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| 1 | Adverse events with bismuth salts for Helicobacter pylori eradication:Systematic review and meta-analysis显示文摘AIM: To assess the safety of bismuth used in Helico- bacter pylori (H pylori) eradication therapy regimens. METHODS: We conducted a systematic review and meta-analysis. MEDLINE and EMBASE were searched (up to October 2007) to identify randomised controlled tri- als comparing bismuth with placebo or no treatment, or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or, in combination, with acid suppres- sion. Total numbers of adverse events were recorded. Data were pooled and expressed as relative risks with 95% confidence intervals (CI). RESULTS: We identified 35 randomised controlled tri- als containing 4763 patients. There were no serious adverse events occurring with bismuth therapy. There was no statistically significant difference detected in total adverse events with bismuth [relative risk (RR) = 1.01; 95% CI: 0.87-1.16], specific individual adverse events, with the exception of dark stools (RR = 5.06; 95% CI: 1.59-16.12), or adverse events leading to withdrawal of therapy (RR = 0.86; 95% CI: 0.54-1.37). CONCLUSION: Bismuth for the treatment of H pylori is safe and well-tolerated. The only adverse event oc- curring significantly more commonly was dark stools. | Alexander C Ford Peter Malfertheiner Monique Giguère José Santana Mostafizur Khan Paul Moayyedi | 2008 | World Journal of Gastroenterology2008,14,48: | 62 |
| 2 | Near-infrared fluorescence sentinel lymph node detection in gastric cancer: A pilot study显示文摘AIM: To investigate feasibility and accuracy of nearinfrared fluorescence imaging using indocyanine green: nanocolloid for sentinel lymph node(SLN) detection in gastric cancer.METHODS: A prospective, single-institution, phaseI feasibility trial was conducted. Patients suffering from gastric cancer and planned for gastrectomy were included. During surgery, a subserosal injection of 1.6 m L ICG:Nanocoll was administered around the tumor. NIR fluorescence imaging of the abdominal cavity was performed using the Mini-FLARE? NIR fluorescence imaging system. Lymphatic pathways and SLNs were visualized. Of every detected SLN, the corresponding lymph node station, signal-to-background ratio and histopathological diagnosis was determined. Patients underwent standard-of-care gastrectomy. Detected SLNs outside the standard dissection planes were also resected and evaluated.RESULTS: Twenty-six patients were enrolled. Four patients were excluded because distant metastases were found during surgery or due to technical failure of the injection. In 21 of the remaining 22 patients, at least 1 SLN was detected by NIR Fluorescence imaging(mean 3.1 SLNs; range 1-6). In 8 of the 21 patients, tumor-positive LNs were found. Overall accuracy of the technique was 90%(70%-99%; 95%CI), which decreased by higher p T-stage(100%, 100%, 100%, 90%, 0% for respectively Tx, T1, T2, T3, T4 tumors). All NIR-negative SLNs were completely effaced by tumor. Mean fluorescence signal-to-background ratio of SLNs was 4.4(range 1.4-19.8). In 8 of the 21 patients, SLNs outside the standard resection plane were identified, that contained malignant cells in 2 patients.CONCLUSION: This study shows successful use of ICG:Nanocoll as lymphatic tracer for SLN detection in gastric cancer. Moreover, tumor-containing LNs outside the standard dissection planes were identified. | Quirijn RJG Tummers Leonora SF Boogerd Wobbe O de Steur Floris PR Verbeek Martin C Boonstra Henricus JM Handgraaf John V Frangioni Cornelis JH van de Velde Henk H Hartgrink Alexander L Vahrmeijer | 2016 | World Journal of Gastroenterology2016,22,13: | 9 |
