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Pancreatic trauma: A concise review

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World Journal of gastroenterology 2013年第47期19卷 9003-9011页

作者： Uma Debi Ravinder Kaur Kaushal Kishor Prasad Saroj Kant Sinha Anindita Sinha Kartar Singh Division of GE Radiology Department of Superspeciality of GastroenterologyPostgraduate Institute of Medical Education and ResearchChandigarh 160 012India department of Radiodiagnosis Government Medical College and HospitalChandigarh 160 012India Division of GE Histopathology Department of Superspeciality of GastroenterologyPostgraduate Institute of Medical Education and ResearchChandigarh 160 012India department of superspeciality of gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160 012India department of Radiodiagnosis Postgraduate Institute of Medical Education and ResearchChandigarh 160 012India

Traumatic injury to the pancreas is rare and difficult to *** contrast,traumatic injuries to the liver,spleen and kidney are common and are usually identified with ease by imaging *** injuries are usually subtle to identify by different diagnostic imaging modalities,and these injuries are often overlooked in cases with extensive multiorgan *** most evident findings of pancreatic injury are posttraumatic pancreatitis with blood,edema,and soft tissue infiltration of the anterior pararenal *** alterations of post-traumatic pancreatitis may not be visualized within several hours following trauma as they are time *** diagnoses of traumatic pancreatic injuries are associated with high morbidity and *** plays an important role in diagnosis of pancreatic injuries because early recognition of the disruption of the main pancreatic duct is *** reviewed our experience with the use of various imaging modalities for diagnosis of blunt pancreatic trauma.

关键词： Pancreas Trauma Pancreatitis Radiology

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States department of gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States department of Internal Medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

Case Control Study of Post-endoscopic Variceal Ligation Bleeding Ulcers in Severe Liver Disease: Outcomes and Management

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Journal of Clinical and Translational Hepatology 2019年第1期7卷 32-39页

作者： Kapil D.Jamwal Rakhi Maiwall Manoj K.Sharma Guresh Kumar Shiv K.Sarin department of gastroenterology Artemis Hospital GurugramHaryanaIndia department of Hepatology Institute of Liver and Biliary SciencesNew DelhiIndia department of gastroenterology Dharamshila Narayana Superspeciality HospitalNew DelhiIndia department of Research and Biostatistics Institute of Liver and Biliary SciencesNew DelhiIndia

Background and Aims:The management of post-endoscopic variceal ligation(EVL)bleeding ulcers(PEBUs)is currently based on local expertise and patients liver disease *** present retrospective study investigated associations between the endoscopic morphology of PEBUs and patient ***:Patients underwent EVL(primary or secondary),from January 2015 to January 2018,in two tertiary care hospitals in India(ILBS New Delhi and Dharamshila Narayana New Delhi).Mortality rates were determined at post-EVL day five and week *** were typified based on Jamwal&Sarin classification system as follows:A,ulcer with active spurting;B,ulcer with ooze;C,ulcer base with visible vessel or clot;and D,clean or pigmented ***:Of 3854 EVL procedures,141(3.6%)patients developed PEBU,and 46/141(32.6%)suffered *** the former,the PEBU types A,B,C,and D accounted for 17.7,26.2,36.3,and 19.8%,*** those who died,39.1,30.4,21.7,and 8.8%had PEBU types A,B,C,and *** included transjugular intrahepatic portosystemic shunts(TIPS),esophageal self-expandable metal stent(SEMS),glue and sclerosant injection,Sengstaken-Blakemore tube placement and liver *** univariate analysis,no correlation with hepatic venous pressure gradient,TIPS placement,size of varices,or number of bands was *** Model for EndStage Liver Disease(MELD)-sodium score correlated positively with *** adjusting for MELD-sodium score,mortality was best predicted by type-A ulcer(p=0.024;OR 8.95,CI 1.34-59.72).Conclusions:PEBU occurred in 3.6%of a large EVL *** patients based on PEBU type can help predict outcomes,independent of the MELD-sodium *** PEBUs by endoscopic morphology may inform treatment strategies,and warrants further validation.

