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Article: Epidemiology and outcomes of non-alcoholic fatty liver disease in African Americans.

Chow, Kenneth W / Ebaid, Mark / Ibrahim, Brittney M / Saab, Sammy

2023 Volume 22, Issue 3, Page(s) 113–115

Abstract: 1_bxolhs28Kaltura. ...

Abstract	1_bxolhs28Kaltura.
Language	English
Publishing date	2023-06-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2657644-2
ISSN	2046-2484
ISSN	2046-2484
DOI	10.1097/CLD.0000000000000064
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Article: Comparison of Guidelines for the Screening, Diagnosis, and Noninvasive Assessment of Nonalcoholic Fatty Liver Disease.

Chow, Kenneth W / Futela, Pragyat / Saharan, Aryan / Saab, Sammy

Journal of clinical and experimental hepatology

2023 Volume 13, Issue 5, Page(s) 783–793

Abstract: Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. However, there is no clear consensus on optimal screening strategies and risk stratification. We conducted a systematic review of society ... ...

Abstract	Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. However, there is no clear consensus on optimal screening strategies and risk stratification. We conducted a systematic review of society guidelines to identify differences in recommendations regarding the screening, diagnosis, and assessment of NAFLD. Methods: We searched PubMed, Web of Science, and Embase databases from January 1, 2015, to August 2, 2022. Two researchers independently extracted information from the guidelines about screening strategies, risk stratification, use of noninvasive tests (NITs) to assess hepatic fibrosis, and indications for liver biopsy. Results: Twenty clinical practice guidelines and consensus statements were identified in our search. No guidelines recommended routine screening for NAFLD, while 14 guidelines recommended case finding in high-risk groups. Of the simple risk stratification models to assess for fibrosis, the fibrosis-4 score was the most frequently recommended, followed by the NAFLD fibrosis score. However, guidelines differed on which cutoffs to use and the interpretation of "high-risk" results. Conclusion: Multiple guidelines exist with varying recommendations on the benefits of screening and interpretation of NIT results. Despite their differences, all guidelines recognize the utility of NITs and recommend their incorporation into the clinical assessment of NAFLD.
Language	English
Publishing date	2023-02-05
Publishing country	India
Document type	Journal Article ; Review
ISSN	0973-6883
ISSN	0973-6883
DOI	10.1016/j.jceh.2023.01.016
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Article ; Online: Circumvention of Gefitinib Resistance by Repurposing Flunarizine via Histone Deacetylase Inhibition.

To, Kenneth K W / Chow, James C H / Cheung, Ka-Man / Cho, William C S

ACS pharmacology & translational science

2023 Volume 6, Issue 10, Page(s) 1531–1543

Abstract: Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) for treating advanced non-small cell lung cancer (NSCLC). However, drug resistance seriously impedes the clinical efficacy of gefitinib. This study investigated the ... ...

Abstract	Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) for treating advanced non-small cell lung cancer (NSCLC). However, drug resistance seriously impedes the clinical efficacy of gefitinib. This study investigated the repositioning of the non-oncology drug capable of inhibiting histone deacetylases (HDACs) to overcome gefitinib resistance. A few drug candidates were identified using the in silico repurposing tool "DRUGSURV" and tested for HDAC inhibition. Flunarizine, originally indicated for migraine prophylaxis and vertigo treatment, was selected for detailed investigation in NSCLC cell lines harboring a range of different gefitinib resistance mechanisms (EGFR T790M, KRAS G12S, MET amplification, or PTEN loss). The circumvention of gefitinib resistance by flunarizine was further demonstrated in an EGFR TKI (erlotinib)-refractory patient-derived tumor xenograft (PDX) model in vivo. The acetylation level of cellular histone protein was increased by flunarizine in a concentration- and time-dependent manner. Among the NSCLC cell lines evaluated, the extent of gefitinib resistance circumvention by flunarizine was found to be the most pronounced in EGFR T790M-bearing H1975 cells. The gefitinib-flunarizine combination was shown to induce the apoptotic protein Bim but reduce the antiapoptotic protein Bcl-2, which apparently circumvented gefitinib resistance. The induction of Bim by flunarizine was accompanied by an increase in the histone acetylation and E2F1 interaction with the
Language	English
Publishing date	2023-09-28
Publishing country	United States
Document type	Journal Article
ISSN	2575-9108
ISSN (online)	2575-9108
DOI	10.1021/acsptsci.3c00202
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Article ; Online: Semaglutide is effective in achieving weight loss in liver transplant recipients.

