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JOURNAL ARTICLE
Akash Roy, Nipun Verma, Surabhi Jajodia, Usha Goenka, Awanish Tiwari, Nikhil Sonthalia, Mahesh Goenka
PURPOSE: Liver stiffness measurement (LSM) by transient elastography has been shown to underperform in high-risk varices (HRVs) prediction in obese non-alcoholic fatty liver disease (NAFLD) compensated cirrhosis (CC). LSM by magnetic resonance elastography (MRE) and acoustic force radiation impulse (ARFI) has been shown to be useful in prediction of oesophageal varices (EVs), but has limited evidence in obese NAFLD-CC. METHODS: Obese patients with NAFLD-CC who underwent MRE and ARFI for LSM and endoscopy for screening of varices were enrolled...
April 23, 2024: Abdominal Radiology
#2
REVIEW
Sergi Guixé-Muntet, Sergio Quesada-Vázquez, Jordi Gracia-Sancho
Portal hypertension represents the primary non-neoplastic complication of liver cirrhosis and has life-threatening consequences, such as oesophageal variceal bleeding, ascites, and hepatic encephalopathy. Portal hypertension occurs due to increased resistance of the cirrhotic liver vasculature to portal blood flow and is further aggravated by the hyperdynamic circulatory syndrome. Existing knowledge indicates that the profibrogenic phenotype acquired by sinusoidal cells is the initial factor leading to increased hepatic vascular tone and fibrosis, which cause increased vascular resistance and portal hypertension...
April 17, 2024: Lancet. Gastroenterology & Hepatology
#3
JOURNAL ARTICLE
Vishal C Patel, Mark J McPhail, Ruhama Uddin, Hassan Jafari, Vanessa Lawrence, Clair Le Boutillier, James Shearer, Nahel Yaziji, Angela Cape, Haroon Ahmed, Christopher Ward, Peter Walsh, Kevin Besly, Ane Zamalloa, Joanna Kelly, Ben Carter
BACKGROUND: Liver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i...
April 16, 2024: Trials
#4
EDITORIAL
Yasser Fouad, Mohamed Alboraie
In this editorial we comment on the in-press article in the World Journal of Gastrointestinal endoscopy about the role of computed tomography (CT) for the prediction of esophageal variceal bleeding. The mortality and morbidity are much increased in patients with chronic liver diseases when complicated with variceal bleeding. Predicting the patient at a risk of bleeding is extremely important and receives a great deal of attention, paving the way for primary prophylaxis either using medical treatment including carvedilol or propranolol, or endoscopic band ligation...
March 16, 2024: World Journal of Gastrointestinal Endoscopy
#5
REVIEW
Maha Elsabaawy, Omkosoum Alhaddad
Patients with liver cirrhosis constitute a critically ill and unique population, and their stability relies on a well-coordinated multidisciplinary team with a carefully structured plan. Overlooking any aspect of this plan can expedite disease progression, leading to severe complications. The lack of disease-specific nutritional guidance, the prevalent sedentary lifestyle among patients, and insufficient screening for hepatocellular carcinoma, oesophageal varices, sarcopaenia, minimal hepatic encephalopathy, and diabetes mellitus, along with fibrosis progression and cirrhosis decompensation, can add further complexities...
2024: Przegla̜d Gastroenterologiczny
#6
JOURNAL ARTICLE
Yu Bin Tan, Chee Hooi Lim, Noor Azlina Binte Johari, Jason Pik Eu Chang, Malcolm Teck Kiang Tan
BACKGROUND: Open-access oesophagogastroduodenoscopy (OAO) is defined as the performance of oesophagogastroduodenoscopy (OGD) requested by referring physicians without a prior specialist consultation. With the increasing demand for specialist appointments, the use of OAO has helped to reduce healthcare utilization by decreasing prior clinic visits. This also allows endoscopies to be scheduled and performed earlier. This study aims to evaluate our experience in providing OAO services to patients with non-alarming dyspepsia symptoms under the age of 60...
