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Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant Singh Dahiya Muhammad nadeem Yousaf Brinda Basida Bhanu Siva Mohan Pinnam Manesh Kumar Gangwani Hassam Ali Sahib Singh Yash R Shah Daksh Ahluwalia Mihir Prakash Shah Saurabh Chandan Neil R Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of Rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related *** To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National Readmission *** aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(Pil and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Role of sterile inflammation in fatty liver diseases

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Liver Research 2018年第1期2卷 21-29页

作者： Yonglin Chen Muhammad nadeem Yousaf Wajahat Z.Mehal Section of Digestive Diseases Yale University School of MedicineNew HavenCTUSA West Haven Veterans Medical Center West HavenCTUSA

Sterile inflammation is a ubiquitous response of tissues to stress and injury,and occurs to a high degree in the *** results in high levels of tissue damage after development of the metabolic syndrome,and with alcohol *** cytokines such as interleukin(il)-1βare key in the initiation and propagation of inflammation and tissue ***-1βis activated by a cytosolic machinery collectively termed the inflammasome,and by proteases released by *** of the inflammatory response is driven by macrophages,but hepatocytes,stellate and sinusoidal endothelial cells also have key *** for example release acute phase reactants which have pro-and anti-inflammatory effects,and are also a major source of pro-inflammatory damage associated *** cells can regulate differentiation of regulatory T cells by the production of transforming growth factor(TGF)βand all-trans retinoic acid,but the overall effect seems to be context *** strong hepatic inflammatory response is regulated in many ways,with epigenetic regulation playing a major *** is seen most notably with the rapid development of non-alcoholic steatohepatitis(NASH)in pups of female mice kept on a high fat diet prior to conception,but is likely occurring in adults that have been under metabolic stress for extended periods of *** regulation is of key importance due to its clinical implications,and potential to reveal new pathways for liver inflammation.

关键词： Sterile inflammation Non-alcoholic steatohepatitis(NASH) Alcoholic steatohepatitis(ASH) Fatty liver Interleukin(il) Transforming growth factorβ(TGFβ) Toll-like receptor(TLR)

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Interleukin-18 polymorphism as an inflammatory index in metabolic syndrome: A preliminary study

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World Journal of Diabetes 2017年第6期8卷 304-310页

作者： Syeda Sadia Fatima Zehra Jamil Syed Hani Abidi Daniyal nadeem Zara Bashir Ahmed Ansari Depart-ment- of Biological and Biomedical Sciences Aga Khan Universit-y Medical College Aga Khan Universit-y

AIMTo assess circulatory levels of interleukin-18 (il-18) and determine whether the presence of il-18 promoter polymorphism influences metabolic syndrome phenotypes. METHODSThis study recruited one hundred and eighty individuals divided into three groups with sixty subjects each as: Normal weight (18.0-22.9 kg/m2), overweight (23.0-25.9 kg/m2) and obese (> 26.0 kg/m2) according to South Asian criteria of BMI. Fasting blood glucose (FBG), Lipid profile, insulin, il-18 and tumor necrosis factor (TNF)α were measured using ELISA kits, whereas low density lipoprotein (LDL)-cholesterol, insulin resistance (HOMA-IR) and insulin sensitivity (QUICKI) were calculated. The body fat percentage (BF) was measured through bioelectrical impedance analysis; waist and hip circumference were measured. Genotyping of il-18 -607 C/A polymorphism was performed by using tetra-primer amplification refractory mutation system. Student t test, One-way analysis of variance, Hardy-Weinberg equilibrium, Pearson’s χ2 test and Pearson’s correlation were used, where a P value il-18 and TNF levels were also seen in obese subjects (il-18: 58.87 ± 8.59 ng/L) (TNF: 4581.93 ± 2132.05 pg/mL). The percentage of il-18 -607 A/A polymorphism was higher in overweight and obese subjects vs normal weight subjects (P il-18 levels when compared with subjects with AC (heterozygous) or CC (wild type) genotypes. However, we did not find any difference in the lipid profile between three subgroups. CONCLUSIONThis preliminary data suggests that il-18 polymorphism affects il-18 levels that might cause low grade inflammation, further exacerbated by increased TNFα. All these incr

关键词： Metabolic syndrome Interleukin-18 Polymorphism Obesity Body fat High density lipoprotein Low density lipoprotein Insulin

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Expression of pro-inflammatory genes （Pro-I） in A2A adenosine receptor （A2A） knockout （KO） mouse model of allergic asthma.

