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management cirrhosis 2016

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https://www.readbyqxmd.com/read/29769038/impact-of-new-daa-therapy-on-real-clinical-practice-a-multicenter-region-wide-cohort-study
#1
Simone Lanini, Paola Scognamiglio, Alessandra Mecozzi, Lorella Lombardozzi, Vincenzo Vullo, Mario Angelico, Antonio Gasbarrini, Gloria Taliani, Adolfo Francesco Attili, Carlo Federico Perno, Adriano De Santis, Vincenzo Puro, Fabio Cerqua, Gianpiero D'Offizi, Adriano Pellicelli, Orlando Armignacco, Francesco Saverio Mennini, Massimo Siciliano, Enrico Girardi, Vincenzo Panella, Giuseppe Ippolito
BACKGROUND: Management of chronic hepatitis C (CHC) has significantly accelerated in the last few years. Currently, second generation direct acting antivirals (DAAs) promise clearance of infection in most of patients. Here we present the results of the first analysis carried out on data of Lazio clinical network for DAAs. METHODS: The study was designed as a multicenter cohort: a) to assess the evolution of treatment during the first 24 months of the activity of the Clinical Network; b) to report overall efficacy of treatments; c) to analyze potential factors associated with lack of virological response at 12 weeks after therapy (SVR12); d) to evaluate the variation of ALT at baseline and 12 weeks after therapy in those who achieved SVR12 in comparison to those who did not...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29743790/safety-and-efficacy-of-sofosbuvir-and-daclatasvir-for-hepatitis-c-virus-infection-in-patients-with-%C3%AE-thalassemia-major
#2
Rajiv Mehta, Mayank Kabrawala, Subhash Nandwani, Pankaj Desai, Vishwa Bhayani, Sanjay Patel, Viral Parekh
Background and Aims: β-thalassemia major patients are susceptible to Hepatitis C Virus (HCV) infection owing to life-long dependency for blood-transfusion. Moreover, this patient population is at risk of progression of liver fibrosis or development of cirrhosis as a consequence of both iron overload and HCV infection. Hence, this study was carried out to evaluate efficacy and safety of the combination regimen of sofosbuvir and daclatasvir for HCV infection in β-thalassemia major patients...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29736833/are-clinicians-ready-for-safe-use-of-stratified-therapy-in-primary-biliary-cholangitis-pbc-a-study-of-educational-awareness
#3
Laura Jopson, Amardeep Khanna, Patricia Peterson, Elaine Rudell, Margaret Corrigan, David Jones
BACKGROUND: Primary Biliary Cholangitis (PBC, formerly cirrhosis), is a chronic cholestatic liver disease which until spring 2016 had a single licensed therapy, Ursodeoxycholic acid (UDCA). Approximately 30% of patients do not respond to UDCA, and are high-risk for progressing to end stage liver disease, transplantation or death. A new era of stratified medicine with second-line therapies to treat high-risk disease is emerging, with the first such second-line agent obeticholic acid recently receiving FDA and EMA approval and entering practice...
May 8, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29717414/primary-central-sleep-apnea-and-anesthesia-a-retrospective-case-series
#4
Alexandru Alexa, Meghna P Mansukhani, Bhargavi Gali, Atousa Deljou, Juraj Sprung, Toby N Weingarten
PURPOSE: Primary (idiopathic) central sleep apnea (PCSA) is a rare central sleep-related breathing disorder characterized by increased chemoreceptor sensitivity to partial pressure of carbon dioxide, which manifests as hyperventilation followed by apnea during non-rapid eye movement sleep. The purpose of this retrospective study was to describe the postoperative course of patients who had PCSA and underwent procedures requiring anesthetic management. METHODS: Patients who received a diagnosis of PCSA at our institution and required procedural anesthesia between 1 January 2010 and 1 June 2016 underwent a comprehensive review of their health records with a focus on identifying respiratory complications...
May 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29709681/class-iii-obesity-is-a-risk-factor-for-the-development-of-acute-on-chronic-liver-failure-in-patients-with-decompensated-cirrhosis
#5
Vinay Sundaram, Rajiv Jalan, Joseph C Ahn, Michael R Charlton, David S Goldberg, Constantine J Karvellas, Mazen Noureddin, Robert Wong
BACKGROUND AND AIMS: Acute on chronic liver failure (ACLF) is a syndrome of systemic inflammation and organ failures. Obesity, also characterized by chronic inflammation, is a risk factor among patients with cirrhosis for decompensation, infection, and mortality. Our aim was to test the hypothesis that obesity predisposes to ACLF development in patients with decompensated cirrhosis. METHODS: We examined the United Network for Organ Sharing (UNOS) database, from 2005-2016, characterizing patients at wait-listing as non-obese (BMI < 30), obese class I-II (BMI 30-39...
