1.Evaluating the clinical endpoint of antibiotic prophylaxis for cirrhosis patients complicated with upper gastrointestinal bleeding: An updated systematic review and meta-analysis
Putu Itta Sandi Lesmana Dewi ; Kadek Mercu Narapati Pamungkas ; Ni Luh Putu Yunia Dewi ; Ni Nyoman Gita Kharisma Dewi ; Dwijo Anargha Sindhughosa ; I Ketut Mariadi
Acta Medica Philippina 2024;58(Early Access 2024):1-10
Background and Objective:
Antibiotic prophylaxis is used to prevent bacterial infections and rebleeding in cirrhosis patients with upper gastrointestinal bleeding (UGIB). However, the effects of various antibiotics on patients with UGIB are still being considered. This study aims to evaluate the effect of antibiotic prophylaxis on cirrhosis patients with UGIB.
Methods:
The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL from 2013 to 2023. We used Revman 5.4 to perform a meta-analysis. I2 statistics measured the heterogeneity test. The odds ratio (OR) and 95% confidence interval (CI) were used to assess the effect of antibiotic prophylaxis.
Results:
Twelve studies involving 14,825 cirrhosis patients were included in this study. Based on the meta-analysis, antibiotic prophylaxis significantly lowered the bacterial infection rate (OR: 0.29, 95%CI: 0.10 to 0.84, P = 0.02), and the incidence of serious adverse events (SAE) (OR: 0.50, 95%CI: 0.28 to 0.88, P = 0.02) in cirrhosis patients with UGIB.
Conclusions
Administration of antibiotics demonstrated a significant reduction in bacterial infection rates and SAEs. Broad-spectrum non-absorbable antibiotics can be used in cirrhosis patients with UGIB. The appropriate use of antibiotics is important to prevent resistance.
Antibiotic
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Anti-Bacterial Agents
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prophylaxis
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prevention &
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control
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Cirrhosis
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Fibrosis
2.Prevention of Variceal Rebleeding According to the Dose of Propranolol.
Jae Young JANG ; Woong Cheul LEE
Korean Journal of Medicine 2014;86(1):30-32
Esophageal variceal bleeding is a common complication of liver cirrhosis. Non-selective beta blockers (NSBB) have been established in numerous studies as one of the medical treatment for cirrhosis, especially in the primary and secondary prevention of variceal bleeding. The dose of NSBB is adjusted for a reduction in the resting heart rate by 25%, to 55 beat/min, or until the occurrence of adverse effect. The mean adjusted dose of propranolol in Korean study is 160 mg/day. Nevertheless, low dose propranolol is frequently used in real clinical field. A study by Kwon et al. showed that effect of propranolol in the prevention for esophageal rebleeding was superior in maximally-tolerable dose group of propranolol than low dose group. In this editorial, we have reviewed the studies of prevention for variceal rebleeding focusing on the dose of propranolol.
Esophageal and Gastric Varices
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Fibrosis
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Heart Rate
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Liver Cirrhosis
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Propranolol*
;
Secondary Prevention
4.Pterostilbene Ameliorates Renal Damage in Diabetic Rats by Suppressing Hyperglycemia with Inhibition of Inflammatory and Fibrotic Responses.
Run Rong DING ; Guo Yu HUANG ; Yu Jing ZHANG ; Hua Lei SUN ; Yi Ming LIU ; Ze XU ; Wen Jie LI ; Xing LI
Biomedical and Environmental Sciences 2021;34(12):1015-1019
5.Progress in integrative Chinese and Western medicine study on prevention and treatment of myocardial fibrosis.
Hai-xiao ZHANG ; Zai-xiang SHI
Chinese Journal of Integrated Traditional and Western Medicine 2006;26(9):860-864
Myocardial fibrosis is an inevitable process of many heart diseases, such as coronary heart disease, myocardial infarction, hypertension, cardiomyopathy, etc. in development from earlier period to terminal stage. To prevent or reverse the process of fibrosis is one of the most important approaches to retard the occurrence of heart failure and reduce the accidence of arrhythmia. In traditional Chinese medicine myocardial fibrosis belongs to the category of "Xinbi". Studies on the occurrence and regulation of myocardial fibrosis, and its treatment by using integrative Chinese and Western medicine or by Chinese drugs singly and their components were reviewed in this paper.
Cardiomyopathies
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drug therapy
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prevention & control
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Drug Therapy, Combination
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Drugs, Chinese Herbal
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therapeutic use
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Fibrosis
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drug therapy
;
prevention & control
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Humans
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Medicine, Chinese Traditional
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Myocardium
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pathology
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Phytotherapy
6.Surgical treatment for idiopathic abdominal cocoon.
Yi LI ; Ning LI ; Wei-ming ZHU ; Jian-feng GONG ; Wei ZHANG ; Li-li GU ; Lu-gen ZUO ; Jie-shou LI
Chinese Journal of Surgery 2013;51(2):139-141
OBJECTIVETo investigate diagnosis and treatment of abdominal cocoon.
METHODSClinical data of patients received treatment for abdominal cocoon from January 2000 to January 2011 was retrospectively analyzed.
