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Noninvasive prognostic models,imaging,and elastography to predict clinical events in primary sclerosing cholangitis:A review

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世界肝病学杂志:英文版(电子版) 2023年第9期15卷 1013-1020页

作者： mark w.russo Division of Hepatology Atrium Health Wake ForestCharlotteNC 28204United States

Surrogate endpoints are needed to estimate clinical outcomes in primary sclerosing cholangitis(PSC).Serum alkaline phosphatase w.s among the first markers studied,but there is substantial variability in alkaline phosphatase levels during the natural history of PSC w.thout *** Mayo risk score incorporates noninvasive variables and has served as a surrogate endpoint for survival for more than tw. *** models have better test performance than the Mayo risk score,including the primary sclerosing risk estimate tool(PREsTo)model and UK-PSC score that estimate hepatic decompensation and transplant free survival,*** c-statistics for transplant-free survival for the Mayo risk model and the long-term UK-PSC model are 0.68 and 0.85,*** c-statistics for hepatic decompensation for the Mayo risk model and PREsTo model are 0.85 and 0.90,*** Amsterdam-Oxford model included patients w.th large duct and small duct PSC and patients w.th PSCautoimmune hepatitis overlap and had a c-statistic of 0.68 for transplant-free *** noninvasive tests that w.rrant further validation include magnetic resonance imaging,elastography and the enhanced liver fibrosis *** models,noninvasive tests or a combination of these surrogate endpoints may not only serve to be useful in clinical trials of investigational agents,but also serve to inform our patients about their prognosis.

关键词： Cholestatic Survival Mortality Predict Cirrhosis Decompensation

Recurrent hepatitis C after liver transplant

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w.rld Journal of Gastroenterology 2014年第31期20卷 10668-10681页

作者： Andrew.S deLemos Paul A Schmeltzer mark w.russo Department of Medicine Center for Liver Diseases and Transplantation Carolinas Medical Center

End stage liver disease from hepatitis C is the most common indication for liver transplantation in many parts of the w.rld accounting for up to 40% of liver transplants. Antiviral therapy either before or after liver transplantation is challenging due to side effects and low.r efficacy in patients w.th cirrhosis and liver transplant recipients, as w.ll as from drug interactions w.th immunosuppressants. Factors that may affect recurrent hepatitis C include donor age, immunosuppression, IL28 B genotype, cytomegalovirus infection, and metabolic syndrome. Older donor age has persistently been show. to have the greatest impact on recurrent hepatitis C. After liver transplantation, distinguishing recurrent hepatitis C from acute cellular rejection may be difficult, although the development of molecular markers may help in making the correct diagnosis. The advent of interferon free regimens w.th direct acting antiviral agents that include NS3/4A protease inhibitors, NS5 B polymerase inhibitors and NS5 A inhibitors holds great promise in improving outcomes for liver transplant candidates and recipients.

关键词： Hepatitis C Liver transplant Donor risk factors Immunosuppression Protease inhibitors Fibrosing cholestatic hepatitis C Acute cellular rejection Cytomegalovirus

Is it time to rethink combined liver-kidney transplant in hepatitis C patients w.th advanced fibrosis?

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w.rld Journal of Hepatology 2017年第5期9卷 288-292页

作者： Niraj James Shah mark w.russo Department of Medicine Division of Dige-stive Diseases the University of Mississippi Medical Center Transplant Center-Carolinas Medical Center 6th Floor Morehead Medical Plaza

AIM To reduce hepatic and extrahepatic complications of chronic hepatitis C in kidney transplant *** w. conducted a systematic review.of kidney only transplant in patients w.th hepatitis C and advanced *** The 5 year patient survival of kidney transplant recipients w.th and w.thout hepatitis C cirrhosis ranged from 31% to 90% and 85% to 92%, respectively. Hepatitis C kidney transplant recipients had low.r 10-year survival w.en compared to hepatitis B patients, 40% and 90% respectively. There w.re no studies that included patients w.th virologic cure prior to kidney transplant that reported post-kidney transplant outcomes. There w.re no studies of direct acting antiviral therapy and effect on patient or graft survival after kidney transplantation. CONCLUSION Data on kidney transplant only in hepatitis C patients that reported inferior outcomes w.re prior to the development of potent direct acting antiviral. w.th the development of potent directing acting antiviral therapy for hepatitis C w.th high cure rates studies are needed to determine if patients w.th hepatitis C, including those w.th advanced fibrosis, can undergo kidney transplant alone w.th acceptable long term outcomes.

关键词： Cirrhosis/cirrhotics Renal transplantation Kidney transplantation Mortality Systematic review Graft outcomes Meta-analysis

Current state of endohepatology: Diagnosis and treatment of portal hypertension and its complications w.th endoscopic ultrasound

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w.rld Journal of Hepatology 2021年第8期13卷 887-895页

作者： Sean R Rudnick Jason D Conw.y mark w.russo Section on Gastroenterology&Hepatology Wake Forest School of MedicineWinston-SalemNC 27157United States Department of Hepatology Atrium HealthCarolinas Medical CenterCharlotteNC 28204United States

The diagnosis and management of cirrhosis and portal hypertension(PH)w.th its complications including variceal hemorrhage,ascites,and hepatic encephalopathy continues to *** there are established“standards of care”in liver biopsy and measurement of PH,gastric varices remain an area w.thout a universally accepted therapeutic *** concept of“Endo Hepatology”has been used to describe of the applications of endoscopic ultrasound(EUS)to these ***-liver biopsy(EUS-LB)offers an alternative to percutaneous and transjuglar liver biopsy w.thout compromising safety or efficacy,and w.th added advantages including the potential to reduce sampling error by allow.ng biopsies in both hepatic ***,EUS-LB can be performed during the same procedure as EUS-guided portal pressure gradient(PPG)measurements,allow.ng for the collection of valuable diagnostic and prognostic ***-guided PPG measurements provide an appealing alternative to the transjugular approach,w.th proposed advantages including the ability to directly measure portal vein *** addition,EUS-guided treatment of gastric varices(GV)offers several possible advantages to current ***-guided treatment of GV allow. detailed assessment of the vascular anatomy,similar efficacy and safety to current therapies,and allow. the evaluation of treatment effect through doppler ultrasound *** appropriate selection of patients for these procedures is paramount to ensuring generation of useful clinical data and patient safety.

