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guide acute liver injury

Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visc Med
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
Fernando Mendes Paschoal, Ricardo Carvalho Nogueira, Karla De Almeida Lins Ronconi, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation...
August 8, 2016: World Journal of Hepatology
Irene K Yan, Xue Wang, Yan W Asmann, Hiroaki Haga, Tushar Patel
BACKGROUND AND AIMS: Although a key determinant of hepatic recovery after injury is active liver regeneration, the ability to detect ongoing regeneration is lacking. The restoration of liver mass after hepatectomy involves systemic changes with coordinated changes in gene expression guiding regenerative responses, activation of progenitor cells, and proliferation of quiescent hepatocytes. We postulated that these responses involve intercellular communication involving extracellular RNA and that these could represent biomarkers of active regenerative responses...
2016: PloS One
Ruth Brauer, Ian Douglas, Luis Alberto Garcia Rodriguez, Gerald Downey, Consuelo Huerta, Francisco de Abajo, Andrew Bate, Maurille Feudjo Tepie, Mark C H de Groot, Raymond Schlienger, Robert Reynolds, Liam Smeeth, Olaf Klungel, Ana Ruigómez
PURPOSE: To assess the impact of varying study designs, exposure and outcome definitions on the risk of acute liver injury (ALI) associated with antibiotic use. METHODS: The source population comprised of patients registered in two primary care databases, in the UK and in Spain. We identified a cohort consisting of new users of antibiotics during the study period (2004-2009) and non-users during the study period or in the previous year. Cases with ALI were identified within this cohort and classified as definite or probable, based on recorded medical information...
March 2016: Pharmacoepidemiology and Drug Safety
Charles Kodner
Nephrotic syndrome (NS) consists of peripheral edema, heavy proteinuria, and hypoalbuminemia, often with hyperlipidemia. Patients typically present with edema and fatigue, without evidence of heart failure or severe liver disease. The diagnosis of NS is based on typical clinical features with confirmation of heavy proteinuria and hypoalbuminemia. The patient history and selected diagnostic studies rule out important secondary causes, including diabetes mellitus, systemic lupus erythematosus, and medication adverse effects...
March 15, 2016: American Family Physician
Danilo Cardim, C Robba, M Bohdanowicz, J Donnelly, B Cabella, X Liu, M Cabeleira, P Smielewski, B Schmidt, M Czosnyka
Although intracranial pressure (ICP) is essential to guide management of patients suffering from acute brain diseases, this signal is often neglected outside the neurocritical care environment. This is mainly attributed to the intrinsic risks of the available invasive techniques, which have prevented ICP monitoring in many conditions affecting the intracranial homeostasis, from mild traumatic brain injury to liver encephalopathy. In such scenario, methods for non-invasive monitoring of ICP (nICP) could improve clinical management of these conditions...
March 3, 2016: Neurocritical Care
Darren P Mareiniss, Tim Xu, Julius Cuong Pham, Yu-Hsiang Hsieh, Jiawei Zhao, Christopher Nguyen, Michael Nguyen, Bradford Winters
BACKGROUND: Subglottic secretion drainage endotracheal tubes (SSD ETTs) have been shown to decrease ventilator-associated pneumonia and are recommended for patients intubated > 48 h or 72 h. However, it is difficult to determine which patients will be intubated > 48 h or 72 h at the time of intubation. OBJECTIVE: We attempted to determine which patient characteristics were associated with intubations ≥ 48 h or 72 h in order to guide proper placement of SSD ETTs...
March 2016: Journal of Emergency Medicine
Stephanie H Hernandez, Maryann Howland, Thomas D Schiano, Robert S Hoffman
OBJECTIVE: Acetaminophen-induced fulminant hepatic failure is associated with acute kidney injury, metabolic acidosis, and fluid and electrolyte imbalances, requiring treatment with renal replacement therapies. Although antidote, acetylcysteine, is potentially extracted by renal replacement therapies, pharmacokinetic data are lacking to guide potential dosing alterations. We aimed to determine the extracorporeal removal of acetylcysteine by various renal replacement therapies. METHODS: Simultaneous urine, plasma and effluent specimens were serially collected to measure acetylcysteine concentrations in up to three stages: before, during and upon termination of renal replacement therapy...
