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  • Author: Pakkapon Rattanachaisit x
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Abstract

Background

Gastrointestinal stromal tumor (GIST) was the most common mesenchymal tumor of the gastrointestinal tract predominately occurring in the stomach. Although GIST was a rare disease, it was considered to be a life-threatening malignancy.

Objective

To explore the current status of gastric GIST in Thai patients.

Method

The medical records of patients who were diagnosed with histologically proven gastric GIST from 2012 to 2016 in King Chulalongkorn Memorial Hospital were reviewed.

Results

Of 22 patients, there were 14 (63.6%) females and 8 (36.4%) males with the mean age of 62.6 ± 14.8 years. The average duration before the first presentation was 12 weeks. The initial symptoms were upper gastrointestinal bleeding (50.0%) followed by abdominal pain (31.8%). Tumor mostly located at the proximal part (fundus and cardia) in 20 (90.9%) patients. At the time of the diagnosis, three patients (13.6%) had distant metastasis. Of this group, 77.3% underwent surgical treatment.

Discussion

Although gastric GIST was an uncommon disease, early diagnosis and prompt treatment could save the lives of many patients.

Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver disease. The primary treatment of NAFLD by statins has not been clearly elucidated.

Objectives

To evaluate the effectiveness of statin use in patients with biopsy-proven NAFLD or non-alcoholic steatohepatitis on the change in liver histology.

Methods

We searched MEDLINE, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials for clinical trials and observational studies investigating the effects of statins on histological change regardless of type or dosage from inception to December 2015. Random-effect model meta-analyses were used to compute changes in outcomes of interest. The study protocol was registered in advance with the International Prospective Register of Systematic Reviews (PROSPERO 2016 CRD42016033132).

Results

We identified 6 studies (111 patients), representing 5 cohort studies and 1 randomized controlled clinical trial. There was significant decrease in steatosis grading with a standardized mean difference of –2.580 (95% confidence interval [CI] –4.623 to –0.536; P = 0.013) and NAFLD activity score standardized mean difference of –1.488 (95% CI –2.506 to –0.471; P = 0.004). However, there was no significant change in fibrosis stage (0.156; 95% CI –0.553 to 0.865; P = 0.667).

Conclusions

Statin use can possibly reduce the extent of steatohepatitis but not the stage of fibrosis. Further randomized controlled studies to assess histological evidence with adequate sample size and duration are required in order to establish the role of statin as a primary treatment of NAFLD.