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Safety of endoscopy in patients undergoing treatments with antiangiogenic agents: A 5-year retrospective review

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World Journal of Gastrointestinal Endoscopy 2022年第7期14卷 416-423页

作者： Mohammad Azam Amit Hudgi Pearl Princess Uy Jinal Makhija john erikson l yap Department of Internal Medicine Medical College of Georgia/Augusta UniversityAugustaGA 30912United States Division of Gastroenterology Medical College of Georgia/Augusta UniversityAugustaGA 30912United States Department of Internal Medicine Rush University Medical CenterChicagoIL 60612United States

BACKGROUND Antiangiogenic agents(AAs)are increasingly used to treat malignant tumors and have been associated with gastrointestinal(GI)bleeding and *** surgeries and endoscopy are recommended to be delayed for 31 d until after AAs *** regarding the safety of endoscopy while on antiangiogenic agents is extremely *** guidelines are in place to address the concern about withholding these anti-angiogenic *** To evaluate the risks of endoscopy in patients on antiangiogenic agents from 2015 to 2020 at our *** This is a single centered retrospective study approved by the institutional review board statement of the *** that underwent endoscopy within 28 d of antiangiogenic agents’treatment were included in the *** outcome of interest was death,and secondary outcomes included perforation and GI *** were analyzed utilizing descriptive ***-nine patients were included in the final analysis and a total of eighty-five procedures were performed that were characterized as low risk and high *** Among the 59 patients a total of 85 endoscopic procedures were performed with 24(28.2%)categorized as high-risk and 61(71.8%)procedures as *** the total number of patients,(50%)were on bevacizumab and the rest were on imatinib(11.7%),lenvatinib(6.7%)and,ramucirumab(5%).The average duration between administration of AAs and the performance of endoscopic procedures was 9.9 *** procedure-related adverse events were noted among our study *** did observe two deaths with one patient,on lenvatinib for metastatic hepatocellular carcinoma,who had persistent bleeding despite esophageal variceal banding and died 4 d later from hemorrhagic *** patient was diagnosed with acute myeloid leukemia died 24 d after an esophagogastroduodenoscopy with biopsy after transition to comfort *** As per this single center retrospective study,the rate of endoscopic p

关键词： Antiangiogenics Endoscopy Bevacizumab lmatinib lenvatinib Adverse events

Safety of upper endoscopy in patients with active cocaine use

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World Journal of Gastrointestinal Endoscopy 2021年第10期13卷 510-517页

作者： Anabel liyen Cartelle Alexander Nguyen Parth M Desai Vikram Kotwal Jinal Makhija Jie Yu john erikson l yap Department of Medicine Beth Israel Deaconess HospitalBostonMA 02215United States Division of Gastroenterology and Hepatology John H.StrogerJr.Hospital of Cook CountyChicagoIL 60612United States Internal Medicine John H.StrogerJr.Hospital of Cook CountyChicagoIL 60612United States Division of Digestive Diseases Rush UniversityChicagoIL 60612United States Division of Infectious Diseases Rush UniversityChicagoIL 60612United States Division of Gastroenterology and Hepatology Augusta UniversityAugustaGA 30912United States

BACKGROUND Cocaine is a synthetic alkaloid initially viewed as a useful local anesthetic,but which eventually fell out of favor given its high addiction *** predominantly sympathetic effects raise concern for cardiovascular,respiratory,and central nervous system complications in patients undergoing *** cocaine use,often detected via a positive urine toxicology test,has been mostly addressed in the surgical and obstetrical ***,there are no clear guidelines on how to effectively risk stratify patients found to be positive for cocaine in the pre-operative setting,often leading to costly procedure *** the field of gastroenterology,there is no current data available regarding safety of performing esophagogastroduodenoscopy(EGD)in patients with recent cocaine *** To compare the prevalence of EGD related complications between active(≤5 d)and remote(>5 d)users of *** In total,48 patients who underwent an EGD at john ***,*** of Cook County from October 2016 to October 2018 were found to have a positive urine drug screen for cocaine(23 recent and 25 remote).Descriptive statistics were compiled for patient *** tests used to analyze patient characteristics,procedure details,and preprocedural adverse events included ttest,chi-square,Wilcoxon rank sum,and Fisher exact *** Overall,20 periprocedural events were recorded with no statistically significant difference in distribution between the two groups(12 active vs 8 remote,P=0.09).Pre-and post-procedure hemodynamics demonstrated only a statistically,but not clinically significant drop in systolic blood pressure and increase in heart rate in the active user group,as well as drop in diastolic blood pressure and oxygen saturation in the remote group(Pll hemodynamics between both *** Our study found no significant difference in the rate of peripro

关键词： Gastrointestinal endoscopy Cocaine-related disorders General anesthesia Risk factors local anesthetics Retrospective studies

