Page 2 - DIFDUF

669
Eitan Israeli
available for the same tumor samples, inherited risk loci for
Science 2018; 362: eaav1898
types. When the data were integrated with other omics data

chromatin landscape in 410 TCGA samples from 23 cancer
associated with clinical prognosis were discovered.
to profile chromatin accessibility to determine the accessible
Doppler showed a mild residual leak
survival differences were identified, and non-coding mutations
cancers. Corces and co-authors used a recently modified assay
septum [g] TTE apical view highlighted by color
resource of molecular data on a large variety of human
enhancers driving molecular subtypes of cancer with patient
the device at the level of the interventricular
cancer predisposition were revealed, transcription factors and
The Cancer Genome Atlas (TCGA) provides a high-quality
(St. Jude Medical, USA) [f] TTE apical view showed
G
F
E
A 20 mm Amplatzer Post-MI VSD Occluder
TM
Cancer chromatin accessibility landscape
artery to advance the 12F delivery system [E]
subsequently positioned in the right pulmonary
Capsule
Stiff TM ST-1 guidewire (Boston Scientific, USA) was
using a balloon tip catheter, and an Amplatz Super
transfemoral venous route. The defect was crossed
closure device using a transeptal access via the
Eitan Israeli
were responsible for promoting Treg induction in the intestine.
percutaneous VSD closure with the insertion of the
Sci Immunol 2018; 3: eaat6975
galactan polysaccharides derived from the cell wall of B. bifidum
D
apex and a 14 mm defect size [D] The steps of the
colitis and Crohn’s disease.
generation of regulatory T cells (Tregs) in the intestine. β-glucan/
showed a VSD with sufficient distance from the
probiotic strain, Bifidobacterium bifidum, promotes the
dysbiosis associated with gastrointestinal disorders, including
45 degree and cranial 25 degree ventriculogram
than live microbes, could potentially be used to treat microbial
in the gut. Verma and colleagues examined how a particular
through the VSD [C] The left anterior oblique at a
express Toll-like receptor 2. Thus, microbial components, rather
also plays a vital role in modulating functions of immune cells
with color Doppler showed left-to-right shunt
This process was dependent on intestinal dendritic cells that
Besides supporting host metabolism, our intestinal microbiota
septal defect (VSD) [B] TTE apical view highlighted
view showed the presence of a large ventricular
Deconstructing probiotics
[A] Transthoracic echocardiogram (TTE) apical
septal defect: a deadly complication
Capsule
C
A
B
figure 1. Post-myocardial infarction ventricular
on preventable prolonged hospitalizations. Patient Saf Surg 2016; 12: 23.
prevention. J Gen Intern Med 2009; 25: 31-8.
hospitals and the potential impact of computerized physician order entry for
orthopedic care identified via the Global Trigger Tool in Sweden – implications
formed after 7 days.
pump (IABP), is the first step in its clini-
Still, it is associated with a high mortality
25. Hug BL, Witkowski DJ, Sox CM, et al. Adverse drug event rates in six community
13. Rutberg H, Borgstedt-Risberg M, Gustafson P, Unbeck M. Adverse events in
transcatheter closure of VSD was per-
the insertion of an intra-aortic balloon
taneous coronary intervention (PCI) [1,2].
hosp Pharm 2014; 67 (6): 423-8.
Tool. BMJ Open 2017; 7 (3): e012492.
with the Institute for Healthcare Improvement Trigger Tool: a chart review. Can J
hospital adverse events rates between Norway and Sweden using Global Trigger
complication in the era of primary percu-
Hemodynamic stabilization, mainly with
cases cited in the literature in which the
24. Lau I, Kirkwood A. Measuring adverse drug events on hospital medicine units
12. Deilkas ET, Risberg MB, Haugen M, et al. Exploring similarities and differences in
a VSD complication. It is one of the rare
P tricular septal defect (VSD) is a rare
transthoracic echocardiography (TTE).
of decision support. Jt Comm J Qual Patient Saf 2013; 39 (7): 312-8.
department. BMC Pharmacol Toxicol 2017; 18 (1): 71.
ost-myocardial infarction (MI) ven-
size the complexity of the management of
auscultation and confirmed by emergent
computerized physician order entry in four community hospitals: the importance
Edmond MB. Use of a trigger tool to detect drug reactions in an emergency
23. Zimlichman E, Keohane C, Franz C, et al. Return on investment for vendor
11. De Almeida SM, Romulado A, de Abreu Ferraresi A, Zelezoglo GR, Marra AR,
sidered in cases of pathologic cardiac
We describe a clinical case to empha-
patients. Adverse drug events prevention study group. JAMA 1997; 277: 307-11.
triggertoolformeasuringadversedrugevents.aspx]. [Accessed 8 Aug 2014].
ation (ECMO) should be considered.
