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  • 1
    Language: English
    In: Gastroenterology, May 2010, Vol.138(5), pp.1667, 2025
    Keywords: Alphapapillomavirus -- Isolation & Purification ; Anus Diseases -- Virology ; Anus Neoplasms -- Virology ; Carcinoma, Squamous Cell -- Virology ; Condylomata Acuminata -- Virology ; Hypercalcemia -- Virology ; Papillomavirus Infections -- Virology ; Paraneoplastic Syndromes -- Virology
    E-ISSN: 1528-0012
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  • 2
    Language: English
    In: Gastroenterology, 2011, Vol.141(6), pp.e1-e2
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 3
    Language: English
    In: Gastroenterology, 2010, Vol.138(5), pp.1667,2025-1667,2025
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
    Source: ScienceDirect Journals (Elsevier)
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  • 4
    Language: English
    In: Gastroenterology, 2010, Vol.139(4), pp.e5-e7
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 5
    Language: English
    In: World journal of gastroenterology, 07 March 2013, Vol.19(9), pp.1424-37
    Description: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/T1b esophageal neoplasms. A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane Library, from 1997 up to January 2011 was performed. An analysis was carried out, pooling the effects of outcomes of 4241 patients enrolled in 80 retrospective studies. For comparisons across studies, each reporting on only one endoscopic method, we used a random effects meta-regression of the log-odds of the outcome of treatment in each study. "Neural networks" as a data mining technique was employed in order to establish a prediction model of lymph node status in superficial submucosal esophageal carcinoma. Another data mining technique, the "feature selection and root cause analysis", was used to identify the most important predictors of local recurrence and metachronous cancer development in endoscopically resected patients, and lymph node positivity in squamous carcinoma (SCC) and adenocarcinoma (ADC) separately in surgically resected patients. Endoscopically resected patients: Low grade dysplasia was observed in 4% of patients, high grade dysplasia in 14.6%, carcinoma in situ in 19%, mucosal cancer in 54%, and submucosal cancer in 16% of patients. There were no significant differences between endoscopic mucosal resection and endoscopic submucosal dissection (ESD) for the following parameters: complications, patients submitted to surgery, positive margins, lymph node positivity, local recurrence and metachronous cancer. With regard to piecemeal resection, ESD performed better since the number of cases was significantly less [coefficient: -7.709438, 95%CI: (-11.03803, -4.380844), P 〈 0.001]; hence local recurrence rates were significantly lower [coefficient: -4.033528, 95%CI: (-6.151498, -1.915559), P 〈 0.01]. A higher rate of esophageal stenosis was observed following ESD [coefficient: 7.322266, 95%CI: (3.810146, 10.83439), P 〈 0.001]. A significantly greater number of SCC patients were submitted to surgery (log-odds, ADC: -2.1206 ± 0.6249 vs SCC: 4.1356 ± 0.4038, P 〈 0.05). The odds for re-classification of tumor stage after endoscopic resection were 53% and 39% for ADC and SCC, respectively. Local tumor recurrence was best predicted by grade 3 differentiation and piecemeal resection, metachronous cancer development by the carcinoma in situ component, and lymph node positivity by lymphovascular invasion. With regard to surgically resected patients: Significant differences in patients with positive lymph nodes were observed between ADC and SCC [coefficient: 1.889569, 95%CI: (0.3945146, 3.384624), P 〈 0.01). In contrast, lymphovascular and microvascular invasion and grade 3 patients between histologic types were comparable, the respective rank order of the predictors of lymph node positivity was: Grade 3, lymphovascular invasion (L+), microvascular invasion (V+), submucosal (Sm) 3 invasion, Sm2 invasion and Sm1 invasion. Histologic type (ADC/SCC) was not included in the model. The best predictors for SCC lymph node positivity were Sm3 invasion and (V+). For ADC, the most important predictor was (L+). Local tumor recurrence is predicted by grade 3, metachronous cancer by the carcinoma in-situ component, and lymph node positivity by L+. T1b cancer should be treated with surgical resection.
    Keywords: Adenocarcinoma ; Controversies in Treatment ; Deep Third Submucosal Layer ; Dysplasia ; Endoscopic Gastrointestinal Surgery ; Endoscopic Gastrointestinal Surgical Procedures ; Endoscopic Resection ; Esophageal Cancer ; Lymph Node Dissection ; Lymphatic Invasion ; Middle Third Submucosal Layer ; Mucosal Infiltration ; Recurrent Tumor ; Squamous Cell Carcinoma ; Submucosal Involvement ; Submucosal Layer ; Superficial Esophageal Cancer ; Superficial Submucosal Layer ; Vascular Invasion ; Esophagoscopy ; Carcinoma -- Surgery ; Esophageal Neoplasms -- Surgery ; Esophagectomy -- Methods
    ISSN: 10079327
    E-ISSN: 2219-2840
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  • 6
    Language: English
    In: World journal of gastroenterology, 21 August 2014, Vol.20(31), pp.10703-14
    Description: Thirty-six randomized controlled trials and two meta-analyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation (OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroid-free groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.
