Advanced research in gastroenterology & hepatology最新文献_第3页

Non-Operative Management of Splenic Injuries (NOMSI) in a Limited Resources Setup 有限资源条件下脾损伤的非手术治疗

Advanced research in gastroenterology & hepatology Pub Date : 2020-10-02 DOI: 10.19080/ARGH.2020.16.555926

S. Salah

{"title":"Non-Operative Management of Splenic Injuries (NOMSI) in a Limited Resources Setup","authors":"S. Salah","doi":"10.19080/ARGH.2020.16.555926","DOIUrl":"https://doi.org/10.19080/ARGH.2020.16.555926","url":null,"abstract":"Introduction: Gadarif is an endemic area of medical disorders causing splenomegaly in patients who are also subjected to abdominal trauma. Despite the lack of resources, which make adherence to the international guidelines of NOMSI somehow difficult, we apply it based on clinical evaluation, laboratory tests and ultrasound. Objectives: To study the outcome of NOMSI based on hemodynamic stability, ultrasound findings and follow-up. Methods: A prospective analytic hospital based study conducted in Gadarif, Eastern Sudan from 2015 to 2019, including patients who were having splenic injury with no clear indication for immediate surgery. Results: A total of 30 patients were included, of them 29 (96.7%) were male. Their age ranges between 7-65 years with the mean of 29.8. Twenty patients (66.7%) presented within 24 hours from trauma, while the rest presented later. Three patients (10%) had no history of abdominal trauma, one is an epileptic and the other 2 had concomitant severe malaria. Hemodynamic instability at presentation was found in 14 patients (46.7 %). Left hypochondrial pain was the predominant symptom in 20 patients (66.7 %) and two thirds of patients had tender LHQ. More than half (53.3%) had splenic hematoma/laceration on initial ultrasound. We encountered 5 (16.6%) patients with pathological spleens of Malaria or Visceral Leishmaniasis (Kala-azar). Four patients (13.3%), of those who had increased spleen size on initial US scan, were hemodynamically unstable and required emergency splenectomy resulting in a success rate of NOMSI in 86.7%. Conclusion: NOMSI based on clinical judgment and ultrasound examination in limited resources setup, is feasible and applicable with comparable success rates. Further studies are needed to evaluate NOMSI in endemic areas with pathological spleen.","PeriodicalId":72074,"journal":{"name":"Advanced research in gastroenterology & hepatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42197793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Role of Incision Support Using Elastic Abdominal Binders in Reducing Postoperative Pain after Midline Laparotomy: A Randomized Controlled Trial 使用弹性腹部粘合剂的切口支持在减轻中线剖腹产术后疼痛中的作用：一项随机对照试验

Advanced research in gastroenterology & hepatology Pub Date : 2020-09-15 DOI: 10.19080/ARGH.2020.15.555924

Byshetty Rajendar

引用次数: 0

Durability of Hbsag Loss During or After Antiviral Treatment and Impact on Clinical Outcome 抗病毒治疗期间或之后Hbsag损失的持久性及其对临床结果的影响

Advanced research in gastroenterology & hepatology Pub Date : 2020-09-10 DOI: 10.19080/ARGH.2020.15.555923

G. Teuber

{"title":"Durability of Hbsag Loss During or After Antiviral Treatment and Impact on Clinical Outcome","authors":"G. Teuber","doi":"10.19080/ARGH.2020.15.555923","DOIUrl":"https://doi.org/10.19080/ARGH.2020.15.555923","url":null,"abstract":"Aims: Concerning the durability of HBsAg loss during or after antiviral treatment only a few studies with conflicting results are available indicating a rate of reactivation with reocurrence of HBsAg and/or HBV-DNA in 4.2% 16.4% in predominantly Asian patients. However, there are no larger European studies available concerning the durability of HBsAg loss during or after antiviral treatment and the impact on further clinical outcome. Patients and Methods: In this retrospective German multicentre study, 143 patients with chronic hepatitis B (mean age: 43 ± 13.8 years, 93 males, 50 females) who lost HBsAg during or after antiviral treatment were included. Antiviral treatment with peginterferon-alpha2a (PegIFNalpha2a) and/or nucleus(t)ides were administered between April 2008 and July 2014. Before antiviral treatment, 17 patients had established liver cirrhosis. Primary endpoint was reactivation with reoccurrence of HBsAg Further endpoints were clinical progressive liver disease, liver transplantation and death. Result: During the follow-up period (mean: 3.0 ± 2.1 years) a reoccurrence of HBsAg was observed in only 3/143 patients (2.1%), and in none with previous seroconversion to Anti-HBs. The HBV reactivation in these patients was not associated with detectable HBV-DNA levels, 2/3 patients had baseline cirrhosis and 1/2 subsequently died due to recurrent multifocal hepatocellular carcinoma. Among the 140 patients with persisting HBsAg loss, two initially cirrhotic patients died, and one received liver transplantation all due to hepatocellular carcinoma. Conclusion: In a predominantly Caucasian patient population HBsAg loss during and/or after antiviral treatment seems to be durable with low rates of reactivation. Cirrhotic patients, however, have a high risk developing hepatocellular carcinoma even after HBsAg loss. Continous surveillance in these patients seems to be mandatory.","PeriodicalId":72074,"journal":{"name":"Advanced research in gastroenterology & hepatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43142472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Prophylaxis of Gastric Variceal Bleeding Comparing Cyanoacrylate Injection and Beta-Blockers in Patients with Liver Cirrhosis: A Randomized Controlled Trial 比较氰基丙烯酸酯注射液和受体阻滞剂对肝硬化患者胃静脉曲张出血的初级预防:一项随机对照试验