A diagnosis of VSD should be con-
22. Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized
drug events. 2004. [Available from http://www.ini.org/resrources/pages/tools/
IMAJ 2018; 20: 720–721
30 day mortality rate to 30–40%.
arterial extracorporeal membrane oxygen-
10. Institute of Healthcare Improvement. Trigger Tool for measuring adverse
Pharmacol 1999; 54 (11): 887-92.
of refractory cardiogenic shock, a veno-
tion. Successful closure could decrease the
surveillance of adverse drug reactions in hospital: implementation. Eur J Clin
ventricular septal defect (VSD)
and stimulated voluntary report. J Am Med Inform Assoc 1998; 5 (3): 305-14.
21. Levy M, Azaz-Livshits T, Sadan B, Shalit M, Geisslinger G, Brune K. Computerized
increases the coronary perfusion. In cases
development of a computer-based monitor and comparison with chart review
especially 1 week after a myocardial infarc-
closure, transcatheter closure,
1998; 45 (3): 309-14.
9. Jha AK, Kuperman GJ, Teich JM, et al. Identifying adverse drug events:
transcatheter closure of this type of VSD,
afterload, and oxygen consumption. It also
coronary intervention (PCI), surgical
surveillance of adverse drug reactions in hospital: pilot study. Br J Clin Pharmacol
order entry in community hospitals. J Gen Intern Med 2012; 27 (7): 801-7.
may be a decrease in the left-to-right shunt,
complexity of the management and the
20. Azaz-Livshits T, Levy M, Sadan B, Shalit M, Geisslinger G, Brune K. Computerized
intracardiac shunt, percutaneous
KEY WORDS:
8. Leung AA, Keohane C, Amato M, et al. Impact of vendor computerized physician
with Trigger Tool. Rev Sauide Publica 2013; 47: 1102-11.
cal management [4]. With an IABP, there
rate [3]. Our clinical case emphasizes the
1 June 2018].
19. Rozenfled S, Giordani F, Coelho S. Adverse drug events in hospital: pilot study
[Available from https://www.ncbi.nlm.nih.gov/books/NBK470273/]. [Accessed
surgery using the “Trigger Tool” methodology. Cir Esp 2015; 93 (2): 84-90.
[Internet]. Treasure Island (FL): StatPearls Publishing; 2017 Jun–2017 Nov 8.
EM, Gomez de la Camara A, Ruiz Lopez P. Detection of adverse events in general
7. Connelly TP, Korvek SJ. Computer Provider Order Entry (CPOE). StatPearls
18. Perez Zapata Al, Gutierrez Samaniego M, Rodriguez Cuellar E, Andres Esteban
Washington (DC): National Academies Press (US); 2001.
Pract 2010; 18: 305-11.
Crossing the Quality Chasm: A New Health System for the 21st Century.
detecting harm from medication errors in a UK hospital: a pilot study. Int J Pharm
6. Institute of Medicine (US) Committee on Quality of Health Care in America.
17. Franklin BD, Birch S Schachter, Barber N. Testing a trigger tool as a method of
events in community hospitals. Jt Comm J Qual Patient Saf 2012; 38 (3): 120-6.
in a Belgian hospital. Ann Pharmacother 2013; 47 (11): 1414-9.
5. Hug BL, Keohane C, Seger DL, Yoon C, Bates DW. The costs of adverse drug
1
2
2
1,2
Tool and the global Trigger Tool for identifying adverse drug events: experience
JAMA 1995; 274 (1): 29-34.
16. Carnevali L, Krug B, Amant F, et al. Performance of the adverse drug event Trigger
adverse drug events. Implications for prevention. ADE Prevention Study Group.
2016; 82 (4): 1048-57.
4. Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential
adverse drug events in emergency patients: a validation study. Br J Clin Pharmacol
324 (6): 377-84.
15. Karpov A, Parcero C, Mok CP, et al. Performance of trigger tools in identifying
patients. Results of the Harvard Medical Practice Study II. N Engl J Med 1991;
of print].
3. Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalized
opportunities to improve interrater reliability. J Patient Saf 2017. [Epub ahead
doi.org/10.17226/11623]. [Accessed 20 May 2018].