Chow, Kenneth W / Ibrahim, Brittney / Rahal, Kabir / Hsu, Ryan H / Tan, Teresa / Meneses, Katherine / Saab, Sammy

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2023 Volume 30, Issue 2, Page(s) 223–225

MeSH term(s)	Humans ; Liver Transplantation/adverse effects ; Weight Loss ; Glucagon-Like Peptides/therapeutic use ; Diabetes Mellitus, Type 2 ; Hypoglycemic Agents
Chemical Substances	semaglutide (53AXN4NNHX) ; Glucagon-Like Peptides (62340-29-8) ; Hypoglycemic Agents
Language	English
Publishing date	2023-08-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1097/LVT.0000000000000247
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Article: Diffuse-Type Pancreatic Ductal Adenocarcinoma Mimicking Autoimmune Pancreatitis.

Chow, Kenneth W / Hu, Steve / Sikavi, Cameron / Bell, Matthew T / Gisi, Brandon / Chiu, Richard / Yap, Caroline G / Eysselein, Viktor / Reicher, Sofiya

ACG case reports journal

2023 Volume 10, Issue 6, Page(s) e01070

Abstract: Pancreatic ductal adenocarcinoma (PDAC) classically presents as a solitary mass on cross-sectional imaging. Diffuse-type PDAC is an unusual variant that accounts for 1%-5% of PDACs. Owing to its rarity, there are no established radiographic or ... ...

Abstract	Pancreatic ductal adenocarcinoma (PDAC) classically presents as a solitary mass on cross-sectional imaging. Diffuse-type PDAC is an unusual variant that accounts for 1%-5% of PDACs. Owing to its rarity, there are no established radiographic or endosonographic definitions. We report a unique case of diffuse-type PDAC presenting with imaging findings of 2 distinct masses in the pancreatic head and tail and with endoscopic ultrasound findings of diffuse gland enlargement mimicking autoimmune pancreatitis. The case illustrates the importance of sampling several areas of the pancreas when diffuse enlargement is present on endoscopic ultrasound and multiple masses are seen on cross-sectional imaging.
Language	English
Publishing date	2023-06-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000001070
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Article ; Online: Barriers to Lactulose Adherence in Patients with Cirrhosis and Hepatic Encephalopathy.

Chow, Kenneth W / Ibrahim, Brittney M / Yum, Jung J / Dang, An / Dang, Long / Chen, Kuan-Ting / Jackson, Nicholas J / Saab, Sammy

Digestive diseases and sciences

2023 Volume 68, Issue 6, Page(s) 2389–2397

Abstract: Background: Hepatic encephalopathy (HE) is a major cause of mortality and morbidity in patients with cirrhosis. Lactulose non-adherence is one of the most frequently reported precipitants of hospital admission for HE.: Aims: We aimed to identify ... ...

Abstract	Background: Hepatic encephalopathy (HE) is a major cause of mortality and morbidity in patients with cirrhosis. Lactulose non-adherence is one of the most frequently reported precipitants of hospital admission for HE. Aims: We aimed to identify which factors contribute most to lactulose non-adherence and propose strategies to promote greater adherence and utilization of lactulose. Methods: Participants in this study consisted of patients with cirrhosis who were taking lactulose for prevention of HE. Subjects were administered the Morisky Adherence Scale 8 (MAS-8) and a customized 16-question survey that assessed barriers to lactulose adherence. Results from the MAS-8 were used to stratify subjects into "adherent" and "non-adherent" groups. Survey responses were compared between groups. Results: We enrolled 129 patients in our study, of whom 45 were categorized as "adherent and 72 were categorized as "non-adherent." Barriers to adherence included large volumes of lactulose, high frequency of dosing, difficulty remembering to take the medication, unpleasant taste, and medication side-effects. Most patients (97%) expressed understanding of the importance of lactulose, and 71% of patients felt that lactulose was working to manage their HE. Hospital admission rates for HE was higher in non-adherent patients, although this difference was not statistically significant. Conclusion: We identified several factors that contribute to lactulose non-adherence among patients treated for HE. Many of these factors are potentially modifiable. Patient and care-giver education are critical to assure adherence. Pharmacists and nurses are an essential but underutilized aspect of education regarding proper medication use.
MeSH term(s)	Humans ; Lactulose/therapeutic use ; Hepatic Encephalopathy/drug therapy ; Hepatic Encephalopathy/etiology ; Hepatic Encephalopathy/prevention & control ; Gastrointestinal Agents/adverse effects ; Liver Cirrhosis/complications ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/chemically induced ; Hospitalization
Chemical Substances	Lactulose (4618-18-2) ; Gastrointestinal Agents
Language	English
Publishing date	2023-04-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-023-07935-z
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Article ; Online: Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: A Systematic Review of the Literature.

