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Hepatocellular Carcinoma Incidence and Mortality in the USA by Sex, Age, and Race: A Nationwide Analysis of two Decades

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Journal of Clinical and translational Hepatology 2024年第2期12卷 172-181页

作者： Yazan Abboud Mohamed Ismail Hamza Khan Esli Medina-Morales Saqr Alsakarneh Fouad Jaber nikolaos t.pyrsopoulos Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA Department of Internal Medicine University of Missouri-Kansas CityKansas CityMOUSA Division of Gastroenterology and Hepatology Rutgers New Jersey Medical SchoolNewarkNJUSA

Background and Aims:While the incidence rates of hepa-tocellular carcinoma(HCC)are increasing,there are limited comprehensive data on demographic-specific incidence and mortality trends in the *** aimed to evaluate recent trends in HCC incidence and mortality among different de-mographic groups in the ***:Age-adjusted HCC incidence rates were calculated from the Centers for Disease Control's United States Cancer Statistics database,which combines incidence data on newly diagnosed cancer cases and covers approximately 98%of the population in the ***,age-adjusted HCC mortality rates were obtained from the Centers for Disease Control's National Center for Health Statistics database,which offers comprehensive Cov-erage spanning nearly 100%of deaths attributed to HCC in the *** were stratified by sex,age(older[≥55 years]and younger[ts),race and ethnicity(Non-Hispanic White,Non-Hispanic Black,Hispanic,Non-Hispanic Asian/Pacific Islander,and Non-Hispanic American Indian/Alaska Native),and tumor stage at diagnosis(early and late).Annual and average annual percentage change(AAPC)were calculated using joinpoint regression.A sex-specific pairwise comparison was ***:Between 2001 and 2020,there were 467,346 patients diagnosed with HCC(26.0%women),with increasing incidence in both sexes without significant difference(p=0.65).In younger adults(78,169 patients),the incidence decreased in men but not in women(AAPC difference=-2.39,p=0.002).this was seen in various racial and ethnic groups,mostly driven by early-stage tumors(AAPC difference=-2.65,p=0.02).there were 329,973 deaths attributed to HCC between 2000 and 2020(28.4%women).In younger adults(43,093 deaths),mortal-ity decreased in men at a greater rate than in women(AAPC difference=1.61,p=0.007).this was seen in various racial and ethnic groups,most notably in non-Hispanic American Indian/Alaska Natives(AAPC difference=-4.51,p=0.01).Conclusions:Nationwide USA data,coveri

关键词： Liver cancer Hepatocellular carcinoma Incidence Mortality Epidemiology Health disparity

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Hepatocellular carcinoma national burden across different geographical regions in the United States between 2001 and 2020

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World Journal of Methodology 2024年第4期14卷 110-120页

作者： Yazan Abboud Raj Malhotra Muhammad Hassaan Arif Maan Anna Mathew Ibrahim Abboud Chun-Wei Pan Saqr Alsakarneh Fouad Jaber Islam Mohamed David Kim nikolaos t pyrsopoulos Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarkNJ 07103United States University of California Riverside School of Medicine RiversideCA 92521United States Department of Internal Medicine John H Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine University of Missouri-Kansas CityKansasMO 64108United States Division of Gastroenterology and Hepatology Rutgers New Jersey Medical SchoolNewarkNJ 07101United States

BACKGROUND While prior data showed an increasing incidence of hepatocellular carcinoma(HCC)in the United States,there are limited comprehensive and comparative data on the geographical variations of HCC trends in different demographicspecific *** to evaluate sex and age-specific incidence rates and time trends in different geographical regions in the United *** Age-adjusted HCC incidence rates were collected from the United States Cancer Statistics(USCS)database which covers approximately 98%of the population in the United *** rates were stratified by sex,age,and geographical *** percentage change(APC)and average APC(AAPC)were estimated using Joinpoint Regression.A pairwise comparison was conducted between sex-specific *** there were 467344 patients diagnosed with HCC in the United States in the USCS database between 2001 and *** rates and trends varied by geographical *** looking at the West region(115336 patients),incidence rates of HCC were overall increasing and also increasing in older ***,when evaluating younger adults,HCC incidence rates decreased in men but not in women with a sex-specific absolute AAPC-difference of 2.15(P=0.005).When evaluating the Midwest region(84612 patients),similar results were *** incidence rates were increasing in the overall population and in older adults as well,they were decreasing in younger men but not in women with a sex-specific absolute AAPC-difference of 1.61(Pthe Northeast region(87259 patients),the analysis showed similar results with decreasing HCC incidence rates in younger men but not counterpart women(Sex-specific AAPC-difference=3.26,Ptly,when evaluating the south(180137 patients),the results were also decreasing in younger men but not in women(Sex-specific AAPC-difference=2.55,Ptionwide analysis covering around 98%of the United States population shows an increasing incidence of HCC across all