0.9% saline is neither normal nor physiological

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2016年第3期17卷 181-187页

作者： Heng lI Shi-ren SUN john Q.yap Jiang-hua CHEN Qi QIAN Kidney Disease Center the First Affiliated HospitalSchool of MedicineZhejiang University Division of Nephrology Xijing HospitalFourth Military University College of Medicine Department of Physiology and Biomedical Engineering Mayo Clinic College of Medicine Division of Nephrology and Hypertension Department of MedicineMayo Clinic College of Medicine

The purpose of this review is to objectively evaluate the biochemical and pathophysiological properties of 0.9% saline （henceforth： saline） and to discuss the impact of saline infusion, specifically on systemic acid-base bal- ance and renal hemodynamics. Studies have shown that electrolyte balance, including effects of saline infusion on serum electrolytes, is often poorly understood among practicing physicians and inappropriate saline prescribing can cause increased morbidity and mortality. large-volume （〉2 l） saline infusion in healthy adults induces hyperohloremia which is associated with metabolic acidosis, hyperkalemia, and negative protein balance. Saline overload （80 ml/kg） in rodents can cause intestinal edema and contractile dysfunction associated with activation of sodium-proton exchanger （NHE） and decrease in myosin light chain phosphorylation. Saline infusion can also adversely affect renal hemody- namics. Microperfusion experiments and real-time imaging studies have demonstrated a reduction in renal perfusion and an expansion in kidney volume, compromising 02 delivery to the renal perenchyma following saline infusion. Clinically, saline infusion for patients post abdominal and cardiovascular surgery is associated with a greater number of adverse effects including more frequent blood product transfusion and bicarbonate therapy, reduced gastric blood flow, delayed recovery of gut function, impaired cardiac contractility in response to inotropes, prolonged hospital stay, and possibly increased mortality. In critically ill patients, saline infusion, compared to balanced fluid infusions, in- creases the occurrence of acute kidney injury. In summary, saline is a highly acidic fluid. With the exception of saline infusion for patients with hypochloremic metabolic alkalosis and volume depletion due to vomiting or upper gastroin- testinal suction, indiscriminate use, especially for acutely ill patients, may cause unnecessary complications and should be avoided. M

关键词： 0.9% saline Hyperchloremia Acidosis Hyperkalemia Balanced fluids Renal hemodynamics

The molecular conformation of silk fibroin regulates osteogenic cell behavior by modulating the stability of the adsorbed protein-material interface

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Bone Research 2021年第2期9卷 188-199页

作者： Yanlin long Xian Cheng john A.Jansen Sander G.C.leeuwenburgh Jing Mao Fang Yang lili Chen Department of Stomatology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Hubei Province Key laboratory of Oral and Maxillofacial Development and Regeneration Wuhan 430022China Department of Dentistry–Biomaterials Radboud University Medical CenterPhilips van Leydenlaan 256525 EX NijmegenThe Netherlands Center of Stomatology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Silk fibroin(SF)can be used to construct various stiff material interfaces to support bone *** essential preparatory step is to partially transform SF molecules from random coils toβ-sheets to render the material water ***,the influence of the SF conformation on osteogenic cell behavior at the material interface remains ***,three stiff SF substrates were prepared by varying theβ-sheet content(high,medium,and low).The substrates had a comparable chemical composition,surface topography,and *** adsorbed fibronectin was used as a model cellular adhesive protein,the stability of the adsorbed protein-material interface,in terms of the surface stability of the SF substrates and the accompanying fibronectin detachment resistance,increased with the increasingβ-sheet content of the SF ***,(i)larger areas of cytoskeleton-associated focal adhesions,(ii)higher orders of cytoskeletal organization and(iii)more elongated cell spreading were observed for bone marrow-derived mesenchymal stromal cells(BMSCs)cultured on SF substrates with high ***β-sheet contents,along with enhanced nuclear translocation and activation of yap/TAZ and ***,osteogenic differentiation of BMSCs was stimulated on highβ-sheet *** results indicated that theβ-sheet content influences osteogenic differentiation of BMSCs on SF materials in vitro by modulating the stability of the adsorbed protein-material interface,which proceeds via protein-focal adhesion-cytoskeleton links and subsequent intracellular *** findings emphasize the role of the stability of the adsorbed protein-material interface in cellular mechanotransduction and the perception of stiff SF substrates with differentβ-sheet contents,which should not be overlooked when engineering stiff biomaterials.

