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Risk prediction rule for advanced neoplasia on screening colonoscopy for average-risk individuals

World Journal of Gastroenterology 2020年第37期26卷 5705-5717页

作者： Ala I Sharara Ali El Mokahal Ali H Harb Natalia Khalaf Fayez S Sarkis Mustapha M El-Halabi Nabil M Mansour Ahmad Malli robert habib Division of Gastroenterology Department of Internal MedicineAmerican University of Beirut Medical CenterBeirut 11072020Lebanon Digestive and Liver Diseases Division University of Texas-SouthwesternDallasTX 75390United States Division of Gastroenterology Department of Internal MedicineBaylor College of MedicineHoustonTX 77030United States Division of Gastroenterology and Hepatology University of Kansas Medical CenterKansas CityMO 66160United States Division of Gastroenterology St Elizabeth HealthcareCrestview HillsKY 41017United States Department of Internal Medicine Section of Gastroenterology and HepatologyBaylor College of MedicineHoustonTX 77030United States Gastroenterology Hennepin HealthcareMinneapolisMN 55404United States Department of Internal Medicine American University of BeirutBeirut 11072020Lebanon

BACKGROUND In resource-limited countries,risk stratification can be used to optimize colorectal cancer *** prospective risk prediction models exist for advanced neoplasia(AN)in true average-risk *** To create and internally validate a risk prediction model for detection of AN in METHODS Prospective study of asymptomatic individuals undergoing first screening *** characteristics including diet,exercise and medications were *** logistic regression was used to elucidate risk factors for AN(adenoma≥1 cm,villous histology,high-grade dysplasia or carcinoma).The model was validated through bootstrapping,and discrimination and calibration of the model were *** 980 consecutive individuals(51%F;49%M)were *** and AN detection rates were 36.6%(F 29%:M 45%;P<0.001)and 5.1%(F 3.8%;M 6.5%)*** multivariate analysis,predictors of AN[OR(95%CI)]were age[1.036(1.00-1.07);P=0.048],BMI[overweight 2.21(0.98-5.00);obese 3.54(1.48-8.50);P=0.018],smoking[<40 pack-years 2.01(1.01-4.01);≥40 pack-years 3.96(1.86-8.42);P=0.002],and daily red meat consumption[2.02(0.92-4.42)P=0.079].Nomograms of AN risk were developed in terms of risk factors and age separately for normal,overweight and obese *** model had good discrimination and *** The prevalence of adenoma and AN in average-risk Lebanese individuals is similar to the ***,smoking,and BMI are important predictors of AN,with obesity being particularly *** external validation is needed,this model provides an important platform for improved risk-stratification for screening programs in regions where universal screening is not currently employed.

关键词： Colon Adenoma Cancer Risk factors

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No difference in mortality among ALPPS,two-staged hepatectomy,and portal vein embolization/ligation:A systematic review by updated traditional and network meta-analyses

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 411-419页

作者： Paschalis Gavriilidis robert P Sutcliffe Keith J roberts Madhava Pai Duncan Spalding Nagy habib Long R Jiao Mikael H Sodergren Department of Hepatopanceaticobiliary Surgery Imperial College Healthcare NHS TrustHammersmith HospitalLondon W120HSUK Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUK

Background:There is an ongoing debate on the feasibility,safety,and oncological efficacy of the associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)*** aim of this study was to compare ALPPS,two-staged hepatectomy(TSH),and portal vein embolization(PVE)/ligation(PVL)using updated traditional meta-analysis and network meta-analysis(NMA).Data sources:Electronic databases were used in a systematic literature *** traditional metaanalysis and NMA were performed and *** and major morbidity were selected as primary ***:Nineteen studies including 1200 patients were selected from the pool of 436 *** these patients,315(31%)and 702(69%)underwent ALPPS and portal vein occlusion(PVO),*** mortality based on updated traditional meta-analysis,subgroup analysis of the randomized controlled trials(RCTs),and both Bayesian and frequentist NMA did not demonstrate significant differences between the ALPPS cohort and the PVE,PVL,and TSH ***,analysis of RCTs did not demonstrate significant differences of major morbidity between the ALPPS and PVO *** ALPPS cohort demonstrated significantly more favorable outcomes in hypertrophy parameters,time to operation,definitive hepatectomy,and R0 margins rates compared with the PVO *** contrast,1-year disease-free survival was significantly higher in the PVO cohort compared to the ALPPS ***:This study is the first to use updated traditional meta-analysis and both Bayesian and frequentist NMA and demonstrated no significant differences in 90-day mortality between the ALPPS and other hepatic hypertrophy ***,two high quality RCTs including 147 patients demonstrated no significant differences in major morbidity between the ALPPS and PVO cohorts.

