Liver cirrhosis is the end stage of chronic liver diseases. The current gold standard for diagnosing this condition, liver biopsy, has too many drawbacks, and research for better alternatives is ongoing. One major diagnostic arsenal includes various serological composition scores or so-called formulas. They are constantly being validated for development of new formulas. In our retrospective study of 215 patients case files who had confirmed cirrhosis of various etiologies, we examined the sensitivity and set new cut-offs for five of the most well-documented formulas. Data was obtained from the Rīga East University Hospital from 2012 to 2017 and analysed using SPSS V.22.00. In our study we found that FIB-4 at cut-off > 1.45 had over 95% sensitivity for excluding advanced fibrosis regardless of cirrhosis etiology. None of evaluated formulas had high sensitivity for detecting cirrhosis of alcohol etiology. For the viral hepatitis C genesis group, the best choice was deRitis index with almost 90% sensitivity. FIB-4 at cut-off > 2.75 was the best choice for the combined alcohol and viral hepatitis C group; BONACINI at score 8+ and FIB-4 at > 3.25 were the most sensitive in the main group containing all patients irrespective of cirrhosis etiology.
Kefir is a fermented dairy product, created by fermentation of milk by bacteria and yeasts. Kefir is the most common traditional non-sweetened fermented dairy beverage in the Baltic countries. Whole kefir and specific fractions and individual organisms isolated from kefir provide a multitude of health benefits, including regulation of composition of the gut microbiome. This review aims to summarise the available data about influence of kefir consumption on the gut microbiome in healthy individuals and to highlight the effects that kefir consumption as well as separated fractions of kefir can have in disease states via modulation of the host microbiome.