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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(P<0.001).The 30 d all-cause readmission rates between frail 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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siRNA-mediated downregulation of TC21 sensitizes esophageal cancer cells to cisplatin

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World Journal of Gastroenterology 2012年第31期18卷 4127-4135页

作者： Md.Raghibul Hasan Shyam Singh Chauhan Rinu sharma Ranju Ralhan Department of Biochemistry All India Institute of Medical SciencesNew Delhi 110029India Department of Biotechnology School of BiotechnologyGuru Gobind Singh Indraprastha UniversityNew Delhi 110075India Department of Otolaryngology-Head and Neck Surgery Joseph and Mildred Sonshine Family Centre for Head and Neck DiseasesMount Sinai HospitalTorontoON M5G 1X5Canada Department of Pathology and Laboratory Medicine Alex Simona Shnaider Laboratory for Molecular OncologyMount Sinai HospitalTorontoON M5G 1X5Canada

AIM： To determine the functional significance of TC21 in esophageal squamous cell carcinoma （ESCC）. METHODS： TC21 siRNA transfection was carried out using Hyperfectamine to knock down TC21, and tran- scripts were analyzed by reverse transcription-poly- merase chain reaction and protein by Western *** demonstrated the effect of TC21 downregulation of cell signaling in esophageal cancer cells by assess- ing the phosphorylation status of its downstream tar- gets, phosphoinositide 3-kinase （PI3K）, phosphatase and tensin homolog （PTEN）, protein kinase B （pal〈t）, nuclear factor-KB （NF-~B） and cyclinD1 using specific antibodies. Cell survival analysis after cisplatin treat- ment was carried out by cell viability assay and cell cycle analysis using flow cytometry. RESULTS： TC21 knockdown in human ESCC cell line TEl3 cells, showed only a marginal increase （14.2%） in cell death compared with control cells. The expres- sions of the signaling proteins PI3K and pAkt, transcrip- tion factor NF-KB, and cell cycle protein cyclin D1 were markedly decreased in response to TC21 downregula- tion, whereas the level of pPTEN, an antagonist of PI3K, was increased. In addition, we evaluated the potential of TC21 as a putative target for sensitizing ESCC cells to the chemotherapeutic agent cisplatin. Increased cell death （38.4%） was observed in cells treated with cis- platin after TC21 knockdown compared with cells which were treated with cisplatin alone （20% cell death）. CONCLUSION： Results suggest that TC21 mediates its effects via the PI3K-Akt pathway, NF-KB and cyclin D1, and enhances chemoresistance in esophageal cancer cells.

关键词： TC21 Esophageal squamous cell carci-noma siRNA Cisplatin Chemosensitivity

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Conventional risk factors among newly diagnosed coronary heart disease patients in Delhi

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World Journal of Cardiology 2011年第6期3卷 201-206页

作者： Sanjiv K Bhasin Shridhar Dwivedi Ali Dehghani Rahul sharma Department of Community Medicine University College of Medical Sciences and GTB Hospital Department of Medicine/Preventive Cardiol-ogy Hamdard Institute of Medical Sciences and ResearchJamia Hamdard(Hamdard University)

AIM:To analyze the conventional risk factors among newly diagnosed cases of coronary heart disease(CHD) admitted to a hospital in Delhi,***:This hospital-based prospective study in-cluded 276 consecutive newly diagnosed cases of CHD in the Coronary Care Unit of a tertiary care hospital in ***:The mean age of the cases was 49.7± 9.5 years,with the youngest case aged 27 *** two risk factors present most frequently among the cases were inadequate physical activity and abnormal lipid *** about 3.6%of cases in our study had a physical activity level(pal)that could be termed as"active",with a large proportion(96.4%)having a pal suggestive of a sedentary lifestyle.A majority of patients were found to be current tobacco smokers(53.3%)and 188(68.1%)subjects were lifetime ever *** was not a single case who did not have one or more of the risk *** than one-quarter(n=76)had six or more of the studied risk ***:Indians have among the CHD highest mortality rates amongst all ethnic groups studied so *** is important to study the regional epidemiology of the cardiovascular events to allow for location-specific prevention and control programs.

