51
|
Wan J, Shin D, Syed M, Abuabara K, Gelfand J. 390 Atopic dermatitis and risk of major neuropsychiatric disorders: A population-based cohort study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
52
|
Tao XC, Peng WH, Xie WM, Wan J, Liu M, Gao L, Gao Q, Zhang S, Zhai ZG, Wang C. [Efficacy and safety of Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension]. ZHONGHUA YI XUE ZA ZHI 2020; 100:437-441. [PMID: 32146766 DOI: 10.3760/cma.j.issn.0376-2491.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the efficacy and safety of Balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Patients who were diagnosed CTEPH in China-Japan Friendship Hospital from Feb 2018 to Sep 2019 were evaluated. The ineligibility for pulmonary endarterectomy (PEA) and the indication for BPA were decided on the basis of a consensus among the multidisciplinary team for all CTEPH patients. 6-min walk distance (6MWD), the plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP), mixed venous oxygen saturation, mean pulmonary artery pressure (mPAP), cardiac index (CI) and pulmonary vascular resistance (PVR) were collected and analyzed before the first and the last BPA session. Results: A total of 67 BPA sessions were performed for 302 subsegmental pulmonary arteries in 25 inoperable CTEPH patients. 10 males (40.0%) and 15 females (60.0%), with the age of (57.8±7.1) years old. The median interval between CTEPH diagnosis and first BPA was 20.0 (9.0, 48.5) months. 18 patients were received more than 2 BPA sessions, the median follow-up time was 5.0 (3.5, 8.3) months. 6MWD, CI and the mixed venous oxygen saturation were significant improved after BPA [(425±74) vs (345±109) m, (1.99±0.45) vs (1.62±0.35) L·min(-1)·m(-2), (68.1%±6.5%) vs (61.2%±6.3%)](all P<0.05). The plasma level of NT-proBNP, mPAP and PVR were significantly decreased after BPA [259 (93, 739) vs 806 (148, 2 159) ng/L, (40.6±8.3) vs (47.3±10.7) mmHg (1 mmHg=0.133 kPa), (11.9±4.9) vs (17.2±6.5) WU (1 WU=80 dyn·s·cm(-5))](all P<0.05). Hemoptysis occurred in 5 sessions (7.5%) and reperfusion pulmonary edema (RPE) occurred in 2 sessions (1.5%), 1 patient needed non-invasive mechanical ventilation because of RPE, 1 patient died from right heart failure caused by hemoptysis during perioperative period. Conclusions: BPA can significantly improve the exercise tolerance and hemodynamic parameters for inoperable CTEPH patients, the risks of BPA are acceptable. BPA is an effective and relatively safe treatment for inoperable CTEPH patients.
Collapse
|
53
|
Xie WM, Wang J, Zhang S, Wan J, Tao XC, Gao Q, Zhai ZG, Wang C. [Clinical characteristics of patients with chronic thromboembolic pulmonary hypertension]. ZHONGHUA YI XUE ZA ZHI 2019; 99:3461-3465. [PMID: 31826562 DOI: 10.3760/cma.j.issn.0376-2491.2019.44.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical characteristics of patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: CTEPH cases consecutively admitted into China-Japan Friendship Hospital from September 2015 to June 2019 were enrolled with prospective data collection. The medical histories, clinical characteristics, laboratory tests, imaging manifestation and hemodynamic parameters were analyzed. Patients were divided into high pulmonary vascular resistance (PVR) group and low PVR group according to the PVR level>1 000 dyn·s·cm(-5) or not, and clinical characteristics were compared between these two groups. Results: In the 148 cases of CTEPH, right heart catheterization was performed in 103 cases with mPAP (45.1±11.0) mmHg and PVR of (992±430) dyn·s·cm(-5). At diagnosis, 88 (59.5%) cases were in WHO functional class Ⅲ and 27 (18.2%) in class Ⅳ. Most common presenting symptoms were dyspnea (147, 99.3%), chest tightness (68, 45.9%), hemoptysis (42, 28.3%), syncope (30, 20.3%), and most common signs were P2 accentuation (95, 64.9%), edema (65, 43.9%), cyanosis (47, 31.8%), systolic murmur (44, 29.7%) and jugular vein distention (35, 23.6%). In 103 cases with right heart catheterization, 52 were in the low PVR group and 51 in high PVR group. Compared to the low PVR group, high PVR group patients had higher WHO functional class and more jugular vein distention (both P<0.05). In all the 148 cases, previous venous thromboembolism (VTE) was confirmed in 105 (70.9%) patients, with a higher prevalence of previous VTE in low PVR group than that in high PVR group (P<0.001). 30 (20.3%) patients had varicose veins of the lower extremities, and 21 (14.2%) had other thrombophilic disorders including antiphospholipid syndrome, protein C and S deficiency and antithrombin Ⅲ deficiency. Conclusions: Dyspnea, P2 accentuation and edema are the most common clinical presentation of CTEPH. Previous history of VTE is common in CTEPH patients with thrombophilia in some cases.
