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Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第5期13卷 77-87页

作者： Kavya M Reddy Preston Lee Parul J Gor Antonio Cheesman Noor Al-Hammadi david john westrich Jason Taylor Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at University of California Los AngelesLos AngelesCA 90095United States Department of Internal Medicine Santa Clara Valley Medical CenterSan JoseCA 95128United States Division of Gastroenterology and Hepatology Mercy HospitalSaint LouisMO 63141United States david john westrich Jason TaylorDivision of Gastroenterology and HepatologySaint Louis University School of MedicineSaint LouisMO 63104United States Saint Louis University Center for Health Outcomes Research Saint Louis UniversitySaint LouisMO 63104United States

BACKGROUND Percutaneous Endoscopic Gastrostomy(PEG)tubes are often placed for dysphagia following a stroke in order to maintain sufficient caloric *** 2011 ASGE guidelines recommend delaying PEG tube placement for two weeks,as half of patients with dysphagia improve within 2 *** are few studies comparing outcomes based on timing of PEG tube placement,and there is increasing demand for early PEG tube placement to meet requirements for timely discharge to rehab and skilled nursing *** To assess the safety of early(≤7 d post stroke)vs late(>7 d post stroke)PEG tube placement and evaluate whether pre-procedural risk factors could predict mortality or *** We performed a retrospective study of patients undergoing PEG tube placement for dysphagia following a stroke at two hospitals in Saint Louis,MO between January 2011 and December *** were identified by keyword search of endoscopy ***,peri-procedural complication rates,and post-procedural complication rates were compared in both *** of morbidity and mortality such as protein-calorie malnutrition,presence of an independent cardiovascular risk equivalent,and presence of Systemic inflammatory response syndrome(SIRS)criteria or documented infection were evaluated by multivariate logistic *** 154 patients had a PEG tube placed for dysphagia following a stroke,92 in the late group and 62 in the early *** were 32 observed deaths,with 8 occurring within 30 d of the *** was an increase in peri-procedural and post-procedural complications with delayed PEG placement which was not statistically *** length of stay was significantly less in patients with early PEG tube placement(12.9 vs 22.34 d,P<0.001).Protein calorie malnutrition,presence of SIRS criteria and/or documented infection prior to procedure or having a cardiovascular disease risk equivalent did not significantly predict mortality or complicati

关键词： Percutaneous endoscopic gastrostomy tube Dysphagia Stroke Enteral nutrition Gastrostomy/adverse effect

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Hepatic angiotensin-converting enzyme 2 expression in metabolic dysfunction-associated steatotic liver disease and in patients with fatal COVID-19

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World Journal of Gastroenterology 2024年第31期30卷 3705-3716页

作者： Angus K Jacobs Steven D Morley Kay Samuel Katie Morgan Lyndsey Boswell Timothy J Kendall david A Dorward Jonathan A Fallowfield Peter C Hayes john N Plevris Hepatology Laboratory University of EdinburghEdinburgh EH164SBUnited Kingdom Scottish National Blood Transfusion Service Jack Copland CentreEdinburgh EH144BEUnited Kingdom Institute for Regeneration and Repair University of EdinburghEdinburgh EH164UUUnited Kingdom Edinburgh Pathology University of EdinburghEdinburgh EH164SBUnited Kingdom

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and *** injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated *** of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell *** To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe *** ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel *** ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct ***,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in ***2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD *** A

关键词： Metabolic dysfunction-associated steatotic liver disease Angiotensin-converting enzyme 2 Immunohistochemistry COVID-19 COVID-19-associated cholangiopathy

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Storylines of family medicine Ⅺ:professional identity formation—nurturing one’s own story

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Family Medicine and Community Health 2024年第S03期12卷 99-108页

作者： William B Ventres Leslie A Stone Hamish J Wilson Sumi M Sexton david J Doukas Jessica P Cerdena david M Kelley Michael D Fetters Jeffrey J Haney john J Frey III Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA General Practice and Rural Health University of Otago Dunedin School of MedicineDunedinNew Zealand Family Medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA Family and Community Medicine Tulane University School of MedicineNew OrleansLouisianaUSA Family Medicine Residency Program Middlesex HealthMiddletownConnecticutUSA Family Medicine University of Michigan Medical SchoolAnn ArborMichiganUSA Medical Education and Clinical Sciences Washington State UniversitySpokaneWashingtonUSA Family Medicine and Community Health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅺ:professional identity formation—nurturing one’s own story’,authors address the following themes:‘The social construction of professional identity’,‘On becoming a family physician’,‘What’s on the test?—professionalism for family physicians’,‘The ugly doc-ling’,‘Teachers—the essence of who we are’,‘Family medicine research—it starts in the clinic’,‘Socially accountability in medical education’,‘Personal philosophy and how to find it’and‘Teaching and learning with Storylines of Family Medicine’.May these essays encourage readers to find their own creative spark in medicine.

