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The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri Jose Nieto Abed Al-Lehibi mo.an ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly Gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA Department of Gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly Gastroenterology and Digestive Endoscopy Unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA Department of Gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of Gastroenterology HyderabadIndia Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 ***: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

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Comparison between Different Shapes of Structure by Response Spectrum Method of Dynamic Analysis

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Open Journal of Civil Engineering 2016年第2期6卷 131-138页

作者： Jaya Rajkumar ramchandani Madhuri Nilesh Mangulkar Department of Civil Engineering J.N.E.C Aurangabad (M.S) India

Several procedures for non-linear static and dynamic analysis of structures have been developed in recent years. In this paper, the response spectrum analysis is performed on two different shapes i.e. regular and irregular shape of structure by using STAAD PRO. And the comparison results are studied and compared accounting for the earthquake characteristics and the structure dynamic characteristics. As the results show that the earthquake response peak values and the main response frequencies are very close and comparable. It can be referred to by the engineering applications.

关键词： Seismic Response Spectrum Analysis STAAD PRO Dynamic Characteristics Earthquake Response Peak

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Elevated Linoleic Acid (A Pro-Inflammatory PUFA) and Liver Injury in a Treatment Naive HIV-HCV Co-Infected Alcohol Dependent Patient

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Journal of Biosciences and Medicines 2016年第7期4卷 23-27页

作者： Vatsalya Vatsalya Shirish S. Barve Craig J. McClain Vijay A. ramchandani Division of Gastroenterology Hepatology and Nutrition Department of Medicine University of Louisville School of Medicine Louisville USA Section on Human Psychopharmacology LCTS/DICBR/NIAAA at National Institutes of Health Bethesda USA Department of Pharmacology and Toxicology University of Louisville School of Medicine Louisville USA Robley Rex VA Medical Center Louisville USA

HIV and HCV co-infection is a unique disease condition, and medical management of such condition is difficult due to severity and systemic complications. Added with heavy alcohol drinking, risk of liver injury increases due to several pro-inflammatory responses that subsequently get involved with alcohol metabolism. Elevated levels of fatty acids have been reported both in viral infections as well as alcoholic liver disease though such investigations have not addressed the adverse event with dual viral infection of HIV and HCV along with heavy drinking. This case report of a patient with excessive alcohol drinking and first time diagnosis of HIV and HCV dual infection, elaborating concurrent alteration in Linoleic Acid (LA) levels and pro-inflammatory shift in ω-6/ω-3 ratio along with the elevations in liver injury markers. Elevated LA has been recently studied extensively for its role in alcoholic liver disease;and in the present case, we also found it to be clinically relevant to liver injury.

关键词： Alcohol Fatty Acids HCV HIV Liver Injury

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Glomus Tumor of the Kidney: A Case Report with CT, MRI, and Histopathological Findings

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Open Journal of Urology 2016年第5期6卷 80-85页

作者： Jillian W. Lazor Thomas J. Guzzo Zhanyong Bing Priti Lal Parvati ramchandani Drew A. Torigian Department of Radiology Hospital of the University of Pennsylvania Philadelphia PA USA Department of Surgery Hospital of the University of Pennsylvania Philadelphia PA USA Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania Philadelphia PA USA

We describe the computed tomographic (CT) and magnetic resonance imaging (MRI) features of a very rare renal neoplasm, a glomus tumor. Our patient was a 68-year-old woman with a history of high grade T1 stage bladder cancer, status post intravesical Bacillus Calmette-Guérin (BCG) therapy and left ureteral stent placement, who presented for routine follow-up imaging evaluation of the urothelial tract. Computed tomographic urography (CTU) incidentally demonstrated a 1.7 cm well-circumscribed, non-calcified, non-fat containing lesion in the left renal cortex with arterial phase continuous peripheral rim enhancement and central hypoattenuation relative to enhanced renal parenchyma. Subsequent MRI showed the lesion to be isointense in signal intensity relative to the renal parenchyma on T1-weighted imaging and hyperintense on T2-weighted imaging. No macroscopic fat or microscopic lipid was seen within the lesion, and there were no foci of susceptibility artifact on T1-weighted images. Diffusion-weighted and apparent diffusion coefficient images demonstrated no restricted diffusion. Contrast-enhanced images demonstrated continuous peripheral rim enhancement in the arterial phase and persistent rim enhancement with partial centripetal fill in of enhancement on venous phase images, similar to the pattern seen on CT. Partial left nephrectomy was performed for the suspected solid renal neoplasm. Histopathological assessment was diagnostic of a renal glomus tumor.

