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Yield of alarm features in predicting significant endoscopic findings among hospitalized patients with dyspepsia

World Journal of Gastroenterology 2024年第26期30卷 3210-3220页

作者： Lama Ibrahim Maamoun Basheer tawfik khoury Wisam Sbeit Department of Internal Medicine Galilee Medical CenterNahariya 22001Israel Department of Gastroenterology Galilee Medical CenterNahariya 22001Israel Azrieli Faculty of Medicine Bar-Ilan UniversitySafed 1311502Israel

BACKGROUND Dyspepsia is a very prevalent upper gastrointestinal tract symptoms *** of these symptoms might arise from serious underlying diseases,so the promotion of evidence-based guidelines could potentially better align evaluation and *** To determine the value of alarm features as a predictive factor for significant endoscopic findings(SEFs)among hospitalized patients presenting with *** We conducted a retrospective case-control study including information about 6208 endoscopic procedures performed for hospitalized *** were divided into two groups,with and without SEFs,and compared to elucidate the ability of the different alarm features to predict *** During the study,605 patients fulfilled the inclusion *** the demographics and clinical characteristics of the two groups were compared,tachycardia(P<0.05),normocytic anemia,(P<0.05),leukocytosis(P<0.05),and hypoalbuminemia(P<0.05)documented on admission prior to endoscopy were strong predictors of *** the alarm features,upper gastrointestinal bleeding,persistent vomiting,odynophagia[odds ratio(OR)=3.81,P<0.05;OR=1.75,P=0.03;and OR=7.81,P=0.07,respectively]were associated with *** weight loss was strongly associated with malignancy as an endoscopic finding(OR=2.05;P<0.05).In addition,long-term use of anti-aggregate medications other than aspirin(P<0.05)was correlated to *** Novel predictors of SEFs were elucidated in this *** parameters could be used as an adjunctive in decision making regarding performing upper endoscopy in hospitalized patients with dyspepsia.

关键词： Dyspepsia Endoscopy Weight loss Anti-aggregate medications Persistent vomiting Odynophagia

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Endoscopic ultrasound role in pancreatic adenocarcinoma treatment:A review focusing on technical success,safety and efficacy

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World Journal of Gastroenterology 2022年第3期28卷 332-347页

作者： Wisam Sbeit Bertrand Napoléon tawfik khoury Department of Gastroenterology Galilee Medical CenterFaculty of Medicine in the GalileeBar-Ilan UniversityNahariya 2221006Israel

The impressive technological advances in recent years have rapidly translated into the shift of endoscopic ultrasound(EUS)from diagnostic modality into an interventional and therapeutic *** the great advance in its diagnosis,the majority of pancreatic adenocarcinoma cases are inoperable when diagnosed,thus demanding alternative optional *** has emerged as an easy,minimally invasive modality targeting this carcinoma with different interventions that have been reported *** this review we summarize the evolving role of interventional therapeutic EUS in pancreatic adenocarcinoma management.

关键词： Endoscopic ultrasound Pancreas Cancer Management Palliative

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Endoscopic ultrasound guided radiofrequency ablation for pancreatic tumors: A critical review focusing on safety, efficacy and controversies

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World Journal of Gastroenterology 2023年第1期29卷 157-170页

作者： tawfik khoury Wisam Sbeit Bertrand Napoléon Department of Gastroenterology Galilee Medical CenterNahariya 2210001Israel Department of Endoscopy Unit Private Hospital Jean MermozLyon 69008France

The role of endoscopic ultrasound(EUS)in the last two decades has shifted from a diagnostic tool to an important therapeutic tool treating mainly pancreatobiliary *** recent years,its applications for treating pancreatic diseases have broadened,including the implementation of radiofrequency ablation(RFA),which has been traditionally used for treating solid *** this critical indepth review,we summarized all the papers throughout the literature regarding EUS-RFA for pancreatic neuroendocrine neoplasms,adenocarcinoma,and pancreatic cystic ***,for pancreatic neuroendocrine neoplasms we identified 16 papers that reported 96 patients who underwent EUS-RFA,with acceptable adverse events that were rated mild to moderate and a high complete radiological resolution rate of 90%.For pancreatic adenocarcinoma,we identified 8 papers with 121 *** events occurred in 13%of patients,mostly rated ***,no clear survival benefit was *** pancreatic cystic lesions,we identified 4 papers with 38 *** adverse events were mostly mild and occurred in 9.1%of patients,and complete or partial radiological resolution of the cysts was reported in 36.8%.Notably,the procedure was technically feasible for most of the ***,a long road remains before this technique finds its definite place in guidelines due to several ***-RFA for pancreatic tumors seems to be safe and effective,especially for pancreatic neuroendocrine neoplasms,but multicenter prospective trials are needed to consider this treatment as a gold standard.