February 2024: Curēus
#7
JOURNAL ARTICLE
Dhiraj Tripathi, David Patch, Homoyon Mehrzad, Dominic Yu, Richard J Aspinall, Matthew J Armstrong, Adrian Stanley, Hamish Ireland, Simon Travis, Peter Hayes, Mandy Lomax, Nicholas Roslund, Emily Lam, Gemma Slinn, Sue Jowett, Catherine Moakes, Alisha Maher, Elizabeth Brettell, Sukhwant Sehmi
INTRODUCTION: In liver cirrhosis, acute variceal bleeding (AVB) is associated with a 1-year mortality rate of up to 40%. Data on early or pre-emptive transjugular intrahepatic portosystemic stent-shunt (TIPSS) in AVB is inconclusive and may not reflect current management strategies. Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent-shunt in AVB (REACT-AVB) aims to investigate the clinical and cost-effectiveness of early TIPSS in patients with cirrhosis and AVB after initial bleeding control...
March 22, 2024: BMJ Open Gastroenterology
#8
JOURNAL ARTICLE
Sowmiya Velusamy, Souradeep Dutta, Debasis Naik, Vishnu Prasad Nelamangala Ramakrishnaiah
Liver haemangiomas are the most common benign hepatic tumours, but secondary portal hypertension resulting from haemangiomas is exceedingly uncommon. We present a case of a man in his 50s who presented with a progressively enlarging mass in the right upper abdomen. CT of the liver revealed a large hypodense lesion involving the right lobe, with two smaller lesions in the left lobe. The portal vein was compressed by the tumour, causing portal hypertension. The patient underwent right hepatectomy. Postoperatively, the patient had an uneventful course, and a 3-month follow-up demonstrated resolution of the oesophageal varices, portal gastropathy, with hypertrophy of the left lobe...
March 19, 2024: BMJ Case Reports
#9
MULTICENTER STUDY
Xi Jiang, Jun Pan, Qing Xu, Yu-Hu Song, Huan-Huan Sun, Cheng Peng, Xiao-Long Qi, Yang-Yang Qian, Wen-Bin Zou, Yang Yang, Shao-Qin Jin, Ben-Song Duan, Shan Wu, Ye Chu, Ding-Hua Xiao, Li-Juan Hu, Jun-Zhi Cao, Jin-Feng Dai, Xiao Liu, Tian Xia, Wei Zhou, Tao Chen, Chun-Hua Zhou, Wei Wu, Shao-Jun Liu, Zhen-Yu Yang, Fen Wang, Lu Zhang, Cheng-Zhong Li, Hao Xu, Jun-Xue Wang, Bo Wei, Yong Lin, Xing Deng, Li-Hong Qu, Ying-Qiu Shen, Hui Wang, Yi-Fei Huang, Hai-Biao Bao, Shuo Zhang, Li Li, Yi-Hai Shi, Xiao-Yan Wang, Duo-Wu Zou, Xin-Jian Wan, Mei-Dong Xu, Hua Mao, Chao-Hui He, Zhen Li, Xiu-Li Zuo, Shui-Xiang He, Xiao-Ping Xie, Jun Liu, Chang-Qing Yang, Cristiano Spada, Zhao-Shen Li, Zhuan Liao
OBJECTIVE: To evaluate the diagnostic accuracy and safety of using magnetically guided capsule endoscopy with a detachable string (ds-MCE) for detecting and grading oesophagogastric varices in adults with cirrhosis. DESIGN: Prospective multicentre diagnostic accuracy study. SETTING: 14 medical centres in China. PARTICIPANTS: 607 adults (>18 years) with cirrhosis recruited between 7 January 2021 and 25 August 2022...
