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Portal hypertension, an important consequence of liver disease, results in the development of significant collateral circulation between the portal system and systemic venous drainage (porto-caval circulation). Portal venous congestion causes venous blood leaving the stomach and intestines to be diverted along auxiliary routes of lesser ...
Only patients with measurable disease at baseline should be included in protocols where objective tumor response is the primary endpoint. Measurable disease – the presence of at least one measurable lesion. If the measurable disease is restricted to a solitary lesion, its neoplastic nature should be confirmed by cytology/histology.
A computer-based protocol system is a paradigm providing a set of tools which allow health care providers access to current guidelines which they can apply in practice. [1] Studies have shown that protocols can aid in optimising patient care. [2] There are two types of protocol systems: passive and active.
Portal hypertension is commonly seen with liver cirrhosis and/or other liver diseases such as Budd–Chiari syndrome, primary biliary cirrhosis (PBC), and portal vein thrombosis. [2] The purpose of the shunt is to divert blood flow away from the liver, reducing the high pressure in the portal venous system and decreasing the risk of bleeding. [3]
Overall Treatment Utility is an example of a multidimensional composite endpoint in cancer clinical trials. [ 8 ] Regarding humane endpoints, a combined endpoint may constitute a threshold where there is enough cumulative degree of disease, symptoms, signs or laboratory abnormalities to motivate an intervention.
Ultrasonography (US) is the first-line imaging technique for the diagnosis and follow-up of portal hypertension because it is non-invasive, low-cost and can be performed on-site. [17] A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [18]
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Portal hypertensive gastropathy can also be treated with endoscopic treatment delivered through a fibre-optic camera into the stomach. Argon plasma coagulation and electrocautery have both been used to stop bleeding from ectatic vessels, and to attempt to obliterate the vessels, but have limited utility if the disease is diffuse.