检索结果-南通市图书馆

Perspectives of physicians regarding screening patients at risk of hepatocellular carcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第3期4卷 237-240,I0003页

作者： Shishira Bharadwaj Tushar D gohel Department of Gastroenterology/Hepatology the Cleveland Clinic FoundationClevelandOhioUSA

Background and aims:Screening patients at risk for hepatocellular carcinoma(HCC)facilitates early detection of disease,with improved *** most common causes of HCC include chronic viral hepatitis infection—namely hepatitis B,hepatitis C,and *** aim of this study was to assess the awareness of screening among physicians involved in the management of patients at risk for ***:Three hundred physicians from three academic centers were invited to participate in a mailed survey *** main outcome measure was physicians’knowledge of the current HCC screening *** and clinical variables were obtained from the survey ***:A total of 177(59.0%)out of the 300 invited physicians responded to the survey questionnaire,including faculty members(n=129),residents(n=46),and fellows(n=2).The specialty areas of the responding physicians were internal medicine(62.1%),family medicine(16.4%),gastroenterology(15.3%),oncology(3.4%)and others(2.8%).The number of physicians who performed HCC screening in patients with cirrhosis secondary to chronic hepatitis B and chronic hepatitis C infection were 163(92.1%)and 167(94.4%),respectively;35.0%of them used alpha-fetoprotein(AFP)every 6 months,while 22.0%used imaging modalities every 6 months to screen for ***,22 physicians(12.4%)did not check for serum AFP levels and 33(18.6%)never used imaging to screen for ***:The majority of the participating physicians screen high-risk patients for ***,the most appropriate modality of screening(***)is not employed by most physicians and there is greater reliance on AFP levels.

关键词： hepatocellular carcinoma screening chronic liver disease cirrhosis

Thermophysical properties of iridium at finite temperature

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Physics B 2016年第11期25卷 404-411页

作者： Priyank Kumar N K Bhatt P R Vyas V B gohel Department of Science Government PolytechnicGandhinagar Department of Physics Sardar Patel University Department of Physics School of Science Gujarat University

The bulk properties of materials in an extreme environment such as high temperature and high pressure can be understood by studying anharmonic effects due to the vibration of lattice ions and thermally excited *** this spirit,in the present paper,anharmonic effects are studied by using the recently proposed mean-field potential（MFP） approach and Mermin functional which arise due to the vibration of lattice ions and thermally excited electrons,*** MFP experienced by a wanderer atom in the presence of surrounding atoms is constructed in terms of cold energy using the local form of the *** have calculated the temperature variation of several thermophysical properties in an extreme environment up to melting *** results of our calculations are in excellent agreement with the experimental findings as well as the theoretical results obtained by using first principle *** conclude that presently used conjunction scheme（MFP＋pseudo potential） is simple computationally,transparent physically,and accurate in the sense that the results generated are comparable and sometimes better than the results obtained by first principle *** pseudopotential used is transferable to extreme environment without adjusting its parameters.

关键词： extreme experienced melting presently excited thermally sometimes understood comparable conclude

Cutis laxa presenting as recurrent ileus

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第1期4卷 77-79,I0003页

作者： Shishira Bharadwaj Prakash Shrestha Tushar D.gohel Maninder Singh Department of Gastroenterology/Hepatology The Cleveland Clinic FoundationClevelandOHUSA Department of Internal Medicine Guthrie/Robert Packer HospitalSayrePAUSA

Cutis laxa(CL)is a rare connective tissue disorder characterized by phenotypic appearance of loose and redundant *** can be congenital or *** forms include autosomal dominant,autosomal recessive and X-linked *** from cutaneous abnormalities,CL can present with visceral *** this article,we report a case of CL presenting as recurrent ileus.