Chow, Kenneth W / Pham, Nguyen V / Ibrahim, Britney M / Hong, Kimberly / Saab, Sammy

Digestive diseases and sciences

2022 Volume 67, Issue 9, Page(s) 4574–4580

Abstract: Objectives: During the summer of 2021, case reports began to emerge documenting a small number of individuals who developed autoimmune hepatitis (AIH) following COVID-19 vaccination. These cases are rare and novel, and very little is known. In our ... ...

Abstract	Objectives: During the summer of 2021, case reports began to emerge documenting a small number of individuals who developed autoimmune hepatitis (AIH) following COVID-19 vaccination. These cases are rare and novel, and very little is known. In our systematic review, we analyzed every published case of AIH and reviewed their characteristic findings, treatment, and outcomes. Methods: We searched PubMed, Embase, and Web of Science from December 1, 2019, to November 1, 2021. Two researchers independently extracted information from the articles about vaccine type, patient history, laboratory values, histology results, treatment regimens, and disease course. Results: Thirty-two patients developed AIH-like syndromes after receiving a COVID-19 vaccine. Jaundice was the most frequently reported symptom (81%), and 19% of patients were initially asymptomatic and presented with elevated liver enzymes found during routine bloodwork. Mean alanine transaminase, aspartate transaminase, and total bilirubin were 1231 U/L, 921 U/L, and 14 mg/dL, respectively. Anti-nuclear antibody was positive in 56%, and anti-smooth muscle antibody in 28% of patients. Steroids were used in 75% of patients. Improvement or complete resolution was seen in 97% of patients. One patient died despite aggressive steroid treatment. Conclusion: COVID-19 vaccine-induced AIH is an uncommon association with just 32 documented cases in the literature. Clinicians should be vigilant for AIH in patients who present with liver injury following vaccination. These new findings should under not deter individuals from getting vaccinated, as the benefits of vaccination far outweigh the risks. Fortunately, COVID-19 vaccine-induced AIH appears amendable to corticosteroid therapy and appears to have a favorable outcome.
MeSH term(s)	COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/drug therapy ; Hepatitis, Autoimmune/etiology ; Humans ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-04-29
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-022-07504-w
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Article ; Online: Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) - A Systematic Review.

Chow, Ronald / So, Olivia W / Im, James H B / Chapman, Kenneth R / Orchanian-Cheff, Ani / Gershon, Andrea S / Wu, Robert

International journal of chronic obstructive pulmonary disease

2023 Volume 18, Page(s) 2581–2617

Abstract: Introduction: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally and is responsible for over 3 million deaths annually. One of the factors contributing to the significant healthcare burden for these patients is ... ...

Abstract	Introduction: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally and is responsible for over 3 million deaths annually. One of the factors contributing to the significant healthcare burden for these patients is readmission. The aim of this review is to describe significant predictors and prediction scores for all-cause and COPD-related readmission among patients with COPD. Methods: A search was conducted in Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from database inception to June 7, 2022. Studies were included if they reported on patients at least 40 years old with COPD, readmission data within 1 year, and predictors of readmission. Study quality was assessed. Significant predictors of readmission and the degree of significance, as noted by the Results: In total, 242 articles reporting on 16,471,096 patients were included. There was a low risk of bias across the literature. Of these, 153 studies were observational, reporting on predictors; 57 studies were observational studies reporting on interventions; and 32 were randomized controlled trials of interventions. Sixty-four significant predictors for all-cause readmission and 23 for COPD-related readmission were reported across the literature. Significant predictors included 1) pre-admission patient characteristics, such as male sex, prior hospitalization, poor performance status, number and type of comorbidities, and use of long-term oxygen; 2) hospitalization details, such as length of stay, use of corticosteroids, and use of ventilatory support; 3) results of investigations, including anemia, lower FEV Conclusion: The findings from this review may enable better predictive modeling and can be used by clinicians to better inform their clinical gestalt of readmission risk.
MeSH term(s)	Adult ; Humans ; Male ; Hospitalization ; Oxygen ; Patient Readmission ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-11-18
Publishing country	New Zealand
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2212419-6
ISSN	1178-2005 ; 1176-9106
ISSN (online)	1178-2005
ISSN	1176-9106
DOI	10.2147/COPD.S418295
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Article ; Online: Health Care Access Expansions and Use of Veterans Affairs and Other Hospitals by Veterans.

