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| 1 | NAFLD fibrosis score:A prognostic predictor for mortality and liver complications among NAFLD patients显示文摘AIM:To study whether the severity of liver fibrosis estimated by the nonalcoholic fatty liver disease(NAFLD) fibrosis score can predict all-cause mortality,cardiac complications,and/or liver complications of patients with NAFLD over long-term follow-up.METHODS:A cohort of well-characterized patients with NAFLD diagnosed during the period of 1980-2000 was identified through the Rochester Epidemiology Project.The NAFLD fibrosis score(NFS) was used to separate NAFLD patients with and without advanced liver fibrosis.We used the NFS score to classify the probability of fibrosis as <-1.5 for low probability,>-1.5 to < 0.67 for intermediate probability,and > 0.67 for high probability.Primary endpoints included allcause death and cardiovascular-and/or liver-related mortality.From the 479 patients with NAFLD assessed,302 patients(63%) greater than 18 years old were included.All patients were followed,and medical charts were reviewed until August 31,2009 or the date when the first primary endpoint occurred.By using a standardized case record form,we recorded a detailed history and physical examination and the use of statins and metformin during the follow-up period.RESULTS:A total of 302/479(63%) NAFLD patients(mean age:47 ± 13 year) were included with a followup period of 12.0 ± 3.9 year.A low probability of advanced fibrosis(NFS <-1.5 at baseline) was found in 181 patients(60%),while an intermediate or high probability of advanced fibrosis(NSF >-1.5) was found in 121 patients(40%).At the end of the follow-up period,55 patients(18%) developed primary endpoints.A total of 39 patients(13%) died during the follow-up.The leading causes of death were non-hepatic malignancy(n = 13/39;33.3%),coronary heart disease(CHD)(n = 8/39;20.5%),and liver-related mortality(n = 5/39;12.8%).Thirty patients had new-onset CHD,whereas 8 of 30 patients(27%) died from CHD-related causes during the follow-up.In a multivariate analysis,a higher NFS at baseline and the presence of new-onset CHD were significantly predictive of death(OR = 2.6 and 9.2,respectively;P < 0.0001).Our study showed a significant,graded relationship between the NFS,as classified into 3 subgroups(low,intermediate and high probability of liver fibrosis),and the occurrence of primary endpoints.The use of metformin or simvastatin for at least 3 mo during the follow-up was associated with fewer deaths in patients with NAFLD(OR = 0.2 and 0.03,respectively;P < 0.05).Additionally,the rate of annual NFS change in patients with an intermediate or high probability of advanced liver fibrosis was significantly lower than those patients with a low probability of advanced liver fibrosis(0.06 vs 0.09,P = 0.004).The annual NFS change in patients who died was significantly higher than those in patients who survived(0.14 vs 0.07,P = 0.03).At the end of the follow-up,we classified the patients into 3 subgroups according to the progression pattern of liver fibrosis by comparing the NFS at baseline to the NFS at the end of the followup period.Most patients were in the stable-fibrosis(60%) and progressive-fibrosis(37%) groups,whereas only 3% were in the regressive fibrosis.CONCLUSION:A higher NAFLD fibrosis score at baseline and a new onset of CHD were significantly predictive of death in patients with NAFLD. | Sombat Treeprasertsuk Einar Bjrnsson Felicity Enders Sompongse Suwanwalaikorn Keith D Lindor | 2013 | World Journal of Gastroenterology2013，19，8： | 13 |
| 2 | Swallowed Fluticasone Improves Histologic but Not Symptomatic Response of Adults With Eosinophilic Esophagitis显示文摘 | Jeffrey A. Alexander Kee Wook Jung Amindra S. Arora Felicity Enders David A. Katzka Gail M. Kephardt Hirohito Kita Lori A. Kryzer Yvonne Romero Thomas C. Smyrk Nicholas J. Talley | 2012 | Clinical Gastroenterology and Hepatology2012，，7： | 3 |
| 3 | Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction显示文摘 | Carolyn S.P. Lam Véronique L. Roger Richard J. Rodeheffer Barry A. Borlaug Felicity T. Enders Margaret M. Redfield | 2009 | Journal of the American College of Cardiology2009，，13： | 1 |
