3 research outputs found
AΡΠΎΡΠΈΡΠ°ΡΠΈΡΠ° Π½Π° ΠΏΠ»Π°Π·ΠΌΠ° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΡΠΎ ΡΡΠ°Π΄ΠΈΡΠΌΠΈΡΠ΅ Π½Π° ΡΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠΈΡΠΎΠ·Π° ΠΈ Π½Π΅ΡΠ·ΠΈΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ
Aim of the study: To investigate plasma D-dimer levels in correlation with Child-Pugh-Turcotte (CTP) and Model for End-Stage Liver Disease (MELD) scores in patients with liver cirrhosis (LC) of different severity, as well as the correlation with LC-associated clinical, biochemical parameters and complications. Material and methods: Fifty patients with LC were divided in three groups according to LC severity using the CTP Score (CTP-A, CTP-B, CTP-C).Β The levels of D-dimer were measured in sodium-citrate plasma on Siemens, BCS XP Blood Coagulometer. Kruskal-Wallis test was used to compare D-dimer levels between the groups. Mann-Whitney U test was used to evaluate the difference of D-dimer levels in groups with different MELD score, and to evaluate the difference in D-dimer levels in patients with presence or absence of ascites and the difference of D-dimer levels in patients with or without spontaneous bacterial peritonitis (SBP). Pearsonβs coefficient of correlation was used to evaluate the correlation between D-dimer levels with MELD score and the correlation between D-dimer levels and the concentration of LC-associated biochemical, clinical parameters and complications. Results: D-dimer levels increased with severity of the disease as assessed with CTP and MELD scores, with a statistically significant difference between the groups (p=.0000 and p=.0001, respectively). Group CTP-C demonstrated the highest D-dimer levels, followed by groups B and A. Patients with SBP had significantly higher levels of D-dimers than patients without SBP (p=.0006). A significant positive correlation between D-dimers and CTP and MELD score was detected (r= 0.74 and r=0.44, respectively; p<.001). A correlation between D-dimer levels and several biochemical parameters characterizing progressive liver dysfunction was observed. From all investigated biochemical parameters, the highest significant correlation was detected between D-dimer levels and the concentration of serum albumin (r= -0.65, p<.001). Conclusions: Plasma D-dimer levels are tightly correlated with the degree of liver dysfunction and LC-associated complications. Therefore, D-dimer levels could be utilized as a prognostic stratification marker and adjunctive diagnostic marker in LC-associated complications.Β Π¦Π΅Π» Π½Π° ΡΡΡΠ΄ΠΈΡΠ°ΡΠ°: ΠΠ° ΡΠ΅ ΠΈΡΠΏΠΈΡΠ° Π½ΠΈΠ²ΠΎΡΠΎ Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ Π²ΠΎ ΠΏΠ»Π°Π·ΠΌΠ° Π²ΠΎ ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° ΡΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈΡΠ΅ ΡΠΊΠΎΡΠΎΠ²ΠΈ: Child-Pugh-Turcotte (CTP) ΠΈ Model for End-Stage Liver Disease (MELD) ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΡΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠΈΡΠΎΠ·Π° ΡΠΎ ΡΠ°Π·Π»ΠΈΡΠ½Π° ΡΠ΅ΠΆΠΈΠ½Π°, ΠΊΠ°ΠΊΠΎ ΠΈ Π½ΠΈΠ²Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° ΡΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈ, Π±ΠΈΠΎΡ