关键词： Hepatocellular carcinoma Incidence Epidemiology Health disparity Geography

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Bacterial Infections in Cirrhotic Patients in a tertiary Care Hospital

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Journal of Clinical and translational Hepatology 2021年第1期9卷 32-39页

作者： Vivek A.Lingiah nikolaos t.pyrsopoulos Department of Medicine Division of Gastroenterology and HepatologyRutgers UniversityNew Jersey Medical SchoolNewarkNJUSA

Background and Aims:Patients with cirrhosis are immunocompromised and at higher risk of developing infections compared to the general *** aim of this study was to assess the incidence of infections in cirrhotic patients in a large academic liver center and investigate potential associations between infections,bacteria isolated,therapeutic regimens used,and ***:this was a retrospective chart review study,including 192 *** patients had a diagnosis of cirrhosis and were admitted to University *** collected included demographics,etiology of cirrhosis,identification of bacteria from cultures,multidrug-resistant(MDR)status,antibiotics administered,intensive care unit(ICU)admission,and patient ***:Infections were present in 105(54.6%)patients,and 60(31.2%)patients had multiple infections during a hospitalization(s)for infections.A total of 201 infections were *** tract infections(UtIs)were the most common infection(37.8%),followed by bacteremia(20.4%),pneumonia(12.9%),spontaneous bacterial peritonitis(SBP)(11.9%),abscess/cellulitis(6.0%),infectious diarrhea(6.0%),and other(5.0%).Escherichia coli was the most common bacteria isolated(13.4%),both among sensitive and MDR *** bacteria were the cause for 41.3%of all infections *** accounted for 9.5%of infections.21.9%of patients had decompensation from their infection(s)that required ICU care,and 14.6%of patients died during hospitalization or soon after ***:the incidence of infections in cirrhotic patients is much higher than in their non-cirrhotic counterparts(54.6%),even higher than prior studies *** many of these infections are caused by MDR bacteria and fungal organisms,stronger empiric antibiotics and antifungals should be considered when initially treating this immunocompromised ***,once organism sensitivities are discovered,narrowing of antibiotic regimens must occur to maintain g

关键词： Cirrhosis Bacterial infections Multidrug resistance Fungal infections

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Management and treatment of Hepatocellular Carcinoma with Immunotherapy:A Review of Current and Future Options

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Journal of Clinical and translational Hepatology 2020年第2期8卷 168-176页

作者： Shima Ghavimi tehila Apfel Hamed Azimi Alana Persaud nikolaos t.pyrsopoulos Division of Gastroenterology and Hepatology Department of MedicineRutgers New Jersey Medical SchoolNewarkNJUSA

With mortality rates of liver cancer doubling in the last 20 years, this disease is on the rise and has become the fifth most common cancer in men and the seventh most common cancer in women. Hepatocellular carcinoma (HCC) represents approximately 90% of all primary liver cancers and is a major global health concern. Patients with HCC can be managed curatively with surgical resection or with liver transplantation, if they are diagnosed at an early stage. Unfortunately, most patients with HCC present with ad-vanced stages of the disease and have underlying liver dysfunction, which allows only 15%of patients to be eligible for curative treatment. Several different treatment modal-ities are available, including locoregional therapy radiofre-quency ablation, microwave ablation, percutaneous ethanol injection, trans-arterial chemoembolization, transarterial radio-embolization, cryoablation, radiation therapy, stereo-tactic radiotherapy, systemic chemotherapy, molecularly targeted therapies, and immunotherapy. Immunotherapy has recently become a promising method for inhibiting HCC tumor progression, recurrence, and metastasis. the term"Immunotherapy"is a catch-all, encompassing a wide range of applications and targets, including HCC vaccines, adoptive cell therapy, immune checkpoint inhibitors, and use of oncolytic viruses to treat HCC. Immunotherapy in HCC is a relatively safe option for treating patients with advanced disease in the USA who are either unable to receive or failed sorafenib/lenvatinib therapy and thus may offer an addi-tional survival benefit for these patients. the purpose of this review is to elaborate on some of the most recent advance-ments in immunotherapy.