| 3 | Pyrrolidine dithiocarbamate reduces ischemia-reperfusion injury of the small intestine显示文摘AIM: To evaluate whether pyrrolidine dithiocarbamate (PDTC), an enhancer of HO production, attenuates intestinal IR injury.METHODS: Eighteen male rats were randomly allocated into three groups: (a) sham; (b) IR, consisting of 30 min of intestinal ischemia, followed by 2-h period of reperfusion; and (c) PDTC treatment before IR. Intestinal microvascular perfusion (IMP) was monitored continuously by laser Doppler fiowmetry. At the end of the reperfusion, serum samples for lactate dehydrogenase (LDH) levels and biopsies of ileum were obtained. HO activity in the ileum was assessed at the end of the reperfusion period.RESULTS: At the end of the reperfusion in the IR group,IMP recovered partially to 42.5% of baseline (P<0.05vs sham), whereas PDTC improved IMP to 67.3% of baseline (P<0.01 vs IR). There was a twofold increase in HO activity in PDTC group (2 062.66±106.11) as compared to IR (842.3±85.12) (P<0.001). LDH was significantly reduced (P<0.001) in PDTC group (585.6±102.4)as compared to IR group (1 973.8±306.5). Histological examination showed that the ileal mucosa was significantly less injured in PDTC group as compared with IR group.CONCLUSION: Our study demonstrates that PDTC improves the IMP and attenuates IR injury of the intestine possibly via HO production. Additional studies are warranted to evaluate the clinical efficacy of PDTC in the prevention of IR injury of the small intestine. | Ismail H Mallick Wen-Xuan Yang Marc C Winslet Alexander M Seifalian | 2005 | World Journal of Gastroenterology2005,11,46: | 8 |
| 4 | 溃疡性结肠炎显示文摘溃疡性结肠炎(ulcerativecolitis,uc)是一种消化道炎症性疾病,病变主要位于结直肠。UC好发于青年人,发达国家的人群患病率较高。UC表现为结直肠弥漫性、连续性浅表炎症,以及相应的组织学改变。下消化道内镜或影像检查可以明确诊断。目前尚未发现UC的明确病因,其发病机制与遗传易感个体的结肠内环境变化有关,具有慢性、终身、易复发的病程特点。 | Alexander C Ford Paul Moayyedl Steven B Hanauer Joseph B Kirsner 谭蓓 吴东 | 2017 | 英国医学杂志中文版2017,20,7: | 7 |
| 5 | Efficacy and safety of tenofovir in chronic hepatitis B: Australian real world experience显示文摘AIM To evaluate the long-term treatment outcomes of tenofovir therapy in patients in a real world Australian tertiary care setting.METHODS We performed a retrospective analysis of treatment outcomes among treatment-na?ve and treatment-experienced patients receiving a minimum 3 mo tenofovir therapy through St Vincent's Hospital Melbourne, Australia. We included patients receiving tenofovir [tenofovir disoproxil fumarate(TDF)] monotherapy, as well as patients treated with TDF in combination with a second antiviral agent. Patients were excluded if they demonstrated human immune-deficiency virus/hepatitis C virus/hepatitis delta virus coinfection or were less than 18 years of age. We considered virological and biochemicalresponse, as well as safety outcomes. Virological response was determined by measurement of hepatitis B virus(HBV) DNA using sensitive assays; biochemical response was determined via serum liver function tests; histological response was determined from liver biopsy and fibroscan; safety analysis focused on glomerular renal function and bone mineral density. The primary efficacy endpoint was complete virological suppression over time, defined by HBV DNA < 20 IU/m L. Secondary efficacy endpoints included rates of biochemical response, and HB e antigen(HBe Ag)/HB surface antigen loss and seroconversion over time.RESULTS Ninety-two patients were identified who fulfilled the enrolment criteria. Median follow-up was 26 mo(range 3-114). Mean age was 46(24-78) years, 64(70%) were male and 77(84%) were of Asian origin. 