关键词： Glomus Tumor Kidney Renal Computed Tomography (CT) Magnetic Resonance Imaging (MRI)

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儿童与青少年抑郁症的治疗多数选择性5-羟色胺再摄取抑制剂不再被推荐

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英国医学杂志中文版 2004年第3期7卷 135-136页

作者： Paul ramchandani 薛海波 MRC fellow Section of Child and Adolescent Psychiatry University of Oxford Department of Psychiatry Warneford Hospital Oxford OX3 7JX

多数选择性5-羟色胺再摄取抑制剂不再被推荐

关键词：儿童青少年抑郁症治疗氟西汀

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一项产后及儿童发育期父亲抑郁症的前瞻性人群研究

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世界核心医学期刊文摘（妇产科学分册） 2005年第10期1卷 1-2页

作者： ramchandani.P SteinA EvansJ O'ConnorT.G 朱国栋 University of Oxford Department of Psychiatry Warneford Hospital Headington Oxford OX3 7JX United Kingdom.Dr

Background:Depression is common and frequently affects mothers and fathers of young children. Postnatal depression in mothers affects the quality of maternal care, and can lead to disturbances in their children’s social, behavioural, cognitive, and physical development. However, the effect of depression in fathers during the early years of a child’s life has received little attention. Methods: As part of a large, population- based study of childhood, we assessed the presence of depressive symptoms in mothers (n=13 351) and fathers (n=12 884) 8 weeks after the birth of their child with the Edinburgh postnatal depression scale (EPDS). Fathers were reassessed at 21 months. We identified any subsequent development of behavioural and emotional problems in their children (n=10 024) at age 3.5 years with maternal reports on the Rutter revised preschool scales. Findings: Information was available for 8431 fathers, 11 833 mothers, and 10 024 children. Depression in fathers during the postnatal period was associated with adverse emotional and behavioural outcomes in children aged 3.5 years (adjusted odds ratio 2.09, 95% CI 1.42- 3.08), and an increased risk of conduct problems in boys (2.66, 1.67- 4.25). These effects remained even after controlling for maternal postnatal depression and later paternal depression. Interpretation: Our findings indicate that paternal depression has a specific and persisting detrimental effect on their children’s early behavioural and emotional development.

关键词：郁症产后抑郁量表 EPDS 社会行为妇幼保健发育不良特异性

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Per oral cholangiopancreatoscopy in pancreatico biliary diseases- Expert consensus statements

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World Journal of Gastroenterology 2015年第15期21卷 4722-4734页

作者： mo.an ramchandani Duvvur Nageshwar Reddy Sundeep Lakhtakia Manu Tandan Amit Maydeo Thoguluva Seshadri Chandrashekhar Ajay Kumar Randhir Sud Rungsun Rerknimitr Dadang Makmun Christopher Khor Asian Institute of Gastroenterology Baldota Institute of Digestive Sciences Gastro-enterology and Endocrinology MedIndia Hospitals Department of Gastroenterology Apollo Hospital Delhi Department of Gastro-enterology Medanta Gastroenterology and Hepatology King Chulalongkorn Memorial Hospital Department of Medicine Cipto Mangunkusumo Hospital Department of Internal Medicine Faculty of Medicine National University Hospital Department of Gastroenterology and Hepatology

AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy(POCPS).METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography(ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature ***: Six consensus statements were generated:(1) POCPS is now an important additional tool during ERCP;(2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis;(3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail;(4) in patients with main duct intraductal papillary mucinous neoplasms(IPMN) POPS may be used to assess extent of tumor to assist surgicalresection;(5) in difficult pancreatic ductal stones,POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and(6) additional indications for POCPS include selective guidewire placement,unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusua indications involving selective guidewire placement,assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents.

