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https://www.readbyqxmd.com/read/29243898/invasive-treatment-of-superficial-veins-of-the-lower-extremities
#1
Jukka Saarinen
Modern invasive treatment of superficial venous insufficiency of the lower extremities is largely based on the use of intravenous procedures under ultrasound guidance. The first-line treatment is thermoablation, in which the insufficient superficial vein, typically vena saphena magna or parva, is constricted by using laser or radio frequency energy under ultrasound guidance. The procedure is nearly always successful under local anesthesia and can be performed as an outpatient operation. When necessary, visible collateral varices can be treated with foam sclerotherapy or by surgical excision...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29243516/gas6-as-a-predictor-of-esophageal-varices-in-patients-affected-by-hepatitis-c-virus-related-chronic-liver-disease
#2
Mattia Bellan, Pier Paolo Sainaghi, Margherita Tran Minh, Rosalba Minisini, Luca Molinari, Marco Baldrighi, Livia Salmi, Matteo Nazzareno Barbaglia, Luigi Mario Castello, Paolo Ravanini, Gian Carlo Avanzi, Mario Pirisi
AIM: Plasma Gas6 was tested as an alternative to Baveno VI criteria (liver stiffness <20 kPa and platelet count >150 × 109/l) in an endoscopy-sparing strategy. METHODS:  A total of 160 patients with chronic hepatitis C and advanced fibrosis/cirrhosis underwent, on the same occasion, liver elastography, upper endoscopy, a platelet count and serum Gas6 measurement Results: A total of 74/160 (46%) patients had esophageal varices, that were small (diameter <5 mm) in 57/160 (34%) and large in 17/160 (11%) cases...
December 15, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29238587/bacterial-infections-in-acute-variceal-hemorrhage-despite-antibiotics-a-multicenter-study-of-predictors-and-clinical-impact
#3
Stephen Lee, Lynora Saxinger, Mang Ma, Verónica Prado, Joaquin Fernández, Deepali Kumar, Juan Gonzalez-Abraldes, Adam Keough, Ravin Bastiampillai, Michelle Carbonneau, Javier Fernandez, Puneeta Tandon
Background and aims: Current guidelines recommend antibiotic prophylaxis in all patients presenting with cirrhosis and acute variceal hemorrhage (AVH). We aimed to evaluate the characteristics and clinical impact of "early" infections (developing within 14 days) of AVH in a real-world setting. Methods: We analyzed retrospective data from a cohort of 371 adult patients with cirrhosis and AVH all of whom had received antibiotic prophylaxis (74% men; mean age 56 years), admitted to tertiary care hospitals in Edmonton, Alberta, Canada, and Barcelona, Spain...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29238586/international-prospective-observational-study-of-upper-gastrointestinal-haemorrhage-does-weekend-admission-affect-outcome
#4
Iain A Murray, Harry R Dalton, Adrian J Stanley, Jing H Ngu, Brian Maybin, Mahmoud Eid, Kenneth G Madsen, Rozeta Abazi, Hamad Ashraf, Mohamed Abdelrahim, Rebecca Lissmann, Jenny Herrod, Christopher Jl Khor, Hock S Ong, Doreen Sc Koay, Yung K Chin, Stig B Laursen
Introduction: Out of hours admissions have higher mortality for many conditions but upper gastrointestinal haemorrhage studies have produced variable outcomes. Methods: Prospective study of 12 months consecutive admissions of upper gastrointestinal haemorrhage from four international high volume centres. Admission period (weekdays, weeknights or weekends), demographics, haemodynamic parameters, laboratory results, endoscopy findings, further procedures and 30-day mortality were recorded...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29238436/idiopathic-isolated-colonic-varices-an-extremely-rare-condition
#5
Tagore Sunkara, Megan E Caughey, Andrea Culliford, Vinaya Gaduputi
Colonic varices are an incredibly rare phenomenon to begin with; however, they are even more unusual when isolated and occurring in the absence of common comorbidities, like portal hypertension or portal vein thrombosis. We present a case of a 71-year-old female, who was asymptomatic and referred to gastroenterology for a routine colorectal cancer screening. The patient was ultimately found to have this anomalous condition when colonic varices were first identified on colonoscopy. Since these varices did not result from any obvious etiology, they were determined to be idiopathic colonic varices, an especially unusual presentation...
