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| 1 | Mortality associated with gastrointestinal bleeding in children: A retrospective cohort study显示文摘AIM To determine the clinical characteristics of children with gastrointestinal bleeding (GIB) who died during the course of their admission.METHODS We 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, v.3.2.3. RESULTS The 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 consideringonly 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 conditions. CONCLUSION GIB 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. | Thomas M Attard Mikaela Miller Chaitanya Pant Ashwath Kumar Mike Thomson | 2017 | World Journal of Gastroenterology2017，23，9： | 6 |
| 2 | Clinical outcome of pediatric collagenous gastritis: Case series and review of literature显示文摘Collagenous gastritis (CG) is characterized by patchy subepithelial collagen bands. Effective treatment and the clinical and histological outcome of CG in children are poorly defined. The aim of this study is to summarize the published literature on the clinical outcome and response to therapy of pediatric CG including two new cases. We performed a search in Pubmed, OVID for related terms; articles including management and clinical and/or endo-histologic follow up information were included and abstracted. Reported findings were pooled in a dedicated database including the corresponding data extracted from chart review in our patients with CG. Twenty-four patients were included (17 females) with a mean age of 11.7 years. The clinical presentation included iron deficiency anemia and dyspepsia. The reported duration of follow up (in 18 patients) ranged between 0.2-14 years. Despite most subjects presenting with anemia including one requiring blood transfusion, oral iron therapy was only documented in 12 patients. Other treatment modalities were antisecretory measures in 13 patients; proton pump inhibitors (12), or histamine-2 blockers (3), sucralfate (5), prednisolone (6), oral budesonide in 3 patients where one received it in fish oil and triple therapy (3). Three (13%) patients showed no clinical improvement despite therapy; conversely 19 out of 22 were reported with improved symptoms including 8 with complete symptom resolution. Spontaneous clinical resolution without antisecretory, anti-inflammatory or gastroprotective agents was noted in 5 patients (4 received only supplemental iron). Follow up endohistopathologic data (17 patients) included persistent collagen band and stable Mononuclear cell infiltrate in 12 patients with histopathologic improvement in 5 patients. Neither collagen band thickness nor mononuclear cell infiltrate correlated with clinical course. Intestinal metaplasia and endocrine cell hyperplasia were reported (1) raising the concern of long term malignant transformation. In summary, CG in children is a chronic disease, typically with a variable clinical response and an indolent course that is distinct from the adult phenotype. Long term therapy usually inclused iron supplementation but cannot be standardized, given the chronicity of the disease, variability of response and potential for adverse events. | Nadia Mazen Hijaz Seth Steven Septer James Degaetano Thomas Mario Attard | 2013 | World Journal of Gastroenterology2013，19，9： | 5 |
| 3 | Aggressive juvenile polyposis in children with chromosome 10q23 deletion显示文摘Juvenile polyps are relatively common findings in children,while juvenile polyposis syndrome(JPS) is a rare hereditary syndrome entailing an increased risk of colorectal cancer.Mutations in BMPR1A or SMAD4 are found in roughly half of patients diagnosed with JPS.Mutations in PTEN gene are also found in patients with juvenile polyps and in Bannayan-Riley-Ruvalcaba syndrome and Cowden syndrome.Several previous reports have described microdeletions in chromosome 10q23 encompassing both PTEN and BMPR1A causing aggressive polyposis and malignancy in childhood.These