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| 1 | Characteristics of gastric cancer in Asia显示文摘Gastric cancer(GC)is the fourth most common cancer in the world with more than 70%of cases occur in the developing world.More than 50%of cases occur in Eastern Asia.GC is the second leading cause of cancer death in both sexes worldwide.In Asia,GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer.Although the incidence and mortality rates are slowly declining in many countries of Asia,GC still remains a significant public health problem.The incidence and mortality varies according to the geographic area in Asia.These variations are closely related to the prevalence of GC risk factors;especially Helicobacter pylori(H.pylori)and its molecular virulent characteristics.The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H.pylori seroprevalence rates leading to a reduction in the GC incidence.However,GC remains a significant public health and an economic burden in Asia.There has been no recent systemic review of GC incidence,mortality,and H.pylori molecular epidemiology in Asia.The aim of this report is to review the GC incidence,mortality,and linkage to H.pylori in Asia. | Rubayat Rahman Akwi W Asombang Jamal A Ibdah | 2014 | World Journal of Gastroenterology2014，20，16： | 50 |
| 2 | Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes显示文摘BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity,and socio-economic challenges faced on the African continent.METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology,risk factors,management and outcomes of EC.A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer,and the Cancer in Sub-Saharan reports.We searched EMBASE,PubMed,Web of Science,and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved.Random effects metaanalyses were used to assess heterogeneity between studies and to obtain odds ratio(OR)of the associations between EC and risk factors;and incidence rate ratios for EC between sexes with their respective 95%confidence intervals(CI).RESULTS The incidence of EC is higher in males than females,except in North Africa where it is similar for both sexes.The highest age-standardized rate is from Malawi(30.3 and 19.4 cases/year/100000 population for males and females,respectively)followed by Kenya(28.7 cases/year/100000 population for both sexes).The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old.Meta-analysis shows a strong association with tobacco(OR 3.15,95%CI:2.83-3.50).There was significant heterogeneity between studies on alcohol consumption(OR 2.28,95%CI:1.94-2.65)and on low socioeconomic status(OR 139,95%CI:1.25-1.54)as risk factors,but these could also contribute to increasing the incidence of EC.The best treatment outcomes were with esophagectomy with survival rates of 76.6%at 3 years,and chemo-radiotherapy with an overall combined survival time of 267.50 d.CONCLUSION Africa has high incidence and mortality rates of EC,with preventable and nonmodifiable risk factors.Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption.Management requires a multidisciplinary approach,and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy. | Akwi W Asombang Nathaniel Chishinga Alick Nkhoma Jackson Chipaila Bright Nsokolo Martha Manda-Mapalo Joao Filipe G Montiero Lewis Banda Kulwinder S Dua | 2019 | World Journal of Gastroenterology2019，25，31： | 9 |
| 3 | Gastric cancer in Africa:Current management and outcomes显示文摘Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide.Globally,gastric cancer poses a significant public health burden-both economically and socially.In 2008,the economic burden from premature cancer deaths and disability was$895 billion and gastric cancer was the second highest cancer responsible for healthy life lost.With the expected increase in cancer deaths and non-communicable diseases,these costs are expected to rise and impact patient care.World Health Organization,estimates a 15%increase in non-communicable disease worldwide,with more than 20%increase occurring in Africa between 2010 and 2020.Mali,West Africa,is ranked 15th highest incidence of gastric cancer worldwide at a rate of 20.3/100000,yet very scarce published data evaluating etiology,prevention or management exist.It is understood that risk factors of gastric cancer are multifactorial and include infectious agents(Helicobacter pylori,Epstein-Barr virus),genetic,dietary,and environmental factors(alcohol,smoking).Interestingly,African patients with gastric cancer are younger,in their 3rd-4th decade,and present at a late stage of the disease.There is sparse data regarding gastric cancer in Africa due to lack of data collection and under-reporting,which impacts incidence and mortality rates.Currently,GLOBOCAN,an International Agency for Research on Cancer resource,is the most comprehensive available resource allowing comparison between nations.In resource limited settings,with already restricted healthcare funding,data is needed to establish programs in Africa that increase gastric cancer awareness,curtail the economic burden,and improve patient management and survival outcomes. | Akwi W Asombang Rubayat Rahman Jamal A Ibdah | 2014 | World Journal of Gastroenterology2014，20，14： | 4 |
