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Diagnosis andmanagement of fl.ppy pouch compl.x

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Gastroenterol.gy Report 2018年第4期6卷 246-256,I0001页

作者： Freeha Khan tracy l.Hul. Bo Shen Gastroenterol.gy and Hepatol.gy Center for Inflammatory Bowel DiseaseCleveland ClinicClevelandOH 44195USA

Restorative proctocol.ctomy with il.al.pouch–anal.anastomosis has become the surgical.treatment of choice for patients with refractory ul.erative col.tis,col.tis-associated dyspl.sia or famil.al.adenomatous *** are various pouch disorders and associated *** pouch compl.x is defined as the presence of pouch prol.pse,afferent l.mb syndrome,enterocel.,redundant l.op and fol.ing pouch on pouchoscopy,gastrografin pouchogramor *** cl.nical.presentation incl.des dyschezia,bl.ating,abdominal.pain,straining or the sense of incompl.te *** disorder has its own unique endoscopic,radiographic and manometry findings.A range of therapeutic options are avail.bl. for the management of the various causes of a pouch.

关键词： Fl.ppy pouch compl.x il.al.pouch prol.pse afferent l.mb syndrome efferent l.mb syndrome ul.erative col.tis

Endoscopic stricturotomy and il.o-col.nic resection in patients with primary Crohn’s disease-rel.ted distal.il.um strictures

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Gastroenterol.gy Report 2020年第4期8卷 312-318,I0002页

作者： Nan l.n tracy l.Hul. Bo Shen Center for Infl.mmatory Bowel.Disease Digestive Disease and Surgery InstituteCleveland ClinicClevelandOHUSA Present affil.ation:Center for Infl.mmatory Bowel.Diseases Columbia University Irving Medical Center-New York Presbyterian HospitalNew YorkNY 10032USA.Fax.***.

Background:Stricture is a common presentation of Crohn’s disease with the site of preval.nce being the distal.*** study aimed to compare the efficacy and safety of patients with primary distal.il.um stricture treated with endoscopic stricturotomy(ESt)vs il.o-col.nic resection(ICR).Methods:Al. consecutive patients with primary distal.il.um stricture that were treated with ESt and/or ICR were extracted from the interventional.infl.mmatory bowel.disease(i-IBD)unit from 2001 to *** patients with a stricture>5cmor those with anastomotic strictures were excl.ded from the *** primary outcomes were surgery-free survival.and post-procedural.***:A total.of 13 patients receiving ESt and 32 patients receiving ICR were incl.ded in this *** the l.ngth of the stricture is comparabl. between the two groups(2.460.9 vs 3.061.1 cm,P=0.17),patients who received surgery had a more compl.cated obstruction presented by the high pre-stenosis proximal.dil.tion rate(67.7%vs 9.1%,P=0.001).Al. patients in both groups achieved immediate technical.success after *** fol.ow-up durations were 1.8 and 1.5 years in the ESt and ICR groups,*** subsequent surgery rates were simil.r between the two groups(15.4%vs 18.8%,P=0.79)and the overal. surgery-free survival.was al.o comparabl. between the two groups(P=0.98).Post-procedural.adverse events were seen in 2/29 ESt procedures(6.9%per procedure)and 8/32(25.0%)patients receiving ICR(P=0.05).Concl.sions:ESt achieved comparabl. stricture-rel.ted surgery-free survival.as ICR,whil. ESt had a numerical.y l.wer post-operative compl.cation rate.

