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Higher infliximab and adalimumab trough levels are associated with fistula healing in patients with fistulising perianal Crohn’s disease

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World Journal of Gastroenterology 2022年第23期28卷 2597-2608页

作者： Bonita Gu Kavya Venkatesh Astrid-Jane Williams Watson Ng Crispin Corte Ali Gholamrezaei Simon Ghaly Wei Xuan Sudarshan Paramsothy Susan Connor South Western Sydney Clinical School University of New South WalesSydney 2170New South WalesAustralia Department of Gastroenterology and Hepatology Liverpool HospitalSydney 2170New South WalesAustralia AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred HospitalSydney 2050New South WalesAustralia Department of Medicine University of NewcastleNewcastle 2308New South WalesAustralia Central Clinical School University of SydneySydney 2050New South WalesAustralia Ingham Institute of Applied Medical Research Sydney 2170New South WalesAustralia Department of Gastroenterology St Vincent’s Hospital SydneySydney 2010New South WalesAustralia St Vincent’s Clinical School University of New South WalesSydney 2010New South WalesAustralia Department of Gastroenterology and Hepatology Concord Repatriation General HospitalSydney 2139New South WalesAustralia Concord Clinical School University of SydneySydney 2139New South WalesAustralia

BACKGROUND Tumor necrosis factor-alpha inhibitors,including infliximab and adalimumab,are effective medical treatments for perianal fistulising Crohn’s disease(CD),but not all patients achieve fistula healing.AIM To determine the correlation between perianal fistula healing and closure with infliximab and adalimumab trough levels.METHODS In this multicentre retrospective study conducted across four tertiary inflammatory bowel disease centres in Australia,we identified CD patients with perianal fistulae on maintenance infliximab or adalimumab who had a trough level within twelve weeks of clinical assessment.Data collected included demographics,serum infliximab and adalimumab trough levels(mg/L)within 12 wk before or after their most recent clinical assessment and concomitant medical or surgical therapy.The primary outcome was fistula healing,defined as cessation in fistula drainage.The secondary outcome was fistula closure,defined as healing and closure of all external fistula openings.Differences between patients who did or did not achieve fistula healing were compared using the chi-square test,t test or Mann-Whitney U test.RESULTS One hundred and fourteen patients(66 infliximab,48 adalimumab)were included.Forty-eight(72.7%)patients on maintenance infliximab achieved fistula healing and 18(27.3%)achieved fistula closure.Thirty-seven(77%)patients on maintenance adalimumab achieved fistula healing and 17(35.4%)achieved fistula closure.Patients who achieved fistula healing had significantly higher infliximab and adalimumab trough levels than patients who did not[infliximab:6.4(3.8-9.5)vs 3.0(0.3-6.2)mg/L,P=0.003;adalimumab:9.2(6.5-12.0)vs 5.4(2.5-8.3)mg/L,P=0.004].For patients on infliximab,fistula healing was associated with lower rates of detectable anti-infliximab antibodies and younger age.For patients on adalimumab,fistula healing was associated with higher rates of combination therapy with an immunomodulator.Serum trough levels for patients with and without fistula closure were not significantly different for

关键词： Crohn’s disease Perianal disorders Biologics Inflammatory bowel disease

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To scope or not-the challenges of managing patients with positive fecal occult blood test after recent colonoscopy

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World Journal of Gastrointestinal Oncology 2022年第9期14卷 1798-1807页

作者： Nivedita Rattan Laura Willmann Diana Aston Shani George Milan Bassan David Abi-Hanna Sulakchanan Anandabaskaran George Ermerak Watson Ng Jenn Hian Koo Gastroenterology and Liver Services Liverpool HospitalLiverpool 2170New South WalesAustralia Faculty of Medicine University of New South WalesSydney 2052New South WalesAustralia

BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent colonoscopy.AIM To determine the prevalence of advanced neoplasia in patients with a positive iFOBT after a recent colonoscopy, and clinical and endoscopic predictors for advanced neoplasia.METHODS The study recruited i FOBT positive patients who underwent colonoscopy between July 2015 to March 2020. Data collected included demographics, clinical characteristics, previous and current colonoscopy findings. Primary outcome was the prevalence of CRC and advanced neoplasia in a patient with positive iFOBT and previous colonoscopy. Secondary outcomes included identifying any clinical and endoscopic predictors for advanced neoplasia.RESULTS The study included 1051 patients(male 53.6%;median age 63). Forty-two(4.0%) patients were diagnosed with CRC, 513(48.8%) with adenoma/sessile serrated lesion(A-SSL) and 257(24.5%) with advanced A-SSL(AA-SSL). A previous colonoscopy had been performed in 319(30.3%). In this cohort, four(1.3%) were diagnosed with CRC, 146(45.8%) with A-SSL and 56(17.6%) with AA-SSL. Among those who had a colonoscopy within 4 years, none had CRC and 7 had AA-SSL. Of the 732 patients with no prior colonoscopy, there were 38 CRCs(5.2%). Independent predictors for advanced neoplasia were male [odds ratio(OR) = 1.80;95% confidence interval(CI): 1.35-2.40;P < 0.001), age(OR = 1.04;95%CI: 1.02-1.06;P < 0.001) and no previous colonoscopy(OR = 2.07;95%CI: 1.49-2.87;P < 0.001).CONCLUSION A previous colonoscopy, irrespective of its result, was associated with low prevalence of advanced neoplasia, and if performed within four years of a positive iFOBT result, was protective against CRC.

关键词： Colorectal cancer Adenoma Screening Fecal occult blood test Colonoscopy

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Prospective single-blinded single-center randomized controlled trial of Prep Kit-C and Moviprep:Does underlying inflammatory bowel disease impact tolerability and efficacy?

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World Journal of Gastroenterology 2021年第11期27卷 1090-1100页

作者： Waled Mohsen Astrid-Jane Williams Gabrielle Wark Alexandra Sechi Jenn-Hian Koo Wei Xuan Milan Bassan Watson Ng Susan Connor Department of Digestive Diseases Gold Coast University HospitalGold Coast4215QueenslandAustralia Department of Gastroenterology and Hepatology Liverpool HospitalSydney 2170New South WalesAustralia South West Sydney Clinical School University of New South WalesSydney 2170New South WalesAustralia Ingham Institute Applied Medical Research Sydney 2170New South WalesAustralia

BACKGROUND Colonoscopy remains the gold standard for detection of colonic disease.An optimal evaluation depends on adequate bowel cleansing.Patients with inflammatory bowel disease(IBD),require frequent endoscopic assessment for both activity and dysplasia assessment.Two commonly used bowel preparations in Australia are Prep Kit-C(Pc)and Moviprep(Mp).Little is known about tolerability,efficacy and safety of split protocols of Mp and Pc in both IBD and non-IBD patients.AIM To primary aim was to compare the tolerability,efficacy and safety of split protocols of Mp and Pc in patients having a colonoscopy.The secondary aim was to compare the efficacy,tolerability and safety of either preparation in patients with or without IBD.METHODS Patients were randomized to Pc or Mp bowel preparation.Patients completed a questionnaire to assess tolerability.Efficacy was assessed using the Ottawa Bowel Preparation Score.Serum electrolytes and renal function were collected one week prior to colonoscopy and on the day of colonoscopy.RESULTS Of 338 patients met the inclusion criteria.Of 168 patients randomized to Mp and 170 to Pc.The efficacy of bowel preparation(mean Ottawa Bowel Preparation Score)was similar between Mp(5.4±2.4)and Pc(5.1±2.1)(P=0.3).Mean tolerability scores were similar in Mp(11.84±5.4)and Pc(10.99±5.2;P=0.17).125 patients had IBD(73 had Crohn’s Disease and 52 had Ulcerative colitis).Sixtyfour IBD patients were allocated to Mp and 61 to Pc.In non-IBD patients,104 were allocated to Mp and 109 to Pc.The mean tolerability score in the IBD group was lower than the non-IBD group(mean tolerability scores:IBD:10.3±5.1 and non-IBD:12.0±5.3;P=0.01).IBD patients described more abdominal pain with Mp when compared with Pc;(Mp:5.7±4.4 vs Pc:3.6±2.6,P=0.046).Serum magnesium level increased with Pc compared with Mp in all patients(mean increase in mmol/L:Mp:0.03±0.117 and Pc:0.11±0.106;P<0.0001).CONCLUSION In this study,the efficacy,tolerability and safety of Mp and Pc were similar in all patients.However,patients with IBD repo