2015: Clinical Toxicology
Changzhe Wu, Yue Cao, Xiaolin Huo, Ming Li
BACKGROUND: Bioartificial liver support system (BALSS) based on culturing hepatocytes is an important research field for the treatment of acute liver failure. It is necessary to monitor the state of liver cell functions during the treatment of BALSS in order to guide clinical treatment. OBJECTIVE: To design a micro-channel chip to achieve flash mixing for timely detection of liver cell status in bioreactors and improving liver cells growth environment to ensure the efficacy of the bio-artificial liver support system...
2015: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Tomaz Crochemore, Felipe Maia de Toledo Piza, Eliézer Silva, Thiago Domingos Corrêa
INTRODUCTION: Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening disease. AFLP is characterized by liver failure with different degrees of coagulopathy. Outcome and survival can be dramatically improved with prompt recognition and treatment. Thromboelastometry has been considered a point of care for the management of bleeding patients. It could, therefore, be an alternative tool to treat the complex cases of AFLP involving liver failure and coagulopathy. Through this study, we present our successful experience of an AFLP case that was submitted to an emergency cesarean section in which blood transfusion was guided by thromboelastometry...
2015: Journal of Medical Case Reports
Li-Min Li, Dong Wang, Ke Zen
Drug-induced liver injury (DILI) is a leading cause of acute liver failure, and a major reason for the recall of marketed drugs. Detection of potential liver injury is a challenge for clinical management and preclinical drug safety studies, as well as a great obstacle to the development of new, effective and safe drugs. Currently, serum levels of alanine and aspartate aminotransferases are the gold standard for evaluating liver injury. However, these levels are assessed by nonspecific, insensitive, and non-predictive tests, and often result in false-positive results...
September 2014: Journal of Clinical and Translational Hepatology
Andrew S Allegretti, Guillermo Ortiz, Julia Wenger, Joseph J Deferio, Joshua Wibecan, Sahir Kalim, Hector Tamez, Raymond T Chung, S Ananth Karumanchi, Ravi I Thadhani
Background/Aims. Acute kidney injury is a common problem for patients with cirrhosis and is associated with poor survival. We aimed to examine the association between type of acute kidney injury and 90-day mortality. Methods. Prospective cohort study at a major US liver transplant center. A nephrologist's review of the urinary sediment was used in conjunction with the 2007 Ascites Club Criteria to stratify acute kidney injury into four groups: prerenal azotemia, hepatorenal syndrome, acute tubular necrosis, or other...
2015: International Journal of Nephrology
Jorge Ribeiro, Tiago Pereira, Ana Rita Caseiro, Paulo Armada-da-Silva, Isabel Pires, Justina Prada, Irina Amorim, Sandra Amado, Miguel França, Carolina Gonçalves, Maria Ascensão Lopes, José Domingos Santos, Dina Morais Silva, Stefano Geuna, Ana Lúcia Luís, Ana Colette Maurício
AIM: To study the therapeutic effect of three tube-guides with electrical conductivity associated to mesenchymal stem cells (MSCs) on neuro-muscular regeneration after neurotmesis. METHODS: Rats with 10-mm gap nerve injury were tested using polyvinyl alcohol (PVA), PVA-carbon nanotubes (CNTs) and MSCs, and PVA-polypyrrole (PPy). The regenerated nerves and tibialis anterior muscles were processed for stereological studies after 20 wk. The functional recovery was assessed serially for gait biomechanical analysis, by extensor postural thrust, sciatic functional index and static sciatic functional index (SSI), and by withdrawal reflex latency (WRL)...
