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Asian Journal of Urology 2024年第1期11卷 26-32页

作者： Awad Elsid Osman Sahar Alharbi Atif Ali Ahmed Asim Ali Elbagir Pathology and Clinical Laboratory Management Department(PCLM) King Fahad Medical CityRiyadhSaudi Arabia Department of Pathology and Laboratory Medicine University of Missouri at Children's Mercy HospitalKansas CityMOUSA

Objective: Genome-wide association studies have demonstrated that single nucleotide polymorphisms (SNPs) are important risk factors for the development of prostate cancer (PCa). Preliminary studies have suggested that the incidence of PCa in Saudi males is low but is probably familial or genetically ***: To identify any possible association of SNP with PCa development in Saudi patients, we investigated a group of SNPs in Saudi PCa patients (n=85) and compared the outcomes to healthy normal controls (n=115) and nodular hyperplasia patients (n=120). DNA was extracted from paraffin-embedded formalin fixed tissue or whole blood from both patients’ groups and healthy control group. A total of thirteen SNPs were genotyped using TaqMan® minor groove binder polymerase chain reaction ***: The rs16901979A, s629242T and rs1447295A alleles were found at significantly higher frequency in PCa patients than controls (p< 0.05). The rs16901979 CA genotype was found at significantly greater frequency in PCa patients than in healthy controls (43% vs. 14%, odds ratio=4.6, p=0.0001) and benign hyperplasia group (43% vs. 25%, odds ratio=2.2, p=0.009).Conclusion: Our study has highlighted the association of rs16901979 SNP with PCa in Saudi males. Such findings have important implications in the PCa diagnosis and in screening unaffected family members of Saudi patients.

关键词： Prostatecancer Saudi Singlenucleotide polymorphism Allele

Mortality associated with gastrointestinal bleeding in children: A retrospective cohort study

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World Journal of Gastroenterology 2017年第9期23卷 1608-1617页

作者： Thomas M Attard Mikaela Miller Chaitanya Pant Ashwath Kumar Mike Thomson Department of Gastroenterology Children’s Mercy Hospital Clinical Decision Support Children’s Mercy Hospital Department of Gastroenterology The University of Kansas Hospital University of Missouri Medical School Sheffield Children’s hospital Western Bank

To determine the clinical characteristics of children with gastrointestinal bleeding (GIB) who died during the course of their *** interrogated the Pediatric hospital Information System database, including International Classification of Diseases, Current Procedural Terminology and Clinical Transaction Classification coding from 47 pediatric tertiary centers extracting the population of patients (1-21 years of age) admitted (inpatient or observation) with acute, upper or indeterminate GIB (1/2007-9/2015). Descriptive statistics, unadjusted univariate and adjusted multivariate analysis of the associations between patient characteristics and treatment course with mortality was performed with mortality as primary and endoscopy a secondary outcome of interest. All analyses were performed using the R statistical package, *** population with GIB was 19528; 54.6% were male, overall mortality was 2.07%; (0.37% in patients with the principal diagnosis of GIB). When considering only the mortalities in which GIB was the principal diagnosis, 48% (12 of 25 principal diagnosis GIB mortalities) died within the first 3 d of admission, whereas 19.8% of secondary diagnosis GIB patients died with 3 d of admission. Patients who died were more likely to have received octreotide (19.8% c.f. 4.04%) but tended to have not received proton pump inhibitor therapy in the first 48 h, and far less likely to have undergone endoscopy during their admission (OR = 0.489, P < 0.0001). Chronic liver disease associated with a greater likelihood of endoscopy. Mortalities were significantly more likely to have multiple complex chronic *** associated mortality in children is highest within 7 d of admission. Multiple comorbidities are a risk factor whereas early endoscopy during the admission is protective.

关键词： Pediatrics Gastrointestinal hemorrhage Endoscopy Proton pump inhibitors Mortality Liver disease hospital Information Systems Octreotide

Comparison of the demographic characteristics of pediatric and adult colorectal cancer patients: a national inpatient sample based analysis

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World Journal of Pediatrics 2019年第1期15卷 37-41页

作者： Thomas M.Attard Caitlin E.Lawson University of Missouri Kansas City Kansas CityMOUSA Pediatric Gastroenterology Children's Mercy Hospital2401Gillham RdKansas CityMO 64108USA Division of Genetics Children's Mercy HospitalKansas CityMOUSA

Background Colorectal cancer in children is rare,but characterized by late presentation,unfavorable histology and poor *** factors for colorectal cancer in children overlap with those for adults with greater influence of hereditary *** epidemiology of colon cancer in children is poorly understood;the aim of this study was to characterize and compare the demographics and relevant clinical characteristics of pediatric and adult colon cancer,using a national inpatient *** The AHRQ online resource HCUPnet/KID database was queried for children,under the age of 18 admitted with ICD 9 CM diagnoses relating to colorectal cancer,at the time of *** comparison,the corresponding diagnoses in adult patients were queried for each successive *** demographics including residential type and median income by zip-code,tumor localization;if recorded,and mean hospital charges were all accrued and *** Inpatient admissions for pediatric colorectal cancer were more likely male (54%),in the 15-17 years age bracket (57%).They were significantly more likely from Southwestern regions of the Unites States,and were significantly more likely from residential zip-codes identified as at or below the lowest income quartile than adult CRC patients or pediatric patients as a *** charges have more than quadrupled over the time period studied (1997-2012).Conclusions Pediatric colorectal cancer is the most common primary gastrointestinal malignancy in *** understanding associated risk factors including those associated with gender,geographic region and social economic status may contribute to future prevention or early detection strategies.

