Conclusion: Endoscopic comprehensive treatments have the advantages of safety, effectiveness and micro-trauma

and replenished markedly the management of chronic CP 673451 pancreatitis. Key Word(s): 1. Chronic pancreatitis; 2. Endoscopic therapy; Presenting Author: MARIO REY Corresponding Author: MARIO REY Affiliations: I. NAL. DE CANCEROLOGIA Objective: The indication for undifferentiated intramucosal gastric carcinomas are controversial because of the increased likelihood of nodal metastases is low but is 4.2% vs. 0.4% of differentiated. Methods: A 34 year female patient, was sent to the National Cancer Institute, Colombia, 2 months dyspeptic symptoms evolution with upper endoscopy, identifying a lesion type II c of 10 mms without ulceration in the lesser curvature in distal third of the body; Biopsies are taken showing GSK-3 inhibition undifferentiated

adenocarcinoma with signet ring cells which was corroborated by a second pathologist, extension studies were conducted in with abdominal CT scan, rx chest which were normal. On August 8, 2005 Endoscopic Submucosal Dissection (ESD) was performed using It knife 1. Endoscopy was performed in 24 hours control.Pathology showed undifferentiated adenocarcinoma infiltrating only the mucosa (m3) without invasion of the muscularis mucosa or lymphovascular invasion. Immunohistochemistry studies were done with Keratine AE1 and AE3 showing more clearly the signet-ring cell. Results: It was conducted a endoscopic follow every 3 months – 6 months with biopsy sampling, abdominal

CT and ultrasonography in the following 7 years without identifying persistence or recurrence. Conclusion: In the last decade the endoscopic resection comes to be the first choice for early gastric carcinoma treatment in the east countries.In the clinical setting in patients with undifferentiated Thiamine-diphosphate kinase EGC clinical studies from Korea and Japan conclude that complete endoscopic resection as a curative treatment is acceptable to an undifferentiated CGT when the tumor is smaller than 2 cm, this confined to the mucosa and has no lymphovascular involvement.This case of endoscopically resected Undifferentiated EGC on August 8, 2005 is the first to demonstrate survival seven years made in America in our review. Key Word(s): 1. ESD; 2. UNDIFERENTIATED EGC; 3. EARLY GASTRIC CANCER; 4. WESTERN EXPERIENCE; Presenting Author: MOU YI Additional Authors: HU BING Corresponding Author: MOU YI Affiliations: West China Hospital, Sichuan University Objective: To discuss the clinical outcome of endoscopic resection of gastric gastrointestinal stromal tumor(GIST). Methods: Retrospective analysis of 23 GIST patients treated by endoscopy and 31 treated by surgery in our hospital. The baseline data of the two groups were comparable. Endoscopic treatment was carried out byendoscopic submucosal dissection(ESD).Recurrence of tumor was treated as the terminal event.

For internal porosity, the casting (12 × 12 × 2 mm3) was studied by the X-ray method, and the projected porous area percentage was measured by an image-analysis system (n = 10). The apparent porosity of the investment (n = 10) was measured in accordance FDA-approved Drug Library with the ASTM C373-88 standard. Results: Analysis of variance (One-way

ANOVA) of castability was significant, and the Tukey test indicated that RU had the highest mean but the investing technique with coating increased the castability for all phosphate-bonded investments. The analysis of the internal porosity of the cast by the nonparametric test demonstrated that the RP, RE, and CA with coating and RP without coating did not differ from the control group (RU), while the CA and RE casts without coating were more porous. The one-way ANOVA of apparent porosity of the investment was significant, and the Tukey test showed that the means of RU (36.10%) and CA (37.22%) were higher than those of RP (25.91%) and RE (26.02%).

Conclusion: Pattern coating with spinel-based material prior to phosphate-bonded investments can influence the castability and the internal Idasanutlin chemical structure porosity of CP Ti. “
“Purpose: To evaluate the effects of different levels of vertical misfit between implant and bar framework on distribution of static stresses in an overdenture-retaining bar system using finite element analysis. Material and Methods: A 3D finite element model (11,718 elements and 21,625 nodes) was created and included two titanium implants heptaminol and a bar framework placed in the medial region of the anterior part of a severely reabsorbed-jaw. All materials were presumed to be linear elastic, homogenous, and isotropic. Mechanical simulation software (NEiNastran 9.0) was used, where displacements were applied on the end of the bar framework to simulate the closure of the vertical misfits (5, 25, 50, 100, 200, and 300 μm) after tightening of the screws.

