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Novel non-invasive score to predict cirrhosis in the era of hepatitis C elimination: A population study of ex-substance users in Singapore

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 143-148页

作者： Yue Zhao Prem Harichander Thurairajah Rahul Kumar jessica tan Eng Kiong Teo John Chen Hsiang Department of Gastroenterology and Hepatology Changi General Hospital

Background: Chronic hepatitis C infection is common among people with history of substance use. Liver fibrosis assessment is a barrier to linkage to care, particularly among those with history of substance users. The use of non-invasive scores can be helpful in predicting liver cirrhosis in the era of HCV elimination, especially in countries where transient elastography(TE) is not available. We compared the commonly used non-invasive scores with a novel non-invasive score in predicting liver cirrhosis in this population. Methods: HCV patients with history of substance use between 2011 and 2016 were analyzed. All patients had TE for liver fibrosis assessment. Clinical performance of established non-invasive scores for fibrosis assessment and novel score were compared. Youden's index was used to determine optimal cut-off of the novel score. Results: A total of 579 patients were included. In multivariate logistic regression, cirrhosis on TE was associated with age( P = 0.002), aspartate aminotransferase(AST)( P = 0.004), and platelet count( P < 0.001), but not alanine aminotransferase(ALT)( P = 0.896). These form the components of modified AST-toplatelet ratio index(APRI) score. Modified APRI was superior to APRI in predicting cirrhosis(AUROC, 0.796 vs. 0.770, P = 0.007), but not fibrosis-4 score(FIB-4)( P = 1.00). Modified APRI at cut-off of 4 has sensitivity, specificity and negative predictive value(NPV) of 94.4%, 26.9% and 92.6%, respectively, and at 19, has sensitivity, specificity and positive predictive value(PPV) of 33.3%, 96.2% and 77.1%, respectively. FIB-4 has a NPV and PPV of 88.6%, 41.8% and 78.5%, 77.6%, at cut-off of 1.45 and 3.25, respectively. Using the cut-off of 4 and 14 for modified APRI, 32.5% of patients can be correctly classified and misses out only 5.6% of cirrhosis patients. Conclusions: Modified APRI score is superior in predicting cirrhosis in HCV population, with 32.5% of the population being correctly classified using cut-off of 4 and 14. Further studies are required to validate the fin

关键词： Hepatitis C Cirrhosis Fibrosis assessment AST-to-platelet ratio index Modified APRI Fibrosis-4 score

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Real world experience with Pegylated Interferon and ribavirin in Hepatitis C Genotype 1 population with favourable IL28B polymorphism

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Gastroenterology Report 2017年第3期5卷 208-212,I0002页

作者： Victoria Ekstrom Rajneesh Kumar Yi Zhao Mei Ling Yee Cynthia Sung Dorothy Toh Poh Yen Loh jessica tan Eng Kiong Teo Wan Cheng Chow Department of Gastroenterology and Hepatology Singapore General HospitalSingapore Department of Clinical Translational Research Singapore General HospitalSingapore Department of Pharmacy Singapore General HospitalSingapore Health Products Regulation Group Health Sciences AuthoritySingapore Emerging Infectious Disease Programme Duke-NUS Medical SchoolSingapore Department of Gastroenterology and Hepatology Changi General HospitalSingapore

背景与目的:丙型肝炎(HCV)的传统治疗是应用聚乙二醇干扰素(FEG-IFN)和病毒唑,但副作用明显。IL28B基因多态性可以预测治疗反应,CC基因型者效果更好。ITPA基因缺失能对治疗引起的临床贫血起到保护作用。本研究目的是检测接受FEG-IFN和... 详细信息