关键词： Colorectal cancer Colorectal neoplasms Demography International classification of diseases Pediatric risk factors

Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease

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World Journal of Gastroenterology 2019年第28期25卷 3808-3822页

作者： Nadia Mazen Hijaz Thomas Mario Attard Jennifer Marie Colombo Neil Joseph Mardis Craig Alan Friesen Division of Gastroenterology Hepatology and Nutrition University of Missouri Kansas City Children’s Mercy Hospital Kansas City

BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) and indeterminate colitis (IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn's Disease Activity Index (PCDAI), and histological indices. AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC. METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion. After informed consent, patient’s demographic and clinical data was abstracted. The current pediatric disease activity index (PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists (Attard TM and Colombo JM) blinded to each other's findings and to the findings on MRE (Mardis NJ). Agreement between WCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed. RESULTS Forty-five patients were included in the study, 18 withdrew and 27 (20 males and 20 CD), mean age (standard deviation) 13.46 (2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good

关键词： Crohn’s disease Wireless capsule endoscopy Inflammatory bowel disease Magnetic resonance enterography Small bowel involvement Small bowel disease Indeterminate colitis Pediatric Children

Restrictive perimembranous ventricular septal defect with left to right Shunt post urgent aortic balloon valvuloplasty and transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2018年第1期15卷 113-116页

作者： Emmanouil Chourdakis Ioanna Konlari Nicholas G Kounis Dimitrios Velissaris George Hahalis Karl Eugen Hauptmann Cardiology Department Hospital of the Brothers of Mercy Trier Germany Cardiology Department Queen Elizabeth University Hospital Birmingham UK Cardiology Department Patras University Hospital Rio Patras Greece

An 86-year-old male patient was admitted in our cardiology ward with signs of congestive biventricular heart failure. The patient presented with deteriorating dyspnea on mild exertion and at rest the last days, compatible with class NYHA Ⅲ-Ⅳ heart failure, bilateral peripheral oedema, increased NT-proBNP （9198 pg/mL）, mildly elevated Troponin （TnT 64 pg/mL）, interstitial pulmonary oedema and bilateral pleural effusions in chest X ray.

关键词： Aortic stenosis Aortic rupture Shunt Transcatheter aortic valve replacement Valvuloplasty Ventricular septal defect

Olanzapine-induced acute necrotising pancreatitis leading to recurrent multiple organ dysfunction syndrome

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General Psychiatry 2022年第1期35卷 53-56页

作者： Stelios Naxakis Meghan Wafer Ruth Collins St.Michael's Unit Mercy University HospitalNorth Lee Mental Health ServicesCorkIreland

SUMMARY A married mother in her 50s acutely developed vomiting,diarrhoea and severe epigastric pain 2 weeks following discharge from an acute psychiatric inpatient *** presented to the emergency department complaining of a 2-day history of the above *** tests revealed neutrophilia,grossly raised inflammatory markers and amylase levels triple the normal *** on radiological investigations,she was treated for necrotising pancreatitis that quickly escalated to multi-system organ failure and a lengthy intensive care unit *** causes of pancreatitis,including cholelithiasis,alcohol and other drugs,were ruled *** this,she suffered recurrent episodes of pancreatitis with significant ***,started during her psychiatric admission,was determined to be the offending *** years following the discontinuation of olanzapine,the patient has had no further episodes of acute pancreatitis.

关键词： pancreatitis acute Blood

Co-morbidity,not age predicts adverse outcome in clostridium difficile colitis

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World Journal of Gastroenterology 2000年第2期6卷 198-201页

作者： TS Dharmarajan M Sipalay R Shyamsundar EP Norkus CS Pitchumoni Divisions of Geriatrics Our Lady of mercy Medical Center BronxNew YorkUSA Department of Biomedical Research Our Lady of Mercy Medical CenterBronxNew YorkUSA Divisions of Gastroenterology Our Lady of mercy Medical Center BronxNew YorkUSA

AIM To examine whether age alone or co-morbidity is a risk factor for death in olderadults who developed Clostridium difficile(Cd)colitis during *** A retrospective,observationalstudy design was performed in our Lady ofmercy Medical Center,a 650-bed,urban,community-based,university-affiliated teachinghospital.121 patients with a positive diagnosisof Cd colitis Caged 23-97 years)were studied,and data pertinent to demographic variables,medical history,co-morbidity,physicalexamination,and laboratory results *** was examined as a continuousvariable and stratified into Age1(80 years).However,age,per se,had no effect onmortality.A history of cardiac disease(P=0.036),recurrent or refractory infection>4weeks(P=0.007),low serum total protein(P=0.034),low serum albumin(P=0.001),antibiotic use >4 weeks(P<0.010),use of over 4 antibiotics(P=0.026),and use of certainclasses of antibiotics(P=0.035-0.004)werepredictive of *** was stronglypredicted by the use of penicillin-like antibioticsplus clindamycin,in the presence ofhypoalbuminemia,refractory sepsis,andcardiac disease(P=0.00005).CONCLUSION Cd colitis is common in the ***,unlike co-morbidity,age alonedoes not affect the clinical outcome(survival vsdeath).