Collapse
|
54
|
Zhen YN, Liu XP, Lin F, Yang YG, Sun G, Zhang YJ, Wang LF, Zhai ZG, Xie WM, Wan J, Tao XC, Duan J, Li AL, Liu P. [Brain protection strategy and effectivity in pulmonary thromboendarterectomy]. ZHONGHUA YI XUE ZA ZHI 2019; 99:2916-2920. [PMID: 31607021 DOI: 10.3760/cma.j.issn.0376-2491.2019.37.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the experience and effectivity of brain protection in 25 patients who suffered from chronic thromboembolic pulmonary hypertension (CTEPH) and received pulmonary thromboendarterectomy (PTE) under deep hypothermic circulatory arrest. Methods: Retrospective analysis of 25 PTE surgeries in our center from December 2016 to August 2018. All cases were completed underdeep hypothermic circulatory arrest. Standard brain protections were strictly executed, including: balanced and controlled extracorporeal circulation cooling, cerebral oxygen saturation (rSO(2)) monitoring, strictly control of circulatory arrest time, and etc. The neurological adverse events during the perioperative period were recorded and statistically analyzed, and the intelligence level and cognitive function of the patients were evaluated by MMSE scale and MoCA scale before surgery and discharge. Results: All the 25 patients successfully completed the surgery, and 1 patient (4%) died of postoperative infection. The mean pulmonary arterial pressure decreased from (52.9±16.7) mmHg before surgery to (23.6±8.1) mmHg immediately after surgery (t=10.01, P<0.01), and(20.7±7.9) mmHg at 3 months follow-up (t=10.73, P<0.01). Pulmonary vascular resistance decreased from 975.4 (788.6-1 292.8) dyn·s·cm(-5) to 376.1 (283.6-565.5) dyn·s·cm(-5) (Z=5.34, P<0.01). Neurological complications occurred in 3 patients during the perioperative period, including 2 patients with hypoxic encephalopathy, and 1 patient with cerebral hemorrhage. All 3 patients fully recovered before discharge. Univariate analysis showed that the duration of rSO(2)<40% and the maximum decrease rate of rSO(2) from baseline were significantly correlated with postoperative neurological damage. Multivariate analysis showed only time of rSO(2)<40% was significantly correlated with postoperative neurological damage. There was no significant difference in MMSE and MoCA score before and after surgery (P>0.05). Conclusions: Adequate brain protection measures are essential to reduce the neurological complications of PTE surgery. Real-time intraoperative monitoring of rSO(2) and strict control of circulatory arrest time can further reduce the occurrence of neurological damage.
