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| 1 | 全球药物滥用的疾病负担:来自2010年全球疾病负担研究显示文摘背景:直到目前还没有研究者系统地估计过全球及区域性的苯丙胺类、大麻、可卡因和阿片类药物依赖的患病率及其造成的疾病负担。我们旨在用伤残损失寿命年(YLDs)、过早死亡损失寿命年(YLLs)和伤残调整寿命年(DALYs)来估计药物依赖的患病率和其造成的疾病负担。方法:采用贝叶斯Meta回归的方法(Dis Mod-MR)对药物依赖的流行病学研究及2010年全球疾病、伤害及危险因素负担研究(GBD 2010)进行了系统综述,估计人群水平的药物依赖患病率。GBD 2010通过代表性社区调查和基于互联网的调查计算出新的失能权重。我们把估计的药物依赖患病率和新的失能权重结合起来估算药物依赖导致的YLDs、YLLs、DALYs和其作为相关疾病危险因素时导致的YLDs、YLLs和DALYs。结果:2010年,药物依赖直接造成了2千万的DALYs(95%UI(不确定区间)1.3-2.54千万),占全球全因DALYs的0.8%(0.6%-1.0%)。世界范围内,相比于其他药物,越来越多的人依赖于阿片类和苯丙胺类药物。阿片类药物依赖直接造成的疾病负担最大(DALYs为920万,95%UI为710-1140万)。在某些地区,药物依赖导致的DALYs所占比例比其他地区高出20倍,收入越高的国家药物依赖造成的负担所占比例也越高。注射吸毒所致HIV感染造成210万的DALYs(95%UI 110-360万),所致HCV感染导致50.2万的DALYs(95%UI 28.6-89.1万)。苯丙胺类药物依赖所致自杀造成85.4万的DALYs(95%UI 29.1-179.1万),阿片类药物依赖所致自杀造成67.1万的DALYs(95%UI 32.9-173.0万),可卡因依赖所致自杀造成32.4万的DALYs(95%UI 10.9-68.2万)。药物依赖导致的疾病负担最高的国家(>650 DALYs/10万人)包括美国,英国,俄罗斯和澳大利亚。结论:药物滥用是造成全球疾病负担的一个重要因素。为减少人群水平的疾病负担,我们需采取有效的措施(比如给予阿片类药物依赖者替代治疗及针具交换等)降低阿片类药物依赖和注射吸毒导致的疾病负担。 | 王同瑜 Degenhardt L Whiteford HA Ferrari AJ Baxter AJ Charlson FJ Hall WD Freedman G Burstein R Johns Engell RE Flaxman A Murray CJ Vos T | 2015 | 中国药物依赖性杂志2015，24，6： | 3 |
| 2 | Evaluating the accuracy of American Society for Gastrointestinal Endoscopy guidelines in patients with acute gallstone pancreatitis with choledocholithiasis显示文摘BACKGROUND Acute gallstone pancreatitis(AGP) is the most common cause of acute pancreatitis(AP) in the United States. Patients with AGP may also present with choledocholithiasis. In 2010, the American Society for Gastrointestinal Endoscopy(ASGE) suggested a management algorithm based on probability for choledocholithiasis, recommending additional imaging for patients at intermediate risk and endoscopic retrograde cholangiopancreatography(ERCP) for patients at high risk of choledocholithiasis. In 2019, the ASGE guidelines were updated using more specific criteria to categorize individuals at high risk for choledocholithiasis. Neither ASGE guideline has been studied in AGP to determine the probability of having choledocholithiasis.AIM To determine compliance with ASGE guidelines, assess outcomes, and compare 2019 vs 2010 ASGE criteria for suspected choledocholithiasis in AGP.METHODS We conducted a retrospective cohort study of 882 patients admitted with AP to a single tertiary care center from 2008-2018. AP was diagnosed using revised Atlanta criteria and AGP was defined as the presence of gallstones on imaging or with cholestatic pattern of liver injury in the absence of another cause. Patients with chronic pancreatitis and pancreatic malignancy were excluded as were those who went directly to cholecystectomy prior to assessment for choledocholithiasis. Patients were assigned low, intermediate or high risk based on ASGE guidelines. Our primary outcomes of interest were the proportion of patients in the intermediate risk group undergoing magnetic resonance cholangiopancreatography(MRCP) first and the proportion of patients in the high risk group undergoing ERCP directly without preceding imaging. Secondary outcomes of interest included outcome differences based on if guidelines were not adhered to. We then evaluated the diagnostic accuracy of 2019 in comparison to the 2010 ASGE criteria for patients with suspected choledocholithiasis. We performed the t test or Wilcoxon rank sum test, as appropriate, to analyze if there were outcome differences based on if guidelines were not adhered to. Kappa coefficients were calculated to measure the degree of agreement between pairs of variables.RESULTS In this cohort, we identified 235 patients with AGP of which 79 patients were excluded as they went directly to surgery for cholecystectomy without prior MRCP or ERCP. Of the remaining 156 patients, 79 patients were categorized as intermediate risk and 77 patients were high risk for choledocholithiasis according to the 2010 ASGE guidelines. Among 79 intermediate risk patients, 54(68%) underwent MRCP first whereas 25 patients(32%) went directly to ERCP. For the 54 patients with intermediate risk who had MRCP first, 36 patients had no choledocholithiasis while 18 patients had evidence of choledocholithiasis prompting ERCP. Of these patients, ERCP confirmed stone disease in 11 patients. Of the 25 intermediate risk patients who directly underwent ERCP, 18 patients had stone disease. One patient with a normal ERCP developed post ERCP pancreatitis. Patients undergoing MRCP in this group had a significantly longer length of stay(5.0 vs 4.0 d, P = 0.02). In the high risk group, 64 patients(83%) had ERCP without preceding imaging, of which, 53 patients had findings consistent with choledocholithiasis, of which 13 patients(17%) underwent MRCP before