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Tetsuya Yasunaka - One of the best experts on this subject based on the ideXlab platform.

  • Prevalence and associated factors with Esophageal Varices in early primary biliary cirrhosis.
    Journal of gastroenterology and hepatology, 2012
    Co-Authors: Fusao Ikeda, Ryoichi Okamoto, Nobuyuki Baba, Shin Ichi Fujioka, Bon Shoji, Kazuhisa Yabushita, Masaharu Ando, Shuji Matsumura, Junichi Kubota, Tetsuya Yasunaka
    Abstract:

    Background and Aims:  Recent routine testing for anti-mitochondrial antibodies has increased the number of patients with early primary biliary cirrhosis (PBC). The prevalence and clinical significance of Esophageal Varices in those patients remains obscure. Methods:  A systematic cohort analysis of 256 PBC patients was performed to clarify the prevalence, characteristics, and prognosis of the patients with early PBC and Esophageal Varices. Results:  Twenty-two patients had Esophageal Varices at the time of diagnosis: 5.5% (12/217) with early disease of histological stage 1 or 2, and 25.6% (10/39) with advanced disease of stage 3 or 4. Immediate treatments were required for two patients with early PBC: one for bleeding Varices, and the other for large Varices. The overall survival of the patients with early PBC and Esophageal Varices at diagnosis did not significantly differ from that of patients without Esophageal Varices (P = 0.66). High alkaline phosphatase (ALP) ratios (odds ratio = 2.3) and low platelet counts (odds ratio = 0.77) were significantly associated with the presence of Esophageal Varices in the patients with early PBC. Significant associations of these two factors with the development of Esophageal Varices during follow-up were also revealed (odds ratio = 1.4 and 0.88, respectively). The patients with early PBC and high ALP ratios ≥ 1.9 had significantly high risks of developing Esophageal Varices during follow-up (P = 0.022). Conclusions:  High ALP ratios and low platelet counts at diagnosis and decreased platelet counts during follow-up are useful predictors of Esophageal Varices in patients with early PBC.

Roberto De Franchis - One of the best experts on this subject based on the ideXlab platform.

  • Screening for Esophageal Varices
    Nature reviews. Gastroenterology & hepatology, 2009
    Co-Authors: Roberto De Franchis
    Abstract:

    Two multicenter trials have evaluated the potential of capsule endoscopy as a diagnostic tool for screening and surveillance of Esophageal Varices in cirrhotic patients. Their results are similar and show that capsule endoscopy has good performance characteristics, although it is somewhat inferior to esophagogastroduodenoscopy.

  • Noninvasive diagnosis of Esophageal Varices: is it feasible?
    The American journal of gastroenterology, 2006
    Co-Authors: Roberto De Franchis
    Abstract:

    The possibility of identifying cirrhotic patients with Esophageal Varices by noninvasive means is attractive, because it would allow for the restriction of the performance of screening endoscopy to patients at high risk of having Varices. Over the years, several studies addressing this issue have been performed with little success. The recently proposed platelet count/spleen diameter ratio appears to be the best noninvasive predictor of Esophageal Varices developed so far. However, the available evidence is not yet sufficient to allow for the modification of the current policy of screening cirrhotic patients by endoscopy at the time of diagnosis to detect Varices.

Fusao Ikeda - One of the best experts on this subject based on the ideXlab platform.

  • Prevalence and associated factors with Esophageal Varices in early primary biliary cirrhosis.
    Journal of gastroenterology and hepatology, 2012
    Co-Authors: Fusao Ikeda, Ryoichi Okamoto, Nobuyuki Baba, Shin Ichi Fujioka, Bon Shoji, Kazuhisa Yabushita, Masaharu Ando, Shuji Matsumura, Junichi Kubota, Tetsuya Yasunaka
    Abstract:

    Background and Aims:  Recent routine testing for anti-mitochondrial antibodies has increased the number of patients with early primary biliary cirrhosis (PBC). The prevalence and clinical significance of Esophageal Varices in those patients remains obscure. Methods:  A systematic cohort analysis of 256 PBC patients was performed to clarify the prevalence, characteristics, and prognosis of the patients with early PBC and Esophageal Varices. Results:  Twenty-two patients had Esophageal Varices at the time of diagnosis: 5.5% (12/217) with early disease of histological stage 1 or 2, and 25.6% (10/39) with advanced disease of stage 3 or 4. Immediate treatments were required for two patients with early PBC: one for bleeding Varices, and the other for large Varices. The overall survival of the patients with early PBC and Esophageal Varices at diagnosis did not significantly differ from that of patients without Esophageal Varices (P = 0.66). High alkaline phosphatase (ALP) ratios (odds ratio = 2.3) and low platelet counts (odds ratio = 0.77) were significantly associated with the presence of Esophageal Varices in the patients with early PBC. Significant associations of these two factors with the development of Esophageal Varices during follow-up were also revealed (odds ratio = 1.4 and 0.88, respectively). The patients with early PBC and high ALP ratios ≥ 1.9 had significantly high risks of developing Esophageal Varices during follow-up (P = 0.022). Conclusions:  High ALP ratios and low platelet counts at diagnosis and decreased platelet counts during follow-up are useful predictors of Esophageal Varices in patients with early PBC.

Adil Abdalla - One of the best experts on this subject based on the ideXlab platform.

  • The role of endoscopy in the treatment of Esophageal Varices, 2002-2003.
    Current opinion in gastroenterology, 2003
    Co-Authors: Larry S. Miller, Adil Abdalla
    Abstract:

    Great strides have been made in the endoscopic and radiologic therapy of Esophageal Varices in the past few years. With the advent of variceal band ligation and transjugular intrahepatic portosystemic shunt, almost every acute variceal bleed can be controlled. In addition, over the past decade great strides have been made in the noninvasive imaging and pressure measurement of Esophageal Varices. Yet, the mortality rate from variceal bleeding has not changed significantly and the pharmacologic therapy of Esophageal Varices and the prophylaxis of the initial variceal bleed has lagged behind these other interventional advances. These authors believe that progress in these areas has been slow because the pathophysiology and hemodynamics of Esophageal Varices are not well understood. It is through progress in the areas of endoluminal ultrasound imaging of Esophageal Varices and noninvasive pressure measurement that progress has finally been made in the area of the pathophysiology of variceal bleeding. In this update, two novel ideas regarding the pathophysiology of variceal bleeding are described. The first regards increased variceal pressure during peristaltic contraction. The second describes increased variceal pressure with increasing intraabdominal pressure. These new observations suggest a new pathophysiology in the cause of variceal bleeding and imply new methods to prevent and treat variceal bleeding. This update and review of Esophageal Varices is given in five sections: new developments in the pathophysiology of Esophageal variceal bleeding, screening for Esophageal Varices, prediction of variceal bleeding, treatment of Esophageal Varices and new modalities to evaluate Esophageal Varices.

Steven K. Kappes - One of the best experts on this subject based on the ideXlab platform.