检索结果-南通市图书馆

Primary Sclerosing Cholangitis and Inflammatory Bowel Disease: A Review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2022年第3期10卷 531-542页

作者： Teresa Da Cunha haleh vaziri George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Primary sclerosing cholangitis is a disease affecting around 0.006–0.016%of the *** these,around 75%have concomitant inflammatory bowel disease(IBD)according to the most recent epidemiological *** theories have been proposed regarding the pathogenesis of primary sclerosing cholangitis(PSC).These include changes in the function of cholangiocytes,effects of the gut microbiome,association with specific human leukocyte antigen haplotypes and dysregulation of the immune ***,these do not explain the observed association with ***,there are considerable differences in the frequency and outcomes between patients with PSC and ulcerative colitis compared with PSC and Crohn’s *** aim of this review is to appraise the most recent studies that have contributed to the epidemiology,advances in the pathophysiology,and characterization of important clinical aspects of the association of PSC and IBD.

关键词： Primary sclerosing cholangitis Cholangitis Inflammatory bowel disease Ulcerative colitis Crohn’s disease

Immunotherapy-induced Hepatotoxicity:A Review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2022年第6期10卷 1194-1204页

作者： Teresa Da Cunha George Y.Wu haleh vaziri Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Immune checkpoint inhibitors(ICIs)suppress the func-tion of immune checkpoints,which are involved in down-regulating immune *** lead to an increased activation of the function of T cells,increased release of cytokines,and decreased activity of regulatory T *** allows for a more significant and less regulated im-mune response and subsequent enhanced cytotoxic activity against cancer cells.A number of cancers are now being treated with these agents and this increased use has re-sulted in more reports of *** almost every organ can be affected,the skin,gastrointestinal tract,liver,and endocrine glands are most commonly *** is neces-sary that gastroenterologists and hepatologists familiarize themselves with diagnostic steps and management plan in patients with these undesirable *** assessing for possible ICIs induced hepatotoxicity,it is of utmost im-portance to use a formal scoring system such as the Rous-sel Uclaf causality assessment method(RUCAM)to assess for risk factors,alternative causes,and response to cessa-tion and re-exposure of a given *** this review is based on studies with and without RUCAM,the conclusions were carefully established mainly from studies that used *** aim of this review is to provide information on the epidemiology,risk factors,clinical presentation,di-agnostic tools,and management plan based on the most recent studies of immunotherapy-induced hepatotoxicity.

关键词： Immune checkpoint inhibitors Immunotherapy Hepatitis Liver injury.

Chylous Ascites:A Review of Pathogenesis,Diagnosis and Treatment

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2018年第1期6卷 105-113页

作者： Richa Bhardwaj haleh vaziri Arun Gautam Enrique Ballesteros David Karimeddini George Y. Wu Department of Medicine Division of Gastroenterology-HepatologyUCONN HealthFarmingtonCTUSA Department of Pathology and Lab Medicine UCONN HealthFarmingtonCTUSA Department of Diagnostic Imaging and Therapeutics UCONN HealthFarmingtonCTUSA Department of Medicine Division of Gastroenterology-HepatologyUCONN HealthFarmingtonCT 06030USA

Chylous ascites(CA)is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal *** usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to *** underlying etiologies for CA have been classified as traumatic,congenital,infectious,neoplastic,postoperative,cirrhotic or *** malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries,in this article we have attempted to reclassify CA based on portal and non-portal *** diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of>200 mg/*** management consists of identifying and treating the underlying disease process,dietary modification,and *** studies have also supported the use of agents such as orlistat,somatostatin,octreotide and *** and surgical interventions in the form of transjugular intrahepatic portosystemic shunt(commonly known as TIPS),peritoneal shunt,angiography with embolization of a leaking vessel,and laparotomy remain as treatment options for cases refractory to medical management.

关键词： Chylous ascites Portal hypertension Cirrhosis Ascitic fluid Lymphatic system

Case report and review of esophageal lichen planus treated with fluticasone

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第10期19卷 1652-1656页

作者： Marie Lourdes Ynson Faripour Forouhar haleh vaziri Department of Medicine University of Connecticut Health CenterFarmingtonCT 06030United States Department of Pathology University of Connecticut Health CenterFarmingtonCT 06030United States Department of Gastroenterology University of Connecticut Health CenterFarmingtonCT 06030United States

Lichen planus is a fairly common chronic idiopathic disorder of the skin,nails and mucosal *** involvement of this disease on the other hand is rare and only about 50 cases have been reported in *** its rarity,it can be difficult to diagnose and may be easily misdiagnosed as reflux ***,there are no clear recommendations on the optimal management of this disease and little is known about the best treatment *** steroids are usually the first line treatment and offer a favorable *** this report,we would like to present a novel approach in the management of esophageal lichen planus in a middle-aged woman treated successfully with swallowed fluticasone propionate 220 mcg twice a day for 6 wk,as evidenced by objective clinical *** on our review of related literature and experience in this patient,we feel that a trial of swallowed fluticasone may be a prudent approach in the management of these patients since it has a more favorable side effect profile than systemic treatment.

