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Diagnostic approach to patients with acute idiopathic and recurrent pancreatitis,what should be done?

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World Journal of Gastroenterology 2008年第7期14卷 1007-1010页

作者： mohammad al-haddad Michael B Wallace Division of Gastroenterology and Hepatology Mayo Clinic College of MedicineJacksonvilleFL 32224United States

Acute recurrent pancreatitis (ARP) is a common clinical condition that may be difficult to diagnose. Endoscopic ultrasound (EUS) is proposed to be a safe first line test of choice in the majority of patients. When interventions are needed to remove biliary stones, evaluate sphincter of Oddi or pancreas divisum, endoscopic retrograde cholangiopancreatography (ERCP) is recommended. Magnetic resonance cholangiopancreatography (MRCP) can be a suitable alternative from a diagnostic standpoint although may not be widely available. Finally, genetic testing is increasingly used to detect certain mutations that are associated with this diagnosis.

关键词： Acute recurrent pancreatitis Idiopathic pancreatitis Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography

An exclusive fine-needle biopsy approach to sampling solid lesions under EUS guidance:a prospective cohort study

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Gastroenterology Report 2020年第5期8卷 349-354,I0001页

作者： Lindsey M.Temnykh Mahmoud A.Rahal Zahra Zia mohammad A.al-haddad Department of Internal Medicine Indiana University School of MedicineIndianapolisINUSA Division of Gastroenterology and Hepatology Department of Internal MedicineIndiana University School of MedicineIndianapolisINUSA

Background Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is increasingly utilized to enhance the cytological yield of sampling solid lesions,but its superiority over existing fine-needle aspiration(FNA)platforms has not been clearly *** aim of our study was to compare the diagnostic accuracy and procedural outcomes of FNB using a new Franseen-tip needle to that of a traditional FNA in sampling solid lesions under EUS *** Consecutive patients with solid lesions referred for EUS-FNB sampling were ***-related outcomes were collected prospectively including patient demographics,number of passes performed,diagnostic sample adequacy,adverse events,and recovery *** Acquire needle was used to sample all lesions in the study *** EUSFNA procedures performed to sample solid lesions using the Expect needle were utilized as *** There were 180 patients undergoing EUS-FNB compared to 183 patients undergoing EUS-FNA procedures for solidlesion *** procedure time was significantly shorter in patients who underwent FNB compared to FNA(mean:37.4 vs 44.9 minutes,Pall passes,shorter procedure time,and improved diagnostic *** may replace FNA as the primary sampling modality of choice in all solid lesions.

关键词： endoscopic ultrasound fine-needle biopsy fine-needle aspiration pancreatic tumors

Applications of endoscopic ultrasound in pancreatic cancer

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World Journal of Gastroenterology 2014年第24期20卷 7808-7818页

作者： Leticia Perondi Luz mohammad ali al-haddad Michael Sai Lai Sey John M DeWitt Division of Gastroenterology and Hepatology Indiana UniversityMedical CenterRoudebush VA Medical CenterIndianapolisIN 46202United States

Since the introduction of endoscopic ultrasound guided fine-needle aspiration(EUS-FNA),EUS has assumed a growing role in the diagnosis and management of pancreatic ductal adenocarcinoma(PDAC).The objective of this review is to discuss the various applications of EUS and EUS-FNA in ***,its use for detection,diagnosis and staging will be *** and EUS-FNA are highly accurate modalities for detection and diagnosis of PDAC,this high accuracy,however,is decreased in specific situations particularly in the presence of chronic *** techniques such as contrast-enhanced EUS,elastography and analysis of DNA markers such as k-ras mutation analysis in FNA samples are in progress and might improve the accuracy of EUS in the detection of PDAC in this setting and will be *** and EUS-FNA have recently evolved from a diagnostic to a therapeutic technique in the management of *** developments in therapeutic EUS have occurred including advances in celiac plexus interventions with direct injection of ganglia and improved pain control,EUS-guided fiducial and brachytherapy seed placement,fine-needle injection of intra-tumoral agents and advances in EUS-guided biliary *** future role of EUS and EUS in management of PDAC is still emerging.

