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Background: Malnutrition is commonly seen in cirrhotic patients and has been shown to adversely affect outcome. However, it remains associated with the severity of cirrhosis. Therefore, its role as an independent prognostic factor is still under debate. The aims of our study were to determine the prevalence of malnutrition in cirrhotic patients and determine whether this condition was an independent prognostic factor
Patients and methods: We prospectively analyzed the nutritional status of 104 consecutive patients with cirrhosis Subjective global nutritional assessment [SGA] and anthropometry [dry body mass index [BMI], triceps skinfold [TSF], arm muscle circumference [AMC]] were used for the evaluation of the nutritional status. Complications of cirrhosis during follow-up and patient's survival were recorded. Global survival and survival without complications was studied by Kaplan Meier method and using Log Rank test
Results: Prevalence of malnutrition ranged from 16.3 and 62.5% according to the method of nutritional assessment used. Survival without complications was reduced in malnourished patients. This difference was significant when assessing malnutrition by dry BMI [p=0.001]. In multivariate analysis, malnutrition defined by dry BMI<18.5 kg/m2 was an independent predictor of complications [p<0.001; RR 3.2] especially hepatic encephalopathy [p=0.001; RR 2.66]. In univariate analysis, global survival was worse in malnourished patients [by BMI and SGA; p=0.03 and p=0.0014 respectively], but this trend was lost in multivariate analysis
Conclusion: In our study, malnutrition was an independent predictor of complications in cirrhosis. However, it did not appear as an independent prognostic factor for global survival. These results raise again difficulties to clarify whether malnutrition influence itself the prognosis of cirrhosis or if it is only related to the severity of cirrhosis
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Background: Hyponatremia is the most common electrolyte abnormality encountered in cirrhotic patients. Recent studies have shown that hyponatremia was correlated with severity of cirrhosis and associated with increased risk of complications and mortality. However this relationship is still unclear. The aims of the present study were to search predictive factors for hyponatremia in cirrhosis and to assess its prognostic value
Methods: We performed a retrospective study, including consecutive cirrhotic patients admitted to our department between January 2011 and April 2014. Patients and cirrhosis characteristics were studied. Serum sodium levels were determined at admission. The cutoff level of 130 mmol/l was chosen because it is widely accepted to define hyponatremia in patients with cirrhosis. Predictive factors of hyponatremia development and its impact on the outcome [cirrhosis complications and survival] were evaluated
Results: We included 143 cirrhotic patients: 67 females [46.9%] and 76 males [53.1%] with a mean age of 58 years. Etiology of cirrhosis was mainly viral [56.7%]. Child-Pugh stage was B in 41.2% and C in 25.9%. Mean MELD score was 15 [6-40]. The prevalence of dilutional hyponatremia as defined by a serum sodium concentration 16 [OR=6.76; p=0.001]. Survival without complications was reduced in patients with hyponatremia but was only significant if a serum sodium concentration
Conclusion: Low serum sodium level was correlated with severity of cirrhosis. Hyponatremia was a negative prognostic factor associated with increased short-term morbi-mortality
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Introduction: Sorafenib, an oral multikinase inhibitor, has recently been shown to improve overall survival in patients with advanced hepatocellular carcinoma [HCC] but only a handful of reports of complete remission on sorafenib have been issued
Case report: We report an intriguing case of advanced HCC complicating HCV infection with cirrhosis, in which the patient achieved complete remission by prolonged administration of sorafenib
Conclusion: Identifying factors that could be associated with good response to this therapy are needed
RESUMEN
To evaluate the prevalence of osteoporosis during inflammatory bowel disease [IBD] and to determine the risk factors. We conducted a prospective study that includes IBD patients. For all patients, bone mineral density was measured by dual-energy X-rays absorptiometry. Study has included 50 IBD patients; thirty had Crohn's disease and 20 had ulcerative colitis. The average age of our patients was of 36, 4 +9, 9 years. A low osseous mineral density was noted in 21 patients [45%] distributed in 13% of osteoporosis and 32% of osteopenia. Only the age superior to 35 years, the duration of evolution of the disease superior to 10 years and intestinal resection constituted a risk factors of osteoporosis. After adaptation on the age and the intestinal resection the duration of evolution superior to 10 years persisted as risk factor of osteoporosis. The other risk factors: sex, type of IBD, denutrition and corticoids were not incriminated in the low osseous mineral density during IBD. These results confirm the necessity of the systematic search of the osteoporosis during IBD with the aim of proposing an early and effective treatment