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1Efficacy of peroral endoscopic myotomy vs other achalasia treatments in improving esophageal function显示文摘AIM: To assess and compare the esophageal function after peroral endoscopic myotomy(POEM) vs other conventional treatments in achalasia.METHODS: Chart review of all achalasia patients who underwent POEM, laparoscopic Heller myotomy(LHM) or pneumatic dilation(PD) at our institution between January 2012 and March 2015 was performed. Patient demographics, type of achalasia, prior treatments, pre- and post-treatment timed barium swallow(TBE) and high-resolution esophageal manometry(HREM) findings were compared between the three treatment groups. Patients who had both pre- and 2 mo posttreatment TBE or HREM were included in the final analysis. TBE parameters compared were barium column height, width and volume of barium remaining at 1 and 5 min. HREM parameters compared were basal lower esophageal sphincter(LES) pressures and LES-integrated relaxation pressures(IRP). Data are presented as mean ± SD, median [25th, 75 th percentiles] or frequency(percent). Analysis of variance, KruskalWallis test, Pearsons χ~2 test and Fishers Exact tests were used for analysis.RESULTS: A total of 200 achalasia patients were included of which 36 underwent POEM, 22 underwent PD and 142 underwent LHM. POEM patients were older(55.4 ± 16.8 years vs 46.5 ± 15.7 years, P = 0.013) and had higher BMI than LHM(29.1 ± 5.9 kg/m^2 vs 26 ± 5.1 kg/m^2, P = 0.012). More number of patients in POEM and PD groups had undergone prior treatments compared to LHM group(72.2% vs 68.2% vs 44.3% respectively, P = 0.003). At 2 mo post-treatment, all TBE parameters including barium column height, width and volume remaining at 1 and 5 min improved significantly in all three treatment groups(P = 0.01 to P < 0.001) except the column height at 1 min in PD group(P = 0.11). At 2 mo post-treatment, there was significant improvement in basal LES pressure and LES-IRP in both LHM(40.5 mm Hg vs 14.5 mm Hg and 24 mm Hg vs 7.1 mm Hg respectively, P < 0.001) and POEM groups(38.7 mm Hg vs 11.4 mm Hg and 23.6 mm Hg vs 6.6 mm Hg respectively, P < 0.001). However, when the efficacy of three treatments were compared to each other in terms of improvement in TBE or HREM parameters at 2 mo, there was no significant difference(P > 0.05).CONCLUSION: POEM, PD and LHM were all effective in improving esophageal function in achalasia at shortterm. There was no difference in efficacy between the three treatments.Madhusudhan R Sanaka Umar Hayat Prashanthi N Thota Ramprasad Jegadeesan Monica Ray Scott L Gabbard Neha Wadhwa Rocio Lopez Mark E Baker Sudish Murthy Siva Raja 2016World Journal of Gastroenterology2016,22,20:7
2The structure of glycosaminoglyeans and their interactions with proteins 显示文摘Neha S Gandhi Ricardo L Mancera 2008Chemical Biology Drug Design2008,72,6:1
3Nuclear EGFR as a molecular tar- get in cancer显示文摘Brand TM Mari I Neha L 2013Radiother Oncol2013,108,3:1
4Critical care practices in the world:Results of the global intensive care unit need assessment survey 2020显示文摘BACKGROUND There is variability in intensive care unit(ICU)resources and staffing worldwide.This may reflect variation in practice and outcomes across all health systems.AIM To improve research and quality improvement measures administrative leaders can create long-term strategies by understanding the nature of ICU practices on a global scale.METHODS The Global ICU Needs Assessment Research Group was formed on the basis of diversified skill sets.We aimed to survey sites regarding ICU type,availability of staffing,and adherence to critical care protocols.An international survey‘Global ICU Needs Assessment’was created using Google Forms,and this was distributed from February 17^(th),2020 till September 23^(rd),2020.The survey was shared with ICU providers in 34 countries.Various approaches to motivating healthcare providers were implemented in securing submissions,including use of emails,phone calls,social media applications,and WhatsApp^(TM).By completing this survey,providers gave their consent for research purposes.This study was deemed eligible for category-2 Institutional Review Board exempt status.RESULTS There were a total 121 adult/adult-pediatrics ICU responses from 34 countries in 76 cities.A majority of the ICUs were mixed medical-surgical[92(76%)].108(89%)were adult-only ICUs.Total 36 respondents(29.8%)were 31-40 years of age,with 79(65%)male and 41(35%)female participants.89 were consultants(74%).A total of 71(59%)respondents reported having a 24-h inhouse intensivist.A total of 87(72%)ICUs were reported to have either a 2:1 or≥2:1 patient/nurse ratio.About 44%of the ICUs were open and 76%were mixed type(medical-surgical).Protocols followed regularly by the ICUs included sepsis care(82%),ventilator-associated pneumonia(79%);nutrition(76%),deep vein thrombosis prophylaxis(84%),stress ulcer prophylaxis(84%),and glycemic control(89%).CONCLUSION Based on the findings of this international,multi-dimensional,needs-assessment survey,there is a need for increased recruitment and staffing in critical care facilities,along with improved patientto-nurse ratios.Future research is warranted in this field with focus on implementing appropriate health standards,protocols and resources for optimal efficiency in critical care worldwide.Faisal A Nawaz Neha Deo Salim Surani William Maynard Martin L Gibbs Rahul Kashyap 2022World Journal of Critical Care Medicine2022,11,3:0
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