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Multicenter,randomized study to optimize bowel for colon capsule endoscopy

World Journal of Gastroenterology 2017年第48期23卷 8615-8625页

作者： david Kastenberg Wilmot c Burch Jr david P Romeo Pankaj K Kashyap David C Pound Neophytos Papageorgiou Ignacio Fernández-Urien Sainz carly E Sokach Douglas K Rex Division of Gastroenterology Thomas Jefferson University Franklin Gastroenterology PLLC Dayton Gastroenterology Inc. Pinnacle Research Group LLc Indianapolis Gastroenterology and hepatology Department of Gastroenterology American Medical Center Department of Gastroenterology Servicio de Digestivohospital de Navarra Sidney Kimmel Medical college at Thomas Jefferson University Indiana University hospital

AIM To assess the cleansing efficacy and safety of a new colon capsule endoscopy(ccE) bowel preparation regimen.METHODS This was a multicenter,prospective,randomized,controlled study comparing two ccE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation ccE system(Pill cam? cOLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,ccE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,control = 77.3%;P = 0.88) and individual segments. In the Study group,ccE completion was superior(Study = 90.9%,control = 76.9%;P = 0.048) and colonic transit was more often control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study groups.cONcLUSION A ccE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior ccE completion.

关键词： Bowel preparation Purgative capsule endoscopy Endoscopy capsule colonoscopy Large intestine

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Exercise immunology:Novel insights

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Journal of Sport and Health Science 2024年第3期13卷 277-279,I0001页

作者： david c.Nieman Human Performance Laboratory Appalachian State UniversityNorth Carolina Research CampusKannapolisNC 28081USA

The coronavirus disease 2019(cOVID-19)pandemic heightened worldwide attention on the influence of exercise on the immune system.Questions were raised about whether regular moderate-to-vigorous physical activity(MVPA)could help prevent cOVID-19 or mitigate symptoms when ill.could MVPA bolster immunity among those most prone to cOVID-19 including the elderly,obese,and immunocompromised patients?Does regular MVPA dampen systemic inflammation,thereby lessening the cOVID-19 cytokine storm?

关键词： immunity inflammation thereby

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Physical activity lowers the risk for acute respiratory infections:Time for recognition

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Journal of Sport and Health Science 2022年第6期11卷 648-655,F0003页

作者： david c.Nieman camila A.Sakaguchi Human Performance Laboratory Appalachian State UniversityNorth Carolina Research CampusKannapolisNC 28081USA

Physical inactivity is a well-established risk factor for chronic diseases,such as cardiovascular disease,cancer,and diabetes mellitus.There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections(ARIs).ARIs,such as the common cold,influenza,pneumonia,and coronavirus disease 2019(cOVID-19),are among the most pervasive diseases on earth and cause widespread morbidity and mortality.Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the cOVID-19 pandemic because of increased scientific scrutiny.Large-scale studies have consistently reported that the risk for severe cOVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness,even after adjusting for other risk factors.The lowered risk for severe cOVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects,including enhanced surveillance of key immune cells and reduced chronic inflammation.Scientific consensus groups,including those who submitted the Physical Activity Guidelines for Americans,have not yet given this area of research the respect that is due.It is time to add“reduced risk for ARIs”to the“Exercise is Medicine”list of physical activity-related health benefits.

关键词： Acute respiratory infections cOVID-19 Immune system Physical activity Pneumonia

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coronavirus disease-2019: A tocsin to our aging, unfit, corpulent, and immunodeficient society

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Journal of Sport and Health Science 2020年第4期9卷 293-301页

作者： david c.Nieman Department of Biology College of Arts and SciencesAppalachian State UniversityNorth Carolina Research CampusKannapolisNC 28081USA