Data were qualitatively evaluated using Von Mises stress given by the software. Results: The models showed stress concentration in cortical bone, corresponding to the cervical part of the implant, and in cancellous bone, corresponding to the apical part of the implant; however, in these regions few changes were observed in stress to the misfits studied. While in the bar framework, retaining-screw neck, and implant platform, a considerable stress increase proportional to the misfit amplification was observed. Conclusions: The different levels of vertical misfit did not considerably influence the static stress levels in the peri-implant bone tissue; however, the mechanical components of the overdenture-retaining bar system are more sensitive to lack of passive fit. “
“Purpose: To investigate the reliability and failure modes of indirect composites as single-unit implant crowns.

019; r2 = 0.407) (Supporting Fig. 6b), and plasma IL-17 (P = 0.0003; r2 = 0.708) (Supporting Fig. 6c). In the SALF cohort, increased neutrophil ROS production correlated with higher APACHE II score (P = 0.003; r2 = 0.635) and SOFA score (P = 0.01; r2 = 0.561) and increased serum high density lipoprotein levels (P = 0.001; r2 = 0.763). When stimulated OB with E. coli was impaired in the ALF cohort it correlated with lower plasma concentrations of IL-6 (P = 0.038; r2 = 0.190), IL-10 (P = 0.047; r2 = 0.175) and IL-17 (P = 0.007; r2 = 0.301) and in the SALF cohort, correlated with higher plasma concentrations Carfilzomib clinical trial of IL-8 (P

= 0.007; r2 = 0.465) and lower plasma concentration of IL-17 (P = 0.025; r2 = 0.354). Patients with ALF/SALF who died or were transplanted (considered nonsurvivors in the analysis) had lower NPA on day 1 than spontaneous survivors (P = 0.01) (Table 3; Fig. 4A). Impaired NPA predicted nonsurvival in ALF/SALF even

when the transplanted patients were removed from the analysis (P = 0.029). No difference was observed NVP-LDE225 when comparing admission neutrophil spontaneous OB in spontaneous survivors to patients who died or underwent LT (P = 0.5). Four deaths occurred in the ALF cohort; three patients died of MODS (two on day 10 of ICU admission and one on day 45) and one died of uncontrolled intracranial hypertension. In the SALF cohort, two patients died from MODS on days 15 and 17 of the ICU admission, respectively. The incidence of culture-positive sepsis in the ALF/SALF cohorts overall was low, with one patient with seronegative SALF developing an episode of Staphylococcus epidermidis bacteremia on day 3 (day 1 NPA 29.7% improving to 40.3% post-LT on day 6) and in another seronegative SALF a Klebsiella spp. urinary tract infection developed on day 18 (patient had an NPA of 61%). This prospective study is the most comprehensive performed to date characterizing circulating neutrophil dysfunction in patients admitted to ICU with ALF and SALF until spontaneous recovery, death, or

LT. It demonstrates significant reduction in neutrophil Rho surface expression of CD16 (FcγRIII), which may contribute to the reduced ability of the neutrophil to bind to an opsonized microbe, akin to patients with sepsis and MODS. Pronounced impaired phagocytic activity of opsonized E. coli was also observed in neutrophils isolated from patients with ALF and particularly SALF. Lower NPA at presentation predicted poor outcomes, with patients who died or required LT showing a lower NPA compared to non-LT survivors. Neutrophil dysfunction has been implicated both in the immune paresis observed in ALF13, 14 and in direct injury to the liver6 and extrahepatic organs.9 Neutrophil-driven hepatocellular injury has also been shown to contribute to hepatocellular damage in models of ischemia-reperfusion injury,20 alcoholic hepatitis,21 and endotoxemia.

