Medicina clinica
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Non-alcoholic fatty liver disease (NAFLD) is a chronic disease that may lead to cirrhosis and hepatocellular carcinoma; its close relationship with obesity and the metabolic syndrome involves an increasing prevalence. Invasive liver biopsy is the gold standard diagnosis technique for NAFLD but entails risks. Therefore, transient elastography, a non-invasive technique with high reliability, is frequently used in clinical practice. ⋯ Although studies report encouraging results of bariatric surgery as a valuable therapy for NAFLD, guidelines for its use in NAFLD are ambiguous. Indeed, the mechanisms driving this improvement are largely unknown, but likely involve weight loss-dependent and independent factors including anatomic and hormonal changes. This review aims to update the relationship between NAFLD and bariatric surgery, focusing on the indications for surgery and the mechanisms implied in NAFLD improvement.
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Case Reports
Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-19 associated pneumonia.
Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC). ⋯ Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.
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Observational Study
Vascular target organ damage in patients with Philadelphia negative myeloproliferative syndrome: A propensity score analysis.
To assess whether subjects with Philadelphia negative myeloproliferative neoplasms (Ph-MPNs) show differences in the presence of vascular, cardiac or renal target organ damage (TOD) and other vascular function parameters as compared to individuals without this condition. ⋯ Subjects with Ph-MPNs have twice the risk of by carotid injury than those without haematological disease.