关键词： Bowel preparation Inflammatory bowel disease Tolerability Efficacy Moviprep Prep Kit-C

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Gastroenterologist perceptions of faecal microbiota transplantation

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World Journal of Gastroenterology 2015年第38期21卷 10907-10914页

作者： Sudarshan Paramsothy Alissa J Walsh Thomas Borody Douglas Samuel Johan van den Bogaerde Rupert WL Leong Susan Connor Watson Ng Hazel M Mitchell Nadeem O Kaakoush Michael A Kamm Gastroenterology and Hepatology Department St Vincent’s Hospital Centre for Digestive Diseases Gastroenterology and Hepatology Department Bankstown-Lidcombe Hospital Gastroenterology and Hepatology Department Nambour General Hospital Gastroenterology and Hepatology Department Liverpool Hospital University of New South Wales School of Biotechnology and Biomolecular Sciences Departments of Gastroenterology and Medicine St Vincent's Hospital and University of Melbourne

AIM: To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation(FMT).METHODS: A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed.RESULTS: Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT,8% more than once. Ninety percent would refer patients with Clostridium difficile infection(CDI) for FMT if easily available,37% for ulcerative colitis,13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication,including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic,17% nasoduodenal,13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence,12% infection risk,10% non infectious adverse effects/lack of safety data,10% aesthetic,10% lack of efficacy,4% disease exacerbation,and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution.CONCLUSION: Despite general enthusiasm,most gastroenterologists have limited experience with,or access to,FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required.

关键词： Perceptions Gastroenterologist Clostridium diffici

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Wooden Radio

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Frontiers of Literary Studies in China-Selected Publications from Chinese Universities 2020年第3期14卷 424-433页

作者：苏童 Honey watson(Translated) 不详 Department of Comparative Literature New York UniversityNew YorkNY 10003USA

Doctor Mo held a black cotton umbrella in his hand as he passed beneath the overpass.A metallic eruption came from overhead and the umbrella's handle shook in his palms while he lowered its canopy,running out from the other side of the bridge as he did.He looked up to see a black freight train passing along the tracks,its sections either covered by tarpaulin or pain ted with white codes flashing before his eyes,a breath of wind rolli ng along beside them as they went.

关键词： beneath handle passing

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Effects and safety of natriuretic peptides as treatment of cirrhotic ascites:A systematic review and meta-analysis

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World Journal of Hepatology 2022年第4期14卷 827-845页

作者： Rasmus Hvidbjerg Gantzel Mikkel Breinholt Kjær Peter Jepsen Niels Kristian Aagaard Hugh watson Lise Lotte Gluud Henning Grønbæk Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus N 8200Denmark Gastroenterology Unit Copenhagen University HospitalHvidovre 2650Denmark Department of Clinical Medicine University of CopenhagenHvidovre 2650Denmark

BACKGROUND Natriuretic peptides are involved in the cascade of pathophysiological events occurring in liver cirrhosis,counterbalancing vasoconstriction and anti-natriuretic factors.The effects of natriuretic peptides as treatment of cirrhotic ascites have been investigated only in small studies,and definitive results are lacking.AIM To examine the effects and safety of natriuretic peptides in cirrhosis patients with ascites.METHODS We searched MEDLINE,Web of Science,Scopus,Cochrane Library and Embase for all available studies applying intravenous administration of any natriuretic peptide to patients suffering from cirrhotic ascites.Inclusion was not limited by treatment duration or dose,or by follow-up duration.Both randomised controlled trials and non-randomised studies were eligible for inclusion.The primary outcome was change in renal sodium excretion.Secondary outcomes included safety measures and changes in renal water excretion,plasma aldosterone concentration,and plasma renin activity.RESULTS Twenty-two studies were included.Atrial natriuretic peptide(ANP)was the only intensively studied treatment.Sodium excretion increased in response to continuous ANP infusion and was more pronounced when infusion rates of>30 ng/kg/min were administered compared with≤30 ng/kg/min(Png a statistically significant dose-response gradient.Plasma aldosterone concentration and plasma renin activity were significantly lower at baseline in study subgroups achieving a negative sodium balance in response to an ANP administration compared with treatment non-responders(Png/kg/min were applied.The quality of evidence for a natriuretic response to ANP was low,mainly due to small sample sizes and considerable between-study heterogeneity.D

关键词： Atrial natriuretic peptide B-type natriuretic peptide Urodilatin Cirrhosis Ascites Refractory ascites

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Improvements in Au Wire Bondability of Rigid and Flexible Substrates using Plasma Cleaning

Improvements in Au Wire Bondability of Rigid and Flexible Su...