reports have also described extra-intestinal findings in most cases including cardiac anomalies,developmental delay and macrocephaly.In this report we describe a boy with a 5.75 Mb deletion of chromosome 10q23 and a 1.03 Mb deletion within chromosome band 1p31.3who displayed aggressive juvenile polyposis and multiple extra-intestinal anomalies including macrocephaly,developmental delay,short stature,hypothyroidism,atrial septal defect,ventricular septal defect and hypospadias.He required colectomy at six years of age,and early colectomy was a common outcome in other children with similar deletions.Due to the aggressive polyposis and reports of dysplasia and even malignancy at a young age,we propose aggressive gastrointestinal surveillance in children with 10q23 microdeletions encompassing the BMPR1A and PTEN genes to include both the upper and lower gastrointestinal tracts,and also include a flowchart for an effective genetic testing strategy in children with juvenile polyposis. | Seth Septer Lei Zhang Caitlin E Lawson Jose Cocjin Thomas Attard Holly H Ardinger | 2013 | World Journal of Gastroenterology2013，19，14： | 4 |
| 4 | Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease显示文摘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 correlation between the two Lewis scores (r=0.875, P<0.001). Concordance between WCE and MRE was poor (69%). In CD patients, when both MRE and WCE were compared using PCDAI>10 as the standard reference reflecting active small intestinal CD, the sensitivity of MRE and WCE were 100% and 83% respectively and the specificity of MRE and WCE were 57.14% and 78.6%, respectively. If the histology in ileum or/and duodenum was used as the reference for active small bowel involvement, WCE had a higher specificity as compared to MRE (83.3% vs 50%). In patients with Crohn’s disease, those with a positive PCDAI (>10) were more likely to have a positive WCE as compared to those with a negative PCDAI (83% vs 21%;P=0.018). CONCLUSION We suggest that MRE and WCE have a complementary role in the assessment of SBI in CD. WCE detected SBI with a much higher specificity while MRE had a higher sensitivity. | Nadia Mazen Hijaz Thomas Mario Attard Jennifer Marie Colombo Neil Joseph Mardis Craig Alan Friesen | 2019 | World Journal of Gastroenterology2019，25，28： | 3 |
| 5 | Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results显示文摘 | Tommaso Vincenzo Bartolotta Massimo Midiri Massimo Galia Giuseppe Runza Marco Attard Giovanni Savoia Roberto Lagalla Adelfio Elio Cardinale | 2006 | European Radiology2006，，： | 2 |
| 6 | The Association of PI3 Kinase Signaling and Chemoresistance in Advanced Ovarian Cancer显示文摘 | Craig P. Carden Adam Stewart Parames Thavasu Emma Kipps Lorna Pope Mateus Crespo Susana Miranda Gerhardt Attard Michelle D. Garrett Paul A. Clarke Paul Workman Johann S. de Bono Martin Gore Stan B Kaye Udai Banerji | 2012 | Molecular Cancer Therapeutics2012，，7： | 2 |
| 7 | Burden of celiac disease in the Mediterranean area显示文摘AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac patients will die in the next 10 years, with an excess of 44.4% vs age-and sexmatched controls. CONCLUSION: In the near future, the burden of CD will increase tremendously. Few Mediterranean countries are able to face this expanding epidemic alone. | Luigi Greco Laura Timpone Abdelhak Abkari Mona Abu-Zekry Thomas Attard Faouzi Bouguerrà Paskal Cullufi Aydan Kansu Dusanka Micetic-Turk Zrinjka Miak Eleftheria Roma Raanan Shamir Selma Terzic | 2011 | World Journal of Gastroenterology2011，17，45： | 2 |
| 8 | Hydrochlorination of acetylene using supported bimetallic Au-based catalysts显示文摘 | Marco Conte Albert F. Carley Gary Attard Andrew A. Herzing Christopher J. Kiely Graham J. Hutchings | 2008 | Journal of Catalysis2008，，1： | 2 |
