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Albumin as a prognostic marker for ulcerative colitis

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World journal of Gastroenterology 2017年第45期23卷 8008-8016页

作者： Nabeel Khan Dhruvan Patel Yash Shah Chinmay Trivedi Yu-Xiao Yang Section of Gastroenterology University of Pennsylvania Perelman School of Medicine Section of Gastroenterology Corporal Michael J. Crescenz VA Medical Center Department of Gastroenterology Drexel University College of Medicine Department of Internal medicine Icahn School of Medicine at Mount SinaiJames J. Peters VA Medical Center

AIM To evaluate the role of albumin at the time of ulcerative colitis(UC) diagnosis in predicting the clinical course of *** Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified and divided into two categories: hypoalbuminemia(i.e.,≤ 3.5 gm/dl) or normal albumin levels(i.e.,> 3.5 gm/dl) at the time of UC diagnosis. The exposure of interest was presence of hypoalbuminemia defined asalbumin level ≤ 3.5 g/dl at the time of UC diagnosis. Patients were then followed over time to identify the use of ≥ 2 courses of corticosteroids(CS),thiopurines,anti-TNF medications and requirement of colectomy for UC management. RESULTS The eligible study cohort included 802 patients,but 92(11.4%) patients did not have their albumin levels checked at the time of UC diagnosis,and they were excluded. A total of 710 patients,who had albumin levels checked at time of UC diagnosis,were included in our study. Amongst them,536 patients had a normal albumin level and 174 patients had hypoalbuminemia. Patients with hypoalbuminemia at diagnosis had a higher likelihood of ≥ 2 courses of CS use(adjusted HR = 1.7,95%CI: 1.3-2.3),higher likelihood of thiopurine or anti-TNF use(adjusted HR = 1.72,95%CI: 1.23-2.40) than patients with normal albumin level at diagnosis. There was a trend of higher likelihood of colectomy in hypoalbuminemic patients,but it was not statistically significant(Adjusted HR = 1.7,95%CI: 0.90-3.25).CONCLUSION Hypoalbuminemia at disease diagnosis can serve as a prognostic marker to predict the clinical course of UC at the time of diagnosis.

关键词： Prognostic marker Albumin Ulcerative colitis Disease course Colectomy

Using music to reduce anxiety among older adults in the emergency department:a randomized pilot study

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journal of Integrative medicine 2017年第6期15卷 450-455页

作者： Laura Belland Laura Rivera-Reyes Ula Hwang center for family medicine newyork-presbyterian/columbia university medical centerNew YorkNY 10032USA department of emergency medicine icahn school of medicine at mount sinaiNew YorkNY 10029USA geriatric research education and clinical centerjames j.peters vamcNew YorkNY 10029USA

BACKGROUND： An emergency department （ED） visit may be distressing and anxiety-provoking for older adults （age 〉 65 years）. No studies have specifically evaluated the effect of music listening on anxiety in older adults in the ED. OBjECTIVE： The objective of this pilot study was to evaluate the effect of music listening on anxiety levels in older ED patients. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This was a randomized pilot study in the geriatric ED of an urban academic tertiary medical center. This was a sample of English-speaking adults （age 〉 65 years） who were not deaf （n = 35）. Subjects consented to participate and were randomized to receive up to 60 min of music listening with routine care, while the control group received routine care with no music. Subjects in the music treatment group received headphones and an electronic tablet with pre-downloaded music, and were allowed to choose from 5 selections. MAIN OUTCOME MEASURES： The primary outcome was change in anxiety levels, measured by the state- trait anxiety inventory （STAI）, at enrollment and 1 h later. RESULTS： A total of 35 participants were enrolled： 74% were female, 40% were white, and 40% were black; of these, 32 subjects completed the study protocol. When comparing control （n = 18） against intervention subjects （n = 17）, there were no significant differences in enrollment STAI scores （43.00 ± 15.00 vs. 40.30± 12.80, P = 0.57）. STAI scores 1 hour after enrollment （after the music intervention） were significantly reduced in the intervention subjects compared to the control subjects （with reduction of 10.00± 12.29 vs. 1.88 ± 7.97, P = 0.03）. CONCLUSION： These pilot results suggest that music listening may be an effective tool for reducing anxiety among older adults in the ED.