April 27, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29665097/real-world-use-of-elbasvir-grazoprevir-in-patients-with-chronic-hepatitis-c-retrospective-analyses-from-the-trio-network
#6
S L Flamm, B Bacon, M P Curry, S Milligan, C U Nwankwo, N Tsai, Z Younossi, N Afdhal
BACKGROUND: Elbasvir-grazoprevir is indicated for chronic hepatitis C virus (HCV) genotypes 1 and 4. AIMS: To evaluate the utilization and outcomes of chronic HCV patients treated with elbasvir-grazoprevir in the United States. METHODS: We conducted a retrospective cohort study of adults treated with elbasvir-grazoprevir with or without ribavirin for chronic HCV genotypes 1 or 4 infection. Data were collected from healthcare providers and specialty pharmacies through Innervation Platform, a proprietary, cloud-based disease management program from Trio Health...
April 17, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29593899/feasibility-and-safety-of-bariatric-surgery-in-high-risk-patients-a-single-center-experience
#7
Yusef Moulla, Orestis Lyros, Matthias Blüher, Philipp Simon, Arne Dietrich
Introduction: Despite the feasibility and safety of bariatric procedures nowadays, high-risk patients with vast obesity and severe comorbidities demonstrate relatively high perioperative morbidity and mortality rates and, therefore, form a distinguished challenge for the bariatric surgeons. Methods: We retrospectively analyzed high-risk patients, who underwent bariatric surgery in University Hospital Leipzig between May 2012 and December 2016. High-risk patients were defined when (Bergeat et al...
2018: Journal of Obesity
https://www.readbyqxmd.com/read/29584594/acoustic-radiation-force-impulse-us-imaging-liver-stiffness-in-patients-with-chronic-hepatitis-b-with-and-without-antiviral-therapy
#8
Tung-Hung Su, Chun-Hsun Liao, Chen-Hua Liu, Kai-Wen Huang, Tai-Chung Tseng, Hung-Chih Yang, Chun-Jen Liu, Pei-Jer Chen, Ding-Shinn Chen, Jia-Horng Kao
Purpose To investigate the clinical utility and longitudinal change of acoustic radiation force impulse (ARFI) ultrasonographic (US) imaging in patients with chronic hepatitis B. Materials and Methods A retrospective cohort study of patients with chronic hepatitis B who underwent serial ARFI examinations in a tertiary referral center in Taiwan between 2012 and 2016 was conducted. The clinical information and noninvasive liver stiffness measurement tests (ARFI, Fibrosis-4 index [FIB-4], and FibroScan) were collected...
March 27, 2018: Radiology
https://www.readbyqxmd.com/read/29514697/cardiac-output-optimisation-following-liver-transplant-colt-trial-study-protocol-for-a-feasibility-randomised-controlled-trial
#9
Farid Froghi, Rahul Koti, Kurinchi Gurusamy, Susan Mallett, Douglas Thorburn, Linda Selves, Sarah James, Jeshika Singh, Manuel Pinto, Christine Eastgate, Margaret McNeil, Helder Filipe, Fatima Jichi, Nick Schofield, Daniel Martin, Brian Davidson
BACKGROUND: Patients with liver cirrhosis undergoing liver transplantation have a hyperdynamic circulation which persists into the early postoperative period making accurate assessment of fluid requirements challenging. Goal-directed fluid therapy (GDFT) has been shown to reduce morbidity and mortality in a number of surgery settings. The impact of GDFT in patients undergoing liver transplantation is unknown. A feasibility trial was designed to determine patient and clinician support for recruitment into a randomised controlled trial of GDFT following liver transplantation, adherence to a GDFT protocol, participant withdrawal, and to determine appropriate endpoints for a subsequent larger trial to evaluate the efficacy of GDFT in patients undergoing liver transplantation...
March 7, 2018: Trials
https://www.readbyqxmd.com/read/29506913/determinants-of-survival-following-hepatocellular-carcinoma-in-egyptian-patients-with-untreated-chronic-hcv-infection-in-the-pre-daa-era
#10
Reem Waziry, Asmaa Gomaa, Imam Waked, Gregory J Dore
BACKGROUND AND STUDY AIMS: In this study we assessed rates and determinants of survival in people with untreated chronic HCV infection and hepatocellular carcinoma (HCC) in an Egyptian liver clinic setting. PATIENTS AND METHODS: This is a prospective cohort study of patients diagnosed with HCV-related HCC and undergoing HCC management at a national liver centre in Egypt in 2013-2014 and with a follow-up through 2016. RESULTS: A total of 345 patients diagnosed with HCV-related liver cirrhosis complicated by HCC were included...