Collapse
|
55
|
Marchetti KA, Lee T, Raja N, Corona L, Kraft KH, Wan J, Ellison JS. Extracorporeal shock wave lithotripsy versus ureteroscopy for management of pediatric nephrolithiasis in upper urinary tract stones: multi-institutional outcomes of efficacy and morbidity. J Pediatr Urol 2019; 15:516.e1-516.e8. [PMID: 31326329 DOI: 10.1016/j.jpurol.2019.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/11/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION As the incidence of pediatric nephrolithiasis rises, understanding the efficacy and morbidity of surgical treatment options is critical. Currently, there are limited comparative data assessing shock wave lithotripsy (SWL) and ureteroscopy (URS) outcomes in children. OBJECTIVE The objective of this study was to compare stone clearance, 30-day emergency department visits, and the number of general anesthetics required per stone treatment for both modalities. STUDY DESIGN A multi-institutional retrospective review of children presenting for either URS or SWL between 2000 and 2017 was performed. Stone clearance, need for retreatment, the number of anesthetics, as well as the number and reason for emergency room visit were captured and compared between groups. Multivariate statistical analysis accounting for age, stone location, stone diameter, pre-intervention stent, and provider volume was performed for adjusted analysis. RESULTS A total of 84 SWL and 175 URS procedures were included. Complete stone clearance and rates of residual stone fragments <4 mm after final procedure for SWL were 77.0% and 90.8% and for URS were 78.5% and 91.7%, respectively. Retreatment rates for both procedures were not significantly different (17.9% SWL vs. 18.9% URS, P = 0.85). Children who underwent SWL had lower rates of emergency room visits for infections (0% vs. 5.1%, P = 0.03) and flank pain (3.6% vs. 10.9%, P = 0.05) and required fewer general anesthetics per treatment (1.2 vs. 2.0, P < 0.01) than those who underwent URS (Figure). DISCUSSION Stone clearance after both the initial and final treatments and need for repeat interventions were similar between surgical modalities. However, SWL carries less morbidity than URS. Specifically, patients who underwent SWL experienced lower rates of ED visits for urinary tract infection and for flank pain, parallel to conclusions in current comparative literature. In addition, SWL requires less general anesthetics (2.0 vs. 1.2), secondary to lower rates of ureteral stent placement and removal. Data on the potential risk of general anesthetics to neurodevelopment support thoughtful utilization of these medications. Limitations of this study include its retrospective nature and the prolonged 20-year time period over which data were collected. CONCLUSIONS When adjusting for confounders, SWL and URS achieve similar stone clearance. In the setting of equivalent efficacy, considerations regarding necessity of repeat interventions, morbidity of anesthesia, and complications should be integrated into clinical practice.
Collapse
|
56
|
Wang J, Fan J, Li C, Shen L, Yang L, Xia F, Wan J, Zhang Z, Zhu J. The impact of completeness of chemotherapy on the efficacy of irinotecan in the preoperative chemoradiotherapy of (CRT) locally advanced rectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
57
|
Wang J, Fan J, Li C, Yang L, Wan J, Shen L, Zhu J, Zhang Z. Comparison of Three Preoperative Chemoradiotherapy Regimens for Locally Advanced Rectal Cancer: A Retrospective Analysis of a Comprehensive Cancer Center. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
58
|
Yao Y, Xu X, Yang L, Zhu J, Wan J, Shen L, Xia F, Fu G, Deng Y, Pan M, Guo Q, Gao X, Li Y, Rao X, Liang L, Wang Y, Zhang J, Zhang H, Zhang L, Peng J, Cai S, Gao J, Clevers H, Zhang Z, Hua G. Patient-Derived Organoids (PDO) As the Potential Model to Predict Treatment Outcome of Rectal Cancer Patients Underwent Neo-Adjuvant Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
