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Journal of Sport and Health Science 2017年第4期6卷 443-446页

作者： Nitzan Dror liat oren Michal Pantanowitz Alon Eliakim Dan Nemet Child Health and Sports Center Pediatric Department Meir Medical Center Sackler School of Medicine Tel Aviv University Kfar-Saba 44281 Israel

Purpose: To assess the growth hormone(GH) response to the Wingate anaerobic test(WAn T) among children with short stature and suspected GH deficiency. We hypothesized that the GH response to the WAn T would be similar to the GH response to a commonly used pharmacologic provocation ***: Ten children(6 males and 4 females, age range 9.0–14.9 years) participated in the study. Each participant performed 2 tests: a standard all-out WAn T, cycling for 30 s against constant resistance, and a standardized pharmacologic test(clonidine or glucagon). Blood samples for GH were collected before and 10, 30, 45, and 60 min after the beginning of exercise. In addition, we collected pre-and post-exercise blood lactate ***: There was a significant increase in GH levels after the WAn T, yet in 9 of 10 participants, this increase was below the threshold for GH sufficiency. Peak GH after the WAn T was significantly lower compared to the pharmacologic GH provocation tests(with 9 of 10 demonstrating GH-sufficient response).Conclusion: The traditional WAn T cannot be used as a GH provocation test. Further research is needed to develop anaerobic exercise protocols sufficient to promote GH secretion.

关键词： Anaerobic Exercise Growth hormone Lactate Provocation test Short stature

Hepatocellular carcinoma in the post-hepatitis C virus era: Should we change the paradigm?

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World Journal of Gastroenterology 2019年第29期25卷 3929-3940页

作者： Hadar Meringer oren Shibolet liat Deutsch Department of Gastroenterology and Hepatology Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine Tel Aviv University

Hepatocellular carcinoma (HCC) is a common and deadly malignancy. The disease usually develops on a background of chronic liver disease. Until recently, the most common etiology was infection with the hepatitis C virus (HCV). The advent of direct-acting antiviral (DAA) therapies has been a major breakthrough in HCV treatment. Sustained virologic response can now be achieved in almost all treated patients, even in patients with a high risk for the development of HCC, such as the elderly or those with significant fibrosis. Early reports raised concerns of a high risk for HCC occurrence after DAA therapy both in patients with previous resection of tumors and those without previous tumors. As the World Health Organization’s goals for eradication of HCV are being endorsed worldwide, the elimination of HCV seems feasible. Simultaneous to the decrease in the burden of cirrhosis from HCV, non-alcoholic fatty liver disease (NAFLD) incidence has been increasing dramatically including significant increased incidence of cirrhosis and HCC in these patients. Surprisingly, a substantial proportion of patients with NAFLD were shown to develop HCC even in the absence of cirrhosis. Furthermore, HCC treatment and potential complications are known to be influenced by liver steatosis. These changes in etiology and epidemiology of HCC suggest the beginning of a new era: The post–HCV era. Changes may eventually undermine current practices of early detection, surveillance and management of HCC. We focused on the risk of HCC occurrence and recurrence in the post–HCV era, the surveillance needed after DAA therapy and current studies in HCC patients with NAFLD.

关键词： Hepatocellular carcinoma Hepatitis C virus Direct-acting antivirals Nonalcoholic fatty liver disease Non-alcoholic steatohepatitis

Treatment of hepatocellular carcinoma: Steps forward but still a long way to go

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World Journal of Hepatology 2015年第3期7卷 566-574页

作者： liat Mlynarsky Yoram Menachem oren Shibolet Department of Gastroenterology Tel-Aviv Medical Center and the Sackler Faculty of Medicine Tel-Aviv University

Hepatocellular carcinoma(HCC) is the fifth most common malignancy and the third cause of tumor associated deaths worldwide. HCC incidence rates are increasing in many parts of the world including developing and developed countries. Potentially curative treatments for HCC are resection and liver transplantation, but these are only suitable for patients with small tumors, meeting strict pre-defined criteria, or well-compensated liver disease. Early diagnosis of HCCcan be achieved by surveillance of at-risk populations. For patients with non-resectable disease treatments modalities include loco-ablative and systemic therapies. In this review we focus on treatment options in HCC and their allocation. Although significant research is in progress, to this date, the results are unsatisfactory with limited long-term survival. In the fight against this deadly disease, there is still a long way to go.

