American Journal Of Biomedical Science & Pharmaceutical Innovation

Innovations in Managing Decompensated Cirrhosis: A Review of Contemporary Treatment Strategies

Dr. Samuel Chen — 2025-09-01

Background: Liver cirrhosis, the end-stage of chronic liver disease, is a major cause of global morbidity and mortality. Its clinical course is characterized by the development of life-threatening complications, including portal hypertension, ascites, hepatic encephalopathy (HE), hepatorenal syndrome-acute kidney injury (HRS-AKI), and hepatocellular carcinoma (HCC). The management of these conditions is complex and has evolved significantly in recent years.

Objective: This review aims to synthesize recent evidence and provide a comprehensive overview of the contemporary, evidence-based strategies for the diagnosis and management of the major complications of decompensated liver cirrhosis.

Methods: A narrative review of the literature was conducted using prominent databases. The synthesis focuses on seminal studies, clinical guidelines, and recent trials that have shaped the current understanding and treatment paradigms for cirrhosis complications, drawing from a curated list of 34 key references.

Findings: Management of portal hypertension and varices has been refined with non-invasive diagnostics and clear prophylactic strategies. For ascites, the focus remains on diuretic management and timely intervention for refractory cases, while new insights into bacterascites and spontaneous bacterial peritonitis (SBP) have improved infection control. The treatment of HE is centered on ammonia-lowering agents like lactulose and rifaximin. The diagnostic criteria for HRS-AKI have been updated for earlier recognition, with vasoconstrictors (e.g., terlipressin) and albumin forming the cornerstone of medical therapy. For HCC, enhanced risk stratification models and regular surveillance in cirrhotic patients are critical for early detection and access to potentially curative therapies.

Conclusion: The management of cirrhosis complications has advanced significantly, moving towards earlier diagnosis and targeted, evidence-based interventions. A multi-faceted approach addressing each complication is crucial for improving patient outcomes. Future research should focus on novel therapies targeting the underlying pathophysiology of portal hypertension and fibrosis to prevent decompensation and improve survival.

Involutional Changes In The Brain In Alzheimer's Disease: Macroscopic And Micromorphological Correlations

Djumaev Nizomitdin Umurzakovich — 2025-09-26

Alzheimer's disease (AD) is the most common cause of dementia, which is characterized by progressive involutional changes in the brain. Establishing clear correlations between macroscopic manifestations of atrophy and underlying micromorphological pathological processes (formation of amyloid plaques and neurofibrillary tangles) is key to understanding the pathogenesis and developing diagnostic and treatment methods. Objective: To analyze current data on macroscopic and micromorphological changes in the brain in AD and their relationship with the clinical picture, with an emphasis on the possibilities of early diagnosis and treatment according to international recommendations. Materials and methods: A systematic review of the literature from 2018 to 2024 was conducted using PubMed, Google Scholar, and the Cochrane Library databases. Original studies, meta-analyses, and clinical guidelines on neuroimaging, pathomorphology, and biomarkers of AD met the inclusion criteria. Results: A close correlation was found between the sequential accumulation of pathological beta-amyloid (Aβ) and tau protein with specific macroscopic changes. Early atrophy of the medial temporal lobe, especially the entorhinal cortex and hippocampus, correlates with memory impairment and precedes significant cortical atrophy. According to PET imaging and cerebrospinal fluid biomarker studies, the pathological process begins 10-20 years before the onset of clinical symptoms. Current global guidelines (NIA-AA, 2018; IWG, 2021) shift the focus to the preclinical and prodromal stages, defining AD through biological markers. Conclusion: The integration of macroscopic neuroimaging data (MR morphometry) with the assessment of micromorphological changes using biomarkers (PET, cerebrospinal fluid) enables the diagnosis of AD at the earliest, potentially treatable stages. The advent of pathogenetic therapy aimed at clearing the brain of amyloid (aducanumab, lecanemab) makes early diagnosis clinically significant, opening up opportunities to slow the progression of the disease.

Comparative Analysis Of Computed Tomography And Magnetic Resonance Imaging Data With Anatomical Specimens To Clarify The Topography Of The Retroperitoneal Organs

Djumaev Alokhiddin Umirzakovich — 2025-09-26

Accurate knowledge of the topographic and anatomical features of the retroperitoneal space (RPS) is critical for diagnosis and surgical planning. Modern imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), have become the gold standard in clinical practice; however, their compliance with classical anatomical concepts requires constant verification. Objective: To conduct a comparative analysis of CT and MRI data with the anatomical structure of RPS organs on specimens to clarify their topography and assess variability. Materials and Methods: An analysis of 50 CT and 30 MRI studies of patients without RPS pathology, as well as macroscopic specimens from 15 adult cadavers, was conducted. The topographic relationships of the kidneys, adrenal glands, large vessels (aorta, inferior vena cava), pancreas, and duodenum were assessed. Results: It was established that modern high-resolution imaging methods (contrast-enhanced CT, MRI with fat-suppressed sequences) reliably depict the anatomical structures of the renal pelvis. Cases of clinically significant variability were identified: atypical branching of the renal arteries (18% of cases according to CT angiography), retroaortic position of the left renal vein (4%), which fully correlated with the data of anatomical specimens. However, fascial relationships and thin nerve plexuses are reliably visualized only on specimens. Conclusion: The integrated use of CT/MRI data and classical anatomical examination on specimens provides the most complete understanding of the topography of the renal pelvis. The integration of virtual 3D models reconstructed from tomography data into the educational process of medical universities helps to overcome the limitations associated with the shortage of cadaveric material and improve the effectiveness of student training in topographic anatomy.

Morphofunctional Characteristics Of The Abdominal Muscles In Individuals With Different Types Of Physical Activity: Historical Evolutionary Context And Challenges Of The Digital Age

Parmonov Egamkul Karshiyevich — 2025-09-26

The abdominal muscles play a key role in trunk stabilization, posture, and movement. Their morphofunctional characteristics are flexible and depend on the type of physical activity. In the 21st century, the consequences of physical inactivity due to digitalization are becoming more pressing, requiring a rethinking of classical anatomical concepts. Objective: To study the morphofunctional characteristics of the abdominal muscles in individuals with different types of physical activity, taking into account historical changes in human physical development over the past 100 years. Materials and Methods: A systematic review of the scientific literature covering the past 5-6 years was conducted using PubMed, Google Scholar, and CyberLeninka. Studies using ultrasound, MRI, and electromyography (EMG) to assess muscle thickness, cross-sectional area, and activity in athletes (strength athletes, martial artists, and gymnasts) and individuals with a sedentary lifestyle were considered. Results: Significant differences were identified: strength athletes are characterized by hypertrophy of the rectus abdominis and oblique abdominal muscles, while gymnasts have predominantly developed transverse abdominis (TrA) and internal oblique muscles responsible for stabilization. Individuals with physical inactivity exhibit decreased TrA thickness, functional weakness of the deep stabilizers, and compensatory overstrain of the rectus abdominis. It was established that over the past 100 years, the average person has experienced a decrease in muscle mass, changes in posture (sloping neck, anterior pelvic tilt), and weakening of the abdominal corset. Conclusion: Digitalization and a sedentary lifestyle led to an "anatomical restructuring" toward weakening of the deep stabilizing abdominal muscles, which is a risk factor for back pain. Modern approaches to physical training should be aimed at correcting these changes, with an emphasis on functional stability, not just aesthetics.