59
|
Yang L, Wang Y, Bao H, Wan J, Fan X, Bao H, Shen L, Guan Y, Wu X, Shao Y, Zhu J, Zhang Z. ctDNA As a Potential Prognostic Marker for Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant Chemo-Radiation Therapy on Disease-Free Survival (DFS). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
60
|
Wang Y, Yang L, Zhou M, Zhang J, Shen L, Wan J, Zhu J, Zhang Z. Less Than 4 Lymph Nodes Harvested Indicates More Tumor Deposits and Worst Survival in Locally Advanced Rectal Cancer with Neoadjuvant Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
61
|
Crowther TW, van den Hoogen J, Wan J, Mayes MA, Keiser AD, Mo L, Averill C, Maynard DS. The global soil community and its influence on biogeochemistry. Science 2019; 365:365/6455/eaav0550. [DOI: 10.1126/science.aav0550] [Citation(s) in RCA: 316] [Impact Index Per Article: 63.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/18/2019] [Indexed: 12/17/2022]
Abstract
Soil organisms represent the most biologically diverse community on land and govern the turnover of the largest organic matter pool in the terrestrial biosphere. The highly complex nature of these communities at local scales has traditionally obscured efforts to identify unifying patterns in global soil biodiversity and biogeochemistry. As a result, environmental covariates have generally been used as a proxy to represent the variation in soil community activity in global biogeochemical models. Yet over the past decade, broad-scale studies have begun to see past this local heterogeneity to identify unifying patterns in the biomass, diversity, and composition of certain soil groups across the globe. These unifying patterns provide new insights into the fundamental distribution and dynamics of organic matter on land.
Collapse
|
62
|
Mariano C, Jamal R, Bains P, Hejazi S, Chao L, Wan J, Ho J. Utility of a chemotherapy toxicity prediction tool for older patients in a community setting. ACTA ACUST UNITED AC 2019; 26:234-239. [PMID: 31548802 DOI: 10.3747/co.26.4869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Expert groups have recommended incorporation of a geriatric assessment into clinical practice for older patients starting oncologic therapy. However, that practice is not standard primarily because of resource limitations. In the present study, we evaluated the effect on treatment decisions by oncologists in the community oncology setting of a brief geriatric assessment tool that estimates risk of toxicity. Methods This prospective longitudinal study in 5 community oncology practices in British Columbia involved patients 70 years of age and older starting a new cytotoxic chemotherapy regimen. Clinical personnel completed a brief validated geriatric assessment tool-the Cancer and Aging Research Group chemotherapy toxicity tool (carg-tt)-that estimates the risk of grade 3 or greater toxicity in older patients. Physicians were asked if the carg-tt changed their treatment plan or prompted extra supports. Patients were followed to assess the incidence of toxicity during treatment. Results The study enrolled 199 patients between July 2016 and February 2018. Mean age was 77 years. Treatment was palliative in 61.4% of the group. Compared with physician judgment, the carg-tt predicted higher rates of toxicity. In 5 patients, treatment was changed based on the carg-tt. In 38.5% of the patients, data from the tool prompted extra supports. Within the first 3 cycles of treatment, 21.3% of patients had experienced grade 3 or greater toxicity. Conclusions This study demonstrates that use of a brief geriatric assessment tool is possible in a broad community oncology practice. The tool modified the oncologist's supportive care plan for a significant number of older patients undertaking cytotoxic chemotherapy.
