Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association

Ивашкин, В. Т.; Mayevskaya, M.V.; Павлов, Ч. С.; Fedosyina, Ye.A.; Bessonova, Ye.N.; Pirogova, I. Yu.; Garbuzenko, Dmitry Victorovich

doi:10.22416/1382-4376-2016-4-71-102

Cited by 40 publications

(30 citation statements)

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“…In accordance with modern clinical recommendations, the severity of ascites determines its treatment[ 13 ]. Accordingly, patients with LC and mild ascites do not need diuretics and a low-sodium diet.…”

Section: Treatment Of Hhmentioning

confidence: 99%

Hepatic hydrothorax: An update and review of the literature

Garbuzenko

Arefyev

2017

WJH

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This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: “liver cirrhosis”, “portal hypertension”, “hepatic hydrothorax”, “pathogenesis”, “diagnostics”, and “treatment”. To limit the scope of this review, only articles dealing with uncomplicated hydrothorax in patients with liver cirrhosis were included. The analysis of the data showed that despite the progress of modern hepatology, the presence of HH is associated with poor prognosis and high mortality. Most patients suffering from it are candidates for orthotopic liver transplantation. In routine clinical practice, stratification of the risk for an adverse outcome and the subsequent determination of individual therapeutic strategies may be the keys to the successful management of the patient’s condition. The development of pathogenetic pharmacotherapy and optimization of minimally invasive treatment will improve the quality of life and increase the survival rate among patients with HH.

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Section: Treatment Of Hhmentioning

confidence: 99%

Hepatic hydrothorax: An update and review of the literature

Garbuzenko

Arefyev

2017

WJH

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“…Among existing therapeutic agents, EPLs have accumulated clear evidence against steatosis. Their positive influence on the grade of liver steatosis was highlighted in several randomised clinical trials based on histology, CT and ultrasound dynamic evaluation 23. Moreover, EPLs have shown, in in vitro and animal investigations, antioxidant, anti-inflammatory and lipid-regulating effects 35.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the concept of using EPL to reduce hepatic steatosis appears a very attractive option for liver protection in patients with NAFLD with metabolic comorbidities 17. Moreover, EPLs were recommended to treat NAFLD in the Russian Guidelines for the Diagnosis and Management of NAFLD 23 24. Considering these factors, the aim of the present study was to evaluate if PPC administered as adjunctive therapy can effectively improve the ultrasonographic features of NAFLD in routine clinical practice in Russian patients with metabolic comorbidities.…”

Section: Introductionmentioning

confidence: 99%

“…Hence, any therapeutic intervention that targets fat accumulation in the liver and ameliorates hepatic histology would be of great benefit 19 21 22. In terms of influencing steatosis, essential phospholipids (EPLs) are currently considered as one of the most promising therapeutic agents 23. EPLs contain a highly purified extract of polyenylphosphatidylcholine (PPC) molecules from soybean.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of phosphatidylcholine in alleviating steatosis in patients with non-alcoholic fatty liver disease and cardiometabolic comorbidities (MANPOWER study)

Маев

Самсонов

Пальгова

et al. 2020

BMJ Open Gastroenterol

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ObjectiveThe concept of using naturally occurring compounds such as polyenylphosphatidylcholine (PPC) as an adjunctive therapy to treat non-alcoholic fatty liver disease (NAFLD) and alleviate or reverse hepatic steatosis appears a very attractive option for liver protection. We aim to evaluate if PPC adjunctive therapy can effectively improve the ultrasonographic features of NAFLD in routine clinical practice in Russian patients with cardiometabolic comorbidities.DesignThis 24-week, observational, prospective study was carried out in 174 medical sites across 6 federal districts of Russia. A total of 2843 adult patients with newly diagnosed NAFLD, who had a least one of four comorbidities, namely overweight/obesity, hypertension, type 2 diabetes mellitus and hypercholesterolaemia, and who received PPC as an adjunctive treatment to standard care, were enrolled. The assessment of liver ultrasonography was qualitative.ResultsOverall, 2263 (79.6%) patients had at least two metabolic comorbidities associated with NAFLD, and overweight/obesity was the most common comorbidity reported in 2298 (80.8%) patients. Almost all study participants (2837/2843; 99.8%) were prescribed 1.8 g of PPC administered three times daily. At baseline, the most frequently identified abnormalities on ultrasound were liver hyperechogenicity (84.0% of patients) and heterogeneous liver structure (62.9%). At 24 weeks, a significant (p<0.05) improvement in liver echogenicity and in liver structure was observed in 1932/2827 (68.3%) patients (95% CI 66.6% to 70.1%) and in 1207/2827 (42.7%) patients (95% CI 40.9% to 44.5%), respectively. The analysis of ultrasonographic signs by number of comorbidities revealed similar findings—liver echogenicity improved in 67.2%–69.3% and liver structure in 35.6%–45.3% of patients depending on the number of comorbidities.ConclusionThis study showed that PPC adjunctive therapy may be useful in improving the ultrasonographic features of NAFLD in patients with associated cardiometabolic comorbidities. It also supports evidence regarding the role of PPC in the complex management of NAFLD.

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“…Выявить пациентов с высоким риском развития предраковых заболеваний колоректальной области в практике участкового врача-терапевта для направления на эндоскопическое обследование толстой кишки. [16,17]. В исследование были включены пациенты в возрасте 45-75 лет, подписавшие информированное добровольное согласие, не имеющие противопоказаний для проведения эндоскопических методов обследования, не проходившие эндоскопическое обследование толстой кишки ранее.…”

Section: Introductionunclassified

Identification of Patients with a High Risk of Developing Precancerous Colon Diseases at the Outpatient Stage

Гаязова

Болотнова

2019

Kuban. nauсh. med. vestnik

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Aim. To identify patients with a high risk of precancerous diseases of the colorectal region for colonoscopy assignment in the practice of a district physician.Materials and methods. 122 patients were surveyed who underwent colonoscopy by the appointment of a district physician at the Municipal Polyclinic No. 3 in Tyumen. All examined patients were divided into two groups according to colonoscopy: with colon polyps — 64 (52.5 %) and without colon polyps — 58 patients (47.5 %).Results. The mean age of patients in the group with colon polyps was 59.8 ± 4.7 years, in the second group — 58.2 ± 4.8 years. In the group with colon polyps, more patients exhibited a low physical activity and poor nutrition compared to the group without colon polyps. Erosive gastritis and obesity prevailed in patients of the group with colon polyps as compared to the second group. The number of patients who smoked and drank alcohol prevailed in the group with colon polyps, in comparison with the second group. Patients with colon polyps were twice as likely to have a burdened hereditary history of colorectal cancer as those without colon polyps. Conclusion. Thus, the group of high risk of colon polyps included patients with risk factors: smoking, low physical activity and burdened hereditary history of colon cancer, as well as erosive gastritis in the history.

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Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association

Cited by 40 publications

References 0 publications

Hepatic hydrothorax: An update and review of the literature

Hepatic hydrothorax: An update and review of the literature

Effectiveness of phosphatidylcholine in alleviating steatosis in patients with non-alcoholic fatty liver disease and cardiometabolic comorbidities (MANPOWER study)

Identification of Patients with a High Risk of Developing Precancerous Colon Diseases at the Outpatient Stage

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