The aim of this study was to make use of the natural consequences of drug shortages by observing rates of ABP among these regimens, to determine which regimen provided the best bowel prep, and to ...provide data for future inevitable drug shortages and prep changes. There was no statistical difference between PEG-3350 + MC + B and PEG-ELS + B. All regimens performed well and thus practical concerns such as drug availability, cost, shipping, renal function, and other practical factors can be considered when choosing a regimen. Statistical Analysis Comparing Rates of Adequate Bowel Preparation (ABP) Between Varying Bowel Preparation Regimens – Chi-square testing was used to evaluate for statistical significance between the rates of ABP in the various regimens of polyethylene glycol 3350 (PEG-3350) + bisacodyl (B) + magnesium citrate (MC) vs polyethylene glycol electrolyte lavage solution (PEG-ELS) + MC vs PEG-ELS + B Regimen Comparison P-value All regimens 0.02 PEG-3350 + MC + B (94.1%) vs PEG-ELS + MC (91.6%) 0.01 PEG-3350 + MC + B (94.1%) vs PEG-ELS + B (93.7%) 0.69 PEG-ELS + MC (91.6%) vs PEG-ELS + B (93.7%) 0.03 The rates of ABP (in parentheses) varied significantly when comparing PEG-3350 + MC + B vs PEG-ELS + MC and the PEG-ELS + MC vs PEG-ELS + B, and all regimens to each other.
Non-alcoholic fatty liver disease (NAFLD) has been recently identified as a risk factor of gastrointestinal tract cancers, especially hepatocellular carcinoma, and colorectal cancer. Whether NAFLD is ...a risk factor for cholangiocarcinoma (CCA) remains inconclusive. The aim of this study is to determine a potential association between NAFLD and CCA, stratifying by its subtypes; intrahepatic CCA (iCCA), and extrahepatic CCA (eCCA).
A search was conducted for relevant studies published up to April 2017 using MEDLINE, EMBASE, Scopus and Cochrane databases. Odds ratio (OR) and adjusted OR with 95% confidence interval (CI) were estimated using a random-effects model. Subgroup analyses were conducted with study characteristics.
Seven case-control studies were included in the analysis, with a total of 9,102 CCA patients (5,067 iCCA and 4,035 eCCA) and 129,111 controls. Overall, NAFLD was associated with an increased risk for CCA, with pooled OR of 1.95 (95%CI: 1.36-2.79, I
=76%). When classified by subtypes, NAFLD was associated with both iCCA and eCCA, with ORs of 2.22 (95%CI: 1.52-3.24, I
=67%) and 1.55 (95%CI: 1.03-2.33, I
=69%), respectively. The overall pooled adjusted ORs were 1.97 (95%CI: 1.41-2.75, I
=71%), 2.09 (95%CI, 1.49-2.91, I
=42%) and 2.05 (95%CI, 1.59-2.64, I
=0%) for all CCAs, iCCA, and eCCA, respectively.
This meta-analysis suggests that NAFLD may potentially increase the risk of CCA development. The magnitude of NAFLD on CCA risk is greater for iCCA than eCCA subtype, suggestive of a common pathogenesis of iCCA and hepatocellular carcinoma. Further studies to confirm this association are warranted.
