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World Journal of Gastroenterology 2011年第10期17卷 1332-1335页

作者： Menachem Moshkowitz Noya Horowitz Zamir Halpern erwin santo Department of Gastroenterology Tel-Aviv Sourasky Medical Center and the Sackler Faculty of MedicineTel-Aviv University

AIM: To evaluate the prevalence and sociodemographics of gastroesophageal reflux disease (GERD) symptoms and to identify treatment patterns among GERD patients. METHODS: A telephone survey of a representative sample of the adult Israeli population was conducted. The questionnaire included detailed sociodemographics, history of GERD symptoms and the various treatments used. RESULTS: The survey included 2027 subjects. Twice weekly, once weekly and monthly GERD symptoms were reported by 8.4%, 12.5% and 21.5% of subjects, respectively. There was no difference in prevalence between men and woman; however, GERD symptoms were significantly more prevalent within the older age group and lower socioeconomic status. Among those reporting weekly symptoms, a quarter did not use any kind of therapy and another quarter used various traditional remedies (e.g. soda, milk, almonds, etc.). Antacids were used by 35.1%, H2 blockers by 13.2% and PPIs by 17.5%. CONCLUSION: We found that 12.5% of the adult Israeli population experience weekly GERD symptoms. GERD prevalence and sociodemographics are similar to those described in other Western countries, and treatment is still suboptimal.

关键词：患病率症状治疗人口反流食管成人胃

Older age, longer procedures and tandem endoscopic-ultrasound as risk factors for post-endoscopic retrograde cholangiopancreatography bacteremia

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World Journal of Gastroenterology 2020年第41期26卷 6402-6413页

作者： Liat Deutsch Shay Matalon Adam Phillips Moshe Leshno Oren Shibolet erwin santo The Sackler Faculty of Medicine Tel Aviv UniversityTel Aviv 6997801Israel Department of Gastroenterology and Hepatology Tel Aviv Sourasky Medical CenterTel Aviv 6423906Israel Department of Gastroenterology Assaf Harofe Medical CenterZeriffin 70300Israel Faculty of Management Tel Aviv UniversityTel Aviv 6997801Israel

BACKGROUND Clinically significant post-endoscopic retrograde cholangiopancreatography(ERCP) bacteremia(PEB) occurs in up to 5% of cases, while antibiotic prophylaxis is recommended only when an ERCP is unlikely to achieve complete biliary drainage. However, the current recommendations may not cover all potential risk factors for *** To identify novel risk factors for PEB and evaluate appropriateness of antibiotic *** A retrospective study of 1082 ERCP procedures performed between January 2012-December 2013 in a single tertiary medical center. Data collection included: Demographic and clinical characteristics such as pre and post procedure antibiotic treatment and bacterial blood cultures. Exclusion criteria were:(1) Age < 18 years;(2) Positive bacterial blood culture before ERCP;(3) Scheduled antibiotic treatment prior to ERCP;(4) Hospitalization longer than 14 d before ERCP;and(5) missing critical data. Stepwise Logistic Regression analysis and Decision Tree algorithms were used for prediction modeling of *** A total of 626 ERCPs performed in 434 patients were included. Mean age 66.49 ± 15.4 years and 46.5% were males. PEB prevalence was 3.7%. Antibiotic prophylaxis was administrated in 139/626(22.2%) cases but was indicated according to the guidelines only in 44/626(7%) cases. In all the PEB cases, prophylaxis was deemed not indicated. A stepwise logistic regression [receiver operating characteristic(ROC), 0.766], identified 3 variables as independent risk factors for PEB: Age at ERCP ≥ 75 years(OR, 3.780, 95%CI: 1.519-9.408, P = 0.004);Tandem EUS/ERCP with fine needle aspiration(FNA)(OR, 14.528, 95%CI: 3.571-59.095, P < 0.001);ERCP duration longer than 60 min(OR, 5.396, 95%CI: 1.86-15.656, P = 0.002). In a decision tree model(ROC, 0.778) the probability for PEB without any risk factors was 1% regardless of prophylaxis *** The prevalence of PEB in our study is similar to previous reports, despite the fact that anti

关键词： Endoscopic retrograde cholangiopancreatography Bacteremia Tandem-procedures Fine needle aspiration Antibiotic prophylaxis Biliary drainage

Comparison of fatty liver index with noninvasive methods for steatosis detection and quantification

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World Journal of Gastroenterology 2013年第1期19卷 57-64页

