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https://www.readbyqxmd.com/read/28533667/octogenarian-liver-grafts-is-their-use-for-transplant-currently-justified
#1
Carlos Jiménez-Romero, Felix Cambra, Oscar Caso, Alejandro Manrique, Jorge Calvo, Alejandro Marcacuzco, Paula Rioja, David Lora, Iago Justo
AIM: To analyse the impact of octogenarian donors in liver transplantation. METHODS: We present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28532688/progress-in-the-contemporary-management-of-hemophilia-the-new-issue-of-patient-aging
#2
REVIEW
Pier Mannuccio Mannucci, Massimo Iacobelli
The management of inherited coagulation disorders such as hemophilia A and B has witnessed dramatic progresses since the last few decades of the last century. Accordingly, persons with hemophilia (PWH) now enjoy a life expectancy at birth not different from that of males in the general population, at least in high income countries. Nowadays, a substantial proportion of PWH are aging, like their peers in the general population. This outstanding progress is accompanied by problems that are in part similar to those of any old person (multiple concomitant diseases and the resulting intake of multiple drugs other than those specific for hemophilia treatment)...
May 20, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28529137/medicaid-participation-among-liver-transplant-candidates-after-the-affordable-care-act-medicaid-expansion
#3
Dmitry Tumin, Eliza W Beal, Khalid Mumtaz, Don Hayes, Joseph D Tobias, Timothy M Pawlik, W Kenneth Washburn, Sylvester M Black
BACKGROUND: The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. STUDY DESIGN: Data on LT candidates age 18-64 years in 2012-2013 (pre-expansion) and 2014-2015 (post-expansion) were obtained from the United Network for Organ Sharing registry...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28527279/-cases-of-acute-pesticide-poisoning-in-colonia-puerto-pirap%C3%A3-itap%C3%A3%C2%BAa-paraguay-february-2014
#4
María Esther Pedrozo, Sandra Ocampos, Rosa Galeano, Andrea Ojeda, Agueda Cabello, Dalva De Assis
In Paraguay, pesticides are the causative agent in 13.7% of poisonings, especially organophosphorus compounds. Such poisoning produces the inhibition of acetylcholinesterase generating three possible clinical conditions: acute poisoning, intermediate syndrome or late neurotoxicity. We present 15 cases of acute poisoning, ten women and five men from a rural community between 5 and 67 years of age, whose symptoms began after using water contaminated by pesticides from the community network. The most common symptoms were nausea and vomiting, followed by abdominal pain, headache, fever, itching, red eyes and sweating...
June 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526997/nafld-as-a-sexual-dimorphic-disease-role-of-gender-and-reproductive-status-in-the-development-and-progression-of-nonalcoholic-fatty-liver-disease-and-inherent-cardiovascular-risk
#5
REVIEW
Stefano Ballestri, Fabio Nascimbeni, Enrica Baldelli, Alessandra Marrazzo, Dante Romagnoli, Amedeo Lonardo
Nonalcoholic fatty liver disease (NAFLD) spans steatosis through nonalcoholic steatohepatis, cirrhosis, and hepatocellular carcinoma (HCC) associated with striking systemic features and excess cardiovascular and liver-related mortality. The pathogenesis of NAFLD is complex and multifactorial. Endocrine derangements are closely linked with dysmetabolic traits. For example, in animal and human studies, female sex is protected from dysmetabolism thanks to young individuals' ability to partition fatty acids towards ketone body production rather than very low density lipoprotein (VLDL)-triacylglycerol, and to sex-specific browning of white adipose tissue...
May 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28523571/congenital-immature-pure-erythroid-leukemia-with-e-cadherin-expression
#6
Akihiro Tamura, Suguru Uemura, Atsuro Saito, Saki Okubo, Nanako Nino, Teppei Tahara, Takehito Yokoi, Kenji Kishimoto, Toshiaki Ishida, Daiichiro Hasegawa, Keiichiro Kawasaki, Seiji Yoshimoto, Hideto Nakao, Makiko Yoshida, Yoshiyuki Kosaka
Congenital pure erythroid leukemia is exceedingly rare and poses a diagnostic challenge. We report an atypical case of congenital pure erythroid leukemia that did not express typical erythroid markers. The patient presented with a high white blood cell count with blastic cells at birth. Although flow cytometric analyses of peripheral blood and bone marrow showed a large CD45-negative cell population, we did not identify any evidence of monoclonality. While the circulating blasts decreased with only supportive care, hepatomegaly with multiple nodules was accompanied by liver failure, disseminated intravascular coagulation, and development of hemophagocytic lymphohistiocytosis...