关键词： Pancreatic ductal carcinoma Pancreatic neoplasm Endoscopic Ultrasound-Guided Fine Needle Aspiration Endosonography Endoscopic ultrasound guided fine-needle aspiration

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

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World Journal of Nephrology 2014年第3期3卷 92-100页

作者： Melissa Martinez Julia Le Blanc mohammad al-haddad Stuart Sherman John DeWitt Department of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis In 46202 United States

AIM： To report the clinical impact of adrenal endoscop-ic ultrasound fine-needle aspiration （EUS-FNA） in the evaluation of patients with adrenal gland enlargement or ***： In a retrospective single-center case-series, patients undergoing EUS-FNA of either adrenal gland from 1997-2011 in our tertiary care center were included. Medical records were reviewed and results of EUS, cytology, adrenal size change on follow-up imag-ing ≥ 6 mo after EUS and any repeat EUS or surgery were abstracted. A lesion was considered benign if：（1） EUS-FNA cytology was benign and the lesion remained 〈 1 cm from its original size on follow-up computed tomography （CT）, magnetic resonance imaging or repeat EUS ≥ 6 mo after EUS-FNA; or （2） subsequent adrenalectomy and surgical pathology was benign. RESULTS： Ninety-four patients had left （n = 90） and/or right （n = 5） adrenal EUS-FNA without adverse events. EUS indications included： cancer staging or suspected recurrence （n = 31）, pancreatic （n = 20）, medi-astinal （n = 10）, adrenal （n = 7）, lung （n = 7） mass or other indication （n = 19）. Diagnoses after adrenal EUS-FNA included metastatic lung （n = 10）, esophageal （n= 5）, colon （n = 2）, or other cancer （n = 8）; benign primary adrenal mass or benign tissue （n = 60）; or was non-diagnostic （n = 9）. Available follow-up confrmed a benign lesion in 5/9 non-diagnostic aspirates and 32/60 benign aspirates. Four of the 60 benign aspirates were later confrmed as malignant by repeat biopsy, follow-up CT, or adrenalectomy. Adrenal EUS-FNA diagnosed metastatic cancer in 24, and ruled out metastasis in 10 patients. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specifcity, positive predic-tive value and negative predictive value of 86%, 97%, 96% and 89%, ***： Adrenal gland EUS-FNA is safe, mini-mally invasive and a sensitive technique with signifcant impact in the management of adrenal gland mass or enlargement.

关键词： Adrenal gland neoplasms/diagnosis Adrenal glands/pathology Adrenal gland/ultrasonography Adrenal gland neoplasms/secondary Endosonography Biopsy Fine-needle

Peptic ulcer disease in non-alcoholic fatty liver disease hospitalizations:A new challenge on the horizon in the United States

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World Journal of Hepatology 2023年第4期15卷 564-576页

作者： Dushyant Singh Dahiya Vinay Jahagirdar Hassam ali Manesh Kumar Gangwani Muhammad Aziz Saurabh Chandan Amandeep Singh Abhilash Perisetti Aakriti Soni Sumant Inamdar Madhusudhan R Sanaka mohammad al-haddad Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States Department of Internal Medicine East Carolina UniversityGreenvilleNC 27858United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68131United States Department of Gastroenterology Hepatology and NutritionCleveland Clinic FoundationClevelandOH 44195United States Division of Gastroenterology and Hepatology Kansas City Veterans Affairs Medical CenterKansas CityMO 64128United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACKGROUND Peptic ulcer disease(PUD)is frequently seen in patients with liver ***,current literature lacks data on PUD in non-alcoholic fatty liver disease(NAFLD)*** To identify trends and clinical outcomes of PUD in NAFLD hospitalizations in the United *** The National Inpatient Sample was utilized to identify all adult(≥18 years old)NAFLD hospitalizations with PUD in the United States from *** trends and outcomes were ***,a control group of adult PUD hospitalizations without NAFLD was also identified for a comparative analysis to assess the influence of NAFLD on *** The total number of NAFLD hospitalizations with PUD increased from 3745 in 2009 to 3805 in *** noted an increase in the mean age for the study population from 56 years in 2009 to 63 years in 2019(Pal differences were also prevalent as NAFLD hospitalizations with PUD increased for Whites and Hispanics,while a decline was observed for Blacks and *** all-cause inpatient mortality for NAFLD hospitalizations with PUD increased from 2%in 2009 to 5%in 2019(Pality(2%vs 3%,P=0.0004),mean length of stay(LOS)(11.6 vs 12.1 d,Pal healthcare cost(THC)($178598 vs$184727,Palizations with PUD compared to non-NAFLD PUD *** of the gastrointestinal tract,coagulopathy,alcohol abuse,malnutrition,and fluid and electrolyte disorders were identified to be independent predictors of inpatient mortality for NAFLD hospitalizations with *** Inpatient mortality for NAFLD hospitalizations with PUD increased for the study ***,there was a significant decline