关键词： Post-endoscopic variceal ligation bleeding ulcers Severe liver disease Case control study Clinical outcomes

Visco chop-a new technique for nucleus separation for soft cataracts in femtolaser assisted cataract surgery

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International Journal of Ophthalmology(English edition) 2015年第4期8卷 843-845页

作者： Sri Ganesh Sheetal Brar department of Phacorefractive Nethradhama Superspeciality Eye Hospital

INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract *** experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the *** studies indicate that less effective phacoemulsification time is needed to emulsify the lens

关键词： Visco chop-a new technique for nucleus separation for soft cataracts in femtolaser assisted cataract surgery OVD

Wilson's disease in two siblings from Ecuador:Two case reports

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World Journal of Clinical Cases 2025年第3期13卷 50-60页

作者： Enrique Carrera Jonathan Alvarado Martina Astudillo Galo Pillajo department of gastroenterology and Hepatology Hospital de Especialidades Eugenio EspejoQuito 170136PichinchaEcuador Faculty of Medicine Pontificia Universidad Catolica del EcuadorQuito 170143PichinchaEcuador department of Radiology Hospital de Especialidades Eugenio EspejoQuito 170136PichinchaEcuador

BACKGROUND Wilson's disease(WD)is a rare metabolic disorder of copper accumulation in organs such as liver,brain,and *** and treatments are challenging in settings,where advanced diagnostic tests are unavailable,copper chelating agents are frequently scarce,healthcare professionals lack disease awareness,and medical follow-ups are *** diagnoses and treatments help prevent complications,improve patients’quality of life,and ensure a normal life *** clinical presentations and outcomes of WD can vary within a single *** SUMMARY We present the cases of two siblings(19 and 27 years)from a consanguineous family in rural Ecuador,diagnosed as having WD during a family *** male patient,diagnosed at age 19 after his brother’s death from acute liver failure,presented with compensated cirrhosis,neurological symptoms,and bilateral Kayser-Fleischer *** developed progressive neurological deterioration during an irregular treatment with D-penicillamine due to medication *** condition improved upon switching to trientine tetrahydrochloride,and his neurological symptoms improved over an 8-year period of *** female patient,diagnosed at age 10,exhibited only biochemical *** treatment history was similar;however,she remained asymptomatic without disease progression over the same follow-up *** discuss the potential influence of epigenetic mechanisms and modifier genes on the various phenotypes,emphasizing the need for research in these areas to optimize therapeutic *** Our patients’medical histories show how early diagnosis and treatment can prevent disease progression;and,how suboptimal treatments impact disease outcomes.

关键词： Wilson disease Kayser-Fleischer rings Copper chelator D-penicillamine Trientine tetrahydrochloride Case report

Proton pump inhibitors and all-cause mortality risk among cancer patients

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World Journal of Clinical Oncology 2025年第1期16卷 34-42页

作者： Arunkumar Krishnan Carolin Victoria Schneider Declan Walsh department of Supportive Oncology Atrium Health Levine CancerCharlotteNC 28204United States department of Medicine Section of Hematology and OncologyWake Forest University School of MedicineWinston-SalemNC 27101United States department of Medicine Ⅲ GastroenterologyMetabolic Diseasesand Intensive CareUniversity Hospital RWTH AachenAachen 52074Germany

BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related *** evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater *** To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize *** This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare *** study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer *** prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)*** primary outcome was all-cause *** patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding *** Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these *** a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individual

关键词： All-cause mortality Cancer Histamine-2 receptor antagonists Mortality Malignancy Proton pump inhibitors Carcinoma Outcome

Gut microbiota-astrocyte axis: new insights into age-related cognitive decline

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Neural Regeneration Research 2025年第4期20卷 990-1008页

作者： Lan Zhang Jingge Wei Xilei Liu Dai Li Xiaoqi Pang Fanglian Chen Hailong Cao Ping Lei Haihe Laboratory of Cell Ecosystem Department of GeriatricsTianjin Medical University General HospitalTianjinChina Tianjin Geriatrics Institute Tianjin Medical University General HospitalTianjinChina department of gastroenterology and Hepatology Tianjin Medical University General HospitalNational Key Clinical SpecialtyTianjin Institute of Digestive DiseasesTianjin Key Laboratory of Digestive DiseasesTianjinChina department of Urology Tianjin Medical University General HospitalTianjinChina Tianjin Neurological Institution Tianjin Medical University General HospitalTianjinChina

