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Safety and efficacy of Kaffes intraductal self-expanding metal stents in the management of post-liver transplant anastomotic strictures

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World Journal of Transplantation 2024年第2期14卷 88-98页

作者： Chee Lim Jonathan Ng Babak Sarraf rhys Vaughan Marios Efthymiou Leonardo Zorron Cheng Tao pu Sujievvan Chandran Department of Gastroenterology and Hepatology Austin HealthMelbourne HeidelbergVIC 3084Australia Melbourne Medical School The University of MelbourneMelbourne ParkvilleVIC 3052Australia

BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic *** the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is *** to limited access to endoscopic retrograde cholan-giopancreatography(ERCp)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable *** was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic *** Adult liver transplant recipients aged 18 years and above who underwent ERCp were retrospectively identified during a 10-year period through a database *** admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical *** main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 *** efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 *** During the study period,a total of 66 ERCps with Kaffes insertion were performed in 54 patients throughout their stenting *** 33 ERCps,the stent was removed or exchanged on a 3-month *** pancreatitis,perfor-ations or deaths *** post-ERCp complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,p=*** strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 *** recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(p=0.03).There were 28 patients that were treated with a sin

关键词： Liver transplantation Cholangiopancreatography Endoscopic retrograde Constriction pathologic Self expandable metallic stents Bile duct diseases Cholestasis

Does Resisted Sled Towing Improve the physical Qualities of Elite Youth Soccer players of Differing Maturity Status?

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Journal of Science in Sport and Exercise 2021年第1期3卷 75-87页

作者： rhys Morris Tony Myers Stacey Emmonds Dave Singleton Kevin Till School of Life Sciences Coventry UniversityCoventryUK Sport Exercise and Health Research CenterNewman University BirminghamBirminghamUK Carnegie School of Sport Leeds Beckett UniversityLeedsUK Birmingham City Football Club BirminghamUK Leeds Rhinos RLFC LeedsUK

purpose Sled towing has been shown to be an effective method to enhance the physical qualities in youth *** aim of this study was to evaluate the impact of a 6-week sled towing intervention on muscular strength,speed and power in elite youth soccer players of differing maturity *** Seventy-three male elite youth soccer players aged 12-18 years(pre-peak Height Velocity[pHV]n = 25;Circa-pHV n = 24;post-pHV n = 24)from one professional soccer academy participated in this *** assessments(10 m and 30 m),countermovement jump and isometric mid-thigh pull were undertaken before(T1)and after(T2)a 6-week *** training intervention consisted of 6 weeks(2xper week,10 sprints over 20 m distance)of resisted sled towing(linear progression 10%-30%of body mass)during the competitive *** regression models analysed differences between T1 and T2 within each maturity *** There were minimal changes in strength,speed and power(p=0.35-0.80)for each maturity group across the 6-week *** there were changes with greater certainty,they are unlikely to represent real effect due to higher regres-sion to the mean(RTM).Conclusion It appears that a 6-week sled towing training programme with loadings of 10%-30%body mass only maintains physical qualities in elite youth soccer players pre-,circa-,and *** research is required to determine the effectiveness of this training method in long-term athletic development programmes.

关键词： Youth development Long-term athletic development Maturation Strength Speed IMTp

Extramural vascular invasion and response to neoadjuvant chemoradiotherapy in rectal cancer: influence of the CpG island methylator phenotype

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World Journal of Gastrointestinal Oncology 2017年第5期9卷 209-217页

作者： Jeremy Stuart Williamson Huw Geraint Jones Namor Williams Anthony paul Griffiths Gareth Jenkins John beynon Dean Anthony Harris Department of General and Colorectal Surgery Singleton Hospital Department of pathology Singleton Hospital Department of Life Sciences Swansea University

To identify whether CpG island methylator phenotype (CIMp) is predictive of response to neoadjuvant chemoradiotherapy (NACRT) and outcomes in rectal cancer. METHODSpatients undergoing NACRT and surgical resection for rectal cancer in a tertiary referral centre between 2002-2011 were identified. pre-treatment tumour biopsies were analysed for CIMp status (high, intermediate or low) using methylation specific pCR. KRAS and BRAF status were also determined using pyrosequencing analysis. Clinical information was extracted from case records and cancer services databases. Response to radiotherapy was measured by tumour regression scores determined upon histological examination of the resected specimen. The relationship between these molecular features, response to NACRT and oncological outcomes were analysed. RESULTSThere were 160 patients analysed with a median follow-up time of 46.4 mo. Twenty-one (13%) patients demonstrated high levels of CIMp methylation (CIMp-H) and this was significantly associated with increased risk of extramural vascular invasion (EMVI) compared with CIMp-L [8/21 (38%) vs 15/99 (15%), p = 0.028]. CIMp status was not related to tumour regression after radiotherapy or survival, however EMVI was significantly associated with adverse survival (p p status was significantly associated with KRAS mutation (p = 0.01). There were 14 (9%) patients with a pathological complete response (pCR) compared to 116 (73%) patients having no or minimal regression after neoadjuvant chemoradiotherapy. Those patients with pCR had median survival of 106 mo compared to 65.8 mo with minimal regression, although this was not statistically significant (p = 0.26). Binary logistic regression analysis of the relationship between EMVI and other prognostic features revealed, EMVI positivity was associated with poor overall survival, advanced “T” stage and CIMp-H but not nodal status, age, sex, KRAS mutation status and presence of local or systemic recurre

