Esbensenziegler2011
CIC is a common condition in adults, occurring more frequently in the elderly and in women. Proper management is defined by detailed medical history and physical examination, together with appropriate therapeutics, regardless pharmacological or not, and depending on the best moment of indication. This way, the impact on quality of life is also optimized.
CIC is a common condition in adults, occurring more frequently in the elderly and in women. Proper management is defined by detailed medical history and physical examination, together with appropriate therapeutics, regardless pharmacological or not, and depending on the best moment of indication. This way, the impact on quality of life is also optimized.
Deceased donor liver transplantation (DDLT) is the first choice, but living donor transplantation (LDLT) is an alternative to be considered in special situations, such as lack of donated organs and emergencies. So far, there is no consensus on which transplantation method provides better survival and fewer complications, which is still an open point for discussion.
This meta-analysis compared the 1, 3, and 5-year patient and graft survival rates of LDLT and DDLT. We included studies published from April-2009 to June-2021 and adopted the generic model of the inverse of variance for the random effect of hazard ratios. The adequacy of the studies was determined using the Newcastle-Ottawa Scale - NOS (WELLS).
For patient survival analysis, we included a total of 32,258 subjects. We found a statistically significant better survival for the LDLT group at 1, 3 and 5 years, respectively 1.35 HR (95%CI 1.10-1.66, P=0.005), 1.26 HR (95%CI 1.09-1.46, P=0.002) and 1.27 HR (95%CI 1.09-1.48, P=0.002). Our meta-analysis evaluated a total of 21,276 grafts. In the overall analysis, the 1-year survival was improved in favor of the LDLT group (1.36 HR, 95%CI 1.16-1.60, P<0.0001), while the 3-year survival (1.13 HR, 95%CI 0.96-1.33, P<0.13), and 5 (0.99 HR, 95%CI 0.74-1.33, P<0.96), did not differ significantly.
This metanalysis detected a statistically significant greater 1-, 3- and 5-years patient survival favoring LDLT compared to DDLT as well as a statistically significant difference better 1-year graft survival favoring the LDLT group.
This metanalysis detected a statistically significant greater 1-, 3- and 5-years patient survival favoring LDLT compared to DDLT as well as a statistically significant difference better 1-year graft survival favoring the LDLT group.
Supplementation with probiotics, prebiotics and symbiotics has shown positive effects on clinical markers and risk factors for non-alcoholic fatty liver disease (NAFLD).
To evaluate the effect of supplementation with probiotic, prebiotic or symbiotic on intestinal microbiota in NAFLD patients.
Two investigators conducted independently search for articles in the Medline databases, via PubMed, Web of Science, Embase, Scopus, Lilacs, Central Cochrane Library, Clinical Trials.gov and on the Ovid platform for the gray literature search.
A total of 3,423 papers were identified by searching the electronic databases; 1,560 of them were duplicate and they were excluded; 1,825 articles were excluded after reading the title and abstract. A total of 39 articles were select to reading, however only four articles met the eligibility criteria to include in this systematic review. Three of the included studies that used prebiotic or symbiotic supplementation showed that after the intervention there were changes in the intestinal microbiota pattern. Only in one study such changes were not observed. A high risk of bias was observed in most assessments.
Although there is a possible change in the gut microbiota of individuals with NAFLD after supplementation with symbiotics or prebiotics, a clinical indication as part of NAFLD treatment is not yet possible.
Although there is a possible change in the gut microbiota of individuals with NAFLD after supplementation with symbiotics or prebiotics, a clinical indication as part of NAFLD treatment is not yet possible.
Behçet's disease is a rare immune-mediated disorder that can affect the gastrointestinal tract. The prevalence and extension of small bowel involvement is largely unknown.
The aim of this study was to describe the small bowel lesions diagnosed by double-balloon enteroscopy (DBE) and to verify if these findings were associated to the presence of gastrointestinal symptoms and disease activity after long-term follow-up.
This study included 19 Behçet's disease patients who underwent DBE. After a mean follow-up of 15 years the endoscopic findings were associated to the presence of gastrointestinal symptoms, disease activity and current therapy through collection of electronic medical records.
A total of 63.2% patients were female and the mean age was 37 years at the time of DBE. Mean disease duration at baseline was 24 years. 11 patients had no gastrointestinal symptoms and eight patients presented either abdominal pain, gastrointestinal bleeding or diarrhea. The average procedure time was 1 hour and 30 mifor novel treatment.
Small bowel involvement in Behçet's disease was frequently demonstrated by DBE even in asymptomatic patients. Understanding clinical evolution of the disease over the years and the impact of such diagnosis still represents a challenge, possibly with the need for novel treatment.
Non-invasive markers are useful and practical tools for assessing non-alcoholic fatty liver disease (NAFLD), but liver biopsy remains the gold-standard method. Dooku1 Liver biopsy can be easily obtained on individuals undergoing bariatric surgery, but there is no ultimate evidence on the relationship between costs, risks and benefits of its systematic performance.
