检索结果-南通市图书馆

World Journal of Gastroenterology 2015年第40期21卷 11379-11386页

作者： Hamish Philpott Sanjay Nandurkar John Lubel Peter R Gibson Monash University Eastern HealthThe Alfred Hospital

Patients presenting with abdominal pain and diarrhea are often labelled as suffering from irritable bowel syndrome,and medications may be used often without success. Advances in the understanding of the causes of the symptoms(including pelvic floor weakness and incontinence,bile salt malabsorption and food intolerance) mean that effective,safe and well tolerated treatments are now available.

关键词： Bile acids Pelvic floor Food intolerance Irritable

Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第48期23卷 8526-8532页

作者： Ken Liu Vikram Joshi Louise van Camp Qi-Wei Yang Judith E Baars Simone I Strasser Geoffrey W McCaughan Avik Majumdar Payal Saxena Arthur J Kaffes Sydney Medical School The University of Sydney AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital Department of Radiology Royal Prince Alfred Hospital

AIM To determine the prevalence,characteristics and clinical course of pancreatic cystic neoplasms(PCNs) in liver transplantation(LT) *** We retrospectively studied consecutive patients who underwent LT between January 1998 to April 2016. Clinical and laboratory data were obtained from patient medical records. Imaging findings on computed tomography and magnetic resonance cholangiopancreatography were reviewed by two *** During the study period,872 patients underwent cadaveric LT. Pancreatic cysts were identified in 53/872(6.1%) and 31/53(58.5%) were PCNs [28 intraductal papillary mucinous neoplasm(IPMN),2 mucinous cystic neoplasm(MCN),1 serous cystadenoma]. Patients with PCNs exhibited less male predominance(55% vs 73%,P = 0.03) compared to patients without pancreatic cysts. Thirteen patients(42%) were diagnosed with PCN pre-LT while 18 patients(58%) developed PCN post-LT. The median size of PCNs was 13 mm [interquartile range(IQR) 10-20 mm]. All IPMNs were side-branch type. Most PCNs were found in the head and body of pancreas(37% each),followed by the tail(25%). Five patients underwent further evaluation with endoscopic ultrasound. Progress imaging was performed on 81% of patients. PCNs remained stable in size and number in all but 2 patients. During a median follow up of 39 mo(IQR 26-58 mo),the 2(6%) patients with MCN underwent pancreatectomy. No PCN patient developed pancreatic adenocarcinoma,while 5 died from illnesses unrelated to the PCN. Among patients without PCN,1/841(0.1%) developed pancreatic *** The prevalence of PCNs in LT recipients was similar to the general population(3.6%,31/872). Side-branch IPMNs do not appear to have accelerated malignant potential in post-LT patients,indicating the current surveillance guidelines are applicable to this group.

关键词： Pancreatic cystic neoplasm Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Liver transplantation Pancreatic adenocarcinoma Immunosuppression

Staged liver resection for colorectal metastases:a valuable strategy or a waste of time?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 600-604页

作者： Raaj Chandra Charles HC Pilgrim Val Usatoff the alfred hospital Upper Gastrointestinal/Hepatobiliary Surgery Unit

BACKGROUND:The use of staged liver resections for colorectal metastases has been increasing in recent *** aim of this study was to determine the practices and outcomes of those surgeons attending the Australia and New Zealand Hepatic, Pancreatic and Biliary Association(ANZHPBA)meeting in 2008 who perform staged resections. METHODS:A questionnaire was sent to all members of the ANZHPBA and the international faculty who were invited to attend the annual meeting held in Coolum,Queensland, Australia in October 2008. RESULTS:There were 30 responses from 7 centres across the UK,Germany and ***-eight patients completed *** study population was predominantly male (n=20,67%),with an average age of 59.4 *** patients had bilobar disease.A right-sided first resection was planned in 39%of *** percent of patients underwent portal vein embolization prior to first resection.A second operation was performed at an average of 2.8 months from the first ***,50%(n=14)of patients eventually achieved a complete(R0)staged *** complications after the first resection were seen in 32%patients(n=9).Twenty- three patients underwent a second liver ***-five complications after the second resection were present in 57% (n=13). CONCLUSIONS:Two-stage liver resections are beneficial if both stages are completed and an R0 resection is achieved. While there is increased morbidity and mortality,we believe that staged liver resection for colorectal metastases is a valuable strategy in selected cases.

