Boesentermansen4500
At present, minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy's lesions, , as it has the advantages of minimal trauma, short operation time and good hemostatic effect, although bleeding can easily recur postoperatively. Recently, extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa.
A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool, and he was diagnosed with Dieulafoy's disease. We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall. Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall, which was confirmed to have no blood flow signals by endoscopic ultrasonography.
Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.
Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.
Approximately 20% of patients with neuroendocrine tumours (NETs) develop carcinoid syndrome (CS), characterised by flushing and diarrhoea. Somatostatin analogues or telotristat can be used to control symptoms of CS through inhibition of serotonin secretion. Although CS is often the cause of diarrhoea among patients with gastroenteropancreatic NETs (GEP-NETs), other causes to consider include pancreatic enzyme insufficiency (PEI), bile acid malabsorption and small intestinal bacterial overgrowth. If other causes of diarrhoea unrelated to serotonin secretion are mistaken for CS diarrhoea, these treatments may be ineffective against the diarrhoea, risking detrimental effects to patient quality of life.
To identify and synthesise qualitative and quantitative evidence relating to the differential diagnosis of diarrhoea in patients with GEP-NETs.
Electronic databases (MEDLINE, Embase and the Cochrane Library) were searched from inception to September 12, 2018 using terms for NETs and diarrhoea. Congresses, syrature review highlights gaps for further research on prevalence of non-CS diarrhoea and suitability of diagnostic approaches, to determine an effective algorithm for differential diagnosis of GEP-NET diarrhoea.
Diarrhoea in GEP-NETs can be multifactorial with misdiagnosis leading to delayed patient recovery and inefficient resource use. This systematic literature review highlights gaps for further research on prevalence of non-CS diarrhoea and suitability of diagnostic approaches, to determine an effective algorithm for differential diagnosis of GEP-NET diarrhoea.
No studies have evaluated the predictive value of alarm symptoms for organic dyspepsia and organic upper gastrointestinal (GI) diseases based on Rome IV criteria in the Chinese population.
To evaluate the predictive value of alarm symptoms for dyspeptic patients based on Rome IV criteria.
We performed a cross-sectional study of dyspepsia patients who met the inclusion and exclusion criteria at two academic urban tertiary-care centers from March 2018 to January 2019. Tofacitinib Basic demographic data, dyspeptic information, alarm symptoms, lifestyle, examination results, family history and outpatient cost information were collected. Dyspepsia patients with normal findings on upper GI endoscopy, epigastric ultrasound and laboratory examination and without
-associated dyspepsia were classified as functional dyspepsia.
A total of 381 patients were enrolled in the study, including 266 functional dyspepsia patients and 115 organic dyspepsia patients. There were 24 patients with organic upper GI disease among patienteria. Gastroscopic screening should not be based solely on alarm symptoms.
No guideline recommends antiviral therapy for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients with persistently normal alanine aminotransferase levels and a high hepatitis B virus (HBV) DNA viral load.
To evaluate the feasibility and safety of a Chinese herbal formula as a therapeutic option for chronic HBV infection.
In total, 395 patients (30-65 years old) with confirmed HBeAg-positive chronic hepatitis B infection and persistently normal alanine aminotransferase were randomized to receive either Chinese herbal formula or placebo for 96 wk. Endpoints to evaluate therapeutic efficacy included (1) HBV DNA levels decreased to less than 4 log10 IU/mL at weeks 48 and 96; and (2) HBeAg clearance and seroconversion rates at weeks 48 and 96.
HBV DNA levels ≤ 4 log10 IU/mL were 10.05% at week 48 and 18.59% at week 96 in the treatment group. The HBeAg clearance and conversion rates were 8.54% and 8.04% at week 48 and 16.08% and 14.57% at week 96, respectively. However, HBV DNA levels ≤ 4 lnine aminotransferase. The ability of the compound to modulate host immune function probably contributed to this effect.
Sequential transarterial chemoembolization (TACE) and portal vein embolization (PVE) are associated with long time interval that can allow tumor growth and nullify treatments' benefits.
To evaluate the effect of simultaneous TACE and PVE for patients with large hepatocellular carcinoma (HCC) prior to elective major hepatectomy.
Fifty-one patients with large HCC who underwent PVE combined with or without TACE prior to hepatectomy were included in this study, with 13 patients in the simultaneous TACE + PVE group, 17 patients in the sequential TACE + PVE group, and 21 patients in the PVE-only group. The outcomes of the procedures were compared and analyzed.
All patients underwent embolization. The mean interval from embolization to surgery, the kinetic growth rate of the future liver remnant (FLR), the degree of tumor size reduction, and complete tumor necrosis were significantly better in the simultaneous TACE + PVE group than in the other groups. Although the patients in the simultaneous TACE + PVE group had a higher transaminase levels after PVE and TACE, they recovered to comparable levels with the other two groups before surgery.