| 4 | Lumen apposing metal stents for pancreatic fluid collections:Recognition and management of complications显示文摘For patients recovering from acute pancreatitis,the development of a pancreatic fluid collection (PFC) predicts a more complex course of recovery,and introduces difficult management decisions with regard to when,whether,and how the collection should be drained.Most PFCs resolve spontaneously and drainage is indicated only in pseudocysts and walled-off pancreatic necrosis when the collections are causing symptoms and/or local complications such as biliary obstruction.Historical approaches to PFC drainage have included surgical (open or laparoscopic cystgastrostomy or pancreatic debridement),and the placement of percutaneous drains.Endoscopic drainage techniques have emerged in the last several years as the preferred approach for most patients,when local expertise is available.Lumen-apposing metal stents(LAMS) have recently been developed as a tool to facilitate potentially safer and easier endoscopic drainage of pancreatic fluid collections,and less commonly,for other indications,such as gallbladder drainage.Physicians considering LAMS placement must be aware of the complications most commonly associated with LAMS including bleeding,migration,buried stent,stent occlusion,and perforation.Because of the patient complexity associated with severe pancreatitis,management of pancreatic fluid collections can be a complex and multidisciplinary endeavor.Successful and safe use of LAMS for patients with pancreatic fluid collections requires that the endoscopist have a full understanding of the potential complications of LAMS techniques,including how to recognize and manage expected complications. | Michael L DeSimone Akwi W Asombang Tyler M Berzin | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，9： | 2 |
| 5 | Esophageal squamous cell cancer in a highly endemic region显示文摘AIM: To identify risk factors associated with esophageal cancer in Zambia and association between dietary intake and urinary 8-iso prostaglandin F2α(8-iso PGF2α).METHODS: We conducted a prospective, case control study at the University Teaching Hospital. Subjects included both individuals admitted to the hospital and those presenting for an outpatient upper endoscopy. Esophageal cancer cases were compared to age and sex-matched controls. Cases were defined as patients with biopsy proven esophageal cancer; controls were defined as subjects without endoscopic evidence ofesophageal cancer. Clinical and dietary data were collected using a standard questionnaire, developed a priori. Blood was collected for human immunodeficiency virus(HIV) serology. Urine was collected, and 8-iso PGF2α was measured primarily by enzyme-linked immunosorbent assay and expressed as a ratio to creatinine.RESULTS: Forty five controls(mean age 54.2 ± 15.3, 31 male) and 27 cases(mean age 54.6 ± 16.4, 17 males) were studied. Body mass index was lower in cases(median 16.8) than controls(median 23.2), P = 0.01. Histopathologically, 25/27(93%) were squamous cell carcinoma and 2/27(7%) adenocarcinoma. More cases smoked cigarettes(OR = 11.24, 95%CI: 1.37-92.4, P = 0.02) but alcohol consumption and HIV seropositivity did not differ significantly(P = 0.14 for both). Fruit, vegetables and fish consumption did not differ significantly between groups(P = 0.11, 0.12, and 0.10, respectively). Mean isoprostane level was significantly higher in cases(0.03 ng/mg creatinine) than controls(0.01 ng/mg creatinine)(OR = 2.35, 95%CI: 1.19-4.65, P = 0.014).CONCLUSION: Smoking and isoprostane levels were significantly associated with esophageal cancer in Zambians, but diet, HIV status, and alcohol consumption were not. | Akwi W Asombang Violet Kayamba Mpala M Lisulo Kathryn Trinkaus Victor Mudenda Edford Sinkala Stayner Mwanamakondo Themba Banda Rose Soko Paul Kelly | 2016 | World Journal of Gastroenterology2016，22，9： | 2 |
