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Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

World Journal of Gastroenterology 2021年第24期27卷 3466-3482页

作者： Abhilash Perisetti Hemant Goyal rachana yendala Ragesh B Thandassery Emmanouil Giorgakis Department of Internal Medicine Division of GastroenterologyUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Macon University School of MedicineMaconGA 31207United States Department of Hematology and Oncology Conway Regional Health System(CRHS)ConwayAR 72034United States Department of Gastroenterology and Hepatology Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States Department of Transplant University of Arkansas for Medical Sciences Little RockAR 72205United States

Primary liver cancers carry significant morbidity and *** carcinoma(HCC)develops within the hepatic parenchyma and is the most common malignancy originating from the *** 80%of HCCs develop within background cirrhosis,20%may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC(NCHCC).NCHCC is often diagnosed late due to lack of *** addition,the rising prevalence of non-alcoholic fatty liver disease and diabetes mellitus have increased the risk of developing HCC on noncirrhotic *** infections such as chronic Hepatitis B and less often chronic hepatitis C with advance fibrosis are associated with *** individuals may have Hepatitis B core antibodies and occult HBV infection,signifying the role of Hepatitis B infection in *** the effectiveness of current antiviral therapies,surgical techniques and locoregional treatment options,nowadays such patients have more options and potential for ***,these lesions need early identification with diagnostic models and multiple surveillance strategies to improve overall *** understanding of the NCHCC risk factors,tumorigenesis,diagnostic tools and treatment options are critical to improving prognosis and overall outcomes on these *** this review,we aim to discuss NCHCC epidemiology,risk factors,and pathogenesis,and elaborate on NCHCC diagnosis and treatment strategies.

关键词： Cirrhosis Hepatic fibrosis Non-alcoholic liver disease Primary liver cancer Hepatocellular carcinoma Hepatoma Liver cancer Hepatitis B virus Hepatitis C virus Liver resection Liver transplantation

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Sarcopenia in hepatocellular carcinoma:Current knowledge and future directions

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World Journal of Gastroenterology 2022年第4期28卷 432-448页

作者： Abhilash Perisetti Hemant Goyal rachana yendala Saurabh Chandan Benjamin Tharian Ragesh BabuThandassery Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Interventional Oncology and Surgical Endoscopy Parkview HealthFort WayneIN 46825United States Department of Internal Medicine The Wright Center for Graduate Medical EducationThe Wright Center for Graduate Medical EducationScrantonPA 18501United States Department of Hematology and Oncology Conway Regional Medical CenterConwayAR 72034United States Department of Internal Medicine Gastroenterology and Hepatology DivisionCHI Creighton University Medical CenterOmahaNE 68107United States Department of Medicine Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States

Liver cancer is the second most occurring cancer worldwide and is one of the leading causes of cancer-related *** carcinoma(HCC)is the most common(80%-90%)type among malignant liver *** occurs very early in HCC and can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant *** prognostic stating systems have been developed in HCC,such as Barcelona Clinic Liver Cancer,Child-Pugh score and Albumin-Bilirubin ***,the evaluation of patients’performance status is a major limitation of these scoring *** this review,we aim to summarize the current knowledge and recent advances about the role of sarcopenia in cirrhosis in general,while focusing specifically on ***,the role of sarcopenia in predicting clinical outcomes and prognostication in HCC patients undergoing loco-regional therapies,liver resection,liver transplantation and systematic therapy has been discussed.A literature review was performed using databases PubMed/MEDLINE,EMBASE,Cochrane,Web of Science,and CINAHL on April 1,2021,to identify published reports on sarcopenia in *** can independently predict HCC-related mortality especially in patients undergoing treatments such as loco-regional,surgical liver transplantation and systemic *** research is focused on evaluating a balance of anabolic and catabolic pathways responsible for muscle *** clinical studies have shown promising results in methods to improve sarcopenia in HCC which can potentially increase prognosis in these *** sarcopenia occurs very early in HCC,it can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant ***,sarcopenia measurement can obviate the confounding caused by the abdominal ascites in these *** use of sarcopenia can

关键词： Sarcopenia Skeletal muscle Hepatocellular carcinoma Cirrhosis Outcomes Liver cancer

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Colorectal cancer screening use among insured adults: Is out-of-pocket cost a barrier to routine screening?

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2018年第4期9卷 31-38页

作者： Abhilash Perisetti Hafiz Khan Nayana E George rachana yendala Aamrin Rafiq Summre Blakely Drew Rasmussen Nathan Villalpando Hemant Goyal Department of Gastroenterology University of Arkansas for Medical Sciences Department of Public Health Texas Tech University Health Sciences Department of Internal Medicine University of Arkansas Medical Sciences Department of Hematology and Oncology Texas Tech University Health Sciences Department of Biological Sciences Texas Tech University School of Medicine Texas Tech University Health Sciences Center Department of Internal Medicine Mercer University School of Medicine

AIM To describe the characteristics of adults who needed to see a doctor in the past year but could not due to the extra cost and assess the impact of limited financial resources on the receipt of routine fecal occult blood test, sigmoidoscopy, or colonoscopy for colon cancer screening among insured patients. METHODS Data obtained from the 2012 Behavioral Risk Factor Surveillance System included 215436 insured adults age 50-75 years. We computed frequencies, adjusted odds ratios(a ORs), and 95%CIs using SAS v9.3 software. RESULTS Nine percent of the study population needed to see a doctor in the past year but could not because of cost. The numbers were significantly higher among those aged 50-64(P < 0.0001), Non-Hispanic Whites(P < 0.0001), and those with a primary care physician(P < 0.0001) among other factors. Adjusting for possible confounders, a ORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year a OR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year a OR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year a OR = 0.91; 95%CI: 0.81-1.02. CONCLUSION We found that the limited financial resources within the past 12 mo were significantly associated with colorectal cancer(CRC) non-screening. Patients with risk factors identified in this study should adhere to CRC guidelines and should receive financial help if needed.

关键词： Fecal occult blood Healthcare delivery Sigmoidoscopy Colorectal cancer Screening Access to care Behavioral Risk Factor Surveillance System

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