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Factors associated with surgery in patients with intra-abdominal fistulizing Crohn's disease

World Journal of Gastroenterology 2016年第47期22卷 10380-10387页

作者： Shaul Yaari Ariel Benson Eyal Aviran Naama Lev Cohain Ran Oren Jacob Sosna eran israeli IBD Unit Institute of Gastroenterology and Liver Diseases Hadassah-Hebrew University Medical Center Department of Radiology and Medical Imaging Hadassah-Hebrew University Medical Center

AIM To characterize radiological and clinical factors associated with subsequent surgical intervention in Crohn's disease(CD) patients with intra-abdominal *** From a cohort of 1244 CD patients seen over an eight year period(2006 to 2014), 126 patients were identified as having intra-abdominal fistulae, and included in the study. Baseline patient information was collected from the medical records. Imaging studies were assessed for: anatomic type and number of fistulae; diameter of the inflammatory conglomerate; length of diseased bowel; presence of a stricture with pre-stenotic dilatation; presence of an abscess; lymphadenopathy; and the degree of bowel enhancement. Multivariate analysis for the prediction of abdominal surgery was calculated via Generalized Linear *** In total, there were 193 fistulae in 132 patients, the majority(52%) being entero-enteric. Fifty-nine(47%) patients underwent surgery within one year of the imaging study, of which 36(29%) underwent surgery within one month. Radiologic features that were associated with subsequent surgery included: multiple fistulae(P = 0.009), presence of stricture(P = 0.02), and an entero-vesical fistula(P = 0.01). Evidence of an abscess, lymphadenopathy, or intense bowel enhancement as well as C-reactive protein levels was not associated with an increased rate of surgery. Patients who were treated after the imaging study with combination immunomodulatory and anti-TNF therapy had significantly lower rates of surgery(P = 0.01). In the multivariate analysis, presence of a stricture [RR 4.5(1.23-16.3), P = 0.02] was the only factor that increased surgery *** A bowel stricture is the only factor predicting an increased rate of surgery. Radiological parameters may guide in selecting treatment options in patients with fistulizing CD.

关键词： Crohn’s disease Fistula Cross-sectional imaging Intra-abdominal surgery Magnetic resonance imaging Computed tomography-scan

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Five years of fecal microbiota transplantation-an update of the israeli experience

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World Journal of Gastroenterology 2018年第47期24卷 5403-5414页

作者： Sharon A Greenberg Ilan Youngster Nathaniel A Cohen Dan M Livovsky Jacob Strahilevitz eran israeli Ehud Melzer Kalman Paz Naomi Fliss-Isakov Nitsan Maharshak Department of Gastroenterology and Liver Diseases Tel Aviv Sourasky Medical Centeraffiliated with the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 6423906Israel Bacteriotherapy Clinic Tel Aviv Sourasky Medical Centeraffiliated with the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 6423906Israel Assaf Harofe Medical Center Zerifin 70300Israel Digestive Diseases Institute Shaare Zedek Medical CenterJerusalem 91031Israel Department of Clinical Microbiology and Infectious Diseases Hadassah-Hebrew UniversityJerusalem 91120Israel Department of Gastroenterology and Liver Diseases Hadassah-Hebrew UniversityJerusalem 91120Israel Gastrointestinal and Liver Diseases Institute Kaplan Medical CenterRehovot 76100Israel

AIM To evaluate and describe the efficacy of fecal microbiota transplantation(FMT) for Clostridium difficile infection(CDI) in a national israeli *** All patients who received FMT for recurrent(recurrence within 8 wk of the previous treatment) or refractory CDI from 2013 through 2017 in all the five medical centers in Israel currently performing FMT were included. Stool donors were screened according to the israeli Ministry of Health guidelines. Clinical and laboratory data of patients were collected from patients' medical files, and they included indications for FMT, risk factors for CDI and disease severity. Primary outcome was FMT success(at least 2 mo free of CDI-related diarrhea post-FMT). Secondary outcomes included initial response to FMT(cessation of diarrhea within 7 d) and recurrence at 6 *** There were 111 FMTs for CDI, with a median age of 70 years [interquartile range(IQR): 53-82], and 42%(47) males. Fifty patients(45%) were treated via the lower gastrointestinal(LGI, represented only by colonoscopy) route, 37(33%) via capsules, and 24(22%) via the upper gastrointestinal(UGI) route. The overall success rate was 87.4%(97 patients), with no significant difference between routes of administration(P = 0.338). In the univariant analysis, FMT success correlated with milder disease(P = 0.01), ambulatory setting(P < 0.05) and lower Charlson comorbidity score(P < 0.05). In the multivariant analysis, only severe CDI [odd ratio(OR) = 0.14, P < 0.05] and inpatient FMT(OR = 0.19, P < 0.05) were each independently inversely related to FMT success. There were 35(32%) patients younger than 60 years of age, and 14(40%) of them had a background of inflammatory bowel *** FMT is a safe and effective treatment for CDI, with capsules emerging as a successful and well-tolerated route. Severe CDI is less likely to respond to FMT.

