Non-invasive markers as predictors of oesophageal varices in cirrhotic patient in a teaching hospital in Ghana

Prevalence and risk factors of hypertension among adolescents living in Ghana

This study assessed the prevalence of and risk factors for hypertension among adolescents in two selected districts in Ghana. The data were analyzed using SPSS version 24. Multivariate logistic regression analyses were conducted to determine the risk factors of hypertension among adolescents. The overall prevalence of high blood pressure (BP) was 11.6%. The non-modifiable risk factors that predicted high BP were district of residence (Adjusted odds ratio [AOR] = 0.328, 95% confidence interval [CI] = 0.328-0.203), age (AOR = 1.540, 95%CI = 1.240-1.913), relationship status (AOR = 1.960 95%CI = 1.059-3.628) and possessing a phone (AOR = 0.538, 95%CI = 0.325-0.890). The modifiable risk factors that predicted high BP were high BMI, not checking BP regularly, and not having an awareness of salt intake. In accordance with these results, prevention programs must focus on adolescent knowledge, lifestyle practices, and attitudes toward control measures. It is important to incorporate health education in school curricula to promote a healthy lifestyle and limit the risks associated with high BP.

Nomogram model for predicting esophsagogastric varices in hepatocellular carcinoma with cirrhosis

BACKGROUND/AIMS

The prognosis for hepatocellular carcinoma (HCC) with cirrhosis is poor. The risk of death also increases in patients with esophagogastric varices (EGV). Based on routine clinical features and related noninvasive parameters, a nomogram prediction model was developed in this study to facilitate the early identification of EGV in HCC patients.

METHODS

A retrospective cohort analysis of patients with HCC in the Renmin Hospital of Wuhan University from 2020 to 2021 was performed. Clinical and noninvasive parameters closely related to EGV risk were screened by univariate and multivariate logistic regression analysis and integrated into a nomogram. The nomogram was validated internally and externally by calibration, receiver operating characteristic curve and decision curve analysis (DCA).

RESULTS

A total of 165 patients with HCC-related cirrhosis were recruited. In the raining cohort, multivariate logistic regression analysis identified platelet (PLT) [odds ratio (OR), 0.950; 95% confidence interval (CI), 0.925-0.977; P < 0.001], D-dimer (OR. 3.341; 95% CI, 1.751-6.376, P < 0.001), spleen diameter (SD) (OR, 2.585; 95% CI, 1.547-4.318; P < 0.001) as independent indicators for EGV. The nomogram for predicting EGV risk was well calibrated with a favorable discriminative ability and an area under curve of 0.961. In addition, the nomogram showed better net benefits in the DCA. The results were validated in the validation cohort.

CONCLUSIONS

The proposed nomogram model based on three indicators (PLT, D-dimer and SD) showed an excellent predictive effect, leading to the avoidance of unnecessary esophagogastroduodenoscopy.

Small varices in chronic liver diseases

PURPOSE OF REVIEW

Gastroesophageal varices are common complications of chronic liver diseases (CLDs) and portal hypertension. Small varices have the risk of progressing to larger varices, causing bleeding or even death. Thus, early detection and appropriate management of small varices are necessary. The purpose of this review is to summarize the advance in the recent 5years about diagnosing and managing the small varices in CLDs.

RECENT FINDINGS

The diagnosing methods of small varices in recent studies include improved endoscopic examinations, such as capsule endoscopy, and many noninvasive methods, including blood tests, ultrasound, computed tomography and magnetic resonance. For the management of small varices, though it is controversial, prevention using nonselective beta-blockers is still an essential part.

SUMMARY

In this review, we summarize the classification of varices, the invasive and noninvasive diagnostic methods, their performances, and the emerging progression in the management of small varices in the recent 5 years. We hope that this review provides relevant information to understand better and appropriately manage small varices.