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Gastroenteropancreatic neuroendocrine neoplasms:A clinical snapshot

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World Journal of Gastrointestinal Surgery 2021年第3期13卷 231-255页

作者： Cornelius J Fernandez Mayuri Agarwal Biju Pottakkat Nisha Nigil Haroon Annu susan george Joseph MPappachan Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Surgical Gastroenterology Jawaharlal Institute of Post Graduate Medical Education and Research(JIPMER)Puducherry 605006India Department of Endocrinology and Internal Medicine Northern Ontario School of MedicineSudbury P3E 2C6OntarioCanada Department of Medical Oncology VPS Lakeshore HospitalCochin 682040KeralaIndia Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPR29HTPrestonThe University of ManchesterOxford Road M139PLManchester Metropolitan UniversityAll Saints Building M156BHManchesterUnited Kingdom.

Our understanding about the epidemiological aspects,pathogenesis,molecular diagnosis,and targeted therapies of neuroendocrine neoplasms(NENs)have drastically advanced in the past ***(GEP)NENs originate from the enteroendocrine cells of the embryonic gut which share common endocrine and neural differentiation *** NENs are welldifferentiated,and slow *** neuroendocrine biomarkers that are used in the diagnosis of functional NENs include insulin,glucagon,vasoactive intestinal polypeptide,gastrin,somatostatin,adrenocorticotropin,growth hormone releasing hormone,parathyroid hormone-related peptide,serotonin,histamine,and 5-hydroxy indole acetic acid(5-HIAA).Biomarkers such as pancreatic polypeptide,human chorionic gonadotrophin subunits,neurotensin,ghrelin,and calcitonin are used in the diagnosis of non-functional NENs.5-HIAA levels correlate with tumour burden,prognosis and development of carcinoid heart disease and mesenteric fibrosis,however several diseases,medications and edible products can falsely elevate the 5-HIAA ***-specific transcription factors are useful in the differential diagnosis of metastasis from an unknown primary of well-differentiated *** novel biomarkers include circulating tumour cells,circulating tumour DNA,circulating micro-RNAs,and neuroendocrine neoplasms test(NETest)(simultaneous measurement of 51 neuroendocrine-specific marker genes in the peripheral blood).NETest has high sensitivity(85%-98%)and specificity(93%-97%)for the detection of gastrointestinal NENs,and is useful for monitoring treatment response,recurrence,and *** terms of management,surgery,radiofrequency ablation,symptom control with medications,chemotherapy and molecular targeted therapies are all considered as *** is the mainstay of treatment,but depends on factors including age of the individual,location,stage,grade,functional status,and the heredity of the tumour(sporadic vs inherited).Me

关键词： Gastroenteropancreatic neuroendocrine neoplasms Neuroendocrine tumours Neuroendocrine carcinoma Targeted molecular therapy Octreoscan Chemotherapy

Gram-negative bacteria causing infective endocarditis: Rare cardiac complication after liver transplantation

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World Journal of Hepatology 2013年第5期5卷 296-297页

作者： susan george Joy Varghese Sujatha Chandrasekhar Rajasekar Perumalla Mettu Srinivas Reddy Venkataraman Jayanthi Mohamed Rela Department of Cardiology Global Hospitals and Health CityChennai 600100India Department of Hepatology and Liver Transplantation Global Hospitals and Health CityChennai 600100India Department of Microbiology Global Hospitals and Health CityChennai 600100India Institute of HPB and Transplantation Global Hospitals and Health CityChennai 600100India

Bacterial endocarditis is a rare complication amongst solid organ transplant recipients and is often linked to bacteremia. Majority of these recipients do not have underlying valvular heart disease or congenital valvular abnormalities. Staphylococoocusaureus and Enterococcus species are the most commonly isolated organisms. There are very few reports of gram-negative bacteria causing endocarditis in liver transplant recipients. We report a 51-yearold male, a liver transplant recipient, who developed bacterial endocarditis of the mitral valve due to extended spectrum of betalactamase producing strain of Escherichia coli and was managed successfully with antibiotics.

