scholarly journals Antibiotic Prophylaxis in Transarterial Therapy of Hepatocellular Carcinoma: A Meta-Analysis

2012 ◽  
Vol 26 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Jun Wang ◽  
Xiao Dong He ◽  
You Cheng Zhang

Transarterial therapies, either alone or in conjunction with adjuvant therapies, have been demonstrated to improve survival rates in patients with hepatocellular carcinoma (HCC). Although generally well tolerated and widely used for more than two decades, transarterial procedures have been reported to be associated with several infectious complications when performed in patients with HCC. However, the question of whether antibiotic prophylaxis is necessary for patients undergoing transarterial procedures for HCC remains controversial. Accordingly, this meta-analysis examined clinical trial evidence regarding the effects of prophylactic antibiotic therapy versus no prophylactic treatment with respect to infectious complications in patients undergoing transarterial therapy for HCC.BACKGROUND: The use of prophylactic antibiotics against postprocedure infection in patients undergoing transarterial therapy for hepatocellular carcinoma is controversial.AIM: To compare the effects of prophylactic antibiotic treatment and no prophylactic antibiotic treatment on infectious complications following transarterial procedures.METHODS: Clinical trials fulfilling predefined selection criteria were identified by searching several bibliographic databases; a meta-analysis was performed where appropriate.RESULTS: Four trials of inadequate quality consisting of 210 patients were included in the analysis. Only one case of possible postprocedure infection in each group was reported. The rate of patients developing fever (RR 0.91 [95% CI 0.61 to 1.35]), changes in peripheral white blood cell count or serum C-reactive protein levels, and the mean length of hospital stay (mean difference 0.20 [95% CI 0.75 to 1.14]) showed no significant intergroup differences between antibiotic and no antibiotic treatment. Furthermore, the results of the present study indicated that the incidence of bacteremia, septicemia, sepsis or hepatic abscess after transarterial therapy was rare.CONCLUSION: Antibiotic prophylaxis in patients undergoing transarterial therapy for hepatocellular carcinoma may not be routinely necessary. However, a more judicious use of antibiotics is recommended for patients who are at an increased risk of infection. Nevertheless, prospective trials on a larger scale are clearly needed.

2021 ◽  
Vol 79 ◽  
pp. S242-S243
Author(s):  
B. Tadayon Najafabadi ◽  
M. Kandi ◽  
M. Ding ◽  
T. Bladeh ◽  
K. Bausch ◽  
...  

2017 ◽  
Vol 139 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Myriam Safrai ◽  
Doron Kabiri ◽  
Rani Haj-Yahya ◽  
Adi Reuveni-Salzman ◽  
Michal Lipschuetz ◽  
...  

2011 ◽  
Author(s):  
Adam Lerner ◽  
Huihong Xu ◽  
Karen H Antman

Sarcomas originate from bone or soft tissue. The most common bone sarcomas are osteosarcomas, Ewing sarcomas, and chondrosarcomas. Soft tissue sarcomas develop in fibrous tissue, fat, muscle, blood vessels, and nerves. Historically, soft tissue sarcomas of the trunk and extremities were reported separately from those of visceral organs (e.g., gastrointestinal and gynecologic sarcomas). This chapter discusses the classification, epidemiology, diagnosis, staging, and treatment of sarcomas of bone and cartilage, and classic soft tissue sarcomas. Management of Kaposi sarcoma, gastrointestinal stromal tumors (GISTs), mesothelioma, and rhabdomyosarcoma is also described. Figures include images of patients with osteosarcoma, liposarcoma, uterine leiomyosarcoma, GIST, and osteosarcoma in a patient with Paget disease of bone. Tables list epidemiologic features of sarcomas, a summary of sarcomas by histology, familial syndromes associated with increased risk of sarcoma, survival rates in sarcoma patients, staging of soft tissue sarcomas, and results of a meta-analysis of doxorubicin-based adjuvant chemotherapy for localized resectable soft tissue sarcoma. This chapter contains 126 references.


