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| 1 | AIMS65: A promising upper gastrointestinal bleeding risk score but further validation required显示文摘A novel upper gastrointestinal bleeding risk stratification score(AIMS65) has recently been developed and validated. It has advantages over existing risk scores including being easy to remember and lack of subjectivity in calculation. We comment on a recent study that has cast doubt on the applicability of AIMS65 in the peptic ulcer disease population. Although promising, further studies are required to evaluate the validity of AIMS65 in various populations. | Ray Boyapati Avik Majumdar Marcus Robertson | 2014 | World Journal of Gastroenterology2014，20，39： | 7 |
| 2 | Prognostic significance of hepatic encephalopathy in patients with cirrhosis treated with current standards of care显示文摘BACKGROUND Hepatic encephalopathy(HE)is a reversible neuropsychiatric complication of liver cirrhosis and occurs in up to 50%of cirrhotic patients.Studies examining the prognostic significance of HE are limited despite the high prevalence in cirrhosis.AIM To define the clinical outcomes of patients after an episode of HE treated with current standards-of-care.METHODS All patients hospitalised with HE requiring Rifaximin to 3 tertiary centres over46-mo(2012–2016)were identified via pharmacy dispensing records.Patients with hepatocellular carcinoma and those prescribed Rifaximin prior to admission were excluded.Medical records were reviewed to determine baseline characteristics and survival.The Kaplan-Meier method was used to calculate survival probability.Univariate survival analysis was performed with variables reaching statistical significance included in a multivariate analysis.The primary outcome was 12-mo mortality following commencement of Rifaximin.RESULTS188 patients were included.Median age was 57 years(IQR 50-65),71%were male and median model for end stage liver disease and Child Pugh scores were 25(IQR 18-31)and 11(IQR 9-12)respectively.The most common causes of cirrhosis were alcohol(62%),hepatitis C(31%)and non-alcoholic fatty liver disease(20%).A precipitating cause for HE was found in 92%patients with infection(43%),GI bleeding(16%),medication non-compliance(15%)and electrolyte imbalance(14%)the most common.During a mean follow up period of 12±13 mo 107(57%)patients died and 32(17%)received orthotopic liver transplantation.Themost common causes of death were decompensated chronic liver disease(57%)and sepsis(19%).The probability of survival was 44%and 35%at 12-and 24-mo respectively.At multivariate analysis a model for end stage liver disease>15 and international normalised ratio reached statistical significance in predicting mortality.CONCLUSION Despite advances made in the management of HE patients continue to have poor survival.Thus,in all patients presenting with HE the appropriateness of orthotopic liver transplantation should be considered. | Anuj Bohra Thomas Worland Samuel Hui Ryma Terbah Ann Farrell Marcus Robertson | 2020 | World Journal of Gastroenterology2020，26，18： | 4 |
| 3 | Comparison of two emergency medical services in Beijing and Hong Kong, China显示文摘To Out-of-hospital cardiac arrest (OHCA) is a major issue in emergency care worldwide. The incidence of OHCA is estimated to be 50 to 60 per 100,000 persons globally.Despite advances in treatment and technology, survival following OHCA remains low. There are multiple factors affecting the survival outcome. The type of emergency medical service (EMS) system is likely to be one of them. In Asia, the EMS structure and its service capability in terms of dispatch, airway management, and medications vary widely between communities. This study aimed to evaluate the survival outcomes of OHCA in Beijing and Hong Kong (HK), China and the effect of the type of EMS system on the survival outcomes for patients with OHCA. | Fei Shao Kit-Ling Fan Colin Robertson Marcus Ong Nan Liu Ling-Pong Leung Reynold Leung Chun-Sheng Li | 2019 | Chinese Medical Journal2019，，11： | 2 |
| 4 | Low-dose enoximone improves exercise capacity in chronic heart failure ? ? A list of the Enoximone Study Group Members and institutional affiliations is provided in the appendix .显示文摘 | Brian D Lowes Michael Higginbotham Lawrence Petrovich Marcus A DeWood Mark A Greenberg Peter S Rahko G.William Dec Thierry H LeJemtel Robert L Roden Margo M Schleman Alastair D Robertson Richard J Gorczynski Michael R Bristow | 2000 | Journal of the American College of Cardiology2000，，： | 1 |