Yoon, Jean / Kizer, Kenneth W / Ong, Michael K / Zhang, Yue / Vanneman, Megan E / Chow, Adam / Phibbs, Ciaran S

JAMA health forum

2022 Volume 3, Issue 6, Page(s) e221409

Abstract: This cohort study examines changes in the use of Veterans Affairs (VA) and non-VA hospitals by VA enrollees and mortality associated with these policies. ...

Abstract	This cohort study examines changes in the use of Veterans Affairs (VA) and non-VA hospitals by VA enrollees and mortality associated with these policies.
MeSH term(s)	Cohort Studies ; Health Services Accessibility ; Hospitals ; Humans ; United States ; United States Department of Veterans Affairs ; Veterans
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2689-0186
ISSN (online)	2689-0186
DOI	10.1001/jamahealthforum.2022.1409
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Article ; Online: Use of Continuous Glucose Monitoring to Assess Parenteral Nutrition-Induced Hyperglycemia in an Adult Patient With Severe COVID-19.

Chow, Kenneth W / Kelly, Danielle J / Gupta, Rajarsi / Miller, Joshua D

JPEN. Journal of parenteral and enteral nutrition

2020 Volume 45, Issue 1, Page(s) 208–211

Abstract: Many patients admitted to the intensive care unit (ICU) are acutely malnourished and often require aggressive and early nutrition support with parenteral nutrition (PN). However, PN-induced hyperglycemia is a predictor of hospital mortality and is ... ...

Abstract	Many patients admitted to the intensive care unit (ICU) are acutely malnourished and often require aggressive and early nutrition support with parenteral nutrition (PN). However, PN-induced hyperglycemia is a predictor of hospital mortality and is associated with increased length of stay. Elevated blood glucose in hospitalized patients with coronavirus disease 2019 (COVID-19) is also associated with increased mortality. Real-time continuous glucose monitoring (rtCGM) is primarily used in the outpatient setting, but there is rapidly growing interest in its applicability to help treat dysglycemia in critically ill patients, especially during the ongoing COVID-19 pandemic. We assessed the use of rtCGM data (Dexcom G6) in a 58-year-old male admitted to the ICU for severe COVID-19 infection, who developed PN-induced hyperglycemia with markedly elevated total daily insulin requirements as high as 128 units. rtCGM was used to safely titrate insulin infusion and monitor glucose levels. No episodes of hypoglycemia were observed, despite an extremely aggressive insulin regimen. This case demonstrates the potential utility of rtCGM in the critical care setting and highlights its potential to help conserve personal protective equipment and minimize unnecessary staff exposure in the setting of COVID-19.
MeSH term(s)	Blood Glucose/analysis ; Blood Glucose/metabolism ; Blood Glucose Self-Monitoring/methods ; COVID-19/complications ; COVID-19/diagnosis ; Critical Illness/therapy ; Humans ; Hyperglycemia/blood ; Hyperglycemia/diagnosis ; Hyperglycemia/drug therapy ; Insulin/administration & dosage ; Male ; Middle Aged ; Pandemics ; Parenteral Nutrition/adverse effects ; SARS-CoV-2
Chemical Substances	Blood Glucose ; Insulin
Keywords	covid19
Language	English
Publishing date	2020-11-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	800861-9
ISSN	1941-2444 ; 0148-6071
ISSN (online)	1941-2444
ISSN	0148-6071
DOI	10.1002/jpen.2032
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