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| 1 | Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly显示文摘AIM: To characterize the effects of age on clinical presentations and endoscopic diagnoses and to determine outcomes after endoscopic therapy among patients aged ≥ 65 years admitted for acute upper gastrointestinal bleeding (UGIB) compared with those aged < 65 years. METHODS: Medical records and an endoscopy data-base of 526 consecutive patients with overt UGIB admitted during 2007-2009 were reviewed. The initial presentations and clinical course within 30 d after endoscopy were obtained. RESULTS: A total of 235 patients aged ≥ 65 years constituted the elderly population (mean age of 74.2 ± 6.7 years, 63% male). Compared to young patients, the elderly patients were more likely to present with melena (53% vs 30%, respectively; P < 0.001), have comorbidities (69% vs 54%, respectively; P < 0.001), and receive antiplatelet agents (39% vs 10%, respectively; P < 0.001). Interestingly, hemodynamic instability was observed less in this group (49% vs 68%, respectively; P < 0.001). Peptic ulcer was the leading cause of UGIB in the elderly patients, followed by varices and gastropathy. The elderly and young patients had a similar clinical course with regard to the utilization of endoscopic therapy, requirement for transfusion, duration of hospital stay, need for surgery [relative risk (RR), 0.31; 95% confidence interval (CI), 0.03-2.75; P = 0.26], rebleeding (RR, 1.44; 95% CI, 0.92-2.25; P = 0.11), and mortality (RR, 1.10; 95% CI, 0.57-2.11; P = 0.77). In Cox's regression analysis, hemodynamic instability at presentation, background of liver cirrhosis or disseminated malignancy, transfusion requirement, and development of rebleeding were significantly associated with 30-d mortality. CONCLUSION: Despite multiple comorbidities and the concomitant use of antiplatelets in the elderly patients, advanced age does not appear to influence adverse outcomes of acute UGIB after therapeutic endoscopy. | Phunchai Charatcharoenwitthaya Nonthalee Pausawasdi Nuttiya Laosanguaneak Jakkrapan Bubthamala Tawesak Tanwandee Somchai Leelakusolvong | 2011 | World Journal of Gastroenterology2011，17，32： | 14 |
| 2 | Yield,etiologies and outcomes of capsule endoscopy in Thai patients with obscure gastrointestinal bleeding显示文摘AIM:To investigate the yield,etiologies and impact of capsule endoscopy(CE) in Thai patients with obscure gastrointestinal bleeding(OGIB).METHODS:The present study is a retrospective cohort study.All patients with OGIB who underwent CE in Siriraj Hospital,Bangkok,Thailand during 2005-2009 were included in the study.All the patients' medical records and results of the CE videos were reviewed.CE findings were classified as significant,suspicious/equivocal and negative.Sites of the lesions were located to duodenum,jejunum,jejunoileum,ileum and diffuse lesions by the localization device of the CE.Impact of CE on the patients' management was defined by any investigation or treatment given to the patients that was more than an iron supplement or blood transfusion.Patients' outcomes(rebleeding,persistent bleeding,anemia or requirement of blood transfusion) were collected from chart reviews and direct phone interviews with the patients.RESULTS:Overall,there were 103 patients with OGIB included in the study.Mean age of the patients was 64 ± 16 years(range 9-88 years) and 57 patients(55%) were male.Types of OGIB were overt in 80(78%) and occult in 23 patients(22%).The median time interval of CE after onset of OGIB was 10 d(range 1-180 d).The median time of follow-up was 19 mo(range 1-54 mo).Capsules reached caecum in 77 patients(74%) and capsule retention was found in 1 patient(1%).The diagnostic yield of CE revealed significant