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Background: To compare the impact of telbivudine (LDT) and entecavir (ETV) administration on nephritic function. Method: One hundred thirty patients diagnosed with hepatitis B virus (HBV)-related compensated cirrhosis were randomly divided into LDT (600 mg/d) or ETV (0.5 mg/d) groups. Results: The drug resistance rate was higher following LDT treatment compared to ETV treatment (16.9% vs. 1.5%, P=0.0006). The mean creatinine level decreased compared to baseline in the LDT group (0.81 vs. 0.94 mg/dl, P=0.000). The change in median glomerular filtration rate (eGFR) compared to baseline in the LTD and ETV groups was 22.3 and -3.3, respectively, at 2 years (P=0.000). In patients with mild nephritic injury (eGFR< 90 ml/min/1.73m²), the median eGFR increased by 28.0 ml/min/1.73m² in the LDT group and decreased by 4.3 ml/min/1.73m² in the ETV group (p=0.000). The eGFR in 88.5% of patients (23/26) from the LDT group increased > 90 ml/min/1.73m². The percentage of patients with an eGFR > 90 ml/min/1.73m² increased from 60.0% to 92.3% in the LDT group and from 64.6% to 69.2% in the ETV group. Conclusion: In patients with HBV-related compensated cirrhosis, LDT treatment was more effective in protecting nephritic function and was associated with a higher drug resistance rate, but did not contribute to a better outcome compared with ETV treatment.

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Background and aims COUNT score, PNI score, and GNRI scores are associated with cardiovascular events. This review identifies the most accurate malnutrition assessment tools based on these scores in predicting mortality and readmission outcomes in HF patients. Material and Methods PubMed via MEDLINE, EMBASE were searched to identify studies assessing malnutrition using CONUT, PNI and GNRI. A meta-analysis was carried out to pool the hazard ratios on mortality and readmission rates. The methodological quality was assessed using the Newcastle-Ottawa Scale. Results The mortality in HF patients with malnutrition assessed by CONUT showed pooled HR of 1.23. HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 3.56, 2.71 and 1.57 respectively. For malnutrition assessed with GNRI, HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 4.17, 2.73 and 1.73 respectively. No significance difference in association of CONUT score with pooled HR of readmission rate was observed HR 0.99. With PNI, HF patients with all severe and moderate risk of malnutrition showed mortality with HR 2.14 and HR 1.68 respectively, although they failed to achieve significance. Conclusion CONUT and GNRI are the superior prognostic indicator than PNI in prediction of mortality associated with risk of malnutrition.

ObjectiveThis study aimed to review studies comparing outcomes following percutaneous coronary intervention (PCI) in saphenous vein grafts (SVG) with and without embolic protection devices (EPD).MethodsDatabases including PubMed Central, Cochrane Library, EMBASE, CINAHL, MEDLINE, Google Scholar, ScienceDirect, and Scopus were searched from January 1964 to April 2021. We used the Cochrane risk of bias tool and the Newcastle Ottawa scale to assess the quality of published studies based on study design. From the results, we carried out a meta-analysis with a random-effects model and reported pooled odds ratio (OR) with 95% CI.ResultsIn total, 11 studies were analyzed that included 79,009 total participants. EPD use had significantly lower odds of mortality (pooled OR = 0.69; 95% CI: 0.5–0.94). There was no significant difference in terms of major adverse cardiovascular events (MACE) (pooled OR = 0.83; 95% CI: 0.67–1.03), target vessel revascularization (pooled OR = 1; 95% CI: 0.95–1.05), periprocedural (pooled OR = 1.12; 95% CI: 0.65–1.9) and late myocardial infarction (MI) (pooled OR = 0.79; 95% CI: 0.55–1.14) with or without EPD for PCI in SVG patients.ConclusionAlthough not statistically beneficial for MACE, target vessel revascularization, periprocedural, and late MI, EPD use does appear to significantly reduce mortality for the patients undergoing PCI in SVG. Clinicians might consider using EPD for such patients to reduce the burden of post-procedural morbidity and mortality.