RESULTSA total of 67 patients underwent treatment in our hospital were analyzed, the preoperatively diagnosis rate was only 47.8% (32/67). Patients who received preoperatively nutrition support have a lower postoperative complication (8/27 vs.13/20, χ(2) = 5.815, P < 0.05) and patients with less extent of intestine involved had a lower early postoperative inflammatory ileus (EPII) rate (9/25 vs. 1/22, χ(2) = 6.912, P < 0.05) when compared with large extent.
CONCLUSIONSAppropriate perioperative management play an important role in the prognosis of abdominal cocoon. The main treatment is surgery while preoperatively nutrition support can reduce postoperative complications.
Adolescent ; Adult ; Aged ; Female ; Humans ; Ileus ; prevention & control ; Male ; Middle Aged ; Peritoneal Fibrosis ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Young Adult
7.Management of viral hepatitis in patients with hepatocellular carcinoma.
Journal of the Korean Medical Association 2013;56(11):1001-1011
Globally, viral hepatitis due to hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection is the major cause of advanced liver diseases such as liver cirrhosis and hepatocellular carcinoma (HCC). Chronic inflammation resulting from persistent viral hepatitis is also associated with an increased risk of HCC recurrence. Replication of HBV and/or HCV can reactivate during anti-cancer treatments of HCC and lead to hepatic dysfunction, adversely affecting patient outcomes. The most effective way to prevent chronic viral hepatitis, cirrhosis, or HCC would be the implementation of a vaccine. Unfortunately, a vaccine for HCV is currently not available. For chronically infected patients, antiviral therapy may be the only option that can prevent or retard disease progression. Emerging evidence continues to support direct or indirect benefits from antiviral therapy for preventing liver disease progression to cirrhosis, HCC development, and recurrence after curative treatments in patients with chronic HBV or HCV infection. This paper reviews the literature on the management of viral hepatitis in patients with HCC, focusing on primary and tertiary prevention of HCC.
Carcinoma, Hepatocellular*
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Disease Progression
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Fibrosis
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Hepacivirus
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Hepatitis B virus
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Hepatitis*
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Humans
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Inflammation
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Liver Cirrhosis
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Liver Diseases
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Recurrence
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Tertiary Prevention
9.Effects of mycophenolate mofetil on renal interstitial fibrosis after Unilateral ureteral obstruction in rats.
Chun ZHANG ; Zhonghua ZHU ; Gang WANG ; Anguo DENG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2003;23(3):269-282
To investigate the effects of mycophenolate mofetil (MMF) on the process of renal interstitial fibrosis, unilateral ureteral obstruction (UUO) model was established in rats. Twenty Sprague-Dawley rats underwent UUO and received vehicle (n = 10) or MMF (20 mg.kg-1.d-1, by daily gastric gavage, n = 10) during a period of 5 days following surgery, and the additional 10 rats were served as sham-operated group. The rats were killed 5 days after surgery. Immunohistochemistry was performed on renal tissue for proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (alpha-SMA) and type I and III collagen (col I, col III). Histological studies were also done by MASSON staining. Five days after surgery, proliferating cells in tubules, interstitium as well as interstitial myofibroblast (MyoF) infiltration and interstitial col I, col III deposition were all significantly reduced by MMF treatment. MMF also alleviated the histological changes of UUO rats. These results suggested that the reduction of interstitial MyoF infiltration may be an important event by which MMF prevents renal injury caused by UUO and MMF could be used to limit the progression of renal fibrosis.
Animals
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Female
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Fibrosis
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Kidney
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pathology
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Kidney Diseases
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etiology
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pathology
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prevention & control
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Mycophenolic Acid
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analogs & derivatives
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pharmacology
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Random Allocation
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Rats
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Rats, Sprague-Dawley
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Ureteral Obstruction
;
complications
10.Laser inducing mucosal fibrosis for preventing recurrence of esophageal varices.
Huan-yuan LU ; Xun-yang LIU ; Fei-zhou HUANG ; Wan-pin NIE ; Shu-ping REN ; Rang-lang HUANG
Chinese Journal of Surgery 2004;42(24):1513-1515
OBJECTIVETo investigate the prevention of esophageal varices recurrence by laser inducing esophageal mucosal fibrosis.
METHODSOur study included 42 patients after esophageal varices eradicated by endoscopic varices ligation, and they were divided into 2 groups randomly, each group included 21 patients. One group was assigned to received laser treatment, and indocyanine green solution (1 mg/ml) was injected submucosally, a diode laser (power 10 watts) was applied to the surface from the esophagogastric junction to 5 cm above it. Another group was controlling without any treatments. All patient were followed up by endoscopy every 3 months until 12 months.
RESULTSLaser irradiation was performed safely without any major complications. And lower esophageal mucosa produced fibrosis widely after laser irradiated 1 month. After 12 months follow up, the cumulative recurrence rate was significantly lower than the control group, 14% (3/21) vs 43% (9/21) (chi(2) = 4.20, P < 0.05).
CONCLUSIONSOur study indicates that laser inducing mucous fibrosis is safely and can prevent recurrence of esophageal varices.
Adult ; Esophageal and Gastric Varices ; pathology ; surgery ; Esophagoscopy ; Esophagus ; pathology ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Laser Coagulation ; methods ; Ligation ; Male ; Middle Aged ; Mucous Membrane ; pathology ; Secondary Prevention