关键词： Bacteria Infective endocarditis Liver transplantation

Cocaine-induced methemoglobinemia

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World Journal of Emergency Medicine 2021年第1期12卷 81-82页

作者： Kamal Kant Sahu Ajay Kumar Mishra Amos Lal Ahmad Daniyal Siddiqui susan Vgeorge MD Medicine Saint Vincent HospitalWorcester 10608USA MD Medicine Mayo ClinicRochester 55905USA

Dear editor,We congratulate Chowdhury et al[1] for their excellentreport and successful management of a young ladysuffering from cocaine-induced *** this letter, we aim to address some additionalconcerns, which would ... 详细信息

关键词： editor letter caine

Epidemiological link between obesity,type 2 diabetes mellitus and cancer

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World Journal of Methodology 2021年第3期11卷 23-45页

作者： Cornelius J Fernandez Annu susan george Nikhila A Subrahmanyan Joseph M Pappachan Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Medical Oncology VPS Lakeshore HospitalCochin 682040India Department of Internal Medicine Al-Azhar Medical CollegeThodupuzha 685605India Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom

There exists a complex interaction between obesity,type 2 diabetes mellitus(T2DM)and cancer,and an increase in the incidence of cancer is expected with the growing obesity-diabetes *** association of cancer with diabetes mellitus and obesity appears to be site-specific,the highest risk being for postmenopausal breast cancer,endometrial cancer,and colorectal ***,there is worsening of hyperglycaemia with the onset of cancer,evidencing a bidirectional link between cancer and diabetes mellitus and the need for monitoring for diabetes in cancer *** this review,we look at the epidemiological evidence from observational studies and Mendelian randomization studies linking obesity,diabetes,and cancer,as well as the complex pathophysiological mechanisms involved,including insulin resistance with associated hyperinsulinaemia,the effect of chronic low-grade inflammation,and the effect of various adipokines that are associated with obesity and ***,we describe the novel therapeutic strategies,based on their role on the discrete pathophysiological mechanisms involved in the tumourigenesis.

关键词： Cancer Obesity Type 2 diabetes mellitus Hyperinsulinaemia Epidemiological link

Concomitant Aortoplasty with Septal Myectomy for Supravalvar Aortic Stenosis in an Adult

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World Journal of Cardiovascular Surgery 2012年第1期2卷 5-6页

作者： Raja Saravanan Elumalai Kirthivasan Vaidyanathan Madhu Sankar Nainar Karthik Vaidyanathan Govini Balasubramaniam susan george Department of Cardiac Anaesthesiology Global Hospital and Health City Perumbakkam India Department of Cardiology Global Hospital and Health City Perumbakkam India Department of Cardiothoracic Surgery Global Hospital and Health City Perumbakkam India

Survival of patients with severe congenital aortic stenosis beyond third decade is uncommon. This report describes a 31 year old patient who underwent successful aortoplasty and in addition septal myectomy for complet... 详细信息

关键词： Aortoplasty Myectomy Supravalvar Aortic Stenosis

Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

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World Journal of Virology 2024年第2期13卷 78-86页

作者： Sumukh Arun Kumar Sushmita Prabhu Ankushi Sanghvi Maya Gogtay Mithil Gowda Suresh Harshit Khosla Yuvaraj Singh Ajay Kumar Mishra susan george Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Hospice and Palliative Care UTHSC and McGovern School of MedicineTexasTX 77030United States Department of Gastroenterology and Hepatology UMass Chan Medical SchoolWorcesterMA 01655United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a *** the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical *** COVID era and pre-COVID *** We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community *** was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional ***-square was applied to test the statistical association between qualitative *** t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative *** A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID *** leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

关键词： Blood transfusion Restrictive transfusion COVID-19 Pre-COVID-19 Blood shortage Pandemic

Cardiovascular physiology in the older adults

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Journal of Geriatric Cardiology 2015年第3期12卷 196-201页

