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Capsule endoscopy in pediatric patients

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World Journal of Gastroenterology 2008年第26期14卷 4152-4155页

作者： Raanan Shamir rami eliakim Institute of Gastroenterology Nutrition and Liver DiseasesSchneider Children's Medical CenterTel-Aviv UniversityTel-Aviv 69978Israel Department of Gastroenterology Rambam Health Care CampusRuth and Bruce Rappaport School of MedicineTechnion-Israel Institute of TechnologyHaifa 91360Israel

Wireless capsule endoscope (WCE) for the investigation of the small bowel is an approved technique both in adults and children (more than 10 years old). The present review provides data on the indications, diagnostic yield, adverse events and limitations of the WCE technique in children and tries to predict the future of WCE usage in this population of patients.

关键词： Capsule Wireless Pediatric Children

Nutritional status and nutritional therapy in inflammatory bowel diseases

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World Journal of Gastroenterology 2009年第21期15卷 2570-2578页

作者： Corina Hartman rami eliakim Raanan Shamir Institute of Gastroenterology Nutritionand Liver DiseaseSchneider Children's Medical Center of Israel Institute of Gastroenterology Rambam Health Care CampusRappaport School of MedicineTechnion Institute

Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear *** has an important role in the management of *** adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than *** EN is an established primary therapy for pediatric *** data suggests that EN is as efficient as corticosteroids for induction of *** advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse *** available evidence suggests that supplementary EN may be effective also for maintenance of remission in *** studies are needed to confirm these ***,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in *** does not have a primary therapeutic role in ulcerative *** compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further *** theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.

关键词： Inflammatory bowel disease Crohn'sdisease Ulcerative colitis Adults Children Malnutrition Growth disorders Nutrition therapy

Rectal bleeding as a presenting symptom of AL amyloidosis and multiple myeloma

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World Journal of Gastrointestinal Endoscopy 2010年第1期2卷 44-46页

作者： Itay Maza Evgene Vlodavsky rami A eliakim Department of Gastroenterology Rambam Health Care CampusTechnion School of MedicineHaifa 31096Israel Department of Pathology Rambam Health Care CampusTechnion School of MedicineHaifa 31096Israel

Amyloidosis of the gastrointestinal tract is a rare disease that presents with common,nonspecific signs and *** may affect any part of the gastrointestinal tract from mouth to *** clinical and endoscopic features are diverse and may mimic other diseases,such as inflammatory bowel disease,malignancy,ischemic colitis and,at times,collagenous *** describe an uncommon case of rectal bleeding and anemia with polypoid lesions and ulcerations in the colon,as the presenting symptom of AL amyloidosis and light chain multiple myeloma.

关键词： Amyloidosis Multiple myeloma Colonic polyp Rectal bleeding

Inflammatory bowel disease patient profiles are related to specific information needs: A nationwide survey

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World Journal of Gastroenterology 2019年第30期25卷 4246-4260页

作者： Saleh Daher Tawfik Khoury Ariel Benson John R Walker Oded Hammerman Ron Kedem Timna Naftali rami eliakim Ofer Ben-Bassat Charles N Bernstein Eran Israeli Institute of Gastroenterology and Liver Diseases Hadassah-Hebrew University Medical CenterJerusalem 91120Israel Department of Gastroenterology Galilee Medical CenterFaculty of Medicine in the GalileeBar-Ilan UniversityNahariya 22100Israel IBD Clinical and Research Centre University of ManitobaWinnipegMB R3E3P4Canada Research Branch IDF Medical CorpsTel-HashomerRamat Gan 52630Israel Institute of Gastroenterology Meir Medical CenterKfar-saba 4428164Israel Sackler School of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel Institute of Gastroenterology Sheba Medical CenterRamat-Gan 52630Israel Institute of Gastroenterology Rabin Medical CenterPetach-Tikva 49100Israel

BACKGROUND Inflammatory bowel diseases(IBD) is a heterogenous, lifelong disease, with an unpredictable and potentially progressive course, that may impose negative psychosocial impact on *** informed patients with chronic illness have improved adherence and outcomes, previous research showed that the majority of IBD patients receive insufficient information regarding their *** large heterogeneity of IBD and the wide range of information topics makes a one-size fits all knowledge resource overwhelming and *** hypothesized that different patient profiles may have different and specific information needs, the identification of which will allow building personalized computer-based information resources in the *** To evaluate the scope of disease-related knowledge among IBD patients and determine whether different patient profiles drive unique information *** We conducted a nationwide survey addressing hospital-based IBD clinics.A Total of 571 patients completed a 28-item questionnaire, rating the amount of information received at time of diagnosis and the importance of information, as perceived by participants, for a newly diagnosed patient, and for the participants themselves, at current *** performed an exploratory factor analysis of the crude responses aiming to create a number of representative knowledge domains(factors), and analyzed the responses of a set of 15 real-life patient profiles generated by the study *** Participants gave low ratings for the amount of information received at disease onset(averaging 0.9/5) and high ratings for importance, both for the newly diagnosed patients(mean 4.2/5) and for the participants themselves at current time(mean 3.5/5).Factor analysis grouped responses into six *** responses of selected profiles, compared with the rest of the participants, yielded significant associations(defined as a difference in rating of >0.5 points with a P < 0.05).Patients w