作者： Shira Zelber-Sagi Muriel Webb Nimer Assy Laurie Blendis Hanny Yeshua Moshe Leshno Vlad Ratziu Zamir Halpern Ran Oren erwin santo Department of Gastroenterology Tel Aviv Sourasky Medical Center64239 Tel-AvivIsrael School of Public Health Faculty of Social Welfare and Health SciencesUniversity of Haifa31905 HaifaIsrael Liver Unit Ziv Medical CenterIsrael and Bar Ilan University13100 SafedIsrael The Sackler Faculty of Medicine Tel-Aviv University69978 Ramat AvivIsrael Université Pierre et Marie Curie H pital Pitié Salpêtrière75013 ParisFrance

AIM:To compare noninvasive methods presently used for steatosis detection and quantification in nonalcoholic fatty liver disease(NAFLD).METHODS:Cross-sectional study of subjects from the general population,a subgroup from the First Israeli National Health Survey,without excessive alcohol consumption or viral *** subjects underwent anthropometric measurements and fasting blood *** of liver fat was performed using four noninvasive methods:the SteatoTest;the fatty liver index(FLI);regular abdominal ultrasound(AUS);and the hepatorenal ultrasound index(HRI).Two of the noninvasive methods have been validated vs liver biopsy and were considered as the reference methods:the HRI,the ratio between the median brightness level of the liver and right kidney cortex;and the SteatoTest,a biochemical surrogate marker of liver *** FLI is calculated by an algorithm based on triglycerides,body mass index,γ-glutamyl-transpeptidase and waist circumference,that has been validated only vs *** < 30 rules out and FLI ≥ 60 rules in fatty ***:Three hundred and thirty-eight volunteers met the inclusion and exclusion criteria and had valid *** prevalence rate of NAFLD was 31.1% according to *** FLI was very strongly correlated with SteatoTest(r = 0.91,P < 0.001) and to a lesser but significant degree with HRI(r = 0.55,P < 0.001).HRI and SteatoTest were significantly correlated(r = 0.52,P < 0.001).The κ between diagnosis of fatty liver by SteatoTest(≥ S2) and by FLI(≥ 60) was 0.74,which represented good *** sensitivity of FLI vs SteatoTest was 85.5%,specificity 92.6%,positive predictive value(PPV) 74.7%,and negative predictive value(NPV) 96.1%.Most subjects(84.2%) with FLI < 60 had S0 and none had *** κ between diagnosis of fatty liver by HRI(≥ 1.5) and by FLI(≥ 60) was 0.43,which represented only moderate *** sensitivity of FLI vs HRI was 56.3%,specificity 86.5%,PPV 57.0%,and NPV 86.1%.The diagnostic accuracy of F

关键词： Steatosis Hepatorenal ultrasound index SteatoTest Fatty liver index Screening Agreement Sensitivity Specificity

Incidence of colorectal neoplasms among male pilots

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World Journal of Gastroenterology 2014年第27期20卷 9116-9120页

作者： Menachem Moshkowitz Ohad Toledano Lior Galazan Aharon Hallak Nadir Arber erwin santo Integrated Cancer Prevention Center and Department of Gastroenterology Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel-Aviv University

AIM: To assess the prevalence of colorectal neoplasms(adenomas, advanced adenomas and colorectal cancers) among Israeli military and commercial airline ***: Initial screening colonoscopy was performed on average-risk(no symptoms and no family history) airline pilots at the Integrated Cancer Prevention Center(ICPC) in the Tel-Aviv Medical Center. Visualized polyps were excised and sent for pathological examination. Advanced adenoma was defined as a lesion >10 mm in diameter, with high-grade dysplasia or villous histology. The results were compared with those of an age- and gender-matched random sample of healthy adults undergoing routine screening at the ***: There were 270 pilots(mean age 55.2 ± 7.4 years) and 1150 controls(mean age 55.7 ± 7.8 years). The prevalence of colorectal neoplasms was 15.9% among the pilots and 20.6% among the controls(P = 0.097, χ2 test). There were significantly more hyperplastic polyps among pilots(15.5% vs 9.4%, P = 0.004) and a trend towards fewer adenomas(14.8% vs 20.3% P = 0.06). The prevalence of advanced lesions among pilots and control groups was 5.9% and 4.7%, respectively(P = 0.49), and the prevalence of cancer was 0.7% and 0.69%, respectively(P = 0.93).CONCLUSION: There tends to be a lower colorectal adenoma, advanced adenoma and cancer prevalence but a higher hyperplastic polyp prevalence among pilots than the general population.