关键词： Carcinoma Hepatocellular Immunotherapy Immunotherapy Adoptive Nivolumab

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Liver transplantation Beyond Milan Criteria

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Journal of Clinical and translational Hepatology 2020年第1期8卷 69-75页

作者： Vivek A Lingiah Mumtaz Niazi Raquel Olivo Flavio Paterno James V Guarrera nikolaos t pyrsopoulos Department of Medicine Division of Gastroenterology and HepatologyRutgers UniversityNew Jersey Medical SchoolNewarkNJUSA Department of Surgery Division of Liver Transplantation and Hepatobiliary SurgeryRutgers UniversityNew Jersey Medical SchoolNewarkNJUSA

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related death worldwide,being the fifth most common cancer and the third most common cause of cancer-related *** incidence of HCC has been rising in the USA over the last 20 *** transplanta-tion is an optimal treatment option,as it eliminates HCC as well as the underlying liver *** Milan criteria(1 lesion greater than or equal to 2 cm and less than or equal to 5 cm,or up to 3 lesions,each greater than or equal to 1 cm and less than or equal to 3 cm)have been adopted by many transplant societies worldwide as the criteria to determine whether patients with HCC can move forward with liver ***,many believe that the Milan criteria may be too strict in regard to its size require-ments for *** has led to a number of expanded criteria for liver transplantation,concerning both overall size and number of lesions,as well as incorporation of other markers of tumor *** markers,such as alpha-fetoprotein,can also be used to follow treatment of HCC and possibly exclude patients from *** presenting beyond Milan criteria can also be down-staged with locore-gional *** response to locoregional therapy and longer wait times after locoregional therapy prior to transplant can serve as surrogate markers of tumor biology as well.

关键词： Hepatocellular carcinoma Liver transplantation Cancer staging tumor burden Alpha-fetoprotein

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Cannabis use history is associated with increased prevalence of ascites among patients with nonalcoholic fatty liver disease:A nationwide analysis

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World Journal of Hepatology 2020年第11期12卷 993-1003页

作者： Catherine J Choi Stanley H Weiss Umair M Nasir nikolaos t pyrsopoulos Department of Medicine Rutgers New Jersey Medical SchoolNewarkNJ 07101United States Department of Medicine Biostatistics and EpidemiologyRutgers New Jersey Medical SchoolNewarkNJ 07103United States Division of Gastroenterology and Hepatology Department of MedicineRutgers-New Jersey Medical SchoolNewarkNJ 07103United States

BACKGROUND Recent studies have revealed the endocannabinoid system as a potential therapeutic target in the management of nonalcoholic fatty liver disease(NAFLD).Cannabis use is associated with reduced risk for NAFLD,we hypothesized that cannabis use would be associated with less liver-related clinical complications in patients with *** to assess the effects of cannabis use on liver-related clinical outcomes in hospitalized patients with *** We performed a retrospective matched cohort study based on querying the 2014 National Inpatient Sample(NIS)for hospitalizations of adults with a diagnosis of *** NIS database is publicly available and the largest all-payer inpatient database in the United *** patients with cannabis use were selected as cases and those without cannabis were selected as ***-control matching at a ratio of one case to two controls was performed based on sex,age,race,and *** liver-related outcomes such as portal hypertension,ascites,varices and variceal bleeding,and cirrhosis were compared between the *** A total of 49911 weighed hospitalizations with a diagnosis of NAFLD were *** these,3820 cases were selected as the cannabis group,and 7625 noncannabis cases were matched as *** with cannabis use had a higher prevalence of ascites(4.5%vs 3.6%),with and without cannabis use,P=*** prevalence of portal hypertension(2.1%vs 2.2%),varices and variceal bleeding(1.3%vs 1.7%),and cirrhosis(3.7%vs 3.6%)was not different between the groups,with and without cannabis use,all P>***,race/ethnicity other than White,Black,Asian,Pacific Islander or Native American,and higher comorbidity score were independent risk factors for ascites in the cannabis *** non-cannabis users,obesity and hyperlipidemia were independent protective factors against ascites while older age,Native American and higher comorbidity index were independent risk factors for ***