关键词： Inflammatory bowel diseases Information needs Patient education Knowledge resources Patient profiles

Significance of low level infliximab in the absence of anti-infliximab antibodies

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World Journal of Gastroenterology 2015年第6期21卷 1907-1914页

作者： Bella Ungar Adi Anafy Henit Yanai Yulia Ron Miri Yavzori Orit Picard Ella Fudim Ronen Loebstein Uri Kopylov Yehuda Chowers Iris Dotan rami eliakim Shomron Ben-Horin Department of Gastroenterology Sheba Medical Center Tel Hashomer and Sack-ler School of Medicine Tel-Aviv University IBD Center Department of Gastroenterology Tel-Aviv Sourasky Medical Center and Sackler School of Medicine Tel-Aviv University Institute of Clinical Pharmacology Sheba Medical Center Tel Hashomer and Sackler School of Medicine Tel-Aviv University Rambam Health Care Campus and Bruce Rappaport School of Medicine Technion Institute of Technology

AIM:To evaluate the prevalence of double negative(DN)sera and the mechanisms responsible for DN ***:Sera of inflammatory bowel disease patients treated with infliximab(IFX)were tested for drug/antibodies to infliximab(ATI)trough levels and the proportion of DN results was compared between a commercially available double antigen ELISA(with labeled IFX as the detection antibody)and an antilambda ELISA(with anti-human lambda chain detection antibody).Repeat testing with lower than customary serum dilution(1:10)was *** with DN status were matched with IFX+/ATI-controls and were followed-up for subsequent development of nontransient ATI to investigate if DN status precedes ***:Of 67 sera obtained at time of loss of response,only 6/67(9%)were DN by anti-lambda ELISA compared to 27/67(40%)with double antigen ELISA(P<0.001,Fisher’s Exact test).Of the latter27 sera,22%were also DN by anti-lambda ELISA,whereas 44%were actually IFX positive(IFX+ATI-),30%were ATI positive(IFX-ATI+)and 4%were double positive(IFX+ATI+).Re-testing using a 1:10 dilution converted most DN results into IFX+and/or ATI+*** with DN status had shorter survival free of non-transient ATI compared with matched controls(log rank test,P<0.001).In 9/30(30%)of these patients,non transient ATI occurred before and after the event at which the DN serum was obtained,supporting the view that a DN result may represent aparticular time-point along the two curves of ATI titer rise and infliximab drug level ***:DN status may result from false negative detection of IFX or ATI by double antigen ELISA,suggesting a transitional state of low-level immunogenicity,rather than non-immunological clearance.

关键词： Inflammatory bowel disease Biological therapy Infl

Does capsule endoscopy have an added value in patients with perianal disease and a negative work up for Crohn's disease?

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World Journal of Gastrointestinal Endoscopy 2012年第5期4卷 185-188页

作者： Samuel N Adler Metzger Yoav Scapa Eitan Chowers Yehuda rami eliakim Departments of Gastroenterology Bikur Holim HospitalJerusalem91104(ASNMY)Asaf HarofehZrifin 70300(ES)and Rambam Health Care CampusHaifa 31096(CYER)Israel

AIM:To investigate the role of capsule endoscopy in patients with persistent perianal disease and negative conventional work up for Crohn's disease(CD).METHODS:Patients with perianal disease(abscesses,fistulas,recurrent fissures) were evaluated for underlying *** who had a negative work up,defined as a negative colonoscopy with a normal ileoscopy or a normal small bowel series or a normal CT/MR enterography,underwent a Pillcam study of the small bowel after signing informed *** using nonsteroidal anti-inflammatory drugs or who had a history of inflammatory bowel disease or rheumatic disease were ***:We recruited 26 patients aged 21-61 years(average 35.6 years),17 males and 9 *** case could not be evaluated since the capsule did not leave the *** 6 of 25(24%) patients with a negative standard work up for Crohn's disease,capsuleendoscopy(CE) findings were consistent with Crohn's disease of the small *** history of CD,white blood cell,hemoglobin,erythrocyte sedimentation rate or C-reactive protein did not predict a diagnosis of *** endoscopy findings led to a change in ***:In patients with perianal disease and a negative conventional work up to exclude CD,CE leads to incremental diagnostic yield of 24%.