0 (The Metabolomics Innovation Centre (TMIC). Results: In all 42 metabolites were assigned in the proton NMR spectrum of patients with celiac disease. PLS-DA clearly differentiated patients with celiac disease from controls. A significantly higher concentration of lactate, pyruvate, succinate, fumarate, aspartate

and leucine were observed in the intestinal mucosa of patients with celiac disease than controls suggesting selleckchem abnormalities in glycolysis and Kreb’s cycle (energy deficiency) and amino acid metabolism which may affect the biosynthetic pathways and consequently may contribute to villous abnormalities. Accumulation of aspartate indicated lower activity of aspartate

transaminase affecting its availability for urea cycle. Conclusion: Our data indicated characteristic metabonomic signature of small intestinal mucosa of patients with celiac disease. Key Word(s): 1. Celiac Disease; 2. Villous atrophy; 3. NMR spectroscopy; Presenting Author: WEIHONG TANG Additional Authors: QIAN XU, WENYU CONG Corresponding Author: QIAN XU, WENYU CONG Affiliations: General Hospital Z-VAD-FMK supplier of Armed Police Forces, Beijing; Department of Gastroenterology, Xijing hospital, The Fourth Military Medical University, Xi’an; Department of experimental therapy of Acute Radiation Sickness, Institute of Radiation Medicine, Academy of Military Medical Science, Beijing Objective: To establish a method of visualizing the microvascular system in the

small intestinal villi of mice by a cardiac perfusion of fluorescent dye DiI (1,1′-dioctadecyl – 3,3,3′3′ – tetramethylindocarbocyanine perchlorate) and to observe the villous microvascular changes Mannose-binding protein-associated serine protease in the pathogenesis of radiation enteritis (RE). Methods: C57BL/6 mice were irradiated with a single dose of γ rays to the abdomen to establish an animal model of RE. Radiation-induced intestinal mucosa damage in mice was examined by H&E staining. The blood vessels of mice were labeled by a cardiac perfusion of fluorescent dye DiI, and the labeled villous microvascular system, as well as its changes after irradiation, were observed by conventional and confocal fluorescence microscopy. Results: According to the pathological changes of the small intestine in irradiated mice, the method of visualizing blood vessels of mice by a cardiac perfusion of DiI was established. Complete and clear three-dimensional structure of the villous microvascular system of mice could be observed for the first time by fluorescence microscope or confocal laser scanning microscope thanks to DiI labeling.

Key Word(s): 1. Fundic gland polyps; 2. hyperplastic polyps;

3. adenomatous polyps; 4. colorectal neoplasia; Presenting Author: YOUNG JAE BYUN Additional Authors: DONG SOO HAN, YU HWA LEE, YOUNGOUK RO, SUN MIN KIM, TAE YEOB KIM, CHANG SOO EUN, KYO-SANG YOO, YONG CHEOL JEON, JOO HYUN SOHN Corresponding Author: DONG SOO HAN Affiliations: Hanyang University Guri Hospital Objective: Patients with functional constipation are often recommended to increase dietary fiber intake. Overactive bladder (OAB) may be associated with bowel symptoms. We examined the associations among functional constipation, dietary fiber intake, and OAB in Korean AZD2281 in vitro population cohort. Methods: This cohort study, using a reliable and valid questionnaire based on the Rome III criteria was performed in Yangpyeong city, Korean community on subjects aged ≥40 years between 2011 and 2012. Total, grain, vegetable, fruit and seaweed fiber intakes were estimated

from dietary questionnaires. OAB was defined through overactive bladder symptom score. The associations among functional constipation, dietary fiber intake, and OAB were assessed separately by age and gender. Results: A total of 1,173 patients were enrolled, with mean age of 62.4 ± 29.0, of which 63% was comprised of women. There were 134 (11.4%) patients with functional constipation. Total fiber intake was associated with a significantly lower prevalence of functional constipation in men, not in women. On the contrary, OAB was correlated with functional constipation in elderly women. Conclusion: Men who consumed high amount of fiber have a lower prevalence of functional constipation. selleck kinase inhibitor OAB is associated with functional constipation in elderly women. This population-based study suggests that the pathogenesis of functional constipation

PtdIns(3,4)P2 may be different between men and women. Key Word(s): 1. Constipation; 2. Dietary fiber; 3. Overactive bladder; 4. Cohort study; Presenting Author: HUA YANG Additional Authors: BING-QING XIA, BO JIANG, YI-PENG YANG, HAO CHEN, BING-SHENG LI LI, AN-GAO XU, YUN-BO HUANG, XIN-YING WANG Corresponding Author: HUA YANG Affiliations: Nanfang Hospital, Southern Medical University; Huizhou Medical Institute Objective: The diagnostic value of stool DNA (sDNA) testing for colorectal neoplasms remains controversial. To compensate for the lack of large-scale unbiased population studies, we performed a meta-analysis to evaluate the diagnostic value of sDNA testing for multiple markers of colorectal cancer (CRC) and advanced adenoma. Methods: The Pubmed, Science Direct, Biosis Review, Cochrane Library, and Embase databases were systematically searched in January 2012 without time restriction. Meta-analysis was performed using a random-effects model using sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver-operating characteristic (sROC) curves, area under the curve (AUC), and 95% confidence intervals (95% CIs) as effect measures.