关键词： Endoscopic ultrasound Radiofrequency ablation Efficacy Safety Pancreas Tumors

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Diagnostic approach to faecal incontinence:What test and when to perform?

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World Journal of Gastroenterology 2021年第15期27卷 1553-1562页

作者： Wisam Sbeit tawfik khoury Amir Mari Department of Gastroenterology Galilee Medical CenterNaharia 2210001Faculty of Medicine in the GalileeBar-Ilan UniversitySafedIsrael Gastroenterology and Endoscopy Unit The Nazareth HospitalEMMSNazareth 464000Faculty of Medicine in the GalileeBar-Ilan UniversitySafedIsrael

Faecal incontinence(FI)is a debilitating common end result of several diseases affecting the quality of life and leading to patient disability,morbidity,and increased societal *** the various causes of FI,it is important to assess and identify the underlying *** investigatory tools are available including high-resolution anorectal manometry,transrectal ultrasound,magnetic resonance imaging,and *** review article provides an overview on the causes and pathophysiology of FI and the author’s perspective of the stepwise investigation of patients with FI based on the available ***,high-resolution anorectal manometry should be the first investigatory tool for FI,followed by either transrectal ultrasound or magnetic resonance imaging for anal internal sphincter and external anal sphincter injury,respectively.

关键词： Incontinence Manometry Ultrasound Rectal Magnetic resonance imaging Faecal

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Predictors of recurrent bile duct stone after clearance by endoscopic retrograde cholangiopancreatography:A case-control study

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 50-55页

作者： Wisam Sbeit Anas Kadah Matta Simaan Amir Shahin tawfik khoury Department of Gastroenterology Galilee Medical CenterNahariyaIsrael Faculty of Medicine in the Galilee Bar-Ilan UniversitySafedIsrael

Background:Recurrent common bile duct(CBD)stone is a long-term sequalae among patients who un-derwent endoscopic retrograde cholangiopancreatography(ERCP)with CBD stone *** regard-ing risk factors for recurrent CBD stone are *** aimed to identify predictors of recurrent CBD ***:We performed a retrospective case-controlled study from January 2010 to December ***-clusion criteria included patients who had recurrent CBD stone at least 6 months after the index ERCP,in which complete stone extraction was performed and normal cholangiogram was ***,457 patients were ***-two patients(9.2%)had recurrent CBD stone,and 415 patients(90.8%)did not have recurrent CBD ***:In univariate analysis,male sex[odds ratio(OR)=0.49,P=0.033]was a protective factor,while endoscopic stone extraction by basket ***(OR=2.55,P=0.005),older age(OR=1.03,P=0.003),number of CBD stones(OR=1.99,P=0.037),size of CBD stone(OR=4.06,P=0.003)and mechanical lithotripsy(OR=9.22,P=0.004)were risk factors for recurrent CBD *** multivariate logistic regression analysis,mechanical lithotripsy[OR=9.73,95%confidence interval(CI):1.69-55.89,P=0.010],basket clearance *** basket and balloon(OR=18.25,95%CI:1.05-318.35,P=0.046)and older age(OR=1.02,95%CI:1.00-1.05,P=0.023)were risk factors,and male sex(OR=0.39,95%CI:0.19-0.81,P=0.012)was a protective factor.

关键词： Endoscopic retrograde cholangiopancreatography Common bile duct Stone Recurrence

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Predicting common bile duct stones by non-invasive parameters

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Hepatobiliary & Pancreatic Diseases International 2020年第3期19卷 266-270页

作者： Anas Kadah tawfik khoury Mahmud Mahamid Nimer Assy Wisam Sbeit Department of Gastroenterology Galilee Medical CenterNahariyaIsraelFaculty of Medicine in the GalileeBar-Ilan UniversitySafedIsrael Gastroenterology and Endoscopy Units The Nazareth HospitalEMMSNazarethFaculty of Medicine in the GalileeBar-Ilan UniversitySafedIsrael Department of Internal Medicine Galilee Medical CenterNahariyaIsraelFaculty of Medicine in the GalileeBar-Ilan UniversitySafedIsrael