Acute and chronic respiratory illnesses cause widespread morbidity and mortality,and this class of illness now includes the novel coronavirus severe acute respiratory syndrome that is causing coronavirus disease-2019(cOVID-19).The world is experiencing a major demographic shift toward an older,obese,and physically inactive populace.Risk factor assessments based on pandemic data indicate that those at higher risk for severe illness from cOVID-19 include older males,and people of all ages with obesity and related comorbidities such as hypertension and type 2 diabetes.Aging in and of itself leads to negative changes in innate and adaptive immunity,a process termed immunosenescence.Obesity causes systemic inflammation and adversely impacts immune function and host defense in a way that patterns immunosenescence.Two primary prevention strategies to reduce the risk for cOVID-19 at both the community and individual levels include mitigation activities and the adoption of lifestyle practices consistent with good immune health.Animal and human studies support the idea that,in contrast to high exercise workloads,regular moderate-intensity physical activity improves immunosurveillance against pathogens and reduces morbidity and mortality from viral infection and respiratory illnesses including the common cold,pneumonia,and influenza.The odds are high that infectious disease pandemics spawned by novel pathogens will continue to inflict morbidity and mortality as the world’s population becomes older and more obese.cOVID-19 is indeed a wake-up call,a tocsin,to the world that primary prevention countermeasures focused on health behaviors and hygiene demand our full attention and support.

关键词： cOVID-19 Exercise Immunology Infection Obesity

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Portal vein embolization for induction of selective hepatic hypertrophy prior to major hepatectomy: rationale,techniques, outcomes and future directions

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cancer Biology & Medicine 2016年第4期13卷 426-442页

作者： david Li david c.Madoff Department of Radiology Division of Interventional Radiology New York-Presbyterian Hospital Weill Cornell Medical Center

The ability to modulate the future liver remnant(FLR) is a key component of modern oncologic hepatobiliary surgery practice and has extended surgical candidacy for patients who may have been previously thought unable to survive liver resection. Multiple techniques have been developed to augment the FLR including portal vein embolization(PVE), associating liver partition and portal vein ligation(ALPPS), and the recently reported transhepatic liver venous deprivation(LVD). PVE is a well-established means to improve the safety of liver resection by redirecting blood flow to the FLR in an effort to selectively hypertrophy and ultimately improve functional reserve of the FLR. This article discusses the current practice of PVE with focus on summarizing the large number of published reports from which outcomes based practices have been developed. Both technical aspects of PVE including volumetry, approaches, and embolization agents; and clinical aspects of PVE including data supporting indications, and its role in conjunction with chemotherapy and transarterial embolization will be highlighted. PVE remains an important aspect of oncologic care; in large part due to the substantial foundation of information available demonstrating its clear clinical benefit for hepatic resection candidates with small anticipated FLRs.

关键词：肝切除切除术门静脉栓塞技术肥大原理诱导

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基因工程猪到人器官移植:新的开始

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Science Bulletin 2022年第18期67卷 1827-1829页

作者：张玄 david K.c.cooper 窦科峰 Department of Hepatobiliary Surgery Xijing HospitalFourth Military Medical UniversityXi’an 710032China center for Transplantation Sciences Department of SurgeryMassachusetts General Hospital/Harvard Medical SchoolBoston 02114USA

There has been a continuing inadequate number of human organs for the treatment of patients with terminal organ failure worldwide.The transplantation of organs from genetically engineered pigs may prove an alternative solution[1].In recent years,great progress has been made in pig-to-nonhuman primate(NHP)organ transplantation models(Table S1 online).

关键词：器官移植 organs 1]

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Primary Non-HFE Hemochromatosis:A Review

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Journal of clinical and Translational Hepatology 2023年第4期11卷 925-931页