关键词： Colorectal cancer Adenomatous polyps Colon neoplas

Diet of patients after pouch surgery may affect pouch inflammation

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World Journal of Gastroenterology 2013年第38期19卷 6458-6464页

作者： Orit Ianco Hagit Tulchinsky Michal Lusthaus Amos Ofer erwin santo Nachum Vaisman Iris Dotan Comprehensive Pouch Clinic IBD CenterDepartment of Gastroenterology and Liver DiseasesTel Aviv Sourasky Medical CenterTel Aviv 64239Israel Sackler Faculty of Medicine Tel Aviv UniversityTel Aviv 64239Israel Comprehensive Pouch Clinic and the Proctology Unit Department of SurgeryTel Aviv Sourasky Medical CenterTel Aviv 64239Israel Unit of Clinical Nutrition Tel Aviv Sourasky Medical CenterTel Aviv 64239Israel

AIM:To investigate the diet of pouch patients compared to healthy controls,and to correlate pouch patients’diet with disease ***:Pouch patients were recruited and prospectively followed-up at the Comprehensive Pouch Clinic at the Tel Aviv Sourasky Medical *** behavior was determined based on clinical,endoscopic and histological *** age-and sex-matched volunteers were selected from the"MABAT"Israeli Nutrition and Public Health Governmental Study and served as the control *** the participants completed a 106-item food frequency questionnaire categorized into food groups and nutritional values based on those used in the United States Department of Agriculture food pyramid and the Israeli food *** on Dietary behavior,food avoidance,the use of nutritional supplements,physical activity,smoking habits,and body-mass index(BMI)were also *** patients who had familial adenomatous polyposis(n=3),irritable pouch syndrome(n=4),or patients whose pouch surgery took place less than one year previously(n=5)were excluded from ***:The pouch patients(n=80)consumed significantly more from the bakery products food group(1.2±1.4 servings/d vs 0.6±1.1 servings/d,P<0.05)and as twice as many servings from the oils and fats(4.8±3.4 servings/d vs 2.4±2 servings/d,P<0.05),and the nuts and seeds food group(0.3±0.6 servings/d vs 0.1±0.4 servings/d,P<0.05)compared to the controls(n=80).The pouch patients consumed significantly more total fat(97.6±40.5 g/d vs 84.4±39 g/d,P<0.05)and fat components[monounsaturated fatty acids(38.4±16.4 g/d vs 30±14 g/d,P<0.001),and saturated fatty acids(30±15.5 g/d vs 28±14.1 g/d,P<0.00)]than the *** contrast,the pouch patients consumed significantly fewer carbohydrates(305.5±141.4 g/d vs 369±215.2 g/d,P=0.03),sugars(124±76.2 g/d vs 157.5±90.4 g/d,P=0.01),theobromine(77.8±100 mg/d vs 236.6±244.5 mg/d,P<0.00),retinol(474.4±337.1μg/d vs 832.4±609.6μg/d,P<0.001)and dietary fibers(26.2±15.4

关键词： Ulcerative colitis Dietary reference intake Body mass index Ileal-pouch anal anastomosis Pouch surgery Food frequency questionnaire

prevalence of colorectal neoplasms in young, average risk individuals: A turning tide between East and West

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World Journal of Gastroenterology 2016年第32期22卷 7365-7372页

作者： Ari Leshno Menachem Moshkowitz Maayan David Lior Galazan Alfred I Neugut Nadir Arber erwin santo Integrated Cancer Prevention Center Tel-Aviv Sourasky Medical Center Tel-Aviv University Department of Gastroenterology Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine Tel-Aviv University Department of Epidemiology Mailman School of Public Health Columbia University Herbert Irving Comprehensive Cancer Center Columbia University Department of Medicine College of Physicians and Surgeons Columbia University

