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Liver critical care

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https://www.readbyqxmd.com/read/29770847/the-investigation-of-the-survival-time-after-recurrence-in-patients-with-pancreatic-ductal-adenocarcinoma-for-individualization-of-adjuvant-chemotherapy
#1
Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Tadafumi Asaoka, Takehiro Noda, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; however, the frequency of recurrence can be reduced if curative surgery following adjuvant chemotherapy is applied. At present, adjuvant chemotherapy is uniformly performed in all patients, as it is unclear which tumor types are controlled best or worst. We investigated patients with recurrence to establish the optimum treatment strategy. METHODS: Of 138 patients who underwent curative surgery for PDAC, 85 developed recurrence...
May 17, 2018: Surgery Today
https://www.readbyqxmd.com/read/29750131/tissue-engineering-toward-organ-specific-regeneration-and-disease-modeling
#2
Christian Mandrycky, Kiet Phong, Ying Zheng
Tissue engineering has been recognized as a translational approach to replace damaged tissue or whole organs. Engineering tissue, however, faces an outstanding knowledge gap in the challenge to fully recapitulate complex organ-specific features. Major components, such as cells, matrix, and architecture, must each be carefully controlled to engineer tissue-specific structure and function that mimics what is found in vivo. Here we review different methods to engineer tissue, and discuss critical challenges in recapitulating the unique features and functional units in four major organs-the kidney, liver, heart, and lung, which are also the top four candidates for organ transplantation in the USA...
September 2017: MRS Communications
https://www.readbyqxmd.com/read/29735789/direct-acting-antivirals-improve-hcv-treatment-initiation-and-adherence-among-underserved-african-americans
#3
Kendall R Beck, Nicole J Kim, Mandana Khalili
INTRODUCTION: Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA. MATERIAL AND METHODS: Clinical records of AAs undergoing HCV evaluation attending a safety net health system liver clinic were reviewed from 2006 to 2011 (pre-DAA), and January 1, 2014 to December 31, 2016 (post-DAA)...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735026/modern-management-of-acute-liver-failure
#4
REVIEW
Ruben Khan, Sean Koppe
Acute liver failure is a rare but life-threatening disease that can lead to progressive encephalopathy, intracranial hypertension, and multiorgan failure. In the developed world, the most common cause remains acetaminophen overdose, but there are still many cases in which there is acute liver failure of unknown etiology. The mainstay of acute liver failure management remains supportive care in the critical care setting. If supportive treatment does not stabilize the disease process, the patient may require emergent liver transplantation...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29732655/external-validation-and-improvement-of-life-score-as-a-prediction-tool-in-critically-ill-cirrhosis-patients
#5
Shuangzhe Yao, Xihui Jiang, Chao Sun, Zhongqing Zheng, Bangmao Wang, Tao Wang
PURPOSE: The LiFe (liver, injury, failure, evaluation) score, calculated according to arterial lactate, total bilirubin, and INR, is a novel score for risk prediction in ICU patients with cirrhosis. The present study aimed to externally validate and optimize the LiFe score for predicting outcomes in critically ill cirrhosis patients. METHODS: The study employed the single-center database Medical Information Mart for Intensive Care-III (MIMIC-III) for analysis. A total of 536 critically ill cirrhosis patients from the MIMIC-III database were analyzed...
May 7, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29731716/protective-effect-of-casperome-%C3%A2-an-orally-bioavailable-frankincense-extract-on-lipopolysaccharide-induced-systemic-inflammation-in-mice
#6
Konstantin Loeser, Semjon Seemann, Stefanie König, Isabell Lenhardt, Mona Abdel-Tawab, Andreas Koeberle, Oliver Werz, Amelie Lupp
Introduction: Despite recent advances in critical care, sepsis remains a crucial cause of morbidity and mortality in intensive care units. Therefore, the identification of new therapeutic strategies is of great importance. Since ancient times, frankincense is used in traditional medicine for the treatment of chronic inflammatory disorders such as rheumatoid arthritis. Thus, the present study intends to evaluate if Casperome® (Casp), an orally bioavailable soy lecithin-based formulation of standardized frankincense extract, is able to ameliorate systemic effects and organ damages induced by severe systemic inflammation using a murine model of sepsis, i...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29723898/the-relationship-between-liver-enzymes-and-insulin-resistance-in-type-2-diabetes-patients-with-nonalcoholic-fatty-liver-disease
#7
Xia Sheng, Hui Che, Qingming Ji, Fan Yang, Jie Lv, Yueqiu Wang, Huimin Xian, Lihong Wang
Non-: alcoholic fatty liver disease (NAFLD) is prevalent worldwide, especially in patients with type 2 diabetes. Liver enzymes are the main warning signs of liver injury and insulin resistance (IR) is critical to NAFLD. This study was aimed to investigate the association between liver enzymes and insulin resistance in type 2 diabetes patients with NAFLD. Data from 212 diabetes patients with NAFLD were analyzed, including 118 males and 94 females who received care from 2014 to 2015. The patients were divided into three groups by severity (mild n=87, moderate n=89, severe n=36)...