关键词： clostridium difficile colitis/old age comorbidity/old age diarrhea colitis/therapy physical examination

A systematic review of dedicated models of care for emergency urological patients

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Asian Journal of Urology 2021年第3期8卷 315-323页

作者： Ned Kinnear Matheesha Herath Dylan Barnett Derek Hennessey Christopher Dobbins Tarik Sammour James Moore Discipline of Surgery Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideAustralia Department of Surgery Royal Adelaide HospitalAdelaideAustralia Department of Urology Mercy University HospitalCorkIreland

Objective:To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients(EUPs).Methods:A search of Cochrane,Embase,Medline and grey literature from January 1,2000 to March 26,2019 was performed using methods pre-published on *** followed Preferred Reporting Items for Systematic Review and meta-analysis *** studies were articles or abstracts published in English describing dedicated models of care for EUPs,which reported at least one secondary *** were excluded if they examined pathways dedicated only to single presentations,such as torsion,or outpatient solutions,such as rapid access *** primary outcome was the spectrum of *** outcomes were time-to-theatre,length of stay,complications and ***:Seven studies were identified,totalling 487 *** studies were conference abstracts,while one study was of full-text length but published in grey *** distinct models were *** included consultant urologists allocated solely to the care of EUPs(“Acute Urological Unit”)or dedicated registrars or operating theatres(“Hybrid structures”).In some services,EUPs bypassed emergency department assessment and were referred directly to urology(“Urological Assessment Unit”)or were managed by other dedicated *** services to EUPs was associated with reduced time-to-theatre,length of stay and hospital cost,and improved supervision of junior medical ***:Multiple dedicated models of care exist for ***-level evidence suggests these may improve outcomes for patients,staff and *** quality studies are required to explore patient outcomes and minimum requirements to establish these models.

关键词： Acute surgical unit Acute care surgery Urology Emergency Acute Dedicated

Eosinophils and mast cells as therapeutic targets in pediatric functional dyspepsia

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2013年第4期4卷 86-96页

作者： Craig A Friesen Jennifer V Schurman Jennifer M Colombo Susan M Abdel-Rahman Division of Gastroenterology Hepatology and Nutritionthe Children’s Mercy Hospital and Clinics Division of Developmental and Behavioral Sciences the Children’s Mercy Hospital and Clinics Division of Pediatric Pharmacology and Medical Toxicology the Children’s Mercy Hospital and Clinics

There is an increasing appreciation for the importance of inflammation as a pathophysiologic entity that contributes to functional gastrointestinal disorders including functional dyspepsia(FD).Importantly,inflammation may serve as a mediator between psychologic and physiologic *** manuscript reviews the literature implicating two inflammatory cell types,mast cells and eosinophils,in the generation of dyspeptic symptoms and explores their potential as targets for the treatment of *** are a number of inciting events which may initiate an inflammatory response,and the subsequent recruitment and activation of mast cells and *** include internal triggers such as stress and anxiety,as well as external triggers such as microbes and *** studies suggest that there may be efficacy in utilizing medications directed at mast cells and *** exists to suggest that combining "anti-inflammatory" medications with other treatments targeting stress can improve the rate of symptom resolution in pediatric FD.

关键词： Eosinophils Mast cells Functional dyspepsia Abdominal pain Stress

美国临床护理岗位及护士类别对我国护理专业发展方向的启示

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护理研究 2020年第4期34卷 677-679页

作者：薛小静杨小林 Ka Yee Chan 何芳绵阳市中心医院四川621000 mercy hospital in chicago

介绍了美国护士助理、职业操作护士、注册护士、开业护士、旅行护士和专科护士的职责,提示美国临床护理岗位种类较多,分工明确,护士自身定位清晰,护理岗位培养体系完善,对我国护理专业发展具有借鉴意义,尤其在临床护理岗位类别和层级设... 详细信息

介绍了美国护士助理、职业操作护士、注册护士、开业护士、旅行护士和专科护士的职责,提示美国临床护理岗位种类较多,分工明确,护士自身定位清晰,护理岗位培养体系完善,对我国护理专业发展具有借鉴意义,尤其在临床护理岗位类别和层级设置、护理教育体系、专科护士和护士多点执业等方面。

关键词：护理岗位职责注册护士开业护士旅行护士专科护士护理教育综述