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Small bowel adenocarcinoma and Crohn's disease: Any further ahead than 50 years ago?

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World Journal of Gastroenterology 2014年第33期20卷 11486-11495页

作者： Caitlin Cahill Philip H Gordon Andrea Petrucci marylise Boutros McGill University Department of Surgery Sir Mortimer B. Davis Jewish General Hospital Colorectal Surgery Montreal PQ H3T 1E2 Canada

This review of the literature on small bowel carcinoma associated with Crohn's disease specifically addresses the incidence, risk factors, and protective factors which have been identified. It also reviews the clinical presentation, the current modalities of diagnosis, the pathology, treatment, and surveillance. Finally, the prognosis and future direction are addressed. Our experience with small bowel adenocarcinoma in Crohn's disease is reported. Readers will be provided with a better understanding of this rare and often poorly recognized complication of Crohn's disease.

关键词： Crohn's disease Small bowel adenocarcino-ma Cancer risk Cancer malignancy Incidental carcino-ma Late complications of Crohn's disease Inflammatory bowel disease

Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation

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World Journal of Gastroenterology 2009年第27期15卷 3426-3430页

作者： Nassim Kamar Laurence Lavayssière Fabrice Muscari Janick Selves Céline Guilbeau-Frugier Isabelle Cardeau Laure Esposito Olivier Cointault Marie Béatrice Nogier Jean Marie Peron Philippe Otal marylise Fort Lionel Rostaing Department of Nephrology Dialysis and Multi-Organ Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U858 IFR 31 CHU Rangueil TSA 50032 31059 Toulouse Cédex 9 France Department of Liver Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France Department of Radiology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Immunology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U563 IFR 30 CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France

Acute humoral rejection （AHR） is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.

关键词： Acute humoral rejection Liver transplantation Donor-specific antibodies Rituximab Plasmapheresis

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杜哈市新地标——运动城之塔

中国建筑装饰装修 2007年第3期 138-145页

作者： Mathieu.vigneau（摄影） AREP（图）

AREP（Aménagement,Recherche,Pole d＇Echanges）是法国综合性的建筑设计和工程公司，主要从事城市规划、建筑设计、施工工程。公司创建于1997年，现在已经发展成了顶级车站设计公司。

关键词：运动地标建筑设计工程公司城市规划施工工程车站设计

The Short-Term and Medium-Term Prognosis of a Stroke and the Factors of Poor Prognosis in Liberville

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Neuroscience & Medicine 2022年第4期13卷 135-144页

作者： Nyangui Mapaga Jennifer Gningone Pupchen marylise Mambila Grass Aurelle Diouf Mbourou Nelly Saphou-Damon Michel-Arnaud Nsounda Annick Andréa Camara Aissata Ibrahima Kouna Ndouongo Philomène Department of Neurology Centre Hospitalier Universitaire Libreville Libreville Gabon

Objectives: was to determine the factors influencing stroke prognosis in Libreville. Methods: This was a multicenter study prospective with a descriptive and analytical focus carried out from March 1st to July 31, 2014. Recruitment was systematic and exhaustive. The data collected was processed and analyzed using Epi-Info 3.3.5 software. Results: This study involved 66 patients including 27 male (40.9%) and 39 female (59.1%). Mean age was 55.1 +/? 15.3 years, mostly female. There were 57.5% ischemic stroke, 42.5% hemorrhagic stroke. The mean NIHSS was 7.8 +/? 6.6 at admission. Intra- hospital stroke mortality rates at 1 and 3 months were 7.6% and 9.1% respectively, ranging from 18.2% to 31.8%. The following factors were identified as associated with death at 1 month: age, high NIHSS at admission, high blood pressure, leukocytosis, hyperthermia and delay in admission. As for functional outcome, patients were relatively autonomous at discharge and factors associated with poor functional outcome (Rankin Conclusion: This study highlights many factors influencing prognosis of stroke. The poor prognostic factors were age, high NIHSS at admission, high blood pressure, hyperthermia, blood glucose, leukocytosis, delay in admission and length of hospital stay. Addressing these factors in the acute phase management strategies may improve the prognosis of stroke patients in Gabon.

关键词： Prognosis Stroke Libreville

Operative management of acute diverticulitis in immunosuppressed compared to immunocompetent patients: A systematic review

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World Journal of Surgical Procedures 2015年第1期5卷 155-166页

作者： Ahmed Al-Khamis Jad Abou Khalil Nazi Torabi Marie Demian Abbas Kezouh Philip H Gordon marylise Boutros Division of Colorectal Surgery Jewish General HospitalMc Gill University Schulich Library of Science and Engineering Mc Gill University Department of Statistics and Epidemiology Jewish General Hospital

AIM: To determine short and long-term outcomes following operative management of acute diverticulitis in immunosuppressed(IMS) compared to immunocompetent(IMC) ***: PRISMA guidelines were followed in conducting this systematic review. We searched Pub Med(1946 to present), OVID MEDLINE(R) In-Process and Other Non-Indexed Citations, OVID MEDLINE(R) Daily and OVID MEDLINE(R)(1946 to present), EMBASE on OVID platform(1947 to present), CINAHL on EBSCO platform(1981 to present), and Cochrane Library using a systematic search strategy. There were no restrictions on publication date and language. We systematically reviewed all published cohort comparative studies, casecontrol studies, and randomized controlled trials that reported outcomes on operative management of acute episode of colonic diverticulitis in IMS in comparison to IMC patients. RESULTS: Seven hundred and fifty-five thousand five hundred and eighty-three patients were included in this systematic review; of which 1478 were IMS and 754105 were IMC patients. Of the nine studies included there was one prospective cohort, seven retrospective cohorts, one retrospective case-control study, and no randomized controlled trials. With the exception of solid organ transplant patients, IMS patients appeared to be older than IMC when they presented with an acuteepisode of diverticulitis. IMS patients presented with more severe acute diverticulitis and more insidious onset of symptoms than IMC patients. In the emergency setting, peritonitis was the main indication for operative intervention in both IMS and IMC patients. IMS patients were more likely to undergo Hartmann's procedure and less likely to undergo reconstructive procedures compared to IMC patients. Furthermore, IMS patients had higher morbidity and mortality rates in the emergency setting compared to IMC patients. In the elective settings, it appeared that reconstruction with primary anastomosis with or without a diverting loop stoma is the procedure o

关键词： Diverticular disease Immunosuppression Diverticulitis Chemotherapy Transplant Steroids