作者： Xuming Dai Scott L Hummel Jorge B Salazar george E Taffet susan Zieman Janice B Schwartz Division of Cardiology University of North Carolina at Chapel Hill Chapel Hill NC USA Division of Cardiovascular Medicine Department of Medicine University of Michigan Ann Arbor Ml Ann Arbor Veterans Affairs Health System Ann Arbor M1 USA Division of Cardiology Mayo Clinic Rochester MN USA Division of Geriatrics Geriatrics and Cardiovascular Sciences Houston Methodist Hospital Baylor College of'Medicine Houston TX USA Division of Geriatrics and Clinical Gerontology National Institute of Aging Bethesda ME) USA Divisions of Geriatrics and Clinical Pharmacology Department of Medicine University of California San Francisco CA USA

1 Introduction In an aging society with persistent high prevalence of cardiovascular disease （CVD） in the elderly population, the health care system is facing an increasing challenge to effectively care for these patients. However, due to the under-representation of CVD patients over 75 years of age in clinical trials, assessing safety and efficacy of diagnostic and therapeutic approaches, the evidence for managing elderly CVD patients is especially limited. Physiological changes of aging intertwined with pathophysiology of CVD, and comorbid conditions often complicate clinical management.

关键词： Aging Cardiovascular disease Left ventricular

“If we are waiting for the numbers alone,we will miss the point”:a qualitative study of the perceived rise of food allergy and associated risk factors in the Greater Accra Region,Ghana

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Global Health Research and Policy 2017年第1期2卷 159-170页

作者： george A.Atiim susan J.Elliott Ann E.Clarke Department of Geography and Environmental Management Faculty of EnvironmentUniversity of WaterlooWaterlooOntarioCanada Department of Medicine Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada

Background:Globally,food allergy[FA]is considered a growing health *** much of what is known comes from developed countries,there is growing interest in the epidemiology of FA in developing regions such as sub-Saharan ***,researchers are beginning to document the incidence and prevalence of FA and *** results outlined in this paper stem from an exploratory qualitative study examining the emergence of the health risk of FA in Ghana,a country undergoing epidemiologic ***:Between June and August,2015,we conducted thirty-seven(37)semi-structured in-depth *** comprised seventeen(17)healthcare workers across 12 public and private hospitals and twenty(20)individuals with FA and families with allergic *** interviews were recorded and transcribed *** were analyzed to develop thematic areas that characterize perceptions and experiences around ***:Three key broad themes arise from this ***,FA is an emerging health risk,whose incidence is perceived to be ***,participants expressed mixed perceptions about the public health burden of ***,participants identified individual and societal factors that may be influencing FA risks and ***:Our research suggests FA is a growing but unrecognized public health *** is the need for health policies and researchers to consider the full extent of ongoing epidemiologic changes for the health of populations in developing regions.

关键词： Food allergy Chronic illness Epidemiologic transition Qualitative Ghana

Smoking in schizophrenic patients:A critique of the selfmedication hypothesis

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World Journal of Psychiatry 2015年第1期5卷 35-46页

作者： Francesca Manzella susan E Maloney george T Taylor Behavioral Neuroscience Program Department of Psychological SciencesUniversity of Missouri-St. Louis Department of Genetics Washington University School of Medicine Department of Psychiatry Washington University School of Medicine

A common remark among laypeople, and notably also among mental health workers, is that individuals with mental illnesses use drugs as self-medication to allay clinical symptoms and the side effects of drug treatments. Roots of the self-medication concept in psychiatry date back at least to the 1980 s. Observations that rates of smokers in schizophrenic patients are multiple times the rates for regular smoking in the general population, as well as those with other disorders, proved particularly tempting for a self-medication explanation. Additional evidence came from experiments with animal models exposed to nicotine and the identification of neurobiological mechanisms suggesting self-medication with smoking is a plausible idea. More recently, results from studies comparing smoking and non-smoking schizophrenic patients have led to the questioning of the self-medication hypothesis. Closer examination of the literature points to the possibility that smoking is less beneficial on schizophrenic symptomology than generally assumed while clearly increasing the risk of cancer and other smoking-related diseases responsible for early mortality. It is a good time to examine the evidence for the self-medication concept as it relates to smoking. Our approach is to focus on data addressing direct or implied predictions of the hypothesis in schizophrenic smokers.

关键词： Nicotine Nicotinic receptor Dopamine Positive-negative symptoms Side effects Age of onset Smoking cessation