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https://www.readbyqxmd.com/read/28210086/prognostic-factors-associated-with-mortality-in-patients-with-gastric-fundal-variceal-bleeding
#1
Keishi Komori, Masaru Kubokawa, Eikichi Ihara, Kazuya Akahoshi, Kazuhiko Nakamura, Kenta Motomura, Akihide Masumoto
AIM: To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding. METHODS: In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We retrospectively reviewed the patients' medical records and assessed their history, etiology of liver cirrhosis, disease conditions, treatment options for GFV bleeding, medications administered before and after onset of GFV bleeding, blood test results (hemoglobin, albumin, and bilirubin concentrations), and imaging results (including computed tomography and abdominal ultrasonography)...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28209963/the-impact-of-esophagogastric-varices-on-the-prognosis-of-patients-with-hepatocellular-carcinoma
#2
Wei-Yao Hsieh, Ping-Hsien Chen, I-Yen Lin, Chien-Wei Su, Yee- Chao, Teh-Ia Huo, Yi-Hsiang Huang, Ming-Chih Hou, Han-Chieh Lin, Jaw-Ching Wu
Whether or not esophagogastric varices (EGV) could determine the outcomes of patients with hepatocellular carcinoma (HCC) is still unclear. A total of 990 treatment-naive HCC patients who received an esophagogastroduodenoscopy at the time of HCC diagnosis were retrospectively enrolled. The factors in terms of prognosis were analyzed by Cox proportional hazards model and propensity score matching analysis. Among the enrolled patients, 480 (48.5%) patients had EGV. Patients with EGV had a significantly lower cumulative 5-year survival rate than those without EGV (24...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28203136/massive-hemorrhage-from-ectopic-duodenal-varices-importance-of-a-multidisciplinary-approach
#3
Tyler House, Patrick Webb, Chad Baarson
Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28201851/the-design-of-clinical-trials-in-portal-hypertension
#4
Juan G Abraldes, Guadalupe Garcia-Tsao
Portal hypertension (PH) is the main consequence of cirrhosis and is responsible for the majority of its complications. Gastroesophageal varices and variceal hemorrhage are direct consequences of PH; therefore, most clinical trials in PH have been directed toward treating or preventing variceal hemorrhage. However, varices and variceal hemorrhage are not isolated events; they must be considered in the context of the presence (or absence) of other complications of cirrhosis/PH. Cirrhosis progresses across different stages, each with a different prognosis and pathophysiology and hence different therapeutic targets...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#5
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
February 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28196353/importance-of-screening-for-esophagogastric-varices-in-na%C3%A3-ve-hepatocellular-carcinoma-patients-within-milan-criteria-indicator-for-liver-transplantation
#6
Takamasa Kawakami, Atsushi Hiraoka, Kojiro Michitaka, Tomoyuki Ninomiya, Masashi Hirooka, Yoichi Hiasa
BACKGROUND/AIMS: Patients with hepatocellular carcinoma (HCC) beyond Milan criteria (MC) are not eligible for liver transplantation (LT). To elucidate prognostic factors significantly linked to recurrence beyond MC or death related to the liver, we evaluated the clinical features in a series of HCC patients within MC at baseline. METHODS: We enrolled 255 naïve HCC patients (≤70 years) within the MC who underwent upper-gastrointestinal-endoscopy, and were treated with resection or radiofrequency ablation (62 years old [median]; male:female = 202:53; Child-Pugh A:B = 216:39)...