Advanced research in gastroenterology & hepatology Pub Date : 2020-09-01 DOI: 10.19080/ARGH.2020.15.555922

G. SalamaA, M. A. Tawfik

{"title":"Primary Prophylaxis of Gastric Variceal Bleeding Comparing Cyanoacrylate Injection and Beta-Blockers in Patients with Liver Cirrhosis: A Randomized Controlled Trial","authors":"G. SalamaA, M. A. Tawfik","doi":"10.19080/ARGH.2020.15.555922","DOIUrl":"https://doi.org/10.19080/ARGH.2020.15.555922","url":null,"abstract":"Background and study aim: The bleeding from gastric varices are more severe, requiring more blood transfusions, and has a higher mortality rate than esophageal variceal bleeding, there is little data on primary prophylaxis of GV bleeding, we compared the efficacy of cyanoacrylate injection and beta-blockers in primary prophylaxis of gastric variceal bleeding. Methods: Cirrhotics with gastroesophageal varices type 2 with eradicated esophageal varices or large isolated gastric varix type 1, who had never bled from gastric varix, were randomized to cyanoacrylate injection (Group I, n = 30), beta-blockers (Group II, n = 30) or no treatment (Group III, n = 30). Primary endpoints were bleeding from gastric varix or death. Results: bleeding from gastric varices over 6 months follow up was 6.67% in Group I, 20% in Group II, 36.67% in Group III (p = 0.017). GV obliterated or decreased in size 42.86% and 57.14% of group I respectively. No patients neither in group II nor in group III had an obliteration or decrease in GV size. (p < 0.001). Conclusion: Primary prophylaxis in patients with gastric varices is recommended to reduce the risk of first bleeding. Cyanoacrylate injection is more effective than beta-blocker therapy in preventing first gastric variceal bleeding.","PeriodicalId":72074,"journal":{"name":"Advanced research in gastroenterology & hepatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42708992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Hyperferritinemia Has Multifactorial Etiology in Naive Patients with Chronic Hepatitis C 慢性丙型肝炎初发患者高铁蛋白血症有多因素病因

Advanced research in gastroenterology & hepatology Pub Date : 2020-07-10 DOI: 10.19080/argh.2020.15.555914

Ibrahim Ahmad H. El Bacha, M. Elias, I. Silva, A. Martins, E. Parise

引用次数: 0

Cholelithiasis: A Brief Review on Diagnostic Approach and Management in Clinical Practice 胆石症:临床诊断方法及治疗综述

Advanced research in gastroenterology & hepatology Pub Date : 2020-07-07 DOI: 10.19080/argh.2020.15.555913

Febyan, Ruswhandi

引用次数: 1

Nutritional Status of the Patients with Chronic Liver Disease are More often Overlooked During Clinical Observations 慢性肝病患者的营养状况在临床观察中往往被忽视

Advanced research in gastroenterology & hepatology Pub Date : 2020-07-02 DOI: 10.19080/argh.2020.15.555912

Guney Merve

引用次数: 0

Unusual Submucosal Haemotoma in Esophagus on Upper G.I. Endoscopy 上消化道内镜下食管粘膜下异常出血

Advanced research in gastroenterology & hepatology Pub Date : 2020-06-12 DOI: 10.19080/argh.2020.15.555911

Z. P. Sharma, Ravi C. Sharma, D. Sharma

引用次数: 0

Reversed Intestinal Rotation with Annular Pancreas Presented as Acute Necrotizing Pancreatitis- A Case report 小肠反向旋转伴环状胰腺表现为急性坏死性胰腺炎1例

Advanced research in gastroenterology & hepatology Pub Date : 2020-06-08 DOI: 10.19080/argh.2020.15.555909

Byshetty Rajendar

引用次数: 0

Ulcerative Colitis – Prevention and Treatment with a Plant-Based Diet 溃疡性结肠炎-植物性饮食的预防和治疗

Advanced research in gastroenterology & hepatology Pub Date : 2020-06-05 DOI: 10.19080/argh.2020.15.555908

A. Strombom

引用次数: 3