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| 1 | Clopidogrel and proton pump inhibitors-where do we stand in 2012?显示文摘Clopidogrel in association with aspirine is considered state of the art of medical treatment for acute coronary syndrome by reducing the risk of new ischemic events.Concomitant treatment with proton pump inhibitors in order to prevent gastrointestinal side effects is recommended by clinical guidelines.Clopidogrel needs metabolic activation predominantly by the hepatic cytochrome P450 isoenzyme Cytochrome 2C19(CYP2C19) and proton pump inhibitors(PPIs) are extensively metabolized by the CYP2C19 isoenzyme as well.Several pharmacodynamic studies investigating a potential clopidogrel-PPI interaction found a significant decrease of the clopidogrel platelet antiaggregation effect for omeprazole,but not for pantoprazole.Initial clinical cohort studies in 2009 reported an increased risk for adverse cardiovascular events,when under clopidogrel and PPI treatment at the same time.These observations led the United States Food and Drug Administration and the European Medecines Agency to discourage the combination of clopidogrel and PPI(especially omeprazole) in the same year.In contrast,more recent retrospective cohort studies including propensity score matching and the only existing randomized trial have not shown any difference concerning adverse cardiovascular events when concomitantly on clopidogrel and PPI or only on clopidogrel.Three meta-analyses report an inverse correlation between clopidogrel-PPI interaction and study quality,with high and moderate quality studies not reporting any association,rising concern about unmeasured confounders biasing the low quality studies.Thus,no definite evidence exists for an effect on mortality.Because PPI induced risk reduction clearly overweighs the possible adverse cardiovascular risk in patients with high risk of gastrointestinal bleeding,combination of clopidogrel with the less CYP2C19 inhibiting pantoprazole should be recommended. | Michael D Drepper Laurent Spahr Jean Louis Frossard | 2012 | World Journal of Gastroenterology2012，18，18： | 8 |
| 2 | Age,smoking and overweight contribute to the development of intestinal metaplasia of the cardia显示文摘AIM:To assess the role of Helicobacter pylori(H.pylori),gastroesophageal reflux disease(GERD),age,smoking and body weight on the development of intestinal metaplasia of the gastric cardia(IMC).METHODS:Two hundred and seventeen patients scheduled for esophagogastroduodenoscopy were enrolled in this study.Endoscopic biopsies from the esophagus,gastroesophageal junction and stomach were evaluated for inflammation,the presence of H.pylori and intestinal metaplasia.The correlation of these factors with the presence of IMC was assessed using logistic regression.RESULTS:IMC was observed in 42% of the patients.Patient age,smoking habit and body mass index(BMI) were found as potential contributors to IMC.The risk of developing IMC can be predicted in theory by combining these factors according to the following formula:Risk of IMC = a + s-2B where a = 2,…6 decade of age,s = 0 for non-smokers or ex-smokers,1 for < 10 cigarettes/d,2 for > 10 cigarettes/d and B = 0 for BMI < 25 kg/m2(BMI < 27 kg/m2 in females),1 for BMI > 25 kg/m2(BMI > 27 kg/m2 in females).Among potential factors associated with IMC,H.pylori had borderline signif icance(P = 0.07),while GERD showed no signif icance.CONCLUSION:Age,smoking and BMI are potential factors associated with IMC,while H.pylori and GERD show no significant association.IMC can be predicted in theory by logistic regression analysis. | Christian Felley Hanifa Bouzourene Marianne Bründler G VanMelle Antoine Hadengue Pierre Michetti Gian Dorta Laurent Spahr Emiliano Giostra Jean Louis Frossard | 2012 | World Journal of Gastroenterology2012，18，17： | 5 |
| 3 | Alcoholic pancreatitis:A tale of spirits and bacteria显示文摘Alcohol is a major cause of chronic pancreatitis.About5%of alcoholics will ever suffer from pancreatitis,suggesting that additional co-factors are required to trigger an overt disease.Experimental work has implicated lipopolysaccharide,from gut-derived bacteria,as a potential co-factor of alcoholic pancreatitis.This review discusses the effects of alcohol on the gut flora,the gut barrier,the liver-and the pancreas and proposes potential interventional strategies.A better understanding of the interaction between the gut,the liver and the pancreas may provide valuable insight into the pathophysiology of alcoholic pancreatitis. | Alain Vonlaufen Laurent Spahr Minoti V Apte Jean-Louis Frossard | 2014 | World Journal of Gastrointestinal Pathophysiology2014，5，2： | 3 |