July 26, 2015: World Journal of Stem Cells
Anselm Wong, Marco L A Sivilotti, Paul I Dargan, David M Wood, Shaun L Greene
CONTEXT: Risk prediction in paracetamol (acetaminophen, or APAP) poisoning treated with acetylcysteine helps guide initial patient management and disposition. The paracetamol-aminotransferase multiplication product may be a useful and less time-sensitive risk predictor. OBJECTIVE: The aim of this study was to validate this multiplication product in an independent cohort of patients with paracetamol overdose. MATERIALS AND METHODS: Using an existing toxicology dataset of poisoned patients from two large inner-city United Kingdom teaching hospitals, we retrospectively identified by electronic search all paracetamol overdoses from February 2005 to March 2013...
2015: Clinical Toxicology
V W Xia, A Worapot, S Huang, A Dhillon, V Gudzenko, A Backon, V G Agopian, O Aksoy, G Vorobiof, R W Busuttil, R H Steadman
Postoperative atrial fibrillation (POAF) is common after major surgeries and is associated with increased morbidity and mortality. POAF after liver transplantation (LT) has not been reported. This study was undertaken to investigate the incidence, impact, and risk factors of POAF in LT patients. After IRB approval, LT between January 2006 and August 2013 at our center were retrospectively reviewed. POAF that occurred within 30 days after LT was included. Patients with and without POAF were compared and independent risk factors were identified by logistic regression...
March 2015: American Journal of Transplantation
Ke Yu, Jie Zhang, Minjun Chen, Xiaowei Xu, Ayako Suzuki, Katarina Ilic, Weida Tong
BACKGROUND: Given the significant impact on public health and drug development, drug safety has been a focal point and research emphasis across multiple disciplines in addition to scientific investigation, including consumer advocates, drug developers and regulators. Such a concern and effort has led numerous databases with drug safety information available in the public domain and the majority of them contain substantial textual data. Text mining offers an opportunity to leverage the hidden knowledge within these textual data for the enhanced understanding of drug safety and thus improving public health...
2014: BMC Bioinformatics
Alexander Dechêne, Jan-Peter Sowa, Martin Schlattjan, Alexander Wree, Sandra Blomeyer, Jan Best, Evelyn J Maldonado, Lars P Bechmann, Guido Gerken, Hideo A Baba, Wing-Kin Syn, Ali Canbay
BACKGROUND/AIMS: For diagnosis, prognosis, and treatment of acute liver failure (ALF), macroscopic evaluation and histological assessment of the liver are important. Due to impaired coagulation in ALF, the risk of bleeding is high after a percutaneous liver biopsy. Our aims were to assess (i) safety and benefit of mini laparoscopy (ML) in patients with ALF and (ii) the potential utility of histological markers in ALF prognosis. METHODS: ML was performed in 39 patients with ALF to assess liver surface and to obtain a liver biopsy...
2014: Digestion
Christopher Atkins, Tina Maheswaran, Simon Rushbrook, Ajay Kamath
A 61-year old woman was admitted with increasing dyspnea and deranged liver function tests. A chest X-ray revealed small volume lungs with reticulo-nodular shadowing. High resolution computed tomography of the chest revealed interlobular septal thickening. The patient subsequently underwent an open lung biopsy and ultrasound-guided liver biopsy, which were consistent with a hypersensitivity pneumonitis and drug-induced liver injury respectively. The patient had previously been commenced on lansoprazole 10 days before the onset of symptoms; this had been stopped at diagnosis...
December 2014: International Journal of Clinical Pharmacology and Therapeutics
Mark I Avigan, Einar S Bjornsson, Markku Pasanen, Charles Cooper, Raul J Andrade, Paul B Watkins, James H Lewis, Michael Merz
A workshop was convened to discuss best practices for the assessment of drug-induced liver injury (DILI) in clinical trials. In a breakout session, workshop attendees discussed necessary data elements and standards for the accurate measurement of DILI risk associated with new therapeutic agents in clinical trials. There was agreement that in order to achieve this goal the systematic acquisition of protocol-specified clinical measures and lab specimens from all study subjects is crucial. In addition, standard DILI terms that address the diverse clinical and pathologic signatures of DILI were considered essential...
November 2014: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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