Collapse
|
63
|
Ge X, Zhao H, Zhou Z, Li X, Sun B, Wu H, Wan J, Xu J, Villablanca JP, Liu X. Association of Fractional Flow on 3D-TOF-MRA with Cerebral Perfusion in Patients with MCA Stenosis. AJNR Am J Neuroradiol 2019; 40:1124-1131. [PMID: 31196857 DOI: 10.3174/ajnr.a6095] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/03/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND PURPOSE Fractional flow measured on 3D-TOF-MRA was proposed to quantify cerebral hemodynamic changes in patients with artery stenosis. We investigated the association between fractional flow and cerebral perfusion changes in patients with symptomatic MCA stenosis. MATERIALS AND METHODS This prospective study was approved by the institutional review board, and all participants provided written informed consent. From June 2015 to May 2018, four hundred twenty-nine patients with symptomatic intracranial arterial stenosis were consecutively recruited and underwent conventional brain MR imaging, 3D-TOF-MRA, and brain CTP. A total of 91 patients with unilateral M1 segment stenosis of the MCA and a stenosis degree of 50%∼99% were included in the analysis. Fractional flow was measured by comparing distal and proximal signal intensity changes across the stenosis on 3D-TOF-MRA. The cutoff value for fractional flow for discriminating between normal perfusion and hypoperfusion was obtained from the receiver operating characteristic curve. Associations between fractional flow and hypoperfusion were assessed using univariate and multivariate analyses. RESULTS The receiver operating characteristic curve showed a significant fractional flow threshold value at 0.90 (sensitivity, 70.1%; 95% CI, 55.9%-81.2%; specificity, 69.6%; 95% CI, 47.6%-84.1%). Participants with a fractional flow of ≤0.90 were independently associated with cerebral hypoperfusion downstream from the stenosis site (adjusted OR, 3.68; 95% CI, 1.63-11.62; P = .027). CONCLUSIONS Fractional flow measured on 3D-TOF-MRA may serve as a noninvasive and practical tool for determining the cerebral hypoperfusion in patents with symptomatic MCA stenosis.
Collapse
|
64
|
Shi H, Wan J, Xu SP, Liao L. [A retrospective analysis of clinical characteristics and mortality risks in elderly patients with acute cholecystitis and cholangitis]. ZHONGHUA NEI KE ZA ZHI 2019; 58:415-418. [PMID: 31159518 DOI: 10.3760/cma.j.issn.0578-1426.2019.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical characteristics and explore the risk predictors on mortality in elderly patients with acute cholecystitis and cholangitis. Methods: We conducted a retrospective analysis of elderly patients hospitalized in the Second Medical Center of General Liberation Army Hospital for acute cholecystitis and cholangitis during 2000 to 2018. Clinical data and risk predictors on mortality were assessed. The patients were stratified into three groups based on age:Ⅰ (65-74 years old),Ⅱ (75-84 years old), and Ⅲ (≥85 years old). Logistic regression analysis was used to identify the predictors of mortality. Results: A total of 574 patients were finally enrolled with the mean age 87.6 years including 191 in group Ⅰ, 167 in group Ⅱ, and 216 in group Ⅲ. The main cause of acute cholecystitis and cholangitis was gallstone (76.3%),and the main symptom was abdominal pain (62.9%),followed by chills(62.5%),fever(59.8%),jaundice (47.2%) and septic shock(26.3%). Cholecystitis was the most common diagnosis in groups Ⅰ and Ⅱ,whereas it was cholangitis in group Ⅲ. Percutaneous transhepatic biliary/gallbladder drainage (PTBD/PTGD) and endoscopic retrograde cholangiopancreatography (ERCP) were administrated more frequently in groups Ⅲ. A total of 35 patients (6.1%) died during follow-up. Senior in age (OR=11.1),the Charlson comorbidity index (OR=19.5),cancers (OR=9.6),blood stream infections (OR=7.4),severity of cholecystitis and cholangitis (OR=4.2) were risk factors associated with mortality. Conclusions: Even in the elderly patients with acute cholecystitis and cholangitis,comorbidity is one of the main factors affecting clinical outcomes. Due to the poor performance, this group of population presents more severe disease and undergoes conservative treatment strategies.
