European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Dec 2020
Elastography and serum markers of fibrosis versus liver biopsy in 1270 Egyptian patients with hepatitis C.
Chronic hepatitis C (CHC) is a leading cause of liver fibrosis. ⋯ Liver elastography is superior to APRI, FIB4, Forns and GUCI scores in predicting fibrosis in CHC patients.
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Eur J Gastroenterol Hepatol · Nov 2020
Analysis of the hemostatic therapy in liver transplantation guided by rotational thromboelastometry or conventional laboratory tests.
Coagulopathy is quite common in chronic liver disease patients undergoing orthotopic liver transplantation (OLT). Diagnosis of intraoperative bleeding disorders is based on conventional laboratory tests (CLTs), and thus, the patients are frequently exposed to unnecessary transfusions of blood products. The present study aimed to analyze the intraoperative administration of blood products in patients undergoing OLT, using rotational thromboelastometry (ROTEM) or CLTs. ⋯ Transfusion protocol-based thromboelastometry was able to guide administration of hemostatic factors and reduced administration of FFP and antifibrinolytics.
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Eur J Gastroenterol Hepatol · Jan 2020
Identification of upper gastrointestinal malignancy in patients with uncomplicated dyspepsia referred under the two-week-wait cancer pathway: a single-centre, 10-year experience.
In the United Kingdom, the National Institute for Health and Care Excellence 2015 guidance recommend that for suspected gastric or oesophageal cancer, general practitioners consider a non-urgent, direct-access endoscopy in patients over 55 years with only uncomplicated treatment-resistant dyspepsia. In practice, patients are referred under the urgent 2-week-wait cancer pathway. ⋯ Dyspepsia as a parameter to investigate gastric or oesophageal cancer contributes significantly to the growth in number of 2-week-wait referrals at a time when endoscopy units battle to meet demand. Our data show patients with uncomplicated dyspepsia rarely have gastric or oesophageal cancer and should not undergo endoscopies under the urgent 2-week-wait pathway.
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Eur J Gastroenterol Hepatol · Nov 2019
Meta AnalysisFaecal calprotectin as a diagnostic marker of inflammatory bowel disease in patients with gastrointestinal symptoms: meta-analysis.
Colonoscopy is the standard medical procedure to identify inflammatory bowel disease (IBD) in patients with gastrointestinal symptoms. Noninvasive measurement of faecal calprotectin concentration may replace colonoscopy in this indication. The study aimed to assess efficacy of faecal calprotectin as a diagnostic marker of IBD in patients with symptoms suggestive of such diagnosis. ⋯ Calculated pooled sensitivity and specificity were 0.882 [95% confidence interval (CI), 0.827-0.921] and 0.799 (95% CI, 0.693-0.875), respectively. Following faecal calprotectin incorporation in the diagnostic work-up of 100 people with suspected IBD, 18 non-IBD patients will have a colonoscopy performed and one patient with the disease will not be referred for this examination. Faecal calprotectin concentration measurement is a useful screening test to rule out IBD, at the same time reducing the need for colonoscopy by 66.7%.
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Eur J Gastroenterol Hepatol · Jun 2019
Comparative StudyComparative effectiveness of antitumour necrosis factor agents and vedolizumab in ulcerative colitis.
Antitumour necrosis factor (TNF) agents and vedolizumab are used to treat ulcerative colitis (UC) but the response is variable and there is little data on comparative effectiveness. Apart from previous exposure to anti-TNF agents, predictors of response have not been identified. We aimed to (i) compare the efficacy of anti-TNF agents and vedolizumab in UC and (ii) investigate the utility of clinical and biochemical parameters in predicting response. ⋯ The efficacy of anti-TNF and vedolizumab in UC appear comparable. We could not identify any predictors of response and remission.