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| 1 | Trans-arterial chemo-embolization is safe and effective for very elderly patients with hepatocellular carcinoma显示文摘AIM: To assess the safety and efficacy of trans-arterial chemo-embolization (TACE) in very elderly patients. METHODS: A prospective cohort study, from 2001 to 2010, compared clinical outcomes following TACE between patients ≥ 75 years old and younger patients (aged between 65 and 75 years and younger than 65 years) with hepatocellular carcinoma (HCC), diagnosed according to the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases criteria. The decision that patients were not candidates for curative therapy was made by a multidisciplinary HCC team. Data collected included demographics, co-morbidities, liver disease etiology, liver disease severity and the number of procedures. The primary outcome was mortality; secondary outcomes included post-embolization syndrome (nausea, fever, abdominal right upper quadrant pain, increase in liver enzymes with no evidence of sepsis and with a clinical course limited to 3-4 d post procedure) and 30-d complications. Additionally, changes in liver enzyme measurements were assessed [alanine and aspartate aminotransferase (ALT and AST), gamma-glutamyl transpeptidase and alkaline phosphatase] in the week following TACE. Analysis employed both univariate and multivariate methods (Cox regression models). RESULTS: Of 102 patients who underwent TACE as sole treatment, 10 patients (9.8%) were > 80 years old at diagnosis; 13 (12.7%) were between 75 and 80 years, 45 (44.1%) were between 65 and 75 years and 34 (33.3%) were younger than 65 years. Survival analysis demonstrated similar survival patterns between the elderly patients and younger patients. Age was also not associated with the adverse event rate. Survival rates at 1, 2 and 3 years from diagnosis were 74%, 37% and 31% among patients < 65 years; 83%, 66% and 48% among patients aged 65 to 75 years; and 86%, 41% and 23% among patients ≥ 75 years. There were no differences between the age groups in the pre-procedural care, including preventive treatment for contrast nephropathy and prophylactic antibiotics. Multivariate survival analysis, controlling for disease stage at diagnosis with the Barcelona Clinic Liver Cancer score, number of TACE procedures, sex and alphafetoprotein level at the time of diagnosis, found no significant difference in the mortality hazard for elderly vs younger patients, and there were no differences in post-procedural complications. Serum creatinine levels did not change after 55% of the procedures, in all age groups. In 42% of all procedures, serum creatinine levels increased by no more than 25% above the baseline levels prior to TACE. Overall, there were 69 post-embolization events (23%). Hepatocellular enzymes often increased following TACE, with no association with prognosis. In 40% of the procedures, ALT and AST levels rose by at least 100%. The increases in hepatocellular enzymes occurred similarly in all age groups. CONCLUSION: TACE is safe and effective in very elderly patients with HCC, and is not associated with decreased survival or increased complication rates. | Matan J Cohen Allan I Bloom Orly Barak Alexander Klimov Tova Nesher Daniel Shouval Izhar Levi Oren Shibolet | 2013 | World Journal of Gastroenterology2013，19，16： | 13 |
| 2 | Immunosuppression and HBV Reactivation显示文摘 | Daniel Shouval Oren Shibolet | 2013 | Semin Liver Dis2013，，02： | 3 |
| 3 | Entecavir versus Lamivudine for Patients with HBeAg-Negative Chronic Hepatitis B显示文摘 | Ching-Lung Lai Daniel Shouval Anna S Lok | 2006 | The New England journal of medicine2006，354，： | 1 |
| 4 | The pros and cons of lamivudine vs. entecavir in decompensated or severe acute exacerbation of chronic hepatitis B显示文摘 | Daniel Shouval | 2014 | Journal of Hepatology2014，，： | 1 |
| 5 | Focus<!-- Doctopic: Focus -->显示文摘 | Daniel Shouval | 2013 | Journal of Hepatology2013，，6： | 1 |
| 6 | Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: A concise review显示文摘 | Daniel Shouval Didier Samuel | 2000 | Hepatology2000，，6： | 1 |
| 7 | Comparative immunogenicity of a PreS/S hepatitis B vaccine in non- and low responders to conventional vaccine显示文摘 | Pamela Rendi-Wagner Daniel Shouval Blaise Genton Yoav Lurie Hans Rümke Greet Boland Andreas Cerny Markus Heim Doris Bach Manfred Schroeder Herwig Kollaritsch | 2006 | Vaccine2006，，15： | 1 |
| 8 | Genotypic and phenotypic resistance: longitudinal and sequential analysis of hepatitis B virus polymerase mutations in patients with lamivudine resistance after liver transplantation显示文摘 | Ziv Ben-Ari Nili Daudi Athalia Klein Jaqueline Sulkes Orit Papo Eytan Mor Zmira Samra Rachamim Gadba Daniel Shouval Ran Tur-Kaspa | 2003 | The American Journal of Gastroenterology2003，，1： | 1 |
| 9 | Expanding the donor pool for liver transplant recipients using HBsAg positive grafts显示文摘 | Daniel Shouval | 2014 | Journal of Hepatology2014，，4： | 1 |
