Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2003
MR and 1H MR spectroscopy of the brain in patients with liver cirrhosis and early stages of hepatic encephalopathy.
Hepatic encephalopathy is a serious problem in patients with liver cirrhosis and precise pathophysiological mechanisms responsible for encephalopathy are not fully understood. Magnetic resonance imaging and magnetic resonance spectroscopy can be used to detect specific morphological and metabolic abnormalities in the brain even in patients with early stages of hepatic encephalopathy. ⋯ Metabolic brain alterations occur earlier than clinical evidence of hepatic encephalopathy but there is no correlation between presence of symptoms encephalopathy and magnetic resonance and magnetic resonance spectroscopy findings.
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Hepato Gastroenterol · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialCoronary artery disease and upper abdominal surgery: impact of anesthesia on perioperative myocardial ischemia.
Some papers claim that epidural anesthesia and analgesia lowers the incidence of perioperative ischemic events and may have a favorable effect on perioperative cardiac morbidity and mortality. We studied the effect of epidural anesthesia and analgesia on perioperative myocardial ischemia, in a group of patients with known coronary artery disease, who underwent upper abdominal surgery. ⋯ Epidural anesthesia and analgesia reduces intraoperative and early postoperative ischemia in patients with known coronary artery disease undergoing upper abdominal surgery.
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Hepato Gastroenterol · Nov 2003
Randomized Controlled Trial Clinical TrialTranscatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of two kinds of dosages of anticancer drugs and analysis of prognostic factors.
To evaluate the efficacy of TACE (transcatheter arterial chemoembolization) with use of low-dose versus conventional-dose anticancer drugs in hepatocellular carcinoma patients with cirrhosis and to analyze their prognostic factors. ⋯ TACE with use of large-dose anticancer drugs does not significantly enhance the anticancer effects and survival compared that with lowdose anticancer drugs. The therapeutic effect of TACE was mainly attributed to embolization of the artery rather than to anticancer drugs.
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Hepato Gastroenterol · Nov 2003
Comparative StudyInnovative chemotherapies for stage III colon cancer: a cost-effectiveness study.
The lower mortality rate associated with Oxaliplatin or Irinotecan added to Fluorouracil chemotherapy for stage III colon cancer should outweigh significantly higher costs of these therapies. While efficacy data currently are lacking, our aim was to generate cost-effectiveness data about a range of potential benefits to define the increase in mortality reduction required for the future acceptance of these new chemotherapies. ⋯ Even the most conservative scenario showed a discounted cost-effectiveness ratio of only 12,485 per life year gained, when compared to best supportive care and therefore met strict cost-effectiveness standards. Oxaliplatin chemotherapy should be accepted for all patients with stage III colon cancer if the required 20% increase in mortality reduction is achieved. Because of the high impact on cost-effectiveness each more expensive chemo-therapy schedule with higher overall dosage should first prove its superior clinical efficacy.
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Hepato Gastroenterol · Nov 2003
Prevalence of pulmonary hypertension in patients with hepatosplenic Mansonic schistosomiasis--prospective study.
Thirty-four patients with portal hypertension and previous history of esophageal varices hemorrhage due to hepatosplenic Mansonic schistosomiasis were prospectively studied. ⋯ In conclusion, pulmonary hypertension is a frequent complication in patients with portal hypertension due to hepatosplenic Mansonic schistosomiasis and, in 20.6% of the cases, it can be considered as moderate or severe. Our results suggest that shunt surgeries, which can aggravate pulmonary hypertension, should be employed very cautiously in the treatment of schistosomal portal hypertension.