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Clinical and Experimental Hepatology

Uday A Sanglodkar, Dinesh Jothimani, Mohamed Rela
Rebleeding after initially successful endoscopic variceal ligation (EVL) occurs in 20-60% of patients, most commonly from band ulcers, and is associated with 20-50% mortality. Although band ulcer bleeding has been treated in a number of different ways, no single therapeutic intervention has shown a clear benefit. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a relatively new non-contact hemostatic modality used in the management of bleeding peptic ulcers. It is a nano-powder that can be sprayed over a larger mucosal area...
March 2018: Clinical and Experimental Hepatology
Archana Kulkarni, Hamza Arif, Manik Veer, Kateyln Ziggas, Amit Kaura, Meera Sareen
Hepatic infarction is rare due to the unique dual hepatic blood supply from the hepatic artery and the portal vein. Herein, we report a case of hepatic infarction that occurred as a complication of acute pancreatitis. The patient was a 58-year-old male with past medical history of chronic alcoholism, who presented with epigastric abdominal pain, nausea, and vomiting. Hepatic infarction was diagnosed with computed tomography of the abdomen and pelvis without contrast, which revealed suspicion of splenic vein thrombosis and peripancreatic fat stranding along with a wedge-shaped, peripheral hypo density in the right hepatic lobe with typical morphology for hepatic infarction...
March 2018: Clinical and Experimental Hepatology
Mahadevan Balkrishanan, Mayank Jain, Chenduran Snk, Sridhar Cg, Ravi Ramakrishnan, Jayanthi Venkataraman
Introduction: Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success rate varies from 61% to 95.4%. Material and methods: Four cases with PAD in which, despite repeated attempts, we were unable to locate the papilla and cannulate. To overcome this difficulty, we used SpyBite forceps (Boston Scientific) to pull out the papillary orifice and then perform the cannulation using a sphincterotome introduced through the same working channel...
March 2018: Clinical and Experimental Hepatology
Ebrahim Shakiba, Mazaher Ramezani, Masoud Sadeghi
Aim of the study: This meta-analysis aimed to evaluate serum IL-10 levels in HCC patients. Material and methods: The three databases PubMed, Scopus and Web of Science were checked on July 2017 for assessment of IL-10 levels in hepatocellular carcinoma (HCC) patients compared with healthy controls in publications with an English abstract. A random-effect meta-analysis was performed using mean difference (MD) and 95% confidence intervals (CIs). Also, publication bias was evaluated through funnel plot analysis with the Begg's and Egger's tests...
March 2018: Clinical and Experimental Hepatology
Osama Siddique, Ayesha S Siddique, Jason T Machan, Kittichai Promrat
Introduction: Post-transplant infections have been studied widely but data on comparisons of deceased donor liver transplants (DDLT) and living donor liver transplants (LDLT), type and timings of infections, and their relations to outcomes are not explored. Material and methods: We analysed data from 612 participants of the Adult-to-Adult Living Donor Liver Transplantation Study (A2ALL), a retrospective data set of LDLT and DDLT. We compared the type and timing of the first post-transplant infection in relation to transplant outcomes between the two groups...
March 2018: Clinical and Experimental Hepatology
Dariusz Wasiak, Jacek Pliszczyński, Beata Łągiewska, Maurycy Jonas, Mariusz Panczyk, Piotr Małkowski, Wojciech Lisik, Maciej Kosieradzki
Introduction: This article summarize the available data on hepatocellular carcinoma (HCC) epidemiology in Poland. Data regarding the HCC incidence rate are divergent. Statistical data presented by NFZ appear more credible in that matter than data published by the Polish Oncology Center (POC). Material and methods: The analysis included data from the Polish Bibliography Database (GBL), the Polish National Health Fund Institution (NFZ), the scientific paper "Malignant neoplasms in Poland" issued by POC and the central liver transplant registry maintained by the Polish transplant coordinating center "Poltransplant" (2010-2015)...
March 2018: Clinical and Experimental Hepatology
Behairy E Behairy, Nermine Ehsan, Magdy Anwer, Alif Allam, Ibramem El-Henawy, Nesreen Abdel Hameed, Haidy M Zakaria
Aim of the study: Assessment of the expression of cluster of differentiation (CD)3, CD4, and CD8 T cells in biliary atresia (BA) cases in comparison to neonatal cholestasis other than BA. Material and methods: This study included 79 patients: 34 patients with BA (BA group) and 35 patients with neonatal cholestasis due to causes other than BA (cholestasis group), and 10 normal liver donor as a control group. Immunohistochemical staining or CD3, CD4, and CD8 T cells in liver tissues for the 3 groups were evaluated...