关键词： Nonalcoholic fatty liver disease Fatty liver Cannabis Marijuana use Liver diseases Hospitalization

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CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study

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Journal of Clinical and translational Hepatology 2018年第4期6卷 241-246页

作者： Raja GR Edula Sujit Muthukuru Serban Moroianu Yucai Wang Vivek Lingiah Phoenix Fung nikolaos t pyrsopoulos Division of Gastroenterology&Hepatology Rutgers New Jersey Medical SchoolNewarkNJUSA Fairview Hospital Cleveland ClinicFairview ParkOHUSA

Background and Aims:to evaluate the prevalence and significance of elevated cancer antigen-125(CA-125)levels in patients with cirrhosis being treated in a tertiary care liver center and its correlation with objective markers of disease ***:We retrospectively reviewed medical records of 172 adult patients with cirrhosis(due to any etiology)after obtaining CA-125 serum ***,etiology of cirrhosis,model of end-stage liver disease(MELD)score,Child's turcotte-Pugh classification,albumin bilirubin(ALBI)score,degree of ascites,presence of esophageal varices,serum CA-125 level and various other parameters were *** analysis was performed using SPSS software and descriptive ***:Elevated CA-125 levels were noted in 147 patients(85%)of the study *** MELD score was associated with higher CA-125 levels(p=0.001).Statistically significant correlation was observed between elevated CA-125 levels and degree of ascites(pturcotte-Pugh class(ption was observed with presence or absence of esophageal ***-normal CA-125 levels were noted in patients with cirrhosis but undetectable ascites on ultrasound *** differences were observed in mean values between male and female patients(p=0.207).Regression analysis confirmed that CA-125 levels had a better correlation with degree of ascites than MELD score or ALBI ***:Elevated CA-125 levels were noted in 85%of patients with cirrhosis at our *** study establishes that the more advanced the degree of decompensation based on MELD score,Child's turcotte-Pugh classification and ALBI score,the higher the elevation in *** of ascites was associated with normal CA-125 level,with a direct correlation between high levels and worsening ascites,but there was no statistically significant correlation with esophageal varices,indicating that elevated CA-125 levels could be related to mech

关键词： Portal hypertension Ascites Esophageal varices MELD score Child's turcotte-Pugh classification

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Liver transplant allocation policies and outcomes in United States: A comprehensive review

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World Journal of Methodology 2022年第1期12卷 32-42页

作者： Nyan L Latt Mumtaz Niazi nikolaos t pyrsopoulos Division of Gastroenterology and Hepatology Department of MedicineRutgers-New Jersey Medical SchoolNewarkNJ 07101-1709United States

Liver transplant allocation policies in the United States has evolved over 3 *** donor liver organs are matched,allocated and procured by the Organ Procurement and transplantation Network which is administered by the United Network of Organ Sharing(UNOS),a not-for-profit organization governed by the United States human health *** reviewed the evolution of liver transplant allocation *** to 2002,UNOS used Child-turcotte-Pugh score to list and stratify patients for liver transplantation(Lt).After 2002,UNOS changed its allocation policy based on model for end-stage liver disease(MELD)*** serum sodium is the independent indicator of mortality risk in patients with chronic liver *** priority assignment of MELD-sodium score resulted in Lt and prevented mortality on ***-Sodium score was implemented for liver allocation policy in *** to the current and most recent policy,livers from adult donors were matched first to the status 1A/1B patients located within the boundaries of the UNOS regions and donor-service areas(DSA).We reviewed the disadvantages of the DSA-based allocation policies and the advantages of the newest acuity circle allocation *** then reviewed the standard and non-standard indications for MELD exceptions and the decision-making process of the National Review Liver Review ***,we reviewed the liver transplant waitlist,donation and survival outcomes in the United States.