Collapse
|
65
|
Wan J, Mitra N, Hoffstad O, Margolis D. 239 Age of atopic dermatitis onset influences longitudinal disease control and persistence in children. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
66
|
Luo Y, Wan J, F. Xiong Y, Lu L, L. Wang G, Y. Ling X, T. Hu Y, Y. Chen Q, Pan Y. Effect of synthesized temperature on the assembly and properties of four lanthanide supramolecular frameworks. B CHEM SOC ETHIOPIA 2019. [DOI: 10.4314/bcse.v33i1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
67
|
Ge FL, Su BB, Li TT, Shi LL, Lyu Y, Wan J. [Study on the application of oral magnesium sulfate solution in split doses as bowel preparation for colonoscopy in elderly patients]. ZHONGHUA NEI KE ZA ZHI 2019; 58:181-184. [PMID: 30803175 DOI: 10.3760/cma.j.issn.0578-1426.2019.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the efficacy and safety of oral magnesium sulfate solution in split doses as bowel preparation in elderly patients undergoing colonoscopy. Methods: A total of 368 elderly patients undergoing colonoscopy were enrolled at PLA General Hospital. The patients were randomly divided into magnesium sulfate solution orally in split doses group (group A, n=178) and single dose group (group B, n=190). Parameters including general information, defecation frequency, Boston bowel preparation score (BBPS), detection rate of lesions and adverse reactions. Results: The frequency of defecations in group A was (7.6±1.4), more than that in group B (6.6±1.5) with statistical significance (P<0.05). The duration of bowel preparation in group A was (128.6±25.3) min, shorter than that of group B (165.4±29.7) min (P<0.05). The BBPS in group A was (8.09±0.67), better than that of group B (7.34±0.58) (P<0.05). The detection rates of intestinal polyps and micropolyps (diameter<0.5 cm) in group A were 73/178 (41.0%) and 51/178 (28.7%) respectively, compared with 58/190 (30.5%) and 37/190 (19.5%) in group B (both P<0.05). In group A, 8 patients reported adverse reactions as abdominal distension and discomfort. One patient had ST-T abnormality of electrocardiogram (ECG). No nausea or vomiting occurred, yet 2 cases needed enema for inadequate bowel preparation. Twenty-one cases in group B reported adverse events including 7 with nausea and vomiting. There were 13 patients treated with enema. Abnormal ECG was found in 4 patients in group B. The satisfaction rate of group A was 97.8%, higher than that of group B (91.6%) (P<0.05). Conclusions: The effect of bowel preparation of elderly patients with magnesium sulfate solution in split dose has a better tolerance, good cleaning effect and low incidence of adverse reactions. It is an ideal choice for the elderly to prepare colonoscopy.
Collapse
|
68
|
Kushner C, Tarazi M, Gaffney R, Feng R, Ardalan K, Brandling‐Bennett H, Castelo‐Soccio L, Chang J, Chiu Y, Gmuca S, Hunt R, Kahn P, Knight A, Mehta J, Pearson D, Treat J, Wan J, Yeguez A, Concha J, Patel B, Okawa J, Arkin L, Werth V. 儿科皮肤病专家和风湿病专家对 CLASI 的评估. Br J Dermatol 2019. [DOI: 10.1111/bjd.17378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
69
|
Kushner C, Tarazi M, Gaffney R, Feng R, Ardalan K, Brandling‐Bennett H, Castelo‐Soccio L, Chang J, Chiu Y, Gmuca S, Hunt R, Kahn P, Knight A, Mehta J, Pearson D, Treat J, Wan J, Yeguez A, Concha J, Patel B, Okawa J, Arkin L, Werth V. Evaluation of CLASI by paediatric dermatologists and rheumatologists. Br J Dermatol 2019. [DOI: 10.1111/bjd.17364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
70
|
Yang L, Wang Y, Wan J, Shen L, Deng W, Zhu J, Zhang Z. Predicting Treatment Outcome of Rectal Cancer Patients with Neoadjuvant Chemoradiotherapy by ctDNA: The Potential Use of ctDNA Monitoring as Organ-Sparing Approach. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
71
|
Kozak K, Mirshams Shahshahani P, Wan J, Wang N, Kapshai A, DeMott T, Richardson J, Ashton-Miller J. ELDERLY DRIVER INGRESS AND EGRESS FROM A VEHICLE: PERCEIVED DISCOMFORT AND TASK DURATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
72
|
Zhang J, Shen L, Wang Y, Deng Y, Yang L, Wan J, Zhang Z. Poor-prognosis locally advanced rectal cancer is defined by a molecularly distinct subtype. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
