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The effect of information level and coping style on pain and anxiety in needle liver biopsy.

https://arctichealth.org/en/permalink/ahliterature167320
Source
Can J Gastroenterol. 2006 Sep;20(9):597-600
Publication Type
Article
Date
Sep-2006
Author
Nir Hilzenrat
Rose Yesovitch
Ian Shrier
Maria Stavrakis
Marc Deschênes
Author Affiliation
Department of Medicine, SMBD-Jewish General Hospital, McGill University, Montreal, Canada. nir.hilzenrat@staff.mcgill.ca
Source
Can J Gastroenterol. 2006 Sep;20(9):597-600
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Anxiety - etiology - prevention & control
Biopsy, Needle - adverse effects - psychology
Cognition
Female
Humans
Informed consent
Liver Diseases - pathology
Male
Middle Aged
Pain - etiology - prevention & control
Pain Measurement
Patient Education as Topic
Quebec
Questionnaires
Time Factors
Truth Disclosure
Abstract
Biopsy of the liver is an important diagnostic procedure. The procedure is invasive and may be painful for patients. Sedative drugs are not used because the associated drop in blood pressure mimics hemorrhage, a major complication of the procedure. Cognitive and behavioural techniques have been used to decrease stress in patients undergoing other medical procedures. In the present study, it is postulated that providing procedural and sensory information may reduce patient anxiety levels. Patient coping styles were evaluated and anxiety and pain levels were assessed by using a visual analogue scale. Subjects were randomly assigned to one of two groups. The control group received basic information about the procedure. The experimental group received the same basic information followed by more detailed educational information. Subjects also filled out the Krantz Health Opinion Survey, a short questionnaire used to classify coping styles as either information-seeking or information-avoiding. Seventy-five subjects (38 control and 37 experimental) with similar demographics were included in the present study. No significant differences were found in anxiety levels or pain levels 30 min and 6 h post-biopsy. There was also no significant difference between groups once coping style was added into the analysis. The study failed to show any advantage in providing additional information to subjects before liver biopsy, regardless of coping style.
Notes
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PubMed ID
17001402 View in PubMed
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Hepatitis B and the infected health care worker: public safety at what cost?

https://arctichealth.org/en/permalink/ahliterature124348
Source
Can J Gastroenterol. 2012 May;26(5):257-60
Publication Type
Article
Date
May-2012
Author
Mamatha Bhat
Peter Ghali
Marc Deschenes
Philip Wong
Author Affiliation
Department of Gastroenterology & Hepatology, McGill University Health Centre, Montreal, Quebec, Canada. mamatha.bhat@mail.mcgill.ca
Source
Can J Gastroenterol. 2012 May;26(5):257-60
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Canada
General Surgery
Guidelines as Topic
Hepatitis B, Chronic - prevention & control - transmission
Humans
Infectious Disease Transmission, Professional-to-Patient
Male
Occupational Health
Abstract
Public safety and the right of the health care worker to practise without prejudice based on underlying illness may be at odds for those affected by the hepatitis B virus (HBV). Nevertheless, HBV does not preclude entry into a health care profession, and the risk of transmission from health care worker to patient is not uniform across the spectrum of health care fields. In the present article, the authors present an overview of the literature regarding transmission of HBV from the health care worker to the patient, and the current recommendations that vary from province to province within Canada. The establishment of national guidelines to standardize monitoring of HBV infection among health care workers would improve health care workplace safety and patient care.
Notes
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PubMed ID
22590698 View in PubMed
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Liver transplantation for hepatic epithelioid hemangioendothelioma: the Canadian multicentre experience.