lesions in 37 patients(36%),suspicious/equivocal lesions in 15 patients(15%) and 51 patients(49%) had negative CE result.Among the significant lesions,the bleeding etiologies were small bowel ulcers in 44%,angiodysplasia in 27%,small bowel tumor in 13%,miscellaneous in 8% and active bleeding without identifiable causes in 8%.Patients with small bowel ulcers were significantly associated with the use of non-steroidal anti-inflammatory drugs(48%,P = 0.034),while patients with small bowel tumors were more commonly female(86%,P = 0.043) compared to the other etiologies.The rate of rebleeding,persistent bleeding or anemia in patients with positive,equivocal and negative CE results were 5%,0% and 18%,respectively(P = 0.078).All the 9 patients with rebleeding after negative CE were subsequently found to be from hematologic disorders(4),colonic diverticulosis(2),colonic Dieulafoy's(1),hemorrhoid(1) and hemosuccus pancreaticus(1).Results of CE had a positive impact on the patients' management in 35% of the patients whose results were positive,but none on the patients whose results were equivocal or negative CE(P < 0.001).CONCLUSION:In Thai OGIB patients,CE had low yield and small bowel ulcer was most common.Positive CE impacted managements and outcomes.Negative CE caused low rebleeding. | Supot Pongprasobchai Songla Chitsaeng Tawesak Tanwandee Sathaporn Manatsathit Udom Kachintorn | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，3： | 8 |
| 3 | Randomized clinical trial: efficacy and safety of telbivudine and lamivudine in treatment‐na?ve patients with HBV‐related decompensated cirrhosis显示文摘 | H. L.Y. Chan Y. C. Chen E. J. Gane S. K. Sarin D. J. Suh T. Piratvisuth B. Prabhakar S. G. Hwang G. Choudhuri R. Safadi T. Tanwandee A. Chutaputti C. Yurdaydin W. Bao C. Avila A. Trylesinski | 2012 | Journal of Viral Hepatitis2012，，10： | 3 |
| 4 | Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma ( EPOIHCC )显示文摘 | Joong‐Won Park Deepak Amarapurkar Yee Chao Pei‐Jer Chen Jean‐Francois H. Geschwind Khean Lee Goh Kwang‐Hyub Han Masatoshi Kudo Han Chu Lee Rheun‐Chuan Lee Laurentius A. Lesmana Ho Yeong Lim Seung Woon Paik Ronnie T Poon Chee‐Kiat Tan Tawesak Tanwandee Gao | 2013 | Liver Int2013，，3： | 2 |
| 5 | Hepatitis C genotype 6:A concise review and response-guided therapy proposal显示文摘Hepatitis C genotype 6 is endemic in Southeast Asia[prevalence varies between 10%-60% among all hepatitis C virus(HCV) infection], as well as also sporadically reported outside the area among immigrations.The diagnosis of HCV genotype can be inaccurate with earlier methods of genotyping due to identical 5'-UTR between genotype 6 and 1b, hence the newer genotyping methods with core sequencing are preferred.Risk factors and clinical course of HCV genotype 6 do not differ considerably from other genotypes. Treatment outcome of HCV genotype 6 with a combination of pegylated interferon and ribavirin is superior to genotype 1, and nearly comparable to genotype 3, with expected sustained virological response(SVR) rates of 60%-90%. Emerging data suggests that a shorter course 24-wk treatment is equally effective as a standard 48-wk treatment, particularly for those patients who attained undetectable HCV RNA at week 4(RVR).In addition, baseline and on-treatment predictors of response used for other HCV genotypes appear effective with genotype 6. Although some pan-genotypic directacting antivirals have completed phase Ⅱ/Ⅲ studies(sofosbuvir and simeprevir) with clinical benefit demonstrated in small number of patients with genotype6, broad availability of these agents in Southeast Asia may not be expected in the near future. While awaiting the newer therapy, response-guided therapy seems appropriate for patients with HCV genotype 6. Patients with RVR(representing>70% of