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A journey of a thousand miles begins with one small step

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Hepatobiliary Surgery and nutrition 2024年第1期13卷 112-114页

作者： Elke Roeb Department of Gastroenterology Medical Clinic IIJustus Liebig UniversityGiessenGermany

Liver disease associated with metabolic dysfunction now affects more than 30%of the world’s population(1).Historically known as non-alcoholic fatty liver disease(NAFLD)is caused by obesity,lack of exercise,and a westernised lifestyle(2).To date,numerous attempts have been made to influence the steatohepatitis and liver fibrosis associated with metabolism-associated fatty liver disease(MAFLD)with *** to date,no substance has been authorised for the indication NAFLD/MAFLD/metabolism-associated steatosis liver disease(MASLD)(3).It has long been known that a consistent change in lifestyle with a reduced diet and physical exercise is able to improve fatty liver disease,steatohepatitis.

关键词： Metabolism-associated steatosis liver disease(MASLD) metabolism-associated fatty liver disease(MAFLD) non-alcoholic fatty liver disease(NAFLD) exercise fatty liver

Shrinking fat,healing liver:unlocking the metabolic dysfunction associated steatohepatitis puzzle

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Hepatobiliary Surgery and nutrition 2024年第1期13卷 132-135页

作者： Sudhakar K.Venkatesh Ilkay S.Idilman Jiahui Li Meng Yin Department of Radiology Mayo ClinicRochesterMNUSA Department of Radiology Hacettepe UniversityAnkaraTurkey

Metabolic dysfunction associated steatohepatitis(MASH)is a silent epidemic,hiding in the shadows of obesity,and often silently advancing towards the grave complication of *** distinction between MASH and simple hepatic steatosis,which is under the spectrum of metabolic dysfunction-associated steatotic liver disease(MASLD),is highly desired as it provides critical information about the prognosis of the *** indicators,such as fibrosis-4(FIB-4)index and nonalcoholic fatty liver disease(NAFLD)fibrosis score that includes conventional laboratory data and clinical parameters.

关键词： Proton density fat fraction(PDFF) metabolic dysfunction associated steatohepatitis(MASH) deep subcutaneous fat

Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors:The iBoneFIT project

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Journal of Sport and Health Science 2024年第3期13卷 419-427页

作者： Andres Marmol-Perez Jose J.Gil-Cosano Esther Ubago-Guisado Francisco J.Llorente-Cantarero Juan Francisco Pascual-Gázquez Kirsten K.Ness Vicente Martinez-Vizcaino Jonatan R.Ruiz Luis Gracia-Marco Department of Physical Education and Sports Faculty of Sport SciencesSport and Health University Research Institute(iMUDS)University of GranadaGranada 18011Spain Department of Epidemiology and Cancer Control St.Jude Children's Research HospitalMemphisTN 38105USA Department of Communication and Education Loyola University AndalusiaSeville 41704Spain Biosanitary Research Institute ibs.GranadaGranada 18012Spain Maimonides Biomedical Research Institute of Cordoba(IMIBIC) Cordoba 14004Spain CIBEROBN Biomedical Research Networking Center for Physiopathology of Obesity and NutritionCarlos III Health InstituteMadrid 28029Spain Department of Specific Didactics Faculty of EducationUniversity of CordobaCordoba 14071Spain Pediatric and adolescent hematology and oncology service Pediatrics and Pediatric Surgery Clinical Management UnitVirgen de las Nieves University HospitalGranada 18014Spain Health and Social Research Center Universidad de Castilla-La ManchaCuenca 13001Spain

Background Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density(aBMD).However,the prevalence of muscle strength deficits is not well documented,and the associations of muscle strength with aBMD are unknown in this ***,this study aimed to investigate the prevalence of upper-and lower-body muscle strength deficits and to examine the associations of upper-and lower-body muscle strength with age-,sex,and race-specific aBMD Z-scores at the total body,total hip,femoral neck,and lumbar *** This cross-sectional study included 116 pediatric cancer survivors(12.1±3.3 years old,mean±SD;42.2%female).Upper-and lower-body muscle strength were assessed by handgrip and standing long jump test,***‑energy X‑ray absorptiometry was used to measure aBMD(g/cm2).Associations between muscle strength and aBMD were evaluated in multivariable linear regression *** regression was used to evaluate the contribution of muscle strength(1-decile lower)to the odds of having low aBMD(Z-score≤1.0).All analyses were adjusted for time from treatment completion,radiotherapy exposure,and body mass *** More than one-half of survivors were within the 2 lowest deciles for upper-(56.9%)and lower-body muscle strength(60.0%)in comparison to age-and sex-specific reference *** strength deficits were associated with lower aBMD Z-scores at all sites(B=0.133–0.258,p=0.001–0.032).Each 1-decile lower in upper-body muscle strength was associated with 30%–95%higher odds of having low aBMD Z-scores at all *** 1-decile lower in lower-body muscle strength was associated with 35%–70%higher odds of having low aBMD Z-scores at total body,total hip,and femoral *** Muscle strength deficits are prevalent in young pediatric cancer survivors,and such deficits are associated with lower aBMD Z-scores at all *** results suggest that interventions designed to improve muscle strength in t