| 10 | Bacteremia and “Endotipsitis” following transjugular intrahepatic portosystemic shunting显示文摘AIM: To identify all cases of bacteremia and suspected endotipsitis after Transjugular intrahepatic portosystemic shunting (TIPS) at our institution and to determine risk factors for their occurrence. METHODS: We retrospectively reviewed records of all patients who underwent TIPS in our institution between 1996 and 2009. Data included: indications for TIPS, underlying liver disease, demographics, positive blood cultures after TIPS, microbiological characteristics, treat- ment and outcome. RESULTS: 49 men and 47 women were included with a mean age of 55.8 years (range 15-84). Indications for TIPS included variceal bleeding, refractory ascites,hydrothorax and hepatorenal syndrome. Positive blood cultures after TIPS were found in 39/96 (40%) patients at various time intervals following the procedure. Seven patients had persistent bacteremia fitting the definition of endotipsitis. Staphylococcus species grew in 66% of the positive cultures, Candida and enterococci species in 15% each of the isolates, and 3% cultures grew other species. Multi-variate regression analysis identified 4 variables: hypothyroidism, HCV, prophylactic use of an- tibiotics and the procedure duration as independent risk factors for positive blood cultures following TIPS (P < 0.0006, 0.005, 0.001, 0.0003, respectively). Prophylactic use of antibiotics before the procedure was associated with a decreased risk for bacteremia, preventing mainly early infections, occurring within 120 d of the procedure. CONCLUSION: Bacteremia is common following TIPS. Risk factors associated with bacteremia include failure to use prophylactic antibiotics, hypothyroidism, HCV and a long procedure. Our results strongly support the use of prophylaxis as a means to decrease early post TIPS infections. | Mizrahi Meir Roemi Lilach Shouval Daniel Adar Tomer Korem Maya Moses Alon Bloom Alan Shibolet Oren | 2011 | World Journal of Hepatology2011，3，5： | 1 |
| 11 | Late cytomegalovirus disease following liver transplantation显示文摘 | Oren Shibolet Yaron Ilan Yosef Kalish Rifaat Safadi Yaffa Ashur Ahmed Eid Daniel Shouval Dana Wolf | 2002 | Transplant International2002，，12： | 1 |
| 12 | Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: A concise review显示文摘 | Daniel Shouval Didier Samuel | 2000 | Hepatology2000，，6： | 1 |
| 13 | Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: A concise review显示文摘 | Daniel Shouval Didier Samuel | 2000 | Hepatology2000，，6： | 1 |
| 14 | Association between consumption of Herbalife ? nutritional supplements and acute hepatotoxicity显示文摘 | Eran Elinav Galia Pinsker Rifaat Safadi Orit Pappo Michal Bromberg Emilia Anis Lital Keinan-Boker Efrat Broide Zvi Ackerman Dorit Nitzan Kaluski Boaz Lev Daniel Shouval | 2007 | Journal of Hepatology2007，，4： | 1 |
| 15 | Acute hepatitis E virus in pregnant women in Israel and in other industrialized countries显示文摘 | Tamar Lachish Ortal Erez Nili Daudi Daniel Shouval Eli Schwartz | 2015 | Journal of Clinical Virology2015，，： | 1 |
| 16 | Hepatitis E in Israel: A nation-wide retrospective study显示文摘AIM: To investigate the epidemiology, risk factors and clinical course of acute hepatitis E virus(HEV) infection in Israel, an industrialized country.METHODS: A retrospective analysis of acute HEV cases diagnosed in Israel from 1993 to 2013. Acute HEV was defined by ALT/AST elevation and a positive HEV PCR test or positive anti-HEV-Ig M serology. HEV RNA was tested by quantitative reverse transcription PCR. Antibodies to HEV were tested retrospectively using an ELISA assay. HEV-RNA was sequenced using RT-PCR of ORF1 and ORF2 regions to diagnose genotype of the virus. Epidemiologic and clinical data were collected by reviewing the clinical files and through a telephone interview according to a structured questionnaire.RESULTS: Acute HEV was diagnosed in 68 patients. Among the 59 patients who gave an informed consent a nd w e re int e r v ie w e d, 4 1% o f infe c t io ns w e re autochthonous(acquired in Israel), 44% travel-related and 15% imported by foreign workers. Autochthonous patients were mainly females(62.5%), more than half of them pregnant, 26% recalled consuming food or water in areas with poor sanitation, 44% ate nonkosher meat. Fulminant hepatitis developed in 3 patients(5%), all of them were females, two of them with post-partum infection, all acquired the disease in Israel(autochthonous). Israeli travelers with imported infection were predominantly males(73%), acquired the disease in the Indian subcontinent(81%), with 100% reporting having consumed fresh vegetables and drinks with ice cubes abroad. Six patients' sera were tested for genotype and revealed HEV genotype 1(all cases acquired in the Indian subcontinent). CONCLUSION: This is the first report which highlights the existence of hepatitis E as an autochthonous infection in Israel. Imported HEV originates mostly from the Indian subcontinent. | Ortal Erez-Granat Tamar Lachish Nili Daudi Daniel Shouval Eli Schwartz | 2016 | World Journal of Gastroenterology2016，22，24： | 0 |
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