patients) are suitable for 24-wk treatment with expected SVR rates>80%. Patients without RVR and/or those with poor response predictors may benefit from 48 wk of therapy,and a detectable HCV RNA at week 12(with no early virological response) serves as a stopping rule. This treatment scheme is likely to have a major economic impact on HCV therapy, particularly in Southeast Asia,wherein treatment can be truncated securely in the majority of patients with HCV genotype 6. | Chalermrat Bunchorntavakul Disaya Chavalitdhamrong Tawesak Tanwandee | 2013 | World Journal of Hepatology2013，5，9： | 2 |
| 6 | Long-term outcomes of chronic hepatitis C patients with sustained virological response at 6 months after the end of treatment显示文摘AIM: To assess the clinical, biochemical, and virological outcome during long-term follow-up of chronic hepatitis C patients with sustained virological response following effective antiviral therapy.METHODS: This study was a retrospective cohort study including 171 sustained responders defi ned as HCV RNA PCR negative at 6 mo after the end of effective antiviral treatment (SVR-6). Clinical signs and symptoms, bio- chemical hepatic parameters, ultrasonography and HCV RNA PCR were followed.RESULTS: Mean follow-up period was 35.38 ± 22.2 mo after the end of treatment. Twenty-seven (15.8%) responders had evidence of cirrhosis before treatment. Forty-eight (28.1%), 107 (62.6%) and 6 (3.5%) patients were genotype 1, 3, and 6 respectively, while 10 patients (5.8%) were unclassifi ed. There were no virological and biochemical relapses during the period of follow-up. None of the patients showed evidence of hepatic decom- pensation. However, there were 3 patients (1.8%) de- veloping hepatocellular carcinoma at 14, 18, 29 mo after treatment discontinuation, two of whom had evidence of cirrhosis prior to therapy.CONCLUSION: The study shows that during a follow- up interval for about 3 years in 171 chronic hepatitis C patients with sustained viral response after effective antiviral treatment there were no evident signs of either biochemical or clinical relapse of liver disease in all but three patients who developed hepatocellular carcinoma. | Disaya Chavalitdhamrong Tawesak Tanwandee | 2006 | World Journal of Gastroenterology2006，12，34： | 2 |
| 7 | Prognostic Relevance of Metabolic Dysfunction-associated Steatohepatitis for Patients with Chronic Hepatitis B显示文摘Background and Aims:Metabolic dysfunction-associated fatty liver disease(MAFLD)is prevalent in patients with chronic hepatitis B(CHB).The effect of the histologic MAFLD phenotype on long-term CHB outcomes is unknown.We performed a longitudinal study to determine the prognostic relevance of biopsy-proven hepatic steatosis and steatohepatitis for CHB patients.Methods:Clinical and laboratory data were obtained from CHB patients who underwent liver biopsy during 2002–2008 and were treated with antiviral drugs.A hepatopathologist reviewed the biopsy specimens.Cox proportional hazards regression was used to estimate the adjusted hazard ratio(aHR)of outcomes,including all-cause mortality,liver transplantation,and liver-related events.Results:In accordance with Brunt’s classification,408 patients had steatohepatitis(n=34),“steatosis but not steatohepatitis”(n=118),or“non-steatosis”(n=256).All steatohepatitis patients had features of metabolic dysfunction.Over a mean follow-up of 13.8±3.1 years,18 patients died or underwent liver transplantation.In multivariate-adjusted analysis,steatohepatitis(aHR,6.37;95%confidence interval[CI]:1.59–25.5)compared with non-steatosis and advanced fibrosis(aHR,11.3;95%CI:1.32–96.3)compared with no fibrosis were associated with overall mortality/liver transplantation.Thirty-five patients developed 43 liver-related events,among