55(60%) patients were treatment-na?ve and 62 patients(67%) were HBe Ag-negative. Complete virological suppression was achieved by 45/65(71%) patients at 12 mo, 37/46(80%) at 24 mo and 25/28(89%) at 36 mo. Partial virological response(HBV DNA 20-2000 IU/m L) was achieved by 89/92(96.7%) of patients. Multivariate analysis showed a significant relationship between virological suppression at end of follow-up and baseline HBV DNA level(OR = 0.897, 95%CI: 0.833-0.967, P = 0.0046) and HBe Ag positive status(OR = 0.373, 95%CI: 0.183-0.762, P = 0.0069). There was no difference in response comparing treatment-na?ve and treatment-experienced patients. Three episodes of virological breakthrough occurred in the setting of noncompliance. Tenofovir therapy was well tolerated.CONCLUSION Tenofovir is an efficacious, safe and well-tolerated treatment in an Australian real-world tertiary care setting. Our data are similar to the reported experience from registration trials. | Grace C Lovett Tin Nguyen David M Iser Jacinta A Holmes Robert Chen Barbara Demediuk Gideon Shaw Sally J Bell Paul V Desmond Alexander J Thompson | 2017 | World Journal of Hepatology2017,9,1: | 7 |
| 6 | Highly efficient derivation of ventricular cardiomyocytes from induced pluripotent stem cells with a distinct epigenetic signature显示文摘从 pluripotent 干细胞导出的 Cardiomyocytes 能在药测试,疾病建模和基于房间的治疗被使用。没有 procardiogenic 生长因素,然而,从 pluripotent 干细胞的 cardiomyogenesis 的效率通常是低的,产生 cardiomyocyte 人口是异构的。这里,我们证明导致的 pluripotent 干细胞( iPSCs )能从鼠科的室的 myocytes ( VM )被导出,并且与从各种各样的体的房间类型导出的 iPSCs 的另外的报告一致,自发地作为与遗传上匹配的胚胎的干细胞(转换字符)或 iPSCs 相比区分 cardiomyocytes 进跳动的显著地更高的倾向从尾巴尖端成纤维细胞导出的 导出VM 的 iPSCs ( ViPSCs )展览。惊人地,导出 ViPSC 的 cardiomyocytes 显示的多数室的显型。在 ViPSCs 的提高的室的 myogenesis 在区别的早阶段经由心血管的祖先的增加的数字被调停。以便从 ViPSCs 调查提高的室的 myogenesis 的机制,我们执行了全球基因表示和 DNA methylation 分析,它揭示了可以涉及在 pluripotent 干细胞指定 VM 命运的不同 epigenetic 签名。 | Huansheng Xu B Alexander Yi Hao Wu Christoph Bock Hongcang Gu Kathy O Lui Joo-Hye C Park Ying Shao Alyssa K Riley Ibrahim J Domian Erding Hu Robert Willette John Lepore Alexander Meissner Zhong Wang Kenneth R Chien | 2012 | Cell Research2012,22,1: | 7 |
| 7 | 纤维母细胞生长因子对复合皮肤移植成活和收缩的影响显示文摘我们曾报道应用同基因表层皮片(IE)和同种异基因真皮(AD)组成复合皮肤移植物(CSG)可一次完成全层皮肤缺损的永久性修复。但由于IE不能及时获得足够血运,IE常有部分坏死,CSG后期收缩仍较明显。在本研究中我们进一步用纤维母细胞生长因子(FGF)预先处理AD获得较好效果。经观察17周表明,FGF组皮片坏死率和坏死面积较对照组明显下降(P<0.05);FGF组CSG收缩较对照组明显减轻(P<0.001);皮片坏死面积与皮片最终面积呈负相关(r=-0.450,P<0.05)。实验预示,完全成活的CSG后期收缩较移植同等厚度的IE为轻。观察2年,AD未被排斥。 | 方承辉 Robb E C 于光曙 Alexander J W Warden G D | 1993 | 中华整形烧伤外科杂志1993,9,1: | 6 |
| 8 | Primary squamous cell carcinoma of the rectum: An update and implications for treatment显示文摘AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC's are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-nodemetastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external siteof primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease. | Glen R Guerra Cherng H Kong Satish K Warrier Andrew C Lynch Alexander G Heriot Samuel Y Ngan | 2016 | World Journal of Gastrointestinal Surgery2016,8,3: | 5 |
| 9 | Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed. | Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee | 2014 | World Journal of Clinical Oncology2014,5,2: | 5 |
| 10 | Transanal total mesorectal excision: Myths and reality显示文摘Transanal total mesorectal excision(TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses. | Nicolas C Buchs Marta Penna Alexander L Bloemendaal Roel Hompes | 2016 | World Journal of Clinical Oncology2016,7,5: | 5 |
| 11 | The diverse heterogeneity of molecular alterations in prostate cancer identified through next-generation sequencing显示文摘前列腺癌症是全球癌症相关的死亡的一个领先的原因,但是试图改善诊断并且开发新奇治疗被重要耐心的异质惊讶。在最近的年里,到几百个前列腺瘤的下一代的定序的应用程序定义新奇分子的子类型并且描绘了位于疾病开始和前进下面的广泛的 genomic 错误。在诊所观察的异质是由与复杂性流行的一处分子的风景的 underpinned,现在是清楚的,在 genomic 重新整理和稀罕变化联合放大 transcriptomic 差异的地方。这评论把我们前列腺癌症 ‘ 的当前的理解; omic 的包括拷贝数字变化的哨兵角色, oncogenic 熔化基因, chromothripsis 的潜在的影响,和在定义联系变化的子类型的突破的成长光谱。增加的证据建议损害经常在特定的细胞的功能和发信号的小径上集成的那 genomic,还周期性的基因错误显得稀罕。因此,我们继续定义单个瘤染色体,是批评的,特别在他们的表示 transcriptome 的上下文。仅仅通过到瘤可变性罐头的瘤的改进描述,我们前进到精确治疗和个性化的肿瘤学的年龄。 | Alexander W Wyatt Fan Mo Yuzhuo Wang Colin C Collins | 2013 | Asian Journal of Andrology2013,15,3: | 5 |
