scholarly journals Patient- oriented approach to management of patients with hepatic cirrhosis

2021 ◽  
pp. 142-149
Author(s):  
N. V. Korochanskaya ◽  
V. M. Durleshter ◽  
S. N. Serikova ◽  
O. A. Usova ◽  
M. A. Bacenko ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Medical Care ◽  
Hepatic Cirrhosis ◽  
Course Of Disease ◽  
Krasnodar Region ◽  
Medical Histories ◽  
Clinic Practice ◽  
Oriented Approach

Aim of the study: Optimization of medical care to patients with liver cirrhosis (LC) based on using of patient- oriented approach in real clinic practiceMaterials and methods: The reviews of 734 medical histories of patients treated in polyclinics and in-patient facilities of general specialization (surgery, therapy) and died from HL in 2015–2019 years in Krasnodar region were analyzed. The experience of regular medical check-up of 85 patients with LC who underwent mini-invasive surgeries was summarized.Results: The number of mistakes in treatment tactics of patients with LC was revealed. The experience of regular medical check-up and schools for patients with LC was summarized.Conclusion: Regular medical check-up of patients with LC in multi- disciplinary clinic with practice in mini-invasive surgeries and liver transplantation, attendance of schools for patients improves stabilization and in some cases treatment course of disease.

Immunosuppression and probiotics: are they effective and safe?

2015 ◽  
Vol 6 (6) ◽  
pp. 823-828 ◽  
Author(s):  
V. Stadlbauer
Keyword(s):  
Bone Marrow ◽  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Bone Marrow Transplantation ◽  
Probiotic Bacteria ◽  
Major Surgery ◽  
Efficacy And Safety ◽  
Immunosuppressed Patients ◽  
Patient Groups ◽  
Prophylaxis Of Infections

This opinion statement discusses indications, efficacy and safety of probiotics in immunosuppressed patients. The best evidence available is for the prophylaxis of infections in patients after liver transplantation and for patients with liver cirrhosis. For other organ transplantations and for bone marrow transplantation the efficacy of probiotic interventions has not been proven yet, but in these patient groups safety is a concern. Also in critically ill patients, the data on efficacy are inconclusive and safety is a concern. In HIV patients and patients after major surgery, probiotic bacteria seem to be safe since there are no associations with increased risks of side effects.

Current State and Future Possibilities in Liver Transplantation

2021 ◽  
Author(s):  
Sebastian Rademacher ◽  
◽  
Niklas Aehling ◽  
Robert Sucher ◽  
Thomas Berg ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Survival Rates ◽  
Tolerance Induction ◽  
Meld Score ◽  
Long Term Results ◽  
Future Research ◽  
Industrialized Countries ◽  
Normothermic Machine Perfusion ◽  
Donor Characteristics

Due to medical and surgical progress, liver transplantation (LT) is is nowadays a routine treatment for terminal liver failure and hepatic malignancies. However, in recent years there has been a change in the indications for LT. Especially in western industrialized countries, the use of LT for chronic hepatis B and hepatitis C cirrhosis is continuously decreasing since the introduction of effective antiviral drugs. Liver cirrhosis due to non-alcoholic steatohepatitis (NASH), alcoholic liver disease and hepatocellular carcinoma (HCC) in cirrhosis are now among the leading indications for LT. Due to tremendous progress in oncology, immunology, and technical aspects, multidisciplinary cancer treatment increasingly includes LT for non-HCC hepatobiliary malignancies. Excellent 5-year survival rates of 75 to 80% can now be achieved after LT. However, in patients with liver cirrhosis, the implementation of a ‘sickest first’ principle for liver allocation has led to an increasing number of critically ill patients undergoing liver transplantation. This results in an increased morbidity and mortality after liver transplantation. Moreover, donor characteristics have markedly shifted to less ideal grafts due to an increasing shortage of donor organs in many countries. In this context, normothermic machine perfusion with oxygenated blood components using pulsatile flow has been shown to reduce liver damage despite a prolonged preservation time and might be able to provide viability testing for otherwise discarded organs. With favorable donor and recipient conditions, excellent long-term results can be obtained with a 10-year survival rate of close to 70%. However, in patients with a high MELD score (>30), survival rates markedly decrease by 12-18%. Future research should focus on optimization of organ allocation, optimization of immunosuppression including tolerance induction, and on increasing the donor organ pool to further improve and the numbers of successful LT.

