Gastroenterology
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Randomized Controlled Trial Comparative Study
Causal relationship of Helicobacter pylori with iron-deficiency anemia or failure of iron supplementation in children.
We investigated Helicobacter pylori (H pylori)-infection as a cause of iron deficiency (ID) and iron-deficiency anemia (IDA) or treatment failure of iron supplementation. ⋯ H pylori is neither a cause of IDA/ID nor a reason for treatment failure of iron supplementation in young Bangladeshi children.
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Comparative Study
Impact of the model for end-stage liver disease allocation policy on the use of high-risk organs for liver transplantation.
Although priority for liver transplantation is determined by the model for end-stage liver disease (MELD) score, the quality of organs used is subject to physician discretion. We aimed to determine whether implementation of MELD affected the quality of organs transplanted, the type of patients who receive the higher-risk organs, and the impact of these changes on their posttransplant survival. ⋯ As an unintended consequence of the MELD allocation policy, patients that are least in need of a liver transplant now receive the highest-risk organs. This has reduced posttransplant survival in recent years among patients with low MELD scores.
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Comparative Study
Re-weighting the model for end-stage liver disease score components.
Liver transplant candidates with mild hepatic synthetic dysfunction and marked renal insufficiency may have higher Model for End-Stage Liver Disease (MELD) scores than candidates with severe liver disease and normal renal function. We re-estimated MELD coefficients and evaluated the effect of updated MELD on the liver transplant waiting list ranking. ⋯ Existing MELD coefficient components are significantly different than those calculated from national waiting list data. Updated MELD assigns lower weight to creatinine and international normalized ratio and higher weight to bilirubin. Updated MELD better predicts waiting list mortality. Using updated MELD for liver allocation would alter waiting list candidate ranking.
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Comparative Study
Hepatic stellate cells secrete angiopoietin 1 that induces angiogenesis in liver fibrosis.
Although angiogenesis is closely associated with liver fibrosis, the angiogenic factors involved in liver fibrosis are not well characterized. Angiopoietin 1 is an angiogenic cytokine indispensable for vascular development and remodeling. It functions as an agonist for the receptor tyrosine kinase with immunoglobulin G-like and endothelial growth factor-like domains 2 (Tie2) and counteracts apoptosis, promotes vascular sprouting or branching, and stabilizes vessels. ⋯ These results reveal an angiogenic role of HSCs mediated by angiopoietin 1, which contributes to development of liver fibrosis. Thus, angiogenesis and hepatic fibrosis are mutually stimulatory, such that fibrosis requires angiogenesis and angiogenesis requires angiopoietin 1 from activated HSCs.