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https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#1
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29142474/clinical-features-of-alcoholic-hepatitis-in-latinos-and-caucasians-a-single-center-experience
#2
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
AIM: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29138587/primary-sclerosing-cholangitis-diagnostic-and-management-challenges
#3
REVIEW
Sanjeev Sirpal, Natasha Chandok
Primary sclerosing cholangitis (PSC) is a chronic immune-mediated disease affecting intra- and extrahepatic bile ducts, primarily the large biliary ducts. Clinical manifestations are broad, and the spectrum encompasses asymptomatic cholestasis, icteric cholangitis with pruritis, cirrhosis, and cholangiocarcinoma. Though rare, PSC has a propensity to affect young to middle-aged males and is strongly associated with inflammatory bowel disease. There is an unmet need for effective medical treatments for PSC, and to date, the only curative therapy is liver transplantation reserved for those with end-stage liver disease...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29122309/the-keys-to-successful-tips-in-patients-with-portal-vein-thrombosis-and-cavernous-transformation
#4
S Lombardo, J J Espejo, M E Pérez-Montilla, L J Zurera, Á González-Galilea
Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization...
November 6, 2017: Radiología
https://www.readbyqxmd.com/read/29121925/advances-and-challenges-in-cirrhosis-and-portal-hypertension
#5
Annalisa Berzigotti
BACKGROUND: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required. DISCUSSION: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice...
November 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29116550/resistance-to-daas-when-to-look-and-when-it-matters
#6
REVIEW
David L Wyles
PURPOSE OF REVIEW: This review provides an overview of HCV resistance-associated substitutions (RASs) with a focus on NS3 protease and NS5A inhibitor resistance. Treatment approaches for managing resistance are also covered including the use of newly approved therapies with improved resistance profiles. RECENT FINDINGS: HCV RASs are frequently selected if the patient is not cured during treatment; NS5A RASs persist for prolonged periods of time (years) after treatment failure and may adversely impact retreatment responses...
November 7, 2017: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/29115717/changes-in-liver-function-and-body-composition-by-direct-acting-antiviral-therapy-for-hepatitis-c-virus-infection
#7
Ryosuke Sugimoto, Motoh Iwasa, Nagisa Hara, Yasuyuki Tamai, Kyoko Yoshikawa, Suguru Ogura, Hideaki Tanaka, Akiko Eguchi, Norihiko Yamamoto, Yoshinao Kobayashi, Hiroshi Hasegawa, Yoshiyuki Takei
AIM: Management of low skeletal muscle mass (LSM) is a very important topic since LSM affects patient mortality in liver diseases. Changes in body composition are unexplored in chronic hepatitis C virus (HCV) patients, including those with liver cirrhosis, who receive direct-acting antiviral (DAA) therapy. Body composition measurements and liver function tests were performed before and after DAA therapy. METHODS: Blood examination, visceral fat area (VFA) and extremity skeletal muscle mass were measured using the multi-frequency bioelectrical impedance analysis method: i) at 24 weeks pre DAA therapy; ii) at the start of DAA therapy; iii) at the end of DAA therapy; iv) at 24 weeks post DAA therapy; and v) at 48 weeks post DAA therapy...
November 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29113177/potential-role-of-indoleamine-2-3-dioxygenase-in-primary-biliary-cirrhosis
#8
Kashif Asghar, John Brain, Jeremy M Palmer, Stephen Douglass, Fatmah M A Naemi, Graeme O'Boyle, John Kirby, Simi Ali
Indoleamine 2,3-dioxygenase (IDO)-induced immunosuppression can be clinically beneficial for autoimmune diseases. Primary biliary cirrhosis (PBC) is characterized by autoimmune lesions of intrahepatic bile duct epithelial cells that may lead to irreversible cirrhosis or hepatocellular carcinoma. The present study assessed the expression and function of IDO in a cell culture model and in PBC patients. IDO expression was monitored in a human immortalized but non-malignant biliary epithelial cell (iBEC) line. Increased expression of IDO1/2 was observed in the iBECs following stimulation with interferon-γ (IFN-γ)...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29108191/-an-interpretation-of-the-aasld-practice-guideline-on-the-diagnosis-and-management-of-nonalcoholic-fatty-liver-disease-in-2017
#9
Y M Nan, N Fu, W C Li, L L Kong, X W Yuan, S Y Zhang, L D Liu, Y Lu, L Y Cui
The American Association for the Study of Liver Diseases (AASLD) updated and published the Practice Guidance for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease (NAFLD) in July 2017, which provides recommendations for the accurate diagnosis, treatment, and effective prevention of NAFLD. Related metabolic diseases should be considered during the initial evaluation of patients suspected of NAFLD. Noninvasive diagnostic techniques including transient elastography, magnetic resonance elastography, and serum biochemical models should be used to evaluate the development and progression of liver fibrosis in patients with NAFLD...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108189/-guidelines-on-the-management-of-ascites-and-complications-in-cirrhosis
#10
(no author information available yet)
No abstract text is available yet for this article.