Trigger Tool methodology: results from a 5-year study in an Italian Hospital and
Washington (DC): The National Academies Press; 2006. [Available from https://
14. Mortaro A, Moretti F, Pascu D, et al. Adverse events detection through Global
2018
20
2018
20
Original articles
LETTERS Department of Medicine, Montreal Heart Institute, Montreal, Canada Cardiology Division, Geneva University Hospital, Geneva, Switzerland 720 2 1 Florian Rey MD , Thibault Ronchard MD PharD , Jawad Chaara MD and Stéphane Noble MD first
IMAJ • VOL 20 • nOVeMber 2018 20 2018
#
Editorial Board of cancer stem cells (CSCs) and/or bone Preoperative MetS is a strong predictor for
Potential Impact of Active marrow-derived stem cells (BMDSCs), in CRC mortality. MetS appears to be an inde-
Helicobacter pylori Infection biopsy specimens was found in a high pro- pendent predictor for CRC recurrence, and
Yehuda Shoenfeld MD FRCP with or without Concomitant portion of CRA patients accompanied with is associated with an increased recurrence
Editor in chief Metabolic Syndrome on Colorectal moderate/severe dysplasia (88%) and CRC risk equally in non-metastatic CRC.
Cancer Invasion and Mortality patients with moderate/severe degree of Thus, casting additional light in the
Joshua Shemer MD and Gad Keren MD malignancy (91%) [3]. CD44 plays a criti- uncertain pathophysiological mechanisms
Associate Editors To the Editor: cal role in oncogenesis, differentiation, and underlying H. pylori with or without con-
ased on serology, Shmuely and col- lymph node metastasis and is predictive of comitant MetS in CRC invasion and mor-
Abu-Shakra Mahmoud, MD Israeli Eitan, PhD B leagues [1] concluded that Helicobacter the prognosis and mortality for various car- tality, our results, as well as those of others,
Afek Arnon, MD Katz Amos, MD CRATER pylori infection (Hp-I) may be a risk factor cinomas including gastric cancer and CRC. have indicated that Hp-I impacts colorectal
Amital Howard, MD Kopolovic Yuri, MD Arik Eldar MD for all-cause mortality among colorectal Comparable pictures were also obtained for oncogenesis and progression by causing
Atar Dan, MD Kotler Moshe, MD cancer (CRC) patients who are evaluated proliferation marker Ki-67 (Ki-67 correlates a possible chronic inflammatory mucosal
Ashkenazi Shai, MD Mittelman Moshe, MD Photo of the “Giant Crater” also known as “Ramon by positron emission tomography/com- with the degree of malignancy, CRC invasive- damage, comparable to upper gastrointesti-
puted tomography imaging.
ness, metastatic behavior, patient survival,
nal tract (UGT) infections, thereby promot-
Balbir-Gurman Alexandra, MD Niv Yaron, MD Crater” in the Israel’s Negev region at dawn in June 2011 However, the serological test does not and the risk of relapse), anti-apoptotic Bcl-2 ing CRC invasion, metastasis, and mortality
Baniel Jack, MD Ophir Avinoam, MD discriminate between current and past infec- (Bcl-2 polymorphism could be a risk factor [3]; inducing an exaggerated gastrin and
Barzilai Asher, MD Raanani Pia, MD r. Arik Eldar has been a family physician for more than tions. Apart from past infection that might of CRC poor prognosis), and CD45 (assess- progastrin release that may be predictive
Belhassen Bernard, MD Rivkind Avraham, MD Dthree decades. He was born in Haifa and lives and works even be more applicable for oncogenesis, ing mainly T and B lymphocytes locally) of aggressive CRC behavior (progastrin
Bentur Yedidia, MD Salai Moshe, MD in the upper Galilee region and Golan Heights areas of Israel. such a distinction is crucial because only immunohistochemical expressions [2,3]. expression by stage IV tumors is consider-
Ben Yehuda Dina, MD Seidman Daniel, MD He became interested in photography as he tried to under- current Hp-I induces humoral and cellular Metabolic syndrome (MetS) is closely ably greater than stage IIa tumors); stimulat-
Birkenfeld Shlomo, MD Sherer Yaniv, MD stand how the beautiful scenes that he saw with his naked immune responses that provoke or perpetu- related to insulin resistance, and Hp-I has ing CSCs or recruiting BMDSCs, similar to
Blachar Yoram, MD Sofer Shaul, MD eye could look completely different through the eye (lens) ate chronic inflammatory processes in gas- been proposed to be a contributing factor UGT Hp-I-associated chronic inflamma-
Ciechanover Aaron, MD Sonnenblick Moshe, MD of the camera. He believes the answer lies in the fact that the trointestinal tract with potential oncogenic [2]. In a systematic review, we reported an tion, atrophic gastritis, hyperplasia, meta-
Eidelman Leonid, MD Talmi Yoav, MD human eye mixes what it sees with the emotions of the heart sequelae including metastases and mortality. association between Hp-I and insulin resis- plasia, dysplasia, and BMDSCs recruitment
Glick Shimon, MD Toubi Elias, MD and passion, while the camera shows stark reality. That said, Many neoplasms, such as CRC, arise at the tance, the major underlying mechanism that may facilitate tumor progression, lymph
Goddard Gisele, MD Tur-Kaspa Ran, MD as a photographer, he makes the reality his own and creates sites of chronic inflammation and infection; responsible for the MetS. Both Hp-I and node metastasis, and mortality [3]; and
Grossman Ehud, MD Weingarten Michael, MD something beautiful and unique. In taking photographs Arik and chronic inflammation via the nuclear MetS are widespread globally and there is affecting MetS parameters, oncogenes, and 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Magenta
Grotto Itamar, MD Yinnon Amos, MD tried to minimize the gap between his inner vision and the factor kappa B pathway promotes CRC inva- growing evidence for a potential association immune surveillance processes that may 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Yellow #131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Black 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 1
Gurman Gabriel, MD Yosefy Chaim, MD outer scene. sion, metastasis, and mortality. between Hp-I and insulin resistance syn- be involved in CRC invasiveness, meta-
Halevy Sima, MD Zimlichman Eyal, MD The photograph Crater was taken using a Nikon COOLPIX Our studies [2,3] comprised 50 CRC drome or MetS and its related morbidity [2]. static behavior, mortality, and the risk of
P510 digital camera, standing on the western edge of the cra- patients, 25 patients with colorectal adeno- In Israel, the probability of MetS appears relapse [2,3] .
