检索结果-南通市图书馆

原发性硬化性胆管炎的诊断:磁共振胆管造影和内镜下逆行胆管造影的一项盲法、对照研究

世界核心医学期刊文摘（胃肠病学分册） 2006年第12期2卷 37-38页

作者： Moff S.L. Kamel I.R. Eustace j. p.j.thuluvath Kantsevoy Kalloo 周智勇 Dept.of Medicine and Ra The Johns Hopkins University School of MedicineBaltimoreMaryland Division of GastroenterologySan FranciscoCAUnited States Drs Dept.of Medicine and Ra The Johns Hopkins University School of MedicineBaltimoreMaryland Dept.of Medicine and Ra The Johns Hopkins University School of MedicineBaltimoreMaryland Dr

Background:We hypothesized that magnetic resonance cholangiography(MRC) may have less accuracy for the diagnosis and the assessment of the severity of primary sclerosing cholangitis(pSC) than endoscopic retrograde cholangiography(ERC) .Objective:The aim of this study was to determine the diagnostic accuracy and interobserver agreement of both ERC and MRC in ***:A case-control ***:University ***:ERCs and MRCs of 36 patients with pSC and 51 controls(normal/other biliary tract diseases) were read in an independent,blinded,and random fashion by 2 magnetic resonance radiologists and 2 interventional endoscopists by using a previously validated classification *** had no access to clinical history,laboratory results,or patient ***:Extrahepatic ductal(EHD) and intrahepatic ductal(IHD) visualization was excellent in 64% of 66% of MRCs and 86% of 74% of *** and specificity for diagnosis of pSC for readers 1 to 4 were 91% and 85%,88% and 90%,81% and 96%,and 83% and 96%.*** operating curve values were excellent for all readers(all >0.9) .Interobserver agreement(κ statistics) for the diagnosis of pSC(MRC,0.83;ERC,0.73) and for identifying the presence of IHD strictures(MRC,0.64;ERC,0.86) was good for both modalities,but only ERC(ERC,0.55;MRC,0.36) was good for the presence and the severity of EHD *** assessment of disease severity was limited to the 36 patients with pSC,interobserver agreement was very poor for both MRC(0.23 and 0.07 for EHD and IHD,respectively) and ERC(0.24 and 0.34 for EHD and IHD,respectively) .Limitations:The retrospective case-control study made it difficult to assess the impact of the diagnosis on patient ***:ERC and MRC were comparable for diagnosing pSC,with very good interobserver agreement for the diagnosis of pSC and IHD *** ERC had good agreement for EHD *** agreement was very poor for both MRC and ERC when

关键词：逆行胆管造影盲法硬化性胆管炎胆管疾病肝外胆管程度评估观测者附属医院诊断作用病例对照

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Modified EASL-CLIF criteria that is easier to use and perform better to prognosticate acute-on-chronic liver failure

引用

World journal of Hepatology 2022年第2期14卷 420-428页

作者： paul j thuluvath Feng Li Institute of Digestive Health and Liver Diseases Mercy Medical CenterBaltimoreMD 21202United States Department of Medicine University of Maryland School of MedicineBaltimoreMD 21202United States

BACKGROUND We have recently shown that the European Association for the Study of the Liver-Chronic Liver Failure Consortium(EASL-CLIF)criteria showed a better sensitivity to detect acute-on-chronic liver failure(ACLF)with a better prognostic capability than the North American Consortium for the Study of End-Stage Liver Disease *** To simplify EASL-CLIF criteria for ease of use without sacrificing its sensitivity and prognostic *** Using the United Network for Organ Sharing data(january 11,2016,to August 31,2020),we modified EASL-CLIF(mEACLF)criteria;the modified mEACLF criteria included six organ failures(OF)as in the original EASL-CLIF,but renal failure was defined as creatinine≥2.35 mg/dL and coagulation failure was defined as international normalized ratio(INR)≥*** mEACLF grades(0,1,2,and≥3)directly reflected the number of *** Of the 40357 patients,14044 had one or more OF,and 9644 had ACLF grades 1-3 by EASL-CLIF *** the mEACLF criteria,15574 patients had one or more *** area under the receiver operating characteristic(AUROC)for 30-d allcause mortality by OF was 0.842(95%CI:0.831-0.853)for mEACLF and 0.835(95%CI:0.824-0.846)for EASL-CLIF(p=0.006),and AUROC for 30-d transplantfree mortality by OF was 0.859(95%CI:0.849-0.869)for mEACLF and 0.851(95%CI:0.840-0.861)for EASL-CLIF(p=0.001).The AUROC of 30-d all-cause mortality by ACLF grades was 0.842(95%CI:0.831-0.853)for mEACLF and 0.793(95%CI:0.781-0.806)for EASL-CLIF(pplant-free mortality by ACLF was 0.859(95%CI:0.848-0.869)for mEACLF and 0.805(95%CI:0.793-0.817)for EASL-CLIF(pplified for ease of use without losing its prognostication capability and sensitivity.