关键词： Bone health Childhood cancer DXA Lean mass Resistance training

An Overview of Chemical Constituents, Medicinal Properties, clinical Trials, and Patents of Twigs of Morus alba(Ramulus Mori)

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World Journal of Traditional Chinese Medicine 2024年第2期10卷 149-158页

作者： Eric Wei Chiang Chan Hung Tuck Chan Siu Kuin Wong Department of Food Science and nutrition Faculty of Applied SciencesUCSI UniversityCherasKuala LumpurMalaysia Secretariat of International Society for Mangrove Ecosystems Faculty of AgricultureUniversity of the RyukyusOkinawaJapan School of Foundation Studies Xiamen University MalaysiaSepangSelangorMalaysia

The rich chemical constituents and diverse pharmacological properties of Ramulus Mori(RM) or the twig of Morus alba with evidence supported by clinical trials and patents are reviewed. Known as Sangzhi in Chinese, RM is widely used in traditional Chinese medicine to treat gout, arthritis, and rheumatism. Chemical constituents include flavonoids, benzofurans, alkaloids, stilbenes, chalcones, phenolic acids, and coumarins. Bioactivities of RM include antidiabetic, anti-obesity, anti-inflammatory, antityrosinase, neuroprotective, antioxidant, hepatoprotective, cytoprotective, renoprotective, antihyperuricemic, analgesic, antifungal, DNA protective, anticancer, gastroprotective, cardioprotective, anti-hair aging, anti-arthritic, and antiplatelet aggregation properties. The most active compounds from RM are mulberrin, oxyresveratrol, and mulberroside A. All four clinical trials on RM are focused on the treatment of diabetes. The patents entail using RM extracts as cosmetics for skin whitening and as agents for hypoglycemia. Topics for further research on RM are suggested.

关键词： clinical trials mulberrin mulberroside A oxyresveratrol patents Sangzhi

Macroangiopathic Complications and Associated Factors in Type 2 Diabetics at CNHU-HKM

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Journal of Diabetes Mellitus 2024年第1期14卷 13-19页

作者： Annelie Kerekou Hode Hubert Dedjan Gaëtan Ayina Endocrinology Metabolism and Nutrition Department CNHU-HKM Cotonou Benin Department of Medicine and Medical Specialties CHUD-OP Porto-Novo Benin

Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.

关键词： Type 2 Diabetes Macroangiopathy Coronary Artery Disease Stroke Peripheral Arterial Disease

Cyanoacrylate spray as treatment in difficult-to-manage gastrointestinal bleeding

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World Journal of Gastrointestinal Endoscopy 2014年第9期6卷 448-452页

作者： Liz Toapanta-Yanchapaxi Norberto Chavez-Tapia Félix Téllez-ávila Gastroenterology Service Digestive Disease and Obesity Clinic Medica Sur Clinic and Foundation Endoscopy Department National Institute of Medical Sciences and Nutrition Salvador Zubirán

Gastrointestinal bleeding can be a life-treating event that is managed with standard endoscopic therapy in the majority of cases. However, up to 5%-10% of patients may have persistent bleeding that does not respond to conventional measures. Several endoscopic treatment techniques have been proposed as strategies to control such cases, such as epinephrine injection, hemoclips or argon plasma coagulation, but there are certain clinical scenarios where it is difficult to achieve hemostasis even though adequate use of the available resources is made. Reasons for these failures can be associated with the lesion features, such as extent or location. The use of long-standing techniques in nontraditional scenarios, such as with cyanoacrylate for gastric varices sclerosis, has been reported with favorable results. Although new products such as TC-325 or Ankaferd Blood Stopper hemosprays may be useful, their formulations are not available worldwide. Here we present two clinical cases with very different scenarios of gastrointestinal bleeding, where the use of cyanoac-rylate in spray had favorable results in uncommon indications. Cyanoacrylate used as a spray is a technique that can be used as an alternative method in emergent settings.

关键词： Cyanoacrylate Gastrointestinal bleeding Hemostasis Mexico Spray

Should perioperative immunonutrition for elective surgery be the current standard of care?

