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Novel anti-diabetic agents in non-alcoholic fatty liver disease: a mini-review

Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 584-588页

作者： manhal olaywi Taruna Bhatia Sury Anand Shashideep Singhal Division of Gastroenterology and Hepatology The Brooklyn Hospital Center/New York Presbyterian Healthcare System Division of Digestive and Liver Diseases Columbia University Medical Center

BACKGROUND:Non-alcoholic fatty liver disease(NAFLD)encompasses a spectrum that ranges from simple steatosis to non-alcoholic steatohepatitis(NASH)and to *** recommended treatment for this disease includes measures that target obesity and insulin *** present review summarizes the role of newer anti-diabetic agents in treatment of *** SOURCES:PubMed,MEDLINE and Ovid databases were searched to identify human studies between January 1990and January 2013 using specified key *** studies that enrolled patients with a diagnosis of NAFLD or NASH and involved use of newer classes of anti-diabetic agents for a duration of at least 3 months were ***:Out of the screened articles,four met eligibility criteria and were included in our *** classes of newer anti-diabetic medications described were dipeptidyl peptidase IV inhibitors and glucagon-like peptide-1 ***:Liraglutide and Exenatide showed improvement in transaminases as well as histology in patients with *** showed improvement in transaminases but limited studies are there to access its effect on *** studies are needed to support use of newer anti-diabetic medications in patients with NAFLD.

关键词： non-alcoholic fatty liver disease non-alcoholic steatohepatitis anti-diabetic agents Sitagliptin Exenatide Liraglutide

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Bariatric surgery proves long-term benefit in patients with cirrhosis

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Gastroenterology Report 2021年第3期9卷 252-256,I0002页

作者： manhal Izzy Mounika Angirekula Barham KAbu Dayyeh Fateh Bazerbachi Kymberly D.Watt Division of Gastroenterology Hepatologyand NutritionVanderbilt University Medical CenterNashvilleTNUSA Division of Gastroenterology and Hepatology Mayo Clinic and FoundationRochesterMNUSA Division of Gastroenterology Massachusetts General HospitalBostonMAUSA

Background:Obesity is commonly observed in patients with cirrhosis,especially with the increasing prevalence of nonalcoholic steatohepatitis(NASH).Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk;therefore,data are lacking regarding long-term *** this study,we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric ***:We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23,2009 and November 9,2011,and followed in a pilot study for evaluation of bariatric surgery *** patients with more than 4 years of follow-up were included in the *** regarding their liver disease,metabolic status,and survival were collected.A descriptive analysis was ***:The cohort consisted of 10 patients,of whom 7 were *** median post-surgical follow-up was 8.7 years(61.4 years).All patients had biopsy-proven NASH;two patients had concurrent,untreated hepatitis C *** the observation period,there was a mean weight loss of 24 kg(19.2%of total body weight pre surgery,P<0.001)and only one patient regained weight to the baseline pre-surgical *** patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later *** remainder of the patients did not have any hepatic decompensation,cardiovascular event,or *** for one patient with Gilbert syndrome,bilirubin was normal in all patients at last ***:Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-termfollow-up.

关键词： obesity weight loss bariatric surgery cirrhosis non-alcoholic steatohepatitis

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Review of efficacy and safety of laxatives use in geriatrics

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第2期7卷 334-342页

作者： manhal Izzy Anju Malieckal Erin Little Sury Anand Division of Gastroenterology and Liver Diseases Montefiore Medical Center Albert Einstein College of Medicine Division of Gastroenterology the Brooklyn Hospital Center Division of Gastroenterology NYU-Lutheran Medical Center

AIM:To study the efficacy and safety of pharmacolo-gical treatment of constipation in ***:Pub Med,MEDLINE,google scholar,and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation,which were conducted between January1990 and January 2013 using the specified *** studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were *** were excluded from this review if they were non-controlled trials,case series,or case ***:Out of twenty three studies we initially retrieved in our search,only nine studies met the eligibility criteria of being controlled trials within *** laxatives examined in the nine studies were senna,lactulose,sorbital,polyethylene glycol(PEG),lubiprostone,linaclotide,and *** those studies,senna combinations had a higher efficacy than sorbitol or lactulose as well as,a very good adverse effect *** was also shown to be safe and effective in geriatric ***,it has been shown that PEG is as safe in geriatrics as in general *** agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrant further ***:Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation.

关键词： Chronic constipation Laxatives Elderly Lubiprostone Linaclotide Prucalopride

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Accuracy of endoscopists' estimate of polyp size: A continuous dilemma

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World Journal of Gastrointestinal Endoscopy 2015年第8期7卷 824-829页

作者： manhal Izzy Muhammad Asif Virk Avi Saund Juan Tejada Faraj Kargoli Sury Anand Division of Gastroenterology the Brooklyn Hospital Center/New York Presbyterian Health Care System Division of Gastroenterology and Liver Diseases Montefiore Medical Center

AIM: To examine the discrepancy, if any, between the endoscopist's estimate and pathologist's measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a clear unequivocal documentation of polyp size by both the endoscopist and pathologist. Endoscopist measurements were based on the visual estimate of polyp size seen on high definition screens. The measurement was done by our pathologists after formalin fixation. We compared the endoscopist estimate of the polyp size to the pathologist measurement in order to explore the discordance between the two readings. Data regarding demographics and method of polypectomy(snare polypectomy vs excisional biopsy) was collected, as well. Statistical analysis software statistical software was used to analyze the data. RESULTS: Our cohort included 88 patients from which 111 polyps were removed. Fifty-two(46.8%) of the 111 polyps were excised using biopsy forceps and fiftynine(53.2%) were removed by snare. In the biopsy forceps group, the mean polyp size documented by the pathologist was 0.38 ± 0.19 cm and the mean polyp size documented by the endoscopist was 0.54 ± 0.16cm. The mean difference was 0.15 cm(P < 0.001). In the snare group, the mean polyp size documented by the pathologist was 0.54 ± 0.24 cm and the mean polyp size documented by the endoscopist 0.97 ± 0.34 cm. The mean difference was 0.42 cm(P < 0.001). Combining both groups, the mean size documented by pathologist was 0.46 ± 0.23 cm compared to 0.76 ± 0.35 cm documented by the endoscopist. The mean difference was 0.3 cm(95%CI: 0.23-0.36).CONCLUSION: Post polypectomy measurement by the pathologist are generally smaller than the endoscopist's estimate.

关键词： Polyp size estimate Colonic polyps Endoscopistestimate

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