March 2018: Clinical and Experimental Hepatology
Kamila Wójcik-Cichy, Ewa Koślińska-Berkan, Anna Piekarska
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries and is associated with obesity, dyslipidaemia, diabetes, and metabolic syndrome. Atherosclerosis and cardiovascular diseases are also highly prevalent in this group of patients, due to the presence of shared risk factors. The incidences of coronary artery calcification, hypertension, aortic valve sclerosis, diastolic dysfunction, atherosclerotic plaques, and increased carotid intima-media thickness were more common in patients with NAFLD than in those without...
March 2018: Clinical and Experimental Hepatology
Mayank Jain, Jenisha Jain, Gauri Rao Passi, Kamna Jain, Shikhar Jain
Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India. Material and methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012. Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6...
December 2017: Clinical and Experimental Hepatology
Magdalena Rogalska-Taranta, Jerzy Jaroszewicz, Robert Flisiak
Aim of the study: We investigated the impact of pegylated interferon α-2 in combination with ribavirin (PEG-IFNα/RBV) treatment on hepcidin and α-1-antitrypsin concentrations in the serum of patients with chronic hepatitis C. Material and methods: We measured serum concentrations of hepcidin, prohepcidin and α-1-antitrypsin by enzyme-linked immunosorbent assays in patients with chronic hepatitis C before and during antiviral therapy. Results: Hepcidin concentrations were increased in both genotype 1b and 3a hepatitis C virus (HCV) infected patients as compared with the control group...
December 2017: Clinical and Experimental Hepatology
Piyush Bawane, Mayank Jain, Mahadevan Balkrishnan, R Ravi, Joy Varghese, Jayanthi Venkataraman, Mukul Vij, Mohamed Rela
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication noted after solid organ transplantation and is frequently related to Epstein-Barr virus infection. The present case highlights an unusual presentation of PTLD - gastrointestinal bleeding - in the absence of systemic symptoms.
December 2017: Clinical and Experimental Hepatology
Gokcen Orgul, Esra Uyanik Ozkan, H Tolga Celik, M Sinan Beksac
Women of childbearing age with autoimmune hepatitis (AIH) are now able to get pregnant. The progress of the disease during pregnancy is not well clarified yet. The first pregnant woman had cirrhosis secondary to AIH, and she delivered by cesarean section. The patient had severe thrombocytopenia at the time of hospitalization. Unfortunately, she died due to massive thromboembolism at the 24th hour after delivery. The other patient had three recurrent abortions with a diagnosis of AIH. Low-dose low molecular weight heparin and low-dose acetylsalicylic acid along with low-dose prednisolone were administered during the course of the following pregnancies...
December 2017: Clinical and Experimental Hepatology
Maria Pokorska-Śpiewak, Barbara Kowalik-Mikołajewska, Małgorzata Aniszewska, Magdalena Pluta, Magdalena Marczyńska
Aim of the study: Recently, novel serum markers modified by the body mass index z -score (BMI z -score) were proposed as a reliable noninvasive alternative for the detection of significant fibrosis and steatosis in children with chronic hepatitis C (CHC). The aim of this study was to evaluate the clinical usefulness of these biomarkers. Material and methods: Thirty children aged 9.4 ± 3.7 years (14 males, 16 females) with CHC were included in this study. In all patients, histopathological evaluation of the liver fibrosis was performed using a 5-point METAVIR scoring system (≥ 2 points = significant fibrosis)...
December 2017: Clinical and Experimental Hepatology
Karola Warzyszyńska, Maurycy Jonas, Dariusz Wasiak, Maciej Kosieradzki, Piotr Małkowski
Aim of the study: New interferon-free direct-acting antiviral (DAA) therapy has led to major progress in hepatitis C virus (HCV) treatment. Current outcomes are promising, especially in compensated cirrhosis. However, there are reports of accelerated hepatocellular carcinoma (HCC) recurrence after surgery in patients treated with DAAs. The influence of DAA therapy on the timing and frequency of recurrence after surgical treatment needs further observation. Material and methods: Fifty-one HCV infected patients with advanced liver cirrhosis and history of surgical treatment for HCC in 2012-2016 were analyzed in a case-control study...