https://arctichealth.org/en/permalink/ahliterature154685
Source
Can J Gastroenterol. 2008 Oct;22(10):821-4
Publication Type
Article
Date
Oct-2008
Author
Carmine G Nudo
Eric M Yoshida
Vincent G Bain
Denis Marleau
Phil Wong
Paul J Marotta
Eberhard Renner
Kymberly D Watt
Marc Deschênes
Author Affiliation
McGill University, Montréal, Québec. carmine.nudo@mail.mcgill.edu
Source
Can J Gastroenterol. 2008 Oct;22(10):821-4
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada - epidemiology
Female
Follow-Up Studies
Hemangioendothelioma, Epithelioid - mortality - pathology - surgery
Humans
Liver Neoplasms - mortality - pathology - surgery
Liver Transplantation
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local
Splenic Neoplasms - secondary
Survival Rate
Treatment Outcome
Young Adult
Abstract
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare entity. At the present time, there is no standardized effective therapy. Liver transplantation (LT) has emerged as a treatment for this rare tumour.
To evaluate the outcome of liver transplantation for HEHE at eight centres across Canada.
The charts of patients who were transplanted for HEHE at eight centres across Canada were reviewed.
A total of 11 individuals (eight women and three men) received a LT for HEHE. All LTs were performed between 1991 and 2005. The mean (+/- SD) age at LT was 38.7+/-13 years. One patient had one large liver lesion (17 cm x 14 cm x 13 cm), one had three lesions, one had four lesions and eight had extensive (five or more) liver lesions. One patient had spleen involvement and two had involved lymph nodes at the time of transplantation. The mean duration of follow-up was 78+/-63 months (median 81 months). Four patients (36.4%) developed recurrence of HEHE with a mean time to recurrence of 25+/-25 months (median 15.6 months) following LT. The calculated survival rate following LT for HEHE was 82% at five years.
The results of LT for HEHE are encouraging, with a recurrence rate of 36.4% and a five-year survival rate of 82%. Further studies are needed to help identify patients who would benefit most from LT for this rare tumour.
Notes
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PubMed ID
18925305 View in PubMed
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Liver transplantation for incidental cholangiocarcinoma: analysis of the Canadian experience.

https://arctichealth.org/en/permalink/ahliterature172356
Source
Liver Transpl. 2005 Nov;11(11):1412-6
Publication Type
Article
Date
Nov-2005
Author
Peter Ghali
Paul J Marotta
Eric M Yoshida
Vincent G Bain
Denis Marleau
Kevork Peltekian
Peter Metrakos
Marc Deschênes
Author Affiliation
Department of Medicine, McGill University, Montréal, Québec, Canada.
Source
Liver Transpl. 2005 Nov;11(11):1412-6
Date
Nov-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bile Duct Neoplasms - mortality - pathology - surgery
Bile Ducts, Intrahepatic
Canada
Cholangiocarcinoma - pathology - surgery
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Incidental Findings
Liver Transplantation - adverse effects - methods
Male
Middle Aged
Postoperative Complications - epidemiology
Probability
Retrospective Studies
Risk assessment
Survival Analysis
Abstract
Cholangiocarcinoma is a biliary tumor, which not infrequently complicates primary sclerosing cholangitis. It carries a poor prognosis and, with the exception of carefully selected individuals in research protocols, contraindicates orthotopic liver transplantation. There has been some suggestion that cholangiocarcinomas incidentally discovered at the time of transplantation carry a better prognosis. The goal of this retrospective study was to perform a national review of outcomes after liver transplantation in Canadian recipients found to have incidental cholangiocarcinoma in their explanted native liver. Six of the seven liver transplant centers in Canada provided clinical and follow-up information on all liver transplant recipients found to have incidental cholangiocarcinoma in their explants. The diagnosis or suspicion of cholangiocarcinoma prior to transplantation were exclusion criteria for this study. Ten individuals with cholangiocarcinoma were transplanted between 1996 and 2003. The median duration of follow-up was 28 months. Eight of the 10 had PSC. All of the tumors were stage I or II. The 3-year survival for these patients was 30%. The median time to recurrence was 26 months (95% confidence interval 13-37), and the median time to death was 30 months (95% confidence interval 28-53). In conclusion, although early survival of patients transplanted for incidental cholangiocarcinoma appears good, intermediate- and long-term survival rates are not better than for individuals historically transplanted with known cholangiocarcinoma. Aggressive investigation for cholangiocarcinoma is mandated. Incidentally found tumours remain a difficult treatment problem, and prospective adjuvant chemo-, radio-, and immunotherapies should be investigated.
PubMed ID
16237695 View in PubMed
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Recurrent hepatitis C post-transplantation: where are we now and where do we go from here? A report from the Canadian transplant hepatology workshop.