| 12 | Antioxidant enriched enteral nutrition and oxidative stress after major gastrointestinal tract surgery显示文摘AIM: To investigate the effects of an enteral supple-ment containing antioxidants on circulating levels of antioxidants and indicators of oxidative stress after major gastrointestinal surgery.METHODS: Twenty-one patients undergoing major upper gastrointestinal tract surgery were randomised in a single centre, open label study on the effect of postoperative enteral nutrition supplementedwith antioxidants. The effect on circulating levels of antioxidants and indicators of oxidative stress, such as F2-isoprostane, was studied. RESULTS: The antioxidant enteral supplement showed no adverse effects and was well tolerated. After surgery a decrease in the circulating levels of antioxidant parameters was observed. Only selenium and glutamine levels were restored to pre-operative values one week after surgery. F2-isoprostane increased in the first three postoperative days only in the antioxidant supplemented group. Lipopolysaccharide binding protein (LBP) levels decreased faster in the antioxidant group after surgery.CONCLUSION: Despite lower antioxidant levels there was no increase in the circulating markers of oxidative stress on the first day after major abdominal surgery. The rise in F2-isoprostane in patients receiving the antioxidant supplement may be related to the conversion of antioxidants to oxidants which raises questions on antioxidant supplementation. Module AOX restored the postoperative decrease in selenium levels. The rapid decrease in LBP levels in the antioxidant group suggests a possible protective effect on gut wall integrity. Further studies are needed on the role of oxidative stress on outcome and the use of antioxidants in patients undergoing major abdominal surgery. | Mireille FM van Stijn Gerdien C Ligthart-Melis Petra G Boelens Peter G Scheffer Tom Teerlink Jos WR Twisk Alexander PJ Houdijk Paul AM van Leeuwen | 2008 | World Journal of Gastroenterology2008,14,45: | 4 |
| 13 | Radical resection of pancreatic cancer显示文摘BACKGROUND: Pancreatic adenocarcinoma (PCa) is a disease with dismal prognosis, and the only possibility of cure, albeit small, is based on the combination of complete resection with negative histopathological margins (R0 resection) with adjuvant treatment. Therefore, a lot of effort has been made during the last decade to assess the role of extensive surgery in both local recurrence and survival of patients with PCa. DATA SOURCES: Medline search and manual cross- referencing were utilized to identify published evidence- based data for PCa surgery between 1973 and 2006, with emphasis to feasibility, efficacy, long-term survival, disease free survival, recurrence rates, pain relief and quality of life. RESULTS: Extended surgery is safe and feasible in high volume surgical centers with comparable short-term results. Organ preserving surgery is a main goal because of quality of life reasons and is performed whenever possible from the tumor extent. Concerning long-term survival major vein resection does not adversely affect outcome. To date, there are no changes in long-term survival attributed to the extended lymph node dissection. However, there is a benefit in locoregional control with fewer local recurrences and extended lymphadenectomy allows better staging for the disease. CONCLUSIONS: Extended PCa surgery is safe and feasible despite the inconclusive results in patient's survival benefit. In the future, appropriately powered randomized trials of standard vs. extended resections may show improved outcomes for PCa patients. | Alexander Koliopanos C Avgerinos Athanasios Farfaras C Manes Christos Dervenis | 2008 | Hepatobiliary & Pancreatic Diseases International2008,7,1: | 4 |
