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| 1 | Carvedilol vs endoscopic variceal ligation for primary and secondary prevention of variceal bleeding: Systematic review and metaanalysis显示文摘BACKGROUND Variceal hemorrhage is associated with high mortality and is the cause of death for 20–30%of patients with cirrhosis.Nonselectiveβblockers(NSBBs)or endoscopic variceal ligation(EVL)are recommended for primary prevention of variceal bleeding in patients with medium to large esophageal varices.Meanwhile,combination of EVL and NSBBs is the recommended approach for the secondary prevention.Carvedilol has greater efficacy than other NSBBs as it decreases intrahepatic resistance.We hypothesized that there was no difference between carvedilol and EVL intervention for primary and secondary prevention of variceal bleeding in cirrhosis patients.AIM To evaluate the efficacy of carvedilol compared to EVL for primary and secondary prevention of variceal bleeding in cirrhotic patients METHODS We searched relevant literatures in major journal databases(CENTRAL,MEDLINE,and EMBASE)from March to August 2018.Patients with cirrhosis and portal hypertension,regardless of aetiology and severity,with or without a history of variceal bleeding,and aged≥18 years old were included in this review.Only randomized controlled trials(RCTs)that compared the efficacy of carvedilol and that of EVL for primary and secondary prevention of variceal bleeding and mortality in patients with cirrhosis and portal hypertension were considered,irrespective of publication status,year of publication,and language.RESULTS Seven RCTs were included.In four trials assessing the primary prevention,no significant difference was found on the events of variceal bleeding(RR:0.74,95%CI:0.37-1.49),all-cause mortality(RR:1.10,95%CI:0.76-1.58),and bleedingrelated mortality(RR:1.02,95%CI:0.34-3.10)in patients who were treated with carvedilol compared to EVL.In three trials assessing secondary prevention,there was no difference between two interventions for the incidence of rebleeding(RR:1.10,95%CI:0.75-1.61).The fixed-effect model showed that,compared to EVL,carvedilol decreased all-cause mortality by 49%(RR:0.51,95%CI:0.33-0.79),with little or no evidence of heterogeneity.CONCLUSION Carvedilol had similar efficacy to EVL in preventing the first variceal bleeding in cirrhosis patients with esophageal varices.It was superior to EVL alone for secondary prevention of variceal bleeding in regard to all-cause mortality reduction. | Michael Dwinata David Dwi Putera Muhamad Fajri Adda’i Putra Nur Hidayat Irsan Hasan | 2019 | World Journal of Hepatology2019，11，5： | 6 |
| 2 | Hepatitis B virus subgenotypes and basal core promoter mutations in Indonesia显示文摘AIM:To identify the distribution of hepatitis B virus (HBV) subgenotype and basal core promoter (BCP) mutations among patients with HBV-associated liver disease in Indonesia.METHODS: Patients with chronic hepatitis (CH, n=61), liver cirrhosis (LC, n=62), and hepatocellular carcinoma (HCC,n=48) were included in this study. HBV subgenotype was identified based on S or preS gene sequence, and mutations in the HBx gene including the overlapping BCP region were examined by direct sequencing.RESULTS: HBV genotype B (subgenotypes B2, B3, B4, B5 and B7) the major genotype in the samples, accounted for 75.4%, 71.0% and 75.0% of CH, LC and HCC patients, respectively, while the genotype C (subgenotypes C1, C2 and C3) was detected in 24.6%, 29.0%, and 25.0% of CH, LC, and HCC patients, respectively. Subgenotypes B3 (84.9%) and C1 (82.2%) were the main subgenotype in HBV genotype B and C, respectively. Serotype adw2 (84.9%) and adrq+ (89.4%) were the most prevalent in HBV genotype B and C, respectively. Double mutation (A1762T/G1764A) in the