关键词： Risk factors Coronary heart disease Geographical-distribution Epidemiology

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The Corpse Is a Silent Witness Who Never Lies—A Case Report

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Forensic Medicine and Anatomy Research 2014年第3期2卷 43-47页

作者： Vijay pal Pawan Mittal Jitender K. Jakhar Yogesh Kumar Vashist A. D. Aggarwal Bhavesh Bohra Department of Forensic Medicine Government Medical College Patiala India Department of Forensic Medicine Jhalawar Medical College Jhalawar India Department of Forensic Medicine Pt. B. D. Sharma PGIMS Rohtak Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India Department of Forensic Medicine Pt. B. D. Sharma PGIMS Rohtak Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India

There are two very common sayings about corpse (dead body). The first common saying is that “the corpse is a silent witness who never lies” and the other common saying is that “the dead body is extremely eloquent and honestly informative, if one exercises patience in listening to it.” Both these sayings were proved in one of our cases. In the present case, decomposed body of an unidentified female individual aged about 25 - 26 years was recovered from the bank of western Yamuna canal in Haryana. The police made the efforts for establishing the identity of the deceased but could not succeed. The body was forwarded to the district hospital for autopsy along with the inquest report. However, the body being in advanced stage of decomposition so it was referred from the district hospital to the department of Forensic Medicine, PGIMS, Rohtak (Haryana) for the examination and the expert opinion regarding the cause of death. The findings observed on examination of the body helped to deduce the cause, time and manner of death whereas certain important objective features of identification were also observed and ultimately proper identity of the deceased could be established beyond the reasonable doubt by DNA profile of the samples preserved at autopsy. The autopsy findings, DNA profile and the results of examination of other materials (exhibits) taken from the body not only revealed the truth from the silent witness—the corpse, but also provided objective and scientific evidence to establish the corpus delicti in this case.

关键词： Corpus Delicti Rape Throttling Murder Putrefaction DNA Profile

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Measurements of dihadron correlations relative to the event plane in Au+Au collisions at√^(S)NN=200 GeV

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Chinese Physics C 2021年第4期45卷 198-241页

作者： H.Agakishiev M.M.Aggarwal Z.Ahammed A.V.Alakhverdyants I.Alekseev J.Alford B.D.Anderson C.D.Anson D.Arkhipkin G.S.Averichev J.Balewski D.R.Beavis N.K.Behera R.Bellwied M.J.Betancourt R.R.Betts A.Bhasin A.K.Bhat H.Bichsel J.Bieleik J.Bielcikova B.Biritz L.C.Bland W.Borowski J.Bouchet E.Braidot A.V.Brandin A.Bridgeman S.G.Brovko E.Bruna S.Bueltmann I.Bunzarov T.P.Burton X.Z.Cai H.Caines M.Calderon de la Barca Sanchez D.Cebra R.Cendejas M.C.Cervantes Z.Chajecki P.Chaloupka S.Chattopadhyay H.F.Chen J.H.Chen J.Y.Chen L.Chen J.Cheng M.Cherney A.Chikanian K.E.Choi W.Christie P.Chung M.J.M.Codrington R.Corliss J.G.Cramer H.J.Crawford S.Dash A.Davila Leyva L.C.De Silvat R.R.Debbe T.G.Dedovich A.A.Derevschikov R.Derradi de Souza L.Didenko P.Djawotho S.M.Dogra X.Dong J.L.Drachenberg J.E.Draper J.C.Dunlop L.G Efimov M.Elnim J.Engelage G Eppley M.Estienne L.Eun O.Evdokimov R.Fatemi J.Fedorisin A.Feng R.G.Fersch P.Filip E.Finch V.Fine Y.Fisyak C.A.Gagliardi D.R.Gangadharan A.Geromitsos F.Geurts P.Ghosh Y.N.Gorbunov A.Gordon O.Grebenyuk D.Grosnick S.M.Guertin A.Gupta W.Guryn B.Haag O.Hajkova A.Hamed L-X.Han J.W.Harris J.P.Hays-Wehle M.Heinz S.Heppelmann A.Hirsch E.Hjort G.W.Hoffmann D.J.Hofiman B.Huang H.Z.Huang T.J.Humanic L.Huo G.Igo P.Jacobs W.W.Jacobs C.Jena F.Jin J.Joseph E.G.Judd S.Kabana K.Kang J.Kapitan K.Kauder H.Ke D.Keane A.Kechechyan D.Kettler D.P.Kikola J.Kiryluk A.Kisiel V.Kizka A.G.Knospe D.D.Koetke T.Kollegger J.Konzer I.Koralt L.Koroleva W.Korsch L.Kotchenda V.Kouchpil P.Kravtsov K.Krueger M.Krus L.Kumar P.Kurnadi M.A.C.Lamont J.M.Landgraf S.LaPointe J.Lauret A.Lebedev R.Lednicky J.H.Lee W.Leight M.J.LeVine C.Lil L.Li N.Li W.Li X.Li X.Li Y.Li Z.M.Li M.A.Lisa F.Liu H.Liu J.Liu T.Ljubicic W.J.Llope R.S.Longacre W.A.Love Y.Lu E.V.Lukashov X.Luo G.L.Ma Y.G.Mai D.P.Mahapatra R.Majka O.I.Mall L.K.Mangotra R.Manweiler S.Margetis C.Markert H.Masui H.S.Matis Yu.A.Matulenko D.MeDonald T.S.McShane A.Meschanin R.Milner N.G.Minaev S.Mioduszewski A.Mischke M.K.Mitrovski B.Mohanty M.M.Mondal B.Morozov D.A.Morozov M.G.Munhoz M Argonne National Laboratory Argonnellinois 60439USA Brookhaven National Laboratory UptonNew York 11973USA University of Califomia BerkeleyCaliformnia 94720USA University of California DavisCalifornia 95616USA University of Califormnia Los AngelesCalifomia 90095USA Universidade Estadual de Campinas Sao PauloBrazil University of Illinois at Chicago ChicagoIlinois 60607USA Creighton University OmahaNebraska 68178USA Czech Technical University in Prague FNSPEPrague11519Czech Republic Nuclear Physics Institute AS CR 25068 Rez/PragueCzech Republic University of Frankfurt FrankfurtGermany Institute of Physics Bhubaneswar 751005India Indian Institute of Technology MumbaiIndia Indiana University BloomingtonIndiana 47408USA Alikhanov Instiute for Theoretical and Experimental Physics MoscowRussia University of Jammu Jammu 180001India Joint Institute for Nuclear Research Dubna141980Russia Kent State University KentOhio 44242USA University of Kentucky LexingtonKentucky40506-0055USA Institute of Modern Physics LanzhouChina Lawrence Berkeley National Laboratory BerkeleyCalifornia 94720USA Massachusetts Institute of Technology CambridgeMA 02139-4307USA Mx-Planck-Institut fir Physik MunichGermany Michigan State University East LansingMichigan 48824USA Moscow Engineering Physics Institute Moscow Russia NIKHEF and Utrecht University AmsterdamThe Netherlands Ohio State University ColumbusOhio 43210USA Old Dominion University NorfolkVA23529USA Panjab University Chandigarh 160014India PennsyIvania State University University ParkPennsylvania 16802USA Institute of High Energy Physics ProtvinoRussia Purdue University West LafayetteIndiana 47907USA Pusan National University PusanRepublic of Korea University of Rajasthan Jaipur 302004India Rice University HoustonTexas 77251USA Universidade de Sao Paulo Sao PauloBrazil University of Science&Technology of China Hefei 230026.China Shandong University JinanShandong 250100China Shanghai Institute of Applied Physics Shanghai 201800Chi