| 4 | Assessment of multi-modality evaluations of obscure gastrointestinal bleeding显示文摘AIM To determine the frequency of bleeding source detection in patients with obscure gastrointestinal bleeding(OGIB) who underwent double balloon enteroscopy(DBE) after pre-procedure imaging [multiphase computed tomography enterography(MPCTE), video capsule endoscopy(VCE), or both] and assess the impact of imaging on DBE diagnostic yield.METHODS Retrospective cohort study using a prospectively maintained database of all adult patients presenting with OGIB who underwent DBE from September 1^(st), 2002 to June 30^(th), 2013 at a single tertiary center.RESULTS Four hundred and ninety five patients(52% females; median age 68 years) underwent DBE for OGIB. AVCE and/or MPCTE performed within 1 year prior to DBE(in 441 patients) increased the diagnostic yield of DBE(67.1% with preceding imaging vs 59.5% without). Using DBE as the gold standard, VCE and MPCTE had a diagnostic yield of 72.7% and 32.5% respectively. There were no increased odds of finding a bleeding site at DBE compared to VCE(OR = 1.3, P = 0.150). There were increased odds of finding a bleeding site at DBE compared to MPCTE(OR = 5.9, P < 0.001). In inpatients with overt OGIB, diagnostic yield of DBE was not affected by preceding imaging.CONCLUSION DBE is a safe and well-tolerated procedure for the diagnosis and treatment of OGIB, with a diagnostic yield that may be increased after obtaining a preceding VCE or MPCTE. However, inpatients with active ongoing bleeding may benefit from proceeding directly to antegrade DBE. | Ryan Law Jithinraj E Varayil Louis M Wong Kee Song Jeff Fidler Joel G Fletcher John Barlow Jeffrey Alexander Elizabeth Rajan Stephanie Hansel Brenda Becker Joseph J Larson Felicity T Enders David H Bruining Nayantara Coelho-Prabhu | 2017 | World Journal of Gastroenterology2017，23，4： | 1 |
| 5 | Interobserver agreement for EUS findings in familial pancreatic-cancer kindreds显示文摘 | Mark Topazian Felicity Enders Michael Kimmey Randall Brand Amitabh Chak Jonathan Clain John Cunningham Mohamad Eloubeidi Hans Gerdes Frank Gress Sanjay Jagannath Sergey Kantsevoy Julia Kim LeBlanc Michael Levy Charles Lightdale Joseph Romagnuolo John R. S | 2007 | Gastrointestinal Endoscopy2007，，1： | 1 |
| 6 | Narrow band imaging evaluation of duodenal villi in patients with and without celiac disease:A prospective study显示文摘BACKGROUND Duodenal biopsies are commonly obtained during esophagogastroduodenoscopy(EGD) but are very often histopathologically normal. Therefore, a more strategic method for evaluating the duodenal mucosa and avoiding unnecessary biopsies is needed.AIM To examine the clinical utility of narrow band imaging(NBI) for evaluating duodenal villous morphology.METHODS We performed a prospective cohort study of adult patients at Mayo Clinic Rochester from 2013-2014 who were referred for EGD with duodenal biopsies. A staff endoscopist scored, in real-time, the NBI-based appearance of duodenal villi into one of three categories(normal, partial villous atrophy, or complete villous atrophy), captured ≥ 2 representative duodenal NBI images, and obtained mucosal biopsies therein. Images were then scored by an advanced endoscopist and gastroenterology fellow, and biopsies(gold standard) by a pathologist, in a masked fashion using the same three-category classification. Performing endoscopist, advanced endoscopist, and fellow NBI scores were compared to histopathology to calculate performance characteristics [sensitivity, specificity,positive and negative, negative predictive value(NPV), and accuracy]. Inter-rater agreement was assessed with Cohen's kappa.RESULTS112 patients were included. The most common referring indications were dyspepsia(47%), nausea(23%), and suspected celiac disease(14%). Duodenal histopathology scores were: 84% normal, 11% partial atrophy, and 5% complete atrophy. Performing endoscopist NBI scores were 79% normal, 14% partial atrophy, and 6% complete atrophy compared to 91%, 5%, and 4% and 70%, 24%,and 6% for advanced endoscopist and fellow, respectively. NBI performed favorably for all raters, with a notably high(92%-100%) NPV. NBI score agreement was best between performing endoscopist and fellow(κ = 0.65).CONCLUSION NBI facilitates accurate, non-invasive evaluation of duodenal villi. Its high NPV renders it especially useful for foregoing biopsies of histopathologically normal duodenal mucosa. | James H Tabibian Jean F Perrault Joseph A Murray Konstantinos A Papadakis Felicity T Enders Christopher J Gostout | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，2： | 0 |
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