59% were diabetic, 44% hypertensive, 33% smokers and 26% hyperlipidaemic. 53% of the patients had ≤2 of these risk factors. There was no difference in age, sex, BMI, number of HCC’s or other metabolic risk factors between the cirrhotic and non-cirrhotic patients. Non-cirrhotics

had a significantly larger mean tumour diameter than cirrhotics (p = 0.041) and were more likely to have HCC outside of Milan criteria for transplantation (p = 0.034). Multivariate analysis did not identify any other patient characteristics that predicted size of hepatomas, but having diabetes (p = 0.03) or more than 2 risk factors (p = 0.03) correlated with having more numerous HCCs. Conclusions: This study demonstrates that HCC can develop in NAFLD without cirrhosis or obesity; and tumours in non-cirrhotics

are MAPK Inhibitor Library concentration larger conferring a poorer prognosis. The fact that smaller HCC were detected in the cirrhotic patients is likely due to formal HCC screening in this patient group. Thus, urgent studies are needed to clarify the role of HCC screening in non-cirrhotic NAFLD. T HONG,1 A THOMPSON,1 P GOW,2 M FINK,8 M RYAN,1 A DEV,3 I KRONBORG,4 N ARACHCHI,4 J LUBEL,5,9 A NICOLL,6 S ROBERTS,7 P DESMOND,1 S BELL1 With the Melbourne collaboration for the study of hepatocellular Adriamycin datasheet carcinoma (MESH) Departments of Gastroenterology & Hepatology, 1St Vincent’s Hospital, Melbourne, Australia. 2The Austin Hospital, Melbourne, Australia. 3Monash Medical Centre, Melbourne, Australia. 4Western Health, Melbourne, Australia. 5Eastern Health, Melbourne, Australia. 6The Royal Melbourne Hospital, Melbourne, Australia. 7The Alfred Hospital, Melbourne, Australia., 8Department of

Surgery, The Austin Hospital, Melbourne, Australia. Background: Recent studies suggest that the incidence of hepatocellular carcinoma (HCC) is rising rapidly. Australian epidemiological data are currently derived from cancer registries, which classify HCC according to histology. However, HCC is now a radiological diagnosis, with histology reserved for a minority of cases. Cancer registry data may therefore underestimate the true incidence of HCC. We have therefore performed the first population-based Chlormezanone study of HCC incidence in Australia using current diagnostic criteria. Method: New diagnoses of HCC were prospectively collected between July 2012 and June 2013 at all tertiary hospital services in Melbourne. Cases were identified using capture-recapture methodology from multiple sources including public hospital HCC multi-disciplinary meetings, medical coding, radiology, pathology and pharmacy databases. Private gastroenterologists and hepato-pancreato-biliary surgeons were surveyed to confirm that all private cases were referred to one of the participating centres for discussion, radiology or surgery. Case definition was based on AASLD clinico-radiological criteria or histological verification.

I wonder how headache specialists would feel if surgeons would research and write an article about failed preventative and abortive medications or their complications. This click here will not occur since we consider this kind of report unscientific, egotistical, and totally

inappropriate. In the conclusion, Dr. Mathew criticizes the destructive nature of the treatment of the zygomaticotemporal branch of the trigeminal nerve. As I indicated earlier, this nerve, which is less than 1 mm in diameter, has been the subject of transection in many aesthetic and reconstructive procedures for decades. We are not aware of any patients developing a neuroma or persistent pain after this surgery that was not present prior to the surgery. This nerve will be decompressed from here on based on our recent study results. This will offer a second option for the patients, should decompression fail. His repeated claim that the patients who benefitted from the surgery may have had different types of headaches rather than MH is another reproachful remark against the headache specialists who are integral members of our research team. These highly respected neurologists have been enormously instrumental in serving many patients and allowing them to gain a quality of life they had never had. Cooperation between plastic surgeons