关键词： Acute on chronic liver failure Organ failure 30-d transplant-free mortality Liver transplantation EASL-CLIF criteria

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Mortality and health care burden of Budd Chiari syndrome in the United States:A nationwide analysis(1998-2017)

引用

World journal of Hepatology 2021年第6期13卷 686-698页

作者： joseph j Alukal Talan Zhang paul joseph thuluvath Institute of Digestive Health and Liver Diseases Mercy Medical CenterBaltimoreMD 21202United States Department of Medicine University of Maryland School of MedicineBaltimoreMD 21202United States

The Budd Chiari syndrome(BCS)is a rare and potentially fatal disease,but there is a paucity of data on the in-hospital mortality as well its economic burden on the health care *** To evaluate trends in mortality,length of hospital stays and resource utilization among inpatients with *** Data on all adult patients with a diagnosis of BCS were extracted from the National Inpatient Sample(NIS)from 1998 to *** make inferences regarding the national estimates for the total number of BCS discharges across the study period,sample weights were applied to each admission per recommendations from the *** During the study period,there were 3591(8.73%)in-patient *** overall inhospital mortality rates among BCS patients decreased from 18%in 1998 to 8%in 2017;the mortality decreased by 4.41%(pjury,acute respiratory failure,hepatic encephalopathy,hepatorenal syndrome,inferior vena cava thrombosis,intestinal infarct,sepsis/septic shock and cancer were associated increased risk of *** average of length of stay was 8.8 d and it consistently decreased by 2.04%(95%CI:-2.67%,-1.41%,pjusted for Medical Care Consumers price Index to 2017 dollars during the time period was$94440 and the annual percentage change increased by 1.15%(95%CI:0.35%,1.96%,p=0.005)from$95515 in 1998 to$103850 in *** The in-hospital mortality rate for patients admitted with BCS in the United States has reduced between 1998 and 2017 and this may a reflection of better management of these patients.

关键词： National Inpatient Sample Budd Chiari syndrome Mortality Length of stay Total charges

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Liver injury in COVID-19:The hepatic aspect of the respiratory syndrome-what we know so far

引用

World journal of Hepatology 2020年第12期12卷 1182-1197页

作者： prajna Anirvan pankaj Bharali Mrinal Gogoi paul j thuluvath Shivaram p Singh Sanjaya K Satapathy Department of Gastroenterology Sriram Chandra Bhanj Medical CollegeCuttack 753007OdishaIndia Department of Gastroenterology Sriram Chandra Bhanj Medical College and HospitalCuttack 753007OdishaIndia Department of Surgery and Medicine Mercy Medical CenterBaltimoreMD 21202United States Division of Hepatology Sandra Atlas Bass Center for Liver Diseases and TransplantationDonald and Barbara Zucker School of Medicine at Hofstra/Northwell HealthManhassetNY 11030United States

The 2019 novel coronavirus disease(COVID-19)pandemic due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has posed a serious threat to global public *** primarily,the infection causes lung injury,liver enzyme abnormalities have also been reported to occur during the course of the *** conducted an extensive literature review using the pubMed database on articles covering a broad range of issues related to COVID-19 and hepatic *** present review summarizes available information on the spectrum of liver involvement,the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 infection,and the prognostic significance of the presence of liver ***,this review will enable clinicians,especially the hepatologists,to understand and manage the liver derangements they may encounter in these patients better and provide guidance for further studies on the liver injury of COVID-19.