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29107152/the-contribution-of-alcohol-use-disorder-to-decompensated-cirrhosis-among-people-with-hepatitis-c-an-international-study
#11
Maryam Alavi, Naveed Z Janjua, Mei Chong, Jason Grebely, Esther J Aspinall, Hamish Innes, Heather M Valerio, Behzad Hajarizadeh, Peter C Hayes, Mel Krajden, Janaki Amin, Matthew G Law, Jacob George, David J Goldberg, Sharon J Hutchinson, Gregory J Dore
BACKGROUND: The aim of this study was to evaluate the contribution of alcohol-use disorder to hepatitis C virus (HCV)-related decompensated cirrhosis diagnosis in three settings. METHODS: HCV notifications from British Columbia (BC), Canada, New South Wales (NSW), Australia, and Scotland (1995-2011/2012/2013, respectively) were linked to hospital admissions (2001-2012/2013/2014, respectively). Alcohol-use disorder was defined by non-liver-related hospitalisation due to alcohol use...
October 26, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29105284/estimating-hcv-disease-burden-volume-4-editorial
#12
G J Dore, A Hatzakis, F Negro, I Waked
Hepatitis C virus (HCV) is a major global public health issue, with an estimated 71 million people living with HCV infection and a rising burden of cirrhosis, hepatocellular carcinoma (HCC) and liver-related mortality. The advent of interferon-free, direct acting antiviral-based (DAA) therapies, with short duration (8-12 weeks), high efficacy, excellent tolerability and ease of delivery (once daily oral dosing), is one of the major advances in clinical medicine in recent decades, and provides the opportunity to address this growing global HCV burden...
October 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29095346/pediatric-non-alcoholic-fatty-liver-disease-current-thinking
#13
Valerio Nobili, Piotr Socha
Non-alcoholic fatty liver disease (NAFLD), an increasingly prevalent paediatric disorder is diagnosed and managed by both paediatric gastroenterologists / hepatologists but also frequently by the general paediatrician. This paper updates recent advances in diagnostic and therapeutic approach which may be applied to everyday practice. Diagnosis of NAFLD takes into account the risk factor profile and is a diagnosis of exclusion. Techniques such as transient elastography and specific biomarkers aimed at improving diagnosis and monitoring of NAFLD need further validation in the paediatric population...
October 31, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29092970/extracorporeal-membrane-oxygenation-for-post-transplant-hypoxaemia-following-very-severe-hepatopulmonary-syndrome
#14
Lakshmi Kumar, Dinesh Balakrishnan, Rekha Varghese, Sudhindran Surendran
Hepatopulmonary syndrome (HPS) associated with end-stage liver disease has a high morbidity when room air PaO2 is less than 50 mm Hg. Safe levels of oxygenation to facilitate transplantation have not been defined despite advancement in care. Postoperatively, hypoxaemia worsens due to ventilation perfusion mismatch contributed by postoperative pulmonary vasoconstriction and due to decrease in endogenous nitric oxide. A 16-year-old boy with cirrhosis presented with HPS and a PaO2 of 37 mm Hg on room air and underwent living donor liver transplant...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29091004/performing-gadoxetic-acid-enhanced-mri-after-ct-for-guiding-curative-treatment-of-early-stage-hepatocellular-carcinoma-a-cost-effectiveness-analysis
#15
Chong Hyun Suh, Kyung Won Kim, Seong Ho Park, So Yeon Kim, Dong-Cheol Woo, Sangjin Shin, Junhee Pyo, Atul B Shinagare, Nikhil H Ramaiya, Young-Suk Lim
OBJECTIVE: We determined the cost-effectiveness of two different diagnostic imaging strategies in guiding curative treatment of early-stage hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We developed a decision analytic model using as its starting point a cohort of patients aged 55 years with early-stage HCC detected at dynamic multiphasic CT and with Child-Pugh class A cirrhosis. The model compared two strategies on the initial workup: conventional CT strategy using dynamic multiphasic CT only and gadoxetic acid-enhanced MRI strategy using additional gadoxetic acid-enhanced MRI after initial CT...