IRRATIONAL USE OF MEDICINES IN MEDICAL ORGANIZATIONS OF THE VOLGA FEDERAL DISTRICT. (ON THE EXAMPLE OF THE PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER N. N. BURDENKO, WHEN PROVIDING SPECIALIZED CARE TO CHILDREN IN THE CONDITIONS OF THE ADULT DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY)

2021 ◽  
pp. 168-175
Author(s):  
Lebedev M.V. ◽  
Abdullina Y.A. ◽  
Zakharova I.Y.
Keyword(s):  
Medical Care ◽  
Maxillofacial Surgery ◽  
Federal District ◽  
Oral And Maxillofacial Surgery ◽  
Medical Organization ◽  
Maxillofacial Region ◽  
Clinical Hospital ◽  
Specialized Care ◽  
Rational Therapy ◽  
Medical Histories

The issues of financing in a medical organization are one of the most relevant areas of healthcare in the Russian Federation. Providing departments with the necessary financial resources to provide effective and accessible medical care to the population is important for both the administration and doctors and nurses. In some regions of the Volga Federal District, the departments are combined (Penza, Saransk), that is, all types of medical care are provided to both adults and children in one place, which leads to a number of problems associated with the irrational use of medicines. One of these is the department of Maxillofacial Surgery of the N.N. Burdenko National Clinical Hospital, on the basis of which the disadvantages of using drugs for parenteral use are considered. The purpose of this work is an economic analysis of the effectiveness of the use of solutions for parenteral use in children on the basis of an adult medical organization. The materials of the study were data from patients ' medical histories, prescribing lists, invoices from the pharmacy organization, and data on the cost of medicines. The results of the work are an analysis of the existing problems of combined type departments related to drug provision, a number of medicines for parenteral use that are not available to order, but are included in the standards of treatment of children with injuries of the maxillofacial region. The ABC - analysis of expenses under the item "medicines" is calculated, the data of the VEN – analysis is presented, which includes vital, necessary and secondary medicines for the treatment of children with injuries of the maxillofacial region. An algorithm for the selection of effective and rational therapy has been developed, using the example of antibacterial agents for parenteral administration.

scholarly journals Q-T Interval Prolongation in Liver Cirrhosis. Reversibility after Orthotopic Liver Transplantation.

1998 ◽  
Vol 39 (3) ◽  
pp. 321-329 ◽  
Author(s):  
Gianfranco FINUCCI ◽  
Federico LUNARDI ◽  
David SACERDOTI ◽  
Roberta VOLPIN ◽  
Andrea BORTOLUZZI ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Orthotopic Liver Transplantation ◽  
Interval Prolongation

scholarly journals Hepatoprotective and Antifibrotic Effects of Indonesian Propolis

2019 ◽  
Vol 51 (3) ◽  
pp. 134-140
Author(s):  
Diding Heri Prasetyo ◽  
Sarsono Sarsono ◽  
Ida Nurwati ◽  
Prihandjojo Andri Putranto ◽  
Martini Martini ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Fibrosis ◽  
Liver Damage ◽  
Liver Cell ◽  
Hepatic Cirrhosis ◽  
Cell Damage ◽  
Liver Cells ◽  
Control Group ◽  
Mice Model ◽  
Liver Cell Damage