February 15, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28195875/endoscopic-variceal-ligation-combined-with-argon-plasma-coagulation-versus-ligation-alone-for-the-secondary-prophylaxis-of-variceal-bleeding-a-systematic-review-and-meta-analysis
#7
Xiaoyan Li, Tingting Jiang, Jian Gao
Endoscopic variceal ligation (EVL) is often recommended as an effective method for the treatment of esophageal varices, despite the important tendency of variceal recurrence. Recent studies indicate that combining EVL with argon plasma coagulation (APC) may be a more effective therapy than ligation alone. To investigate these findings, we carried out a systematic review and meta-analysis to compare the safety and efficacy of EVL combined with APC versus ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28192185/hepatic-decompensation-is-the-major-driver-of-death-in-hcv-infected-cirrhotic-patients-with-successfully-treated-early-hepatocellular-carcinoma
#8
Giuseppe Cabibbo, Salvatore Petta, Marco Barbara, Simona Attardo, Laura Bucci, Fabio Farinati, Edoardo G Giannini, Giulia Negrini, Francesca Ciccarese, Gian Lodovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Rodolfo Sacco, Roberto Virdone, Fabio Andrea Marra Mega, Filomena Morisco, Luisa Benvegnù, Antonio Gasbarrini, Gianluca Svegliati-Baroni, Francesco Giuseppe Foschi, Andrea Olivani, Alberto Masotto, Gerardo Nardone, Antonio Colecchia, Marcello Persico, Antonio Craxì, Franco Trevisani, Calogero Cammà
BACKGROUND & AIMS: A major problem in assessing the long-term outcome of HCV-infected cirrhotic patients with successfully treated Barcelona Clinic Liver Cancer (BCLC) A hepatocellular carcinoma (HCC) arises from the lack of models accounting for early changes during follow-up. AIM: of study is to estimate the impact on 5-year overall survival (OS) of early (occurring within 12 months after complete radiological response) time-dependents events (HCC recurrence or hepatic decompensation) in a large cohort of successfully treated HCC patients with HCV cirrhosis...
February 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28186472/clinical-presentation-and-treatment-outcomes-of-spinal-epidural-arteriovenous-fistulas
#9
Deena M Nasr, Waleed Brinjikji, Michelle J Clarke, Giuseppe Lanzino
OBJECTIVE Spinal epidural arteriovenous fistulas (SEDAVFs) constitute a rare but treatable cause of vascular myelopathy and are a different subtype from the more common Type I spinal dural AVFs. The purpose of this study was to review a consecutive series of SEDAVFs from a single institution and report on the clinical presentations, functional status, and treatment outcomes. METHODS The authors identified all SEDAVFs treated at their institution from 2005 to 2015. SEDAVFs were defined as spinal AVFs in which the fistulous connection occurred in the epidural venous plexus...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28180928/safety-and-efficacy-of-sodium-tetradecyl-sulfate-and-lipiodol-foam-in-balloon-occluded-retrograde-transvenous-obliteration-brto-for-large-porto-systemic-shunts
#10
Amar Mukund, Ganesh Deogaonkar, S Rajesh, Saggerre Muralikrishna Shasthry, Shiv Kumar Sarin
OBJECTIVE: To evaluate the safety and efficacy sodium tetradecyl sulfate and lipiodol foam (STS foam) in BRTO for large (caliber ≥15 mm) porto-systemic shunt and gastric fundal varices. MATERIALS AND METHODS: It is a retrospective record-based study of patients who underwent BRTO using STS foam at the Institute of Liver and Biliary Sciences, New Delhi, for gastric variceal bleed or refractory hepatic encephalopathy (HE) who had large porto-systemic shunt (diameter ≥15 mm) with or without associated gastric varices...
February 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28174362/most-frequent-oral-lesions-in-patients-with-type-2-diabetes-mellitus
#11
Micheline S Trentin, Georgia Verardi, Michele De C Ferreira, João P de Carli, Soluete O da Silva, Igor Fp Lima, Luiz R Paranhos
AIM: Type 2 diabetes mellitus (DM2) is a chronic disease caused by the underproduction of insulin in the organism and it is considered a risk factor to periodontal disease. MATERIALS AND METHODS: This study performed a cross-sectional research on the main oral changes in patients with DM2 and nondiabetics, in Passo Fundo, Rio Grande do Sul, Brazil. The sample included 116 patients examined at the Diabetes Outpatient Clinic of the School of Medicine of the University of Passo Fundo (UPF) and 134 nondiabetic patients examined at the Examinations, Triage, and Emergency Sector of the School of Dentistry of UPF...
February 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28169977/meta-analysis-of-odds-ratios-current-good-practices
#12
Bei-Hung Chang, David C Hoaglin
BACKGROUND: Many systematic reviews of randomized clinical trials lead to meta-analyses of odds ratios (ORs). The customary methods of estimating an overall OR involve weighted averages of the individual trials' estimates of the logarithm of the OR. That approach, however, has several shortcomings, arising from assumptions and approximations, that render the results unreliable. Although the problems have been documented in the literature for many years, the conventional methods persist in software and applications...
February 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28167214/doppler-endoscopic-probe-monitoring-of-blood-flow-improves-risk-stratification-and-outcomes-of-patients-with-severe-non-variceal-upper-gastrointestinal-hemorrhage
#13
Dennis M Jensen, Thomas Og Kovacs, Gordon V Ohning, Kevin Ghassemi, Gustavo A Machicado, Gareth S Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
BACKGROUND & AIMS: For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage...