关键词： Portal hypertension Endoscopic ultrasound Liver biopsy Gastric varices

Risk scoring model for prediction of non-home discharge after transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2020年第10期17卷 621-627页

作者： Alexis K Okoh Ebru Ozturk Justin Gold Emaad Siddiqui Nehal Dhaduk Bruce Haik Chun-Guang CHEN Marc Cohen mark J russo Cardiovascular Outcomes Research Institute RWJ Barnabas Health-NBIMCNewarkNew JerseyUSA Department of Medicine Division of BiostatisticsHacettepe UniversityAnkaraTurkey Rutgers New.Jersey Medical School NewarkNew JerseyUSA Department of Surgery Division of Cardiothoracic SurgeryRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA

Background Patients undergoing transcatheter aortic valve replacement(TAVR) are likely to be discharged to a location other than home. w. aimed to determine the association betw.en preoperative risk factors and non-home discharge after TAVR. Methods Patients discharged alive after TAVR at three centers w.re identified from a prospectively maintained database randomly divided into 80% derivation and 20% validation cohorts. Logistic regression models w.re fit to identify preoperative factors associated w.th non-home discharge in the derivation cohort. Multivariable models w.re developed and a nomogram based risk-scoring system w.s developed for use in preoperative counseling. Results Betw.en June 2012 and December 2018, a total of 1,163 patients had TAVR at three centers. Thirty-seven patients w.o died before discharge w.re excluded. Of the remaining 1,126 patients(97%) w.o w.re discharged alive, the incidence of non-home discharge w.s 25.6%(n = 289). The patient population w.s randomly divided into the 80%(n = 900) derivation cohort and 20%(n = 226) validation cohort. Mean ± SD age of the study population w.s 83 ± 8 years. In multivariable analysis, factors that w.re significantly associated w.th non-home discharge w.re extreme age, female sex, higher STS scores, use of general anesthesia, elective procedures, chronic liver disease, non-transfemoral approach and postoperative complications. The unbiased estimate of the C-index w.s 0.81 and the model had excellent calibration. Conclusions One out of every four patients undergoing TAVR is discharged to a location other than home. Identification of preoperative factors associated w.th non-home discharge can assist patient counseling and postoperative disposition planning.

关键词： Aortic valve replacement Non-home discharge Postoperative risk Transcatheter Transfemoral

Acute liver failure due to natural killer-like T-cell leukemia/ lymphoma: A case report and review.of the Literature

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w.rld Journal of Gastroenterology 2006年第25期12卷 4089-4092页

作者： Evan S Dellon Shannon R Morris w.zhan Tang Cherie H Dunphy mark w.russo Department of Medicine University of North Carolina School of Medicine Chapel HillNCUnited States Department of Pathology University of North Carolina School of Medicine Chapel HillNCUnited States

Acute liver failure （ALF） is a medical emergency requiring immediate evaluation for liver transplantation. w. describe an unusual case of a patient w.o presented w.th ascites, jaundice, and encephalopathy and w.s found to have ALF due to natural killer （NK）-Iike T cell leukemia/lymphoma. The key immunophenotype w.s CD2＋, CD3＋, CD7＋, CD56＋. This diagnosis, w.ich w.s based on findings in the peripheral blood and ascitic fluid, w.s confirmed w.th liver biopsy, and w.s a contraindication to liver transplantation. A review.of the literature show. that hematologic malignancies are an uncommon cause of fulminant hepatic failure, and that NK-like T-cell leukemia/lymphoma is a relatively recently recognized entity w.ich is characteristically CD3＋ and CD56＋. This case demonstrates that liver biopsy is essential in diagnosing unusual causes of acute liver failure, and that infiltration of the liver w.th NK-like T-cell lymphoma/leukemia can cause acute liver failure.

关键词： Liver failure Liver transplant Nutaral killer cell

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法国马恩-拉瓦雷建筑学院

城市环境设计 2016年第1期 90-93页

作者： Bernard Tschumi Kevin Collins Yannis Aesopos Véronique Descharrèires Robert Young Tom Kow.lski mark Haukos Stephanie Bayard Jordan Parnass Grace Cheung.Project:Véronique Descharrèires Alex Reid Kevin Collins Gregory Merryw.ather Rhett russo Frederick Norman Christine Denizzi Lauranne Ponsonnet

新的马恩-拉瓦雷建筑学院项目非常与众不同,它对建筑本身和策划均提出了设计要求。为此竞赛不仅邀请了建筑设计师,也引入了专业的策划咨询师(在这个项目中我们是与Yves Dessuant合作),要求两个团队共同为这所极具创造性的学院打造出独... 详细信息

新的马恩-拉瓦雷建筑学院项目非常与众不同,它对建筑本身和策划均提出了设计要求。为此竞赛不仅邀请了建筑设计师,也引入了专业的策划咨询师(在这个项目中我们是与Yves Dessuant合作),要求两个团队共同为这所极具创造性的学院打造出独特的功能和容纳这些功能的硬件设施。整个项目分成两个阶段,目前第二阶段尚未完成。

关键词：建筑学院马恩拉瓦法国法兰西共和国