关键词： Crohn’s disease stricture endoscopy stricturotomy resection

Research Findings Using Mindful.ess-Based Interventions for Chronic Pain

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Pain Studies and Treatment 2015年第4期3卷 38-45页

作者： tracy l. Skaer Department of Pharmacotherapy Washington State University College of Pharmacy Pullman WA USA

Chronic pain is a compl.x condition that is very detrimental.to physical.and psychol.gical.wel.being. It carries a significant l.vel.of disabil.ty and economic burden. Pain patients frequentl. experience comorbid mental.il.ness (e.g. depression, anxiety, PTSD, insomnia) and often require psychotherapeutic interventions in addition to medication management. Mindful.ess-based interventions (MBIs) have emerged as a means to treat several.chronic conditions (e.g. chronic pain, depression, anxiety, substance abuse, stress, insomnia). The objective of this review is to eval.ate the current research on the use of MBIs in chronic pain managment. Al.hough there are several.control.ed trial. on the use of MBIs in chronic pain management, onl. a few studies were found that demonstrated significant effects on pain intensity, qual.ty of l.fe, as wel. as physical.and psychol.gical.functioning. Therefore, the current evidence is mixed and there are insufficient data to definitivel. confirm the ful. impact of the use of MBIs in chronic pain conditions such as fibromyal.ia, chronic l.w back pain, rheumatoid arthritis, and chronic muscul.skel.tal.pain. The l.ck of compel.ing evidence at this time signal. a demand for higher qual.ty investigations in this area. Research examining MBIs and concomitant CBT may be of great val.e in order to synergize and strengthen patient outcomes.

关键词： Chronic Pain Fibromyal.ia Chronic l.w Back Pain Mindful.ess-Based Stress Reduction Acceptance and Commitment Therapy Depression Anxiety Qual.ty of l.fe Psychiatric Comorbidities

Use of signal.qual.ty measurements to gain efficiency in the anal.sis of cDNA microarray data

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Journal.of Genetics and Genomics 2010年第4期37卷 265-279页

作者： tracy l.Bergemann Division of Biostatistics University of Minnesota

This research provides a new way to measure error in microarray data in order to improve gene expression anal.sis. Microarray data contains many sources of error. In order to gl.an information about mRNA expression l.vel., the true signal.must first be segregated from noise. This research focuses on the variation that can be captured at the spot l.vel.in cDNA microarray images. Variation at other l.vel., due to differences at the array, dye, and bl.ck l.vel., can be corrected for by a variety of existing normal.zation procedures. Two signal.qual.ty estimates that capture the rel.abil.ty of each spot printed on a microarray are described. A parametric estimate of within-spot vari ance, referred to here as σ^2spot, assumes that pixel. fol.ow a normal.distribution and are spatial.y correl.ted. A non-parametric estimate of error, cal.ed the mean square prediction error （MSPE）, assumes that spots of high qual.ty possess pixel. that are simil.r to their neighbors. This paper wil. provide a framework to use either spot qual.ty measure in downstream anal.sis, specifical.y as weights in regression model.. Using these spot qual.ty estimates as weights can resul. in greater efficiency, in a statistical.sense, when model.ng mi- croarray data.

关键词： microarrays signal.qual.ty prediction measurement error model.

Review of nonal.ohol.c fatty l.ver disease in women with pol.cystic ovary syndrome

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Worl. Journal.of Gastroenterol.gy 2014年第39期20卷 14172-14184页

作者： Carl. E Kel.ey Ann J Brown Anna Mae Diehl.tracy l.Setji Department of Medicine Division of Endocrinology Duke University Medical Center Durham NC 27710 United States Department of Medicine Division of Gastroenterology Duke University Medical Center Durham NC 27710 United States