关键词： Rectal cancer CpG islands Methylation

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二尖瓣疾病

国际内科双语杂志（中英文） 2007年第4期7卷 91-94页

作者： Simon Ray rhys beynon Alexander Borg 陈益和（译）纪宝华（校）英国曼彻斯特南曼彻斯特大学英国曼彻斯特Wythenshawe医院不详

二尖瓣狭窄病因学二尖瓣狭窄（MS）几乎都是由于慢性风湿性心脏病所引起，尽管30％的患者没有明确的风湿热病史。风湿性MS的女性患者是男性患者的两倍。风湿性二尖瓣病变的发生率在发达国家中已经明显下降，但是在非洲、中东和亚洲地... 详细信息

二尖瓣狭窄病因学二尖瓣狭窄（MS）几乎都是由于慢性风湿性心脏病所引起，尽管30％的患者没有明确的风湿热病史。风湿性MS的女性患者是男性患者的两倍。风湿性二尖瓣病变的发生率在发达国家中已经明显下降，但是在非洲、中东和亚洲地区，症状性二尖瓣病变可以累及十几岁以上的患者。

关键词：二尖瓣疾病风湿性二尖瓣病变二尖瓣狭窄男性患者女性患者发达国家亚洲地区病因学

One fifth of hospitalizations for peptic ulcer-related bleeding are potentially preventable

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World Journal of Gastroenterology 2014年第30期20卷 10504-10511页

作者： Ray Boyapati Sim Ye Ong Bei Ye Anuk Kruavit Nora Lee rhys Vaughan Sanjay Nurkar peter Gibson Mayur Garg Gastroenterology and Liver Transplant Unit Austin HospitalMelbourneVictoria 3128Australia Department of Gastroenterology and Hepatology Eastern Health and Monash UniversityMelbourneVictoria 3128Australia Department of Gastroenterology The Alfred Hospital and Monash UniversityMelbourneVictoria 3128Australia

AIM: To calculate the proportion of potentially preventable hospitalizations due to peptic ulcer disease (pUD), erosive gastritis (EG) or duodenitis (ED).

关键词： peptic ulcer Gastrointestinal hemorrhage prevention Non-steroidal anti-inflammatory drug proton pump inhibitor Gastroprotection

British Soccer Academy personnel perceive psychological and Technical/Tactical Attributes as the Most Important Contributors to Development

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Journal of Science in Sport and Exercise 2022年第1期4卷 37-48页

作者： Rich J.Kite Mark R.Noon rhys Morris peter Mundy Neil D.Clarke Faculty of Health Academy Sports Science and Medical Department Coventry City Football ClubCoventryUK

purpose Understanding the desired attributes for talented soccer players may give insight into the process of(de)selection and player *** study aimed to explore soccer academy personnel’s perceptions of attributes associated with talent and *** Thirty English and Scottish academy personnel(managers,coaches,recruitment,sports scientists)provided per-ceptions into what attributes contribute to‘talent’,via an online *** an E-Delphi method,seven experts refined these inputs over several rounds until a consensus was reached,resulting in 82 agreed *** terminology was resubmitted via a second online survey,where 45 academy personnel rated each using a Likert *** A ranking of attributes by importance was produced,finding psychological and Technical/Tactical attributes con-sidered of greatest *** were observed,whereby recruitment personnel consistently over-emphasised the importance of several attributes compared to other personnel(p=0.02-0.04).When analyzed within each age phase,11 variations in the perceived importance of attributes were demonstrated in the youth phase(11-16 years,p=0.01)compared with 5 in the professional phases(17-23 years,p=0.01-0.05)Conclusion The present study demonstrates that‘talent’requires multifaceted developments,with academy personnel per-ceiving psychological attributes the most important contributor to development.

关键词： Talent development Characteristics Elite player performance plan Youth

Crohn’s strictures open with anti-mycobacterial antibiotic therapy:A retrospective review

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World Journal of Gastrointestinal Endoscopy 2020年第12期12卷 542-554页

作者： rhys Collyer Annabel Clancy Gaurav Agrawal Thomas J Borody Centre for Digestive Diseases Five Dock 2046NSWAustralia