关键词： music anxiety emergency department randomized controlled trial

Chemotherapy induced Takotsubo cardiomyopathy

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World journal of Clinical Cases 2014年第10期2卷 565-568页

作者： Sunny Goel Abhishek Sharma Aakash Garg Abhinav Chandra Vijay Shetty Department of medicine Maimonides Medical Center Department of Internal medicine James J. Peters VA Medical Center Mount Sinai School of Medicine Bronx NY 10468 United States

Chemotherapy has been linked with Takotsubo cardiomyopathy. Most of the literature on chemotherapy associated Takotsubo cardiomyopathy is on the drug 5-fluorouracil. In this report, we describe the case of a 55-year-old Asian male who developed Takotsubo cardiomyopathy while receiving dual chemotherapy with cytarabine and daunorubicin for acute myeloid leukemia. To our knowledge, it is the first case of Takotsubo cardiomyopathy associated with daunorubicin and/or cytarabine.

关键词： Takotsubo cardiomyopathy Chemotherapy Cytarabine Daunorubicin

Mental health of the male adolescent and young man: the Copenhagen statement

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World journal of Pediatrics 2018年第3期14卷 224-232页

作者： Timothy R.Rice Lesha D.Shah Pilar Trelles Shih-Ku Lin Dinne Skjaerlund Christensen Andreas Walther Leo Sher icahn school of medicine at mount sinai 1 Gustave L.Levy PlaceNew YorkNY 10029USA New York University school of medicine New Y orkNYUSA Taipei City Hospital and T aipei medical University TaipeiChina Department of Public Health Center for Healthy Aging and Section of En vironmental HealthUniversity of Copenhag enCopenhagenDenmark Biological Psychology TU DresdenDresdenGermany Clinical Psychology and Psy chotherapy University of Zur ichZurichSwitzerland james j.peters va medical center and icahn school of medicine at mount sinai New Y orkNYUSA

Background Male adolescents and young men benefit when their mental health care is specialized to match their unique gendered and developmental needs. Sensitivity to the social circumstances of this population is important;additionally, the emerging ability to tailor care through knowledge gleaned from the intersection of psychiatry, neurology, and endocrinol-ogy informs care. Data sources This article summarized the views of six experts in the area of the adolescent and young adult male mental health. These experts were select members of the World Federation of Societies of Biological Psychiatry's Task Force on Men's Mental Health. They convened to present two symposia on the topic of men's mental health at the 13th World Congress of Biological Psychiatry (WCBP) in Copenhagen, Denmark in 2017. Results In these works, a special focus is paid to addictive disorders, disruptive behavior disorders, aggression, and brain development. Collectively, the authors present an argument for the merits of a male-specifi c model of mental health care to advance the overall well-being of this population. Conclusions Men's mental health should be recognized as a social issue as much as a medical issue, with special attention paid to problems such as unemployment, familial disruption, and substance abuse. These problems, and especially those of major societal impact including violence and suicide which are much more frequently the product of male youth and men, should have more male-tailored options for service provision that respond to men's mental health needs.

关键词： Aggression Development Externalizing behaviors Inpatient care Men's mental health Testosterone

Environmental noise alters gastric myoelectrical activity:Effect of age

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World journal of Gastroenterology 2007年第3期13卷 403-407页

作者： james S Castle Mark R Warner Mark A Korsten medical Program and Audiology Service James J Peters VA Medical Center Bronx NY and Mount Sinai School of Medicine New York United States

AIM: To evaluate the effect of age and acoustic stress on gastric myoelectrical activity (GMA) and autonomic nervous system function. METHODS: Twenty-one male subjects (age range 22-71 years, mean 44 years) were recruited and exposed, in random order, to three auditory stimuli (Hospital noise, conversation babble and traffic noise) after a 20-min baseline. All periods lasted 20 min and were interspersed with a 10 min of recovery. GMA was obtained using a Synectics Microdigitrapper. Autonomic nerve function was assessed by monitoring blood pressure and heart rate using an automatic recording device. RESULTS: Dominant power tended to decrease with increase of age (P jects in the younger group (vations were accompanied by a significant increase in bradygastria: hospital noise (P jects over 50 years of age did not exhibit a significant decrease in 3 CPM activity. Regardless of age, noise did not alter blood pressure or heart rate. CONCLUSION: GMA changes with age. Loud noise can alter GMA, especially in younger individuals. Our data indicate that even short-term exposure to noise may alter the contractility of the stomach.

