The American journal of gastroenterology
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Am. J. Gastroenterol. · Jun 2009
Comparative StudyThe serological profile of the autoimmune hepatitis/primary biliary cirrhosis overlap syndrome.
During the last decade patients with concomitant clinical, biochemical, immunoserological, and histological features of both autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) were sporadically described, but definite diagnostic criteria and specific serological markers to support the diagnosis of AIH/PBC overlap syndrome (AIH/PBC OS) are still lacking. ⋯ Concomitant AMA/anti-dsDNA seropositivity can be considered the serological profile of AIH/PBC OS. The combination of UDCA and steroids is effective in achieving persistent biochemical amelioration in most AIH/PBC OS patients.
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Am. J. Gastroenterol. · Jun 2009
Review Meta AnalysisMeta-analysis of randomized clinical trials comparing open and laparoscopic anti-reflux surgery.
The aim of this study was to conduct a meta-analysis of randomized evidence to determine the relative merits of laparoscopic anti-reflux surgery (LARS) and open anti-reflux surgery (OARS) for proven gastro-esophageal reflux disease (GERD). ⋯ On the basis of this meta-analysis, the authors conclude that LARS is an effective and safe alternative to OARS for the treatment of proven GERD. LARS enables a faster convalescence and return to productive activity, with a reduced risk of complications and a similar treatment outcome, than an open approach. However, there is a significantly higher rate of re-operation (79%) in the LARS group.
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Am. J. Gastroenterol. · Jun 2009
Randomized Controlled Trial Multicenter Study Comparative StudySafety and efficacy of a new 3.3 g b.i.d. tablet formulation in patients with mild-to-moderately-active ulcerative colitis: a multicenter, randomized, double-blind, placebo-controlled study.
To evaluate the safety and efficacy of a new twice-daily balsalazide disodium 1.1 g tablet dosing regimen (6.6 g/day, three tablets twice daily) for the treatment of mild-to-moderately-active ulcerative colitis (UC). ⋯ Balsalazide disodium 1.1 g tablets administered as 3.3 g twice daily are effective, well tolerated and significantly better than placebo for improving signs and symptoms of mild-to-moderately-active UC. This new formulation with a reduced pill and dosing burden offers the potential to improve convenience and compliance in patients with active UC.
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Am. J. Gastroenterol. · Jun 2009
Randomized Controlled Trial Multicenter Study Comparative StudyPerformance of the hepatic encephalopathy scoring algorithm in a clinical trial of patients with cirrhosis and severe hepatic encephalopathy.
The grading of hepatic encephalopathy (HE) is based on a combination of indicators that reflect the state of consciousness, intellectual function, changes in behavior, and neuromuscular alterations seen in patients with liver failure. ⋯ HESA extends the traditional WHC for grading HE. In the absence of a "gold" standard, the most useful indicators noted in this trial should be further validated.
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Am. J. Gastroenterol. · Jun 2009
Comparative Study Clinical TrialNovel removable internally fully covered self-expanding metal esophageal stent: feasibility, technique of removal, and tissue response in humans.
Internally fully covered self-expandable metal stents (FCSEMSs) have recently become available offering the possibility of removal. However, to our knowledge, the feasibility, techniques for endoscopic removal, and tissue reaction to FCSEMS have not been reported in humans. Our aims are (1) to report reasons for and success of FCSEMS removal in consecutive patients, (2) to describe methods of esophageal stent retrieval, and (3) to describe stent reactions induced by FCSEMS in humans. ⋯ FCSEMSs palliate dysphagia from both benign and malignant conditions and seal postoperative tracheoesophageal fistulas and mediastinal leaks. Tissue reaction to the stents was common but remained clinically insignificant in the majority of patients. Close follow-up of patients with FCSEMS is required and repeat endoscopy with stent retrieval might be necessary with the development of new symptoms or complications from the stent.