BACKGROUND Medical therapy for strictures is limited and first-line treatment consists of endoscopic balloon dilatation,strictureplasty or surgical *** tuberculosis,Helicobacter pylori and Streptococcus can all cause stenosis,for which antibiotic treatment achieves stricture *** avium *** is a suspected causative agent in Crohn’s disease(CD).Thus,specialized antimicrobial treatment,in particular,anti-mycobacterial antibiotic therapy(AMAT)has been proposed as a potential treatment *** our knowledge,the opening of CD strictures has not been recorded using any form of antibiotic *** hypothesized that AMAT would resolve strictures in patients with *** To investigate the effect and outcomes of AMAT in a cohort of CD patients with an ileal *** A single center,retrospective,medical record case review was conducted on an observational cohort of patients with CD who had an ileal stricture on colonoscopy and were treated with *** patients meeting the inclusion criteria were identified from the internal medical ***(75%)patients had follow-up colonoscopy and clinical data *** AMAT regimen was prescribed after the initial colonoscopy for a duration of at least six months until follow-up colonoscopy with the attending *** demographics,symptoms,colonoscopy reports,inflammatory serum markers and concurrent medications were recorded at pre-treatment and follow-up between January 1995 and June *** Of the patients that returned for follow-up after>24 mo of AMAT,twenty(67%)had complete resolution(CR)of their ileal strictures,three(10%)had partial resolution and seven(23%)had no *** of stricture outcome,21 patients(70%)demonstrated clinical response to AMAT and there was a statistically significant reduction in inflammatory serum markers C-reactive protein(pp=0.04)from pretreatm

关键词： Antibiotics Colonoscopy Crohn’s disease Ileum Inflammatory bowel disease Stricture

Does music reduce anxiety and discomfort during flexible sigmoidoscopy?A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2017年第5期9卷 228-237页

作者： Arun p Shanmuganandan Muhammad R Sameem Siddiqui Nicholas Farkas Kiran Sran rhys Thomas Said Mohamed Robert I Swift Al Mutaz Abulafi Department of Colorectal Surgery Croydon University Hospital Department of Surgery Royal Free Hospital

To investigate the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy. METHODSA systematic review of all comparative studies up to November 2016, without language restriction that were identified from MEDLINE and the Cochrane Controlled Trials Register (1960-2016), and EMBASE (1991-2016). Further searches were performed using the bibliographies of articles and abstracts from major conferences such as the ESCp, NCRI, ASGBI and ASCRS. MeSH and text word terms used included “sigmoidoscopy”, “music” and “endoscopy” and “anxiety”. All comparative studies reporting on the effect of music on anxiety or pain during flexible sigmoidoscopy, in adults, were included. Outcome data was extracted by 2 authors independently using outcome measures defined a priori. Quality assessment was performed. RESULTSA total of 4 articles published between 1994 and 2010, fulfilled the selection criteria. Data were extracted and analysed using OpenMetaAnalyst. patients who listened to music during their flexible sigmoidoscopy had less anxiety compared to control groups [Random effects; SMD: 0.851 (0.467, 1.235), S.E = 0.196, p p = 0.77, Ip>2p> = 0). patients who listened to music during their flexible sigmoidoscopy had less pain compared to those who did not, but this difference did not reach statistical significance [Random effects; SMD: 0.345 (-0.014, 0.705), S.E = 0.183, p = 0.06]. patients who listened to music during their flexible sigmoidoscopy felt it was a useful intervention, compared to those who did not (p p = 0.528, Ip>2p> = 0). CONCLUSIONMusic appeared to benefit patients undergoing flexible sigmoidoscopies in relation to anxiety and was deemed a helpful intervention. pain may also be reduced however further investigation is required to ascertain this.

关键词： Music Flexible sigmoidoscopy Anxiety Discomfort Screening

Effect of supervised exercise on aerobic capacity in cancer survivors: Adherence and workload predict variance in effect

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World Journal of Meta-Analysis 2015年第1期3卷 43-53页

作者： rhys Beaudry Calvin Kruger Yuan Yuan Liang Matthew parliament Mark Haykowsky Margaret L Mc Neely Department of physical Therapy University of Alberta Edmonton Alberta T6G 2G4 Canada School of Medicine Epidemiology and Biostatistics University of Texas San Antonio TX 78229 United States Margaret L Mc Neely Department of Oncology University of Alberta and Cross Cancer Institute Edmonton Alberta T6G 1Z2 Canada

AIM: To examine the efficacy of supervised aerobic exercise training on aerobic capacity in survivors of ***: We conducted a systematic search identifying randomized controlled trials of supervised aerobic exercise interventions among adult cancer survivors with aerobic capacity(VO2max/peak) as the primary outcome. We calculated pooled effect sizes and performed multiple regression moderator analysis. RESULTS: We identified 18 studies including 1149 survivors of cancer. Studies included mixed cancer groups(4 studies), breast cancer(10 studies), hematological cancers(2 studies), lung cancer(1 study) and liver cancer(1 study). Survivors of cancer who participated in supervised aerobic exercise training improved aerobic capacity(VO2peak) more than controls(18 comparisons, 1093 participants; standardized mean effect: 0.74; 95%CI: 0.52, 0.96; p p percent of the between-study heterogeneity was explained by differences in exercise adherence and total exercise workload among studies(R2: 65.8%; p pervised aerobic exercise training provides a moderate-to-large beneficial effect on aerobic capacity among survivors of cancer. Aerobic capacity was improved to a greater degree in exercise studies with better participant attendance and higher overall exercise workload.

关键词： Exercise Neoplasms physical therapy modalities physical fitness Meta-analysis