关键词： Per oral cholangiopancreatoscopy Intraductallithotripsy Indeterninate biliary strictures Cholangioscopy Pancreatoscopy

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睾丸微石症影像和随访:ESUR阴囊成像小组委员会的指南

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国际医学放射学杂志 2015年第2期 196-197页

作者： J.Richenberg J.Belfield P.ramchandani L.Rocher S.Freeman A.C.Tsili 高飞 Royal Sussex County Hospital Brighton and Brighton and Sussex Medical School Brighton Sussex UK

摘要目的阴囊成像小组委员会是由欧洲泌尿生殖放射委员会(ESUR)任命的,对睾丸微石症(TML)的影像和随访制定了指南。方法笔者和一位大学图书管理员独立地用

关键词：阴囊睾丸囊男生殖器睾丸微石症 ESUR 委员会小组

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Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi

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World Journal of Gastrointestinal Surgery 2010年第5期2卷 165-168页

作者： Santosh Darisetty Manu Tandan Duvvuru Nageshwar Reddy Rama Kotla Rajesh Gupta mo.an ramchandani Sandeep Lakhtakia Guduru Venkat Rao Rupa Banerjee Department of Anesthesiology Asian Institute of Gastroenterology Department of Gastroenterology Asian Institute of Gastroenterology

AIM: To evaluate the efficacy of thoracic epidural analgesia for extracorporeal shock wave lithotripsy (ESWL). METHODS: ESWL is an effective, non-invasive technique for the treatment of difficult pancreatic and large bile duct calculi. The procedure is often painful and requires large doses of analgesics. Many different anesthetic techniques have been used. Patients with either large bile duct calculi or pancreatic duct calculi which could not be extracted by routine endoscopic methods were selected. Thoracic epidural anesthesia (TEA) was routinely used in all the subjects unless contraindicated. Bupivacaine 0.25% with or without clonidine was used to block the segments D6 to D12. The dose was calculated depending on the age, height and weight of the patient. It was usually 1-2 mL per segment ***: Ninety eight percent of the 1509 patients underwent ESWL under TEA. The subjects selected were within American Society of Anesthesiologists grade Ⅰ to Ⅲ. ESWL using EA permitted successful elimination of bile duct or pancreatic calculi with minimal morbidity. The procedure time was shorter in patients with TEA than in those who underwent ESWL under total intravenous anesthesia. CONCLUSION: Almost all patients undergoing ESWL with EA had effective blocks with a single catheter insertion and local anesthetic injection.

关键词： Thoracic epidural anesthesia Extracorporeal shock wave lithotripsy Bile duct calculi Pancreatic duct calculi

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超声偶然检出、体检未触及的成人睾丸肿物:影像表现对ESUR阴囊成像委员会的放射学评估及建议的影响

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国际医学放射学杂志 2016年第5期 587-587页

作者： L.Rocher P.ramchandani J.Belfield M.Bertolotto L.E.Derchi J.M.Correas 白雪冬 Hopitaux Paris Sud APHP site Bicêtre 78 avenue du Général Leclerc

摘要目的超声检测出睾丸小病变日益增多,可造成不必要的睾丸切除。本文阐述了此类病变的性质,对相关文献进行综述,并列举了一些典型疾病,同时提出有助于其定性和干预的建议。方法 ESUR阴囊成像委员会应用Pubmed和Medline数据库,检索2015... 详细信息

摘要目的超声检测出睾丸小病变日益增多,可造成不必要的睾丸切除。本文阐述了此类病变的性质,对相关文献进行综述,并列举了一些典型疾病,同时提出有助于其定性和干预的建议。方法 ESUR阴囊成像委员会应用Pubmed和Medline数据库,检索2015年5月以前发表的原创和综述文章,关键词为"睾丸超声、增强超声、超声弹性成像、磁共振成

关键词：超声 ESUR 睾丸性腺阴囊睾丸囊男生殖器委员会

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