RESUMEN
Purpose: to assess whether Helicobacter pylori [H. pylori] eradication therapy benefits patients with functional dyspepsia [FD]
Methods: randomized controlled trials [RCTs] examining the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English [till November 2016] were recognized by searching PubMed, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio [RR] or a standard mean difference [SMD]. All data were analyzed with Review Manager 5.3 and Stata 12.0
Results: this analysis involved 15 RCTs with a total of 3567 patients with FD. These studies were used to assess the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.26 [95%CI: 1.10-1.40, P < 0.0001]. H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at >/= 1 year [RR = 1.27; 95%CI: 1.13-1.41, P < 0.0001] but not during short-term follow-up at < 1 year [RR = 1.26; 95%CI: 0.83-1.92, P = 0.27]. Four studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of -0.01 [95%CI: -0.09 to 0.07, P = 0.74]. Four studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy [RR = 0.34; 95%CI: 0.17-0.67, P = 0.002]. Three studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy [RR = 1.87; 95%CI: 1.08-3.47, P = 0.02]. Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy [RR = 7.05; 95%CI: 3.59-13.74, P < 0.00001]
Conclusion: the decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment
RESUMEN
Background: cirrhosis is a late stage of scarring [fibrosis] of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients. Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function
Objective of the Study: review and evaluate the best practices in diagnosis, complications and management of cirrhosis, and novel clinical and scientific developments
Methods: electronic search in the scientific database from 1966 to 2017- [Medline, Embase, the Cochrane Library as well as NHS center websites were searched for English Publications obtained from both reprint requests and by searching the database. Data extracted included authors, country, and year of publication, age and sex of patients, epidemiology, geographical distribution, pathophysiology, risk factors, clinical manifestations, investigations and types of surgical treatment
Results: there is sufficient body of evidence suggesting that cirrhosis is a pathological diagnosis with no laboratory cutoff values for the diagnosis of cirrhosis. However, it can still be diagnosed clinically, by history, physical examination laboratory analyses and ancillary testing such as ultrasonography. Early diagnosis has proven to give relevantly better case management results while late detection can only hardly manage the symptoms accompanied with cirrhosis
Conclusion: Screening for chronic liver disease is a key factor for early detection of signs for liver damage, which can be performed inexpensively and easily with clinical history-taking, measurement of transaminase concentrations, upper abdominal ultrasonography, and transient elastography [where available]. Abnormal findings should prompt specific diagnostic testing to determine the etiology of the underlying disease. In most patients, the dynamic process of progressive fibrosis, which could ultimately lead to cirrhosis, can be interrupted by the timely recognition of the risk, followed by appropriate treatment