The American journal of gastroenterology
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Am. J. Gastroenterol. · Feb 2009
Review Meta Analysis Comparative StudyRadiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials.
Radiofrequency thermal ablation (RF) and percutaneous ethanol injection (PEI) have been employed in the treatment of small hepatocellular carcinoma (HCC) as curative treatments. The aim of the study was to review the available evidence comparing RF to PEI for small HCC. ⋯ RF ablation is superior to PEI in the treatment of small HCC with respect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3 cancer-free survival rates, and tumor response. RF shows a significantly smaller risk of local recurrence.
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Am. J. Gastroenterol. · Feb 2009
Review Meta AnalysisHelicobacter pylori infection and Barrett's esophagus: a systematic review and meta-analysis.
The majority of distal esophageal adenocarcinomas are believed to arise in patients with Barrett's esophagus (BE). Helicobacter pylori (H. pylori) infection plays an etiological role in gastric carcinogenesis, but any possible role in BE is uncertain. We aimed to explore the possible relationship between H. pylori infection and BE by meta-analysis. ⋯ H. pylori infection and BE are inversely related when compared with endoscopically normal controls but not blood donor controls. Limited evidence suggests that there is no clear association between H. pylori infection and BE. To determine more accurately the effect size of H. pylori infection in BE, high quality prospective case-control studies with age-matched, endoscopically normal healthy controls are needed.
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Am. J. Gastroenterol. · Feb 2009
Comparative Study Clinical TrialAuditory evoked potentials compared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy.
The purpose of this study was to evaluate and compare Bispectral index (BIS) and A-line auditory evoked potential index (AAI) for monitoring depth of low-dose midazolam and propofol sedation during colonoscopy. ⋯ BIS and AAI correlated with the level of sedation. Hemodynamic variables were poor indicators of the hypnotic-anesthetic status of the patient. BIS discriminated best between moderate and deep sedation and could complement clinical observation for guidance of moderate sedation.
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Am. J. Gastroenterol. · Feb 2009
Comparative Study Clinical TrialCentral vs. bilateral endoscopic ultrasound-guided celiac plexus block or neurolysis: a comparative study of short-term effectiveness.
Endoscopic ultrasound (EUS)-guided celiac plexus block/neurolysis (CPB/N) can be performed by injecting at the base (central) or on either side (bilateral) of the celiac axis. Central CPB/N is easier and possibly safer. Bilateral CPB/N is more difficult but may be more effective as it reaches more ganglia. The aim of this study was to compare the short-term safety and efficacy of central and bilateral CPB/N. ⋯ (i) Bilateral CPB/N is more effective than central CPB/N; (ii) bilateral CPB/N is safe, but on rare occasions can cause trauma to the left adrenal artery; it should therefore be avoided in patients with a bleeding diathesis.