May 3, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29701490/influence-of-gut-microbiota-and-intestinal-barrier-on-enterogenic-infection-after-liver-transplantation
#8
Jingzhou Mu, Qiuyu Chen, Liang Zhu, Yunhong Wu, Suping Liu, Yufei Zhao, Tonghui Ma
Liver transplantation is currently a standard therapy for patients with end-stage liver diseases and hepatocellular carcinoma. Given that liver transplantation has undergone a thriving development in these decades, the survival rates after liver transplantation have markedly improved as a result of the critical advancement in surgical techniques, immunosuppressive therapies, and postoperative care. However, infection remains a fatal complication after liver transplantation surgery. In particular, enterogenic infection represents a major complication in liver transplant recipients...
April 27, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29689125/directed-solutions-to-address-differences-in-access-to-liver-transplantation
#9
Fei Ye, Quanhu Sheng, Irene D Feurer, Zhiguo Zhao, Run Fan, Jing Teng, Jie Ping, Scott A Rega, Douglas W Hanto, Yu Shyr, Seth J Karp
The United Network for Organ Sharing recently altered current liver allocation with the goal of decreasing Model for End-stage Liver Disease (MELD) variance at transplant. Concerns over these and further planned revisions to policy include predicted decrease in total transplants, increased flying and logistical complexity, adverse impact on areas with poor quality health care, and minimal effect on high MELD Donor Service Areas (DSAs). To address these issues, we describe general approaches to equalize critical transplant metrics among regions and determine how they alter MELD variance at transplant and organ supply to underserved communities...
April 24, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29681874/alexithymia-in-gastroenterology-and-hepatology-a-systematic-review
#10
Danilo Carrozzino, Piero Porcelli
Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29680333/hydroelectrolytic-and-infectious-complications-in-one-year-of-parenteral-nutrition-in-critical-care
#11
A López, J J Varela, M M Cid, M Couñago, N Gago
OBJECTIVE: Parenteral nutrition consists of the intravenous administration of macronutrients, micronutrients and electrolytes. Our objectives were to evaluate the biochemical alterations during the first ten days of initiation and to quantify the bacteremia related to the central venous catheter during the administration of parenteral nutrition. MATERIAL AND METHODS: Retrospective study of incidence and prevalence. We included 51 patients who started intravenous nutritional support therapy at Critical Care...
April 18, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#12
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29674195/thrombotic-microangiopathies-of-pregnancy-differential-diagnosis
#13
REVIEW
M Gupta, B B Feinberg, R M Burwick
Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic thrombocytopenic purpura (TTP) or atypical hemolytic uremic syndrome (aHUS). Due to overlapping clinical and laboratory features, TTP and aHUS are often mistaken for preeclampsia or HELLP...