February 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28160419/adams-oliver-syndrome-review-of-the-literature-refining-the-diagnostic-phenotype
#14
Susan Hassed, Shibo Li, John Mulvihill, Christopher Aston, Susan Palmer
The Adams-Oliver syndrome (AOS) is defined as aplasia cutis congenita (ACC) with transverse terminal limb defects (TTLD). Frequencies of associated anomalies are not well characterized. Six causative genes have been identified: ARHGAP31, DOCK6, EOGT, RBPJ, NOTCH1, and DLL4. We review 385 previously described individuals (139 non-familial and 246 familial probands and family members) and add clinical data on 13 previously unreported individuals with AOS. In addition to ACC and TTLD, the most commonly associated anomalies included a wide variety of central nervous system (CNS) anomalies and congenital heart defects each seen in 23%...
February 4, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28160373/validating-deconstructing-and-refining-baveno-criteria-for-ruling-out-high-risk-varices-in-patients-with-compensated-cirrhosis
#15
Parastoo Jangouk, Laura Turco, Ana De Oliveira, Filippo Schepis, Erica Villa, Guadalupe Garcia-Tsao
Guidelines recommend variceal screening in patients with cirrhosis to identify varices at high-risk of bleeding requiring primary prophylaxis. Non-invasive criteria to rule out high-risk varices (HRV) will avoid unnecessary endoscopies. Recent Baveno VI criteria define patients with compensated cirrhosis in whom endoscopy can be avoided as those with a liver stiffness (LS) by transient elastography <20 kPa and a platelet count >150,000/mm(3) AIMS: To validate Baveno criteria in two cohorts with a different prevalence of HRV and 2) to determine whether alternate parameters not including LS would be equal/more accurate in ruling out HRV METHODS: Retrospective study evaluating patients with LS >10 kPa who had LS and endoscopy within one year of each other RESULTS: The study included 161 patients from a U...
February 3, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28154409/the-use-of-over-the-scope-clips-in-acute-variceal-hemorrhage
#16
Rajani Sharma, Amrita Sethi
No abstract text is available yet for this article.
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28152572/safety-and-efficacy-of-transhepatic-and-transsplenic-access-for-endovascular-management-of-portal-vein-complications-after-liver-transplantation-1
#17
Joon-Young Ohm, Gi-Young Ko, Kyu-Bo Sung, Dong-Il Gwon, Heung-Gyu Koh
OBJECTIVE: To evaluate and compare the safety and efficacy of endovascular management of the portal vein (PV) via percutaneous transsplenic access versus percutaneous transhepatic access in liver transplant recipients. METHODS: Eighteen patients who underwent endovascular management of PV via percutaneous transhepatic (n = 8) and transsplenic (n = 10) access were enrolled. Transsplenic access was chosen if the spleen was located in a normal position, the splenic vein was preserved, and the target lesion did not involve confluence of the superior mesenteric and splenic veins...
February 2, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28147475/over-the-scope-clip-in-the-management-of-gastrointestinal-defect-and-intractable-non-variceal-bleeding
#18
Hyungkil Kim
No abstract text is available yet for this article.
January 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28144613/complete-esophageal-obstruction-after-endoscopic-variceal-band-ligation-in-a-patient-with-a-sliding-hiatal-hernia
#19
Munthir Mansour, Yousef Abdel-Aziz, Hesham Awadh, Nihar Shah, Akash Ajmera
Complete esophageal obstruction is a rare complication of endoscopic variceal banding, with only 6 cases in the English literature since the introduction of endoscopic variceal banding in 1986. We report a case of complete esophageal obstruction following esophageal banding due to entrapment of part of a sliding hiatal hernia. To our knowledge, our case is one of few with esophageal obstruction post-banding, and the first associated with a hiatal hernia. We recommend caution when performing esophageal banding on patients with a hiatal hernia...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144391/impact-of-transjugular-intrahepatic-porto-systemic-shunt-on-post-liver-transplantation-outcomes-study-based-on-the-united-network-for-organ-sharing-database
#20
Khalid Mumtaz, Sherif Metwally, Rohan M Modi, Nishi Patel, Dmitry Tumin, Anthony J Michaels, James Hanje, Ashraf El-Hinnawi, Don Hayes, Sylvester M Black
AIM: To determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. METHODS: Utilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ(2) tests for categorical measures...
January 18, 2017: World Journal of Hepatology
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