Introduction: Gastro-oesophageal variceal bleeding is one of the most common and severe complications with high mortality in cirrhotic patients who developed portal hypertension. Hepatic venous pressure gradient (HVPG) is a globally recommended golden standard for the portal pressure assessment and an HVPG ≥16 mm Hg indicates a higher risk of death and rebleeding. This study aims to compare the effectiveness and safety of splenectomy and pericardial devascularisation (laparoscopic therapy) plus propranolol and endoscopic therapy plus propranolol for variceal rebleeding in cirrhotic patients with HVPG between 16 and 20 mm Hg.
Methods And Analysis: This is a multicenter, randomised, controlled clinical trial. Participants will be 1:1 assigned randomly into either laparoscopic or endoscopic groups. Forty participants whose transjugular HVPG lies between 16 and 20 mm Hg with a history of gastro-oesophageal variceal bleeding will be recruited from three sites in China. Participants will receive either endoscopic therapy plus propranolol or laparoscopic therapy plus propranolol. The primary outcome measure will be the occurrence of gastro-oesophageal variceal rebleeding. Secondary outcome measures will include overall survival, occurrence of hepatocellular carcinoma, the occurrence of venous thrombosis, the occurrence of adverse events, quality of life and tolerability of treatment. Outcome measures will be evaluated at baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks and 60 weeks. Multivariate COX regression model will be introduced for analyses of occurrence data and Kaplan-Meier analysis with the log-rank test for intergroup comparison.
Ethics And Dissemination: Ethical approval was obtained from all three participating sites. Primary and secondary outcome data will be submitted for publication in peer-reviewed journals and widely disseminated.
Trial Registration Number: NCT03783065; Pre-results.
Trial Status: Recruitment for this study started in December 2018 while the first participant was randomised in January 2019. Recruitment is estimated to stop in October 2019.
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http://dx.doi.org/10.1136/bmjopen-2019-030960 | DOI Listing |
Sci Rep
January 2025
Department of Plastic Surgery, Jiangxi Provincial Children's Hospital, 1666 Diezihu Avenue, Nanchang, China.
The objective of this study was to evaluate the efficacy and safety of propranolol hydrochloride tablets and oral solution in neonates with severe IHs. A retrospective cohort study included 184 consecutive neonates diagnosed with severe IHs and treated with propranolol from January 2016 to June 2023. Of these, 126 patients received propranolol tablets, and 58 received propranolol oral solution.
View Article and Find Full Text PDFBrain Behav
January 2025
Department of Neurology, Peking University First Hospital, Beijing, China.
Introduction: Cerebral cavernous malformation (CCM) is a type of cerebrovascular abnormality in the central nervous system linked to both germline and somatic genetic mutations. Recent preclinical and clinical studies have shown that various drugs can effectively reduce the burden of CCM lesions. Despite significant progress, the mechanisms driving CCM remain incompletely understood, and to date, no drugs have been developed that can cure or prevent CCM.
View Article and Find Full Text PDFBMJ Open Ophthalmol
December 2024
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Objective: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness in preterm infants with low birth weight. The efficacy and safety of prophylactic agents, including vitamin A, propranolol and lipids, in reducing ROP incidence remain unclear. This systematic review and meta-analysis evaluated the effectiveness and safety of these agents in preventing ROP.
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
December 2024
Department of Pathology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Purpose: This systematic review aims to consolidate evidence on ophthalmological manifestations of angiolymphoid hyperplasia with eosinophilia, focusing on its presentation, diagnosis, and management.
Methods: Preferred reporting items for systematic reviews and meta-analyses-adherent systematic review was conducted across 3 databases from inception until September 2024. Case reports and series detailing angiolymphoid hyperplasia with eosinophilia in ocular structures were included.
J Med Case Rep
December 2024
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Background: This case highlights the management of concomitant acute myocarditis and congenital long QT syndrome with electrical storm and incessant Torsade de Pointes.
Case Presentation: An 18 years-old Southeast Asian para 1 abortus 0 (P1A0) postpartum patient with cesarean section owing to severe preeclampsia, acute lymphocytic myocarditis, and prolonged QT interval owing to long QT syndrome. She has incessant Torsade de Pointes treated with beta-blocker, lidocaine, overdrive pacing with a temporary transvenous pacemaker, left cardiac sympathetic denervation per video-assisted thoracoscopic surgery, and implantable cardioverter-defibrillator implantation.
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