Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide DOI
Άδωνις Πρωτοπαπάς, Alexandra Tsankof, Ioanna Papagiouvanni

et al.

World Journal of Hepatology, Journal Year: 2024, Volume and Issue: 16(12), P. 1377 - 1394

Published: Nov. 29, 2024

Acute decompensation in cirrhotic patients signifies the onset of clinically evident events due to portal hypertension. The transition from compensated decompensated cirrhosis involves hemodynamic changes leading multiorgan dysfunction, managed predominantly outpatient settings with regular monitoring. mortality risk is elevated patients. Therefore, diligent management should focus on medical follow-ups, medication adjustments, patient education, addressing emergent issues and evaluation for liver transplantation. ultimate goal improve quality life, prevent disease progression, reduce complications, assess possible recompensation. This guide provides valuable recommendations experts managing post-hospitalization.

Language: Английский

Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults with Underlying Medical Conditions: Systematic Literature Review and Pairwise Meta-Analysis Using GRADE DOI Creative Commons
Xuan Wang,

Ankit Pahwa,

Mary T. Bausch-Jurken

et al.

Advances in Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

This systematic literature review and pairwise meta-analysis evaluated the comparative effectiveness of mRNA-1273 versus BNT162b2 in patients with at least one underlying medical condition high risk for severe COVID-19. MEDLINE, Embase, Cochrane databases were searched relevant articles from January 1, 2019 to February 9, 2024. Studies reporting data two doses vaccination adults conditions developing COVID-19 according US Centers Disease Control Prevention included. Outcomes interest SARS-CoV-2 infection (overall, symptomatic, severe), hospitalization due COVID-19, death Risk ratios (RRs) calculated random effects models. Subgroup analyses by specific conditions, number vaccinations, age, variant conducted. Heterogeneity between studies was estimated chi-square testing. The certainty evidence assessed using Grading Recommendations, Assessments, Development, Evaluations framework. Sixty-five observational capturing original/ancestral-containing primary series Omicron-containing bivalent original-BA4-5 vaccinations included meta-analysis. associated significantly lower (RR, 0.85 [95% CI, 0.79–0.92]; I2 = 92.5%), symptomatic 0.75 0.65–0.86]; 62.3%), 0.83 0.78–0.89]; 38.0%), 0.88 0.82–0.94]; 38.7%), 0.84 0.76–0.93]; 1.3%) than BNT162b2. Findings generally consistent across subgroups. Evidence low or very because sufficiently powered randomized controlled trials are impractical this heterogeneous population. Meta-analysis 65 showed that a COVID-19-related

Language: Английский

Citations

1
Comparative Effectiveness of the mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults With Underlying Medical Conditions: A Systematic Literature Review and Pairwise Meta-Analysis Using GRADE DOI
Xuan Wang,

Ankit Pahwa,

Mary T. Bausch-Jurken

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 14, 2024

ABSTRACT Introduction This systematic literature review and pairwise meta-analysis evaluated the comparative effectiveness of mRNA-1273 versus BNT162b in patients with at least one underlying medical condition high risk for severe COVID-19. Methods MEDLINE, Embase, Cochrane databases were searched relevant articles from January 1, 2019 to February 9, 2024. Studies reporting data two doses BNT162b2 vaccination adults conditions developing COVID-19 according US Centers Disease Control Prevention included. Outcomes interest SARS-CoV-2 infection (overall, symptomatic, severe), hospitalization due COVID-19, death Risk ratios (RRs) calculated random effects models. Subgroup analyses by specific conditions, number vaccinations, age, variant conducted. Heterogeneity between studies was estimated chi-square testing. The certainty evidence assessed using Grading Recommendations, Assessments, Development, Evaluations framework. Results Sixty-five observational capturing original/ancestral-containing primary series Omicron-containing bivalent original-BA4-5 vaccinations included meta-analysis. associated significantly lower (RR, 0.85 [95% CI, 0.79–0.92]; I 2 =92.5%), symptomatic 0.75 0.65–0.86]; =62.3%), 0.83 0.78–0.89]; =38.0%), 0.88 0.82–0.94]; =38.7%), 0.84 0.76–0.93]; =1.3%) than BNT162b2. Findings generally consistent across subgroups. Evidence low or very because sufficiently powered randomized controlled trials are impractical this heterogeneous population. Conclusion Meta-analysis 65 showed that a COVID-19-related

Language: Английский

Citations

3
Serological responses to COVID-19 vaccination in patients with chronic liver diseases DOI Creative Commons
Yu‐Shan Huang, Szu‐Min Hsieh, Feng‐Chiao Tsai

et al.

Journal of the Formosan Medical Association, Journal Year: 2024, Volume and Issue: 123(11), P. 1194 - 1197

Published: June 21, 2024

Longitudinal analysis of antibody responses following three-dose COVID-19 vaccination in patients with chronic liver disease (CLD) has been limited. From August 2021 to February 2023, sequential anti-SARS-CoV-2 spike IgG titers were determined 45 CLD who received two or three doses vaccine. The geometric mean anti-spike at four weeks after the second and third 1313.16 BAU/mL 3042.29 BAU/mL, respectively, it decreased significantly from 24 (1313.16 vs. 198.42 p = 0.002) (3042.29 636.71 < 0.001) dose. participants receiving prime-boost homologous mRNA vaccines (BNT162b2 mRNA-1273) comparable between those without significant fibrosis each follow-up time point. This study demonstrated a notable decrease completion schedule CLD, highlighting importance additional booster doses.

Language: Английский

Citations

1
Vaccination in Patients with Liver Cirrhosis: A Neglected Topic DOI Creative Commons
Tommaso Stroffolini, Giacomo Stroffolini

Vaccines, Journal Year: 2024, Volume and Issue: 12(7), P. 715 - 715

Published: June 27, 2024

Patients with liver cirrhosis, due to their weakened innate and adaptive immunity, are more prone frequent severe vaccine-preventable infections. Moreover, impaired immunity results in a limited antibody response vaccines. Despite this suboptimal response, vaccines have proven be very effective reducing outcomes deaths these patients. In the Western world, regulatory authorities scientific societies (e.g., AASLD EASL) recommended vaccinations for cirrhotic However, despite strong recommendations, vaccine coverage remains suboptimal. Improving effectiveness safety information, providing comprehensive counseling patients, fact-checking combat fake news disinformation removing barriers vaccination disadvantaged individuals may help overcome low rate. view of this, should administered early course chronic diseases, as efficacy declines increasing severity disease.

Language: Английский

Citations

1
Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide DOI
Άδωνις Πρωτοπαπάς, Alexandra Tsankof, Ioanna Papagiouvanni

et al.

World Journal of Hepatology, Journal Year: 2024, Volume and Issue: 16(12), P. 1377 - 1394

Published: Nov. 29, 2024

Acute decompensation in cirrhotic patients signifies the onset of clinically evident events due to portal hypertension. The transition from compensated decompensated cirrhosis involves hemodynamic changes leading multiorgan dysfunction, managed predominantly outpatient settings with regular monitoring. mortality risk is elevated patients. Therefore, diligent management should focus on medical follow-ups, medication adjustments, patient education, addressing emergent issues and evaluation for liver transplantation. ultimate goal improve quality life, prevent disease progression, reduce complications, assess possible recompensation. This guide provides valuable recommendations experts managing post-hospitalization.

Language: Английский

Citations

0