Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · Feb 2013
Comparative StudyDistance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta.
Despite remarkable advances in diagnostic modalities, preoperative assessment of the local tumor extent in esophageal cancer is still very difficult. The aim of this study was to evaluate the predictive value of the computed tomography (CT) attenuation value between the tumor and the aorta for esophageal cancer. ⋯ The assessment of the T-A distance is simple and objective, and it can help prevent unnecessary surgery in patients with inoperable tumors.
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J. Gastroenterol. Hepatol. · Feb 2013
Clinical TrialPreoperative use of romiplostim in thrombocytopenic patients with chronic hepatitis C and liver cirrhosis.
Patients infected with hepatitis C virus (HCV) often develop chronic liver disease, liver cirrhosis and concurrent thrombocytopenia, which manifests as decreased platelet counts and bleeding complications. Romiplostim, a thrombopoietin mimetic peptibody that stimulates the thrombopoietin receptor, has been used as a treatment for primary immune thrombocytopenia. We monitored the efficacy of preoperative romiplostim over 90 days in 35 male patients with chronic hepatitis C, liver cirrhosis and thrombocytopenia secondary to HCV infection. ⋯ Preoperative romiplostim administration may represent a viable alternative to increase platelet counts to a level acceptable for elective surgical interventions in patients with chronic liver disease and severe thrombocytopenia secondary to HCV infection who are unresponsive to standard therapy. Further studies in larger numbers of patients and over a longer period of time are warranted.
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J. Gastroenterol. Hepatol. · Feb 2013
Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in the characterization of pancreatic masses: experience from tropics.
Early detection and differentiation of malignant from benign pancreatic tumors is very essential as mass-forming pancreatitis is a frequently encountered problem. Positron emission tomography (PET) has a role in establishing the diagnosis of pancreatic carcinoma when the conventional imaging modalities or biopsies are nondiagnostic. In this prospective study, the utility of fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in the characterization of mass-forming lesions of the pancreas was reported. ⋯ The FDG uptake pattern in PET/CT can differentiate malignant from benign mass-forming lesions of the pancreas with high accuracy and a discrete cut-off value of SUVmax could not be defined for the same as even lesions with pancreatic tuberculosis showed very high FDG uptake. Hence, in patients with a suspicion of malignancy in the pancreas, a focally increase FDG uptake in PET/CT suggests the diagnosis of malignancy.
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J. Gastroenterol. Hepatol. · Jan 2013
ReviewCurrent prospects for interferon-free treatment of hepatitis C in 2012.
Present interferon-based therapy for chronic hepatitis C is limited by both efficacy and tolerability. Telaprevir and boceprevir are the first two direct-acting antiviral drugs (DAAs) that inhibit hepatitis C virus replication to be licensed for use in conjunction with pegylated interferon and ribavirin. Numerous other DAAs are in clinical development, and phases 2 and 3 trials are evaluating interferon-free combination DAA therapy. ⋯ Some drugs are genotype-specific in their activity, whereas others are pan-genotypic, and differential responses for the genotype 1 subtypes 1a and 1b have emerged with many DAA combinations. Viral breakthrough and resistance are important considerations for future trial design. The prospect of interferon-free combination DAA therapy for hepatitis C virus is now finally becoming a reality.