关键词： liver resection colorectal cancer liver metastases

Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2010年第15期16卷 1885-1889页

作者： Hoi-Poh Tee Arthur J Kaffes A W Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM:To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their ***: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during ***: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular ***: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.

关键词： Bleeding Obscure gastrointestinal bleeding Endoscopy Double-balloon enteroscopy

Patients with non-viral liver disease have a greater tumor burden and less curative treatment options when diagnosed with hepatocellular carcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第15期23卷 2763-2770页

作者： Waled Mohsen Marcia Rodov Emilia Prakoso Barbara Charlton David G Bowen David J Koorey Nicholas A Shackel Geoffrey W McCaughan Simone I Strasser AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM To assess the impact of underlying liver disease etiology on the presenting features and outcomes in a large cohort of patients with hepatocellular carcinoma(HCC). METHODS A prospective database of all patients with HCC was established from 1998 to March 2012. One thousand and seventy-eight patients were categorized into three groups, based on the etiology of their liver disease: hepatitis B virus(HBV), hepatitis C virus(HCV) and non-viral liver disease(NVLD). Overall survival was determined by Kaplan Meier analysis to time of death or last *** HCC patients with HCV(85%) were more likely to be diagnosed as part of a surveillance program, compared to HBV or NVLD(both 71%)(P < 0.001). Patients with NVLD were more likely to receive best supportive care(29%) compared to those with HBV(21%) or HCV(20%)(P < 0.02). Twelve percent of NVLD and 13% of HBV patients underwent liver transplantation compared to 21% of HCV patients(P = 0.001). Median survival from presentation was lowest in NVLD(1.7 years) when compared to HBV(2.8 years) and HCV(2.6 years)(P < 0.05). In multivariate analysis, independent predictors of survival included Child Turcotte Pugh score, size of dominant lesion, absence of vascular invasion, and management with surgical resection or liver transplantation. Patient age and the etiology of the underlying liver disease were not independent predictors of survival CONCLUSION Patients with NVLD and HCC were less likely to be enrolled in a HCC surveillance program and are less likely to have curative therapies such as liver resection and transplantation after diagnosis with HCC, when compared to patients with Hepatitis B and Hepatitis C.

关键词： Hepatitis B Hepatitis C Hepatocellular carcinoma Surveillance Therapy Nonalcoholic fatty liver disease Survival

Double-balloon enteroscopy-assisted dilatation avoids surgery for small bowel strictures: A systematic review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第45期23卷 8073-8081页

作者： Judith E Baars Ruben Theyventhiran Patrick Aepli Payal Saxena Arthur J Kaffes AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM To evaluate the therapeutic role of double-balloon enteroscopy(DBE) in small bowel strictures and to propose a standard approach to small bowel *** Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded. RESULTS In total 13 studies were included,in which 310 patients were dilated. The average follow-up time was 31.8 mo per patient. The complication rate was 4.8% per patient and 2.6% per dilatation. Surgery was avoided in 80% of patients. After the first dilatation,46% were treated with re-dilatation and only 17% required *** DBE-assisted dilatation avoids surgery in 80% of patients with small bowel strictures and is safe and effective. We propose a standardized approach to small bowel strictures.