| 14 | Irritable bowel syndrome显示文摘 | Alexander C Ford Nicholas J Talley | 2012 | BMJ (sep )2012,,041: | 4 |
| 15 | Next generation patient-derived prostate cancer xenograft models显示文摘对为前列腺癌症的更有效的治疗学的途径有批评需要。然而,在这个区域的研究被缺乏严重妨碍了临床上相关,在疾病的 vivo 模型试验性。这评论特别地基于 patients’ 的 subrenal 囊 grafting 集中于前列腺癌症异种皮移植模型的发展;进 nonobese 糖尿病 / 严重的肿瘤组织联合了 immunodeficient (NOD/SCID ) 老鼠。这种技术允许可移植的、导出病人的癌症织物异种皮移植线的成功的开发从不仅好攻击变形,而且从局部性的前列腺癌症纸巾。异种皮移植被发现了保留原来的恶意的关键生物性质,包括组织病理学说、分子的特征,肿瘤异质,对雄激素脱离的反应和变形能力。因此,他们是高度临床上相关并且在细胞、分子的层次,为个性化的癌症治疗屏蔽的药和现出症状之前的潜的药为前列腺癌症前进的研究提供珍贵工具测试的功效;特别当模型的一块面板习惯于盖子时许多疾病。这些异种皮移植模型能因此被看作前列腺癌症的下一代的模型。 | Dong Lin Hui Xue Yuwei Wang Rebecca Wu Akira Watahiki Xin Dong Hongwei Cheng Alexander W Wyatt Colin C Collins Peter W Gout Yuzhuo Wang | 2014 | Asian Journal of Andrology2014,16,3: | 4 |
| 16 | Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature显示文摘AIM:To critically review and summarize the literature on nutritional and health outcomes of semi-elemental formulations on various nutritionally vulnerable patient populations who are unable to achieve adequate nutrition from standard oral diets.METHODS:We conducted a comprehensive literature search of Pubmed and Embase databases.We manually screened articles that examined nutritional and health outcomes(e.g.,growth,disease activity,gastrointestinal impairment,mortality,and economic impact)among various patient groups receiving semi-elemental diets.This review focused on full-text articles of randomized controlled clinical trials and other intervention studies,but pertinent abstracts and case studies were also included.Results pertaining primarily to tolerance,digestion,and absorption were summarized for each patient population in this systematic review.RESULTS:Results pertaining primarily to tolerance,digestion,and absorption were summarized for each patient population.The efficacy of semi-elemental whey hydrolyzed protein(WHP)diet have been reported in various nutritionally high risk patient populations including-Crohn’s disease,short bowel syndrome,acute and chronic pancreatitis,cerebral palsy,cystic fibrosis,cerebrovascular accidents,human immunodeficiency virus,critically ill,and geriatrics.Collectively,the evidence from the medical literature indicates that feeding with a semi-elemental diet performs as well or better than parenteral or amino acid based diets in terms of toler-ance,digestion,and nutrient assimilation measures across various disease conditions.CONCLUSION:Based on this comprehensive review of the literature,patient populations who have difficulty digesting or absorbing standard diets may be able to achieve improved health and nutritional outcomes through the use of semi-elemental WHP diets. | Dominik D Alexander Lauren C Bylsma Laura Elkayam Douglas L Nguyen | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016,7,2: | 3 |
| 17 | Underutilization of palliative care services in the liver transplant population显示文摘AIM To evaluate use of palliative care services in patients with end-stage liver disease who do not have access to liver transplant.METHODS Evaluated were end-stage liver disease patients who were removed from the liver transplant wait-list or died prior to transplant at a single transplant center over a 2-year period. Those who were removed due to noncompliance or ultimately transplanted elsewhere were excluded from this study. Patient characteristics associated with palliative care consultation were assessed using logistic regression