European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Jun 2011
Controlled Clinical TrialDrug-eluting bead loaded with doxorubicin versus conventional Lipiodol-based transarterial chemoembolization in the treatment of hepatocellular carcinoma: a case-control study of Asian patients.
Lipiodol transcatheter arterial chemoembolization (TACE) is widely used to treat hepatocellular carcinoma (HCC). Recently, a drug-eluting bead (DEB) has been developed to enhance drug delivery to the tumor and reduce its systemic availability. The purpose of this study was to compare the efficacy and safety of intra-arterial injection of DEB loaded with doxorubicin versus conventional, Lipiodol-based TACE regimens in Asian patients with HCC. ⋯ In Asian patients with HCC, transcatheter treatment with DEB loaded with doxorubicin offers a distinct advantage in objective tumor response rate as compared with conventional, Lipiodol-based TACE regimens.
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Eur J Gastroenterol Hepatol · May 2011
Risk for colorectal cancer in elderly persons and possible methodologies for their screening.
Most colorectal cancer (CRC) screening guidelines recommend average-risk screening up to the age of 75 years. However, increasing life span and incidence of proximal CRC could require changes to the age guidelines and adapting screening methodology for the elderly persons. Therefore, we reviewed our CRC epidemiology, international screening age-guidelines, and screening tests for the elderly persons and presented our long-term results of colonoscopy and semi-quantitated immunochemical fecal occult blood tests (I-FOBTs) in individuals that are 75 years or more. ⋯ Recently, 41.3% of our CRCs occurred in individuals aged 75 years or more, diagnosed clinically and not by screening. I-FOBT and initial colonoscopic CRC sensitivity were similar, both having false-negative results. Screening age guidelines need reconsideration; our initial results show that semi-quantitated I-FOBT screening is feasible but needs large-scale evaluation in 'healthy' elderly persons.
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Eur J Gastroenterol Hepatol · Mar 2011
Are endoscopic or percutaneous biliary drainage effective for obstructive jaundice caused by hepatocellular carcinoma?
The prognosis of patients with obstructive jaundice caused by hepatocellular carcinoma (HCC) has been reported to be poor. The aims of this study were to determine whether effective biliary drainage in patients with obstructive jaundice caused by HCC can affect clinical outcome and to identify those factors that affect effective biliary drainage and clinical outcome. ⋯ When effective biliary drainage was achieved after an appropriate biliary drainage procedure in patients with obstructive jaundice caused by HCC, survival improved.
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Eur J Gastroenterol Hepatol · Feb 2011
Randomized Controlled TrialEffect of intravenous mannitol in mobilization of resistant cirrhotic ascites.
Cirrhotic ascites is conventionally treated with bed rest, salt restriction, and diuretics. In 20-30% of patients it eventually became resistant to diuretic therapy partly because of reduced sodium excretion owing to the development of resistance against atrial natriuretic peptide. Diuretics resistance can be overcome partially by increasing distal tubular sodium delivery by atrial natriuretic peptide and mannitol administration. ⋯ This study shows that resistant ascites can be initially mobilized by infusion of mannitol. The long-term benefits of such therapy are unknown.
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Eur J Gastroenterol Hepatol · Dec 2010
Trends in incidence, management, and survival of gastric and cardia carcinomas in the area of Finistere (France) between 1984 and 2003.
The aim of this study was to evaluate trends in incidence and prognosis of gastric and cardia carcinomas in the area of Finistère (France) between 1984 and 2003. ⋯ This study showed a significant decrease over time in the incidence of distal gastric carcinomas but no significant increase in the incidence of cardia carcinomas. Despite improvement in the management of patients, prognosis remains dismal, probably because of an increased incidence of poor prognosis of histological and anatomical types.