November 1, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29083080/underappreciation-of-non-alcoholic-fatty-liver-disease-by-primary-care-clinicians-limited-awareness-of-surrogate-markers-of-fibrosis
#16
Preya J Patel, Xuan Banh, Leigh U Horsfall, Kelly L Hayward, Fabrina Hossain, Tracey Johnson, Katherine A Stuart, Nigel N Brown, Nivene Saad, Andrew Clouston, Katharine M Irvine, Anthony W Russell, Patricia C Valery, Suzanne Williams, Elizabeth E Powell
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common cause of incidental liver test abnormalities. General practitioners have a key role in identifying people with NAFLD at risk of significant liver disease. Recent specialist guidelines emphasize the use of fibrosis algorithms or serum biomarkers rather than routine liver tests, to assess advanced fibrosis. This study evaluated primary care clinicians' current approach to diagnosis, management and referral of NAFLD. METHODS: A cross-sectional survey of primary care clinicians was undertaken through a structured questionnaire about NAFLD...
October 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29079534/epigenetic-reprogramming-in-liver-fibrosis-and-cancer
#17
Caroline L Wilson, Derek A Mann, Lee A Borthwick
Novel insights into the epigenetic control of chronic liver diseases are now emerging. Recent advances in our understanding of the critical roles of DNA methylation, histone modifications and ncRNA may now be exploited to improve management of fibrosis/cirrhosis and cancer. Furthermore, improved technologies for the detection of epigenetic markers from patients' blood and tissues will vastly improve diagnosis, treatment options and prognostic tracking. The aim of this review is to present recent findings from the field of liver epigenetics and to explore their potential for translation into therapeutics to prevent disease promoting epigenome reprogramming and reverse epigenetic changes...
October 25, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29076589/non-alcoholic-fatty-liver-disease-histological-scoring-systems-a-large-cohort-single-center-evaluation-study
#18
Archana Rastogi, Saggere Muralikrishna Shasthry, Ayushi Agarwal, Chhagan Bihari, Priyanka Jain, Ankur Jindal, Shiv Sarin
Non-alcoholic fatty liver disease (NAFLD) is an increasingly common cause of chronic liver disease. Till date, liver biopsy remains the gold standard for identification and quantification of the wide histological spectra of NAFLD. Histological scorings are very useful and widely applied for the diagnosis and management in clinical trials and follow-up studies of non-alcoholic steatohepatitis (NASH). However, in view of scarce published literature, there is a need to evaluate them in large cohort of NAFLD. This study was aimed to evaluate the two histological scoring systems (NAS-CRN, SAF) in the diagnosis of NAFLD and to assess the role of histological characteristics as injury markers in NAFLD...
November 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/29072497/efficacy-and-safety-of-ultrasound-guided-percutaneous-glue-embolization-in-iatrogenic-haemorrhagic-complications-of-paracentesis-and-thoracocentesis-in-cirrhotic-patients
#19
Amar Mukund, Vinay Kumar Dp, Naveen Kumar Condati, Ajeet Singh Bhadoria, Shiv Kumar Sarin
OBJECTIVE: To compare the safety and efficacy of ultrasound guided percutaneous glue (N-butyl-2-cyanoacrylate) embolization with transarterial embolization in the management of iatrogenically injured arteries while performing paracentesis or thoracocentesis in patients with chronic liver disease. METHODS: Hospital database was searched for cirrhotic patients having abdominal/thoracic wall haemorrhage following paracentesis/thoracocentesis procedure from January 2011 to June 2016...
November 8, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29070023/portal-vein-thrombosis-in-liver-cirrhosis-incidence-management-and-outcome
#20
Shunichiro Fujiyama, Satoshi Saitoh, Yusuke Kawamura, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Masahiro Kobayashi, Yoshiyuki Suzuki, Fumitaka Suzuki, Yasuji Arase, Kenji Ikeda, Hiromitsu Kumada
BACKGROUND: Portal vein thrombosis (PVT) is a serious complication in liver cirrhosis with portal hypertension. We examined the treatment, recurrence and prognosis of PVT in cirrhotic patients. METHODS: The study subjects were all 90 cirrhotic patients with PVT treated with danaparoid sodium (DS) at our department between July 2007 and September 2016. The mean age was 68 years and mean Child-Pugh score was 7. All patients received 2500 U/day of DS for 2 weeks, and repeated in those who developed PVT recurrence after the initial therapy...
October 25, 2017: BMC Gastroenterology
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