Selective vasopressin type 2 receptor antagonist for patients with cirrhosis

Chávez-Tapia, Norberto C.; Barrientos‐Gutiérrez, Tonatiuh; Téllez-Ávila, Félix Ignacio; Méndez-Sánchez, Nahúm; Uribe, Misael

doi:10.1002/14651858.cd009523

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…In a Cochrane review, Chavez‐Tapia et al (21) concluded that the lack of randomized clinical trials or quasirandomized clinical studies prevents definitive assessment of benefits and harms of bariatric surgery as a therapeutic approach for patients with NASH. In fact, there are a small number of retrospective and prospective cohort studies that compare liver histology in severely obese individuals before and after bariatric surgery.…”

Section: Clinical Indicationsmentioning

confidence: 99%

Indications and Limitations of Bariatric Intervention in Severely Obese Children and Adolescents With and Without Nonalcoholic Steatohepatitis

Nobili

Vajro

Dezsőfi

et al. 2015

J. pediatr. gastroenterol. nutr.

107

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Morbid obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD), which is one of the most common causes of chronic liver disease worldwide. The present best treatment for NAFLD and nonalcoholic steatohepatitis (NASH) is weight reduction through lifestyle modification. Because of frustrating inefficiency of such a therapeutic approach, bariatric surgery is increasingly performed in adolescents as an alternative option for weight reduction. Standards of care and consensus for indications are, however, scarce. We explore the indications and limitations of bariatric surgery in children with severe obesity with and without NASH and aim to provide guidance for the exceptional indications for adolescents with extreme obesity with major comorbidity that may benefit from these controversial interventions. Present evidence suggests that bariatric surgery can decrease the grade of steatosis, hepatic inflammation, and fibrosis in NASH. Uncomplicated NAFLD is not an indication for bariatric surgery. Roux-en-Y gastric bypass is considered a safe and effective option for adolescents with extreme obesity, as long as an appropriate long-term follow-up is provided. Laparoscopic adjustable gastric banding has not been approved by the Food and Drug Administration for use in adolescents and therefore should be considered investigational. Finally, sleeve gastrectomy and other types of weight loss surgery that have grown increasingly common in adults, still need to be considered investigational. Temporary devices may be increasingly being used in pediatrics; however, future studies, including a long-term risk analysis of patients who undergo surgery, are much needed to clarify the exact indications for bariatric surgery in adolescents.

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Section: Clinical Indicationsmentioning

confidence: 99%

Indications and Limitations of Bariatric Intervention in Severely Obese Children and Adolescents With and Without Nonalcoholic Steatohepatitis

Nobili

Vajro

Dezsőfi

et al. 2015

J. pediatr. gastroenterol. nutr.

107

View full text Add to dashboard Cite

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“…Although adhering to and monitoring compliance with preprocedure protocols are likely sensible means of mitigating procedural risks (34), particularly infection, bleeding and sedation, there are limited data for this and few pediatric‐specific studies. In terms of antibiotic prophylaxis, a Cochrane systematic review concluded that its use in adults with cirrhosis and upper gastrointestinal bleeding was beneficial (35). Another Cochrane systematic review found a significant reduction in the incidence of peristomal infection with prophylactic antibiotics after percutaneous endoscopic gastrostomy placement in adults (36).…”

Section: Resultsmentioning

confidence: 99%

Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopy Facilities

Lightdale

Walsh

Narula

et al. 2021

J. pediatr. gastroenterol. nutr.

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Introduction:There is increasing international recognition of the impact of variability in endoscopy facilities on procedural quality and outcomes. There is also growing precedent for assessing the quality of endoscopy facilities at regional and national levels by using standardized rating scales to identify opportunities for improvement.Methods:With support from the North American and European Societies of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN and ESPGHAN), an international working group of the Pediatric Endoscopy Quality Improvement Network (PEnQuIN) used the methodological strategy of the Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument to develop standards and indicators relevant for assessing the quality of facilities where endoscopic care is provided to children. Consensus was reached via an iterative online Delphi process and subsequent in-person meeting. The quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development and Evaluation) approach.Results:The PEnQuIN working group achieved consensus on 27 standards for facilities supporting pediatric endoscopy, as well 10 indicators that can be used to identify high-quality endoscopic care in children. These standards were subcategorized into three subdomains: Quality of Clinical Operations (15 standards, 5 indicators); Patient and Caregiver Experience (9 standards, 5 indicators); and Workforce (3 standards).Discussion:The rigorous PEnQuIN process successfully yielded standards and indicators that can be used to universally guide and measure high-quality facilities for procedures around the world where endoscopy is performed in children. It also underscores the current paucity of evidence for pediatric endoscopic care processes, and the need for research into this clinical area.

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Selective vasopressin type 2 receptor antagonist for patients with cirrhosis

Cited by 2 publications

References 19 publications

Indications and Limitations of Bariatric Intervention in Severely Obese Children and Adolescents With and Without Nonalcoholic Steatohepatitis

Indications and Limitations of Bariatric Intervention in Severely Obese Children and Adolescents With and Without Nonalcoholic Steatohepatitis

Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopy Facilities

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