January 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29234547/testicular-cancer-presenting-as-gastric-variceal-hemorrhage
#6
Carlos Eduardo Salazar-Mejía, David Hernández-Barajas, Edio Llerena-Hernández, José Luis González-Vela, María Inés Contreras-Salcido, Adriana González-Gutiérrez, Omar David Borjas-Almaguer, Luis Alberto Pérez-Arredondo, Blanca Otilia Wimer-Castillo
Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35. The symptomatology caused by this tumor varies according to the site of metastasis. We present the case of a 26-year-old male who arrived to the emergency department with hematemesis. He had no previous medical history. On arrival, we noted enlargement of the left scrotal sac. There was also a mass in the left scrotum which provoked displacement of the penis and right testis. The serum alpha-fetoprotein level was 17,090 ng/mL, lactate dehydrogenase was 1480 U/L, and human chorionic gonadotropin was 287...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29234200/nutrition-and-muscle-in-cirrhosis
#7
REVIEW
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234198/long-term-outcomes-of-patients-with-significant-biliary-obstruction-due-to-portal-cavernoma-cholangiopathy-and-extra-hepatic-portal-vein-obstruction-ehpvo-with-no-shuntable-veins
#8
Akash Shukla, Amit Gupte, Vedant Karvir, Prashant Dhore, Shobna Bhatia
Aims: The natural history of portal cavernoma cholangiopathy (PCC) in patients with significant biliary obstruction (SBO) who cannot undergo shunt surgery, is not known. We therefore, analyzed data of patients of extra-hepatic portal venous obstruction (EHPVO) with PCC. Methods: Prospectively recorded details of 620 (age 21.2 [11.4] years; 400 [65%] males) patients with primary EHPVO were reviewed. Outcomes (hepatic decompensation/mortality) of patients with PCC and SBO without shuntable veins were noted at follow up of 7 [4-11] years...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#9
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234190/can-non-selective-beta-blockers-nsbbs-prevent-enlargement-of-small-esophageal-varices-in-patients-with-cirrhosis-a-meta-analysis
#10
Ashish Kumar, Praveen Sharma, Shrihari A Anikhindi, Ritesh Prajapati, Rachit Agarwal, Bhupendra Sharma, Naresh Bansal, Vikas Singla, Anil Arora
Background: Non-selective beta-blockers (NSBBs) are recommended for prophylaxis of first variceal bleeding in patients of cirrhosis with large esophageal varices. However, the data is conflicting whether NSBBs can also prevent growth of small esophageal varices to large size. Aim: To perform a meta-analysis of the randomized clinical trials comparing NSBBs with placebo for prevention of development of large esophageal varices in patients of cirrhosis with small esophageal varices...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29231188/major-hepatic-complications-in-ursodeoxycholic-acid-treated-patients-with-primary-biliary-cholangitis-risk-factors-and-time-trends-in-incidence-and-outcome
#11
Maren H Harms, Willem J Lammers, Douglas Thorburn, Christophe Corpechot, Pietro Invernizzi, Harry L A Janssen, Pier M Battezzati, Frederik Nevens, Keith D Lindor, Annarosa Floreani, Cyriel Y Ponsioen, Marlyn J Mayo, George N Dalekos, Tony Bruns, Albert Parés, Andrew L Mason, Xavier Verhelst, Kris V Kowdley, Jorn C Goet, Gideon M Hirschfield, Bettina E Hansen, Henk R van Buuren
OBJECTIVES: In this era of near universal ursodeoxycholic acid (UDCA) treatment for primary biliary cholangitis (PBC), progression to cirrhosis still occurs in an important proportion of patients. The aim of this study was to describe the incidence of cirrhosis-associated complications in patients with PBC and assess risk factors and impact on survival. METHODS: Cohorts of UDCA-treated patients from 16 European and North-American liver centers were included. We used Cox proportional hazards assumptions and Kaplan-Meier estimates...
