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Comparative study of endoscopy *** intrahepatic portosystemic shunt in the management of gastric variceal bleeding

Gastroenterology Report 2015年第1期3卷 75-82页

作者： gursimran singh kochhar Udayakumar Navaneethan Jason Hartman Jose Mari Parungao Rocio Lopez Ranjan Gupta Baljendra Kapoor Paresh Mehta Madhu Sanaka Department of Gastroenterology and Hepatology Cleveland Clinic FoundationClevelandOHUSA Case Western School of Medicine ClevelandOHUSA Department of Vascular and Interventional Radiology Cleveland Clinic FoundationClevelandOHUSA

Background and Aim:Gastric varices are associated with high *** have been conflicting reports on whether endoscopic treatment with cyanoacrylate or the placement of a transjugular intrahepatic portosystemic shunt(TIPS)is more effective in the treatment of gastric *** compared the outcomes of patients treated with cyanoacrylate glue or TIPS for the management of acute gastric variceal ***:The study was designed as a retrospective cohort analysis of patients undergoing either TIPS or endoscopic treatment with cyanoacrylate for acute gastric variceal bleeding at our institution from 2001 to *** compared to studied between the two treatment modalities were the short-term treatment outcomes,including re-bleeding within 30 days,length of hospital stay and in-hospital ***-Meier survival analysis was performed to assess factors associated with in-hospital ***:A total of 169 patients were included in the *** TIPS arm contained 140 patients and the cyanoacrylate arm contained 29 *** was no evidence to suggest any significant differences in demographics or disease *** were no differences between the TIPS arm and the cyanoacrylate armtwo groups in treatment outcomes including re-bleeding within 30 days(17.4%vs.17.2%;P=0.98),median length of stay in the hospital(4.5 days vs.6.0 days;P紏0.35)or in-hospital mortality(9.0%vs.11.1%;P=0.74).In-hospital mortality was evaluated for 149 patients and lower albumin(P=0.015),higher MELD score(P<0.001),higher CTP score(P=0.005)and bleeding(P=0.008)were all significantly associated with in-hospital ***:These findings suggest that both treatments are equally *** offers a safe,effective alternative to TIPS for gastric varices,and physician may choose the best therapy for each patient,factoring in the availability of TIPS or cyanoacrylate,the individual patient’s presentation,and cost.

关键词： transjugular intrahepatic portosystemic shunt(TIPS) cyanoacrylate injection gastric varices gastrointestinal bleeding

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Value of routine stool testing for pathogenic bacteria in the evaluation of symptomatic patients with ileal pouches

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Gastroenterology Report 2018年第2期6卷 93-100,I0001页

作者： Amandeep singh Jean Ashburn gursimran kochhar Rocio Lopez Tracy L.Hull Bo Shen Department of Gastroenterology&Hepatology Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Colorectal Surgery Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Quantitative Health Sciences Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA

Background:In symptomatic patients with an ileal pouch,stool studies are often sent to diagnose enteric *** of this study is to find the value of routine stool studies in the evaluation of symptomatic patients and the clinical implications of such pathogens in patients with ileal ***:Consecutive ileal pouch-anal anastomosis(IPAA)patients who had stool tests out of a 2283-case registry from 2002 to 2015 were included in the *** with positive stool cultures were compared with controls(symptomatic without positive stool culture)in a 1:4 *** to antibiotic therapy,recurrence rate and rate of hospitalization at 1 and 3 months were ***:A total of 643(28%)had stool cultures done and only 1.7%(11/643)were found to be positive for stool *** spp.(45%)was the most common pathogen followed by Aeromonas spp.(36%).Non-smokers and patients without any antibiotic use in the last 3 months were found to have higher prevalence of positive stool cultures than controls(p<0.001 and p¼0.023).Patients with pathogenic bacteria were found to have a higher risk of acute kidney injury(27.3%vs 4.5%,p¼0.049),hospitalization within 3 months of initial stool testing(36.4%vs 6.8%,p¼0.009)and mortality(18.2%vs 0%,p¼0.040).However,there were no statistically significant differences in the clinical outcomes in patients with positive stool cultures who received pathogen-directed ***:We found that the yield of stool tests for bacterial pathogens in symptomatic pouch patients was extremely low and the treatment of detected pathogens had a minimum impact on the disease course of *** clinical utility of routine stool culture in those patients warrants further study.

关键词： pouchitis ileal pouch enteric pathogens stool culture

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Diagnosis of Bovine Tuberculosis by Comparative Intradermal Tuberculin Test, Interferon Gamma Assay and <i>esxB</i>(CFP-10) PCR in Blood and Lymph Node Aspirates

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Open Journal of Veterinary Medicine 2019年第5期9卷 55-65页

作者： Derhasar Brahma Deepti Narang Mudit Chandra gursimran Filia Amarjit singh Sikh Tejinder singh Department of Veterinary Microbiology College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University Ludhiana Punjab India Department of Veterinary Microbiology College of Veterinary ScienceGuru Angad Dev Veterinary and Animal Sciences University Ludhiana Punjab India Animal Disease Research Centre College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University Ludhiana Punjab India Department of Veterinary Pathology College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University Ludhiana Punjab India Directorate Livestock Farm College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana Punjab India

Bovine tuberculosis (TB) is a chronic debilitating disease of huge economic importance due to loss in production, morbidity and mortality, and has a potential zoonotic threat. TB is endemic in India and has a worldwide prevalence, therefore, needing early diagnostic technique for the eradication of TB globally. Currently, compared to the eradication programme of TB in Medical sector, Veterinary sector is lagging behind though TB is one of the major zoonotic diseases prevalent in dairy animals and wildlife in India. With the “End TB” strategy by WHO in human, parallel measures for early diagnosis and culling has to be followed in case of animals for an overall successful eradication programme. The objective of this study is diagnosis of TB in cattle and buffaloes by using the cell-mediated immune response tests, i.e. Comparative Intradermal Tuberculin Test (CITT) and Interferon gamma (IFN-γ) assay, and Polymerase Chain Reaction (PCR) targeting esxB gene (CFP-10 protein) and to compare their diagnostic capabilities. This study was carried out in 202 dairy cattle and buffaloes from an organized dairy farm, where almost all of the animals appeared clinically healthy. We found that, the combined use of both CITT and IFN-γ assay lead to more accurate diagnosis of TB, although IFN-γ assay was more specific than CITT. However, esxB PCR showed almost similar sensitivity to IFN-γ assay and may be used as a fast alternative method for the diagnosis of bovine TB from blood samples.

关键词： Bovine TB CITT IFN-γ esxB PCR

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