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Gastric cancer in women: A regional health-center seven year retrospective study

World Journal of Gastroenterology 2015年第25期21卷 7805-7813页

作者： Kunal Suryawala Demiana Soliman Monica Mutyala Shaheen Nageeb Moheb Boktor Abhishek Seth Avinash Aravantagi Ankur Sheth James Morris Paul Jordan Kenneth Manas Urska Cvek Marjan Trutschl felix becker Jonathan Alexander Department of Gastroenterology and Hepatology Louisiana State University Health Sciences Center Department of Molecular and Cellular Physiology Louisiana State University Health Sciences Center Department of Computer Science LSU Shreveport and Center for Molecular and Tumor Virology Louisiana State University Health Sciences Center Department of General and Visceral Surgery University Hospital Muenster

AIM: To investigate whether regional geography influences ethnic and gender trends for the development of gastric cancer(GC).METHODS: This retrospective analysis of the INVISION patient database at Louisiana State University Health Sciences Center-Shreveport(LSUHSC-S), a southern United States regional hospital, was performed from 2005-2011. Using the international statistical classification of diseases 9(ICD-9), inpatient, day surgery outpatient, and emergency outpatient diagnosis codes entered into medical records were used to identify GC patients. For each study year, the patients were evaluated for age, ethnicity, and gender, and each patient was counted only once throughout the study. Subsequent patient encounters were counted as visits and separated by inpatient and clinic visits. Complex or severe disease may require more frequent and intensive clinical management; therefore, we evaluated annual clinic visits as "surrogate markers" of disease severity. Finally, we studied the primary diagnosis for Helicobacter pylori(H. pylori) infection(ICD-9 code 41.86) as an additional factor that might increase the risk of ***: A total of 285 patients were diagnosed with GC at LSUHSC-S between 2005 and 2011. African Americans(181 patients, 89 males and 92 females, 63.5% of total patients) had significantly higher frequencies of GC diagnosis compared with non-Hispanic whites(104 patients, 54 males and 50 females, 36.5% of total patients), at a ratio of 1.74(P = 0.002). Within each ethnic group, men and women were diagnosed at approximately equal annual rates. Our findings differed significantly from United States national trends, which found that African American females and white females had lower risks for GC than their corresponding male counterparts. The United States national trend between 2005 and 2011 showed that African Americans males had a higher incidence of GC, with an annual mean(per 100000) of 16.31 ± 0.76 compared with white males(9 ± 0.1, P < 0.001),

关键词： Gender Helicobacter pylori Ethnicity Riskfactors Health disparities

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Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2015年第4期6卷 156-171页

作者： Pegah Hosseini-Carroll Monica Mutyala Abhishek Seth Shaheen Nageeb Demiana Soliman Moheb Boktor Ankur Sheth Jonathon Chapman James Morris Paul Jordan Kenneth Manas felix becker Jonathan Steven Alexander Department of Medicine Section of Gastroenterology and Hepatology Louisiana State University Health Sciences Center Department of Molecular and Cellular Physiology Louisiana State University Health Sciences Center Digestive Health Center of Louisiana Department of General and Visceral Surgery

Inflammatory bowel diseases(IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them(both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care(particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy duringIBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become,(or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception(in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed.

关键词： Inflammatory bowel diseases Pregnancy Biologics Br

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Comparison of survival outcomes between laparoscopic versus open radical nephroureterectomy in upper tract urothelial cancer patients:Experiences of a tertiary care single center

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Current Urology 2023年第4期17卷 292-298页

作者： Benedikt Hoeh Marina Kosiba Mike Wenzel Nicola Meister felix Preisser Shahrokh F.Shariat Jan Lukas Hohenhorst Andreas becker Philipp Mandel Severine Banek Frederik Roos Pierre I.Karakiewicz felix K.H.Chun Luis A.Kluth Department of Urology University Hospital FrankfurtGoethe University Frankfurt am MainFrankfurt am Main60590Germany Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity of Montreal Health CenterMontrealQuebecCanada Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan Martini-Klinik Prostate Cancer Center University Hospital Hamburg-EppendorfHamburgGermany

Objectives:To test for differences in overall and recurrence-free survival between laparoscopic and open surgical approaches in patients undergoing radical nephroureterectomy(RNU)for upper tract urothelial carcinoma(UTUC).Materials and methods:We retrospectively identified patients treated for UTUC from 2010 to 2020 from our institutional *** undergoing laparoscopic or open RNU with no suspicion of metastasis(cM0)were for the current study *** with suspected metastases at diagnosis(cM1)or those undergoing other surgical treatments were *** was performed according to the laparoscopic versus open surgical ***-Meier plots were used to test for differences in overall and recurrence-free survival with regard to the surgical ***,separate Kaplan-Meier plots were used to test the effect of preoperative ureterorenoscopy on overall and recurrence-free survival within the overall study ***:Of the 59 patients who underwent nephroureterectomy,29%(n=17)underwent laparoscopic nephroureterectomy,whereas 71%(n=42)underwent open *** and tumor characteristics were comparable between groups(p≥0.2).The median overall survival was 93 and 73 months in the laparoscopic nephroureterectomy group compared to the open nephroureterectomy group(p=0.5),*** median recurrence-free survival did not differ between open and laparoscopic nephroureterectomies(73 months for both groups;p=0.9).Furthermore,the median overall and recurrence-free survival rates did not differ between patients treated with and without preoperative ***:The results of this retrospective,single-center institution showed that overall and recurrence-free survival rates did not differ between patients with UTUC treated with laparoscopic and open ***,preoperative ureterorenoscopy before RNU was not associated with higher overall or recurrence-free survival rates.

关键词： Upper tract urothelial carcinoma Laparoscopic radical nephroureterectomy Open radical nephroureterectomy Overall survival

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Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: A case report

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World Journal of Gastroenterology 2005年第31期11卷 4923-4926页

作者： Gerhild becker felix Momm Henning Schwacha Norbert Hodapp Henning Usadel Michael GeiBler Annette Barke Annette Schmitt-Gr(a|¨)ff Karl Henne Hubert E. Blum Department of Medicine Ⅱ Department of Radiotherapy Institute of Pathology

In view of the poor prognosis of patients with cholangiocarcinoma （CCC）, there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC （Klatskin tumors） if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disdplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy （3×4 Gy/wk） was administered. Therapy was well tolerated. After 32 too, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.

关键词： Klatskin tumor Stereotactic radiotherapy Inter-disciplinary treatment

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