With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent *** is considered the main risk factor for cognitive decline and acts through alterations in the composition of the gut microbiota,microbial metabolites,and the functions of *** microbiota–gut–brain axis has been the focus of multiple studies and is closely associated with cognitive *** article provides a comprehensive review of the specific changes that occur in the composition of the gut microbiota and microbial metabolites in older individuals and discusses how the aging of astrocytes and reactive astrocytosis are closely related to age-related cognitive decline and neurodegenerative *** article also summarizes the gut microbiota components that affect astrocyte function,mainly through the vagus nerve,immune responses,circadian rhythms,and microbial ***,this article summarizes the mechanism by which the gut microbiota–astrocyte axis plays a role in Alzheimer’s and Parkinson’s *** findings have revealed the critical role of the microbiota–astrocyte axis in age-related cognitive decline,aiding in a deeper understanding of potential gut microbiome-based adjuvant therapy strategies for this condition.

关键词： age aging Alzheimer’s disease astrocytes cognitive decline dementia gut microbiota gut–brain axis microbial metabolites neuroinflammation Parkinson’s disease

Endotherapy in chronic pancreatitis

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World Journal of gastroenterology 2013年第37期19卷 6156-6164页

作者： Manu Tandan D Nageshwar Reddy department of Medical gastroenterology Asian Institute of Gastroenterology

Chronic pancreatitis(CP)is a progressive disease with irreversible changes in the *** commonly present with pain and with exocrine or endocrine *** therapeutic efforts in CP are directed towards relief of pain as well as the management of associated *** therapy offers many advantages in patients with CP who present with ductal calculi,strictures,ductal leaks,pseudocyst or associated biliary *** offers a high rate of success with low morbidity in properly selected *** procedure can be repeated and failed endotherapy is not a hindrance to subsequent *** pancreatic sphincterotomy is helpful in patients with CP with minimal ductal changes while minor papilla sphincterotomy provides relief in patients with pancreas divisum and chronic *** shock wave lithotripsy is the standard of care in patients with large pancreatic ductal *** term follow up has shown pain relief in over 60%of patients.A transpapillary stent placed across the disruption provides relief in over 90%of patients with ductal *** ductal strictures are managed by single large bore *** stents are placed for *** associated benign biliary strictures(BBS)are best treated with multiple plastic stents,as the response to a single plastic stent is *** self expanding metal stents are increasingly being used in the management of BBS though further long term studies are *** are best drained endoscopically with a success rate of 80%-95%at most ***(EUS)has added to the therapeutic armamentarium in the management of patients with *** of pseudcysts,cannulation of inaccessible pancreatic ducts and celiac ganglion block in patients with intractable pain are all performed using *** should be offered as the first line of therapy in properly selected patients with CP who have failed to respond to med

关键词： Chronic pancreatitis Endoscopic retrograde cholangiopancreatography Pancreatic sphincterotomy Extracorporeal shockwave lithotripsy Endosonography

Pathophysiology and Prevention of Paracentesis-induced Circulatory Dysfunction:A Concise Review

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Journal of Clinical and Translational Hepatology 2020年第1期8卷 42-48页

作者： Anand V Kulkarni Pramod Kumar Mithun Sharma T R Sowmya Rupjyoti Talukdar Padaki Nagaraj Rao D Nageshwar Reddy department of Hepatology Asian Institute of GastroenterologyHyderabadIndia department of gastroenterology Asian Institute of GastroenterologyHyderabadIndia

Annually,10%of cirrhotic patients with ascites develop refractory ascites for which large-volume paracentesis(LVP)is a frequently used therapeutic ***,although a safe method,is associated with circulatory dysfunction in a significant percentage of patients,which is termed para-centesis-induced circulatory dysfunction(PICD).PICD results in faster reaccumulation of ascites,hyponatremia,renal impairment,and shorter *** is diagnosed through laboratory results,with increases of>50%of baseline plasma renin activity to a value≥4 ng/mL/h on the fifth to sixth day after *** this review,we discuss the pathophysi-ology and prevention of PICD.

关键词： Refractory ascites Plasma renin activity Large-volume paracentesis Cirrhosis Portal hypertension