关键词： COVID-19 Hepatitis Infectious disease Liver injury SARS-CoV-2 Management

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Non-alcoholic fatty liver and chronic kidney disease:Retrospect,introspect,and prospect

引用

World journal of Gastroenterology 2021年第17期27卷 1864-1882页

作者： Rajiv Heda Masahiko Yazawa Michelle Shi Madhu Bhaskaran Fuad Zain Aloor paul j thuluvath Sanjaya K Satapathy Department of Internal Medicine Tulane University School of MedicineNew OrleansLA 70112United States Department of Nephrology and Hypertension St.Marianna University School of MedicineKawasaki 216-8511Japan Department of Internal Medicine Donald and Barbara Zucker School of MedicineNorthwell HealthManhassetNY 11030United States Department of Nephrology Northwell Health/Zucker School of Medicine at HosftraManhassetNY 11030United States Department of Internal Medicine Baylor College of MedicineHoustonTX 77030United States Institute of Digestive Health&Liver Diseases Mercy Medical CenterBaltimoreMD 21202United States

With the growing prevalence of obesity and diabetes in the United States and across the world,a rise in the overall incidence and prevalence of non-alcoholic fatty liver disease(NAFLD)is *** risk factors for NAFLD are also associated with the development of chronic kidney disease(CKD).We review the epidemiology,risk factors,genetics,implications of gut dysbiosis,and specific pathogenic mechanisms linking NAFLD to *** such as ectopic lipid accumulation,cellular signaling abnormalities,and the interplay between fructose consumption and uric acid accumulation have led to the emergence of potential therapeutic implications for this patient *** evaluation in the setting of both NAFLD and CKD is also *** strategies for surveillance and management include the monitoring of comorbidities,the use of non-invasive fibrosis scoring systems,and the measurement of laboratory ***,we discuss the management of patients with NAFLD and CKD,from preventative measures to experimental interventions.

关键词： Nonalcoholic fatty liver disease Chronic kidney disease Nonalcoholic steatohepatitis Organ transplant genetic Microbiome pathophysiology

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Outcomes of patients with cirrhosis undergoing non-hepatic surgery:Risk assessment and management

引用

World journal of Gastroenterology 2007年第30期13卷 4056-4063页

作者： Farida Millwala Geoffrey C Nguyen paul j thuluvath Hepatology Section The Johns Hopkins University School of Medicine Baltimore MD 2105 United States

The reported mortality rates in patients with cirrhosis undergoing various non-transplant surgical procedures range from 8.3% to 25%. This wide range of mortality rates is related to severity of liver disease, type of surgery, demographics of patient population, expertise of the surgical, anesthesia and intensive care unit team and finally, reporting bias. In this article, we will review the pathophysiology, morbidity and mortality associated with non-hepatic surgery in patients with cirrhosis, and then recommend an algorithm for risk assessment and evidence based management strategy to optimize post-surgical outcomes.

关键词： pre-operative risk assessment Risk stratification Cirrhosis Model for end-stage liver disease Non-transplant surgery Outcomes

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatorenal syndrome

引用

World journal of Gastroenterology 2007年第30期13卷 4046-4055页

作者： Sharon Turban paul j thuluvath Mohamed G Atta Department of Medicine Division of Nephrology Johns Hopkins School of Medicine and the Johns Hopkins Hospital Baltimore Maryland United States Department of Medicine Division of Gastroenterology Johns Hopkins School of Medicine and the Johns Hopkins Hospital Baltimore Maryland United States

Hepatorenal syndrome (HRS) is a "functional" and reversible form of renal failure that occurs in patients with advanced chronic liver disease. The distinctive hallmark feature of HRS is the intense renal vasoconstriction caused by interactions between systemic and portal hemodynamics. This results in activation of vasoconstrictors and suppression of vasodilators in the renal circulation. Epidemiology, pathophysiology, as well as current and emerging therapies of HRS are discussed in this review.

关键词： Acute renal failure End stage liver disease Hepatorenal syndrome Transjugular intrahepatic portosysternic shunts Dialysis Liver transplantation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hyponatremia in cirrhosis:pathophysiology and management

引用

World journal of Gastroenterology 2015年第11期21卷 3197-3205页

作者： Savio john paul j thuluvath Division of Gastroenterology Department of MedicineSUNY Upstate Medical University University of Maryland School of Medicine and Mercy Medical Center

Hyponatremia is frequently seen in patients with ascites secondary to advanced cirrhosis and portal *** development of ascites in patients with cirrhosis is *** hypertension and the associated systemic vasodilation lead to activation of the sodium-retaining neurohumoral mechanisms which include the renin-angiotensin-aldosterone system,sympathetic nervous system and antidiuretic hormone(ADH).The net effect is the avid retention of sodium and water to compensate for the low effective circulatory volume resulting in the development of *** not apparent in the early stages of cirrhosis,the progression of cirrhosis and ascites leads to impairment of the kidneys to eliminate solutefree *** leads to additional compensatory mechanisms including non-osmotic secretion of ADH,also known as arginine vasopressin,further worsening excess water retention and thereby *** is associated with increased morbidity and mortality in patients with cirrhosis,and is an important prognostic marker both before and after liver *** management of hyponatremia in this setting is a challenge as conventional therapy for hyponatremia including fluid restriction and loop diuretics are frequently *** this review,we discuss the pathophysiology and various treatment modalities,including selective vasopressin receptor antagonists,for the management of hyponatremia in patients with cirrhosis.