关键词： Non-alcoholic fatty liver disease Peptic ulcer disease Trends Outcomes Mortality

Acute pancreatitis in liver transplant hospitalizations:Identifying national trends,clinical outcomes and healthcare burden in the United States

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World Journal of Hepatology 2023年第6期15卷 797-812页

作者： Dushyant Singh Dahiya Vinay Jahagirdar Saurabh Chandan Manesh Kumar Gangwani Nooraldin Merza Hassam ali Smit Deliwala Muhammad Aziz Daryl Ramai Bhanu Siva Mohan Pinnam Jay Bapaye Chin-I Cheng Sumant Inamdar Neil R Sharma mohammad al-haddad Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68131United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Internal Medicine East Carolina UniversityGreenvilleNC 27858United States Division of Digestive Diseases Emory University School of MedicineAtlantaGA 30322United States Division of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology The University of Utah School of MedicineSalt Lake CityUT 84112United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Statistics Actuarial and Data ScienceCentral Michigan UniversityMt.PleasantMI 48859United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Interventional Oncology and Surgical Endoscopy Programs Parkview Cancer InstituteFort WayneIN 46845United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACKGROUND Acute pancreatitis(AP)in liver transplant(LT)recipients may lead to poor clinical outcomes and development of severe *** We aimed to assess national trends,clinical outcomes,and the healthcare burden of LT hospitalizations with AP in the United States(US).METHODS The National Inpatient Sample was utilized to identify all adult(≥18 years old)LT hospitalizations with AP in the US from 2007–***-LT AP hospitalizations served as controls for comparative *** trends of hospitalization characteristics,clinical outcomes,complications,and healthcare burden for LT hospitalizations with AP were *** characteristics,clinical outcomes,complications,and healthcare burden were also compared between the LT and non-LT ***,predictors of inpatient mortality for LT hospitalizations with AP were *** P values≤0.05 were considered statistically *** The total number of LT hospitalizations with AP increased from 305 in 2007 to 610 in *** was a rising trend of Hispanic(16.5%in 2007 to 21.1%in 2018,P-trend=0.0009)and Asian(4.3%in 2007 to 7.4%in 2019,p-trend=0.0002)LT hospitalizations with AP,while a decline was noted for Blacks(11%in 2007 to 8.3%in 2019,P-trend=0.0004).Furthermore,LT hospitalizations with AP had an increasing comorbidity burden as the Charlson Comorbidity Index(CCI)score≥3 increased from 41.64%in 2007 to 62.30%in 2019(P-trendally significant trends in inpatient mortality,mean length of stay(LOS),and mean total healthcare charge(THC)for LT hospitalizations with AP despite rising trends of complications such as sepsis,acute kidney failure(AKF),acute respiratory failure(ARF),abdominal abscesses,portal vein thrombosis(PVT),and venous thromboembolism(VTE).Between 2007–2019,6863 LT hospitalizations with AP were compared to 5649980 non-LT AP *** hospitalizations with AP were slightly older(53.5 vs 52.6 years,P=0.017)and

关键词： Liver transplantation Pancreatitis Mortality Cost Length of stay

Increasing thirty-day readmissions of Crohn’s disease and ulcerative colitis in the United States:A national dilemma

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 85-95页

作者： Dushyant Singh Dahiya Abhilash Perisetti Asim Kichloo Amandeep Singh Hemant Goyal Laura Rotundo Madhu Vennikandam Hafeez Shaka Gurdeep Singh Jagmeet Singh Sailaja Pisipati mohammad al-haddad Madhusudhan R Sanaka Sumant Inamdar Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Division of Gastroenterology Parkview Cancer InstituteFort WayneIN 46845United States Division of Gastroenterology and Hepatology Cleveland Clinic FoundationClevelandOH 44195United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18505United States Department of Internal Medicine Mercer University School of MedicineMaconGA 31207United States Department of Gastroenterology and Hepatology Sparrow Hospital/Michigan State University College of Human MedicineLansingMI 48912United States Department of Internal Medicine John H.StrogerJr.Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Our Lady of Lourdes Memorial HospitalBinghamtonNY 13905United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Mayo ClinicScottsdaleAZ 85259United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States