December 2017: Clinical and Experimental Hepatology
Maria Pokorska-Śpiewak, Barbara Kowalik-Mikołajewska, Małgorzata Aniszewska, Magdalena Pluta, Magdalena Marczyńska
Aim of the study: Was to evaluate liver disease severity in children with chronic viral hepatitis using the FibroTest and ActiTest (FT/AT), and compare the results with the liver biopsy. Material and methods: The study included 11 treatment-naïve children [mean age, 9.0 ± 3.0 years, 10 infected with hepatitis C virus (HCV), and 1 with hepatitis B virus (HBV)] who underwent an FT/AT. Ten of the children underwent a liver biopsy. The histopathological evaluation was based on the METAVIR scoring system...
December 2017: Clinical and Experimental Hepatology
Ivica Grgurevic, Tonci Bozin, Anita Madir
Results from the interferon era have demonstrated reversibility of cirrhosis following viral eradication, but only for patients in the initial stage of cirrhosis. Although direct-acting antivirals (DAA) represent revolutionary treatment of hepatitis C, there are currently no studies showing histological effects of therapy on a large number of cirrhotic patients. However, studies involving transient elastography demonstrated a rapid decrease in liver stiffness after successful DAA therapy, probably due to resolution of inflammation, rather than fibrosis regression, as the latter requires a longer period of time...
December 2017: Clinical and Experimental Hepatology
Kamil Janowski, Maria Goliszek, Joanna Cielecka-Kuszyk, Irena Jankowska, Joanna Pawłowska
Congenital hepatic fibrosis (CHF) is a rare, autosomal recessive disorder, clinically characterized by hepatic fibrosis and portal hypertension. CHF results from ductal plate malformation (DPM) of the intrahepatic bile ducts. Four clinical forms can be observed: portal hypertensive, cholangitic, mixed and latent. CHF is one of the "fibropolycystic diseases" which also include several conditions with a variety of intrahepatic bile duct dilatation and associated periportal fibrosis such as Caroli disease, autosomal recessive and dominant polycystic kidney disease (ARPKD or ADPKD), Ivemark, Jeune, Joubert, Bardet-Biedl, Meckel-Gruber and Arima syndromes...
September 2017: Clinical and Experimental Hepatology
Anna Wieczorek, Piotr M Stępień, Dorota Zarębska-Michaluk, Wiesław Kryczka, Paweł Pabjan, Teodora Król
Although chronic hepatitis C virus (HCV) infection affect 185 million people world-wide, pathomechanism of liver damage is still unclear. Electron microscopy can reveal liver injury in very early stage and help understanding the mechanisms that is crucial in the pathogenesis of chronic hepatitis C. We present the morphological changes in the liver of HCV infected 24-year-old female patient, using light and transmission electron microscopy. Examination by TEM revealed wide range of specific subcellular abnormalities in hepatocellular ultrastructure...
September 2017: Clinical and Experimental Hepatology
Dzmitry Danilau, Nadzeya Malich, Dzmitry Litvinchuk, Igor Karpov
AIM OF THE STUDY: Aim of the study is to evaluate real-world efficacy of the ombitasvir/ paritaprevir/ ritonavir + dasabuvir ± ribavirin for treatment of chronic hepatitis C 1 genotype. MATERIAL AND METHODS: The study included 27 patients according to inclusion criteria. Main laboratory studies were performed in all patients at the baseline and during the treatment. RESULTS: Efficacy of the antiviral therapy was assessed by measuring the SVR12 and the SVR24 along with measuring of viral load during the treatment...
September 2017: Clinical and experimental hepatology
Behairy El-Sayed, Hanaa El-Araby, Nermin Adawy, Mona Hassona, Naglaa El-Nady, Haidy Zakaria, Mohammed Khedr
AIM OF THE STUDY: To assess if elevated serum cystatin C (Cyst-C) is an indicator for renal or hepatic dysfunction in presence of liver fibrosis. MATERIAL AND METHODS: Data of 50 children with chronic liver diseases (CLDs), out of which 25 were without renal impairment, and 25 with renal impairment were analyzed. Twenty healthy children served as a healthy control group. Routine investigations, creatinine clearance, hepatitis viral markers, abdominal ultrasonography, and liver biopsy were performed for patients with CLDs...
September 2017: Clinical and Experimental Hepatology
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