Paclitaxel nmr and neurologists can serve a small group of migraine patients who are not benefiting from the available preventative or abortive measures. Plastic surgical Ku-0059436 decompression of migraine trigger sites is not different from neurosurgical or orthopedic decompression of the different cranial and spinal nerves. The potential complications are extremely low and the benefits are life altering for many of these patients. The patients who are symptom free are not going to call their neurologist to report not having pain or visit their neurologist and pay for the visit when they do not need any care. These neurologists are

not going to hear about the success of the surgery, but invariably they will hear about the failures. I warmly invite our neurology colleagues to join forces with us to figure out how we can better help this small group of patients who suffer from such a devastating condition, but do not benefit from the available preventive or abortive medications. Many of these patients who undergo surgery not only have reduced migraine days or less intense pain, but they can often breathe better and commonly look better. Denouncing the surgery will result in hopeless patients being attracted and persuaded by the advertisements of the few improperly trained and immoral surgeons with unreasonable fees, which will have disappointing and even devastating outcomes.

Both pathways converge to activate mTOR by inhibiting the activity of its negative regulator tuberin [more specifically tumor suppressor complex 2 (TSC2)].21 It has been shown that AKT and ERK may directly phosphorylate different serine residues on TSC2 and thereby inhibit its activity.22, 23 A number of functions modulated by mTOR are potentially relevant for liver cyst growth. Among them, mTOR stimulates

HIF1α, a main transcription factor for VEGF.24 Rapamycin, an inhibitor of mTOR commonly used as an antirejection agent, has shown promising oncological applications because of its ability to promote chemotherapy-induced apoptosis and inhibit angiogenesis.16 Previous studies in animal models of polycystic kidney diseases nonorthologous to polycystin defects, such selleck screening library as the Han:Sprd rats25 and orpk and bpk mice,11 reported that treatment with rapamycin reduced kidney cysts and improved kidney function. Retrospective

studies showed a reduction in kidney and liver cysts in patients with advanced-stage ADPKD who received a renal transplant and were treated with a rapamycin-containing antirejection regimen.14 We found that administration of rapamycin significantly decreased the cystic area of the liver and the liver/body weight ratio in Pkd2KO mice. At a daily dose of 1.5 mg/kg, rapamycin Y27632 was well tolerated with no significant changes in liver function tests in comparison with untreated controls. Treatment with rapamycin Resveratrol decreased the PCNA index of liver cysts while increasing the expression of CC3, and this suggests that rapamycin alters the balance between proliferation and apoptosis by reducing the number of proliferating cells and enhancing cyst apoptosis in vivo. Because of the role of VEGF in polycystic liver disease progression and the reported anti-angiogenic

effects of rapamycin on cancer, we studied the effects of rapamycin on VEGF production in cystic cholangiocytes cultured from PC2-defective mice. We found that rapamycin suppressed the increased HIF1α nuclear expression and VEGF production typical of PC2-defective cells. This indicates that VEGF production in cystic cholangiocytes is controlled by mTOR and that the inhibitory effects of rapamycin on liver cysts could be explained in part by the inhibition of VEGF expression. IGF1 is a cholangiocyte growth factor able to stimulate the PI3K/AKT pathway. IGF1 is overexpressed by the cystic epithelium and reaches a high concentration in the fluid of hepatic cysts in ADPKD patients.5 IGF1R is overexpressed in human cholangiopathies, including cholangiocarcinoma and human liver ADPKD.5, 26 Here we show that administration of IGF1 significantly increased HIF1α and VEGF in cystic cholangiocytes with respect to WT cholangiocytes. Stimulation of IGF1R is known to activate different common transduction pathways that modulate proliferation/survival.

1 This is an impressive study of 151 patients with refractory ascites in whom beta-blockers were shown to have deleterious effects on survival. Despite meticulous analyses of the data, the authors did not find any plausible explanation for the differences between patients treated with beta-blockers and patients not treated with beta-blockers, such as differences in the degree of portal hypertension, the presence of esophageal varices, or liver dysfunction. However, the arterial

blood pressure was lower in the beta-blocker group, and four characteristics—the presence of hepatocellular carcinoma, Child-Pugh score class C, refractory ascites as the etiology, and beta-blocker therapy—predicted death. Apart from the arterial blood pressure and heart rate, characteristics of cardiac function such as