73
|
Kushner CJ, Tarazi M, Gaffney RG, Feng R, Ardalan K, Brandling-Bennett HA, Castelo-Soccio L, Chang JC, Chiu YE, Gmuca S, Hunt RD, Kahn PJ, Knight AM, Mehta J, Pearson DR, Treat JR, Wan J, Yeguez AC, Concha JSS, Patel B, Okawa J, Arkin LM, Werth VP. Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in paediatric cutaneous lupus among paediatric dermatologists and rheumatologists. Br J Dermatol 2018; 180:165-171. [PMID: 30033560 DOI: 10.1111/bjd.17012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a reliable outcome measure for cutaneous lupus erythematosus (CLE) in adults used in clinical trials. However, it has not been validated in children, limiting clinical trials for paediatric CLE. OBJECTIVES This study aimed to validate the CLASI in paediatrics. METHODS Eleven paediatric patients with CLE, six dermatologists and six rheumatologists participated. The physicians were trained to use the CLASI and Physician's Global Assessment (PGA), and individually rated all patients using both tools. Each physician reassessed two randomly selected patients. Within each physician group, the intraclass correlation coefficient (ICC) was calculated to assess the reliability of each measure. RESULTS CLASI activity scores demonstrated excellent inter- and intrarater reliability (ICC > 0·90), while the PGA activity scores had good inter-rater reliability (ICC 0·73-0·77) among both specialties. PGA activity scores showed excellent (ICC 0·89) and good intrarater reliability (ICC 0·76) for dermatologists and rheumatologists, respectively. Limitations of this study include the small sample size of patients and potential recall bias during the physician rerating session. CONCLUSIONS CLASI activity measurement showed excellent inter- and intrarater reliability in paediatric CLE and superiority over the PGA. These results demonstrate that the CLASI is a reliable and valid outcome instrument for paediatric CLE.
Collapse
|
74
|
Sehdev A, Gbolahan O, Hancock B, Stanley M, Shahda S, Wan J, Wu H, Radovich M, O’Neil B. Germline and somatic DNA damage repair gene mutations and overall survival in metastatic pancreatic ductal adenocarcinoma patients treated with FOLFIRINOX. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
75
|
Dizon M, Yu A, Singh R, Wan J, Chren M, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol 2018; 178:1280-1287. [PMID: 29336013 PMCID: PMC6033033 DOI: 10.1111/bjd.16340] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Routinely collected electronic health data obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in routinely collected electronic health data differ, and it is unknown how this might affect study results. OBJECTIVES To evaluate how patients with AD have been identified in studies using routinely collected electronic health data, to determine whether these methods were validated and to estimate how the method for identifying patients with AD affected variability in prevalence estimates. METHODS We systematically searched PubMed, Embase and Web of Science for studies using routinely collected electronic health data that reported on AD as a primary outcome. Studies of localized AD and other types of dermatitis were excluded. The protocol for this review was registered in PROSPERO (CRD42016037968). RESULTS In total, 59 studies met eligibility criteria. Medical diagnosis codes for inclusion and exclusion, number of occasions of a code, type of provider associated with a code and prescription data were used to identify patients with AD. Only two studies described validation of their methods and no study reported on disease severity. Prevalence estimates ranged from 0·18% to 38·33% (median 4·91%) and up to threefold variation in prevalence was introduced by differences in the method for identifying patients with AD. CONCLUSIONS This systematic review highlights the need for clear reporting of methods for identifying patients with AD in routinely collected electronic health data to allow for meaningful interpretation and comparison of results.
Collapse
|