关键词： own becoming professional

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The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[^(18)F]fluoro-D-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology:A single centre retrospective study

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Asian Journal of Urology 2024年第1期11卷 33-41页

作者： Anthony Franklin Troy Gianduzzo Boon Kua david Wong Louise McEwan James Walters Rachel Esler Matthew J.Roberts Geoff Coughlina john W.Yaxley Department of Urology The Wesley HospitalBrisbaneQLDAustralia Wesley Medical Research BrisbaneQLDAustralia School of Medicine The University of QueenslandBrisbaneQLDAustralia Department of Radiology Wesley Medical ImagingBrisbaneQLDAustralia Department of Urology Royal Brisbane and Women's HospitalBrisbaneQLDAustralia

Objective:To review the risk of prostate cancer(PCa)in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography(18F-FDG PET/CT)ordered at Department of Urology,The Wesley Hospital,Brisbane,QLD,Australia for non-PCa related ***:Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F-FDG PET/CT for non-prostate related conditions was *** were classified as benign,indeterminate,or malignant depending of the results of prostate-specific antigen(PSA),PSA velocity,biopsy histopathology,and three-Tesla(3 T)multiparametric MRI(mpMRI)Prostate Imaging Reporting and Data System score,or gallium-68-prostate-specific membrane antigen(68Ga-PSMA)PET/CT ***:Three percent(273/9122)of men demonstrated 18F-FDG avidity within the ***-five percent(231/273)were further investigated,including with PSA tests(227/231,98.3%),3 T mpMRI(68/231,29.4%),68Ga-PSMA PET/CT(33/231,14.3%),and prostate biopsy(57/231,24.7%).Results were considered benign in 130/231(56.3%),indeterminate in 31/231(13.4%),and malignant in 70/231(30.3%).PCa was identified in 51/57(89.5%)of the men who proceeded to biopsy,including 26/27(96.3%)men with Prostate Imaging Reporting and Data System scores 4-5 mpMRI and six men with a positive 68Ga-PSMA PET/*** most common Gleason score on biopsy was greater than or equal to 4+5(14/51,27.5%).68Ga-PSMA PET/CT was concordant with the 18F-FDG findings in 26/33(78.8%).All 13 men with a positive concordant 18F-FDG,3 T mpMRI,and 68Ga-PSMA PET/CT had PCa on *** was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups(5.7 vs.6.1;p=0.580).Conclusion:In this study,after an incidental finding of an avid intraprostatic lesion on 18F-FDG PET/CT,70 of the 231 cases(30.3%;0.8%of the entire cohort)had results c

关键词： Prostatecancer Positionemission tomography Multiparametric magneticresonance imaging Prostatebiopsy

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Hepatic vein reconstruction during hepatectomy:A feasible and underused technique

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 421-427页

作者： Manish Ahuja Kunal Joshi Chris Coldham Paulo Muiesan Bobby Dasari Manuel Abradelo Ravi Marudanayagam Darius Mirza john Isaac david Bartlett Nikolaos A Chatzizacharias Robert P Sutcliffe Keith J Roberts Department of HPB and Liver Transplant Surgery University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Immunology and Immunotherapy University of BirminghamBirminghamUK

Complete surgical resection(R0)of liver tumors,primary or metastatic,remains the main objective in management of primary and metastatic liver tumors[1].Tumors invading to the proximity of the hepatic venous outflow pose a peculiar challenge to achieve R0 resections,because this location may render a tumor *** median survival of patients with liver tumor without surgery is less than 12 months[2].Even with surgery,post-hepatectomy liver failure and subsequently increased mortality are the main problems associated with complex resection[3].Moreover,when the vein is affected,vein resection and subsequent reconstruction are *** resection is a standard practice in liver resection and transplantation[4],for example,hepatic vein reconstruction during a living-donor liver transplant,porto-mesenteric axis reconstruction during resection of advanced pancreatic cancer and caval reconstruction during resection of retroperitoneal ***,novel techniques like total hepatic vascular exclusion(HVE)[5],veno-venous bypass[6]and ex vivo hepatic resection[7,8]have facilitated curative resections of tumors close to one or more major hepatic veins.