Background:Common bile duct(CBD)stone affect about 10%of patients with symptomatic *** American Society for Gastrointestinal Endoscopy(ASGE)published a strategy in 2010 for managing patients with suspected *** study aimed to assess the performance of different clinical parameters in predicting CBD ***:A total of 344 patients suspected to suffer from CBD stone and referred to endoscopic ultrasound(EUS)were *** were collected and their prediction power for CBD stones was ***:One hundred and sixty-seven patients without CBD stone according to EUS(group A)were compared to 177 patients with CBD stones(group B).Several predictive factors for CBD stone were identified on univariate *** multivariate regression analysis,CBD width by US(OR=1.224,95%CI:1.073–1.359;P=0.0026),age(OR=1.023,95%CI:1.011–1.035;P=0.0002)and gamma glutamyl transferase(GGT)level(OR=1.001,95%CI:1.000–1.002;P=0.0018)were significantly correlated with CBD stone,with receiver operator characteristics(ROC)of *** generated a diagnostic equation[age(yr)×0.1+CBD width(mm)by US×1+GGT(U/L)×0.005]to predict CBD stone with ROC of ***:We suggest this score as a very strong predictor for CBD stones,and to reduce the strength of total bilirubin and transaminases as predictors.

关键词： Stones Common bile duct Predictors

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Current and Future Treatment of Hepatocellular Carcinoma:An Updated Comprehensive Review

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Journal of Clinical and Translational Hepatology 2018年第1期6卷 69-78页

作者： Saleh Daher Muhammad Massarwa Ariel A. Benson tawfik khoury Gastroenterology and Liver Units Department of MedicineHadassah-Hebrew University Medical CenterJerusalemIsrael

Hepatocellular carcinoma(HCC)is among the leading causes of cancer-related *** principal treatment is surgical resection or liver transplantation,depending on whether the patient is a suitable transplant ***,in most patients with HCC the diagnosis is often late,thereby excluding the patients from definitive surgical *** treatment includes sorafenib,which is the most commonly used systemic therapy;although,it has been shown to only minimally impact patient survival by several *** and radiotherapy are generally *** to the poor prognosis of patients with HCC,newer treatments are needed with several being in development,either in preclinical or clinical *** this review article,we provide an update on the current and future medical and surgical management of HCC.

关键词： HCC Treatments Sorafenib Mortality

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Bedside score predicting retained common bile duct stone in acute biliary pancreatitis

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World Journal of Clinical Cases 2020年第8期8卷 1414-1423页

作者： tawfik khoury Anas Kadah Mahmud Mahamid Amir Mari Wisam Sbeit Faculty of Medicine in the Galilee Bar-Ilan UniversitySafed 1311502Israel Department of Gastroenterology Galilee Medical CenterNahariya 22100Israel Gastroenterology and endoscopy units The Nazareth Hospital EMMSNazareth 16100Israel

BACKGROUND Retained common bile duct(CBD) stone after an acute episode of biliary pancreatitis is of paramount importance since stone extraction is *** To generate a simple non-invasive score to predict the presence of CBD stone in patients with biliary *** We performed a retrospective study including patients with a diagnosis of biliary pancreatitis. One hundred and fifty-four patients were included. Thirty-three patients(21.5%) were diagnosed with CBD stone by endoscopic ultrasound(US).RESULTS In univariate analysis, age(OR: 1.048, P = 0.0004), aspartate transaminase(OR:1.002, P = 0.0015), alkaline phosphatase(OR: 1.005, P = 0.0005), gamma-glutamyl transferase(OR: 1.003, P = 0.0002) and CBD width by US(OR: 1.187, P = 0.0445)were associated with CBD stone. In multivariate analysis, three parameters were identified to predict CBD stone;age(OR: 1.062, P = 0.0005), gamma-glutamyl transferase level(OR: 1.003, P = 0.0003) and dilated CBD(OR: 3.685, P = 0.027),with area under the curve of 0.8433. We developed a diagnostic score that included the three significant parameters on multivariate analysis, with assignment of weights for each variable according to the co-efficient estimate. A score that ranges from 51.28 to 73.7 has a very high specificity(90%-100%) for CBD stones, while a low score that ranges from 9.16 to 41.04 has a high sensitivity(82%-100%). By performing internal validation, the negative predictive value of the low score group was 93%.CONCLUSION We recommend incorporating this score as an aid for stratifying patients with acute biliary pancreatitis into low or high probability for the presence of CBD stone.

关键词： Stones Common bile duct Predictors Biliary Pancreatitis

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Hepatitis C infection and lymphoproliferative disease:Accidental comorbidities?

