Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · May 2019
Meta AnalysisPeripherally acting μ-opioid antagonist for the treatment of opioid-induced constipation: Systematic review and meta-analysis.
Opioid-induced constipation (OIC) is a frequent adverse event (AE) that impairs patients' quality of life (QOL). Peripherally acting μ-opioid receptor antagonists (PAMORAs) have been recognized as a treatment option for OIC, but the effect consistent across the studies has not been evaluated. ⋯ Peripherally acting μ-opioid receptor antagonist has been shown to be effective and durable for patients with OIC and is the only drug with confirmed evidence in meta-analysis. The possibility of publication bias was the limitation of this study.
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J. Gastroenterol. Hepatol. · Jan 2019
Meta AnalysisSystematic review with meta-analysis: The association between post-traumatic stress disorder and irritable bowel syndrome.
Post-traumatic stress disorder (PTSD) is a psychiatric condition characterized by symptoms of hyperarousal and hypervigilance. Increasing research on the "gut-brain" axis (bidirectional signaling between the gut and the brain) has drawn links between PTSD and irritable bowel syndrome (IBS), an exceedingly common yet incompletely understood gastrointestinal condition. This meta-analysis thus aimed to examine the body of evidence and extent of association of PTSD with IBS. ⋯ Overall, PTSD is associated with an increased likelihood of IBS. This is the first meta-analysis to specifically examine the association between PTSD and IBS, and it provides insights into the probable (patho)physiology and management of IBS, supporting a holistic consideration of the psychosocial aspects of IBS and further research into effective multi-modal therapeutics.
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J. Gastroenterol. Hepatol. · May 2018
Meta AnalysisFecal immunochemical test for predicting mucosal healing in ulcerative colitis patients: A systematic review and meta-analysis.
Fecal immunochemical test (FIT) is a promising marker for assessment of inflammatory bowel disease activity. However, the utility of FIT for predicting mucosal healing (MH) of ulcerative colitis (UC) patients has yet to be clearly demonstrated. The objective of our study was to perform a diagnostic test accuracy test meta-analysis evaluating the diagnostic accuracy of FIT in predicting MH of UC patients. ⋯ Our meta-analysis has found that FIT is a simple, reliable non-invasive marker for predicting MH in UC patients.
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J. Gastroenterol. Hepatol. · Sep 2016
Meta AnalysisEarly TIPS versus endoscopic therapy for secondary prophylaxis after management of acute esophageal variceal bleeding in cirrhotic patients: a meta-analysis of randomized controlled trials.
American College of Gastroenterology and American Association for the Study of Liver Disease guidelines recommend endoscopic and pharmacologic treatment for esophageal variceal bleed. Transjugular intrahepatic portosystemic shunt (TIPS) placement is reserved for cases of therapeutic failure. Several studies have suggested improved prevention of rebleeding and improved survival without excess hepatic encephalopathy in patients who receive TIPS within the first 5 days after bleeding (early TIPS). In this meta-analysis, we evaluated the safety and efficacy of early TIPS versus endoscopic therapy for secondary prophylaxis after acute esophageal variceal bleeding in cirrhotic patients. ⋯ TIPS placed within 5 days after a major esophageal variceal hemorrhage is superior to endoscopic treatment in reducing subsequent bleeding. Early TIPS placement is also associated with superior 1-year survival without significantly increasing the incidence of hepatic encephalopathy.
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J. Gastroenterol. Hepatol. · Jul 2016
Meta AnalysisMyeloid-derived suppressor cells in gastrointestinal cancers: A systematic review.
Gastrointestinal (GI) cancers are a heterogeneous group of cancers originating from the digestive system. Considering key roles of myeloid-derived suppressor cells (MDSCs) in the immunosuppression network, levels of MDSCs in patients with cancer are assumed to be of prognostic and predictive value. In this systematic review, we aimed to evaluate the clinical relevancy of MDSCs and their relationship with clinical features and prognosis of GI malignancies in patients with GI cancers. ⋯ In conclusion, results of this systematic review based on the available literature suggest that MDSC levels are of clinical relevancy and prognostic and predictive value.