Π΅ΠΌΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΈ ΡΠΎ ΡΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠΈΡΠΎΠ·Π°. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ:Β ΠΠΊΡΠΏΠ½ΠΎ 50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΡΠΈΡΠΎΠ·Π° Π½Π° ΡΡΠ½ Π΄ΡΠΎΠ± Π±Π΅Π° ΠΏΠΎΠ΄Π΅Π»Π΅Π½ΠΈ Π²ΠΎ ΡΡΠΈ Π³ΡΡΠΏΠΈ ΡΠΏΠΎΡΠ΅Π΄ ΡΠ΅ΠΆΠΈΠ½Π°ΡΠ° Π½Π° ΡΠΈΡΠΎΠ·Π° Π½Π° ΡΡΠ½ΠΈΠΎΡ Π΄ΡΠΎΠ± Π²ΡΠ· ΠΎΡΠ½ΠΎΠ²Π° Π½Π° CTP Score (CTP-A, CTP-Π, CTP-C). ΠΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ Π±Π΅ΡΠ΅ ΠΎΠ΄ΡΠ΅Π΄Π΅Π½Π° Π²ΠΎ ΠΏΠ»Π°Π·ΠΌΠ° ΡΠΎ Π½Π°ΡΡΠΈΡΠΌ ΡΠΈΡΡΠ°Ρ ΠΊΠΎΡΠΈΡΡΠ΅ΡΡΠΈ Π³ΠΎ Siemens, BCSXP ΠΊΡΠ²Π½ΠΈΠΎΡ ΠΊΠΎΠ°Π³ΡΠ»ΠΎΠΌΠ΅ΡΠ°Ρ. Kruskal-Wallis ΡΠ΅ΡΡΠΎΡ Π±Π΅ΡΠ΅ ΠΊΠΎΡΠΈΡΡΠ΅Π½ Π·Π° Π΄Π° ΡΠ΅ ΡΠΏΠΎΡΠ΅Π΄Π°Ρ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ ΠΏΠΎΠΌΠ΅ΡΡ CTP Π³ΡΡΠΏΠΈΡΠ΅. Mann-Whitney U ΡΠ΅ΡΡΠΎΡ Π±Π΅ΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π΅Π½ Π·Π° Π΄Π° ΡΠ΅ ΠΎΠ΄ΡΠ΅Π΄ΠΈ ΡΠ°Π·Π»ΠΈΠΊΠ°ΡΠ° Π²ΠΎ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΏΠΎΠΌΠ΅ΡΡ Π³ΡΡΠΏΠΈΡΠ΅ ΡΠΎ ΡΠ°Π·Π»ΠΈΡΠ΅Π½ MELD ΡΠΊΠΎΡ, ΠΈ Π·Π° Π΄Π° ΡΠ΅ ΠΎΡΠ΅Π½ΠΈ ΡΠ°Π·Π»ΠΈΠΊΠ°ΡΠ° Π²ΠΎ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΏΡΠΈΡΡΡΡΠ²ΠΎ ΠΈΠ»ΠΈ ΠΎΡΡΡΡΡΠ²ΠΎ Π½Π° Π°ΡΡΠΈΡ ΠΈ ΡΠ°Π·Π»ΠΈΠΊΠ°ΡΠ° Π²ΠΎ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΈΠ»ΠΈ Π±Π΅Π· ΡΠΏΠΎΠ½ΡΠ°Π½ Π±Π°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈ ΠΏΠ΅ΡΠΈΡΠΎΠ½ΠΈΡΠΈΡ (SBP). Pearson-ΠΎΠ²ΠΈΠΎΡ ΠΊΠΎΠ΅ΡΠΈΡΠΈΠ΅Π½Ρ Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° Π±Π΅ΡΠ΅ ΠΊΠΎΡΠΈΡΡΠ΅Π½ Π·Π° Π΄Π° ΡΠ΅ ΠΎΡΠ΅Π½ΠΈ ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ°ΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ ΡΠΎ MELD ΡΠΊΠΎΡΠΎΡ ΠΈ ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ°ΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° Π±ΠΈΠΎΡ
Π΅ΠΌΠΈΡΠΊΠΈ, ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΈ ΡΠΎ ΡΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠΈΡΠΎΠ·Π°. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΡΠ΅ Π·Π³ΠΎΠ»Π΅ΠΌΠΈ ΡΠΎ ΡΠ΅ΠΆΠΈΠ½Π°ΡΠ° Π½Π° Π±ΠΎΠ»Π΅ΡΡΠ° ΠΏΡΠΎΡΠ΅Π½Π΅ΡΠ° ΡΠΎ CTP ΠΈ MELDΡΠΊΠΎΡΠΎΡ ΡΠΎ ΡΡΠ°ΡΠΈΡΡΠΈΡΠΊΠΈ Π·Π½Π°ΡΠ°ΡΠ½Π° ΡΠ°Π·Π»ΠΈΠΊΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π³ΡΡΠΏΠΈΡΠ΅ (p=,0000 ΠΈ p=,0001, ΡΠΎΠΎΠ΄Π²Π΅ΡΠ½ΠΎ). ΠΡΡΠΏΠ°ΡΠ° CTP-C ΠΏΠΎΠΊΠ°ΠΆΠ° Π½Π°ΡΠ²ΠΈΡΠΎΠΊΠ° ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ, ΠΏΠΎ ΡΡΠΎ ΡΠ»Π΅Π΄ΡΠ²Π°Π° Π³ΡΡΠΏΠΈΡΠ΅ Π ΠΈ Π. ΠΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ SBP ΠΈΠΌΠ°Π° Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠ° ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈ Π²ΠΎ ΡΠΏΠΎΡΠ΅Π΄Π±Π° ΡΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π±Π΅Π· SBP (p= ,0006). ΠΠ΅ΡΠ΅ ΡΡΠ²ΡΠ΄Π΅Π½Π° Π·Π½Π°ΡΠΈΡΠ΅Π»Π½Π° ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΈ CTP ΠΈ MELD ΡΠΊΠΎΡΠΎΡ (ΠΊΠΎΠ΅ΡΠΈΡΠΈΠ΅Π½Ρ Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° r= 0,74 ΠΈ r= 0,44, ΡΠΎΠΎΠ΄Π²Π΅ΡΠ½ΠΎ; p< ,001). ΠΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»Π½ΠΎ, ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΏΠΎΠΊΠ°ΠΆΠ°Π° Π΄Π΅ΠΊΠ° ΠΏΠΎΡΡΠΎΠΈ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΎΡΡ ΠΌΠ΅ΡΡ ΠΏΠ»Π°Π·ΠΌΠ° ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΡΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈΡΠ΅ ΠΈ Π±ΠΈΠΎΡ