March 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/29497685/radiofrequency-ablation-rfa-vs-argon-plasma-coagulation-apc-for-the-management-of-gastric-antral-vascular-ectasia-gave-in-patients-with-and-without-cirrhosis-results-from-a-retrospective-analysis-of-a-large-cohort-of-patients-treated-at-a-single-center
#11
Paul St Romain, Amanda Boyd, Jiayin Zheng, Shein-Chung Chow, Rebecca Burbridge, Daniel Wild
Introduction and study aims:  Gastric antral vascular ectasia (GAVE) is a mucosal abnormality associated with multiple conditions, most notably cirrhosis and systemic sclerosis, that causes indolent gastrointestinal bleeding. It is primarily managed with endoscopic therapy. Traditionally, GAVE is endoscopically ablated using argon plasma coagulation (APC) but radiofrequency ablation (RFA) is emerging as an alternative modality. No prior comparison of the 2 modalities has been published...
March 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29486621/comorbidities-and-cardiovascular-risk-factors-in-an-aged-cohort-of-hiv-infected-patients-on-antiretroviral-treatment-in-a-spanish-hospital-in-2016
#12
Carmen Fontela, Jesús Castilla, Regina Juanbeltz, Iván Martínez-Baz, María Rivero, Aisling O'Leary, Natalia Larrea, Ramón San Miguel
OBJECTIVES: The increased survival of HIV-infected individuals has resulted in a premature aging of this population, with the consequent development of premature age-related comorbidities and risk factors. We aimed to describe the prevalence of age-related comorbidities and cardiovascular risk factors in older adults with HIV infection on antiretroviral therapy (ART). METHODS: A retrospective cross-sectional study was undertaken in a cohort of HIV patients aged ≥50 years on ART in September 2016 in Spain...
April 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29465472/a-new-prognostic-score-can-predict-survival-after-hepatocellular-carcinoma-treatment-in-a-cohort-of-1302-egyptian-hepatocellular-carcinoma-patients
#13
Ashraf O Abdelaziz, Hend I Shousha, Ahmed H Abdelmaksoud, Yasmin Saad, Tamer M Elbaz, Zeinab A Soliman, Ayman Salah, Rania Lithy, Mona Ahmed, Mohamed M Nabil
INTRODUCTION: Survival of hepatocellular carcinoma (HCC) differs between regions and countries according to the different underlying factors and the degree of standard of care that enables early diagnosis and management. Our aim was to identify the most potent predictive factors of survival in Egyptian HCC patients receiving curative or palliative treatments. PATIENTS AND METHODS: This retrospective study included 1302 HCC patients attending the HCC multidisciplinary clinic, Cairo University, between February 2009 and December 2016...
May 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29152988/value-and-innovation-of-direct-acting-antivirals-long-term-health-outcomes-of-the-strategic-plan-for-the-management-of-hepatitis-c-in-spain
#14
Juan Turnes, Raquel Domínguez-Hernández, Miguel Ángel Casado
OBJECTIVE: To assess the long-term healthcare costs and health outcomes in association with the access to new direct-acting antivirals (DAAs), during the first year of the National Strategic Plan for Chronic Hepatitis C (SPCHC) in patients with chronic hepatitis C (CHC) in Spain. METHODS: A decision tree and a lifetime Markov model were developed to simulate the natural history, morbidity, and mortality of a cohort of 51,900 patients with CHC before (pre-DAA strategy) and after (post-DAA strategy) access to DAAs, following SPCHC approval...
December 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29152039/hepatic-hydrothorax-an-update-and-review-of-the-literature
#15
REVIEW
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29076589/non-alcoholic-fatty-liver-disease-histological-scoring-systems-a-large-cohort-single-center-evaluation-study
#16
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
#17
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...
January 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29070023/portal-vein-thrombosis-in-liver-cirrhosis-incidence-management-and-outcome
#18
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
https://www.readbyqxmd.com/read/29025385/the-impact-of-preoperative-variables-on-intraoperative-blood-loss-and-transfusion-requirements-during-orthotopic-liver-transplant
#19
Mohammad Hossein Eghbal, Kazem Samadi, Mohammad Bagher Khosravi, Mohammad Ali Sahmeddini, Sina Ghaffaripoor, Mohammad Ghorbani, Sakineh Shokrizadeh
OBJECTIVES: Liver transplant traditionally and potentially is associated with the risk of massive blood loss and transfusion, which can adversely affect transplant outcomes. Many variables influence the amount of bleeding, and these can be categorized as patient related, surgery related, and graft related. We aimed to assess the effects of these variables on the amount of bleeding and transfusion during liver transplant; predicting the risk of massive blood loss can help transplant teams to select and manage patients more effectively...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28913620/a-brief-review-on-prognostic-models-of-primary-biliary-cholangitis
#20
REVIEW
Sha Chen, Weijia Duan, Hong You, Jidong Jia
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease characterized by progressive destruction of small intrahepatic bile ducts. If left untreated, PBC may eventually result in end-stage liver disease. For better management of PBC and optimal allocation of medical resources, it is pivotal to accurately estimate the prognosis of patients with PBC. This article will briefly review the models that predict long-term outcome of PBC patients, with special focus on the applicability, strengths and limitations of the widely used models reported from 1983 to 2016...
September 2017: Hepatology International
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