关键词： interface stability adsorbed

Interaction between age and gender on survival outcomes in extramedullary multiple myeloma over the past two decades

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World Journal of Clinical Oncology 2023年第4期14卷 179-189页

作者： Ayrton I Bangolo Pierre Fwelo Chinmay Trivedi Sowmya Sagireddy Hamed Aljanaahi Auda Auda Maryama Mohamed Sonia Onyeka Miriam Fisher Jyoti Thapa Erwin J Tabucanon lyuben Georgiev Annetta Wishart Shilpee Kumari Conrad erikson Mary Bangura Orent Paddy Rashmi Madhukar Eugenio l Gomez Joshua Rathod Mansi Naria Basel Hajal Mohammad Awadhalla David Siegel Harsh Parmar Noa Biran David H Vesole Pooja Phull Simcha Weissman Department of Medicine Palisades Medical CenterNorth BergenNJ 07047United States Department of Epidemiology Human Geneticsand Environmental SciencesUTHealth School of Public HealthHoustonTX 77204United States Division of Myeloma John Theurer Cancer CenterHackensackNJ 07601United States

BACKGROUND Extramedullary multiple myeloma(MM)(EMM)is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease *** is a paucity of data on the clinical characteristics and overall epidemiology of ***,there is a scarcity of data on how the interaction of age and gender influences the survival of *** To evaluate the clinical characteristics of patients with EMM over the past 2 decades and to identify epidemiologic characteristics that may impact overall *** A total of 858 patients diagnosed with EMM,between 2000 and 2017,were ultimately enrolled in our study by retrieving the Surveillance,Epidemiology,and End Results *** analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of *** with a P valueltivariate Cox model to determine the independent prognostic factors,with a hazard ratio(HR)of greater than 1 representing adverse prognostic *** From a sample of 858 EMM,the male gender(63.25%),age range 60-79 years(51.05%),and non-Hispanic whites(66.78%)were the most *** Nervous System and the vertebral column was the most affected site(33.10%).Crude analysis revealed higher OM in the age group 80+[HR=6.951,95%confidence interval(95%CI):3.299-14.647,P=0],Non-Hispanic Black population(HR=1.339,95%CI:1.02-1.759,P=0.036),Bones not otherwise specified(NOS)(HR=1.74,95%CI:1.043-2.902,P=0.034),and widowed individuals(HR=2.107,95%CI:1.511-2.938,P=0).Skin involvement(HR=0.241,95%CI:0.06-0.974,P=0.046)and a yearly income of$75000+(HR=0.259,95%CI:0.125-0.538,P=0)had the lowest OM in the crude *** analysis revealed higher CSM in the age group 80+,Non-Hispanic Black,Bones NOS,and *** cox proportional hazard regression analyses only revealed higher OM in the age group 80+(HR=9.792,95%CI:4.403-21.774,P=0)

关键词： Multiple myeloma Age Gender Mortality Plasmacytoma

Reprogramming of ovarian granulosa cells by yap1 leads to development of high-grade cancer with mesenchymal lineage and serous features

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Science Bulletin 2020年第15期65卷 1281-1296,M0004页

作者： Xiangmin lv Chunbo He Cong Huang Guohua Hua Xingcheng Chen Barbara K.Timm Victoria M.Maclin Abigail A.Haggerty Shelly K.Aust Denae M.Golden Bhavana J.Dave Yun-An Tseng li Chen Hongbo Wang Peichao Chen David l.Klinkebiel Adam R.Karpf Jixin Dong Ronny I.Drapkin Bo R.Rueda john S.Davis Cheng Wang Vincent Center for Reproductive Biology Department of Obstetrics and GynecologyMassachusetts General HospitalHarvard Medical SchoolBostonMA 02114USA Olson Center for Women's Health Department of Obstetrics and GynecologyUniversity of Nebraska Medical CenterOmahaNE 68198USA College of Animal Sciences and Veterinary Medicine Huazhong Agricultural UniversityWuhan 470000China Fred&Pamela Buffett Cancer Center University of Nebraska Medical CenterOmahaNE 68198USA Department of Pathology and Microbiology.University of Nebraska Medical Center OmahaNE 68198USA Heartland Center for Reproductive Medicine OmahaNE 68198USA Munroe-Meyer Institute University of Nebraska Medical CenterOmahaNE 68198USA Key laboratory of Animal Ecology and Conservation Biology Institute of ZoologyChinese Academy of SciencesBeijing 100101China College of life and Environmental Science Wenzhou UniversityWenzhou 325035China Biochemistry and Molecular Biology University of Nebraska Medical CenterOmahaNE 68198USA Department of Obstetrics and Gynecology University of PennsylvaniaPhiladelphiaPA 19104USA

Understanding the cell-of-origin of ovarian high grade serous cancer(HGSC)is the prerequisite for efficient prevention and early diagnosis of this most lethal gynecological ***,a mesenchymal type of ovarian HGSC with the poorest prognosis among ovarian cancers was identified by both TCGA and AOCS *** cell-of-origin of this subtype of ovarian cancer is *** pursuing studies to understand the role of the Hippo pathway in ovarian granulosa cell physiology and pathology,we unexpectedly found that the Yes-associated protein 1(yap1),the major effector of the Hippo signaling pathway,induced dedifferentiation and reprogramming of the ovarian granulosa cells,a unique type of ovarian follicular cells with mesenchymal lineage and high plasticity,leading to the development of high grade ovarian cancer with serous *** research results unveil a potential cell-of-origin for a subtype of HGSC with mesenchymal features.

关键词： Ovarian granulosa cells Cell reprogramming Cell dedifferentiation The Hippo pathway yap1 oncogene Mesenchymal type of high grade serous cancer