March 5, 2024: BMJ: British Medical Journal
#10
JOURNAL ARTICLE
Jieyu Peng, Xinyi Zeng, Shu Huang, Han Zhang, Huifang Xia, Kang Zou, Wei Zhang, Xiaomin Shi, Lei Shi, Xiaolin Zhong, Muhan Lü, Yan Peng, Xiaowei Tang
OBJECTIVES: This study aimed to assess the internal law and time trend of hospitalisation for oesophagogastric variceal bleeding (EGVB) in cirrhosis and develop an effective model to predict the trend of hospitalisation time. DESIGN: We used a time series covering 72 months to analyse the hospitalisation for EGVB in cirrhosis. The number of inpatients in the first 60 months was used as the training set to establish the autoregressive integrated moving average (ARIMA) model, and the number over the next 12 months was used as the test set to predict and observe their fitting effect...
February 29, 2024: BMJ Open
#11
JOURNAL ARTICLE
Clay Hallman, Ryan Baumwart, Ruth Mackenzie Hallman
BACKGROUND: Brachycephalic dogs with pulmonary stenosis are known to have a higher incidence of concurrent coronary artery abnormalities than non-brachycephalic breeds, which increases risk when performing balloon valvuloplasty. The use of ECG-gated CT angiography has been reported for the evaluation of coronary arteries in normal dogs and dogs with pulmonary stenosis. The purpose of this study was to report findings of coronary artery origination and morphology of main branches using ECG-gated CT angiography in brachycephalic dogs with pulmonary stenosis...
February 20, 2024: Veterinary Record
#12
REVIEW
Francesca Tamarozzi, Tamara Ursini, Giacomo Stroffolini, Geraldo Badona Monteiro, Dora Buonfrate, Veronica Andrea Fittipaldo, Simone Conci, Clizia Gasparini, Giancarlo Mansueto, Alfredo Guglielmi, Federico Gobbi
Hepatosplenic schistosomiasis is a complex clinical condition caused by the complications of chronic infection with Schistosoma species that cause intestinal schistosomiasis. Hepatosplenic schistosomiasis derives from the fibrotic reaction stimulated around parasite eggs that are transported by the mesenteric circulation to the liver, causing periportal fibrosis. Portal hypertension and variceal gastrointestinal bleeding are major complications of hepatosplenic schistosomiasis. The clinical management of hepatosplenic schistosomiasis is not standardised and a parameter that could guide clinical decision making has not yet been identified...
February 15, 2024: Lancet Infectious Diseases
#13
RANDOMIZED CONTROLLED TRIAL
Thomas Yau, Ahmed Kaseb, Ann-Lii Cheng, Shukui Qin, Andrew X Zhu, Stephen L Chan, Tamar Melkadze, Wattana Sukeepaisarnjaroen, Valery Breder, Gontran Verset, Edward Gane, Ivan Borbath, Jose David Gomez Rangel, Baek-Yeol Ryoo, Tamta Makharadze, Philippe Merle, Fawzi Benzaghou, Steven Milwee, Zhong Wang, Dominic Curran, Robin Kate Kelley, Lorenza Rimassa
BACKGROUND: The aim of the COSMIC-312 trial was to evaluate cabozantinib plus atezolizumab versus sorafenib in patients with previously untreated advanced hepatocellular carcinoma. In the initial analysis, cabozantinib plus atezolizumab significantly prolonged progression-free survival versus sorafenib. Here, we report the pre-planned final overall survival analysis and updated safety and efficacy results following longer follow-up. METHODS: COSMIC-312 was an open-label, randomised, phase 3 study done across 178 centres in 32 countries...
April 2024: Lancet. Gastroenterology & Hepatology
#14
JOURNAL ARTICLE
Jiaming Huang, Haifeng Liu
OBJECTIVE: To investigate risk factors for portal venous thrombosis (PVT) after partial splenic artery embolization (PSE) in hepatic cirrhosis patients. METHODS: The authors retrospectively analyzed 151 hepatic cirrhosis patients with hypersplenism who underwent partial splenic artery embolization between January 2020 and December 2021. The patients were divided into a PVT group and a non-PVT group according to whether they had PVT after PSE. Univariate analyses were performed to select risk factors for PVT after PSE, and multivariate analysis was used to analyze variates with a value of P less than 0...