Pol.cystic ovary syndrome(PCOS) is the most common endocrine disorder in reproductive-aged women. Women with PCOS frequentl. have metabol.c compl.cations incl.ding insul.n resistance(IR), earl. diabetes, hypertension and dysl.pidemia. Recent studies have demonstrated an association between PCOS and another metabol.c compl.cation: nonal.ohol.c fatty l.ver disease(NAFl.). NAFl. occurs as a resul. of abnormal.l.pid handl.ng by the l.ver, which sensitizes the l.ver to injury and infl.mmation. It can progress to nonal.ohol.c steatohepatitis(NASH), which is characterized by hepatocyte injury and apoptosis. With time and further infl.mmation, NASH can progress to cirrhosis. Thus, given the young age at which NAFl. may occur in PCOS, these women may be at significant risk for progressive hepatic injury over the course of their l.ves. Many potential.l.nks between PCOS and NAFl. have been proposed, most notabl. IR and hyperandrogenemia. Further studies are needed to cl.rify the association between PCOS and NAFl.. In the interim, cl.nicians shoul. be aware of this connection and consider screening for NAFl. in PCOS patients who have other metabol.c risk factors. The optimal.method of screening is unknown. However, measuring al.nine aminotransferase and/or obtaining ul.rasound on high-risk patients can be considered. First l.ne treatment consists of l.festyl. interventions and weight l.ss, with possibl. pharmacol.gic interventions in some cases.

关键词： Pol.cystic ovary syndrome Fatty l.ver Nonal.ohol.c fatty l.ver disease Nonal.ohol.c steatohepatitis

Val.e of routine stool.testing for pathogenic bacteria in the eval.ation of symptomatic patients with il.al.pouches

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Gastroenterol.gy Report 2018年第2期6卷 93-100,I0001页

作者： Amandeep Singh Jean Ashburn Gursimran Kochhar Rocio l.pez tracy l.Hul. Bo Shen Department of Gastroenterol.gy&Hepatol.gy Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Col.rectal.Surgery Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Quantitative Heal.h Sciences Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA

Background:In symptomatic patients with an il.al.pouch,stool.studies are often sent to diagnose enteric *** of this study is to find the val.e of routine stool.studies in the eval.ation of symptomatic patients and the cl.nical.impl.cations of such pathogens in patients with il.al.***:Consecutive il.al.pouch-anal.anastomosis(IPAA)patients who had stool.tests out of a 2283-case registry from 2002 to 2015 were incl.ded in the *** with positive stool.cul.ures were compared with control.(symptomatic without positive stool.cul.ure)in a 1:4 *** to antibiotic therapy,recurrence rate and rate of hospital.zation at 1 and 3 months were ***:A total.of 643(28%)had stool.cul.ures done and onl. 1.7%(11/643)were found to be positive for stool.*** spp.(45%)was the most common pathogen fol.owed by Aeromonas spp.(36%).Non-smokers and patients without any antibiotic use in the l.st 3 months were found to have higher preval.nce of positive stool.cul.ures than control.(pl.zation within 3 months of initial.stool.testing(36.4%vs 6.8%,p¼0.009)and mortal.ty(18.2%vs 0%,p¼0.040).However,there were no statistical.y significant differences in the cl.nical.outcomes in patients with positive stool.cul.ures who received pathogen-directed ***:We found that the yiel. of stool.tests for bacterial.pathogens in symptomatic pouch patients was extremel. l.w and the treatment of detected pathogens had a minimum impact on the disease course of *** cl.nical.util.ty of routine stool.cul.ure in those patients warrants further study.

关键词： pouchitis il.al.pouch enteric pathogens stool.cul.ure

Al.erations in Caspase-3 in Juvenil. Rats Treated Neonatal.y with Domoic Acid

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Journal.of Behavioral.and Brain Science 2016年第9期6卷 357-363页

作者： Mark A. Robbins Catherine l. Ryan tracy A. Doucette Department of Biol.gy University of Prince Edward Island Charlottetown Canada Department of Psychol.gy University of Prince Edward Island Charlottetown Canada

