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Systemic air embolism complicating upper gastrointestinal endoscopy:a case report with post-mortem CT scan findings and review of literature

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Forensic Sciences Research 2016年第1期1卷 52-57页

作者： Zabiullah Ali Ferdia Bolster eric goldberg David Fowler Ling Li Office of the Chief Medical Examiner State of MarylandBaltimoreMDUSA Sino-US Forensic Evidence Science Research Center Collaborative Innovation Center of Judicial CivilizationChina University of Political Science and LawBeijingChina Division of Forensic Pathology University of Maryland School of MedicineBaltimoreMDUSA Department of Radiology Mater Misericordiae University HospitalDublin 7Ireland Division of Gastroenterology and Hepatology University of Maryland School of MedicineBaltimoreMDUSA

Endoscopy of the gastrointestinal and biliary tract is a common procedure and is routinely performed for therapeutic and diagnostic ***,bleeding and infection are some of the more common reported side *** embolism on the other hand,is a rare complication of gastrointestinal *** report a 77-year-old African-American female with a history of pancreatic cancer,which was resected with a Whipple *** part of diagnostic and therapeutic procedure,an endoscopic retrograde cholangiopancreatography was planned several months after the *** patient’s heart rate suddenly slowed to 40 bpm during the procedure and she became cyanotic and difficult to oxygenate after the endoscope was introduced and CO2 gas was insufflated.A forensic autopsy was performed with post-mortem computed tomography(PMCT)and revealed extensive systemic air *** detailed PMCT and autopsy findings are presented and current literature is reviewed.

关键词： Forensic science forensic pathology air embolism endoscopy,digestive system pancreaticoduodenectomy post-mortem computed tomography scan

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Performance characteristics of retrograde single-balloon endoscopy: A single center experience

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World Journal of Gastrointestinal Endoscopy 2016年第15期8卷 501-507页

作者： Kaci E Christian Karan Kapoor eric M goldberg Department of Medicine Division of Gastroenterology University of Maryland Medical Center

AIM: To evaluate the technical success, diagnostic yield(DY) and therapeutic potential of retrograde single balloon enteroscopy(rS BE). METHODS: A retrospective review of 136 rS BE procedures performed at a tertiary academic referral center from January 2006 and September 2013 was completed. Patient characteristics including age, gender and inpatient status were collected. The indication for the procedure was categorized into one of three groups: Obscure gastrointestinal bleeding(GIB), evaluation for Crohn's disease and abnormal imaging. Procedural characteristics including insertion depth(ID), procedure time, concordance with pre-procedural imaging and complications were also recorded. Lastly, DY, defined as the percentage of cases producing either a definitive diagnosis or findings that could explain clinical symptoms and therapeutic yield(TY), defined as the percentage of cases in which a definitive intervention was performed, were determined. Mucosal tattooing and biopsy alone were not included in the TY. RESULTS: A total of 136 rS BE procedures were identified. Mean patient age was 57.5(± 16.2) years, 67(49.2%) were male, and 110(80.9%) procedures were performed on an outpatient basis. Indications for rS BE included GIB in 55(40.4%), evaluation of inflammatory bowel disease(IBD) in 29(21.3%), and imaging suggestive of pathology other than GIB or IBD in 43(31.6%). Nine(6.6%) rS BEs were performed for other indications. Mean ID was 68.3(± 39.3) cm proximal to the ileocecal valve and mean time to completion was 41.7(± 15.5) min. Overall, 73(53.7%) cases were diagnostic and 25(18.4%) cases were therapeutic in which interventions(argon plasma coagulation, stricture dilatation, polypectomy, etc.) were performed. Pre-procedural imaging was performed in 88(64.7%) patients. Endoscopic concordance of positive imaging findings was seen in 31(35.2%) cases. Follow up data was available in 93(68.4%) patients; 2(2.2%) reported post-procedural abdominal pain within 30 d follow

关键词： Retrograde Single-balloon Enteroscopy Endoscopy

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Differential Etiology of Posttraumatic Stress Disorder with Conduct Disorder and Major Depression in Men

Differential Etiology of Posttraumatic Stress Disorder with ...

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北京论坛（2006）文明的和谐与共同繁荣—对人类文明方...

作者： Karestan C.Koenen Mark W.Miller Andrew C.Heath Kathleen K.Bucholz Michael J.Lyons Seth A.Eisen William R.True Jack goldberg Ming T.Tsuang Department of Society Human Developmentand HealthHarvard School of Public HealthBostonMA Department of Psychiatry Boston University School of Medicine Midwest Alcoholism Research Center at Washington University Department of Psychiatry Washington University School of MedicineSt.LouisMO Department of Psychology Boston UniversityBostonMA Harvard Institute of Psychiatric Epidemiology and Genetics Department of EpidemiologyHarvard School of Public HealthBostonMA Department of Psychiatry Harvard Medical School at MassachusettsMental Health CenterBostonMA Department of Internal Medicine Washington University School of MedicineSt.LouisMO Department of Community Health St.Louis University School of Public HealthSt.LouisMO Seattle VA eric/Vietnam Era Twin Registry SeattleWashington Department of Epidemiology University of WashingtonSeattleWashington University of California Medical School in San Diego San DiegoCA

Posttraumatic stress disorder(PTSD) is a notable public health *** is an extremely debilitating condition that can occur following exposure to a psychologically distressing event that is outside the range of usual human *** events that can trigger PTSD include violent personal assaults(*** and sexual abuse),natural or human-caused disasters(*** and terrorism bombing),accidents(*** traffic accidents and families of victims),or military *** etiology of PTSD is not clear, although exposure to a traumatic event constitutes a necessary,but not sufficient,*** is highly comorbid with major depression(MD) and conduct disorder(CD) in both epidemiologic and clinical *** of individuals who are at elevated risk for developing PTSD has important implications for public health disaster preparedness and prevention of *** examine the genetic and environmental architecture of the comorbidity of PTSD with MD and CD,we analyzed 6,744 middle aged male-male monozygotic and dizygotic twins from the Vietnam Era Twin Registry maintained in the *** members of a pair were interviewed by telephone using the Diagnostic Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders,Third Edition,Revised(DSM-Ⅲ-R) in *** equation modeling was used to estimate additive genetic,shared environmental and nonshared environmental effects common and specific to PTSD,CD,and MD.A set of competing nested models were assessed by comparing the goodness-of-fit between the full model and the submodel using the chi-square test and *** found that genetic,shared environmental and nonshared environmental influences contributed to 19%(95%CI:11-26%),9%(95%CI:6-17%), and 70%(95%CI:64-77%) of the total variance in PTSD,*** genetic effects on PTSD overlapped with those on MD,while all shared environmental effects on PTSD overlapped with those on *** 3%and 8%of nonshared env

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