    Keywords: Evidence Based ; Hepatitis C Virus Recurrence ; Liver Transplantation ; Meta-Analysis ; Orthotopic Liver Transplantation ; Steroid Withdrawal ; Liver Transplantation ; Adrenal Cortex Hormones -- Therapeutic Use ; Graft Rejection -- Prevention & Control ; Graft Survival -- Drug Effects ; Immunosuppressive Agents -- Therapeutic Use
    ISSN: 10079327
    E-ISSN: 2219-2840
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  • 7
    Language: English
    In: Expert Review of Anticancer Therapy, 01 April 2011, Vol.11(4), pp.601-612
    Description: Lymph node status is the most important single prognostic factor in esophageal cancer. The detection of involved lymph nodes is therefore the key to cure. This article will provide a meta-analysis and metaregression analysis on the diagnostic performances of current lymph node-detection devices; discuss the recent status of the sentinel lymph node concept in esophageal cancer by the two sentinel node-mapping procedures (the radio-guided and the blue dye techniques) and the developing computed tomography (CT) lymphography; discuss the detection of micrometastases; and the potential clinical application of molecular-based patients' profiles. Combined use of endoscopic ultrasonography fine-needle aspiration and CT significantly improves the diagnostic performance for regional lymph node metastases. Endoscopic ultrasonography is highly sensitive and specific for celiac lymph node metastases, while CT should mostly be performed in order to exclude other abdominal lymph node metastases. Sentinel lymph node navigation may be feasible for cT1N0 or cT2N0 esophageal cancer, and immunohistochemical staining of micrometastatic disease might be feasible in combination with this modality.
    Keywords: Esophageal Cancer ; Imaging Devices ; Lymph Node Metastasis ; Meta-Analysis ; Micrometastasis ; Molecular Markers ; Sentinel Lymph Node Navigation ; Systematic Review ; Medicine
    ISSN: 1473-7140
    E-ISSN: 1744-8328
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  • 8
    Language: English
    In: Surgical endoscopy, July 2013, Vol.27(7), pp.2526-41
    Description: The aim of this study is to evaluate the most cost-effective treatment strategy using preperitoneal mesh for patients with recurrent inguinal hernia. Currently, the issue of cost-effectiveness is entirely unresolved. A decision analysis was carried out based on the results of a systematic literature review of articles concerning recurrent inguinal hernia repair that were published between 1979 and 2011. A virtual cohort was programmed to undergo three different treatment procedures: (1) laparoscopic totally extraperitoneal hernia repair (TEP), (2) open preperitoneal mesh repair according to Stoppa, and (3) open preperitoneal mesh repair according to Nyhus. We carried out a base-case analysis and varied all variables over a broad range of reasonable hypotheses in multiple one-way and two-way sensitivity analyses. The average cost-effectiveness ratio of Nyhus, Stoppa, and TEP per quality-adjusted life year was US $ ($)1,942, $1,948, and $2,011, respectively. In terms of the incremental cost-effectiveness ratio (ICER), Stoppa was dominated. The choice between TEP or Nyhus procedure depends on the combination of a specific center's rates of recurrence and morbidity as disclosed by three-way sensitivity analysis. Nyhus and TEP repairs are possible optimal choices depending primarily on the institution's rates of recurrence and morbidity. Based on our net benefit-related decision analysis, a hypothetical "fixed budget trade-off" suggests potential annual incremental health system cost savings of $200,000 attained by shifting care for 1,000 patients from TEP to Nyhus repair (depending on clinical end-points, which is a decisive factor).
    Keywords: Decision Trees ; Surgical Mesh ; Hernia, Inguinal -- Economics ; Laparoscopy -- Economics
    ISSN: 09302794
    E-ISSN: 1432-2218
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  • 9
    In: Plastic and Reconstructive Surgery, 2010, Vol.126(4), pp.195e-197e
    Keywords: Breast Neoplasms -- Surgery ; Mastectomy, Segmental -- Methods ; Minimally Invasive Surgical Procedures -- Methods ; Wound Healing -- Physiology;
    ISSN: 0032-1052
    E-ISSN: 15294242
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  • 10
    Language: English
    In: Expert Review of Anticancer Therapy, 01 September 2010, Vol.10(9), pp.1345-1347
    Keywords: Endoscopic Resection ; Endoscopic Submucosal Dissection ; Radical Oncologic Surgery ; Superficial Esophageal Cancer ; Medicine
    ISSN: 1473-7140
    E-ISSN: 1744-8328
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