AIM To determine the prevalence of colorectal neoplasia in average risk persons 40-59 years of age in Israel and to compare the results with other populations. METHODS We reviewed the results of asymptomatic average-risk subjects, aged 40 to 59 years, undergoing their first screening colonoscopy between April 1994 and January 2014. The detection rates of adenoma, advanced adenoma(AA) and colorectal cancer(CRC) were determined in the 40's and 50's age groups by gender. The prevalence of lesions was compared between age groups. After meticulous review of the literature, these results were compared to published studies addressing the prevalence of colorectal neoplasia in similar patient groups, in a variety of geographical *** We included first screening colonoscopy results of 1750 individuals. The prevalence of adenomas, AA and CRC was 8.3%, 1.0% and 0.2% in the 40-49 age group and 13.7%, 2.4% and 0.2% in the 50-59 age group, respectively. Age-dependent differences in adenoma and AA rates were significant only among men(p < 0.005). Literature review disclosed 17 relevant studies. As expected, in both Asian and Western populations, the risks for overall adenoma and advanced adenoma was significantly higher in the 50's age group as compared to the 40's age group in a similar fashion. The result of the current study were similar to previous studies on Western populations. A substantially higher rate of adenoma, was observed in studies conducted among Asian populations in both age *** The higher rate of colorectal neoplasia in Asian populations requires further investigation and reconsideration as to the starting age of screening in that population.

关键词： Colonoscopy Adenoma Colorectal cancer Average risk Young Asian Western

Non-alcoholic fatty liver disease is not associated with a lower health perception

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World Journal of Gastroenterology 2016年第17期22卷 4362-4372页

作者： Liat Mlynarsky Dalit Schlesinger Roni Lotan Muriel Webb Zamir Halpern erwin santo Oren Shibolet Shira Zelber-Sagi Department of Gastroenterology Tel Aviv Medical Center The Sackler Faculty of Medicine Tel-Aviv University School of Public Health University of Haifa

AIM: To examine the association between nonalcoholic fatty liver disease(NAFLD) and general health ***: This cross sectional and prospective follow-up study was performed on a cohort of a subsample of the first Israeli national health and nutrition examination survey, with no secondary liver disease or history of alcohol abuse. On the first survey, in 2003-2004, 349 participants were included. In 2009-2010 participants from the baseline survey were invited to participate in a follow-up survey. On both baseline and follow-up surveys the data collected included: self-reported general health perception, physical activity habits, frequency of physician's visits, fatigue impact scale and abdominal ultrasound. Fatty liver was diagnosed by abdominal ultrasonography using standardized criteria and the ratio between the median brightness level of the liver and the right kidney was calculated to determine the Hepato-Renal ***: Out of 349 eligible participants in the first survey, 213 volunteers participated in the follow-up cohort and were included in the current analysis, NAFLD was diagnosed in 70/213(32.9%). The prevalence of "very good" self-reported health perception was lower among participants diagnosed with NAFLD compared to those without NAFLD. However, adjustment for BMI attenuated the association(OR = 0.73, 95%CI: 0.36-1.50, P = 0.392). Similar results were observed for the hepato-renal index; it was inversely associated with "very good" health perception but adjustment for BMI attenuated the association. In a full model of multivariate analysis, that included all potential predictors for health perception, NAFLD was not associated with the self-reported general health perception(OR = 0.86, 95%CI: 0.40-1.86, P = 0.704). The odds for "very good" self-reported general health perception(compared to "else") increased among men(OR = 2.42, 95%CI: 1.26-4.66, P = 0.008) and those with higher performance of leisure time physical activity(OR = 1.01, 9

关键词： Non-alcoholic fatty liver disease Health perception quality of life Fatigue Health-care services uti

Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial

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World Journal of Gastroenterology 2014年第15期20卷 4382-4392页

作者： Shira Zelber-Sagi Assaf Buch Hanny Yeshua Nahum Vaisman Muriel Webb Gil Harari Ofer Kis Naomi Fliss-Isakov Elena Izkhakov Zamir Halpern erwin santo Ran Oren Oren Shibolet Department of Gastroenterology Tel Aviv Medical Center6423906 Tel-AvivIsrael School of Public Health University of Haifa3498838 HaifaIsrael The Sackler Faculty of Medicine Tel-Aviv University6997801 Tel AvivIsrael Wingate Institute for Physical Education and Sport 4290200 NetanyaIsrael