关键词： hepatectomy surgery mortality

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Projected Changes in Extreme Event Indices for Alaska

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Atmospheric and Climate Sciences 2024年第2期14卷 191-209页

作者： john E. Walsh Kyle Redilla Norman Shippee Lukas Cheung david Bigelow Ronni Wilcock International Arctic Research Center University of Alaska Fairbanks Fairbanks USA Stantec Ottawa Canada Stantec Montreal Canada Stantec Calgary Canada Two Bears Environmental Consulting Anchorage USA

As climate has warmed in recent decades, Alaska has experienced a variety of high-impact extreme events that include heat waves, wildfires, coastal storms and freezing rain. Because the warming is projected to continue, it is essential to consider future changes when planning adaptation actions and building resilience. In this study, we synthesize information on future changes in extreme events in Alaska from an ensemble of regional climate model simulations performed as part of Arctic-CORDEX (Coordinated Regional Climate Downscaling Experiment). A set of 13 extreme event indices, based on those developed by the World Climate Research Programme’s Expert Team on Climate Change Detection and Indices (ETCCDI), are evaluated from the Arctic-CORDEX output for Alaska. Of the 13 indices, six pertain to temperature, five to total precipitation, one to wind and one to snow. The results for locations in seven different climate zones of Alaska include large increases (5˚C - 10˚C) in the temperature thresholds for the five hottest and coldest days of the year, and large increases in warm spell duration and decreases in cold spell duration. Changes in the cold day temperature threshold are generally larger than the changes in the hot day temperature threshold, consistent with the projections of a stronger warming in winter than in summer in Alaska yearly maximum 1-day and 5-day precipitation amounts as well as the yearly number of consecutive wet days are projected to increase at all locations. The indices for heavy snow days and high-wind days show mixed changes, although the results indicate increases in heavy snow days at the more northern locations and increases in windy days at coastal locations. The changes in the extreme event indices continue through 2100 under the higher-emission (RCP 8.5) emission scenario, while the changes generally stabilize under the lower-emission (RCP 4.5) scenario. .

关键词： Extreme Events Temperature Precipitation Alaska Climate

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2024 Adult Compendium of Physical Activities:A third update of the energy costs of human activities

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Journal of Sport and Health Science 2024年第1期13卷 6-12页

作者： Stephen D.Herrmann Erik A.Willis Barbara E.Ainsworth Tiago V.Barreira Mary Hastert Chelsea L.Kracht john M.Schuna Jr. Zhenghui Cai Minghui Quan Catrine Tudor-Locke Melicia C.Whitt-Glover david R. Jacobs Jr. Kansas Center for Metabolism and Obesity Research University of Kansas Medical CenterKansas CityKS 66160USA Division of Physical Activity and Weight Management Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKS 66160USA Center for Health Promotion and Disease Prevention University of North Carolina at Chapel HillChapel HillNC 27599USA College of Health Solutions Arizona State UniversityPhoenixAZ 85003USA School of Exercise and Health Shanghai University of SportShanghai 200438China Exercise Science Department Syracuse UniversitySyracuseNY 13244USA Clinical Sciences Division Pennington Biomedical Research CenterBaton RougeLA 70808USA School of Exercise and Sport Science Oregon State UniversityCorvallisOR 97331USA College of Health and Human Services University of North Carolina at CharlotteCharlotteNC 28223USA Gramercy Research Group KnightdaleNC 27545USA Division of Epidemiology and Community Health School of Public HealthUniversity of MinnesotaMinneapolisMN 55454USA

Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across *** original version was updated in 2000,and again in 2011,and has been widely used to support PA research,practice,and public health ***:This 2024 update was tailored for adults 19-59 years of age by removing data from those≥60 *** a systematic review and supplementary searches,we identified new activities and their associated measured metabolic equivalent(MET)values(using indirect calorimetry)published since *** replaced estimated METs with measured values when ***:We screened 32,173 abstracts and 1507 full-text papers and extracted 2356 PA energy expenditure values from 701 *** added303 new PAs and adjusted 176 existing MET values and descriptions to reflect the addition of new data and removal of METs for older *** added a Major Heading(Video Games).The 2024 Adult Compendium includes 1114 PAs(912 with measured and 202 with estimated values)across 22 Major ***:This comprehensive update and refinement led to the creation of The 2024 Adult Compendium,which has utility across research,public health,education,and healthcare domains,as well as in the development of consumer health *** new website with the complete lists of PAs and supporting resources is available at https://***.

关键词： Adults Energy expenditure Exercise MET Physical Activities

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A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations

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Journal of Sport and Health Science 2024年第1期13卷 61-71页

作者： Alex E.Mohr david B.Pyne Geovana Silva Fogaça Leite Deborah Akins Jamie Pugh College of Health Solutions Arizona State UniversityPhoenixAZ 85004USA Research Institute for Sport and Exercise University of CanberraCanberraACT 2617Australia Laboratory of Functional Fermented Food Faculty of Pharmaceutical SciencesUniversity of São PauloSão Paulo 05508-030Brazil Research Institute for Sport and Exercise Sciences Liverpool John Moores UniversityLiverpool L33AFUK

