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Data from the National Cancer Data Base support the inclusion of surgery after concurrent chemoradiotherapy for patients with locally advanced rEC. Cancer 2017;123:3476-85. © 2017 American Cancer Society.
Angioplasty for PVS after pediatric LT is a safe and effective treatment with good patency and improved clinical outcomes. Longer follow-up studies are required.
Background & Aims Most studies on autoimmune hepatitis (AIH) in children are in predominantly Caucasian cohorts. Paediatric AIH in African Americans (AA) is understudied, with a dearth of clinical predictors of outcome, often leading to serious complications and even mortality. The aim of the study was to define disease presentation, progression, response to therapy and outcomes in paediatric AIH in a well‐defined, large, single centre, demographically diverse population. Methods We conducted a review of patients with AIH who were followed at this tertiary liver transplant centre. Clinical and laboratory covariates were assessed with regard to disease presentation, progression and outcomes in AA vs Non‐AA children. Results African Americans patients constituted 42% of this cohort. At 1‐year follow‐up, AA children were receiving significantly higher doses of steroids compared to non‐AA. More AA presented with end‐stage liver disease (ESLD) with high immunoglobulin G and GGT:platelet ratio. After adjusting for other risk factor variables like gender, age at presentation and ESLD, AA children were at 4.5 times higher risk for significant outcome liver transplant/death within the first 12 months of presentation. Post‐transplant, recurrent AIH was seen in 50% of AA vs 8% in non‐AA. Conclusions African American patients with AIH are more likely to present with ESLD and have an increased early risk for transplantation with high likelihood of disease recurrence post‐transplantation. Studies are needed to delineate factors such as inherent biology, genetics and access to care. Early referral and tailored immunosuppressive regimens are required for AA patients with AIH.
The UK bowel cancer awareness campaigns appear to have improved public awareness of CRC and encouraged symptomatic individuals to seek urgent medical attention. The increase in 2WW referrals has not translated into better survival for symptomatic patients, partly due to the proportion presenting with advanced disease.
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