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第六届电子封装技术国际学术会议

作者： Jang-Kyo Kim Peter Chou Kee Liu Ming Wai ng Department of Mechanical Engineering Hong Kong University of Science and Technology Clear Water Bay Kowloon Hong Kong ASM Assembly Automation Ltd. 4/F watson Centre 16 Kung Yip St. Kwai Chung Hong Kong ASM Assembly Automation Ltd. 4/F watson Centre 16 Kung Yip St. Kwai Chung Hong Kong

Thermosonic Au wire bonding is the most widely used interconnection technology in the BGA packages. Compare with Au ball bonding, the lower wire loop and finer bond pitch of Au wedge bond makes its id

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DESIGN OF A HIGH SPEED AIR BEARIng LINEAR PRECISION STAGE

DESIGN OF A HIGH SPEED AIR BEARING LINEAR PRECISION STAGE

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第二届亚洲机械电子学学术会议

作者： Gary Peter Widdowson Siu Wai ng Jacob W.F.Cheung ASM Assembly Automation Ltd.4/F watson Center 16 Kung Yip StreetKwai ChungN.T.Hong Kong

This paper describes the design and experimental verification of a high speed air bearing linear precision stage.With a direct drive linear motor and almost zero friction air bearing guide,this stage has the potential to achieve high speed and precision motion.As the stiffness of the air bearing is important to the dynamic performance of the stage,the selection and design of the air bearing are discussed in detail.The experimental stiffness is also presented.A numerical modal analysis is presented together with the experiment data of the air bearing to optimize the design and predict its performance.To validate the analysis,a modal test with an impulse hammer is carried out.To demonstrate the system design,the running performance is investigated with a given motion profile.

关键词： Air bearing Porous graphite Stiffness Modal analysis Modal test

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有孤立性小耳畸形的婴儿无需做肾脏超声检查

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世界核心医学期刊文摘（儿科学分册） 2006年第5期2卷 14-14页

作者： Deshpande S.A. watson H. 郭战宏 Royal Shrewsbury Hospital Mytton Oak Road Shrewsbury SY3 8XQ United Kingdom.Dr

Aim: To determine whether infants with isolated minor anomalies of the externa l ear are at increased risk of renal malformations. Methods: Consecutive infants with isolated minor anomalies of the external ear (preauricular skin tags, prea uricular sinuses, ear pits, and misshapen pinnae) were offered renal ultrasonogr aphy by experienced sonographers over a 41 month period. The prevalence of renal anomalies in such infants was compared with that detected on routine fetal scan ning during the same period. Results: Ninety six of 13 136 liveborn infants (7.3 /1000, 95%confidence interval (CI) 5.9 to 8.9) were noted to have isolated mino r ear anomalies on routine neonatal examination, with preauricular skin tags bei ng the most common (85%). Ninety one (95%) infants underwent renal sono- graphy at a mean (SD) age of 40 (19.0) days. Only one infant (1.1%, 95%CI 0. 03 to 5.9) had transient unilateral pyelectasia. During the same period, non-sy ndromic renal anomalies were found in 0.64%(95%CI 0.52 to 0.73) of infants, a prevalence no different from that of infants with minor ear anomalies (p = 0.44) . Conclusions: Routine renal imaging is not warranted in infants with such minor external ear anomalies unless accompanied by other systemic malformations.

关键词：肾脏畸形超声检查小耳畸形孤立性婴儿外耳畸形耳前窦道发生率检查时新生儿

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High Voltage High Frequency Power Transformer for Pulsed Power Applications

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Journal of Energy and Power Engineering 2011年第10期5卷 960-965页

作者： T. Filchev A. watson J. Clare P. Wheeler F. Carastro Department of Electrical and Electronics Engineering University of Nottingham Nottingham NG7 2RD UK

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