Background:The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers,practitioners,and the lay public *** has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut ***,compared to other ergogenic aids and dietary supplements,probiotics present unique study *** objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active ***:Four databases(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Database of Systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active *** intervention with probiotics and inclusion of a control and/or placebo group were *** peer-reviewed articles in English were considered,and there were no date *** were extracted and presented in tabular form to detail study protocols,characteristics,and *** in randomized controlled trials was determined with the RoB 2.0 ***:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over *** half the studies used a single probiotic and the other half a multi-strain *** probiotic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was between 7 and 150 *** than half the studies directly assessed gastrointestinal symptoms,gut permeability,or the gut *** sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated ***-level adverse events were reported in only 2 studies,although the methodology of reporting varied *** risk of bias was generally low,although details on randomization were lacking in some s

关键词： Exercise Experimental methodology Gastrointestinal symptoms Gut microbiota Probiotic supplementation

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Fusobacterium is toxic for head and neck squamous cell carcinoma and its presence may determine a better prognosis

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Cancer Communications 2024年第8期44卷 879-883页

作者： Anjali Chander Jacopo Iacovacci Aize Pellon Radhika Kataria Anita Grigoriadis john Maher Cynthia Sears Gilad Bachrach Teresa Guerrero Urbano Mary Lei Imran Petkar Anthony Kong Tony Ng Ester Orlandi Nicola Alessandro Iacovelli Loris De Cecco Mara Serena Serafini david Moyes Tiziana Rancati Miguel Reis Ferreira Centre for Host-Microbiome Interactions King’s College LondonLondonUK Comprehensive Cancer Centre King’s College LondonLondonUK Department of Oncology Guys and St Thomas NHS Foundation TrustLondonUK Data Science Unit Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly Medicine Department Johns Hopkins University School of MedicineBaltimoreMarylandUSA Institute of Biomedical and Oral Research The Hebrew University-Hadassah School of Dental MedicineHadassah Ein Kerem CampusJerusalemIsrael Dipartimento di scienze Clinico-Chirurgiche Diagnostiche e PediatricheUniversitàdegli studi di PaviaPaviaItaly Radiation Oncology Department Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly Department of Medicine Weill Cornell MedicineNew YorkUSA

Head and neck squamous cell carcinoma(HNSCC)is a devastating *** morbid treatment,5-year survival rates remain poor(28%-67%)[1].There is a significant knowledge gap regarding how the microbiota may impact HNSCC treatment efficacy[2].We used microbiome data from two independent cohorts to test and validate the hypothesis that oral bacteria are associated with HNSCC prognosis and in vitro models to investigate mechanistic *** are detailed in Supplementary Materials.

关键词： prognosis squamous carcinoma

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Chronic effects of stretching on range of motion with consideration of potential moderating variables:A systematic review with meta-analysis

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Journal of Sport and Health Science 2024年第2期13卷 186-194页

作者： Andreas Konrad Shahab Alizadeh Abdolhamid Daneshjoo Saman Hadjizadeh Anvar Andrew Graham Ali Zahiri Reza Goudini Chris Edwards Carina Scharf david George Behm Institute of Human Movement Science Sport and HealthGraz UniversityGraz A-8010Austria School of Human Kinetics and Recreation Memorial University of NewfoundlandSt.John’sNL A1C 5S7Canada Department of Sport Injuries and Corrective Exercises Faculty of Sport SciencesShahid Bahonar University of KermanKerman 76169-13439Iran

Background:It is well known that stretch training can induce prolonged increases in joint range of motion(ROM).However,to date more information is needed regarding which training variables might have greater influence on improvements in ***,the purpose of this metaanalysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables,such as stretching technique,intensity,duration,frequency,and muscles stretched,as well as sex-specific,age-specific,and/or trained state-specific adaptations to stretch ***:We searched through PubMed,Scopus,Web of Science,and SportDiscus to find eligible studies and,finally,assessed the results from 77 studies and 186 effect sizes by applying a random-effect ***,by applying a mixed-effect model,we performed the respective subgroup *** find potential relationships between stretch duration or age and effect sizes,we performed a ***:We found a significant overall effect,indicating that stretch training can increase ROM with a moderate effect compared to the controls(effect size=-1.002;Z=-12.074;95%confidence interval:-1.165 to-0.840;p<0.001;I^(2)=74.97).Subgroup analysis showed a significant difference between the stretching techniques(p=0.01)indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic ***,there was a significant effect between the sexes(p=0.04),indicating that females showed higher gains in ROM compared to ***,further moderating analysis showed no significant relation or ***:When the goal is to maximize ROM in the long term,proprioceptive neuromuscular facilitation or static stretching,rather than ballistic/dynamic stretching,should be *** to consider in future research as well as sports practice is that neither volume,intensity,nor frequency of stretching were

关键词： Flexibility Long-term stretching Stretch training

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