Digestion
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The follow-up study of up to 71 months of a randomized phase II B2222 trial has demonstrated a long-term survival in patients with recurrent or unresectable gastrointestinal stromal tumors (GISTs). One subset of the patients (17.7%) has been alive for over 9 years with continuous imatinib mesylate (imatinib) treatment. Here, we report the retrospective analysis of recurrent or unresectable GIST patients with imatinib treatment at our institution. ⋯ Imatinib had a high efficacy in patients with unresectable and recurrent GIST during long-term follow-up. All patients were well managed by supportive treatment against adverse events and they were able to take imatinib without discontinuation. The management of adverse events was a key factor for achieving a long-term survival. In addition, the potential risk of imatinib-resistant GISTs tends to depend on the size of the primary GISTs.
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This prospective study investigated the performance of pre-endoscopy and the complete Rockall scores in predicting the occurrence of adverse outcomes and the need for endoscopic or surgical intervention in patients with nonvariceal upper gastrointestinal bleeding. ⋯ The pre-endoscopy Rockall score was not useful for predicting the need for therapeutic intervention or adverse outcomes. The complete Rockall score showed an acceptable performance in predicting mortality, but was unable to predict rebleeding.
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Roux-en-Y gastric bypass surgery is the most common bariatric surgery worldwide. We have described thiamine deficiency in patients with small intestinal bacterial overgrowth after gastric bypass. We hypothesized that symptoms of thiamine deficiency are common after gastric bypass. The aims of this study were to examine the prevalence of and treatment of symptoms of thiamine deficiency after gastric bypass. ⋯ Thiamine deficiency resulting from small intestinal bacterial overgrowth should be considered in patients being seen for constipation after gastric bypass surgery.