| 5 | Natural history and outcomes of patients with liver cirrhosis complicated by hepatic hydrothorax显示文摘BACKGROUNDHepatic hydrothorax (HH) is an uncommon and difficult-to-manage complicationof cirrhosis with limited treatment options.AIMTo define the clinical outcomes of patients presenting with HH managed withcurrent standards-of-care and to identify factors associated with mortality.METHODSCirrhotic patients with HH presenting to 3 tertiary centres from 2010 to 2018 wereretrospectively identified. HH was defined as pleural effusion in the absence ofcardiopulmonary disease. The primary outcomes were overall and transplant-freesurvival at 12-mo after the index admission. Cox proportional hazards analysiswas used to determine factors associated with the primary outcomes.RESULTSOverall, 84 patients were included (mean age, 58 years) with a mean model forend-stage liver disease score of 29. Management with diuretics alone achievedlong-term resolution of HH in only 12% patients. At least one thoracocentesis wasperformed in 73.8% patients, transjugular intrahepatic portosystemic shuntinsertion in 11.9% patients and 33% patients received liver transplantation within12-mo of index admission. Overall patient survival and transplant-free survival at12 mo were 68% and 41% respectively. At multivariable analysis, current smoking [hazard ratio (HR) = 8.65, 95% confidence interval (CI): 3.43-21.9, P < 0.001) and acute kidneyinjury (AKI) (HR = 2.91, 95%CI: 1.21-6.97, P = 0.017) were associated with a significantly increasedrisk of mortality.CONCLUSIONCirrhotic patients with HH are a challenging population with a poor 12-mo survival despitecurrent treatments. Current smoking and episodes of AKI are potential modifiable factors affectingsurvival. HH is often refractory of diuretic therapy and transplant assessment should beconsidered in all cases. | Sarah Romero Andy KH Lim Gurpreet Singh Chamani Kodikara Rachel Shingaki-Wells Lynna Chen Samuel Hui Marcus Robertson | 2022 | World Journal of Gastroenterology2022，28，35： | 0 |
| 6 | Survival outcomes and predictors of mortality,re-bleeding and complications for acute severe variceal bleeding requiring balloon tamponade显示文摘BACKGROUND Acute severe variceal bleeding(AVB)refractory to medical and endoscopic therapy is infrequent but associated with high mortality.Historical cohort studies from 1970-1980s no longer represent the current population as balloon tamponade is no longer first-line therapy for variceal bleeding;treatments including vasoactive therapies,intravenous antibiotics,endoscopic variceal band ligation are routinely used,and there is improved access to definitive treatments including transjugular intrahepatic portosystemic shunts.However,only a few studies from the current era exist to describe the practice of balloon tamponade,its outcomes,and predictors with a requirement for further updated information.AIM To describe current management of AVB requiring balloon tamponade and identify the outcomes and predictors of mortality,re-bleeding and complications.METHODS A retrospective multi-centre cohort study of 80 adult patients across two large tertiary health networks from 2008 to 2019 in Australia who underwent balloon tamponade using a Sengstaken-Blakemore tube(SBT)were included for analysis.Patients were identified using coding for balloon tamponade.The primary outcome of this study was all-cause mortality at 6 wk after the index AVB.Secondary outcomes included re-bleeding during hospitalisation and complications of balloon tamponade.Predictors of these outcomes were determined using univariate and multivariate binomial regression.RESULTS The all-cause mortality rates during admission and at 6-,26-and 52 wk were 48.8%,51.2%and 53.8%,respectively.Primary haemostasis was achieved in 91.3%and re-bleeding during hospitalisation occurred in 34.2%.Independent predictors of 6 wk mortality on multivariate analysis included the Model for Endstage Liver disease(MELD)score(OR 1.21,95%CI 1.06-1.41,P=0.006),advanced hepatocellular carcinoma(OR 11.51,95%CI 1.61-82.20,P=0.015)and re-bleeding(OR 13.06,95%CI 3.06-55.71,P<0.001).There were no relevant predictors of re-bleeding but a large proportion in which this occurred did not survive 6 wk(76.0%vs 24%).Although mucosal trauma was the most common documented complication after SBT insertion(89.5%),serious complications from SBT insertion were uncommon(6.3%)and included 1 patient who died from oesophageal perforation.CONCLUSION In refractory AVB,balloon tamponade salvage therapy is associated with high rates of primary haemostasis with low rates of serious complications.Re-bleeding and mortality however,remain high. | Charlotte Y Keung Aparna Morgan Suong T Le Marcus Robertson Paul Urquhart Michael P Swan | 2022 | World Journal of Hepatology2022，14，8： | 0 |
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