Dihadron azimuthal correlations containing a high transverse momentum(pr)trigger particle are sensit-ive to the properties of the nuclear medium created at RHIC through the strong interactions occurring between the traversing parton and the medium,*** measurements revealed a strong modification to di-hadron azimuthal correlations in Au+Au collisions with respect to ptp and d+Au *** modification in-creases with the collision centrality,suggesting a path-length or energy density dependence to the je-quenching *** paper reports STAR measurements of dihadron azimuthal correlations in mid-central(20%-60%)Au+Au collisions at√^(S)NN=200 GeV as a function of the trigger particle's azimuthal angle relative to the event plane,Ф_(s)=|Ф_(t)-ψ_(Ep)|.The azimuthal correlation is studied as a function of both the trigger and associated particle *** subtractions of the combinatorial background and anisotropic flow,assuming Zero Yield At Minimum(ZYAM),are *** correlation results are first discussed with subtraction of the even harmonic(elliptic and quadrangu-lar)flow *** away-side correlation is strongly modifed,and the modification varies withФ_(s),with a double-peak structure for out-of-plane trigger *** near-side ridge(long range pseudo-rapidity△_(η)correla-tion)appears to drop with increasingФ_(s)while the jet-like component remains approximately *** correla-tion functions are further studied with the subtraction of odd harmonic triangular flow background arising from *** is found that the triangular flow,while responsible for the majority of the amplitudes,is not sufficient to explain theφs-dependence of the ridge or the away-side double-peak *** dropping ridge withФ_(s)could be attributed to aФ_(s)-dependent lliptie anisotropy;however,the physics mechanism of the ridge remains an open *** with aФ_(s)-dependent elliptic flow,the away-side correlation structure

关键词： relativistic heavy ion collisions dihadron correlations jet-medium interactions anisotropic flow background event plane

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