Background: Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis–related complications has been recognized during recent years. This article aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis–related complications. Methods: Hepatobiliary Study Group of the Chinese Society of Gastroenterology of the Chinese Medical Association and Hepatology Committee of the Chinese Research Hospital Association have invited gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists to formulate the clinical practice guidance based on comprehensive literature review and experts’ clinical experiences. Results: Overall, 10 major guidance statements regarding efficacy and safety of terlipressin in liver cirrhosis were proposed. Terlipressin can be beneficial for the management of cirrhotic patients with acute variceal bleeding and hepatorenal syndrome (HRS). However, the evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction, and bacterial infections and in those undergoing hepatic resection and liver transplantation remains insufficient. Terlipressin-related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored. Conclusion: The current clinical practice guidance supports the use of terlipressin for gastroesophageal variceal bleeding and HRS in liver cirrhosis. High-quality studies are needed to further clarify its potential effects in other liver cirrhosis–related complications.
Aim: To investigate the computed tomography (CT) and clinical characteristics of immunotherapy-induced pneumonitis (IIP) in patients with advanced solid tumors. Patients & methods: CT and clinical data of 254 patients with advanced solid tumors treated with immune checkpoint inhibitors in our hospital were collected retrospectively. Results: The incidences of IIP in patients with non-small-cell lung cancer, lymphoma and gastrointestinal tumors were 19% (19/100), 9.8% (6/61) and 6.2% (4/65), respectively. The median onset time for all 31 IIP patients was 44 days (interquartile range: 24–65). Most IIP patients (21/31) had grade 1–2 disease. Multifocal ground-glass opacities (seen in 21/31 patients) were the main CT findings of IIP. Conclusion: Patients should be alerted to the risk of IIP, an adverse reaction that has a relatively low incidence but which is sometimes life-threatening.
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