Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Jan 2009
Comparative StudyEffect of intravenous albumin on endotoxin removal, cytokines, and nitric oxide production in patients with cirrhosis and spontaneous bacterial peritonitis.
In patients with cirrhosis and spontaneous bacterial peritonitis (SBP), the use of intravenous albumin has been shown to prevent deterioration of renal function and to decrease the mortality rate, but the mechanisms remain unclear. The purpose of this study was to characterize the mechanisms of action of albumin with the focus on endotoxin and cytokines. ⋯ The results confirm that the beneficial effects of albumin are related to the reduction of the levels of TNF-alpha and NOx in both plasma and ascitic fluid. The infusion of albumin continuously for 3 days in addition to antibiotic treatment at the time of SBP detection is recommended as an effective therapy for patients with cirrhosis and SBP.
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Scand. J. Gastroenterol. · Jan 2009
Comparative StudyMCP-1 and MIP3-alpha serum levels in acute liver failure and molecular adsorbent recirculating system (MARS) treatment: a pilot study.
The CC chemokines monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-3 alpha (MIP3-alpha) may be involved in the pathogenesis of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). In ALF and ACLF, the molecular adsorbent recirculating system (MARS) has been used to support liver function. Enhancement of MCP-1, as seen in other extracorporeal support systems such as haemodialysis, might thus have mitigated the beneficial effects of the MARS system in acute hepatic failure. ⋯ The CC chemokines MCP-1 and MIP3-alpha are increased in ALF and ACLF patients. MARS had no effect on MCP-1 and MIP3-alpha serum concentrations in patients with ALF and ACLF, and yielded no evidence of any harmful effects of the increase of these potentially hepatocidal chemokines.
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Scand. J. Gastroenterol. · Jan 2009
Comparative StudyLong-term outcomes of endoscopic submucosal dissection in gastric neoplastic lesions at a single institution in South Korea.
OBJECTIVE. Although endoscopic treatment for early gastric cancer (EGC) is an accepted therapy in South Korea and Japan, long-term outcomes remain unknown. We evaluated the clinical outcome of endoscopic submucosal dissection (ESD) for gastric dysplasia and EGC. ⋯ CONCLUSIONS. Curative treatment with successful en bloc resection can reduce the local recurrence of gastric neoplastic lesions after ESD. Clinical outcome may be excellent, although longer follow-up studies are warranted.
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Scand. J. Gastroenterol. · Jan 2009
Comparative StudySurvey of the management of pancreatic pseudocysts in Sweden.
The management of pancreatic pseudocysts varies, based mainly on local traditions, resources and expertise. No prospective, randomized study has been done comparing different approaches to treatment. The aim of the present study was to identify current treatment strategies in Sweden. ⋯ The lack of protocols and management strategies for pancreatic pseudocysts is reflected by the heterogeneity in treatment strategies, as seen in the present survey. Therefore patients may be at risk of receiving suboptimal treatment. A tailored therapeutic approach that takes into consideration patient preferences and involves a multidisciplinary team should be considered in all cases.