| 4 | phosphatase and tensin homolog is a differential diagnostic marker between nonalcoholic and alcoholic fatty liver disease显示文摘AIM: To investigate the protein expression of phosphatase and tensin homolog(PTEN) in human liver biopsies of patients with alcoholic and non-alcoholic liver disease.METHODS: PTEN protein expression was assessed by immunohistochemistry in formalin-fixed, paraffinembedded liver sections of patients with non-alcoholic fatty liver disease(NAFLD)(n = 44) or alcoholic liver disease(ALD)(n = 25). Liver resections obtained from 3 healthy subjects candidate for partial liver donation served as controls. Histological evaluations were performed by two experienced pathologists, and diagnoses established based on international criteria. The intensity of the PTEN staining in nuclei was compared between steatotic and non-steatotic areas of each liver fragment analyzed. For each liver specimen, the antibody-stained sections were examined and scored blindly by three independent observers, who were unaware of the patients' clinical history.RESULTS: In healthy individuals, PTEN immunostaining was intense in both the cytoplasm and nuclei of all hepatocytes. However, PTEN was strongly downregulated in both the nucleus and the cytoplasm of hepatocytes from steatotic areas in patients with NAFLD, independently of the disease stage. In contrast, no changes in PTEN protein expression were observed in patients with ALD, regardless of the presence of steatosis or the stage of the disease. The degree of PTEN downregulation in hepatocytes of patients with NAFLD correlated with the percentage of steatosis(r = 0.3061, P = 0.0459) and the BMI(r = 0.4268, P = 0.0043). Hovewer, in patients with ALD, PTEN expression was not correlated with the percentage of steatosis with or without obesity as a confounding factor(P = 0.5574). Finally, PTEN expression level in steatotic areas of ALD patients was significantly different from that seen in steatotic areas of NAFLD patients(P < 0.0001).CONCLUSION: PTEN protein expression is downregulated early in NAFLD, but not in ALD. PTEN immunohistochemical detection could help in the differential diagnosis of NAFLD and ALD. | Andrea Sanchez-Pareja Sophie Clément Marion Peyrou Laurent Spahr Francesco Negro Laura Rubbia-Brandt Michelangelo Foti | 2016 | World Journal of Gastroenterology2016，22，14： | 2 |
| 5 | Effects of GnRH treatment on superovulatory responses of dairy cows显示文摘 | Wubiset A Graves C N Spahr S L | 1986 | Theriogenology1986，25，： | 2 |
| 6 | Adiponectin and its receptors are expressed in bone-forming cells显示文摘 | Berner HS Lyngstadaas SP Spahr A | 2004 | Bone2004，35，： | 1 |
| 7 | Histamine H1 blocker hydroxyzine improves Sleep in patients with Cirrhosis and minimal hepatic encephalopathy:a randomized centrolled Pilot trial 显示文摘 | Spahr L CoeytauX A Giostra E | 2007 | Am J Gastroenterol2007，102，4： | 1 |
| 8 | Periodontal infection and coronary heart disease 显示文摘 | Spahr A Klein E Khuseyinova N | 2006 | Arch Intern Med2006，166，5： | 1 |
| 9 | Adiponectin and its receptors are expressed in bone-forming cells显示文摘 | Berner HS Lyngstadaas SP Spahr A | 2004 | Bone2004，35，4： | 1 |
| 10 | Dominant negative effect of TG F- betaland TNF-alpha on basal and IL-6-induced lipoprotein (α)and apolipoprotein (α)mRNA expression in primary monkey hepatocyteeultures显示文摘 | Ramharack R Barkalow D Spahr MA | 1998 | Arterioscler Thromb Vasc Biol1998，18，6： | 1 |
| 11 | Acquired amegakaryocytic thrombocytopenic purpura 显示文摘 | Agarwal N Spahr JE Wemer TL | 2006 | Am J Hematol2006，81，2： | 1 |
| 12 | Characterization of layered lithium nickel manganese oxides synthesized by a novel oxidative coprecipitation method and their electrochemical performance as lithium insertion electrode materials显示文摘 | Spahr M.E Novak P Schnydere B | | 0，，04： | 1 |
| 13 | Persistence of mild parkinsonism 4 months after liver transplantation in patients with preoperative minimal hepatic encephalopathy: a study on neuroradiological and blood manganese changes显示文摘 | Lazeyras F Spahr L DuPasquier R | 2002 | Transpl Int2002，15，： | 1 |
| 14 | Insertion electrode materials for rechargeable lithium batteries显示文摘 | Winier M Besenhard J O Spahr M E | 1998 | Advanced Materials1998，10，10： | 1 |
| 15 | Differential Neurotoxic Effects of Propofol on Dissociated Cortical Cells and Organotypic Hippocampal Cultures显示文摘 | Spahr Schopfer I Vutskits L Toni N | 2000 | Anesthesiology2000，92，5： | 1 |
| 16 | Periodontal infections and coronary heart disease:role of periodontal bacteria and importance of total pathogen burden in the Coronary Event and PeriodontalDisease(CORODONT)study显示文摘 | Spahr A Klein E Khuseyinova N | 2006 | Arch Intem Med2006，166，5： | 1 |
| 17 | Treatment of immune-mediated thrombocyto-penia purpura with concurrent intravenous immunoglobulin and plate-let transfusion:a retrospective review of 40 patients显示文摘 | Spahr JE Rodgers GM | 2008 | Am J Hema-tol2008，83，2： | 1 |
| 18 | Periodontal infections and coronary heart disease:role of periodontal bacteria and importance of total pathogen burden in the coronary event and periodontal disease (CORODONT) study显示文摘 | Spahr A Klein E Khuseyinova N | | 0，，： | 1 |
| 19 | A sensitive period for the development of the central auditory system in children withcochlear implants:implications for age of implantation显示文摘 | SHARMA A DORMAN M F SPAHR A J | 2002 | Ear Hear2002，23，： | 1 |
| 20 | Insertion electrode materials for rechargeable lithium batteries 显示文摘 | WINTER M BESENHARD J O SPAHR M E | 1998 | Adv Mater1998，10，： | 1 |
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