关键词： Hepatocellular carcinoma Liver resection Liver transplantation Loco-ablative therapies Sorafenib

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

Emergency department targeted screening for hepatitis C does not improve linkage to care

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World Journal of Gastroenterology 2020年第32期26卷 4878-4888页

作者： Inbal Houri Noya Horowitz Helena Katchman Yael Weksler Ofer Miller liat Deutsch oren Shibolet Department of Gastroenterology and Hepatology Tel-Aviv Medical CenterTel-Aviv 6423906Israel Sackler Faculty of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel

BACKGROUND Hepatitis C virus(HCV)infection is a leading cause of chronic liver disease *** treatments for HCV revolutionized management and prompted the world health organization to set the goal of viral elimination by *** developments strengthen the need for HCV screening in order to identify asymptomatic carriers prior to development of chronic liver disease and its *** screening strategies have been attempted,most targeting high-risk *** studies focusing on patients arriving at emergency departments showed a higher prevalence of HCV compared to the general *** To identify previously undiagnosed HCV carriers among high risk emergency room attendees and link them to care for anti-viral *** In this single center prospective study,persons visiting the emergency department in an urban hospital were screened by a risk factor-specific *** risk factors screened for were exposure to blood products or organ transplantation before 1992;origins from countries with high prevalence of HCV;intravenous drug use;human immunodeficiency virus carriers;men who have sex with men;those born to HCV-infected mothers;prior prison time;and chronic kidney *** with at least one risk factor were tested for HCV by serum for HCV antibodies,a novel oral test from saliva(OraQuick®)or *** Five hundred and forty-one participants had at least one risk factor and were tested for *** four percent of all study participants had only one risk *** five percent of participants underwent OraQuick®testing,34%were tested for serum anti-HCV antibodies,and 25%had both tests.3.1%of patients(17/541)had a positive result,compared to local population incidence of 1.96%.Of these,82%were people who inject drugs(current or former),and 64%served time in *** patient had a negative HCV-RNA,and two patients died from non-HCV related *** review of past medical records,12 patients w

关键词： Screening Emergency departments Israel Saliva Hepatitis C Liver

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 non-alcoholic fatty liver disease (NAFLD) and general health ***: This cross sectional and prospective follow-up study was performed on a cohort of a sub-sample 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

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

Ultra-brief crisis interpersonal psychotherapy based intervention for suicidal children and adolescents

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World Journal of Psychiatry 2021年第8期11卷 403-411页

作者： Anat Brunstein Klomek liat Haruvi Catalan Alan Apter Baruch Ivcher School of Psychology Interdisciplinary CenterHerzliya 4610101Israel Depression and Suicide Clinic Schneider Children’s Medical CenterPetach Tikva 49202Israel Sackler Faculty of Medicine Tel Aviv UniversityTel Aviv 69978Israel

Suicidal behaviors in adolescence are a major public health *** dramatic rise in self-injurious behaviors among adolescents has led to an overwhelming increase in the number of those presenting to the emergency *** intervention described below was constructed on the basis of brief and focused interventions that were found to be effective among suicidal adults using an adaptation of interpersonal psychotherapy for *** intervention has four main objectives:first,a focused treatment for reducing suicide risk;second,a short and immediate response;third,building a treatment plan based on understanding the emotional distress and interpersonal aspects underlying suicidal behavior;and lastly,to generate hope among adolescents and their *** intervention includes intensive five weekly sessions,followed by 3 mo of email follow-up.

关键词： Suicide Depression Adolescents Crisis intervention Interpersonal psychotherapy

Enigma of primary aortoduodenal fistula

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World Journal of Gastroenterology 2009年第25期15卷 3191-3193页

作者： Miklosh Bala Jacob Sosna liat Appelbaum Eran Israeli Avraham I Rivkind Department of General Surgery and Trauma Unit Hadassah-Hebrew University Medical Center Department of Radiology Hadassah-Hebrew University Medical Center Department of Gastroenterology Hadassah-Hebrew University Medical Center

A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.