ERCP, all of which showed evidence of stone disease. Furthermore, all of these patients ultimately had an ERCP, of which 8 patients had evidence of stones and 5 had normal examination.RESULTS Our cohort also demonstrated that 58% of all 156 patients with AGP had confirmed choledocholithiasis(79% of the high risk group and 37% of the intermediate group when risk was assigned based on the 2010 ASGE guidelines). When the updated 2019 ASGE guidelines were applied instead of the original 2010 guidelines, there was moderate agreement between the 2010 and 2019 guidelines(kappa = 0.46, 95%CI: 0.34-0.58). Forty-two of 77 patients were still deemed to be high risk and 35 patients were downgraded to intermediate risk. Thirty-five patients who were originally assigned high risk were reclassified as intermediate risk. For these 35 patients, 26 patients had ERCP findings consistent with choledocholithiasis and 9 patients had a normal examination. Based on the 2019 criteria, 9/35 patients who were downgraded to intermediate risk had an unnecessary ERCP with normal findings(without a preceding MRCP).CONCLUSION Two-thirds in intermediate risk and 83% in high risk group followed ASGE guidelines for choledocholithiasis. One intermediate-group patient with normal ERCP had post-ERCP AP, highlighting the risk of unnecessary procedures. | Supisara Tintara Ishani Shah William Yakah Awais Ahmed Cristina S Sorrento Cinthana Kandasamy Steven D Freedman Darshan J Kothari Sunil G Sheth | 2022 | World Journal of Gastroenterology2022，28，16： | 3 |
| 3 | A Time-delay Model of Single-species Growth with Structure显示文摘 | W G Aiello H I Freedman | 1990 | Math Biosci1990，101，： | 1 |
| 4 | No Significant Association of 14 Candidate Genes With Schizophrenia in a Large European Ancestry Sample: Implications for Psychiatric Genetics显示文摘 | Sanders Alan R Duan Jubao Levinson Douglas F Shi Jianxin He Deli Hou Cuiping Burrell Gregory J Rice John P Nertney Deborah A Olincy Ann Rozic Pablo Vinogradov Sophia Buccola Nancy G Mowry Bryan J Freedman Robert Amin Farooq Black Donald W | 2008 | The American Journal of Psychiatry2008，，4： | 1 |
| 5 | The effect of multiple reexcisions on the risk of local recurrence after breast conserving surgery显示文摘 | O'Sullivan MJ Li T Freedman G | 2007 | Ann Surg Oncol2007，14，11： | 1 |
| 6 | A Time-delay Model of Single-species Growth with Structure显示文摘 | Aiello W G Freedman H I | 1990 | Mathematical Biosciences1990，101，3： | 1 |
| 7 | Uniform Persistence System显示文摘 | BUTLER G FREEDMAN H I | 1986 | Pro Amer Math Soc(S1563-504X)1986，96，： | 1 |
| 8 | A time delay model of single-species growth with stage structure显示文摘 | Aiello W G Freedman H I | 1990 | Math Biosci1990，101，： | 1 |
| 9 | Analysis of a Model Representing Stage-structured Population Growth with State-dependent Time Delay显示文摘 | W G Aiello H I Freedman J Wu | 1992 | SIAM J Appl Math1992，52，3： | 1 |
| 10 | Persistence in dynamical systems显示文摘 | Butler G Freedman H I Waltman P | 1986 | Journal of Dif- ferential Equations1986，63，： | 1 |
| 11 | Analysis of a Model Representing Stage-structured Population Growth with State-dependentTime Delay显示文摘 | Aiello W G Freedman H I Wu J | 1992 | SIAM J Appl Math1992，52，3： | 1 |
| 12 | Predator-prey systems with group defence: theparadox of enrichment revisited显示文摘 | Freedman H I Wolkowicz G S K | 1986 | Bull Math Biol1986，48，： | 1 |
| 13 | Interactions between eye and head control signals can account for movement kinematics显示文摘 | Freedman E G | 2001 | Biological Cybernetics2001，84，6： | 1 |
| 14 | A time-delay model of single-species growth with stage structure 显示文摘 | Aiello W G Freedman H 1 | 1990 | Math Biosci1990，101，： | 1 |
| 15 | Kümmel 's Disease:A Not-SO-Rare Complication of Osteoporotic Vertebral Compression Fractures显示文摘 | Freedman BA Hel erI G | | 0，，： | 1 |
| 16 | An update on pruritus as- sociated with CKD 显示文摘 | Patel TS Freedman BI Yosipoviteh G | 2007 | Am J Kidney Dis2007，50，1： | 1 |
| 17 | A Time-delay of Single Species Growth with Stage Structure显示文摘 | Walter G Alello Freedman H I | 1990 | Mathematical Bioscience1990，101，： | 1 |
| 18 | A time-delay model of single species growth with stage structure 显示文摘 | AIELLO W G FREEDMAN H I | 1990 | Math Biosci1990，101，： | 1 |
| 19 | Mycobacterium tuberculosis CDC1551 induces a more vigorous host response in vivo and in vitro,but is not more virulent than other clinical isolates显示文摘 | Manca C Tsenova L Barry CE 3rd Bergtold A Freeman S Haslett PA Musser JM Freedman VH Kaplan G | 1999 | J Immunol1999，162，11： | 1 |
| 20 | A time-delay model of single-species growth with stage structure显示文摘 | Aiello W G Freedman H I | 1990 | Math Biosci1990，101，： | 1 |
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