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Current practices and future prospects for the management of gallbladder polyps: A topical review

World Journal of Gastroenterology 2018年第26期24卷 2844-2852页

作者： R Stephen McCain Anna Diamond claire jones Helen G Coleman Centre for Public Health Institute of Clinical Sciences Queens University Belfast Ulster Hospital South Eastern Health and Social Care Trust Mater Hospital Belfast Health and Social Care Trust Queens University Belfast Centre for Public Health Queen’s University Belfast

A gallbladder polyp is an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen. Gallbladder polyps have an estimated prevalence in adults of between 0.3%-12.3%. However, only 5% of polyps are considered to be "true" gallbladder polyps, meaning that they are malignant or have malignant potential. The main radiological modality used for diagnosing and surveilling gallbladder polyps is transabdominal ultrasonography. However, evidence shows that other modalities such as endoscopic ultrasound may improve diagnostic accuracy. These are discussed in turn during the course of this review. Current guidelines recommend cholecystectomy for gallbladder polyps sized 10 mm and greater, although this threshold is lowered when other risk factors are identified. The evidence behind this practice is relatively low quality. This review identifies current gaps in the available evidence and highlights the necessity for further research to enable better decision making regarding which patients should undergo cholecystectomy, and/or radiological follow-up.

关键词： Gallbladder polyps Gallbladder cancer True polyps Pseudo polyps

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Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes

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World Journal of Gastroenterology 2018年第43期24卷 4846-4861页

作者： Andrew McGuigan Paul Kelly Richard C Turkington claire jones Helen G Coleman R Stephen McCain Centre for Cancer Research and Cell Biology Queen’s University Belfast Department of Pathology Royal Victoria HospitalBelfast Department of Hepatobiliary Surgery Mater Hospital Centre for Public Health Queen’s University Belfast

This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to

关键词：癌症治疗胰腺传染病学诊断评论临床风险因素腺癌

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Impacts of timing,length,and intensity of behavioral interventions to COVID-19 dynamics:North Carolina countylevel examples

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Infectious Disease Modelling 2022年第3期7卷 535-544页

作者： claire Quiner Kasey jones Georgiy Bobashev RTI International 3040 E.Cornwallis RoadPO Box 12194Research Triangle ParkNC27709USA

We sought to examine how the impact of revocable behavioral interventions,e.g.,shelterin-place,varies throughout an epidemic,as well as the role that the proportion of susceptible individuals had on an intervention's *** estimated the theoretical impacts of start day,length,and intensity of interventions on disease transmission and illustrated them on COVID-19 dynamics inWake County,North Carolina,to inform how interventions can be most *** used a Susceptible,Exposed,Infectious,and Recovered(SEIR)model to estimate epidemic curves with modifications to the disease transmission parameter(β).We designed modifications to simulate events likely to increase transmission(e.g.,long weekends,holiday seasons)or behavioral interventions likely to decrease it(e.g.,shelter-in-place,masking).We compared the resultant curves'shape,timing,and cumulative case count to baseline and across other modified *** led to changes in COVID-19 dynamics,including moving the peak's location,height,and *** proportion susceptible,at the start day,strongly influenced their *** interventions shifted the curve,while interventions near the peak modified shape and case *** some scenarios,in which the transmission parameter was decreased,the final cumulative count increased over *** showed that the timing of revocable interventions has a strong impact on their *** same intervention applied at different time points,corresponding to different proportions of susceptibility,resulted in qualitatively differential *** estimation of the proportion susceptible is critical for understanding an intervention's *** findings presented here provide evidence of the importance of estimating the proportion of the population that is susceptible when predicting the impact of behavioral infection control *** emphasis should be placed on the estimation of this epidemic component in intervention design and decision-makin

关键词： Sars-cov-2 Public health decision-making Infection control policies

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