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https://www.readbyqxmd.com/read/27912035/failure-to-rescue-after-infectious-complications-in-a-statewide-trauma-system
#1
Elinore J Kaufman, Emily Earl-Royal, Philip S Barie, Daniel N Holena
BACKGROUND: The failure to rescue (FTR) rate, the rate of death after a complication, measures a center's ability to identify and manage complications by "rescuing" vulnerable patients. Infectious complications are common after trauma, but risk factors for death after infection are not established. We hypothesized that risk factors would differ for FTR after infectious complications, development of infections, and for development of and death after non-infectious complications. PATIENTS AND METHODS: We analyzed trauma registry data for adult patients admitted to all 30 level I and II Pennsylvania trauma centers, 2011-2014...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#2
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906797/non-cirrhotic-portal-fibrosis-in-pediatric-population
#3
Vikrant Sood, Bikrant Bihari Lal, Rajeev Khanna, Dinesh Rawat, Chhagan Bihari Sharma, Seema Alam
BACKGROUND: Non-cirrhotic portal fibrosis (NCPF) has been classically described as a disease of young to middle age with limited literature regarding its occurrence, onset or clinical presentation in children. We hereby present a series of 19 patients diagnosed and managed as NCPF in pediatric age group. METHODS: A retrospective review of all the patients presenting to the pediatric hepatology department (age < 18 years) and diagnosed as NCPF was done and data was evaluated...
November 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27905669/secondary-prophylaxis-of-hepatocellular-carcinoma-the-comparison-of-direct-acting-antivirals-with-pegylated-interferon-and-untreated-cohort
#4
R Vukotic, R Di Donato, F Conti, A Scuteri, C Serra, P Andreone
During the past two decades, several studies showed reduced rates of hepatocellular carcinoma recurrence in patients with HCV-related cirrhosis after interferon-based antiviral therapies respect to untreated controls, even without reaching viral clearance. The recent development of new all-oral regimens with direct-acting antivirals has radically improved the therapeutic management of hepatitis C. Nevertheless, paradoxical, or at least unexpected, high rates of both occurrence and recurrence of hepatocellular carcinoma after a treatment with direct-acting antivirals, have been reported in the recent literature...
December 1, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27896359/management-of-chronic-hepatitis-c-in-2017
#5
Leona von Köckritz, Jean-François Dufour
Hepatitis C virus (HCV) represents one of the most common aetiologies of chronic liver disease and causes a major global health burden. Globally an estimated 80 million people are chronically infected, but the majority of whom is still undiagnosed. Prior to the discovery of the virus in 1989 a significant number of patients were exposed and consecutively infected with HCV via contaminated transfusions, as it is a blood-borne disease. Chronic HCV infection pursues a progressive course that ultimately results in the development of cirrhosis, liver failure and hepatocellular carcinoma (HCC), if left untreated...
November 29, 2016: Hämostaseologie
https://www.readbyqxmd.com/read/27895393/emerging-role-of-obeticholic-acid-in-the-management-of-nonalcoholic-fatty-liver-disease
#6
EDITORIAL
Evangelia Makri, Evangelos Cholongitas, Konstantinos Tziomalos
Nonalcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease and its prevalence is increasing driven by the pandemic of obesity and type 2 diabetes mellitus. NAFLD can progress to cirrhosis and is associated with increased risk for cardiovascular disease and hepatocellular cancer. Diet and exercise are limited by suboptimal long-term adherence in patients with NAFLD. On the other hand, current pharmacological treatment of NAFLD has limited efficacy and unfavorable safety profile. In this context, obeticholic acid (OCA), a selective agonist of the farnesoid X receptors, might represent a useful option in these patients...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27884455/-acid-sphingomyelinase-deficiency-niemann-pick-disease-type-b-in-adulthood-a-retrospective-multicentric-study-of-28%C3%A2-adult-cases
#7
O Lidove, N Belmatoug, R Froissart, C Lavigne, I Durieu, K Mazodier, C Serratrice, C Douillard, C Goizet, P Cathebras, G Besson, Z Amoura, A Tazi, M Gatfossé, S Rivière, T Sené, M T Vanier, J-M Ziza
INTRODUCTION: Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive disease with a clinical spectrum ranging from a neurovisceral infantile form (Niemann-Pick disease type A) to a chronic visceral form also encountered in adults (Niemann-Pick disease type B, NP-B). METHODS: Retrospective multicentric analysis of French adult patients with ASMD over the period 1985-March 2015. Clinical, biological, and imaging data were analyzed. RESULTS: Twenty-eight patients (19 males, 9 females) were analyzed...