analysis.RESULTS Six hundred and eighty-three patients were listed for liver transplant in 2013-2014 with 107(16%) dying(n = 62) or removed for clinical decompensation prior to liver transplant(n = 45): Median age was 58 years, and the majority were male(66%), Caucasian(53%), had Child C cirrhosis(61%) or hepatocellular carcinoma(52%). The palliative care team was consulted in only 18 of the 107 patients(17%) who died or were removed, 89% of which occurred as inpatients. Half of these consultations occurred within 72 h of death. In univariable analysis, patients of younger age, white race, and higher end-stage liver disease scores at time of listing and delisting were more likely to receive palliative care services. Only younger age [Odds ratio(OR) = 0.92; P = 0.02] and Caucasian race(OR = 4.90; P = 0.02) were still associated with integration of palliative care services through multivariable analysis.CONCLUSION Palliative care services are grossly underutilized in older, non-white patients with cirrhosis on the liver transplant wait-list. We encourage early integration of these services into clinical decision-making in the transplant population, with further studies aimed at understanding barriers to consultation. | Priya Kathpalia Alexander Smith Jennifer C Lai | 2016 | World Journal of Transplantation2016,6,3: | 3 |
| 18 | Delayed assessment and eager adoption of laparoscopic cholecystectomy:Implications for developing surgical technologies显示文摘Despite the prevailing emphasis in the medical literature on establishing evidence,many changes in the practice of surgery have not been achieved using proper evidence-based assessment.This paper examines the adoption of laparoscopic cholecystectomy(LC)into regular use for the treatment of cholecystitis and the process of its acceptance,focusing on the limited role of technology assessment in its appraisal.A review of the published medical literature concerning LC was performed.Approximately 3000 studies of LC have been conducted since 1985,and there have been nearly 8500 publications to date.As LC was adopted enthusiastically into practice,the results of outcome studies generally showed that it compared favorably with the traditional,open cholecystectomy with regard to mortality,complications,and length of hospital stay.However,despite the rapid general agreement on surgical technique,efficacy,and appropriateness,there remained lingering doubts about safety,outcomes,and cost of the procedure that suggested that essential research questions were ignored even as the procedure became standard.Using LC as a case study,there are important lessons to be learned about the need for important guidelines for surgical innovation and the adoption of minimally invasive surgical techniques into current clinical and surgical practice.We highlight one recent example,natural orifice transluminal endoscopic surgery and how necessary it is to properly evaluate this new technology before it is accepted as a safe and effective surgical option. | Alexander C Allori I Michael Leitman Elizabeth Heitman | 2010 | World Journal of Gastroenterology2010,16,33: | 3 |
| 19 | 使用二甲双胍的禁忌证 证据显示应该修改二甲双胍的禁忌证显示文摘在英国前瞻性糖尿病研究(UNPOS)中,2型糖尿病患者被随机分入二甲双胍、磺酰脲类或胰岛素强化治疗组,3组患者取得了相似的血糖控制效果,微血管并发症终点事件显著降低。该项研究显示,肥胖患者使用二甲双胍治疗可以降低心血管事件的发生,二甲双胍治疗组的患者没有低血糖事件。 | G C Jones J P Macklin W D Alexander 李玉秀 | 2003 | 英国医学杂志中文版2003,6,3: | 2 |
| 20 | Label-retaining liver cancer cells are relatively resistant to sorafenib显示文摘 | Hong-Wu Xin Chenwi M Ambe Danielle M Hari Gordon W Wiegand Tyler C Miller Jin-Qiu Chen Andrew J Anderson Satyajit Ray John E Mullinax Tomotake Koizumi Russell C Langan Douglas Burka Michelle A Herrmann Paul K Goldsmith Alexander Stojadinovic Udo Rudloff S | 2013 | Gut2013,,12: | 2 |