Nonalcoholic fatty liver disease continues to be one of the major health challenges facing the world,with estimates of non-alcoholic steatohepatitis(NASH)prevalence in over 25 percent of the world’s population.NASH r...Nonalcoholic fatty liver disease continues to be one of the major health challenges facing the world,with estimates of non-alcoholic steatohepatitis(NASH)prevalence in over 25 percent of the world’s population.NASH represents a spectrum of disease that may lead to hepatic fibrosis and eventual cirrhosis,with the risk of cirrhosis decompensation,and hepatocellular carcinoma.New therapies are desperately needed for NASH,especially for later stages of fibrosis and cirrhosis.Galectin-3 inhibition is being explored as a new liver antifibrotic therapy.This concise review will outline the state of the art of this new therapeutic target.展开更多
Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery(CRS) and hyper...Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) may prove to be an efficacious treatment option. In addition to reviewing the natural history of gastric cancer with peritoneal carcinomatosis, this mini-review examines literature on the efficacy of CRS and HIPEC as compared to chemotherapy and surgical options. Both randomized and nonrandomized studies were summarized with the emphasis focused on overall survival. In summary, CRS and HIPEC are indeed a promising treatment option for gastric cancer with peritoneal carcinomatosis and large randomized clinical trials are warranted.展开更多
Challenges inherent with the transition to college are often accompanied by weight gain among college freshmen. Weight gain and duration of obesity increase metabolic syndrome and cardiovascular disease risk in young ...Challenges inherent with the transition to college are often accompanied by weight gain among college freshmen. Weight gain and duration of obesity increase metabolic syndrome and cardiovascular disease risk in young adulthood, which supports the need for weight loss interventions tailored to college students. The purpose of this investigation was to conduct a mixed methods pilot trial to determine the efficacy and acceptability of a semester long Internet-and incentive-based weight loss intervention for overweight/obese college freshmen. Participants (n = 27, aged >18 yrs, BMI >25) were randomly assigned to a 12-week social cognitive theory (SCT)-based intervention (Fit Freshmen [FF]) or a health information control group. The FF intervention also included modest financial incentives for weight loss. Primary outcomes included body weight/composition, dietary and physical activity (PA) behaviors, and psychosocial measures (i.e. self-efficacy, self-regulation) associated with diet, PA, and weight loss. Students in the FF intervention participated in focus groups to provide qualitative feedback on program structure and design. FF participants demonstrated significant reductions (all group differences展开更多
Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ...Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.Methods We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke centres.Patients with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,codes.The 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May 2020.The prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal variation.Findings There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative drop.Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this tertile.Interpretation There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic.These findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.展开更多
基金The author acknowledges Dr.Pol Boudes for reviewing this manuscript and Dr.Zachary Goodman for providing the galectin-3 antibody histological images.
文摘Nonalcoholic fatty liver disease continues to be one of the major health challenges facing the world,with estimates of non-alcoholic steatohepatitis(NASH)prevalence in over 25 percent of the world’s population.NASH represents a spectrum of disease that may lead to hepatic fibrosis and eventual cirrhosis,with the risk of cirrhosis decompensation,and hepatocellular carcinoma.New therapies are desperately needed for NASH,especially for later stages of fibrosis and cirrhosis.Galectin-3 inhibition is being explored as a new liver antifibrotic therapy.This concise review will outline the state of the art of this new therapeutic target.
文摘Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) may prove to be an efficacious treatment option. In addition to reviewing the natural history of gastric cancer with peritoneal carcinomatosis, this mini-review examines literature on the efficacy of CRS and HIPEC as compared to chemotherapy and surgical options. Both randomized and nonrandomized studies were summarized with the emphasis focused on overall survival. In summary, CRS and HIPEC are indeed a promising treatment option for gastric cancer with peritoneal carcinomatosis and large randomized clinical trials are warranted.
文摘Challenges inherent with the transition to college are often accompanied by weight gain among college freshmen. Weight gain and duration of obesity increase metabolic syndrome and cardiovascular disease risk in young adulthood, which supports the need for weight loss interventions tailored to college students. The purpose of this investigation was to conduct a mixed methods pilot trial to determine the efficacy and acceptability of a semester long Internet-and incentive-based weight loss intervention for overweight/obese college freshmen. Participants (n = 27, aged >18 yrs, BMI >25) were randomly assigned to a 12-week social cognitive theory (SCT)-based intervention (Fit Freshmen [FF]) or a health information control group. The FF intervention also included modest financial incentives for weight loss. Primary outcomes included body weight/composition, dietary and physical activity (PA) behaviors, and psychosocial measures (i.e. self-efficacy, self-regulation) associated with diet, PA, and weight loss. Students in the FF intervention participated in focus groups to provide qualitative feedback on program structure and design. FF participants demonstrated significant reductions (all group differences
文摘Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.Methods We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke centres.Patients with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,codes.The 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May 2020.The prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal variation.Findings There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative drop.Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this tertile.Interpretation There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic.These findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.