The protocol for this study was registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42016046573).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Liver fibrosis is characterized by the activation and migration of hepatic stellate cells (HSCs), followed by matrix deposition. Recently, several studies have shown the importance of extracellular ...vesicles (EVs) derived from liver cells, such as hepatocytes and endothelial cells, in liver pathobiology. While most of the studies describe how liver cells modulate HSC behavior, an important gap exists in the understanding of HSC‐derived signals and more specifically HSC‐derived EVs in liver fibrosis. Here, we investigated the molecules released through HSC‐derived EVs, the mechanism of their release, and the role of these EVs in fibrosis. Mass spectrometric analysis showed that platelet‐derived growth factor (PDGF) receptor‐alpha (PDGFRα) was enriched in EVs derived from PDGF‐BB‐treated HSCs. Moreover, patients with liver fibrosis had increased PDGFRα levels in serum EVs compared to healthy individuals. Mechanistically, in vitro tyrosine720‐to‐phenylalanine mutation on the PDGFRα sequence abolished enrichment of PDGFRα in EVs and redirected the receptor toward degradation. Congruently, the inhibition of Src homology 2 domain tyrosine phosphatase 2, the regulatory binding partner of phosphorylated tyrosine720, also inhibited PDGFRα enrichment in EVs. EVs derived from PDGFRα‐overexpressing cells promoted in vitro HSC migration and in vivo liver fibrosis. Finally, administration of Src homology 2 domain tyrosine phosphatase 2inhibitor, SHP099, to carbon tetrachloride–administered mice inhibited PDGFRα enrichment in serum EVs and reduced liver fibrosis. Conclusion: PDGFRα is enriched in EVs derived from PDGF‐BB‐treated HSCs in an Src homology 2 domain tyrosine phosphatase 2–dependent manner and these PDGFRα‐enriched EVs participate in development of liver fibrosis. (Hepatology 2018;68:333‐348).
...early detection of CRC is an important population health metric. ...there have been several studies reporting inappropriate use of FIT such as FIT for indications other than CRC screening and FIT ...in patients who are not average risk for colorectal cancer. ...in this quality improvement project, we aimed to decrease the number of inappropriate FIT ordered at the Minneapolis VA Medical Center. Pre- and Post-Intervention Patient Demographics and Number of Inappropriate FIT Pre-Intervention Post-Intervention Time Period 1/12/2023 - 4/12/2023 4/13/2023 - 5/12/2023 Number of Patients 125 30 Number of Inappropriate FIT per month 42 30 Age (average +/- SD) 62 (+/- 7) 62 (+/- 9) Smoker (n, %) 25 (2) 5 (17) Gender (n, %) Male 118 (94) 28 (93) Female 7 (6) 2 (7) Race (n, %) White 116 (93) 20 (67) Other 9 (7) 10 (33) FIT Indication (n, %) CRC Screening 107 (85) 28 (93) Anemia 13 (10) 1 (3) GI Bleed 5 (4) 1 (3) Others 0 (0) 0 (0) Comorbidities (n, %) IBD 1 (1) 0 (0) DM 38 (30) 11 (37) Anxiety 25 (20) 12 (40) Depression 38 (30) 12 (40) PTSD 13 (10) 5 (17) Medications (n, %) Aspirin 42 (34) 9 (30) Antiplatelet 4 (3) 2 (7) Anticoagulation 9 (7) 6 (20) Opioid 9 (7) 3 (10) Distance from the hospital (average +/- SD).
Background
Laparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric surgery. Studies have suggested that LSG can provide effective and sustainable weight loss although most of them ...were conducted in Western populations. Our aim was to characterize the midterm outcome of LSG in Asians with obesity.
Methods
MEDLINE and EMBASE were searched through August 2019 for studies that reported % total body weight loss (TBWL) and/or % excess weight loss (EWL) at 3 and/or 5 years among adult Asians with obesity who underwent LSG. Data on complications and surgical revision rate were also extracted. The pooled effect size and 95% confidence interval (CI) were calculated using a random effects model.
Results
A total of 19 studies involving 6235 patients were included. The pooled mean %EWLs were 72.6% (95% CI 67.2–78.0,
I
2
= 97%); 67.1% (95% CI 61.7–72.6,
I
2
= 95%); and 59.1% (95% CI 48.8–69.4,
I
2
= 94%) at 1, 3, and 5 years, respectively. The pooled mean %TBWLs were 32.1%, 29.0%, and 25.5% at 1, 3, and 5 years, respectively. The pooled rates of revision due to gastroesophageal reflux disease and weight regain were 1.9% and 2.5%, respectively.
Conclusions
Our meta-analysis suggests that LSG is an effective procedure for weight reduction that offers durable response for up to 5 years among Asians with obesity. The longer-term data is needed.
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