关键词： ALPPS Hepatectomy Portal vein embolization Portal vein ligation Network meta-analysis

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<i>In Vitro</i>Characterisation of Pharmacological Effect of Prostacyclin Analogues in Comparison to Phosphodiesterase Inhibitors on Small Human Pulmonary Vessels

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World Journal of Cardiovascular Surgery 2017年第11期7卷 131-142页

作者： Azar Hussain robert Bennett Zaheer Tahir Ahmed habib Michael Cowen Mubarak Chaudhry Mahmoud Loubani Alyn Morice Department of Cardiothoracic Surgery Castle Hill Hospital Cottingham UK Department of Respiratory Medicine Castle Hill Hospital Cottingham UK

Background and Aim of Study: The phosphodiesterase inhibitors (Sildenafil and Milrinone), Nitric Oxide donor Sodium Nitroprusside (SNP) and prostacyclin analogs are commonly used pulmonary vasodilators to treat pulmonary hypertension. In the past few years, we have used human pulmonary artery rings in vitro to evaluate pulmonary vascular resistance. The main objective of the current study is to document the pharmacological impact of clinically used prostacyclin analogs on the human pulmonary system in parallel with phosphodiesterase inhibitors and SNP. Methods: The study used human pulmonary artery rings of internal diameter of 2 - 4 mm and length of 2 mm. These were extracted from patients with lung resections. These rings were then mounted on a multiwire myograph, and changes in isometric tension were noted. Then, concentration response curves were constructed to Sildenafil (Sd), Milrinone (Mil), Sodium Nitroprusside (SNP), Epoprostenol (Ep), Iloprost (Ip) and Treprostinil (Tp). Results: 52 pulmonary artery rings were used in these experiments. Sildenafil, Milrinone, SNP, Epoprostenol, Iloprost and Treprostinil caused a concentration-dependent vasodilation in small human pulmonary arteries (pEC50: 5.97 ± 0.22, 5.99 ± 0.12, 7.64 ± 0.08, 7.53 ± 0.14, 8.84 ± 0.15 and 9.48 ± 0.13 respectively, n = 8 to 12). The efficacy for the same was in the order: Tp = Ip > Ep > Mil > SNP > Sd. The potency varied in the order: Tp > Ip > SNP > Ep > Mil > Sd. Conclusion: This research showed the efficacy as well as the potency of SNP and phosphodiesterase inhibitors and prostacyclin analogs on the human pulmonary vasculature. Treprostinil and Iloprost exhibited maximum relaxation. However, Sildenafil and SNP showed lesser impact. These effects need to be considered for clinical studies for enhanced patient outcomes.

关键词： Pulmonary Artery Rings Human Vasodilators In Vitro Pulmonary Hypertension Study

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CARD15/NOD2基因不是坏死性小肠结肠炎的易患因素

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 10-10页

作者： habib Z. Arnaud B. PascalD.L. 程欣 Fondation Jean Dausset-CEPH27 Rue Juliette Dodu 75010 Paris France Dr.

Multiple factors are incriminated in the etiopathogeny of necrotizing enterocolitis (NEC) in premature infants, including oral feeding, vascular abnormalities, increase in pro- inflammatory cytokines, and inappropriate response of the intestinal barrier to bacterial microflora. CARD15/NOD2 is a gene recently recognized as important in the innate response to gut flora and is involved in Crohn’ s disease susceptibility. We thus tested its putative role in NEC. Ten children (seven boys and three girls) suffering from NEC who were admitted to robert Debré hospital between 1999 and 2002 were retrospectively included in the study. Genetic screening of the 11 constant exons and the exon- intron junctions of CARD15/NOD2 by direct sequencing revealed no novel mutations of that gene in NEC patients. Furthermore, the three main mutations of CARD15/NOD2 (R702W, G908R, and 1007fs) associated with susceptibility to Crohn’ s disease were not found in these patients. Our results suggest that CARD15/NOD2 does not play a major role in genetic susceptibility to NEC.

关键词： CARD15/NOD2 肠道黏膜屏障克罗恩病促炎症细胞因子免疫反应易患性血管畸形直接测序

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