AIM:To evaluate the effect of resistance training(RT)on non alcoholic liver disease(NAFLD)***:A randomized clinical trial enrolling NAFLD patients without secondary liver disease(e.g.,without hepatitis B virus,hepatitis C virus or excessive alcohol consumption).Patients were randomly allocated either to RT,three times weekly,for 3 mo or a control arm consisting of home *** RT included leg press,chest press,seated rowing,latissimus pull down *** 8-12 repetitions,3 sets for each exercise,for a total duration of 40 *** ultrasound,fasting blood tests,anthropometrics and body composition by dual energy X-ray absorptiometry were *** baseline and follow-up,patients filled out a detailed semi-quantitative food frequency questionnaire reporting their habitual nutritional *** was quantified by the hepatorenal-ultrasound index(HRI)representing the ratio between the brightness level of the liver and the right *** HRI has been previously demonstrated to be highly reproducible and was validated against liver biopsy and proton magnetic resonance ***:Eighty two patients with primary NAFLD were randomized to receive 3 mo of either RT or *** dropout or exclusion from analysis because of protocol violation(weight change>3 kg),thirty three patients in the RT arm and 31 in the stretching arm completed the study per *** baseline characteristics were similar for the two treatment groups with respect to demographics,anthropometrics and body composition,blood tests and liver steatosis on *** score was reduced significantly in the RT arm as compared to the stretching arm(-0.25±0.37 vs-0.05±0.28,P=0.017).The RT arm had a significantly higher reduction in total,trunk and android fat with increase in lean body *** was no correlation between the reduction in HRI in the RT arm and weight change during the study,but it was positively correlated with the change in trunk fat(r=0.37,

关键词： Resistance exercise Obesity Nutrition Physical act

Gender-associated differences in urea breath test for Helicobacter pylori infection referrals and results among dyspeptic patients

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World Journal of Gastrointestinal Pathophysiology 2012年第3期3卷 80-84页

作者： Menachem Moshkowitz Noya Horowitz Anat Beit-Or Zamir Halpern erwin santo Department of Gastroenterology Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine Tel-Aviv UniversityTel-Aviv 64239 Maccabi Health Services Tel-Aviv 64239 Israel

AIM: To verify whether there is a gender difference in the 13C-urea breath test results in a large cohort. METHODS: The test results of dyspeptic patients referred for 13C-urea breath testing between January and December, 2007 were evaluated. Testing was carried out at the health insurance organization branches and evaluated at a central laboratory in Israel. RESULTS: Of a total of 28 746 test results, 18 122 (63.04%) were from females and 10 624 (36.95%) from males. Overall, 10 188 (35.4%) results [expressed as delta over baseline (DOB)] were positive (DOB 13C > 5), 18,326 (63.7%) were negative (DOB 13C < 3.5) and 232 (0.8%) were borderline (DOB 13C 3.5-5). There was a significant difference between the total positive rate among females and males (34.8% vs 37.2%, respectively, P = 0.0003). The mean test value was increased by approximately 10 units for females compared to males (P < 0.01) and this difference was consistent for all age groups (i.e., between 10-80 years of age, P < 0.01). CONCLUSION: More females were referred to 13C-urea breath testing. More males had positive results. The mean test values were significantly higher among females of all age groups, possibly representing an increased bacterial load among females and suggesting gender-associated differences in Helicobacter pylori host interactions.

关键词： Helicobacter pylori Urea breath test Gender Dyspepsia

False Color Method for Retinal Oximetry

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Journal of Biomedical Science and Engineering 2019年第12期12卷 533-544页

作者： erwin Michel Davila-Iniesta Santiago Guerrero-Gonzalez Jorge Santiago-Amaya Paola Castillo-Juarez Luis Nino-de-Rivera-Oyarzabal SEPI ESIME Culhuacan Instituto Politecnico NacionalMexico CityMexico ENCB santo Tomas Instituto Politecnico NacionalMexico CityMexico

Oximetry is a method for measuring the oxygen saturation of haemoglobin in blood. Particularly, retinal oximetry based in the measurement of oxygen saturation in retinal vessels has acquired great interest to gather information on blood oxygenation from said vessels within inner and outer retina. Non-invasive spectrophotometric retinal oximetry has been studied for over five decades based on imaging spectroscopy. However, Optical Coherence Tomography (OCT) is an alternative to analyze the absorption difference between oxyhaemoglobin (HbO2) and deoxyhaemoglobin (Hb) in the retinal vessels and the choroidal structure. We propose in this paper an alternative process to manipulate conventional OCT images to evaluate changes in the relative haemoglobin oxygen saturation. Conventional OCT images from 570 nm and 600 nm in gray scale are converted to a corresponding color scale to be compared to the oxygenation information involved in the original gray scale OCT images.

关键词： Choroidal Structure False Color Method Filters Fundus OCT Image Oxygen Saturation Oximetry Retinal Vessels