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World Journal of Gastroenterology 2014年第43期20卷 16197-16202页

作者： tawfik khoury Shmuel Chen Tomer Adar E Ollech Jacob Meir Mizrahi Department of Internal Medicine Hebrew University-Hadassah Medical CenterJerusalemIL 91120Israel Institute for Gastroenterology and Liver Disease Hebrew University-Hadassah Medical CenterJerusalemIL 91120Israel

Chronic hepatitis C virus(HCV)infection has been associated with liver cancer and cirrhosis,autoimmune disorders such as thyroiditis and mixed cryoglobulinema,and alterations in immune function and chronic inflammation,both implicated in B cell lymphoproliferative diseases that may progress to non-Hodgkin lymphoma(NHL).HCV bound to B cell surface receptors can induce lymphoproliferation,leading to DNA mutations and/or lower antigen response *** findings and epidemiological reports suggest an association between HCV infection and *** performed a systematic review of the literature to clarify this potential *** searched the English-language literature utilizing Medline,Embase,Paper First,Web ofScience,Google Scholar,and the Cochrane Database of Systematic Reviews,with search terms broadly defined to capture discussions of HCV and its relationship with NHL and/or lymphoproliferative *** were screened to further identify relevant studies and literature in the basic sciences.A total of 62 reports discussing the relationship between HCV,NHL,and lymphoproliferative diseases were *** studies suggest that at least a portion of NHL may be etiologically attributable to HCV,particularly in areas with high HCV *** that showed a lack of association between HCV infection and lymphoma may have been influenced by small sample size,short follow-up periods,and database *** association appears strongest with the B-cell lymphomas relative to other lymphoproliferative *** by which chronic HCV infection promotes lymphoproliferative disease remains *** is a multifactorial process involving genetic,environmental,and infectious *** most probably have a role in the lymphomagenesis but further study to clarify the association and underlying mechanisms is warranted.

关键词： Blood Hepatitis C infection Non-Hodgkin’ s lymphoma Pathogenesis Treatment

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Do inflammatory bowel disease patient preferences from treatment outcomes differ by ethnicity and gender?A cross-sectional observational study

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World Journal of Clinical Cases 2022年第35期10卷 12899-12908页

作者： Timna Naftali Vered Richter Amir Mari tawfik khoury Haim Shirin Efrat Broide Institute of Gastroenterology Meir Medical CenterKfar-saba 4428164Israel Department of Gastroenterology Shamir Medical CenterZerifin 70300Israel Department of Gastroenterology Nazareth HospitalNazareth 16100Israel Shamir(Assaf Harofeh)Medical Center Affiliated to Sackler School of MedicineThe Gonczarowski Family Institute of Gastroenterology and Liver DiseasesTel Aviv UniversityZerifin 70300Israel Pediatric Gastroenterology Unit Asaf Harofeh Medical CenterZrifin 70300Israel

BACKGROUND Inflammatory bowel disease(IBD)patients’expectations of treatment outcomes may differ by *** To investigate treatment preferences of Jewish and Arabs *** This prospective survey ranked outcomes treatment preferences among Arab IBD patients,based on the 10 IBD-disk items compared to historical data of *** anonymous questionnaire in either Arabic or Hebrew was distributed among IBD *** were required to rank 10 statements describing different aspects of IBD according to their importance to the patients as treatment *** were compared to the answers of a historical group of Jewish *** IBD-disk items of 121 Arabs were compared to 240 Jewish *** Jewish patients included more females,[151(62.9%)vs 52(43.3%);P<0.001],higher education level(P=0.02),more urban residence[188(78.3%)vs 54(45.4%);P<0.001],less unemployment[52(21.7%)vs 41(33.9%);P=0.012],higher income level(P<0.001),and more in a partnership[162(67.8%)vs 55(45.4%);P<0.001].Expectations regarding disease symptoms:abdominal pain,energy,and regular defecation ranked highest for both *** gave significantly lower rankings(range 4.29-6.69)than Jewish patients(range 6.25-9.03)regarding all items,except for body *** to Arab women,Jewish women attached higher priority to abdominal pain,energy,education/work,sleep,and joint *** regression analysis revealed that higher patient preferences were associated with Jewish ethnicity(OR 4.77;95%CI 2.36-9.61,P<0.001)and disease *** more active the disease,the greater the odds ratio for higher ranking of the questionnaire items(1-2 attacks per year:OR 2.13;95%CI 1.02-4.45,P=0.043;and primarily active disease:OR 5.29;95%CI 2.30-12.18,P<0.001).Factors inversely associated with higher patient preference were male gender(OR 0.5;95%CI 0.271-0.935,P=0.030),UC(OR 0.444;95%CI 0.241-0.819,P=0.009),and above average income level(OR 0.267;95%CI:0.124-0.577,P=0.001).CONCL

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Patients’preferences Ethnicity IBD-disk Patients reported outcomes

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