February 2024: Annals of Medicine and Surgery
#15
JOURNAL ARTICLE
Shivali Arya, Rashmi Dixit, Sneha Harish C, Anjali Prakash, Amarender S Puri
BACKGROUND: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive. OBJECTIVES: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. METHOD: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group...
2024: SA journal of radiology
#16
JOURNAL ARTICLE
Joanne O'Rourke, Andrew Todd, Chander Shekhar, Colm Forde, Arvind Pallan, Sharan Wadhwani, Dhiraj Tripathi, Brinder Singh Mahon
BACKGROUND AND AIMS: Gastric varices (GV) are reported in up to 20% of patients with portal hypertension, and bleeding is often more severe and challenging than oesophageal variceal bleeding. There is limited data on prophylaxis of GV bleeding or management in the acute setting, and different techniques are utilised. This study aims to evaluate outcomes following endoscopic ultrasound (EUS) guided placement of coils in combination with thrombin to manage GV. METHODS: We retrospectively reviewed all patients treated with combination EUS-guided therapy with coils and thrombin between October 2015 and February 2020...
February 3, 2024: Gastrointestinal Endoscopy
#17
JOURNAL ARTICLE
Torsten Dahlén, Jingcheng Zhao, Michael P Busch, Gustaf Edgren
BACKGROUND: Identification and prevention of transfusion-transmitted disease is essential for blood transfusion safety. However, current surveillance systems are largely driven by reports of sentinel events, which is an approach that might be inadequate for identifying transmission of pathogens not known to be transmissible or pathogens with long incubation periods. Using a combination of health-data registers and blood-bank databases, we aimed to perform an agnostic search for potential transfusion-transmitted diseases and to identify unknown threats to the blood supply...
February 2024: The Lancet. Digital health
#18
JOURNAL ARTICLE
Cristina Rigamonti, Micol Giulia Cittone, Giulia Francesca Manfredi, Carla De Benedittis, Noemi Paggi, Francesca Baorda, Davide Di Benedetto, Rosalba Minisini, Mario Pirisi
BACKGROUND & AIMS: Primary biliary cholangitis (PBC) may lead to portal hypertension (PH). Spleen stiffness measurement (SSM) by vibration-controlled transient elastography accurately predicts PH. We aimed to assess SSM role in stratifying the risk of liver decompensation in PBC. METHODS: In this monocentric, prospective, cross-sectional study, we included 114 patients with PBC who underwent liver stiffness measurement (LSM) and SSM. In total, 78 and 33 patients underwent two and three sequential vibration-controlled transient elastography examinations, respectively (longitudinal study)...
January 2024: JHEP reports: innovation in hepatology
#19
JOURNAL ARTICLE
Wai Hoong Chang, Alvina G Lai
Comorbidities present considerable challenges to cancer treatment and care. However, little is known about the effect of comorbidity on cancer treatment decisions across a wide range of cancer types and treatment modalities. Harnessing a cohort of 280,543 patients spanning 19 site-specific cancers, we explored pan-cancer frequencies of 109 comorbidities. Multinomial logistic regression was used to analyse the relationship between comorbidities and cancer treatment types, while binomial logistic regression examined the association between comorbidities and chemotherapy drug types, adjusting for demographic and clinical factors...
January 3, 2024: Scientific Reports
#20
JOURNAL ARTICLE
A K Mohamed, Y C Tang
INTRODUCTION: Novel coronavirus 19 disease (COVID-19) pandemic poses healthcare providers challenges in the endoscopic suite. It is unclear whether it affects the endoscopic manifestations of upper gastrointestinal (GI) bleeding. This retrospective study was done to review demographic data, site of lesions and need of interventions for those lesions. MATERIALS AND METHODS: Oesophagoduodenoscopy (OGDS) reports of COVID-19 patients with indication of upper GI bleeding from March 2021 to April 2022 were reviewed...
December 2023: Medical Journal of Malaysia
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