关键词： Cutis Laxa Gastro-intestinal Symptoms Ileus

Fish oil-based lipid emulsion:current updates on a promising novel therapy for the management of parenteral nutrition-associated liver disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2015年第2期3卷 110-114页

作者： Shishira Bharadwaj Tushar gohel Omer J.Deen Robert DeChicco Abdullah Shatnawei Center for Human Nutrition Department of Gastroenterology/HepatologyThe Cleveland Clinic FoundationClevelandOHUSA

Intestinal failure is characterized by loss of enteral function to absorb necessary nutrients and water to sustain *** nutrition(PN)is a lifesaving therapeutic modality for patients with intestinal *** PN is also needed for patients who have short bowel syndrome due to extensive resection or a dysmotility disorder with ***,prolonged PN is associated with short-term and long-term *** nutrition-associated liver disease(PNALD)is one of the long-termcomplications associated with the use of an intravenous lipid emulsion to prevent essential fatty acid deficiency in these *** affects 30–60%of the adult population on long-term ***,PNALD is one of the indications for isolated liver or combined liver and intestinal *** is no consensus on how to manage PNALD,but fish oil-based lipid emulsion(FOBLE)has been suggested to play an important role both in its prevention and *** is significant improvement in liver function in those who received FOBLE as lipid supplement compared with those who received soy-based lipid *** have also demonstrated that FOBLE reverses hepatic steatosis and reduces markers of inflammation in patients on long-term *** prospective studies with larger sample sizes are needed to further strengthen the positive role of FOBLE in PNALD.

关键词： intestinal failure parenteral nutrition parenteral nutrition-associated liver disease fish oil-based lipid emulsion

Malnutrition:laboratory markers vs nutritional assessment

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第4期4卷 272-280,I0001页

作者： Shishira Bharadwaj Shaiva Ginoya Parul Tandon Tushar D.gohel John Guirguis Hiren Vallabh Andrea Jevenn Ibrahim Hanouneh Department of Gastroenterology/Hepatology McMaster UniversityHamiltonOntarioCanada Department of Gastroenterology/Hepatology Cleveland ClinicClevelandOHUSA

Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcarerelated ***,a major dilemma exists due to lack of a unified definition for the ***,there are no standard methods for screening and diagnosing patients with malnutrition,leading to confusion and varying practices among physicians across the *** role of inflammation as a risk factor for malnutrition has also been recently ***,serum proteins such as albumin and prealbumin(PAB)have been widely used by physicians to determine patient nutritional ***,recent focus has been on an appropriate nutrition-focused physical examination(NFPE)for diagnosing *** current consensus is that laboratory markers are not reliable by themselves but could be used as a complement to a thorough physical *** studies are needed to identify serum biomarkers in order to diagnose malnutrition unaffected by inflammatory states and have the advantage of being noninvasive and relatively ***,a thorough NFPE has an unprecedented role in diagnosing malnutrition.

关键词： malnutrition physical examination serum markers

Test-Retest Reliability of Functional Magnetic Resonance Imaging Activation for a Vergence Eye Movement Task

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Neuroscience Bulletin 2020年第5期36卷 506-518页

作者： Cristian Morales Suril gohel Xiaobo Li Mitchell Scheiman Bharat B.Biswal Elio M.Santos Chang Yaramothu Tara L.Alvarez Biomedical Engineering New Jersey Institute of TechnologyNewarkNJ 07102USA Pennsylvania College of Optometry Salus UniversityPhiladelphiaPA 19027USA Department of Health Informatics Rutgers University School of Health ProfessionsNewarkNJ 07107USA

Vergence eye movements are the inward and outward rotation of the eyes responsible for binocular *** studies have mapped and investigated the neural substrates of vergence,it is not well understood whether vergence eye movements evoke the blood oxygen level-dependent signal reliably in separate experimental *** test-retest reliability of stimulus-induced vergence eye movement tasks during a functional magnetic resonance imaging(fMRI)experiment is important for future randomized clinical trials(RCTs).In this study,we established region of interest(ROI)masks for the vergence neural ***-seven binocularly normal young adults participated in two functional imaging sessions measured on different days on the same 3 T Siemens *** fMRI experiments used a block design of sustained visual fixation and rest blocks interleaved between task blocks that stimulated eight or four vergence eye *** test-retest reliability of task-activation was assessed using the intraclass correlation coefficient(ICC),and that of spatial extent was assessed using the Dice *** activation during the vergence eye movement task of eight movements compared to rest was repeatable within the primary visual cortex(ICC=0.8),parietal eye fields(ICC=0.6),supplementary eye field(ICC=0.5),frontal eye fields(ICC=0.5),and oculomotor vermis(ICC=0.6).The results demonstrate significant test-retest reliability in the ROIs of the vergence neural substrates for functional activation magnitude and spatial extent using the stimulus protocol of a task block stimulating eight vergence eye movements compared to sustained *** ROIs can be used in future longitudinal RCTs to study patient populations with vergence dysfunctions.