关键词： Perianal abscess Perianal fistula Ileocolonoscopy Capsule endoscopy Crohn’s disease

Cytomegalovirus positive ulcerative colitis:A single center experience and literature review

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World Journal of Gastrointestinal Pathophysiology 2013年第1期4卷 18-23页

作者： Uri Kopylov Gila Sasson Bella Geyshis Michal Tepperberg Oikawa Iris Barshack rami eliakim Shomron Ben-Horin Department of Gastroenterology Sheba Medical CenterRamat Gan 52621Israel Internal Medicine D Sheba Medical CenterRamat Gan 52621Israel Central Virology Laboratory Public Health LaboratoriesIsrael Ministry of HealthRamat Gan 52621Israel Department of Pathology Sheba Medical CenterRamat Gan 52621Israel

AIM:To compare the clinical outcome of cytomegalovirus(CMV)-positive ulcerative colitis(UC) patients with and without antiviral ***:This was a retrospective case-controlled *** database of UC patients in our institution was scanned for documented presence of CMV on colonic ***,clinical data,endoscopy findings and pathology reports were extracted from the patients' charts and electronic *** available,the data from colonoscopies preceding and following the diagnosis of colonic CMV infection were also *** primary outcomes of the study were colectomy/death during hospitalization and the secondary outcomes were colectomy/death through the course of the ***:Thirteen patients were included in the study,7(53.5%) of them were treated with gancyclovir and 6(46.5%) were *** treated with antivirals presented with a more severe disease and 57% of them were treated with cyclosporine or infliximab before initiation of gancyclovir,while none of the patients without antivirals required rescue *** patient died and another patient underwent urgent colectomy during hospitalization,both of them from the gancyclovir-treatment *** the entire follow-up time(13 ± 13 mo),a total of 3 colectomies and one death occurred,all among the antiviral-treated patients(for colectomy:3/7 vs 0/6 patients,P = 0.19;for combined adverse outcome:4/7 vs 0/6 patients,P = 0.07).In 9/13 patients,immunohistochemistry for CMV was performed on biopsies obtained during a subsequent colonoscopy and was positive in one patient ***:Gancyclovir-treated patients had a more severe disease and outcome,probably unrelated to antiviral ***-CMV-positive patients with mild disease may recover without antiviral therapy.

关键词： Ulcerative colitis Cytomegalovirus Gancyclovir Cyclosporine Immunohistochemistry

Effect of smoking on inflammatory bowel disease: Is it disease or organ specific?

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World Journal of Gastroenterology 2007年第15期13卷 2150-2152页

作者： A Karban R eliakim Department of Medicine C Rambam Health Care Campus Bruce Rappaport School of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael Department of Gastroenterology Rambam Health Care Campus Bruce Rappaport School of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael

Smoking is an important environmental factor in inflammatory bowel disease （IBD） with differing effects in ulcerative colitis （UC） and Crohn＇s disease （CD）. Never smoking and formerly smoking increase the risk of UC, whereas smoking exacerbates the course of CD. The potential mechanisms involved in this dual relationship are yet unknown. A reasonable assumption is that smoking has different effects on the small and large intestine. This assumption is based on animal and human studies that show that the effects of smoking/nicotine on CD and UC depend on the site of inflammation and not on the type of disease.

关键词： Nicotine Smoking Crohn's disease Ulcerative Colitis Small bowel Colon

Accelerated D-Dimensional Compactified Universe in Gauss-Bonnet-Dilatonic Scalar Gravity from D-Brane/M-Theory

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Chinese Physics Letters 2008年第8期25卷 2785-2788页

作者： EL-NABULSI Ahmad rami Department of Nuclear and Energy Engineering Cheju National University Ara-dong 1 Jeju 690-756 South Korea

We discuss a particular d-dimensional Gauss- Ronnet-dilatonie universe compactified on S^1 motivated from Mtheory. We examine the time-evolution of the dynamical equations where many interesting consequences are revealed and discussed in some details. Under reasonable conditions, the discussed model can provide a mechanism to realize, in higher-dimensions （d 〉 4）, the accelerated expansion of the universe in the presence of dark energy, without the presence of phantom energy and without the contraction of some internal dimension.

关键词： COSMOLOGICAL CONSTANT CHAPLYGIN-GAS DARK ENERGY QUINTESSENCE SUPERNOVAE PLANETS OMEGA