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Background And Aim: There is paucity of data about the prevalence of cirrhosis and portal hypertension in the US general population.
Methods: We used National Health and Nutrition Examination Surveys (NHANES 2017-2020) to estimate the prevalence of cirrhosis and clinically significant (CS)-portal hypertension in alcoholic liver disease (ALD), MetALD, viral hepatitis (VH) to include chronic hepatitis B (CHB) and chronic hepatitis C (CHC), and metabolic dysfunction-associated steatotic liver disease (MASLD). Cirrhosis was evaluated using liver stiffness measurement (LSM) by transient elastography or FIB-4 score; CS-portal hypertension was defined via LSM and platelet count or the use of non-selective beta-blockers in the presence of cirrhosis.
Economic impact of initial glaucoma treatment with selective laser trabeculoplasty on the Brazilian Public Health System.
Arq Bras Oftalmol
January 2025
Discipline of Health Management and Economics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Purpose: To evaluate the economic impact of the following initial treatment scenarios for glaucoma on the Brazilian Public Health System (SUS): (1) traditional continuous instillation of hypotensive eye drops and (2) single session of selective laser trabeculoplasty.
Methods: Economic impact was analyzed in three scenarios, from the least to the most conservative, for a hypothetical cohort of 5,000 individuals with open-angle glaucoma. Thereafter, projections were made on the basis of a glaucoma prevalence of 3% in the 2021 Brazilian population size.
The pros and cons of beta-blockers in sepsis: Where do we stand in 2024?
J Intensive Med
January 2025
Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Preventing the progression of cirrhosis to decompensation and death.
Nat Rev Gastroenterol Hepatol
January 2025
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Ministerio de Sanidad, Madrid, Spain.
Two main stages are differentiated in patients with advanced chronic liver disease (ACLD), one compensated (cACLD) with an excellent prognosis, and the other decompensated (dACLD), defined by the appearance of complications (ascites, variceal bleeding and hepatic encephalopathy) and associated with high mortality. Preventing the progression to dACLD might dramatically improve prognosis and reduce the burden of care associated with ACLD. Portal hypertension is a major driver of the transition from cACLD to dACLD, and a portal pressure of ≥10 mmHg defines clinically significant portal hypertension (CSPH) as the threshold from which decompensating events may occur.
View Article and Find Full Text PDFThe Autonomic Nervous System and Inflammation in Chronic Kidney Disease.
Nephrol Dial Transplant
January 2025
Clinica Medica, University Milano-Bicocca and University of Milano-Bicocca, Milan, Italy.
The autonomic nervous system plays a crucial role in regulating physiological processes and maintaining homeostasis through its two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system. Dysregulation of the autonomic system, characterized by increased sympathetic activity and reduced parasympathetic tone, is a common feature in chronic kidney disease (CKD) and cardiovascular disease. This imbalance contributes to a pro-inflammatory state, exacerbating disease progression and increasing the risk for cardiovascular events.
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