Π΅ΠΌΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΊΠΎΠΈ ΠΊΠ°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΈΡΠ°Π°Ρ ΠΏΡΠΎΠ³ΡΠ΅ΡΠΈΠ²Π½Π° Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡΠ° Π½Π° ΡΡΠ½ΠΈΠΎΡΠ΄ΡΠΎΠ±. ΠΠ΄ ΡΠΈΡΠ΅ ΠΈΡΠΏΠΈΡΡΠ²Π°Π½ΠΈ Π±ΠΈΠΎΡ
Π΅ΠΌΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ, Π½Π°ΡΠ²ΠΈΡΠΎΠΊΠ° ΡΡΠ°ΡΠΈΡΡΠΈΡΠΊΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ° Π±Π΅ΡΠ΅ ΡΡΠ²ΡΠ΄Π΅Π½Π° ΠΌΠ΅ΡΡ Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° ΡΠ΅ΡΡΠΌΡΠΊΠΈΡΠ΅ Π°Π»Π±ΡΠΌΠΈΠ½ΠΈ (r = - 0,65, p< 0,001). ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠ»Π°Π·ΠΌΠ°ΡΡΠΊΠ°ΡΠ° ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ Π΅ ΡΠ΅ΡΠ½ΠΎ ΠΏΠΎΠ²ΡΠ·Π°Π½Π° ΡΠΎ ΡΡΠ΅ΠΏΠ΅Π½ΠΎΡ Π½Π° Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡΠ° Π½Π° ΡΡΠ½ΠΈΠΎΡΠ΄ΡΠΎΠ± ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈΡΠ΅ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΈ ΡΠΎ ΡΠΈΡΠΎΠ·Π° Π½Π° ΡΡΠ½ Π΄ΡΠΎΠ±. ΠΠ°ΡΠΎΠ°, Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π½Π° Π-Π΄ΠΈΠΌΠ΅ΡΠΈΡΠ΅ ΠΌΠΎΠΆΠ΅ Π΄Π° ΡΠ΅ ΠΊΠΎΡΠΈΡΡΠ°Ρ ΠΊΠ°ΠΊΠΎ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠΊΠΈ ΠΌΠ°ΡΠΊΠ΅Ρ Π·Π° ΡΡΡΠ°ΡΠΈΡΠΈΠΊΠ°ΡΠΈΡΠ° ΠΈ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»Π΅Π½ Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΊΠΈ ΠΌΠ°ΡΠΊΠ΅Ρ Π²ΠΎ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈΡΠ΅ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΈ ΡΠΎ ΡΠΈΡΠΎΠ·Π° Π½Π° ΡΡΠ½ Π΄ΡΠΎΠ±
Young GI Societies in Europe: 2019 update
Abstract
Background: One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive to young fellows interested in gastroenterology (GI), and to actively involve them in UEG activities and the activities of their respective national societies. In 2017, we conducted a survey among the Friends of the UEG YTG with the aim of identifying the state of organization and needs of Young GI Sections (YGISs) throughout Europe, highlighting areas for further development and improvement.
Aims: The aim of the current web-based survey was to assess the progress of YGISs over 1 year, and persisting hurdles in forming and running a YGIS.
Results: Overall, 38 of 42 Friends answered the survey (91%). The number of YGISs has increased significantly from 12 in 2017 to 25 in 2019. Young gastroenterologists remained supported, but not influenced, by national societies. Results of the survey suggest that a lack of dedicated and motivated fellows has replaced a lack of funding as the most prevalent hurdle in forming these types of sections.
Conclusion: Our survey shows that the development of YGISs has improved markedly within the last 2 years. However, several limitations, like underrepresentation in subcommittees of national societies, remain and need to be addressed in order to involve young gastroenterologists in their respective national societies and within UEG, to pave the way for future research, education and excellent quality of care, and reduce health inequalities across Europe
Endoscopic resection for gastrointestinal neuroendocrine tumors
Gastrointestinal (GI) and neuroendocrine tumors (NETs) can be treated by mini-invasive endoscopic resection when localized in the superficial layers of the bowel wall and their size is 20\ua0mm in size, with penetration of the muscle layer and/or serosa are at high risk for metastases and surgical approach is recommended when feasible