作者： Alla Turshudzhyan david c.Wu George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Iron homeostasis is a complex process in which iron uptake and use are tightly balanced.Primary Type 1 or HFE hemochromatosis results from homozygous mutations in the gene that encodes human homeostatic iron regulator(known as human factors engineering,HFE)protein,a regulator of hepcidin,and makes up approximately 90%of all hemochromatosis cases.However,four types of hemochromatosis do not involve the HFE gene.They are non-HFE hemochromatosis type 2A(HFE2,encoding HJV),type 2B(HAMP,encoding hepcidin),type 3(TFR2,encoding transferring receptor-2),and types 4A and B(SLc40A1,encoding ferroportin.NonHFE hemochromatosis is extremely rare.Pathogenic allele frequencies have been estimated to be 74/100,000 for type 2A,20/100,000 for type 2B,30/100,000 for type 3,and 90/100,000 for type 4 hemochromatosis.current guidelines recommend that the diagnosis be made by ruling out HFE mutations,history,physical examination,laboratory values(ferritin and transferrin saturation),magnetic resonance or other imaging,and liver biopsy if needed.While less common,non-HFE hemochromatosis can cause iron overload as severe as the HFE type.In most cases,treatment involves phlebotomy and is successful if started before irreversible damage occurs.Early diagnosis and treatment are important because it prevents chronic liver disease.This review updates the mutations and their pathogenetic consequences,the clinical picture,diagnostic guidelines,and treatment of hemochromatosis.

关键词： Non-HFE Hemochromatosis cirrhosis Iron homeostasis

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Artificial intelligence analysis of videos to augment clinical assessment:an overview

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Neural Regeneration Research 2024年第4期19卷 717-718页

作者： david c.Wong Stefan Williams University of Leeds Leeds Teaching Hospitals Trust LeedsUK

Observation is a fundamental part of the practice of clinical medicine.Observation of movement is particularly important for the neurologist.conditions such as Parkinson’s disease,multiple sclerosis,stroke,epilepsy,and many others affect a person’s movement in characteristic ways.In some conditions,changes in the patient’s voice can be included in this-changes in sound caused by changes in the movements of speech.The clinician’s detection of a characteristic abnormality,and their judgment of its severity,plays a central role in both diagnosis and the assessment of prognosis or response to treatment.However,that practice depends upon a limited resource of experienced experts.In addition,these experts are limited by human visual judgment,which cannot reliably or precisely detect and measure small or subtle changes in movement(Williams et al.,2023).

关键词： clinical epilepsy diagnosis

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Exercise immunology:Future directions

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Journal of Sport and Health Science 2020年第5期9卷 432-445页

作者： david c.Nieman Brandt D.Pence Human Performance Laboratory Appalachian State UniversityNorth Carolina Research CampusKannapolisNC 28081USA School of Health Studies University of MemphisMemphisTN 38152USA

Several decades of research in the area of exercise immunology have shown that the immune system is highly responsive to acute and chronic exercise training.Moderate exercise bouts enhance immunosurveillance and when repeated over time mediate multiple health benefits.Most of the studies prior to 2010 relied on a few targeted outcomes related to immune function.During the past decade,technologic advances have created opportunities for a multi-omics and systems biology approach to exercise immunology.This article provides an overview of metabolomics,lipidomics,and proteomics as they pertain to exercise immunology,with a focus on immunometabolism.This review also summarizes how the composition and diversity of the gut microbiota can be influenced by exercise,with applications to human health and immunity.Exercise-induced improvements in immune function may play a critical role in countering immunosenescence and the development of chronic diseases,and emerging omics technologies will more clearly define the underlying mechanisms.This review summarizes what is currently known regarding a multi-omics approach to exercise immunology and provides future directions for investigators.

关键词： Exercise Immunology Lipidomics Metabolomics Proteomics

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The compelling link between physical activity and the body's defense system

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Journal of Sport and Health Science 2019年第3期8卷 201-217页

作者： david c.Nieman Laurel M.Wentz Human Performance Laboratory Appalachian State University North Carolina Research Campus Department of Nutrition and Health care Management Appalachian State University

This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators :(1) acute and chronic effects of exercise on the immune system,(2) clinical benefits of the exercise—immune relationship,(3) nutritional influen?ces on the immune response to exercise, and(4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers,and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches(i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise irmmunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the person?alized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.

关键词： Aging Exercise Immunology Infection Inflammation Mass Spectrometry Nutrition

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