which 32 were hepatocellular carcinoma.These events were associated with steatohepatitis(aHR,5.55;95%CI:2.01–15.3)compared with non-steatosis and advanced fibrosis(aHR,6.23;95%CI:1.75–22.2)compared with no fibrosis.The steatosis but not steatohepatitis group had a nonsignificantly higher risk of overall mortality and liver-related events.Conclusions:Metabolic dysfunction-associated steatohepatitis increased the risk of long-term mortality/transplantation and liver-related events in CHB patients. | Manus Rugivarodom Ananya Pongpaibul Siwaporn Chainuvati Supot Nimanong Watcharasak Chotiyaputta Tawesak Tanwandee Phunchai Charatcharoenwitthaya | 2023 | Journal of Clinical and Translational Hepatology2023，11，1： | 2 |
| 8 | Sustained response to peginterferon alfa-2a (40?kD) with or without lamivudine in Asian patients with HBeAg-positive and HBeAg-negative chronic hepatitis B显示文摘 | Teerha Piratvisuth George Lau You-Chen Chao Rui Jin Anuchit Chutaputti Q.-B. Zhang Tawesak Tanwandee Peter Button Matei Popescu | 2008 | Hepatology International2008，，1： | 1 |
| 9 | NEPTUNE Study: On-treatment HBsAg level analysis confirms prediction of response observed in phase 3 study of peginterferon alfa-2a in HBeAg-positive patients 显示文摘 | Gane E Jia J Han K Tanwandee T Chuang WL Marcellin P Chan HL Piratvisuth T Wat C Martins E Liaw YF | 2011 | J Hepatol2011，54，： | 1 |
| 10 | Shorter durations and lower doses of peginterferon alfa‐2a are associated with inferior hepatitis B e antigen seroconversion rates in hepatitis B virus genotypes B or C显示文摘 | Y.‐F. Liaw J.‐D. Jia H.L.Y. Chan K.H. Han T. Tanwandee W.L. Chuang D.M. Tan X.Y. Chen E. Gane T. Piratvisuth L. Chen Q. Xie J.J.Y. Sung C. Wat C. Bernaards Y. Cui P. Marcellin | 2011 | Hepatology2011，，： | 1 |
| 11 | Association between HLA class Ⅱ alleles and autoimmune hepatitis type 1 in Thai patients显示文摘 | Tanwandee T Wanichapol S Vejbaesya S | | 0，，： | 1 |
| 12 | Randomized clinical trial: efficacy and safety of telbivudine and lamivudine in treatment‐na?ve patients with HBV‐related decompensated cirrhosis显示文摘 | H. L.Y. Chan Y. C. Chen E. J. Gane S. K. Sarin D. J. Suh T. Piratvisuth B. Prabhakar S. G. Hwang G. Choudhuri R. Safadi T. Tanwandee A. Chutaputti C. Yurdaydin W. Bao C. Avila A. Trylesinski | 2012 | Journal of Viral Hepatitis2012，，10： | 1 |
| 13 | Brivanib as adjuvant therapy to transarterial chemoembolization in patients with hepatocellular carcinoma: A randomized phase III trial显示文摘 | Masatoshi Kudo Guohong Han Richard S. Finn Ronnie T.P. Poon Jean‐Frederic Blanc Lunan Yan Jijin Yang Ligong Lu Won‐Young Tak Xiaoping Yu Joon‐Hyeok Lee Shi‐Ming Lin Changping Wu Tawesak Tanwandee Guoliang Shao Ian B. Walters Christine Dela Cruz Valerie Po | 2014 | Hepatology2014，，5： | 1 |
| 14 | Randomized clinical trial: efficacy and safety of telbivudine and lamivudine in treatment‐na?ve patients with HBV‐related decompensated cirrhosis显示文摘 | H. L.Y. Chan Y. C. Chen E. J. Gane S. K. Sarin D. J. Suh T. Piratvisuth B. Prabhakar S. G. Hwang G. Choudhuri R. Safadi T. Tanwandee A. Chutaputti C. Yurdaydin W. Bao C. Avila A. Trylesinski | 2012 | Journal of Viral Hepatitis2012，，10： | 1 |
| 15 | Antiviral activity of TMC435 monotherapy in patients infected with HCV genotypes 2-6: TMC435- C 202, a phase IIa, open-label study 显示文摘 | Moreno C Berg T Tanwandee T | 2012 | J Hepatol2012，56，6： | 1 |
| 16 | A cost-utility analysis of drug treatments in patients with HBeAg-positive chronic hepatitis B in Thailand显示文摘 | Tantai N Chaikledkaew U Tanwandee T | 2014 | Bmc Health Serv Res2014，14，54： | 1 |
| 17 | 52-week efficacyand safety of telbivudine with conditional tenofovir intensification at week 24 in HBeAg-positive chronic hepatitis B 显示文摘 | Piratvisuth T Komolmit P Tanwandee T | 2013 | PLoS Orre2013，8，54： | 1 |