关键词： Aortoduodenal fistula Gastrointestinal hemorrhage Computed tomography Aortography

Temperature-mediated structural evolution of vapor–phase deposited cyclosiloxane polymer thin films for enhanced mechanical properties and thermal conductivity

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International Journal of Extreme Manufacturing 2023年第2期5卷 216-228页

作者： Weiwei Du Jing Tu Mingjun Qiu Shangyu Zhou Yingwu Luo Wee-liat Ong Junjie Zhao State Key Laboratory of Chemical Engineering College of Chemical and Biological EngineeringZhejiang University38 Zheda RdHangzhou 310027People's Republic of China Institute of Zhejiang University--Quzhou 78 Jiuhua Roulevard NorthQuzhouZhejiang 324000People's Republic of China ZJU-UIUC Institute College of Energy EngineeringZhejiang UniversityHainingJiaxingZhejiang 314400People's Republic of China State Key Laboratory of Clean Energy Utilization Zhejiang UniversityHangzhouZhejiang 310027People's Republic of China

Polymer-derived ceramic(PDC) thin films are promising wear-resistant coatings for protecting metals and carbon-carbon composites from corrosion and ***,the high pyrolysis temperature hinders the applications on substrate materials with low melting *** report a new synthesis route for PDC coatings using initiated chemical vapor deposited poly(1,3,5-trivinyl-1,3,5-trimethylcyclotrisiloxane)(pV_3D_3) as the precurs *** investigated the changes in siloxane moieties and the network topology,and proposed a three-stage mechanism for the thermal annealing *** rise of the connectivity number for the structures obtained at increased annealing temperatures was found with strong correlation to the enhanced mechanical properties and thermal *** PDC films obtained via annealing at 850℃ exhibit at least 14.6% higher hardness than prior reports for PDCs synthesized below 1100℃.Furthermore,thermal conductivity up to 1.02 W(mK)^(-1) was achieved at the annealing temperature as low as 700℃,which is on the same order of magnitude as PDCs obtained above 1100℃.Using minimum thermal conductivity models,we found that the thermal transport is dominated by diffusons in the films below the percolation of rigidity,while ultra-short mean-free path phonons contribute to the thermal conductivity of the films above the percolation *** findings of this work provide new insights for the development of wear-resistant and thermally conductive PDC thin films for durable protection coatings.

关键词： polymer-derived ceramics vapor–phase deposition mechanical properties thermal conductivity thin films

Nutritional issues in patients with obesity and cirrhosis

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World Journal of Gastroenterology 2018年第30期24卷 3330-3346页

作者： Luigi Schiavo Luca Busetto Manuela Cesaretti Shira Zelber-Sagi liat Deutsch Antonio Iannelli Department of Translational Medical Science University of Campania“Luigi Vanvitelli”Naples 80131Italy Ⅸ Division of General Surgery Vascular Surgery and Applied BiotechnologyNaples University PoliclinicNaples 80131Italy Department of Medicine University of PaduaPadua 35128Italy Center for the Study and the Integrated Management of Obesity University Hospital of PaduaPadua 35128Italy Department of HPB Surgery and Liver Transplantation Hopital BeaujonAP-HPClichy 92110France Department of Nanophysics Italian Institute of TechnologyGenova 16163Italy School of Public Health University of HaifaHaifa 3498838Israel Department of Gastroenterology and Liver disease Tel Aviv Medical Center62431Tel-Aviv 62431Israel The Sackler Faculty of Medicine Tel-Aviv UniversityTel-Aviv 62431Israel Digestive Unit Archet 2 HospitalUniversity Hospital of NiceF-06202NiceFrance Inserm U1065Team 8“Hepatic complications of obesity”Nice F-06204France University of Nice Sophia-Antipolis Nice F-06107France

Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to *** with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver *** obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronicliver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver *** patients with obesity are at high risk for depletion of various fat-soluble,water-soluble vitamins and trace elements and should be supplemented ***,physical activity and protein intake should be carefully monitored in these fragile patients according to recent *** surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver *** risk of sarcopenia,micronutrient status,and the recommended supplementation in patients with obesity and cirrhosis are discussed in this ***,the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.

关键词： obesity cirrhosis sarcopenia malnutrition bariatric surgery