背景与目的:丙型肝炎(HCV)的传统治疗是应用聚乙二醇干扰素(FEG-IFN)和病毒唑,但副作用明显。IL28B基因多态性可以预测治疗反应,CC基因型者效果更好。ITPA基因缺失能对治疗引起的临床贫血起到保护作用。本研究目的是检测接受FEG-IFN和病毒唑治疗的1型HCV患者中IL28B基因多态性和ITPA基因突变情况,并分析其与持续病毒学应答(SVR)的相关性。方法:通过病历记录查询过去10年所有接受FEG-IFN和病毒唑治疗的1型HCV患者,通过信函邀请其参加本次研究。采集患者血液标本用以IL28B和ITPA基因检测。从病历记录中提取治疗反应、贫血发生及治疗中断情况。结果:共有61例1型HCV患者接受了FEG-IFN和病毒唑治疗,其中42例同意参加本次研究。治疗时平均年龄为(45.6±12.9)岁,男性患者占83.3%。33例(78.6%)检测为IL28B CC基因型,其中25例(75.8%)获得SVR,而9例非CC基因型患者中仅3例(33.3%)获得SVR(P=0.041)。11例患者检测为ITPA AC基因型,30例为CC基因型。ITPA AC与CC基因型患者的临床贫血发生率的差异无统计学意义(45.5%vs.63.3%,P=0.302)。即便在出现临床贫血的患者中,仍有70.8%最终获得了SVR。治疗中断对SVR亦无影响。结论:对于IL28B CC基因型的1型HCV患者,在考虑新的治疗选择前,应告知其FEG-IFN和病毒唑具有良好的治疗效果。

关键词：丙型肝炎聚乙二醇干扰素 IL28B基因多态性持续病毒学应答

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A comparison of the clinical, demographic and psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian country

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World Journal of Gastroenterology 2005年第23期11卷 3558-3561页

作者： Tiing-Leong Ang Kwong-Ming Fock Tay-Meng Ng Eng-Kiong Teo Tju-Siang Chua jessica tan Division of Gastroenterology

AIM: To examine the clinical spectrum of gastroesophageal reflux disease (GERD) and compare erosive (ERD) with non-erosive (NERD) in terms of clinical, demographic and psychiatric profiles.METHODS: Patients with reflux symptoms were enrolled and stratified to NERD and ERD after endoscopy (LA classification). Patients with ERD presenting with dyspepsia were included. Patients on proton pump inhibitors (PPI) or H2 receptor antagonists before endoscopy were excluded.Demographic data, Helicobacter pylori (H pylon) status and presence of minor psychiatric morbidity (based on General Health Questionnaire-28) were analyzed. RESULTS: Among 690 patients screened, 533 were eligible for analysis (male to female ratio: 3:2; Chinese: 75.4%; Malay: 9.8%; Indian: 14.8%). Clinical spectrum of GERD: N: 40.5%; A: 46%; B: 9.2%; C: 2.1%; D: 0.6%; Barrett's esophagus: 1.7%. Compared to patients with NERD, patients with ERD were significantly older (45 vs 39.4 years), more likely to be male (64.4% vs 53.7%),tended to smoke (19.6% vs 9.7%), less likely to haveminor psychiatric morbidity (26.4 vs 46.7%) and were more likely to respond to PPI (79.7 vs66.8%). There wasalso a trend towards a higher BMI (24.5 vs 23.5). Race,alcohol consumption and H pylori status were not significant.On multivariate analysis, age and presence of minor psychiatric morbidity remained with significant differences. CONCLUSION: The majority of patients who have typical symptoms of GERD have NERD or mild erosive reflux disease. Compared to patients with erosive reflux disease, patients with NERD were younger and had a higher prevalence of minor psychiatric morbidity.

关键词：精神病学胃食管逆流性疾病亚洲种族遗传临床表现

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Working toward an integrated plasticity/network framework for repetitive transcranial magnetic stimulation to inform tailored treatments

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Neural Regeneration Research 2024年第7期19卷 1423-1424页

作者： jessica Moretti Jennifer Rodger Experimental and Regenerative Neurosciences School of Biological SciencesUniversity of Western AustraliaCrawleyWAAustralia Brain Plasticity Lab Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia

Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuropsychiatric and neurological disorders,albeit with varying success.The rationale behind the use of NIBS has historically been that stim ulation techniques modulate neuronal activity in the targeted region and consequently induce plasticity which can lead to therapeutic outcomes.