May 18, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28521326/the-yield-of-abdominal-ultrasound-in-the-evaluation-of-elevated-liver-enzymes-during-the-second-and-the-third-trimester-of-pregnancy
#7
Aya Mohr-Sasson, Eyal Schiff, Ramy Rahamim Suday, Zehava Hayman, Yeruham Kleinbaum, Anat Kalter-Farber, Roy Mashiach, Yoav Yinon, Moti Dulitzki, Eyal Sivan, Shali Mazaki-Tovi
AIMS: To determine the clinical yield of abdominal ultrasound in the evaluation of elevated liver enzymes (ELEs) in the second and the third trimester of pregnancy. METHODS: A retrospective cohort study including all pregnant women admitted to a single tertiary care center was conducted between April 2011 and January 2015 with ELE. Inclusion criteria included gestational age above 24 weeks and ELEs, abdominal ultrasound report, and live fetus. Exclusion criteria included known maternal liver disease, structural or chromosomal fetal anomalies, and positive serology for viral hepatitis...
May 19, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28515916/ecog-is-as-independent-predictor-of-the-response-to-chemotherapy-overall-survival-and-progression-free-survival-in-carcinoma-of-unknown-primary-site
#8
Rocío Grajales-Álvarez, Ana Martin-Aguilar, Juan A Silva, Jaime G De La Garza-Salazar, Erika Ruiz-García, César López-Camarillo, Laurence A Marchat, Horacio Astudillo-De La Vega
The aim of the present study was to determine whether age, gender, functional status, histology, tumor location, number of metastases, and levels of the tumor markers, lactate dehydrogenase (LDH) and albumin, are poor prognostic factors for the response to chemotherapy in patients with carcinoma of unknown primary site. A total of 149 patients diagnosed with carcinoma of unknown primary site that was histologically confirmed, and treated with chemotherapy in the Oncology Hospital, National Medical Center, 'Century XXI' IMSS, Mexico City, Mexico during the period between January 2002 to December 2009, were carefully selected for the present study...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28510341/living-donor-liver-transplantation-for-patients-older-than-age-70-years-a-single-center-experience
#9
J H Kwon, Y I Yoon, G W Song, K H Kim, D B Moon, D H Jung, G C Park, E Y Tak, V A Kirchner, S G Lee
Over the past two decades, the age of liver transplantation (LT) recipients has been increasing. We reviewed our experience with LT for patients aged 70 years or older (range: 70-78) and investigated the feasibility of performing LT, especially living donor LT (LDLT), for older patients. We retrospectively reviewed the medical records of 25 patients (15 LDLT recipients, 10 DDLT recipients), aged 70 years or older who underwent LT from January 2000 to April 2016. Their perioperative morbidity rate was 28.0% and the in-hospital mortality rate was 16...
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28509578/the-burden-of-hepatorenal-syndrome-among-commercially-insured-and-medicare-patients-in-the-united-states
#10
J Bradford Rice, Alan G White, Philip Galebach, Kevin M Korenblat, Aneesha Wagh, Belinda Lovelace, George J Wan, Khurram Jamil
BACKGROUND: This study evaluated the characteristics healthcare resource utilization (HCRU), and costs, from the payer perspective, of hepatorenal syndrome (HRS) patients covered by commercial and Medicare insurance. Mortality was assessed as a secondary outcome. METHODS: Patients were identified from claims databases of commercially-insured (OptumHealth Care Solutions, Inc.) in 1998-2014 and Medicare beneficiaries in 2009-2013 (5% Standard Analytic Files). At the time of their first inpatient admission ("index date") with an HRS diagnosis (ICD-9 code 572...
May 16, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#11
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28504496/echinococcosis-in-children-experience-in-a-tertiary-care-hospital-outside-the-endemic-area
#12
Griselda Berberian, Teresa Rosanova, Laura Inda, Claudia Sarkis, Horacio Questa, Patricia Paulin, Marina Costa, Moira Taicz
Echinococcosis is a zoonotic disease that is widely spread across Argentina and worldwide. It is acquired during childhood but it is more common during adulthood. The pediatric population accounts for 10-20% of all cases. This study included 47 children diagnosed with echinococcosis over a 20-year period. Their median age was 8 years old (range: 3-17); most patients had some epidemiological history, such as having lived or living in an endemic or rural area and/ or having dogs that are fed with viscera. Findings included 85% of single cysts in only one parenchyma...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#13
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28502983/alkaline-phosphatase-a-novel-treatment-target-for-cardiovascular-disease-in-ckd
#14
REVIEW
Mathias Haarhaus, Vincent Brandenburg, Kamyar Kalantar-Zadeh, Peter Stenvinkel, Per Magnusson
Cardiovascular disease is the main cause of early death in the settings of chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and ageing. Cardiovascular events can be caused by an imbalance between promoters and inhibitors of mineralization, which leads to vascular calcification. This process is akin to skeletal mineralization, which is carefully regulated and in which isozymes of alkaline phosphatase (ALP) have a crucial role. Four genes encode ALP isozymes in humans. Intestinal, placental and germ cell ALPs are tissue-specific, whereas the tissue-nonspecific isozyme of ALP (TNALP) is present in several tissues, including bone, liver and kidney...