https://arctichealth.org/en/permalink/ahliterature166488
Source
Can J Gastroenterol. 2006 Nov;20(11):725-34
Publication Type
Article
Date
Nov-2006
Author
Kymberly D S Watt
Kelly Burak
Marc Deschênes
Les Lilly
Denis Marleau
Paul Marotta
Andrew Mason
Kevork M Peltekian
Eberhard L Renner
Eric M Yoshida
Author Affiliation
Dalhousie University QEII HSC, Halifax, Canada. wattk@cdha.nshealth.ca
Source
Can J Gastroenterol. 2006 Nov;20(11):725-34
Date
Nov-2006
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Gastroenterology - methods - trends
Hepatitis C, Chronic - epidemiology - etiology - prevention & control
Humans
Liver Transplantation - adverse effects
Postoperative Complications
Prognosis
Recurrence - prevention & control
Abstract
Approximately 400 liver transplants are performed in Canada every year and close to 6000 per year in the United States. Forty per cent to 45% of all liver transplants are performed for patients with underlying hepatitis C virus (HCV)-related liver disease. These patients have a different natural history, new complication risks and different treatment efficacy than nontransplant HCV patients. Every effort must be made to identify those patients at highest risk for progressive liver disease post-transplant. Recurrent HCV is an Achilles' heel to transplant hepatology. The true natural history of this disease is only starting to unravel and many questions remain unanswered on the optimal management of these patients after liver transplantation. The present report summarizes the literature and ongoing research needs that are specific to HCV-related liver transplantation.
Notes
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PubMed ID
17111055 View in PubMed
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Transplant immunosuppressive agents in non-transplant chronic autoimmune hepatitis: the Canadian association for the study of liver (CASL) experience with mycophenolate mofetil and tacrolimus.

https://arctichealth.org/en/permalink/ahliterature174002
Source
Liver Int. 2005 Aug;25(4):723-7
Publication Type
Article
Date
Aug-2005
Author
Nazira Chatur
Alnoor Ramji
Vincent G Bain
Mang M Ma
Paul J Marotta
Cameron N Ghent
Leslie B Lilly
E Jenny Heathcote
Marc Deschenes
Samuel S Lee
Urs P Steinbrecher
Eric M Yoshida
Author Affiliation
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Source
Liver Int. 2005 Aug;25(4):723-7
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Drug Therapy, Combination
Female
Glucocorticoids - therapeutic use
Hepatitis, Autoimmune - drug therapy - etiology - immunology
Humans
Immunosuppressive Agents - therapeutic use
Male
Middle Aged
Mycophenolic Acid - analogs & derivatives - therapeutic use
Prednisone - therapeutic use
Recurrence - prevention & control
Retrospective Studies
Tacrolimus - therapeutic use
Transaminases - analysis
Treatment Outcome
Abstract
Conventional treatment of autoimmune hepatitis consists of either prednisone alone or in combination with azathioprine. Ten to 20% of patients do not respond to or are intolerant of this treatment. Novel drug treatments include immunosuppressive drugs such as tacrolimus (TAC), mycophenolate mofetil (MMF), methotrexate and cyclosporine. We describe a multi-centre Canadian experience with MMF and TAC.
To study a multi-centre patient population who had failed conventional therapy and were treated with non-conventional medical therapy for autoimmune hepatitis and document response.
Members of the Canadian Association for the Study of Liver (CASL) obtained MMF from Hoffmann-La Roche Ltd, as part of a compassionate release program, were contacted for standardized data on patients with AIH who received MMF or TAC. Response definitions based on aminotransferase changes were: Complete response (CR)-sustained normalization, partial response (PR)-improvement by greater than 50%, non-response (NR)-less than 50% improvement and relapse (RP)-initial CR or PR followed by an increase in aminotransferases.
A total of 16 patients were identified: six in Ontario, one in Quebec, five in Alberta and four in British Columbia. Three were treated with TAC, eleven with MMF and two with combination MMF and TAC. CR was observed in 50%, PR in 12.5%, RP in 25% and NR occurred in 12.5%. The CR for MMF without TAC was approximately 64%.
MMF is effective and well tolerated by patients with autoimmune hepatitis who do not respond to, or are intolerant of, conventional immunosuppressive agents.
PubMed ID
15998421 View in PubMed
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6 records – page 1 of 1.