关键词： stimulation transcranial treatment

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Orchard Sports Injury and Illness Classification System (OSIICS) Version 15

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Journal of Sport and Health Science 2024年第4期13卷 599-604页

作者： John W.Orchard Ebonie Rio Kay M.Crossley jessica J.Orchard Margo Mountjoy School of Public Health University of SydneySydneyNSW 2006Australia La Trobe Sport and Exercise Medicine Research Centre La Trobe UniversityMelbourneVIC 3083Australia Department of Family Medicine McMaster UniversityHamilton L8S 4L8Canada

Background:Sports medicine(injury and illnesses)requires distinct coding systems because the International Classification of Diseases is insuf-ficient for sports medicine coding.The Orchard Sports Injury and Illness Classification System(OSIICS)is one of two sports medicine coding systems recommended by the International Olympic Committee.Regular updates of coding systems are required.Methods:For Version 15,updates for mental health conditions in athletes,sports cardiology,concussion sub-types,infectious diseases,and skin and eye conditions were considered particularly important.Results:Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in athletes.Two landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology codes.Rugby union protocols on head injury assessment were used to create additional concussion codes.Conclusion:It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international accessibility.The large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

关键词： Sports cardiology Dermatology Eye injuries Concussion Infectious diseases Sports injury classification

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A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region

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儿科学研究(英文) 2024年第1期8卷 53-60页

作者： Lee Tiffany A. Bishop jessica Drover Anne Midodzi William K. Twells Laurie K. School of Pharmacy Memorial University of Newfoundland (MUN) St. John’s Canada Faculty of Medicine Memorial University of Newfoundland (MUN) St. John’s Canada

Importance: Tongue tie (TT) is a condition that can cause infant feeding difficulties due to restricted tongue movement. When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy.Objective: To determine the proportion of babies with TT as well as the frequency of frenotomy.Methods: This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression.Results: Two hundred and forty-one babies were referred. Ninety-two percent (n = 222) were diagnosed with TT and 66.0% (n = 159) underwent frenotomy. In the multivariate model, nipple pain/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (P < 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two-thirds underwent frenotomy.Interpretation: TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.

关键词： Breastfeeding Nutrition Community health services Pediatrics

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Vonoprazan-amoxicillin dual regimen with Saccharomyces boulardii as a rescue therapy for Helicobacter pylori:Current perspectives and implications

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World Journal of Gastroenterology 2024年第10期30卷 1280-1286页

作者： Valerie Josephine Dirjayanto jessica Audrey Daniel Martin Simadibrata Faculty of Medicine Universitas IndonesiaJakarta Pusat 10430DKI JakartaIndonesia Division of Gastroenterology and Hepatology Mayo ClinicRochesterMinnesota 55905United States Nuffield Department of Population Health University of OxfordOxford OX37LFUnited Kingdom

Yu et al’s study in the World Journal of Gastroenterology(2023)introduced a novel regimen of Vonoprazan-amoxicillin dual therapy combined with Saccharomyces boulardii(S.boulardii)for the rescue therapy against Helicobacter pylori(H.pylori),a pathogen responsible for peptic ulcers and gastric cancer.Vonoprazan is a potassium-competitive acid blocker renowned for its rapid and long-lasting acid suppression,which is minimally affected by mealtime.Compared to proton pump inhibitors,which bind irreversibly to cysteine residues in the H+/K+-ATPase pump,Vonoprazan competes with the K+ions,prevents the ions from binding to the pump and blocks acid secretion.Concerns with increasing antibiotic resistance,effects on the gut microbiota,patient compliance,and side effects have led to the advent of a dual regimen for H.pylori.Previous studies suggested that S.boulardii plays a role in stabilizing the gut barrier which improves H.pylori eradication rate.With an acceptable safety profile,the dual-adjunct regimen was effective regardless of prior treatment failure and antibiotic resistance profile,thereby strengthening the applicability in clinical settings.Nonetheless,S.boulardii comes in various formulations and dosages,warranting further exploration into the optimal dosage for supplementation in rescue therapy.Additionally,larger,randomized,double-blinded controlled trials are warranted to confirm these promising results.

关键词： Vonoprazan Saccharomyces boulardii Helicobacter pylori Rescue therapy Eradication rate

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Multiple sclerosis is at a checkpoint: advancing the program

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Neural Regeneration Research 2025年第3期20卷 811-812页

作者： Brandon C.Smith jessica L.Williams Department of Neurosciences Lerner Research InstituteCleveland ClinicClevelandOHUSA Department of Biological Geologicaland Environmental SciencesCleveland State UniversityClevelandOHUSA

Multiple sclerosis(MS) is a chronic inflammatory and demyelinating disease of the central nervous system(CNS). Patients with MS experience sensory and motor function loss due to myelin and/or axon damage perpetuated b... 详细信息

关键词： Hauser sclerosis damage

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Electrobiocorrosion by microbes without outer-surface cytochromes