关键词： Lichen planus Lichen rubra planus Anti-inflammatory agents Steroids Dysphagia Fluticasone

Endoscopy in neutropenic and/or thrombocytopenic patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第46期21卷 13166-13176页

作者： Michelle C Tong Micheal Tadros haleh vaziri Division of Gastroenterology University of Connecticut School of Medicine

AIM: To evaluate the safety of endoscopic procedures in neutropenic and/or thrombocytopenic cancer patients. METHODS: We performed a literature search for English language studies in which patients with neutropenia and/or thrombocytopenia underwent endoscopy. Studies were included if endoscopic procedures were used as part of the evaluation of neutropenic and/or thrombocytopenic patients,yielding 13 studies. Two studies in which endoscopy was not a primary evaluation tool were excluded. Eleven relevant studies were identified by two independent reviewers on Pub Med,Scopus,and Ovid ***: Most of the studies had high diagnostic yield with relatively low complication rates. Therapeutic endoscopic interventions were performed in more than half the studies,including high-risk procedures,such as sclerotherapy. Platelet transfusion was given if counts were less than 50000/mm3 in four studies and less than 10000/mm3 in one study. Other thrombocytopenic precautions included withholding of biopsy if platelet count was less than 30000/mm3 in one study and less than 20000/mm3 in another study. Two of the ten studies which examined thrombocytopenic patient populations reported bleeding complications related to endoscopy,none of which caused major morbidity or mortality. All febrile neutropenic patients received prophylactic broad-spectrum antibiotics in the studies reviewed. Regarding afebrile neutropenic patients,prophylactic antibiotics were given if absolute neutrophil count was less than 1000/mm3 in one study,if the patient was undergoing colonoscopy and had a high inflammatory condition without clear definition of significance in another study,and if the patient was in an aplastic phase in a third study. Endoscopy was also withheld in one study for severe pancytopenia. CONCLUSION: Endoscopy can be safely performed in patients with thrombocytopenia/neutropenia. Prophylactic platelet transfusion and/or antibiotic administration prior to endoscopy may be considere

关键词： Endoscopy Neutropenia Cancer Bone marrow transplan

Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis:a Review Featuring a Women's Health Perspective

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2014年第4期2卷 266-284页

作者： Renée M. Marchioni Beery haleh vaziri Faripour Forouhar Division of Internal Medicine Department of Gastroenterology and Hepatology University of Connecticut Health Center Farmington CT USA Department of Pathology and Lab Medicine University of Connecticut Health Center Farmington CT USA

Primary biliary cirrhosis (PBC) and primary sclerosing cho-langitis (PSC) are two major types of chronic cholestatic liver disease. Each disorder has distinguishing features and variable progression, but both may ultimately result in cirrhosis and hepatic failure. The following offers a review of PBC and PSC, beginning with a general overview of disease etiology, pathogenesis, diagnosis, clinical features, natural course, and treatment. In addition to commonly associated manifestations of fatigue, pruritus, and fat-soluble vitamin deficiency, select disease-related topics pertaining to women's health are discussed including metabolic bone disease, hyperlipidemia and cardiovascular risk, and preg-nancy-related issues influencing maternal disease course and birth outcomes. This comprehensive review of PBC and PSC highlights some unique clinical considerations in the care of female patients with cholestatic liver disease.

关键词： Primary biliary cirrhosis Primary sclerosing cholangitis Cholestasis Women's health Metabolic bone disease Hyperlipidemia Pregnancy Fatigue Pruritus Fat-soluble vitamin deficiency

Sessile serrated adenomas in the proximal colon are likely to be flat,large and occur in smokers

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第32期19卷 5271-5277页

作者： Tarun Rustagi Priya Rangasamy Matthew Myers Melinda Sanders haleh vaziri George Y Wu John W Birk Petr Protiva Joseph C Anderson Section of Digestive Diseases Department of Internal MedicineYale University School of MedicineNew HavenCT 06520United States Department of Gastroenterology University of Connecticut Health CenterFarmingtonCT 06032United States Department of Pathology University of Connecticut Health CenterFarmingtonCT 06063United States Department of Gastroenterology VA West HavenYale School of MedicineNew HavenCT 06520United States Department of Gastroenterology VA Medical CenterWindsorVT 05009United States The Geisel School of Medicine at Dartmouth Medical HanoverNH 03755United States

AIM:To examine the epidemiology and the morphology of the proximal sessile serrated adenomas(SSAs).METHODS:We conducted a retrospective study to identify patients with SSAs using a university-based hospital pathology database query from January 2007to April *** collected included:age,gender,ethnicity,body mass index,diabetes,smoking,family history of colorectal cancer,aspirin,and statin *** collected data on morphology of SSAs including site(proximal or distal),size,and endoscopic appearance(flat or protuberant).We also compared proximal SSAs to proximal tubular adenomas detected during same time ***:One hundred and twenty patients with SSAs were identified:61%were distal and 39%were proximal *** SSAs were more likely to be flat than distal(100%vs 78%respectively;P=0.0001).Proximal SSAs were more likely to occur in smokers(OR=2.63;95%CI:1.17-5.90;P=0.02)and in patients with family history of colorectal cancer(OR=4.72;95%CI:1.43-15.55;P=0.01)compared to *** SSAs were statistically more likely to be≥6 mm in size(OR=2.94;P=0.008),and also more likely to be large(≥1 cm)(OR=4.55;P=0.0005)compared to the distal *** were more likely to have proximal(P=0.02),flat(P=0.01)and large(P=0.007)SSAs compared to *** to proximal tubular adenomas,proximal SSAs were more likely to be large and occur in ***:Proximal SSAs which accounted for two-fifths of all SSAs were more likely to present as flat lesions,larger SSAs,and were more likely to occur in smokers and in patients with family history of colorectal *** data has implications for colorectal cancer screening.

关键词： Proximal Sessile Serrated Adenoma Colonoscopy Colorectal cancer Smoking