关键词： Hyponatremia in cirrhosis Dilutional hypo-natremia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Differences in characteristics of patients with and without known risk factors for hepatocellular carcinoma in the United States

引用

World journal of Gastroenterology 2007年第5期13卷 781-784页

作者： jon D Dorfman Richard Schulick Michael A Choti jean-Francois H Geschwind Ihab Kamel Michael Torbenson paul j thuluvath Department of Surgery The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of Radiology The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of pathology The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of Medicine The Johns Hopkins University School of Medicine Baltimore MD 21205 United States

AIM： To examine the clinical characteristics of a subgroup of patients with hepatocellular carcinoma （HCC） and compare them to those with known risk factors. METHODS： We used the HCC database of 306 patients seen at our institution from january 1, 1995 to December 31, 2001. Of the 306 patients, 63 （20%, group 1） had no known risk factors （hepatitis C virus, hepatitis B virus, alcohol, hemochromatosis or cirrhosis from any cause） and 243 （group 2） had one or more risk factors. RESULTS： The median age was similar in both groups, but there were disproportionate numbers of younger （〈 30 years old）, older （〉 80 years） patients, women （33% vs 18%）, and Caucasians （81% vs 52%） in group 1 as compared to group 2. There were fewer Asians （2% vs 11%） and African Americans （13% vs 27%） in group 1. Abdominal pain （70% vs 37%） was more common while gastrointestinal bleeding （0% vs 11%） and ascites （4% vs17%） were less common in group i compared to group 2. Group 1 had larger tumor burden （median size 9.4 cm vs 5.7 cm） at the time of presentation, but there were no differences in the site （right, left or bilateral lesions）, or number of tumors between the two groups. CONCLUSION： HCC patients without identifiable risk factors have different characteristics and clinical presentation compared to those with known risk *** of cirrhosis and larger tumor burden may explain the differences in the presenting symptoms.

关键词： Hepatocellular carcinoma patient charaocteristics Risk factors

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

肾功能不全可能是准备接受肝移植的患者发生慢性贫血的部分原因

引用

世界核心医学期刊文摘（胃肠病学分册） 2005年第1期1卷 8-9页

作者： patt C.H. Fairbanks K.D. thuluvath p.j. 陈云茹 Div. of Gastroenterol. and Hepatol. Johns Hopkins University Hospital 1830 East Monument Street BaltimoreMD 21205 United States

In patients with cirrhosis, anemia is common and is likely to be multifactorial, including decreased erythrocyte production,sequestration due to hypersplenism, hemolysis, and increased blood loss from gastrointestinal bleeding. Renal dysfunction is also common in liver disease and this may also cause ***, an association between anemia and renal dysfunction has not been reported in patients with cirrhosis. Our objective was to determine whether anemia in cirrhotic patients is independently related to renal dysfunction. We conducted a retrospective chart review of patients in our institution listed for liver transplantation. We collected simultaneous data on age,hemoglobin, creatinine, albumin, liver enzymes, prothrombin time, and bilirubin. We excluded patients who were hospitalized or deceased to avoid confounding variables. Two hundred eighty-six (female n = 130) patients with a mean age of 52.8± 9.7(range,18-73) years were studied. Renal dysfunction(creatinine >1.2 mg/dL) was present in 55(19% ) patients, andanemia (hemoglobinpatients with renal dysfunction(64 versus 34% ;ppared to those with normal renal function. Creatinine, prothrombin time, and bilirubin showed an inverse relationship (all p s positive correlation with hemoglobin (p p =0.038), prothrombin time (p=0.026),bilirubin (p=0.035), and albumin(p=0.001) were independent predictors of anemia. Renal dysfunction is an important cause of anemia in patients with cirrhosis. The role of erythropoietin in the management of anemia in patients with cirrhosis and renal dysfunction should be explored in prospective studies.

关键词：肝移植肾功能不全慢性贫血红细胞生成凝血酶原时间肌酐脾功能亢进肝脏疾病失血量同步数据

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：