关键词： Noise, Acoustic stress, Gastric myoelectrical activity Electrogastmgram Autonomic nervous system

A phantom gallbladder on endoscopic retrograde cholangiopancreatography

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World journal of Gastroenterology 2007年第46期13卷 6274-6276页

作者： jeremy Rochester Caroline K Messer Bruce P Reiter Mark A Korsten Gastroenterology and Radiology Programs James J.Peters VA Medical CenterBronxNY 10468Montefiore Medical CenterBronxNYMount Sinai School of MedicineNew YorkNY and Albert Einstein College of MedicineBronxNew York 10468United States

various complications have been related to laparoscopic cholecystectomy but most occur shortly after the procedure. In this report, we present a case with very late complications in which an abscess developed within the gallbladder fossa 6 years after laparoscopic cholecystectomy. The abscess resolved after treatment with CT-guided extrahepatic aspiration. However, 4 years later, an endoscopic retrograde cholangiopancreatography （ERCP） performed for choledocholithiasis demonstrated a “gallbladder” which communicated with the common bile duct via a patent cystic duct. This unique case indicates that a cystic duct stump may communicate with the gallbladder fossa many years following cholecystectomy.

关键词： Laparoscopic cholecystectomy Complication Abscess Gallbladder Endoscopic retrograde cholangio-pancreatography

Effect of Vitamin E and Alpha Lipoic Acid in Nonalcoholic Fatty Liver Disease: A Randomized, Placebo-Controlled, Open-Label, Prospective Clinical Trial (vaIN Trial)

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Open journal of Gastroenterology 2014年第5期4卷 199-207页

作者： Patrick P. Basu Niraj j. Shah Mark M. Aloysius Robert S. Brown jr. Columbia University College of Physicians and Surgeons New York USA james j. peters va medical center Mount Sinai School of Medicine New York USA King’s County Hospital New York USA

Objective: Antioxidants, including alpha lipoic acid (ALA) and vitamin E, are efficacious for the treatment of nonalcoholic fatty liver disease (NAFLD). The objective was to evaluate the effects of ALA and vitamin E alone or combined as therapy for patients with NAFLD and nonalcoholic steatohepatitis (NASH). Design: Placebo-controlled, open-label, prospective study in which patients with NAFLD and NASH were randomized to treatment with ALA 300 mg (n = 40), vitamin E 700 IU (n = 40), ALA 300 mg plus vitamin E 700 IU (n = 40), or placebo (n = 35) daily for 6 months. Body mass index, homeostasis model assessment scores, fibrosis and steatosis markers, and diagnostic laboratory tests were assessed at baseline and at the end of the study. Results: Treatment with ALA and vitamin E alone or in combination, improved inflammatory cytokine levels, steatosis scores, homeostasis model assessment scores, and triglyceride levels after 6 months relative to baseline. Conclusion: Alpha lipoic acid and vitamin E, either alone or in combination, were effective treatments for patients with NAFLD and NASH.

关键词： Antioxidant Liver Disease Vitamin E Alphalipoic Acid

A Study on the Safety of Liver Biopsy Inpatients with Von Willebrand’s Disease

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Open journal of Gastroenterology 2015年第9期5卷 134-138页

作者： Patrick P. Basu Niraj j. Shah Mark M. Aloysius K. Rayapudi Robert Brown Division of Digestive and Liver Diseases and center for Liver Disease and Transplantation Columbia University Medical Center New York USA King’s County Hospital medical center New York USA Liver Transplant center University of North Carolina School of Medicine Carolinas Medical Center Charlotte USA james j.peters va medical center at icahn school of medicine at mount sinai New York USA