| 9 | Impact of machine perfusion of the liver on post-transplant biliary complications: A systematic review显示文摘AIM To review the clinical impact of machine perfusion(MP) of the liver on biliary complications post-transplantation, particularly ischaemic-type biliary lesions(ITBL). METHODS This systematic review was performed in accordance with the Preferred Reporting Systematic Reviews and MetaAnalysis(PRISMA) protocol. The following databases were searched: PubMed, MEDLINE and Scopus. The keyword 'liver transplantation' was used in combination with the free term 'machine perfusion'. Clinical studies reporting results of transplantation of donor human livers following ex situ or in situ MP were analysed. Details relating to donor characteristics, recipients, technique of MP performed and post-operative biliary complications(ITBL, bile leak and anastomotic strictures) were critically analysed.RESULTS Fifteen articles were considered to fit the criteria for this review. Ex situ normothermic MP was used in 6 studies, ex situ hypothermic MP in 5 studies and the other 4 studies investigated in situ normothermic regional perfusion(NRP) and controlled oxygenated rewarming. MP techniques which have per se the potential to alleviate ischaemia-reperfusion injury: Such as hypothermic MP and NRP, have also reported lower rates of ITBL. Other biliary complications, such as biliary leak and anastomotic biliary strictures, are reported with similar incidences with all MP techniques. There is currently less clinical evidence available to support normothermic MP as a mitigator of biliary complications following liver transplantation. On the other hand, restoration of organ to full metabolism during normothermic MP allows assessment of hepatobiliary function before transplantation, although universally accepted criteria have yet to be validated.CONCLUSION MP of the liver has the potential to have a positive impact on post-transplant biliary complications, specifically ITBL, and expand extended criteria donor livers utilisation. | Yuri L Boteon Amanda PCS Boteon Joseph Attard Lorraine Wallace Ricky H Bhogal Simon C Afford | 2018 | World Journal of Transplantation2018，8，6： | 2 |
| 10 | Follow-up of low risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases显示文摘 | Torlontano M Attard M Crocetti U | 2004 | Clin Endocrinol Metab2004，89，7： | 1 |
| 11 | 查看详情显示文摘 | Attard G S Glyde C Goltner C G | | 0，，： | 1 |
| 12 | Immunomodulatory activity of cucurbitacin isolated from Ecballium elaterium显示文摘 | Attard E Brineat MP Cuschieri A | 2005 | Fitoterapia2005，76，5： | 1 |
| 13 | Use of disodium pamidronate in children with hypercalcemia awaiting liver transplantation显示文摘 | Dhawan A Kaufman S S | 1998 | Pediatr Transplant1998，2，2： | 1 |
| 14 | Effects of Ephedrine and Ephedra fragilis Crude Extracts on Human Peripheral Lymphocytes 显示文摘 | Attard E Vella K | 2009 | Pharmacognosy Research2009，1，2： | 1 |
| 15 | Hyperelastic constitutive modeling under finite strain 显示文摘 | Attard M M Hunt G W | 2004 | International Journal of Solids and Structures2004，41，： | 1 |
| 16 | Carotenaemia with low vitamin a levels and low retinol-binding protein显示文摘 | Attard M S Evavs N Sherwood R A | 1992 | Journal of Inherited Metabolic Disease1992，15，6： | 1 |
| 17 | Immunomodulatory activity of cucurbitaein E isolated from Ecballium elaterium 显示文摘 | ATTARD E BRINCAT M P CUSCHIERI A | 2005 | Fitoterapia2005，76，： | 1 |
| 18 | Neoadjuvant chemoradiation increases the risk of pelvic sepsis after radical excision of rectal cancer 显示文摘 | Buie WD MacLean AR Attard JA | 2005 | Dis Colon Rectum2005，48，10： | 1 |
| 19 | Hydrochlorination of acetylene using supported bimetallic Au-based cata- lysts显示文摘 | Conte M Carley A Attard G | 2008 | Journal of Catalysis2008，257，1： | 1 |
| 20 | Phase I trialinvolving the pharmacodynamic ( PD) study of circulatingtumour cells, of CP - 7 5 1 8 7 1 , a monoclonal antibody againstthe insulin - like growth factor 1 receptor ( IGF -1R ),with docetaxel ( D) in patients with advanced cancer显示文摘 | ATTARD G FONG P C MOLIFE R | | JC lin Oncol0，22，9： | 1 |
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