November 22, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27884053/disability-in-patients-with-end-stage-liver-disease-results-from-the-functional-assessment-in-liver-transplantation-frailt-study
#8
Mariya L Samoylova, Kenneth E Covinsky, Marta Haftek, Selena Kuo, John P Roberts, Jennifer C Lai
: Cirrhosis leads to sarcopenia and functional decline that can severely impact one's ability to function at home and in society. Self-reported disability scales to quantify disability - Activities of Daily Living (ADL) and Instrumental ADL (IADL) - are validated to predict mortality in older adults. To evaluate disability in liver transplant (LT) candidates and quantify its impact on outcomes, consecutive outpatients ≥18y listed for LT with laboratory Model for End-stage Liver Disease (MELD) score ≥12 at a single high-volume U...
November 24, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27881614/performance-characteristics-of-a-new-consensus-commercial-kit-for-hepatitis-d-virus-rna-viral-load-quantification
#9
Frédéric Le Gal, Samira Dziri, Athenaïs Gerber, Chakib Alloui, Zahia Ben Abdesselam, Dominique Roulot, Ségolène Brichler, Emmanuel Gordien
Hepatitis Delta virus (HDV) is responsible for fulminant hepatitis and liver failure, and accelerates evolution towards cirrhosis and hepatocellular carcinoma in hepatitis B virus-infected patients. To date treatment relies upon long-term administration of pegylated alpha-interferon with sustained virological response in 30% of the patients. Very recently, new promising anti HDV therapies have been developed and are already used in clinical trials. HDV-RNA viral load (HDVL) monitoring must be an integral part of the management of the infected-patients...
November 23, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27878476/management-of-post-liver-transplant-recurrence-of-hepatitis-c
#10
Justin Taylor, Paula Cox-North, Charles S Landis
Cirrhosis due to chronic hepatitis C (HCV) is the leading indication for liver transplantation in North America and Europe. HCV re-infection post-transplant is nearly universal and if left untreated negatively affects patient and graft survival. Until recently, treatment options for HCV were limited to interferon (IFN)-based therapies which had low sustained viral response (SVR) rates and were poorly tolerated in the post-transplant setting. In the last 3 years, the promise of the directly acting antivirals (DAAs) for the treatment of HCV has been fulfilled with high sustained viral response (SVR) rates and a low side effect profile demonstrated in both registration trials and real-world studies...
November 23, 2016: Drugs
https://www.readbyqxmd.com/read/27873011/laparoscopic-resection-of-choledochal-cyst-with-roux-en-y-hepaticojejunostomy-a-case-report-and-review-of-the-literature
#11
Bestoun Ahmed, Priya Sharma, Cynthia L Leaphart
BACKGROUND: Choledochal cysts are associated with ductal strictures, stone formation, cholangitis, rupture, secondary biliary cirrhosis and increased incidence of cholangiocarcinoma. The surgical approach to choledochal cysts has evolved from the cyst-enterostomy to a complete excision with more recent use of minimally invasive approaches. We report a complete minimally invasive approach to a Type 1 choledochal cyst and summarize the literature containing large case series of similar approaches...
November 21, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27872682/prophylactic-liver-transplantation-for-high-risk-recurrent-hepatocellular-carcinoma
#12
REVIEW
Po-Chih Yang, Cheng-Maw Ho, Rey-Heng Hu, Ming-Chih Ho, Yao-Ming Wu, Po-Huang Lee
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. Radical treatment of HCC in early stages results in a long disease-free period and improved overall survival. The choice of optimal management strategy for HCC mainly depends on the severity of the underlying liver disease. For patients with decompensated liver cirrhosis and HCC within Milan criteria (MC), liver transplant (LT) is the choice of treatment. However, for patients with good residual liver reserve and HCC within MC, selection of other curative treatments such as liver resection (LR) or radiofrequency ablation may be a reasonable alternative...
November 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27864872/management-of-hepatitis-b-related-cirrhosis-in-the-era-of-effective-antiviral-therapy
#13
EDITORIAL
Vincent W S Wong
No abstract text is available yet for this article.
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27864004/beta-adrenergic-blockade-and-decompensated-cirrhosis
#14
REVIEW
Thomas Reiberger, Mattias Mandorfer
Non-selective betablockers (NSBBs) remain the cornerstone of medical treatment of portal hypertension. The evidence for their efficacy to prevent variceal bleeding is derived from prospective trials, which largely excluded patients with refractory ascites and renal failure. In parallel to the increasing knowledge on portal hypertension-induced changes in systemic hemodynamics, cardiac function, and renal perfusion, emerging studies have raised concerns about harmful effects of NSBBs. Clinicians are facing an ongoing controversy on the use of NSBBs in patients with advanced cirrhosis...