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mLife 2024年第1期3卷 110-118页

作者： Dawn E.Holmes Trevor L.Woodard jessica A.Smith Florin Musat Derek R.Lovley Department of Microbiology University of Massachusetts AmherstAmherstMassachusettsUSA Department of Physical and Biological Science Western New England UniversitySpringfieldMassachusettsUSA Department of Biomolecular Sciences Central Connecticut State UniversityNew BritainConnecticutUSA Department of Biology Section for MicrobiologyAarhus UniversityAarhusDenmark Department of Molecular Biology and Biotechnology Facuity of Biology and GeologyBabes-Bolyai UniversityCluj-NapocaRomania

Anaerobic microbial corrosion of iron-containing metals causes extensive economic damage.Some microbes are capable of direct metal-to-microbe electron transfer(electrobiocorrosion),but the prevalence of electrobiocorrosion among diverse methanogens and acetogens is poorly understood because of a lack of tools for their genetic manipulation.Previous studies have suggested that respiration with 316L stainless steel as the electron donor is indicative of electrobiocorrosion,because,unlike pure Fe^(0),316L stainless steel does not abiotically generate H2 as an intermediary electron carrier.Here,we report that all of the methanogens(Methanosarcina vacuolata,Methanothrix soehngenii,and Methanobacterium strain IM1)and acetogens(Sporomusa ovata and Clostridium ljungdahli)evaluated respired with pure Fe^(0)as the electron donor,but only M.vacuolata,Mx.soehngeni,and S.ovata were capable of stainless steel electrobiocorrosion.The electrobiocorrosive methanogens re-quired acetate as an additional energy source in order to produce methane from stainless steel.Cocultures of S.ovata and Mx.soehngeni demonstrated how acetogens can provide acetate to methanogens during corrosion.Not only was Meth-anobacterium strain IM1 not capable of electrobiocorrosion,but it also did not accept electrons from Geobacter metal-lireducens,an effective electron-donating partner for direct interspecies electron transfer to all methanogens that can directly accept electrons from Fe^(0).The finding that M.vacuolata,Mx.soehngeni,and S.ovata are capable of electrobiocorrosion,despite a lack of the outer-surface c-type cytochromes previously found to be important in other electrobiocorrosive microbes,demonstrates that there are multiple microbial strategies for making electrical contact with Fe^(0).

关键词： acetogen corrosion Fe^(0) methanogen stainless steel

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Epinephrine injection therapy versus a combination of epinepnrine injection and endoscopic hemoclip in the treatment of bleeding ulcers

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World Journal of Gastroenterology 2005年第7期11卷 1044-1047页

作者： Tju-Siang Chua Kwong-Ming Fock Tay-Meng Ng Eng-Kiong Teo jessica Yi-Lyn tan Tiing-Leong Ang Division of Gastroenterology

AIM: To assess the efficacy of hemoclip application in combination with epinephrine injection in the treatment of bleeding peptic ulcers and to compare the clinical outcomes between patients treated with such a combination therapy and those treated with epinephrine injection alone.METHODS: A total of 293 patients (211 males, 82females) underwent endoscopic therapy for bleeding peptic ulcers. Of these, 202 patients (152 males, 50females) received epinephrine injection therapy while 91patients (59 males, 32 females) received combination therapy. The choice of endoscopic therapy was made by the endoscopist. Hemostatic rates, rebleeding rates, need for emergency surgery and 30-d mortality were the outcome measures studied.RESULTS: Patients who received combination therapy were significantly older (mean age 66±16 years, range24-90 years) and more suffered from chronic renal failure compared to those who received epinephrine injection therapy alone (mean age 61±17 years, range 21-89 years).Failure to achieve permanent hemostasis was 4% in the group who received epinephrine injection alone and 11%in the group who received combination therapy. When the differences in age and renal function between the two treatment groups were taken into account by multivariate analysis, the rates of initial hemostasis,rebleeding rates, need for surgery and 30-d mortality for both treatment options were not significantly different.CONCLUSION: Combination therapy of epinephrine injection with endoscopic hemoclip application is an effective method of achieving hemostasis in bleeding peptic ulcer diseases. However, superiority of combination therapy over epinephrine injection alone, could not be demonstrated.

关键词：肾上腺素注射液消化系溃疡药物治疗联合用药

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