BCP was significantly higher in LC (59.7%) and HCC (54.2%) than in CH (19.7%), suggesting that this mutation was associated with severity of liver disease. The T1753V was also higher in LC (46.8%), but lower in HCC (22.9%) and CH (18.0%), suggesting that this mutation may be an indicator of cirrhosis.CONCLUSION: HBV genotype B/B3 and C/C1 are the major genotypes in Indonesia. Mutations in BCP, such as A1762T/G1764A and T1753V, might have an association with manifestations of liver disease. | Andi Utama Sigit Purwantomo Marlinang Diarta Siburian Rama Dhenni Rino Alvani Gani Irsan Hasan Andri Sanityoso Upik Anderiani Miskad Fardah Akil Irawan Yusuf Wenny Astuti Achwan Soewignjo Soemohardjo Syafruddin AR Lelosutan Ruswhandi Martamala Benyamin Lukito Unggul Budihusodo Laurentius Adrianus Lesmana Ali Sulaiman Susan Tai | 2009 | World Journal of Gastroenterology2009，15，32： | 4 |
| 3 | Vaginal myomectomy using posterior colpotomy:feasibility in normal practice显示文摘 | Agostin iA Deval B B irsan A | 2004 | Eur J Obstet Gynecol Reprod Bio2004，116，： | 1 |
| 4 | Phytoestrogens and cognitive function: a review显示文摘 | Mira Soni Tri Budi W. Rahardjo Rodiyah Soekardi Yenny Sulistyowati Lestariningsih Amina Yesufu-Udechuku Atik Irsan Eef Hogervorst | 2013 | Maturitas2013，，： | 1 |
| 5 | Investigations on the viscoelastic performance of pressure sensitive adhesives in drug-in-adhesive type transdermal films 显示文摘 | WOLFF H M IRSAN DODOU K | 2014 | Pharrn Res2014，31，8： | 1 |
| 6 | RNA-K-Seq of Tumor -Educated Platelets Enables Blood- Based Pan -Canc- er, Muhiclass, and Molecular Pathway Cancer Diagnos- tics 显示文摘 | Best M G Nik S Irsan K | 2015 | Cancer Cell2015，28，5： | 1 |
| 7 | Impact of endoscopic ultrasound examination for deep esophageal collateral veins evaluation in liver cirrhosis patients prior to endoscopic treatment:A case series显示文摘Aim:The presence of esophageal collateral veins(ECV)has been reported to be associated with the recurrence of esophageal varices(EV)and bleeding in liver cirrhotic(LC)patients.This study aimed to see the potential clinical value of deep collateral veins assessment using endoscopic ultrasound(EUS)in liver cirrhotic patients with EV.Methods:During 6 months period,a prospective study is conducted,where we identified LC patients who were admitted for esophagogastroduodenoscopy(EGD)screening at the Department of Internal Medicine,Dr.Cipto Mangunkusumo National General Hospital,Jakarta.ECV was examined using EUS.Patients were excluded if they had(1)liver malignancy,(2)history of ligation or glue injection,or(3)portal or splenic vein thrombus.We collected demographic data,medical history,data pertaining to use of nonselective beta blocker(NSBB),and laboratory,imaging,and endoscopy results.EGD was performed using a gastroscope(EG29‐i10,3.2 mm Pentax Medical)while EUS was performed using a linear array echoendoscope(EG‐3870UTK,3.8 mm,Pentax Medical)before band ligation or glue injection.Results:There were 20 LC patients included in this study,where 15(75%)of patients were classified with Child-Pugh(CP)‐A and five(25%)of patients with CP‐B.The most common aetiologies were hepatitis B in seven(35%)patients and hepatitis C in nine(45%)patients.The EV with peri‐or para‐esophageal veins(PEEV or PAEV)were detected in 65%of patients.None of the LC patients with no EV showed the presence of ECV.PEEV or PAEV were detected in grades 1-3 EV.Conclusion:EUS examination can give a better evaluation before managing gastroesophageal varices through deep ECV detection in LC patients. | Cosmas Rinaldi A.Lesmana Saut H.Nababan Kemal F.Kalista Juferdy Kurniawan Chyntia O.M.Jasirwan Andri S.Sulaiman Irsan Hasan Rino A.Gani | 2022 | Portal Hypertension & Cirrhosis2022，1，1： | 0 |
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