[Simultaneous Quadruple Therapy In The Treatment Of Helicobacter Pylori During Peptic Ulcer Disease].

Unlabelled: Helicobacter pylori (Hp) infection plays an important role in the genesis of peptic ulcer disease. In the absence of susceptibility testing, concomitant quadruple therapy is one of the most widely used eradication methods. In the absence of a study on four-drug therapy and the difficulty of studying antibiotic susceptibility in our context, we initiated this work in order to evaluate the efficacy of an empirical treatment with concomitant four-drug therapy currently available.

The combination of a blood test and Fibroscan improves the non-invasive diagnosis of liver fibrosis.

Background And Aims: Blood tests and liver stiffness evaluation (LSE) by ultrasonographic elastometry are accurate tools for diagnosing liver fibrosis. We evaluated whether their synchronous combination in new scores could improve the diagnostic accuracy and reduce liver biopsy requirement in algorithm.

Methods: Three hundred and ninety patients with chronic liver disease of miscellaneous causes were included.

Reproducibility of liver stiffness measurement by ultrasonographic elastometry.

Background & Aims: Fibroscan is a noninvasive device that assesses liver fibrosis by liver stiffness evaluation (LSE) with ultrasonographic elastometry. We evaluated LSE reproducibility and its influencing factors.

Methods: LSE was performed by 4 experienced physicians (>100 LSEs) in 46 patients with chronic liver disease at 4 different anatomic sites.

Learning curve and interobserver reproducibility evaluation of liver stiffness measurement by transient elastography.

Background/aims: Fibroscan allows liver stiffness examination (LSE) that is well correlated with fibrosis stages. Our main objective was to evaluate LSE learning curve.

Methods: LSE results of five novice observers with different medical status were compared with those of five expert observers (physicians with >100 examinations) in 250 patients with chronic liver disease.

Direct percutaneous approach for endoluminal glue embolization of stomal varices.

The present report describes the authors' experience with direct endoluminal embolization for bleeding stomal varices. Between December 1998 and July 2006, seven patients with enterostomies, portal hypertension, and recurrent stomal variceal bleeding resistant to medical treatment were treated at a single institution. Ultrasonography was used to guide direct puncture of the varices.

Reproducibility of blood tests of liver fibrosis in clinical practice.

Objectives: To evaluate the inter-laboratory reproducibility of blood test for liver fibrosis: FibroMeter, Fibrotest, APRI and their composites variables.

Design And Methods: Four studies, including 147 patients, were performed: study #1 included 2 metachronous blood samples and 2 laboratories; studies #2, #3 and #4 included synchronous samples with assays delayed at day 1 in 12 laboratories, at day 0 in 10 laboratories and at day 0 or 1 in 2 laboratories, respectively. Agreement was evaluated by the intraclass correlation coefficient (r(ic)).

[Stomal varices treated by glue embolization].

In patients with cirrhosis and enterostomy, although bleeding stomal varices are rare, they can been severe and difficult to be treat. We report the first two cases of bleeding stomal varices treated by cyanoacrylate embolization, in patients with cirrhosis and colostomy. In each case, after pharmacological treatment of portal hypertension (propranolol) failed, embolization of the stomal varices by transdermal injection of biological glue effectively stopped the bleeding, without recurrence or side effects, after 8 and 16 months of follow-up.

[Non-invasive diagnosis of portal hypertension in cirrhosis. Application to the primary prevention of varices].

One of the major complications of cirrhosis is the occurrence of portal hypertension and esophageal varices. At present, universal endoscopic screening of esophageal varices is recommended in association to primary prophylaxis in patients at high risk of variceal bleeding. But this screening is invasive and could be not cost-effective.

A novel panel of blood markers to assess the degree of liver fibrosis.

The objective was to develop new blood tests to characterize different fibrosis parameters in viral and alcoholic chronic liver diseases. Measurements included 51 blood markers and Fibrotest, Fibrospect, ELFG, APRI, and Forns scores. The clinically significant fibrosis was evaluated via Metavir staging (F2-F4), and image analysis was used to determine the area of fibrosis.