| 18 | Sustained response to peginterferon alfa-2a (40?kD) with or without lamivudine in Asian patients with HBeAg-positive and HBeAg-negative chronic hepatitis B显示文摘 | Teerha Piratvisuth George Lau You-Chen Chao Rui Jin Anuchit Chutaputti Q.-B. Zhang Tawesak Tanwandee Peter Button Matei Popescu | 2008 | Hepatology International2008，，1： | 1 |
| 19 | Hepatocellular carcinoma screening and surveillance in 2293 chronic hepatitis B patients in an endemic area显示文摘AIM To determine the role of screening and surveillance of hepatocellular carcinoma(HCC) in treatment-na?ve chronic hepatitis B(CHB) patients. METHODS We recruited 2293 CHB patients(both males and females; aged 20-65 years). All patients were screened and underwent surveillance using abdominal ultrasonography(AUS) and serum alpha-fetoprotein(AFP) assay every 6 mo. The diagnosis,staging and treatment of HCC followed the American Association for the Study of Liver Diseases practice guidelines and the Barcelona Clinic Liver Cancer guidelines. The exclusion criteria included: decompensated cirrhosis; a history of any cancer in the last 5 years; previous antiviral treatment for CHB; concurrent infection with hepatitis C virus or human immunodeficiency virus; a Karnofsky Performance Status score < 60%; or any medical condition preventing eligibility to complete the protocol. The prevalence and incidence rates of HCC were determined; survival rates were calculated at 3-year post HCC diagnosis. The sensitivity and specificity were calculated on a per-patient basis.RESULTS Among 2293 treatment-na?ve CHB patients,seven cases had HCC at initial screening,giving a prevalence rate of 305 per 100000 persons; 3.3% were diagnosed with liver cirrhosis,all of which were Child-Pugh class A. With a median follow-up time of 42(range,3-48) mo,10 additional cases were diagnosed with HCC,resulting in an incidence rate of 143 per 100000 persons per year. This burden was as high as that reported in other studies from East Asian countries. All HCC patients were aged ≥ 40 years. Most were at an early stage(Stage 0,A or B); 14/17 cases were successfully treated with surgical resection or radiofrequency ablation,with a high 3-year survival rate of 90%. Hemangioma was the most common focal liver lesion in CHB patients detected by AUS; the main causes of AFP elevation at the initial screening were cirrhosis,increased alanine aminotransferase level and HCC. AUS detected 16/17 HCC cases whereas AFP levels ≥ 20 mg/L at diagnosis were observed in only 7/17 patients,most with a tumor size > 5 cm. For HCC screening and surveillance,AUS had a sensitivity and specificity of 94% and 82%,respectively,whereas the sensitivity and specificity of AFP at a cut-off value of ≥ 20 mg/L were 41% and 98%,respectively. Combined use of AUS and AFP assay did not improve effectiveness. CONCLUSION Implementation of active screening and surveillance using AUS to detect early-stage HCC in na?ve CHB patients aged ≥ 40 years in an endemic area is of benefit. | Teerapat Ungtrakul Chulabhorn Mahidol Pattra Chun-on Charlie Laohapand Surachate Siripongsakun Akeanong Worakitsitisatorn Sirachat Vidhayakorn Wariya Boonchuay Jiraporn Dechma Gaidganok Sornsamdang Kamonwan Soonklang Tassanee Sriprayoon Tawesak Tanwandee Chirayu U Auewarakul | 2016 | World Journal of Gastroenterology2016，22，34： | 1 |
| 20 | 慢性丙型肝炎特殊人群的治疗显示文摘本视频重点介绍并发肾脏疾病的丙型肝炎患者、HCV/HIV 共感染者和失代偿期肝病的丙型肝炎此三类慢性丙型肝炎特殊类患者的治疗。提出HCV 感染可能导致肾脏疾病或与肾脏疾病恶化相关,介绍血液透析患者的聚乙二醇化干扰素+利巴韦林治疗的疗效分析。关于HCV/HIV 共感染者的治疗推荐意见为HCV/HIV 共感染者抗HCV 治疗适应证与HCV 感染者相同,在CD4+ T 细胞计数较低(< 200 个/μl)患者中,ART 应迅速启动,HCV治疗可能会延迟直至患者对HIV 治疗稳定。失代偿期肝硬化的丙型肝炎患者(肝移植前或移植失败)的治疗方案较无肝硬化或代偿性肝硬化的患者更为有限,不推荐使用蛋白酶抑制剂。 | Tawesak TANWANDEE | 2019 | 中华实验和临床感染病杂志(电子版)2019，13，3： | 0 |
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