Expression of pro-inflammatory genes （Pro-I） in A2A adenos...

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第十五届国际药理学大会

作者： nadeem Ahmed Ledent Catherine Morrison Ray Mustafa Jamal Department of Physiology ＆ Pharmacology West Virginia University MorgantownWVUSA University of Brassels Belgium St Jude Children’s Research Hospital Memphis Tennessee USA Department of Physiology ＆ Pharmacology West Virginia University MorgantownWVUSA

＜正＞ Adenosine - mediated anti - inflammatory response in the lung involves A2A activation, which may lead to inhibition of Pro - I gene expression. Expression of iNOS,p65 subunit of NF - kappa B （p65） and A2A genes along with NO and Pro- I cytokines were assessed in A2A KO murine model of asthma. KO and WT mice were sensitized according to our published protocol （Fan and Mustafa. Pulm Pharmacol Ther. 15:147, 2000）. A day after last challenge, HALF and lungs were collected for Pro - I gene expression. Ragweed （ RW） challenge in sensitized mice increased gene expression of both p65 and i - NOS of WT and KO as compared to the controls （p ＜ 0.01）. A2A expression was down - regulated by RW challenge in WT sensitized mice as compared to controls with no transcripts being detectable in KO. Pro - I cytokines （il - 2 and il - 4） and NO levels were also increased in KO challenged mice as compared to WT （p ＜ 0. 01）, with KO and WT having greater NO levels than their controls （p ＜ 0.01）. The data show that A2A down - regulation resulted in higher Pro - I gene expression of p65 leading to increased expression of i - NOS, NO and Pro - I cytokines in the lung, implying a role for A2A in Pro - I gene expression in this model.

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Gene-gene,gene-environment,gene-nutrient interactions and single nucleotide polymorphisms of inflammatory cytokines

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World Journal of Diabetes 2015年第4期6卷 642-647页

作者： Amina nadeem Sadaf Mumtaz Abdul Khaliq Naveed Muhammad Aslam Arif Siddiqui Ghulam Mustafa Lodhi Tausif Ahmad Department of Physiology Army Medical CollegeNational University of Sciences and TechnologyIslamabad College of Medicine DammamUniversity of Dammam Department of Biochemistry Islamic International Medical CollegeRifah University Department of Physiology University of Health SciencesLahore Department of Physiology Islamic International Medical CollegeRifah University Department of Physiology AL-Nafees Medical CollegeIsra University Dean-Faculty of Pharmacy Margalla College of PharmacyMargalla Institute of Health Sciences

Inflammation plays a significant role in the etiology of type 2 diabetes mellitus(T2DM).The rise in the pro-inflammatory cytokines is the essential step in glucotoxicity and lipotoxicity induced mitochondrial injury,oxidative stress and beta cell apoptosis in T2 *** the recognized markers are interleukin(il)-6,il-1,il-10,il-18,tissue necrosis factor-alpha(TNF-α),C-reactive protein,resistin,adiponectin,tissue plasminogen activator,fibrinogen and *** mellitus has firm genetic and very strong environmental influence; exhibiting a polygenic mode of *** single nucleotide polymorphisms(SNPs) in various genes including those of pro and antiinflammatory cytokines have been reported as a risk for T2 *** all the SNPs have been confirmed by unifying results in different studies and wide variations have been reported in various ethnic *** inter-ethnic variations can be explained by the fact that gene expression may be regulated by gene-gene,gene-environment and gene-nutrient *** review highlights the impact of these interactions on determining the role of single nucleotide polymorphism of il-6,TNF-α,resistin and adiponectin in pathogenesis of T2 DM.

关键词： Cytokines Gene-environment interaction Diabetes mellitus Single nucleotide polymorphism Gene-gene interaction

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