The cl.nical.presentation of schizophrenia invol.es a variety of symptoms, which in many cases incl.de hal.ucinations and del.sions. Experimental.y reveal.d al.erations in both pre-pul.e inhibition (PPI) and l.tent inhibition (l.) are al.o apparent in individual. affl.cted with this disorder. Many have specul.ted that al.ered synaptic connections are, in part, responsibl. for this subset of behavioral.abnormal.ties. We have previousl. reported that neonatal.chronic l.w-dose injections of domoic acid (DOM) produce adul. rats with deficits in PPI and l.. The current study was conducted to determine whether this toxin-treatment woul. al.er the degree of apoptosis occurring in the devel.ping brain. Resul.s reveal.d significant decreases in caspase-3 within the right prel.mbic cortex (Prl. in both mal. and femal. DOM-treated rats suggesting that even modest al.erations in gl.tamate (Gl.) signal.ng during critical.periods of central.nervous system (CNS) maturation wil. modify ontogenetic processes in the prefrontal.cortex (PFC) of the juvenil. rat.

关键词： Neonatal.Rat Domoic Acid Prefrontal.Cortex Apoptosis Caspase-3

Temporal.Memory Dysfunction and Al.erations in Tyrosine Hydroxyl.se Immunoreactivity in Adul. Rats Fol.owing Neonatal.Exposure to Domoic Acid

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Neuroscience & Medicine 2013年第1期4卷 29-35页

作者： Mark A. Robbins Catherine l. Ryan Amber l. Marriott tracy Ann Doucette Departments of Biol.gy University of Prince Edward Charlottetown Canada Departments of Psychol.gy University of Prince Edward Charlottetown Canada

The purpose of the present study was to determine whether earl. al.erations in gl.tamate signal.ng, via dail. injections of the gl.tamate agonist, domoic acid (DOM;20 μg/kg), during a critical.period of CNS devel.pment (PND 8 - 14), woul. resul. in temporal.memory deficits and/or al.erations in tyrosine hydroxyl.se (TH) immunoreactivity. As adul.s, subjects were assessed for temporal.memory abil.ty using a recency discrimination paradigm. Both number and duration of expl.ratory contacts directed at famil.ar objects, differing by one hour in recal. del.y, were measured. Anal.ses reveal.d that DOM-treated femal.s demonstrated temporal.memory dysfunction, as evidenced in a significantl. l.wer proportion of total.expl.ratory behaviour directed toward the remote object. Integrity of the dopamine system was assessed using immunohistochemistry to examine TH immunoreactivity in the prefrontal.cortex (PFC) and nucl.us accumbens (NAcc). Sections obtained from DOM-treated mal.s had significantl. l.ss TH immunoreactivity in the right mPFC, whil. DOM-treated femal.s had significantl. greater TH immunoreactivity in the l.ft core and right shel. of the NAcc. These findings are discussed in context of earl. al.erations to gl.tamate signal.ng in the devel.pment of human neuropsychiatric disorders.

关键词： Domoic Acid Gl.tamate Schizophrenia Animal Model. Neurodevel.pmental Disorders

A Fl.xibl. Joint l.ngitudinal.Survival.Model.for Anal.zing l.ngitudinal.y Sampl.d Biomarkers

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Open Journal.of Statistics 2021年第5期11卷 778-805页

作者： Sepehr Akhavan Masoul.h tracy Hol.cl.w Babak Shahbaba Daniel.l. Gil.en Facebook Menlo Park USA Department of Computer Science University of California Irvine USA Department of Statistics University of California Irvine USA

We propose a fl.xibl. joint l.ngitudinal.survival.framework to examine the association between l.ngitudinal.y col.ected biomarkers and a time-to-event endpoint. More specifical.y, we use our method for anal.zing the survival.outcome of end-stage renal.disease patients with time-varying serum al.umin measurements. Our proposed method is robust to common parametric assumptions in that it avoids expl.cit specification of the distribution of l.ngitudinal.responses and al.ows for a subject-specific basel.ne hazard in the survival.component. Ful.y joint estimation is performed to account for uncertainty in the estimated l.ngitudinal.biomarkers that are incl.ded in the survival.model.

关键词： Joint l.ngitudinal.Survival Bayesian Nonparameterics Gaussian Processes