| 6 | Gastric cancer in Africa: what do we know about incidence and risk factors?显示文摘 | Akwi W. Asombang Paul Kelly | 2011 | Transactions of the Royal Society of Tropical Medicine and Hygiene2011，，2： | 2 |
| 7 | Prophylactic tracheal intubation for upper GI bleeding: A meta-analysis显示文摘AIM: To evaluate usefulness of prophylactically intubating upper gastrointestinal bleeding(UGIB) patients. METHODS: UGIB results in a significant number of hospital admissions annually with endoscopy being the key intervention. In these patients, risks are associated with the bleeding and the procedure, including pulmonary aspiration. However, very little literature is available assessing the use of prophylactic endotracheal intubation on aspiration in these patients. A comprehensive search was performed in May 2014 in Scopus, CINAHL, Cochrane databases, Pub Med/Medline, Embase, and published abstracts from national gastroenterology meetings in the United States(2004-2014). Included studies examined UGIB patients and compared prophylactic intubation to no intubation before endoscopy. Meta-analysis was conducted using Rev Man 5.2 by Mantel-Haenszel and Der Simonian and Laird models with results presented as odds ratio for aspiration, pneumonia(within 48 h), and mortality. Funnel plots were utilized for publication bias and I2 measure of inconsistency for heterogeneity assessments. RESULTS: Initial search identified 571 articles. Of these articles, 10 relevant peer-reviewed articles in English and two relevant abstracts were selected to review by two independent authors(Almashhrawi AA and Bechtold ML). Of these studies, eight were excluded: Five did not have a control arm, one was a letter the editor, one was a survey study, and one was focused on prevention of UGIB. Therefore, four studies(N = 367) were included. Of the UGIB patients prophylactically intubated before endoscopy, pneumonia(within 48 h) was identified in 20 of 134(14.9%) patients as compared to 5 of 95(5.3%) patients that were not intubated prophylactically(P = 0.02). Despite observed trends, no significantdifferences were found for mortality(P = 0.18) or aspiration(P = 0.11).CONCLUSION: Pneumonia within 48 h is more likely in UGIB patients who received prophylactic endotracheal intubation prior to endoscopy. | Ashraf A Almashhrawi Rubayat Rahman Samuel T Jersak Akwi W Asombang Alisha M Hinds Hazem T Hammad Douglas L Nguyen Matthew L Bechtold | 2015 | World Journal of Meta-Analysis2015，3，1： | 1 |
| 8 | Kinetic modeling of anthocyanin degradation and microorganism growth during postharvest storage of Acai fruits显示文摘 | ROGEZ H AKWIE S N L T MOURA F G | 2012 | Jour- nal of Food Science2012，77，12： | 1 |
| 9 | Understanding deep learning in capsule endoscopy: Can artificial intelligence enhance clinical practice?显示文摘Wireless capsule endoscopy(WCE)enables physicians to examine the gastrointestinal tract by transmitting images wirelessly from a disposable capsule to a data recorder.Although WCE is the least invasive endoscopy technique for diagnosing gastrointestinal disorders,interpreting a WCE study requires significant time effort and training.Analysis of images by artificial intelligence,through advances such as machine or deep learning,has been increasingly applied to medical imaging.There has been substantial interest in using deep learning to detect various gastrointestinal disorders based on WCE images.This article discusses basic knowledge of deep learning,applications of deep learning in WCE,and the implementation of deep learning model in a clinical setting.We anticipate continued research investigating the use of deep learning in interpreting WCE studies to generate predictive algorithms and aid in the diagnosis of gastrointestinal disorders. | Amporn Atsawarungruangkit Yousef Elfanagely Akwi W Asombang Abbas Rupawala Harlan G Rich | 2020 | Artificial Intelligence in Gastrointestinal Endoscopy2020，1，2： | 0 |
| 10 | Gastroenterology training in a resource-limited setting: Zambia, Southern Africa显示文摘AIM: To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders. METHODS: A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised work-shops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Preand post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at thesymposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums. RESULTS: There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others. CONCLUSION: The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease awareness in areas where resources are limited. | Akwi W Asombang Eleanor Turner-Moss Anil Seetharam Paul Kelly | 2013 | World Journal of Gastroenterology2013，19，25： | 0 |
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