To compare the diagnostic accuracy of non-invasive methods with liver biopsy for detection and staging of NAFLD in obese individuals undergoing bariatric surgery.
This is a cross-sectional, observational and descriptive study which enrolled individuals who underwent bariatric surgery from 2018 through 2019 at a public tertiary university hospital. Ultrasound scan, hepatic steatosis index, Clinical Non-Alcoholic Steatohepatitis Score (C-NASH), hypertension, alanine aminotransferase (ALT) and insulin resistance (HAIR), aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), NAFLD Fibrosis Score (NFS) and body mass index, AST/ALT ratio, and dia limitations of non-invasive methods, it is justifiable and should be considered in bariatric routine.
Wedge liver biopsy during bariatric surgery helps to diagnose and stage NAFLD, presents low risks and acceptable costs; given the limitations of non-invasive methods, it is justifiable and should be considered in bariatric routine.
Bacterial infections occur in 43-59% of cirrhotic patients admitted to the intensive care unit with impact in morbidity and mortality. An increase in the frequency of multidrug-resistant (MDRO) and extensively drug-resistant (XDRO) organisms has been described in bacterial infections in cirrhotic patients with an adverse impact on survival.
To characterize community-acquired (CA), healthcare-associated (HCA), and hospital-acquired (HA) infections in cirrhotic patients and their impact in the occurrence of adverse outcomes.
This study included all cirrhotic patients admitted in an intensive care unit specialized in liver and gastrointestinal diseases in Brazil between January 2012 and June 2018. Frequency and topography of infections were retrospectively evaluated, as well as the frequency of MDRO and XDRO organisms, and their impact in occurrence of acute kidney injury, hepatorenal syndrome, acute-on-chronic liver failure, sepsis and mortality.
A total of 374 infections were observed and classified asir recognition and proper selection of appropriate empiric antibiotic regimens are important measures to reduce in-hospital mortality.
Hospital-acquired, HCA and second infections are increasingly associated with either MDRO and/or XDRO and are independent predictors of in-hospital mortality. Their recognition and proper selection of appropriate empiric antibiotic regimens are important measures to reduce in-hospital mortality.
to describe the organizational climate perceived by nurses of a hospital linked to the Brazilian Hospital Services Company and the reasons for the turnover intention.
mixed, concomitant triangulation type. Qualitative data were analyzed according to the discourse of the collective subject, in addition to quantitative data analysis, descriptive analysis, Pearson correlation, and multiple linear regression. Data collection was carried through a semi-structured interview with 116 nurses.
the study presented the speeches in five categories Leadership and organization support; Reward; Physical comfort; Control/pressure; and Cohesion among colleagues. It showed that, with increased Reward factor, there is a decrease in turnover intention; and, with decreased Physical comfort, there is an increase in turnover intention.
there is a dichotomy in the organizational climate perceived by nurses, and personal reasons mainly justify the turnover intention. The reason could be the current processes of institutional reorganization and the hiring of experienced staff.
there is a dichotomy in the organizational climate perceived by nurses, and personal reasons mainly justify the turnover intention. The reason could be the current processes of institutional reorganization and the hiring of experienced staff.
to verify sociodemographic, academic and health risk factors for Central Nervous System drug use among nursing students.
a cross-sectional study with 199 public undergraduate students from Ceará, using Characterization Instrument, Antonovsky's Sense of Coherence Questionnaire, Beck Depression Inventory and Beck Anxiety Inventory. Fischer's exact test and Pearson's chi-square test were performed, verifying an association between variables. Prevalence ratio was used.
a total of 34 used such drugs, with predominance of use of anxiolytics, associated with age (p=0.026), dissatisfaction with the relationship between classmates (p=0.003), insomnia (p=0.009), chronic disease (p=0.001), depression (p=0.035), and severe anxiety (p=0.023).
using Central Nervous System drugs among students was associated with sociodemographic, academic and health factors, evidencing the need for actions promoting undergraduate students' mental health.
using Central Nervous System drugs among students was associated with sociodemographic, academic and health factors, evidencing the need for actions promoting undergraduate students' mental health.
to investigate the correlation between fatigue and quality of life in adolescents with cerebral palsy who are susceptible to more significant fatigue and lower quality of life.
cross-sectional study conducted with 101 adolescents with cerebral palsy. Instruments such as the Pediatric Quality of Life Inventory and Gross Motor Function Classification System were used, and Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests were applied.
older adolescents self-reported higher fatigue levels, and female adolescents, quadriplegic, with worse motor function, older, and not attending school had lower quality of life scores. Higher fatigue levels correlated with lower quality of life in all domains (p<0.01), especially in tiredness (general and mental) and functioning (social, academic, and psychosocial).
fatigue correlated negatively with the quality of life of adolescents with cerebral palsy, showing that the higher the level of fatigue, the more compromised is the adolescents' life.
fatigue correlated negatively with the quality of life of adolescents with cerebral palsy, showing that the higher the level of fatigue, the more compromised is the adolescents' life.