BACKGROUND The prevalence of Crohn’s disease(CD)and ulcerative colitis(UC)is on the rise *** rising prevalence is concerning as patients with CD and UC may frequently relapse leading to recurrent hospitalizations and increased healthcare *** To identify trends and adverse outcomes for 30 d readmissions for CD and *** This was a retrospective,interrupted trends study involving all adult(≥18 years)30 d readmissions of CD and UC from the National Readmission Database(NRD)between 2008 and ***alizations were excluded from this *** identified hospitalization characteristics and readmission rates for each calendar *** of inpatient mortality,mean length of hospital stay(LOS)and mean total hospital cost(THC)were calculated using a multivariate logistic trend analysis adjusting for age,gender,insurance status,comorbidity burden and hospital ***,trends between CD and UC readmissions were compared using regression of the interaction coefficient after adjusting for age and gender to determine relative trends between the two ***®Version 16 software(StataCorp,TX,United States)was used for statistical analysis and P value≤0.05 were considered statistically *** Total number of 30 d readmissions increased from 6202 in 2010 to 7672 in 2018 for CD and from 3272 in 2010 to 4234 in 2018 for *** noted increasing trends for 30-day all-cause readmission rate of CD from 14.9%in 2010 to 17.6%in 2018(P-trendall-cause readmission rate of UC from 14.1%in 2010 to 15.7%in 2018(P-trend=0.003),and UC specific readmission rate from 5.2%in 2010 to 5.6%in 2018(P-trend=0.029).There was no change in the risk adjusted trends of inpatient mortality and mean LOS for CD and UC ***,we found an increasing trend of mean THC for UC *** comparison,there w

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Readmissions Trends

Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh Kumar Syeda Parsa Manesh Kumar Gangwani Hassam ali Amir Humza Sohail Saqr alsakarneh Umar Hayat Sheza Malik Yash R Shah Bhanu Siva Mohan Pinnam Sahib Singh Islam Mohamed Adishwar Rao Saurabh Chandan mohammad al-haddad Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States Department of Internal Medicine Chandka Medical CollegeSindh 77280Pakistan Department of Gastroenterology and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Department of Internal Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Sinai hospitalBaltimoreMD 21215United States Department of Hepatology University of MissouriColumbiaMO 65211United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)*** is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural *** has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug *** also has satisfactory efficacy and has achieved high rates of successful sedation in GI ***,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the ***,the use of Propofol is associated with hemodynamic instability and respiratory *** contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural *** this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural *** also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

关键词： Remimazolam Endoscopy Sedation Outcomes Efficacy Safety Pharmacokinetics

Decoding molecular mechanisms:brain aging and alzheimer's disease

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Neural Regeneration Research 2025年第8期20卷 2279-2299页

作者： Mahnoor Hayat Rafay ali Syed Hammad Qaiser mohammad Uzair Khalid al-Regaiey Roaa Khallaf Lubna Abdullah Mohammed albassam Imdad Kaleem Xueyi Wang Ran Wang Mehwish SBhatti Shahid Bashir Atta-ur-Rahman School of Applied Biosciences(ASAB) National University of Sciences and Technology(NUST)IslamabadPakistan Department of Biotechnology Quaid-i-Azam UniversityIslamabadPakistan Department of Biological Sciences Faculty of Basic&Applied SciencesInternational Islamic University Islamabad(IIUI)IslamabadPakistan Department of Bioengineering King Fahd University of Petroleum and MineralsDhahranSaudi Arabia Department of Physiology College of MedicineKing Saud UniversityRiyadhSaudi Arabia Department of Neurology Neuroscience CenterKing Fahad Specialist HospitalDammamSaudi Arabia Department of Mental Health Neuroscience CenterKing Fahad Specialist HospitalDammamSaudi Arabia Department of Biosciences Commission on Science and Technology for Sustainable Development in the South(COMSATS University)IslamabadPakistan Department of Psychiatry The First Hospital of Hebei Medical UniversityShijiazhuangHebei ProvinceChina Mental Health Institute of Hebei Medical University ShijiazhuangHebei ProvinceChina Department of Neurobiology and Behavior University of CaliforniaIrvineCAUSA Neuroscience Center King Fahad Specialist Hospital DammamDammamSaudi Arabia

The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for *** aging process alters the brain structure that affects functions and cognitions,but the worsening of such processes contributes to the pathogenesis of neurodegenerative disorders,such as alzheimer's *** these observable,mild morphological shifts,significant functional modifications in neurotransmission and neuronal activity critically influence the aging *** these changes is important for maintaining cognitive health,especially given the increasing prevalence of age-related conditions that affect *** review aims to explore the age-induced changes in brain plasticity and molecular processes,differentiating normal aging from the pathogenesis of alzheimer's disease,thereby providing insights into predicting the risk of dementia,particularly alzheimer's disease.

关键词： alzheimer’s disease brain aging cognitive health dementia molecular mechanisms neuronal activity neuroplasticity neurotransmission