关键词： Double-ballloon enteroscopy Dilatation Small bowel stricture Enteroscopy Crohn's disease Systematic review

Mucinous cyst exhibiting severe dysplasia in gastric heterotopic pancreas associated withe gastrointestinal stromal tumour

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第43期13卷 5781-5782页

作者： Antony Kaufman David Storey Cheok Soon Lee Rajmohan Murali Department of Anatomical Pathology Sydney Cancer Centre Royal Prince Alfred Hospital Camperdown New South Wales Australia Department of Surgery Royal Prince Alfred Hospital Camperdown New South Wales Australia Department of Anatomical Pathology Sydney Cancer Centre Royal Prince Alfred Hospital Camperdown New South Wales Australia Sydney Melanoma Unit Sydney Cancer Centre Royal Prince Alfred Hospital Camperdown New South Wales Australia

Heterotopic pancreatic tissue within the stomach is rare and dysplasia within heterotopic pancreatic tissue is very rare. We present the first report of a patient with concurrent occurrence of heterotopic pancreas in ... 详细信息

关键词： Dysplasia Gastrointestinal stromal tumour Heterotopic pancreas Mucinous cyst Stomach

A rare case of failed healing in previously burned skin after a secondary burns

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Burns & Trauma 2017年第4期5卷 268-271页

作者： Stephen J. Goldie Shaun Parsons Hana Menezes Andrew Ives Heather Cleland Victorian Adult Burns Service Alfred Hospital Melbourne Australia Department of Surgery Monash University Melbourne Australia Victorian Adult Burns Service Alfred Hospital Melbourne Australia

Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

关键词： Previous burns Burn scar Non-healing

Investigations for the assessment of adult patients presenting to the emergency department with supraventricular tachycardia

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Emergency Medicine 2020年第1期11卷 54-59页

作者： Harith Fernando Nicholas Adams Biswadev Mitra Emergency and Trauma Centre The Alfred HospitalMelbourneVictoriaAustralia National Trauma Research Institute The Alfred HospitalMelbourneVictoriaAustralia Department of Epidemiology and Preventive Medicine Monash UniversityMelbourneVictoriaAustralia

Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.

关键词： tachycardia routine pathology

Timely completion of multiple life-saving interventions for traumatic haemorrhagic shock: a retrospective cohort study

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Burns & Trauma 2019年第1期7卷 204-212页

作者： Biswadev Mitra Jordan Bade-Boon Mark C.Fitzgerald Ben Beck Peter A.Cameron National Trauma Research Institute The Alfred Hospital89 Commercial RoadMelbourneVIC 3004Australia Emergency&Trauma Centre The Alfred HospitalMelbourneAustralia School of Public Health and Preventive Medicine Monash University MelbourneAustralia Trauma Service The Alfred HospitalMelbourneAustralia Faculty of Medicine Laval University Quebec City QuebecCanada

Background:Early control of haemorrhage and optimisation of physiology are guiding principles of resuscitation after *** outcomes have been previously associated with single,timely *** aim of this study was to assess the association between multiple timely life-saving interventions(LSIs)and outcomes of traumatic haemorrhagic shock ***:A retrospective cohort study was undertaken of injured patients with haemorrhagic shock who presented to Alfered Emergency&Trauma Centre between July 01,2010 and July 31,*** studied included chest decompression,control of external haemorrhage,pelvic binder application,transfusion of red cells and coagulation products and surgical control of bleeding through angio-embolisation or operative *** primary exposure variable was timely initiation of≥50%of the indicated *** association between the primary exposure variable and outcome of death at hospital discharge was adjusted for potential confounders using multivariable logistic regression *** association between total pre-hospital times and pre-hospital care times(time from ambulance at scene to trauma centre),in-hospital mortality and timely initiation of≥50%of the indicated interventions were ***:Of the 168 patients,54(32.1%)patients had≥50%of indicated LSI completed within the specified time *** delivery of LSI was independently associated with improved survival to hospital discharge(adjusted odds ratio(OR)for in-hospital death 0.17;95%confidence interval(CI)0.03–0.83;p=0.028).This association was independent of patient age,pre-hospital care time,injury severity score,initial serum lactate levels and *** patients with pre-hospital time of≥2 h,2(3.6%)received timely ***-hospital care times of≥2 h were associated with delayed LSIs and with in-hospital death(unadjusted OR 4.3;95%CI 1.4–13.0).Conclusions:Timely completion of LSI when indicated was completed in a small

关键词： Wounds Bundle of care Haemorrhage shock Resuscitation Emergency department Blood products Timely life-saving interventions Trauma Injuries