May 15, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28501537/effects-of-exercise-on-liver-fat-and-metabolism-in-alcohol-drinkers
#15
David Houghton, Kate Hallsworth, Christian Thoma, Sophie Cassidy, Timothy Hardy, Sarah Heaps, Kieren G Hollingsworth, Roy Taylor, Christopher P Day, Steve Masson, Stuart McPherson, Quentin M Anstee, Michael I Trenell
BACKGROUND & AIMS: Exercise is an important component of obesity associated disorders and has been shown to reduce markers of non-alcoholic fatty liver disease (NAFLD). However, little is known about how these effects are influenced by alcohol intake. We performed a randomized controlled trial to investigate the effects of exercise on hepatic triglyceride content (HTGC) and metabolism in overweight or obese patients who consume alcohol. METHODS: We performed a prospective study of 27 patients (mean age 54±11years, body mass index [BMI], 31±4kg/m2) with >5% HTGC in the United Kingdom, consuming alcohol (mean 221±75 g/week)...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28495639/safety-and-tolerability-of-the-first-in-class-agent-cpi-613-in-combination-with-modified-folfirinox-in-patients-with-metastatic-pancreatic-cancer-a-single-centre-open-label-dose-escalation-phase-1-trial
#16
Angela Alistar, Bonny B Morris, Rodwige Desnoyer, Heidi D Klepin, Keyanoosh Hosseinzadeh, Clancy Clark, Amy Cameron, John Leyendecker, Ralph D'Agostino, Umit Topaloglu, Lakmal W Boteju, Asela R Boteju, Rob Shorr, Zuzana Zachar, Paul M Bingham, Tamjeed Ahmed, Sandrine Crane, Riddhishkumar Shah, John J Migliano, Timothy S Pardee, Lance Miller, Gregory Hawkins, Guangxu Jin, Wei Zhang, Boris Pasche
BACKGROUND: Pancreatic cancer statistics are dismal, with a 5-year survival of less than 10%, and more than 50% of patients presenting with metastatic disease. Metabolic reprogramming is an emerging hallmark of pancreatic adenocarcinoma. CPI-613 is a novel anticancer agent that selectively targets the altered form of mitochondrial energy metabolism in tumour cells, causing changes in mitochondrial enzyme activities and redox status that lead to apoptosis, necrosis, and autophagy of tumour cells...
May 8, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28493551/utilization-of-a-sobering-center-for-acute-alcohol-intoxication
#17
Shannon Smith-Bernardin, Adam Carrico, Wendy Max, Susan Chapman
OBJECTIVE: To describe the population utilizing a sobering center for public alcohol intoxication, and compare between single-visit users, repeat users, and high users. METHODS: We conducted a secondary analysis of 1,271 adults cared for in the Sobering Center from July 2014 to June 2015. We divided the population into three groups: single-use (1 visit), repeat users (2-5 visits) and high (6+) users, and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28489446/liver-transplantation-need-indications-patient-selection-and-pre-transplant-care
#18
Neil Halliday, Rachel H Westbrook
Chronic or acute liver failure and primary liver cancers can be effectively managed with liver transplantation. The range of indications for liver transplantation is increasing but there is a mismatch between the numbers of available donations and current needs. Specific criteria for listing patients exist but, at minimum, the predicted mortality without transplantation must exceed that with transplantation, coupled with a 50% predicted 5-year survival following liver transplantation. The risk posed by liver disease must be weighed against the risk of liver transplantation, considering the patient's comorbidities, age, nutritional status and behavioural factors in a complex assessment process...
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28487614/patients-with-non-viral-liver-disease-have-a-greater-tumor-burden-and-less-curative-treatment-options-when-diagnosed-with-hepatocellular-carcinoma
#19
Waled Mohsen, Marcia Rodov, Emilia Prakoso, Barbara Charlton, David G Bowen, David J Koorey, Nicholas A Shackel, Geoffrey W McCaughan, Simone I Strasser
AIM: To assess the impact of underlying liver disease etiology on the presenting features and outcomes in a large cohort of patients with hepatocellular carcinoma (HCC). METHODS: A prospective database of all patients with HCC was established from 1998 to March 2012. One thousand and seventy-eight patients were categorized into three groups, based on the etiology of their liver disease: hepatitis B virus (HBV), hepatitis C virus (HCV) and non-viral liver disease (NVLD)...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28485072/therapeutic-plasma-exchange-in-children-one-center-s-experience
#20
Gerard Cortina, Violeta Ojinaga, Thomas Giner, Magdalena Riedl, Siegfried Waldegger, Alejandra Rosales, Raphaela Trojer, Johannes Hofer
BACKGROUND: Therapeutic plasma exchange (TPE) has evolved to an accepted therapy for selected indications. However, it is technically challenging in children. Moreover, data on safety and efficacy are mainly derived from adult series. The aim of this study was to review the procedure in the context of clinical indications, effectiveness, and safety. STUDY DESIGN AND METHODS: All TPE procedures performed at a tertiary care hospital during a 12-year period (2005-2016) were retrospectively evaluated...
May 9, 2017: Journal of Clinical Apheresis
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