关键词： Clostridium difficile infection Capsules Israel Fecal microbiota transplantation

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Oral immune regulation using colitis extracted proteins for treatment of Crohn's disease: Results of a phase Ⅰ clinical trial

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World Journal of Gastroenterology 2005年第20期11卷 3105-3111页

作者： eran israeli eran Goldin Oren Shibolet Athalia Klein Nilla Hemed Dean Engelhardt Elazar Rabbani Yaron Ilan Gastroenterology and Liver Units Department of Medicine Hebrew University-Hadassah Medical Center Jerusalem Israel Enzo Biochem New York NY USA

AIM: To evaluate safety and possible efficacy of induction of oral immune regulation using colitis extracted proteins (CEP) in Crohn's disease (CD) subjects. METHODS: Ten CDs were treated orally with autologous CEP thrice weekly for 16 wk. Subjects were monitored for CDAI and IBDQ. Immune modulatory effect was assessed by T-lymphocyte FACS analysis, CEP-specific IFNγ ELISPOT assay and cytokine levels. RESULTS: Induction of oral immune regulation significantly ameliorated disease activity. All (10/10) subjects had clinical response (CDAI≤70) and 7/10 achieved clinical remission (CDAI≤150). Significant increase in mean IBDQ score was noted (134±9 vs 164±12). No treatment-related adverse events were noted. High levels of CEP-specific IFNγ spot forming colonies were detected in five subjects prior to treatment and in all five, a marked decrease was observed. The CD4+/CD8+ lymphocyte ratio and peripheral NKT cell numbers increased significantly, in 7/10 and in 5/10 subjects, respectively. Significant increase in serum IL-10 and IL-4 levels was observed in 7/10 subjects during treatment period. CONCLUSION: Immune regulation via oral administration of CEP is a safe and possibly effective treatment for subjects with moderate CD and may provide means of antigen-specific immune modulation.

关键词： Crohn's disease Colitis extracted proteins

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Enigma of primary aortoduodenal fistula

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World Journal of Gastroenterology 2009年第25期15卷 3191-3193页

作者： Miklosh Bala Jacob Sosna Liat Appelbaum eran israeli Avraham I Rivkind Department of General Surgery and Trauma Unit Hadassah-Hebrew University Medical Center Department of Radiology Hadassah-Hebrew University Medical Center Department of Gastroenterology Hadassah-Hebrew University Medical Center

A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.

关键词： Aortoduodenal fistula Gastrointestinal hemorrhage Computed tomography Aortography

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Genetic analysis of four consanguineous multiplex families with inflammatory bowel disease

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Gastroenterology Report 2021年第6期9卷 521-532页

作者： Noam Ben-Yosef Matthew Frampton Elena RSchiff Saleh Daher Fadi Abu Baker Rifaat Safadi eran israeli Anthony W.Segal Adam P.Levine Centre for Molecular Medicine Division of MedicineUniversity College LondonLondonUK Institute of Gastroenterology and Liver disease Hadassah Medical CenterJerusalemIsrael Institute of Ophthalmology Moorfields Eye HospitalUniversity College LondonLondonUK Institue of Gastroenterology and Hepatology Hillel Yaffe Medical CenterHaderaIsrael Institute of Gastroenterology and Liver disease E.Wolfson Medical CenterHolonIsrael Department of Pathology University College LondonLondonUK

Background:Family studies support a genetic predisposition to inflammatory bowel diseases(IBD),but known genetic variants only partially explain the disease *** withmultiple affected individuals potentially harbour rare and highimpact causal *** regions of homozygosity due to recent inbreedingmay increase the risk of individuals bearing homozygous loss-of-function *** study aimed to identify rare and homozygous genetic variants contributing to ***:Four families with known consanguinity and multiple cases of IBD were *** a family-specific analysis,we utilised homozygosity mapping complemented by whole-exome ***:We detected a single region of homozygosity shared by Crohn’s disease cases from a family of Druze ancestry,spanning 2.6Mb containing the NOD2 ***-exome sequencing did not identify any potentially damaging variants within the region,suggesting that non-coding variation may be *** addition,affected individuals in the families harboured several rare and potentially damaging homozygous variants in genes with a role in autophagy and innate immunity including LRRK1,WHAMM,DENND3,and ***:This study examined the potential contribution of rare,high-impact homozygous variants in consanguineous families with *** the analysis was not designed to achieve statistical significance,our findings highlight genes or loci that warrant further ***-coding variants affecting NOD2 may be of importance in Druze patients with Crohn’s disease.