February 16, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29661353/recurrent-pyroglutamic-acidosis-related-to-therapeutic-acetaminophen
#14
REVIEW
Hazem M Alhourani, Aneel Kumar, Lekha K George, Tahira Sarwar, Barry M Wall
Pyroglutamic acid, an intermediate in glutathione metabolism, can lead to elevated anion gap metabolic acidosis as rare complication of acetaminophen therapy in adults. Acquired pyroglutamic acidosis has been observed primarily in settings associated with glutathione deficiency. Risk factors for glutathione deficiency include critical illness, chronic liver or kidney disease, advanced age, female gender, alcohol abuse, malnutrition, pregnancy, antiepileptic drugs, and chronic acetaminophen use. Diagnosis of pyroglutamic acidosis requires both the exclusion of common etiologies of increased anion gap metabolic acidosis and a high index of suspicion...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29643913/hair-dye-poisoning-an-early-intervention
#15
Syed Farrukh Umair, Imrana Amin, Ata Urrehman
The use of hair dye has been emerging worldwide however usage of Paraphenylenediamine (PPD) in making hair dye is generally restricted to underdeveloped and developing countries. In particular, prevalence of accidental and suicidal ingestion is more in low socioeconomic areas. The spectra of hair dye toxicity is wide, however, it presents more commonly with severe angioedema of face and neck leading to respiratory failure, rhabdomyolysis complicating into acute kidney injury, myocarditis and acute liver injury...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29625787/tropical-diseases-in-the-icu-a-syndromic-approach-to-diagnosis-and-treatment
#16
Dilip R Karnad, Guy A Richards, Gisele Sampaio Silva, Pravin Amin
Tropical infections form 20-30% of ICU admissions in tropical countries. Diarrheal diseases, malaria, dengue, typhoid, rickettsial diseases and leptospirosis are common causes of critical illness. Overlapping clinical features makes initial diagnosis challenging. A systematic approach involving (1) history of specific continent or country of travel, (2) exposure to specific environments (forests or farms, water sports, consumption of exotic foods), (3) incubation period, and (4) pattern of organ involvement and subtle differences in manifestations help in differential diagnosis and choice of initial empiric therapy...
March 27, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29621834/application-of-accelerated-time-models-to-compare-performance-of-two-comorbidity-adjusting-methods-with-apache-ii-in-predicting-short-term-mortality-among-the-critically-ill
#17
George Mnatzaganian, Melanie Bish, Jason Fletcher, Cameron Knott, John Stephenson
OBJECTIVE: This study aimed to determine how the abilities of the Charlson Index and Elixhauser comorbidities compared with the chronic health components of the Acute Physiology and Chronic Health Evaluation (APACHE II) to predict in-hospital 30 day mortality among adult critically ill patients treated inside and outside of Intensive Care Unit (ICU). METHODS: A total of 701 critically ill patients, identified in a prevalence study design on four randomly selected days in five acute care hospitals, were followed up from the date of becoming critically ill for 30 days or until death, whichever occurred first...
February 2018: Methods of Information in Medicine
https://www.readbyqxmd.com/read/29616404/intensive-care-management-of-patients-with-cirrhosis
#18
REVIEW
Jody C Olson
PURPOSE OF REVIEW: Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. RECENT FINDINGS: Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization...
April 4, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29604566/cirrhotic-patients-admitted-to-the-icu-for-medical-reasons-analysis-of-5506-patients-admitted-to-286-icus-in-8years
#19
Stefano Skurzak, Greta Carrara, Carlotta Rossi, Giovanni Nattino, Daniele Crespi, Michele Giardino, Guido Bertolini
PURPOSE: To describe characteristics and prognostic factors of cirrhotic patients admitted to a representative sample of Italian intensive care units (ICUs). MATERIALS AND METHODS: All patients admitted to 286 ICUs for medical reasons between 2002 and 2010 (excluding 2007) were considered. A logistic regression model was developed on cirrhotics to predict hospital mortality. The prediction was applied to different subgroups defined by both the level of unit expertise with cirrhotics and the overall unit performance, and compared to the actual mortality...
March 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29604150/neurophysiological-study-of-critical-illness-polyneuropathy-and-myopathy-in-mechanically-ventilated-children-additional-aspect-into-pediatric-critical-illness-comorbidities
#20
Ahmed Thabet Mahmoud, Maha A M Tawfik, Sameh Abdallah Abd El Naby, Wafaa Moustafa M Abo El Fotoh, Nagwan Yossery Saleh, Nahla M Said Abd El Hady
BACKGROUND: Critical illness polyneuropathy and myopathy (CIP/CIM) is being increasingly recognized as a significant clinical problem in critically ill children especially who have spent long periods in the intensive care unit. So we aimed to determine the frequency of CIP/CIM among mechanically ventilated children and to analyze the associated risk factors and drawbacks frequently encountered in this cohort. METHODS: The study included 105 patients admitted to the pediatric intensive care unit and underwent mechanical ventilation for ≥7 days...
March 31, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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