the cardiac output were not measured in the study. We therefore propose a potential contributing explanation for the dramatic effect of beta-blockers C59 wnt on survival in patients with refractory ascites. Treatment with a nonselective beta-blocker decreases cardiac output by blockade of the beta-1-adrenergic receptors. We believe that the pronounced inhibitory effect of propranolol on cardiac function may explain the increased mortality. It is well known that in patients with refractory ascites and circulatory dysfunction, renal function often deteriorates further with the development of hepatorenal syndrome. There seems to be a complex and bidirectional interaction between Fulvestrant datasheet the heart and the kidneys, and different observations have suggested that a type of cardiac dysfunction known as cirrhotic cardiomyopathy significantly contributes to the pathophysiology of hepatorenal syndrome. A cardiorenal interaction may be a key element in the homeostasis of the extracellular fluid volume, arterial blood pressure, and effective/central blood volume. We believe that different observations point to impaired cardiac function in cirrhosis as part of the pathogenesis of hepatorenal syndrome.2-4 It has been demonstrated that patients with cirrhosis, before they develop Anidulafungin (LY303366) type 1 hepatorenal syndrome, have

decreased or relatively low cardiac output.2-4 In these patients, treatment by beta-blockers further reduces cardiac output, systemic perfusion, and peripheral oxygen delivery with potentially deleterious effects.2-4 We therefore propose an additional explanation for the reduced survival after beta-blocker treatment. We hypothesize that the reduction of the effective arterial blood volume and renal failure in patients with cirrhosis and refractory ascites are consequences of not only progressive arterial vasodilatation but also cardiac systolic dysfunction. The result of systolic dysfunction is relatively reduced cardiac output insufficient to maintain adequate arterial blood pressure and renal perfusion. These mechanisms are further hampered by treatment with beta-blockers and explain the deleterious effects in patients with refractory ascites, as described by Sersté et al.

[3] Accordingly, AMAs are being used to define PBC-like disease also in mice,[4] even though alterations in serum liver tests or histological changes are sometimes minimal. In our view, however, use of AMAs to define PBC in mice is potentially misleading when insufficiently quantified. Using recombinant PDC-E2170-313,[6] we established an enzyme-linked immunosorbent assay (ELISA) to quantify AMA reactivity in mouse and human serum, determining the half maximal effective concentration. We found significantly increased AMAs in dnTgfβ-R2 mice, a proposed PBC mouse model, at 3 months of age, in line with previous reports.[4] However, their AMA titer was Ulixertinib manufacturer only 3.6-fold increased compared with wild-type

littermates (Fig. 1A,B). In contrast, AMA reactivity in sera of human PBC patients was more than 2,500-fold increased compared with age-matched healthy controls (Fig. 1C,D). Subsequently, we studied AMA reactivity in a cohort of 24 wild-type female C57Bl/6 mice by comparing optical density in single dilutions (1:1,000) and found a significant increase with

age from 0.35 ± 0.11 to 0.55 ± 0.30 and 1.05 ± 0.72 (optical density) at 3, 6, and 12 months of age, respectively (Fig. 1E). This age dependency was not found in a cohort of 116 female human controls (Fig. 1F). We conclude from these observations that (1) AMAs do not adequately define PBC-like disease in mice, (2) other immunologic and histologic features of CH5424802 clinical trial PBC must instead be carefully evaluated in PBC models, and (3) the value of purely AMA-based PBC animal models to test therapeutic compounds should be re-evaluated. Simon Hohenester M.D. “
“Recently, Awad et al.1 presented a meta-analysis comparing peginterferon alfa-2a and peginterferon alfa-2b for the treatment of hepatitis C virus (HCV) infection. The

authors conclude: “Current evidence suggests that peginterferon alpha-2a is significantly superior to peginterferon alfa-2b regarding benefits (SVR, which is clearance of the virus from the blood)”. After a careful revision of the article by Awad et al. and the original articles included in the meta-analysis, Cell Penetrating Peptide the conclusion they reach must be interpreted with caution. A main principle of meta-analysis deals with the homogeneity of the trials that will be analyzed together, in both aspects: population under study and methodological issues.2, 3 In addition, the quality of individual trials is important. However, these principles are not completely satisfied in the work of Awad et al.: 1 Two of the studies cited in Awad et al. (Sinha et al.4 and Kolakowska et al.5) were published as abstracts, without peer review. Simultaneously, Alavian et al.12 presented a very similar article: “The Comparative Efficacy and Safety of Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A Meta-Analysis.” Alavian et al. analyzed only five of the eight trials used by Awad et al. Alavian et al.