AIM: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.
BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the liver.Data on hepatic histopathological findings in COVID-19 is scarce.AIM To characterize hepatic pathological findings in patients with ...BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the liver.Data on hepatic histopathological findings in COVID-19 is scarce.AIM To characterize hepatic pathological findings in patients with COVID-19.METHODS We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA guidelines.Eligible trials were those including patients of any age and COVID-19 diagnosis based on a molecular test.Histopathological reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were reviewed.Articles including less than ten patients were excluded.Proportions were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,respectively.RESULTS We identified 18 studies from 7 countries;all were case reports and case series from autopsies.All the patients were over 15 years old,and 67.2%were male.We performed a meta-analysis of 5 studies,including 116 patients.Pooled prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and necrosis.CONCLUSION We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver features.Other frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or proliferation.Further studies are needed to establish the mechanisms and implications of these findings.展开更多
AIM:To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile,with a prevalence of 73% in general population. METHODS:H pylori-infected patients diagnosed by rapid urea...AIM:To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile,with a prevalence of 73% in general population. METHODS:H pylori-infected patients diagnosed by rapid urease test,with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid,amoxicillin 1 g bid,and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers. RESULTS:One hundred and thirty-one patients were randomized to OAC7 (n = 69) or OAC14 (n = 62). The overall eradication rate (intention-to-treat) was 78.3% in OAC7 and 85.5% in OAC14 groups,without a significant difference (P =0.37). No significant difference in the eradication rate was found among the patients with peptic ulcer disease (n = 31) between the OAC7 group (85.7%) and OAC14 group (87.5%). However,smokers had an obviously lower eradication rate compared to non-smokers,particularly in the OAC7 group (57.1% in smokers vs 83.6% in non-smokers; P = 0.06). Adverse effects rate were similar between both groups. CONCLUSION:Short-term efficacy of triple therapy with OAC for 7 d is comparable to 14 d in this high-prevalence population. Longer follow-up,and studies focused to some subgroups of patients (smokers and non-ulcerpatients) are necessary to support widespread use of 7-d instead of 10-14-d triple therapy in a developing country like Chile.展开更多
AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.
基金Supported by(in part)Chilean Society of GastroenterologyGrants from the Fondo Nacional De Ciencia y Tecnología de Chile,FONDECYT 1110455 to Arrese M and 1120652 to Riquelme Athe Comisión Nacional de Investigación,Ciencia y Tecnología,CONICYT,basal project CARE Chile UC
文摘AIM: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.
基金Supported by Chilean Government Through the Fondo Nacional de Desarrollo Científico y Tecnológico,No.1200227,No.1191183 and No.1191145Comisión Nacional de Investigación Científica y Tecnológica (CONICYT,CARE Chile UC),No.AFB170005European Union’s Horizon 2020 Research,No.825510
文摘BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the liver.Data on hepatic histopathological findings in COVID-19 is scarce.AIM To characterize hepatic pathological findings in patients with COVID-19.METHODS We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA guidelines.Eligible trials were those including patients of any age and COVID-19 diagnosis based on a molecular test.Histopathological reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were reviewed.Articles including less than ten patients were excluded.Proportions were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,respectively.RESULTS We identified 18 studies from 7 countries;all were case reports and case series from autopsies.All the patients were over 15 years old,and 67.2%were male.We performed a meta-analysis of 5 studies,including 116 patients.Pooled prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and necrosis.CONCLUSION We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver features.Other frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or proliferation.Further studies are needed to establish the mechanisms and implications of these findings.
文摘AIM:To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile,with a prevalence of 73% in general population. METHODS:H pylori-infected patients diagnosed by rapid urease test,with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid,amoxicillin 1 g bid,and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers. RESULTS:One hundred and thirty-one patients were randomized to OAC7 (n = 69) or OAC14 (n = 62). The overall eradication rate (intention-to-treat) was 78.3% in OAC7 and 85.5% in OAC14 groups,without a significant difference (P =0.37). No significant difference in the eradication rate was found among the patients with peptic ulcer disease (n = 31) between the OAC7 group (85.7%) and OAC14 group (87.5%). However,smokers had an obviously lower eradication rate compared to non-smokers,particularly in the OAC7 group (57.1% in smokers vs 83.6% in non-smokers; P = 0.06). Adverse effects rate were similar between both groups. CONCLUSION:Short-term efficacy of triple therapy with OAC for 7 d is comparable to 14 d in this high-prevalence population. Longer follow-up,and studies focused to some subgroups of patients (smokers and non-ulcerpatients) are necessary to support widespread use of 7-d instead of 10-14-d triple therapy in a developing country like Chile.
文摘AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.
