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1.  Body mass index and colon cancer screening: The road ahead 
Screening for colorectal cancer (CRC) has been associated with a decreased incidence and mortality from CRC. However, patient adherence to screening is less than desirable and resources are limited even in developed countries. Better identification of individuals at a higher risk could result in improved screening efforts. Over the past few years, formulas have been developed to predict the likelihood of developing advanced colonic neoplasia in susceptible individuals but have yet to be utilized in mass screening practices. These models use a number of clinical factors that have been associated with colonic neoplasia including the body mass index (BMI). Advances in our understanding of the mechanisms by which obesity contributes to colonic neoplasia as well as clinical studies on this subject have proven the association between BMI and colonic neoplasia. However, there are still controversies on this subject as some studies have arrived at different conclusions on the influence of BMI by gender. Future studies should aim at resolving these discrepancies in order to improve the efficiency of screening strategies.
PMCID: PMC4316079  PMID: 25663756
Body mass index; Colorectal cancer; Colon cancer screening; Adenomas; Adipokines; Obesity
3.  Tools for monitoring remission in rheumatoid arthritis: any will do, let's just pick one and start measuring 
Rheumatoid arthritis treatment has seen major changes in the last decade, one of which is the concept of treating to target. Various composite outcome measures have been developed, and the latest is the new American College of Rheumatology/European League Against Rheumatism remission criteria. Zhang and colleagues test the predictive validity of the new criteria in an observational cohort and show that they work as well as other definitions of remission. Our main challenge remains getting rheumatologists to use one of the outcome measures rather than developing new measures that are basically no different from already available measures in predicting functional and radiographic changes, the two most important long-term outcomes of rheumatoid arthritis.
PMCID: PMC3672754  PMID: 23374997
6.  How Much the Quality of Healthcare Costs? A Challenging Question! 
Oman Medical Journal  2011;26(5):301-302.
PMCID: PMC3215450  PMID: 22125721
7.  Hope and despair over health in Gaza 
BMJ : British Medical Journal  2006;333(7573):845-846.
PMCID: PMC1618445  PMID: 17053241
8.  Functional activity of the rectum: A conduit organ or a storage organ or both? 
AIM: To investigate whether the degree of rectal distension could define the rectum functions as a conduit or reservoir.
METHODS: Response of the rectal and anal pressure to 2 types of rectal balloon distension, rapid voluminous and slow gradual distention, was recorded in 21 healthy volunteers (12 men, 9 women, age 41.7 ± 10.6 years). The test was repeated with sphincteric squeeze on urgent sensation.
RESULTS: Rapid voluminous rectal distension resulted in a significant rectal pressure increase (P < 0.001), an anal pressure decline (P < 0.05) and balloon expulsion. The subjects felt urgent sensation but did not feel the 1st rectal sensation. On urgent sensation, anal squeeze caused a significant rectal pressure decrease (P < 0.001) and urgency disappearance. Slow incremental rectal filling drew a rectometrogram with a “tone” limb representing a gradual rectal pressure increase during rectal filling, and an “evacuation limb” representing a sharp pressure increase during balloon expulsion. The curve recorded both the 1st rectal sensation and the urgent sensation.
CONCLUSION: The rectum has apparently two functions: transportation (conduit) and storage, both depending on the degree of rectal filling. If the fecal material received by the rectum is small, it is stored in the rectum until a big volume is reached that can affect a degree of rectal distension sufficient to initiate the defecation reflex. Large volume rectal distension evokes directly the rectoanal inhibitory reflex with a resulting defecation.
PMCID: PMC4125645  PMID: 16874870
Anal pressure; Rectal pressure; Rectometry; First rectal sensation
9.  New challenges facing ill health in Gulf war veterans 
PMCID: PMC1740136  PMID: 11303076
10.  Wrong biochemistry results  
BMJ : British Medical Journal  2001;323(7315):705-706.
PMCID: PMC1121270  PMID: 11576963
11.  The Ross operation in infants and children, when and how? 
Heart  2014;100(24):1905-1906.
PMCID: PMC4251164  PMID: 25324536

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