关键词： inflammatory bowel disease family study genetics homozygosity

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Inflammatory bowel disease patient profiles are related to specific information needs: A nationwide survey

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World Journal of Gastroenterology 2019年第30期25卷 4246-4260页

作者： Saleh Daher Tawfik Khoury Ariel Benson John R Walker Oded Hammerman Ron Kedem Timna Naftali Rami Eliakim Ofer Ben-Bassat Charles N Bernstein eran israeli Institute of Gastroenterology and Liver Diseases Hadassah-Hebrew University Medical CenterJerusalem 91120Israel Department of Gastroenterology Galilee Medical CenterFaculty of Medicine in the GalileeBar-Ilan UniversityNahariya 22100Israel IBD Clinical and Research Centre University of ManitobaWinnipegMB R3E3P4Canada Research Branch IDF Medical CorpsTel-HashomerRamat Gan 52630Israel Institute of Gastroenterology Meir Medical CenterKfar-saba 4428164Israel Sackler School of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel Institute of Gastroenterology Sheba Medical CenterRamat-Gan 52630Israel Institute of Gastroenterology Rabin Medical CenterPetach-Tikva 49100Israel

BACKGROUND Inflammatory bowel diseases(IBD) is a heterogenous, lifelong disease, with an unpredictable and potentially progressive course, that may impose negative psychosocial impact on *** informed patients with chronic illness have improved adherence and outcomes, previous research showed that the majority of IBD patients receive insufficient information regarding their *** large heterogeneity of IBD and the wide range of information topics makes a one-size fits all knowledge resource overwhelming and *** hypothesized that different patient profiles may have different and specific information needs, the identification of which will allow building personalized computer-based information resources in the *** To evaluate the scope of disease-related knowledge among IBD patients and determine whether different patient profiles drive unique information *** We conducted a nationwide survey addressing hospital-based IBD clinics.A Total of 571 patients completed a 28-item questionnaire, rating the amount of information received at time of diagnosis and the importance of information, as perceived by participants, for a newly diagnosed patient, and for the participants themselves, at current *** performed an exploratory factor analysis of the crude responses aiming to create a number of representative knowledge domains(factors), and analyzed the responses of a set of 15 real-life patient profiles generated by the study *** Participants gave low ratings for the amount of information received at disease onset(averaging 0.9/5) and high ratings for importance, both for the newly diagnosed patients(mean 4.2/5) and for the participants themselves at current time(mean 3.5/5).Factor analysis grouped responses into six *** responses of selected profiles, compared with the rest of the participants, yielded significant associations(defined as a difference in rating of >0.5 points with a P < 0.05).Patients w

关键词： Inflammatory bowel diseases Information needs Patient education Knowledge resources Patient profiles

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Navigating the pathways:TAR-DNA-binding-protein-43 aggregation,axonal transport,and local synthesis in amyotrophic lateral sclerosis pathology

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Neural Regeneration Research 2025年第10期20卷 2921-2922页

作者： Ori Bar Avi eran Perlson Department of Physiology and Pharmacology Faculty of Medical&Health ScienceTel-Aviv UniversityTel-AvivIsrael Sagol School of Neuroscience Tel-Aviv UniversityTel-AvivIsrael

Neurons are highly polarized cells with axons reaching over a meter long in adult *** survive and maintain their proper function,neurons depend on specific mechanisms that regulate spatiotemporal signaling and metabolic events,which need to be carried out at the right place,time,and *** mechanisms include axonal transport,local synthesis,and liquid-liquid phase *** and malfunctions in these processes are correlated to neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS).