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Gastroenterology Report 2016年第2期4卷 87-95,I0001页

作者： Shishira Bharadwaj Brandon Trivax Parul Tandon Bilal Alkam Ibrahim Hanouneh Ezra Steiger Center for Human nutrition the Cleveland Clinic FoundationClevelandOHUSA College of Osteopathic Medicine Michigan State UniversityEast LansingMIUSA

Postoperative infectious complications are independently associated with increased hospital length of stay(LOS)and cost and contribute to significant inpatient *** strategies such as avoidance of long periods of preoperative fasting,re-establishment of oral feeding as early as possible after surgery,metabolic control and early mobilization have been used to either prevent or reduce the incidence of postoperative *** these efforts,it remains a big challenge to our current healthcare system to mitigate the cost of postoperative ***,preoperative nutritional status has also been implicated as an independent risk factor for postoperative *** nutritional support using enteral and parenteral routes has been shown to decrease postoperative morbidity,especially in high-risk ***,the role of immunonutrition(IMN)in postoperative infectious complications has been studied *** substrates have been found to positively modulate postsurgical immunosuppression and inflammatory *** have also been shown to be cost-effective by decreasing both tpostoperative infectious complications and hospital *** this review,we discuss the postoperative positive outcomes associated with the use of perioperative IMN,their cost-effectiveness,current guidelines and future clinical implications.

关键词： immunonutrition infections postoperative complications cost-effectiveness guidelines

Bariatric surgery proves long-term benefit in patients with cirrhosis

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Gastroenterology Report 2021年第3期9卷 252-256,I0002页

作者： Manhal Izzy Mounika Angirekula Barham KAbu Dayyeh Fateh Bazerbachi Kymberly D.Watt Division of Gastroenterology Hepatologyand NutritionVanderbilt University Medical CenterNashvilleTNUSA Division of Gastroenterology and Hepatology Mayo Clinic and FoundationRochesterMNUSA Division of Gastroenterology Massachusetts General HospitalBostonMAUSA

Background:obesity is commonly observed in patients with cirrhosis,especially with the increasing prevalence of nonalcoholic steatohepatitis(NASH).Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk;therefore,data are lacking regarding long-term *** this study,we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric ***:We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23,2009 and November 9,2011,and followed in a pilot study for evaluation of bariatric surgery *** patients with more than 4 years of follow-up were included in the *** regarding their liver disease,metabolic status,and survival were collected.A descriptive analysis was ***:The cohort consisted of 10 patients,of whom 7 were *** median post-surgical follow-up was 8.7 years(61.4 years).All patients had biopsy-proven NASH;two patients had concurrent,untreated hepatitis C *** the observation period,there was a mean weight loss of 24 kg(19.2%of total body weight pre surgery,P<0.001)and only one patient regained weight to the baseline pre-surgical *** patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later *** remainder of the patients did not have any hepatic decompensation,cardiovascular event,or *** for one patient with Gilbert syndrome,bilirubin was normal in all patients at last ***:Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-termfollow-up.

关键词： obesity weight loss bariatric surgery cirrhosis non-alcoholic steatohepatitis

Cardiac risk factors limiting survival to liver transplantation in patients with nonalcoholic fatty liver disease

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World Journal of Hepatology 2022年第7期14卷 1398-1407页

作者： Michael Delicce Joseph Mauch Abel Joseph Ruishen Lyu Heather Kren Rose Bartow Donna Ferchill Maan Fares Jamile Wakim-Fleming Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Lerner College of Medicine at Case Western Reserve University Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44195United States Department of Liver Transplantation Cleveland ClinicClevelandOH 44195United States Department of Cardiovascular Medicine Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)describes the hepatic manifestations of metabolic syndrome,which is estimated to affect 25%of adults,and currently represents the second most common indication for liver transplant in the United *** have shown that patients with NAFLD are at an increased risk for heart failure,arrhythmia,and coronary artery disease(CAD),which may impact outcomes of liver ***,it remains unclear whether the presence of cardiac disease affects survival prior to liver *** so,this would represent an important opportunity to optimize cardiac status and improve outcomes before liver *** To identify cardiac factors that impact survival to liver transplantation in patients with NAFLD and on the transplant *** The aim of this study was to identify cardiac risk factors that limit survival to transplant in patients with *** performed a retrospective analysis of patients with NAFLD listed for liver transplant at a tertiary academic medical center in the United States from January 2015 to January 2021,identified through United Network of Organ Sharing *** criteria included a concurrent etiology of liver disease and removal from the transplant list due to chemical dependency,lack of social support,improvement in liver disease,or being lost to *** manually reviewed patient charts including electrocardiogram,echocardiogram,and cardiac catheterization reports as well as physician notes to identify cardiac disease states(i.e.,heart failure,arrhythmia,valvular disease and CAD)and other related *** performed a survival analysis by Cox proportional hazards regression model to analyze the association between cardiac factors at the time listed for transplant and death or clinical deterioration prior to *** Between January 2015 and January 2021,265 patients with nonalcoholic fatty liver disease were listed for liver transplant at our instituti

关键词： Nonalcoholic fatty liver disease Liver transplant Cardiovascular disease Pre-transplant outcomes Coronary artery disease Risk factors