关键词： Liver transplant Allocation Distribution Waiting list Policies Acuity circles transplant exceptions National Review Liver Review Board

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A Case Report of Alloimmune Hepatitis after Direct-acting Antiviral treatment in a Liver transplant Patient

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Journal of Clinical and translational Hepatology 2020年第4期8卷 459-462页

作者： Catherine Choi Youssef Botros Jamil Shah Pei Xue Anja Jones Mark Galan Raquel Olivo Mumtaz Niazi Flavio Paterno James Guarrera nikolaos t.pyrsopoulos Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA Division of Gastroenterology St.Joseph’s University Medical CenterPatersonNJUSA Division of Gastroenterology&Hepatology The Brooklyn Hospital CenterBrooklynNYUSA Rutgers New Jersey Medical School NewarkNJUSA Department of Pathology Immunology&Laboratory MedicineRutgers New Jersey Medical SchoolNewarkNJUSA Division of Gastroenterology&Hepatology Department of MedicineRutgers New Jersey Medical SchoolNewarkNJUSA Division of Liver transplantation&Hepatobiliary Surgery Department of SurgeryRutgers New Jersey Medical SchoolNewarkNJUSA

Direct-acting antiviral (DAA) therapy is often well-tolerated, and adverse events from DAA therapy are uncommon. We report a case of a woman who underwent orthotopic liver transplant for chronic hepatitis C infection and later devel-oped alloimmune hepatitis shortly after starting DAA therapy for recurrent hepatitis C infection. the patient developed acute alloimmune hepatitis approximately 2 weeks after starting treatment with sofosbuvir, velpatasvir, and voxilap-revir. this case report proposes a dysregulation of immune surveillance due to the DAA stimulation of host immunity and rapid elimination of hepatitis C viral load as a precipitating factor for the alloimmune process, leading to alloimmune hepatitis in a post-transplant patient who starts on DAA.

关键词： Autoimmune hepatitis Hepatitis C Liver transplant

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Studies of polyol production by the yeast Yarrowia lipolytica growing on crude glycerol under stressful conditions

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Carbon Resources Conversion 2024年第3期7卷 17-31,F0004页

作者： Eleni-Stavroula Vastaroucha nikolaos G.Stoforos George Aggelis Seraphim Papanikolaou Department of Food Science and Human Nutrition Agricultural University of Athens75 Iera Odos11855AthensGreece Unit of Microbiology Department of BiologyUniversity of Patras26504 Rio PatrasGreece

Crude glycerol,the principal by-product of biodiesel production process,was employed as substrate by three wild-type Yarrowia lipolytica strains(ACA-YC 5030,LMBF 20 and NRRL Y-323).Stressful conditions(low pH value=2.0±0.3,low incubation temperature t=20±1℃,non-aseptic conditions)were ***-esting production of yeast biomass and polyols(***,mannitol and arabitol)was noted at pH=2.0±0.3 and t=20±1℃.Strains failed to produce significant quantities of cellular lipid,while variable quantities of intra-cellular polysaccharides were *** under previously pasteurized media supported significant biomass and polyols production for most of the tested strains,while only one strain(NRRL Y-323),managed to produce polyols at media that were not previously thermally treated at *** production of mannitol was favored at low initial glycerol(Glol0)concentrations,whereas higher Glol0 quantities favored the biosynthesis of *** the strain NRRL Y-323,highly aerated/agitated bioreactor trials showed different physiological profiles as compared to the respective flask ***,in flask experiments with the strain NRRL Y-323 at high Glol0 amounts(≈140 g/L)at low medium pH(=2.0±0.3),a significant production of polyols(=84.2 g/L)with the corresponding remarkable conversion yield on glycerol consumed=62%w/w was *** application:Renewable and biodegradable fuels,such as biodiesel,are safer and environmentally friendlier than the conventional petroleum *** is a cost-effective substrate obtained as the main side-product from biodiesel production process and is currently being employed in the realm of Industrial Microbi-ology and Biotechnology to produce metabolic products with added *** research focuses on using glycerol as a starting substrate for biotechnological conversions aiming at producing,amongst other compounds,polyols,microbial biomass,citric acid,*** selected strains of the Generall

关键词： Biomass Glycerol Polyols Yarrowia lipolytica

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