ter, shooting straight toward the sun as it was beginning to mas (CRA), and 10 controls. Based on to be significantly increased in relation to Therefore, because active Hp-I, with
Copyright © 2018 rise in the east. histology, the practical gold standard for Hp-I and upper gastrointestinal patholo- or without concomitant MetS, might be
Israel Medical Association Journal current Hp-I diagnosis, our research showed gies, thereby suggesting that long-term involved in all-cause invasion and mortality
email: aeldar@012.net.il
significantly higher presence of Hp-I in the gastric inflammation caused by H. pylori among CRC patients, H. pylori eradication
Manuscript and Production Editor CRA (68%) group and CRC (84%) group could play a role in metabolic homeostasis might inhibit or delay CRC progression
Judi Felber
compared to controls (30%). With regard and oncogenesis [4]. Specifically, the risk of and thus large-scale studies are required.
Editorial Secretary to the features of histological severity in synchronous CRC is considerably increased
Tovy Malkin CRA group, presence of Hp-I was observed by gastric cancer occurrence, especially in Jannis Kountouras MD PhD ,
1
in 50% of patients with mild dysplasia and MetS patients; and screening for synchro- Michael Doulberis MD DVM PhD ,
1,2
80% of patients with moderate/severe dys- nous CRC is highly recommended for Stergios A. Polyzos MD PhD ,
3
plasia. Likewise, presence of Hp-I in the gastric cancer patients with MetS [2]. MetS Apostolis Papaefthymiou MD ,
4
Address: Israel Medical Association Journal (IMAJ), 2 Twin Towers, CRC group was observed in 89% of patients is significantly associated with overall and Nikolaos Kapetanakis MD PhD ,
1
11th floor, 35 Jabotinsky St., P.O. Box 3566, Ramat Gan 5251108, Israel
1
Tel: (972-3) 610-0418, Fax: (972-3) 751-9673, email: imaj@ima.org.il with mild and 83% with moderate/severe advanced CRC. It also confers an increased Stergios Arapoglou MD PhD ,
grade (including stage IV) dysplasia, also risk of CRC incidence and mortality in Ioannis Venizelos MD PhD ,
1
The Israel Medical Association Journal (IMAJ) is the successor of the Israel
1
Journal of Medical Sciences that was initiated in 1965 by Prof. Moshe mentioned by the authors [1]. Noteworthy, both genders [2]. Moreover, relative data Elizabeth Vardaka PhD , Georgios
Prywes. During the 32 years of publication. Prof. Prywes served as its H. pylori presence was documented by indicate that Hp-I with concomitant MetS Kotronis MD , Sotirios Anastasiadis MD
1
1
editor-in-chief.
immunohistochemical stain in CRA and could further increase the risk of colorec- and Panagiotis Katsinelos MD PhD 1
All advertisements in this issue are put forward at the sole responsibility CRC tissues. In addition, presence of Hp-I tal neoplasms. The occurrence of MetS is
of the advertisers. Similarly, all articles are the responsibility of the authors with accompanying immunohistochemical associated with a twofold increased risk 1 Department of Medicine, Second Medical Clinic,
alone. The Israel Medical Association and the editors of "IMAJ" are not To enter the IMAJ website Ippokration Hospital, Aristotle University of PERFECTOR
accountable for the contents of any advertisement or article. scan this sign expression of CD44, which is an indicator of CRC mortality and tumor recurrences. Thessaloniki, Thessaloniki, Macedonia, Greece
664 725