RESUMO
Background: Heavy alcohol consumption is an inevitable cause of alcoholic liver disease with a high chance to progress to Alcoholic Liver Cirrhosis. Alcohol could damage the function of body organs and could cause cancer. Liver damage due to excessive alcohol consumption is usually presented as fatty liver [build-up of fats in the liver], steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma. When liver fibrosis progresses, it will ultimately end up as alcoholic cirrhosis
Objective of the Study: This article was intended to explore and investigate the possible optimal diagnosis and management of Alcoholic liver cirrhosis
Methods: We searched the medical literatures to retrieve studies for the review till 30 November 2017. Electronic search in the scientific database from 1965 to 2017- [Medline, Embase. The Cochrane Library websites were searched for English Publications [both reprint requests and by searching the database]. Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and treatment modalities
Conclusion: Absolute abstinence remains the foundation for any treatment of any acute or chronic Alcoholic Liver Disease. It's also important to understand that no treatment will cure cirrhosis or repair scarring in the liver that has already occurred and the only resort would be liver transplantation which is also debatable provided the complications it carries along. Nevertheless, timely diagnosis of alcoholic cirrhosis in people with alcoholic liver disease is the cornerstone for evaluation of prognosis or choosing treatment strategies such as nutritional and medical support and lifestyle change
RESUMO
Background: Patients with severe traumatic brain injury [TBI] are at high risk for airway obstruction and hypoxia at the accident scene, and routine prehospital endotracheal intubation has been widely advocated. Aim of the Study: to evaluate and compare the outcome and mortality rates of trauma patients undergoing Prehospital Tracheal Intubationversus those undergoing Emergency Department Intubation
Methods: A literature search was carried out on MEDLINE [including MEDLINE in-process], CINAHL, Embase and the Cochrane Library [from 1990 to October 2017]. Databases using "Prehospital Tracheal Intubation", "Emergency Department Intubation ", "Adults? trauma", and "mortality" as a MeSH heading and as text word. High yield journals were also had searched
Results: Eleven studies enrolling 17317 patients were included, out of which 4545 underwent PTI while 12772 underwent EDI. Median mortality rate in patients undergoing pre-hospital intubation was 52.12% [7.8-90.16%], compared to 27.98% [6.25-41.56%] in patients undergoing intubation in the emergency department. The overall quality of evidence was very low. Six of the eleven studies found a significantly higher mortality rate after pre-hospital intubation whilst five found no significant differences
Conclusion: Study outcome suggests that EDI was superior to PHI. Nevertheless, prehospital intubation was a marker for more severely ill patients who would have had higher mortality thus, the suggestion of the association between pre-hospital intubation and a higher mortality rate does not essentially oppose the importance of the intervention, but rather a need for further investigation of the possible causes for this finding