关键词： synthesis local aggregation

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Oral mixture of autologous colon-extracted proteins for the Crohn's disease: A double-blind trial

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World Journal of Gastroenterology 2015年第18期21卷 5685-5694页

作者： eran israeli Ehud Zigmond Gadi Lalazar Athalia Klein Nilla Hemed eran Goldin Yaron Ilan Gastroenterology and Liver Units Department of Medicine Hebrew University-Hadassah Medical Center IL 91120 Jerusalem Israel

AIM: To evaluate the safety and efficacy of oral administration of AlequelTM, an autologous proteincontaining colon extract.a randomized,placebo-controlled,double-blind *** were orally administered with autologous protein-containing colon extract three doses of autologous study drug per week for 15 wk,for a total of45 *** were followed for safety *** was defined as a Crohn’s disease activity index(CDAI)score of less than or equal to *** patients were followed for changes in subsets of T cells by fluorescence-activated cell sorting ***:Analysis was performed on a total number of evaluable patients of 14 in the study drug group and15 in the placebo *** was well tolerated by all *** major treatment-related adverse events were reported or observed in any of the treated patients during the feeding or follow-up *** weeks 6 and 9 of the study,six of the 14(43%)evaluable subjects who received the study drug achieved a CDAI of 150 or *** contrast,five of the 15(33%)evaluable subjects in the placebo group achieved *** weeks 9 and 12,the remission rates were 50%and 33%for the drug group and placebo group,*** the drug-treated subjects who achieved remission,the effect of the drug was judged as stable in eight of the 14 subjects as measured by at least two CDAI scores indicating remission in the 15-wk treatment period.A decreased percentage of peripheral natural killer T regulatory cells(a decrease of 28%vs an increase of 16%)and an increased ratio of CD4+/CD8+T lymphocytes(an increase of 11%vs a decrease of9%)were noted in subjects with a significant clinical ***:Oral administration of the autologous colonic extract could be a safe and effective for the treatment of patients with moderate to severe Crohn’s disease.

关键词： Oral tolerance Crohn’s disease Natural killer T cells Immune modulation

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Circumventing the phonon bottleneck by multiphonon-mediated hot exciton cooling at the nanoscale

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npj Computational Materials 2023年第1期9卷 845-852页

作者： Dipti Jasrasaria eran Rabani Department of Chemistry University of CaliforniaBerkeleyCA 94720USA Materials Sciences Division Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA The Sackler Center for Computational Molecular and Materials Science Tel Aviv UniversityTel Aviv 69978Israel Present address:Department of Chemistry Columbia UniversityNew YorkNY 10027USA

Nonradiative processes govern efficiencies of semiconductor nanocrystal(NC)-based devices.A central process is hot exciton cooling,or the nonradiative relaxation of a highly excited electron/hole pair to form a band-edge *** to quantum confinement effects,the timescale and mechanism of cooling are not well understood.A mismatch between electronic energy gaps and phonon frequencies has led to the hypothesis of a phonon bottleneck and extremely slow cooling,while enhanced electron-hole interactions have suggested ultrafast *** measurements of the cooling timescale range six orders of ***,we develop an atomistic approach to describe phonon-mediated exciton dynamics and simulate cooling in NCs of experimentally relevant *** find that cooling occurs on~30 fs timescales in CdSe NCs,in agreement with the most recent measurements,and that the phonon bottleneck is circumvented through a cascade of multiphonon-mediated relaxation ***,we identify NC handles for tuning the cooling timescale.

关键词： phonon relaxation excited

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Intraspecific scaling and early life history determine the cost of free-flight in a large beetle(Batocera rufomaculata)

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Insect Science 2024年第2期31卷 524-532页

作者： Tomer Urcai eran Levin eran Gefen Gal Ribak Faculty of Life Sciences School of ZoologyTel Aviv UniversityTel AvivIsrael Steinhardt Museum of Natural History Israel National Center for Biodiversity StudiesTel AvivIsrael Department of Biology University of Haifa-OranimKiryat TivonIsrael

The scaling of the energetic cost of locomotion with body mass is well documented at the interspecific ***,methodological restrictions limit our understanding of the scaling of flight metabolic rate(MR)in free-flying *** is particularly true at the intraspecific level,where variation in body mass and flight energetics may have direct consequences for the fitness of an *** applied a 13C stable isotope method to investigate the scaling of MR with body mass during free-flight in the beetle Batocera *** species exhibits large intraspecific variation in adult body mass as a consequence of the environmental conditions during larval *** show that the flight-MR scales with body mass to the power of 0.57,with smaller conspecifics possessing up to 2.3 fold higher mass-specific flight MR than larger *** the scaling exponent of free-flight MR was found to be like that determined for tethered-flight,the energy expenditure during free-flight was more than 2.7 fold higher than for *** metabolic cost of flight should therefore be studied under free-flight conditions,a requirement now enabled by the 13C technique described herein for insect flight.

关键词： allometry body mass Coleoptera free-flight insect flight stable carbon isotope tethered-flight

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