Objectives: Liver biopsy remains the gold standard for diagnosis of chronic liver diseases. Outpatient percutaneous biopsy is generally safe with a mortality rate of 0.17% and hospitalization rate for bleeding of 3%. Von Willebrand disease (vWD) syndrome is the most common inherited hematological disorder with a prevalence of 1% - 3% globally. We sought to study whether vWD increases the risk of bleeding for liver biopsies. Methods: All patients (n = 120) who underwent outpatient percutaneous liver biopsies from 1997 to 2007 were analyzed. Demographics, PT/INR, platelet count, vW antigen and ristocetin induced platelet aggregation were studied. Results: No vWD patients had major bleeding that required transfusion, hospitalization or surgery but 9 (75%) had minor local bleeding and all had ecchymosis, which resolved spontaneously within 24 hours. Conclusions: Patients with vW factor deficiency can undergo percutaneous liver biopsy without major bleeding. Minor bleeding may occur at a slightly higher rate. vWD is not a contraindication to percutaneous liver biopsy.

关键词： Liver Biopsy vW Disease Safety Complications

Alzheimer’s Disease Aβ-Amyloid Plaque Morphology varies According to APOE Isotype

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World journal of Neuroscience 2023年第3期13卷 118-133页

作者： Ina Caesar K. Peter R. Nilsson Per Hammarström Mikael Lindgren Stefan Prokop james Schmeidler vahram Haroutunian David M. Holtzman Patrick R. Hof Sam Gandy Department of Neurology Icahn School of Medicine at Mount Sinai New York NY USA Department of Physics Chemistry and Biology Link&#246ping University Link&#246ping Sweden Department of Physics Norwegian University of Science and Technology Trondheim Norway Department of Neuropathology Charité Universit&#228tsmedizin Berlin Berlin Germany Department of Psychiatry Icahn School of Medicine at Mount Sinai New York NY USA Alzheimer’s Disease Research center Icahn School of Medicine at Mount Sinai New York NY USA james j. peters va medical center Bronx NY USA Nash Family Department of Neuroscience and Friedman Brain Institute Icahn School of Medicine at Mount Sinai New York NY USA Department of Neurology Hope Center for Neurological Disorders Knight Alzheimer’s Disease Research Center Washington University St. Louis MO USA Ronald M. Loeb center for Alzheimer’s Disease Icahn School of Medicine at Mount Sinai New York NY USA

Background: The apolipoprotein E (APOE, gene;apoE, protein) ε4 allele is the most commonly identified genetic risk factor for typical late-onset sporadic Alzheimer’s disease (AD). Each APOE ε4 allele roughly triples the relative risk for AD compared to that of the reference allele, APOE ε3. Methods: We have employed hyperspectral fluorescence imaging with an amyloid-specific, conformation-sensing probe, p-FTAA, to elucidate protein aggregate structure and morphology in fresh frozen prefrontal cortex samples from human postmortem AD brain tissue samples from patients homozygous for either APOE ε3 or APOE ε4. Results: As expected APOE ε4/ε4 tissues had a significantly larger load of CAA than APOE ε3/ε3. APOE isoform-dependent morphological differences in amyloid plaques were also observed. Amyloid plaques in APOE ε3/ε3 tissue had small spherical cores and large coronas while amyloid plaques in APOE ε4/ε4 tissues had large irregular and multi-lobulated plaques with relatively smaller coronas. Despite the different morphologies of their cores, the p-FTAA stained APOE ε3/ε3 amyloid plaque cores had spectral properties identical to those of APOE ε4/ε4 plaque cores. Conclusions: These data support the hypothesis that one mechanism by which the APOE ε4 allele affects AD is by modulating the macrostructure of pathological protein deposits in the brain. APOE ε4 is associated with a higher density of amyloid plaques (as compared to APOE ε3). We speculate that multilobulated APOE ε4-associated plaques arise from multiple initiation foci that coalesce as the plaques grow.

关键词： Alzheimer’s Disease Amyloid Apolipoprotein Luminescent Conjugated Oligothiophenes Hyperspectral Separation