December 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29228336/thoracic-park-cardiac-mri-reveals-massive-thoracic-varices-as-consequence-of-inferior-vena-cava-ligation
#12
Christopher J Allen, Tanya Freeman, Wayomi Perera, Simon P Padley, Matthew Hind
No abstract text is available yet for this article.
December 8, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29226103/clinical-application-of-vibration-controlled-transient-elastography-in-patients-with-chronic-hepatitis-b
#13
REVIEW
Xie-Er Liang, Yong-Peng Chen
Evaluation of the extent and progression of liver fibrosis and cirrhosis is of critical importance in the management and prognosis of patients with chronic hepatitis B. Due to the limitation of liver biopsy, non-invasive methods, especially liver stiffness measurement (LSM) by vibration controlled transient elastography, have been developed and widely applied for liver fibrosis assessment. LSM aims to reduce, but not to substitute, the need for liver biopsy for fibrosis/cirrhosis diagnosis. While LSM may have potential utility in monitoring treatment response, its applications in prediction of liver complications in terms of portal hypertension and esophageal varices, as well as disease prognosis, have been gradually validated...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#14
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29218259/melena-as-initial-presentation-of-adenocarcinoma-in-pancreatic-tail
#15
Stella Pak, Damian Valencia, James Kim, Christine Dee
Melena associated with gastric varices, in the setting of possible obstructing pancreatic adenocarcinoma, has been poorly documented as an initial presenting sign for pancreatic malignancy. Considering the late presentation of patients with pancreatic malignancy, it is important to consider all potential presenting symptoms for the early detection and treatment of pancreatic malignancy. Below, we present a patient with no history of liver pathology, who presents with melena and gastric varices, likely relating to portal hypertension in the setting of an obstructing pancreatic malignancy...
October 4, 2017: Curēus
https://www.readbyqxmd.com/read/29218132/portal-vein-thrombosis-in-adult-omani-patients-a-retrospective-cohort-study
#16
Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare
OBJECTIVES: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29216021/long-term-results-and-quality-of-life-assessment-in-biliary-atresia-patients-a-35-year-experience-in-a-tertiary-hospital
#17
Carol Wing Yan Wong, Patrick Ho Yu Chung, Paul Kwong Hang Tam, Kenneth Kak Yuen Wong
OBJECTIVES: To review long-term transplant-free survival and quality of life of patients with biliary atresia. METHODS: A retrospective study reviewing all patients with Kasai operation between 1 January 1980 and 31 December 2015 was performed to evaluate the transplant-free survival. Subgroup analysis of patients over 20 years old was carried out to assess the quality of life using the Short Form-36 Health Survey and incidences of disease-related complications...
December 5, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29214793/mesocaval-shunt-creation-for-jejunal-variceal-bleeding-with-chronic-portal-vein-thrombosis
#18
Ja Kyung Yoon, Man Deuk Kim, Do Yun Lee, Seok Joo Han
The creation of transjugular intrahepatic portosystemic shunt (TIPS) is a widely performed technique to relieve portal hypertension, and to manage recurrent variceal bleeding and refractory ascites in patients where medical and/or endoscopic treatments have failed. However, portosystemic shunt creation can be challenging in the presence of chronic portal vein occlusion. In this case report, we describe a minimally invasive endovascular mesocaval shunt creation with transsplenic approach for the management of recurrent variceal bleeding in a portal hypertension patient with intra- and extrahepatic portal vein occlusion...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29214053/severe-carvedilol-toxicity-without-overdose-caution-in-cirrhosis
#19
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29210030/pharmacologic-prevention-of-variceal-bleeding-and-rebleeding
#20
REVIEW
Anna Baiges, Virginia Hernández-Gea, Jaime Bosch
BACKGROUND: Variceal bleeding is a major complication of portal hypertension, which is associated with significant mortality. Moreover, patients surviving a variceal bleeding episode have very high risk of rebleeding, which is associated with mortality as high as that of the first bleed. Because of this, prevention of bleeding from gastroesophageal varices has been one of the main therapeutic goals since the advent of the first effective therapies for portal hypertension. AIM: This review deals with the present day state-of-the-art pharmacological prevention of variceal bleeding in primary and secondary prophylaxis...
December 5, 2017: Hepatology International
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