Liver cirrhosis is the irreversible stage in liver damage process which occurs after liver fibrosis due to necro-inflammatory activities and liver fibrosis. Therefore, inhibition of liver inflammation and fibrosis is very important to prevent liver cirrhosis. This study aimed to analyze the effect of ethanol extract of propolis (EEP) from mount Lawu, Indonesia to prevent liver damage and fibrosis progression in mice with hepatic cirrhosis. This study was performed during the period of June 2018 to May 2019 on a sample of 32 male Balb/C mice divided into control group (P1), induction of carbon tetrachloride (CCl4 ) group (P2), induction of 50 mg/BW CCl4 + EEP group (P3), and (induction of 100 mg/KgBW CCl4 + EEP (P4) with each group consisted of eight mice. The CCl4 in olive oil was administered intraperitoneally three times a week for six weeks. Mean differences between group was determined using ANOVA test with a significance level of 0.05. The induction of CCl4 increased liver cell damage and serum alanin aminotransferase (ALT) level. However, the addition of EEP significantly (p<0.001) reduced liver cell damage as seen in P3 (54.38±4.17 per 100 liver cells) and P4 (37.13±4.36 per 100 liver cells) groups and serum alanin aminotransferase (ALT) as seen in P3 (291.19±113.92 U/L) and P4 (229.38±73.45 U/L) groups. The APRI scores were also reduced after EEP as seen in P3 (0.738±0.292) and P4 (0.513±0.253) groups. Thus, EEP isolates from Gunung Lawu can reduce liver cell damage and fibrosis in mice model of hepatic cirrhosis.

scholarly journals RESPIRATORY AND SYMPTOMATIC IMPACT OF ASCITES RELIEF BY PARACENTESIS IN PATIENTS WITH HEPATIC CIRRHOSIS

2020 ◽  
Vol 57 (1) ◽  
pp. 64-68
Author(s):  
Verônica Lourenço WITTMER ◽  
Rozy Tozetti LIMA ◽  
Michele Coutinho MAIA ◽  
Halina DUARTE ◽  
Flávia Marini PARO
Keyword(s):  
Liver Cirrhosis ◽  
Tidal Volume ◽  
Hepatic Cirrhosis ◽  
Blood Pressure Reduction ◽  
Vital Signs ◽  
Meld Score ◽  
Minute Volume ◽  
Respiratory Pattern ◽  
Peripheral Oxygen Saturation ◽  
The Impact

ABSTRACT BACKGROUND: Liver cirrhosis is a highly prevalent disease that, at an advanced stage, usually causes ascites and associated respiratory changes. However, there are few studies evaluating and quantifying the impact of ascites and its relief through paracentesis on lung function and symptoms such as fatigue and dyspnea in cirrhotic patients. OBJECTIVE: To assess and quantify the impact of acute reduction of ascitic volume on respiratory parameters, fatigue and dyspnea symptoms in patients with hepatic cirrhosis, as well as to investigate possible correlations between these parameters. METHODS: Thirty patients with hepatic cirrhosis and ascites who underwent the following pre and post paracentesis evaluations: vital signs, respiratory pattern, thoracoabdominal mobility (cirtometry), pulmonary function (ventilometry), degree of dyspnea (numerical scale) and fatigue level (visual analog scale). RESULTS: There was a higher prevalence of patients classified as CHILD B and the mean MELD score was 14.73±5.75. The comparison of pre and post paracentesis parameters evidenced after paracentesis: increase of predominantly abdominal breathing pattern, improvement of ventilatory variables, increase of the differences obtained in axillary and abdominal cirtometry, reduction of dyspnea and fatigue level, blood pressure reduction and increased peripheral oxygen saturation. Positive correlations found: xiphoid with axillary cirtometry, degree of dyspnea with fatigue level, tidal volume with minute volume, Child “C” with higher MELD score, volume drained in paracentesis with higher MELD score and with Child “C”. We also observed a negative correlation between tidal volume and respiratory rate. CONCLUSION: Since ascites drainage in patients with liver cirrhosis improves pulmonary volumes and thoracic expansion as well as reduces symptoms such as fatigue and dyspnea, we can conclude that ascites have a negative respiratory and symptomatological impact in these patients.

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