关键词： Vergence eye movement Test-retest reliability Functional MRI Vergence region of interest masks

Current status of intestinal and multivisceral transplantation

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Gastroenterology Report 2017年第1期5卷 20-28,I0001页

作者： Shishira Bharadwaj Parul Tandon Tushar D.gohel Jill Brown Ezra Steiger Donald F.Kirby Ajai Khanna Kareem Abu-Elmagd Center for Gut Rehabilitation and Transplantation the Cleveland Clinic FoundationClevelandOHUSA

Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure(IF).Traditionally,patients with IF have been relegated to lifelong parenteral nutrition(PN)once surgical and medical rehabilitation attempts at intestinal adaptation have *** the past two decades,however,outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut *** has become possible through relentless efforts in the standardization of surgical techniques,advancements in immunosuppressive therapies and induction protocols and improvement in postoperative patient *** types of intestinal transplants include isolated small bowel transplant,liver-small bowel transplant,multivisceral transplant and modified multivisceral *** guidelines restrict intestinal transplantation to patients who have had significant complications from PN including liver failure and repeated *** an experimental stage to the currently established therapeutic modality for patients with advanced IF,outcome improvements have also been possible due to the introduction of tacrolimus in the early *** have shown that intestinal transplant is cost-effective within 1–3 years of graft survival compared with *** survival and quality of life as well as resumption of an oral diet should enable intestinal transplantation to be an important option for patients with IF in addition to continued *** research should focus on detecting biomarkers of early rejection,enhanced immunosuppression protocols,improved postoperative care and early referral to transplant centers.

关键词： intestinal transplant multivisceral transplant parenteral nutrition intestinal failure gut rehabilitation

Effect of quality of bowel preparation on quality indicators of adenoma detection rates and colonoscopy completion rates

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第2期4卷 148-153,I0003页

作者： Tarun Rai Udayakumar Navaneethan Tushar gohel Amareshwar Podugu Prashanthi N.Thota Ravi P.Kiran Rocio Lopez Madhusudhan R.Sanaka Digestive Disease Institute The Cleveland ClinicClevelandOHUSA

Background and aim:Adequate bowel preparation is important for safe and effective *** indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over *** aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion ***:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December *** main outcome measurements were ADR and colonoscopy completion rates to the ***:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor *** completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼*** the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair *** multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ***:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good ***,there was no difference in ADR between the different grades of preparation.

关键词： bowel preparation adenoma detection rate colonoscopy completion rate quality indicators

Higher prevalence of colon polyps in patients with Barrett’s esophagus:a case-control study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2014年第4期2卷 281-287页

作者： Arthi Kumaravel Prashanthi N.Thota Hyun-Ju Lee Tushar gohel Mehulkumar K.Kanadiya Rocio Lopez Madhusudhan R.Sanaka Center of Excellence for Barrett’s Esophagus Department of Gastroenterology and HepatologyCleveland ClinicClevelandOhioUSA Department of Biostatistics Cleveland ClinicClevelandOhioUSA

Background and aims:Barrett’s esophagus(BE)and colorectal neoplasms share similar risk *** studies have shown variable prevalence of colon polyps in patients with *** aims were to determine the prevalence and incidence of colon polyps in patients with BE,compared to those without ***:In this case-control study,the study group included patients,aged 50–75 years,with biopsy-proven BE,who underwent colonoscopy at Cleveland Clinic from January 2002 to December *** control group consisted of age-and sex-matched patients who underwent colonoscopy and also an endoscopy with no evidence of BE during the same time *** criteria for both groups were family-or personal previous history of colon cancer or polyps,prior colonic resection,inflammatory bowel disease and familial polyposis *** demographics,comorbidities,medication use and endoscopic and colonoscopic details were collected,including biopsy ***:A total of 519 patients were included in the study;173 patients with BE in the study group and 346 without BE in the control *** age at index colonoscopy was 618 years and 75%of patients were *** index colonoscopy,patients with BE were more likely to have polyps than controls(45%vs 32%,respectively;P=0.003).Patients underwent between one and five colonoscopies during the *** multivariate analysis—after adjusting for age,gender and diabetes—patients with BE were 80%more likely to have any type of polyp,and 50%more likely to have adenomas found during ***:Patients with BE had higher prevalence and incidence of colon *** has important clinical implications for screening and surveillance in BE patients.

关键词： Barrett’s esophagus colon polyps cancer prevention