2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094342
Author(s):  
Cunqing Kong ◽  
Miao Chen ◽  
Xiaohui Fan ◽  
Xingcai Chen

Background Interleukin-12 (IL-12) is considered to be a risk factor for cancer; however, its role in hepatocellular carcinoma (HCC) remains unknown. This study aimed to explore the impacts of the IL-12 rs3212227 and rs568408 gene polymorphisms on HCC. Methods We searched PubMed, Embase, Web of Science, and Chinese Knowledge Infrastructure databases for studies on the associations between HCC and IL-12 rs568408 and rs3212227 polymorphisms published prior to 1 May 2020. The effects of the polymorphisms on HCC susceptibility were presented as odds ratios (ORs) and associated 95% confidence intervals. Results Seven studies were ultimately included, including 2375 cases and 3445 controls. The rs3212227 polymorphism was significantly associated with the risk of HCC in both the dominant model (CC+AC vs. AA, OR=1.22) and the allele model (C vs. A, OR=1.12). Combined analysis of rs568408 yielded a significant relative risk for HCC in the dominant (AA+AG vs. GG, OR=1.13), recessive (AA vs. AG+GG, OR=1.72), allele (A vs. G, OR=1.29), heterozygote (AG vs. GG, OR=1.27), and homozygote models (AA vs. GG, OR 1.17). Conclusion The IL-12 rs3212227 and rs568408 gene polymorphisms are associated with an increased risk of HCC.


2019 ◽  
Vol 39 (4) ◽  
pp. 356-361
Author(s):  
Pei-Yi Fan ◽  
Ming-Jen Chan ◽  
Sheng-Hsuan Lin ◽  
Hsin-Hsu Wu ◽  
Ming-Yang Chang ◽  
...  

BackgroundPeritonitis is a serious complication after invasive procedures in patients undergoing peritoneal dialysis (PD). Most studies that have investigated peritonitis following invasive gynecologic procedures enrolled small patient populations. This study focuses on the clinical presentation, outcomes, and effects of prophylactic antibiotic use before invasive techniques.MethodsA retrospective study was conducted on patients who underwent invasive gynecologic procedures between 2005 and 2015 in a tertiary medical center. Eligible patients were identified and enrolled and their demographic data were collected. The use of prophylactic antibiotics and the outcomes of peritonitis were recorded.ResultsTwenty-six gynecologic procedures were performed on 18 PD patients. Seven episodes of peritonitis occurred in 6 patients after invasive gynecologic procedures. Eleven procedures were preceded by prophylactic antibiotic treatment (6 oral cefadroxil, 1 oral cefuroxime, 1 oral clindamycin, 1 intravenous [IV] ceftriaxone, 1 IV ceftazidime, and 1 IV cefazolin). The pathogens were diverse (group B Streptococcus, group D Streptococcus, E. coli, and Enterococcus). All episodes of peritonitis were successfully treated using intraperitoneal antibiotics without recurrence, technique failure, or mortality. The odds ratio of peritonitis in the non-prophylaxis group was 20.29 (95% confidence interval 1.01 – 406.35, p = 0.0103).ConclusionThe use of prophylactic antibiotic treatment considerably reduced the risk of peritonitis after invasive gynecologic procedures.


PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0223063 ◽  
Author(s):  
Alexandra Csenkey ◽  
Gergo Jozsa ◽  
Noemi Gede ◽  
Eszter Pakai ◽  
Benedek Tinusz ◽  
...  

2019 ◽  
Vol 49 (07) ◽  
pp. 1057-1078 ◽  
Author(s):  
Ioannis Angelakis ◽  
Emma Louise Gillespie ◽  
Maria Panagioti

AbstractThis comprehensive systematic review and meta-analysis aims to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using theI2statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from 68 studies based onn= 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR 5.18, 95% CI 2.52–10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.


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