proportion of patients who developed cancer following a CID diagnosis based upon exposure to immunosuppressive *** A total of 21 patients with LS/HNPCC and a CID were compared to 43 patients with LS/HNPCC but no *** occurred in 84.2% with a CID compared to 76.7% without a CID(P=0.74)with no difference in age at first cancer diagnosis 45.5±14.6 vs 43.8±7.1 years(P=0.67).LS specific cancers were diagnosed in 52.4% with a CID vs 44.2% without a CID(P=0.54).Nine of 21(42.9%)patients were exposed to biologics or immunomodulators for the treatment of their *** after diagnosis of CID was seen in 7(77.8%)of exposed individuals vs 5(41.7%)individuals unexposed to biologics/immunomodulators(P=0.18).All 7 exposed compared to 3/5 unexposed developed a LS specific *** exposed and unexposed groups were followed for a median 10 years and 8.5 years,*** hazard ratio for cancer with medication exposure was 1.59(P=0.43,95%CI:0.5-5.1).CONCLUSION In patients with LS/HNPCC,the presence of a concurrent inflammatory condition,or use of immunosuppressive medication to treat the inflammatory condition,might not increase the rate of cancer occurrence in this limited study.

关键词： Lynch syndrome Hereditary non-polyposis colorectal cancer Inflammatory bowel disease Immunosuppression Biologics

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