November 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27862159/risk-for-alcoholic-liver-cirrhosis-after-an-initial-hospital-contact-with-alcohol-problems-a-nationwide-prospective-cohort-study
#15
Gro Askgaard, David A Leon, Mette S Kjaer, Thomas Deleuran, Thomas A Gerds, Janne S Tolstrup
: Alcoholic liver cirrhosis is usually preceded by many years of heavy drinking, in which cessation in drinking could prevent the disease. Alcohol problems are not consistently managed in hospital patients. We followed all Danish patients with an initial hospital contact with alcohol problems (intoxication, harmful use, or dependence) during 1998-2002 for alcoholic liver cirrhosis development (n = 36,044). In this registry-based cohort we identified predictors of the absolute risk for alcoholic liver cirrhosis...
November 16, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27857521/global-chemical-reactivity-parameters-for-several-chiral-beta-blockers-from-the-density-functional-theory-viewpoint
#16
Mona Maria Talmaciu, Ede Bodoki, Radu Oprean
BACKGROUND AND AIM: Beta-adrenergic antagonists have been established as first line treatment in the medical management of hypertension, acute coronary syndrome and other cardiovascular diseases, as well as for the prevention of initial episodes of gastrointestinal bleeding in patients with cirrhosis and esophageal varices, glaucoma, and have recently become the main form of treatment of infantile hemangiomas. The aim of the present study is to calculate for 14 beta-blockers several quantum chemical descriptors in order to interpret various molecular properties such as electronic structure, conformation, reactivity, in the interest of determining how such descriptors could have an impact on our understanding of the experimental observations and describing various aspects of chemical binding of beta-blockers in terms of these descriptors...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27855947/-hepatitis-c-related-cirrhosis-current-status
#17
REVIEW
Isabel Conde, Carmen Vinaixa, Marina Berenguer
Chronic hepatitis C virus (HCV) infection affects around 150 million people. It is a leading cause of liver related morbidity and mortality through its predisposition to liver fibrosis, cirrhosis and end-stage liver complications. New treatments based on direct-acting antivirals have opened a new era in the management of HCV cirrhosis. They allow for HCV eradication without substantial side effects in almost all cirrhotic patients, reducing the risk of hepatocellular carcinoma, liver decompensation and mortality...
November 14, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27855457/-cholestatic-liver-disease
#18
Christine Pichler, Tobias Boettler, Robert Thimme
Common cholestatic liver diseases are primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Both diseases are considered autoimmune disorders; however, the precise pathogenesis remains elusive. Patients usually show no symptoms or present with pruritus and fatigue. High alkaline phosphatase and the presence of antimitochondrial antibodies are sufficient to diagnose PBC. Ursodeoxycholic acid is approved and recommended for the treatment of PBC. The diagnosis of PSC is established by elevated alkaline phosphatase-levels and typical cholangiographic findings...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27849661/pure-laparoscopic-versus-open-right-hepatectomy-for-hepatocellular-carcinoma-in-patients-with-cirrhosis-a-propensity-score-matched-analysis
#19
Young-In Yoon, Ki-Hun Kim, Sung-Hwa Kang, Wan-Joon Kim, Min-Ho Shin, Sang-Kyung Lee, Dong-Hwan Jung, Gil-Chun Park, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Shin Hwang, Sung-Gyu Lee
OBJECTIVE: We aimed to describe our experience with pure laparoscopic right hepatectomy (LRH) and to compare its outcomes with those of open right hepatectomy (ORH) in hepatocellular carcinoma (HCC) patients with liver cirrhosis. BACKGROUND: Laparoscopic liver resection has been reported as a safe and effective approach for the management of liver cancer; however, its outcomes have not been evaluated in a large cohort of HCC patients with liver cirrhosis. METHODS: We retrospectively reviewed the medical records of 152 patients who underwent pure LRH (n = 37) or ORH (n = 115) between June 2008 and July 2015 at the Asan Medical Center in Seoul, Korea...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27843598/cancer-and-liver-cirrhosis-implications-on-prognosis-and-management
#20
REVIEW
Matthias Pinter, Michael Trauner, Markus Peck-Radosavljevic, Wolfgang Sieghart
Liver cirrhosis, the end-stage of every chronic liver disease, is not only the major risk factor for the development of hepatocellular carcinoma but also a limiting factor for anticancer therapy of liver and non-hepatic malignancies. Liver cirrhosis may limit surgical and interventional approaches to cancer treatment, influence pharmacokinetics of anticancer drugs, increase side effects of chemotherapy, render patients susceptible for hepatotoxicity, and ultimately result in a competitive risk for morbidity and mortality...
2016: ESMO Open
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