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decompensated liver disease

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https://www.readbyqxmd.com/read/28719013/in-an-era-of-highly-effective-treatment-hepatitis-c-screening-of-the-general-population-of-the-united-states-for-hepatitis-c-should-be-considered
#1
Zobair Younossi, Deidre Blissett, Rob Blissett, Linda Henry, Youssef Younossi, Rachel Beckerman, Sharon Hunt
BACKGROUND AND AIMS: Hepatitis C virus (HCV) treatment with all oral direct acting antiviral agents (DAA's) achieve sustained virologic response (SVR) rates of 98%. Re-assessment of general US population screening for HCV is imperative. This study compared the cost-effectiveness (CE) of three HCV screening strategies: screen all (SA), screen Birth Cohort (BCS), and screen high risks (HRS). METHODS: Using a previous designed decision-analytic Markov model, estimations of the natural history of HCV and CE evaluation of the three HCV screening strategies over a lifetime horizon in the US population was undertaken...
July 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28711320/liver-stiffness-measurement-by-transient-elastography-predicts-late-posthepatectomy-outcomes-in-patients-undergoing-resection-for-hepatocellular-carcinoma
#2
Muthukumarassamy Rajakannu, Daniel Cherqui, Oriana Ciacio, Nicolas Golse, Gabriella Pittau, Marc Antoine Allard, Teresa Maria Antonini, Audrey Coilly, Antonio Sa Cunha, Denis Castaing, Didier Samuel, Catherine Guettier, René Adam, Eric Vibert
BACKGROUND: Postoperative hepatic decompensation is a serious complication of liver resection in patients undergoing hepatectomy for hepatocellular carcinoma. Liver fibrosis and clinical significant portal hypertension are well-known risk factors for hepatic decompensation. Liver stiffness measurement is a noninvasive method of evaluating hepatic venous pressure gradient and functional hepatic reserve by estimating hepatic fibrosis. Effectiveness of liver stiffness measurement in predicting persistent postoperative hepatic decompensation has not been investigated...
July 12, 2017: Surgery
https://www.readbyqxmd.com/read/28706961/multiple-myeloma-presenting-as-acute-liver-failure
#3
Stephanie Cull, David J Westrich, Ruchi Bhatia, Jinping Lai, Alex S Befeler
Liver failure is rarely caused by multiple myeloma (MM). We present an unusual case of MM initially presenting as acute liver injury. A 79-year-old man with new-onset fatigue, decreased appetite, and no history of liver disease was found to have evidence of hepatic decompensation. Liver biopsy demonstrated diffuse plasma cell infiltration, and MM was confirmed with bone marrow biopsy. Chemotherapy was initiated, but the patient decompensated and died due to respiratory failure. MM should be considered on the differential for acute decompensated liver disease...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28706365/obstetric-outcome-in-women-with-chronic-liver-disease
#4
Pinky Jena, C N Sheela, Rao Preethi Venkatachala, Harshad Devarbhavi
AIM: This study determines the prevalence, causes and outcome of pregnancy in women with chronic liver diseases in a tertiary level teaching institute in Southern India. METHODS: Retrospective analysis of case records was carried out between December 2010 and May 2015 in the departments of Obstetrics and Gynecology and Gastroenterology including pregnant women diagnosed to have chronic liver diseases prenatally or during pregnancy. RESULTS: The frequency of chronic liver disease in pregnancy was 50 among 10,823 deliveries (0...
August 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28704381/sofosbuvir-based-treatment-of-chronic-hepatitis-c-genotype-3-infections-a-scandinavian-real-life-study
#5
Olav Dalgard, Ola Weiland, Geir Noraberg, Lars Karlsen, Lars Heggelund, Martti Färkkilâ, Ulla Balslev, Erika Belard, Anne Øvrehus, Mette Skalshøi Kjær, Henrik Krarup, Birgit Thorup Røge, Sofie Hallager, Lone G Madsen, Alex Lund Laursen, Martin Lagging, Nina Weis
BACKGROUND AND AIMS: Chronic hepatitis C virus (HCV) genotype 3 infection with advanced liver disease has emerged as the most challenging to treat. We retrospectively assessed the treatment outcome of sofosbuvir (SOF) based regimes for treatment of HCV genotype 3 infections in a real life setting in Scandinavia. METHODS: Consecutive patients with chronic HCV genotype 3 infection were enrolled at 16 treatment centers in Denmark, Sweden, Norway and Finland. Patients who had received a SOF containing regimen were included...
2017: PloS One
https://www.readbyqxmd.com/read/28703134/genetic-variants-underlying-vitamin-d-metabolism-and-vdr-tgf%C3%AE-1-smad3-interaction-may-impact-on-hcv-progression-a-study-based-on-dbgap-data-from-the-halt-c-study
#6
Laura A de Azevedo, Ursula Matte, Themis R da Silveira, Mário R Álvares-da-Silva
Vitamin D deficiency is prevalent in liver disease and vitamin D has been shown to decrease hepatic fibrosis through an anti-TGFβ-1/SMAD3 effect mediated by the vitamin D receptor. Thus, we hypothesized that genetic variants involved in vitamin D metabolism and/or VDR/TGFβ-1/SMAD3 interaction could impact on the progression of chronic HCV. We obtained or imputed genotypes for 40 single nucleotide polymorphisms (SNPs) located in genes implicated in vitamin D metabolism from the HALT-C cohort via dbGaP. The HALT-C study followed 692 chronic HCV patients over 4 years, evaluating clinical outcomes including worsening of fibrosis, hepatic decompensation (gastric/esophageal bleeding, CTP>7, ascites, spontaneous bacterial peritonitis and encephalopathy), development of hepatocellular carcinoma, and liver death...
July 13, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28702738/impact-of-etiological-treatment-on-prognosis
#7
REVIEW
Chien-Wei Su, Ying-Ying Yang, Han-Chieh Lin
Portal hypertension (PHT) is a frequent and severe complication of cirrhosis. PHT may lead to the development of various complications with high mortality. Liver transplantation is the gold standard as a surgical curative treatment for end-stage liver disease. Theoretically, etiological treatment focusing on the pathophysiology of the underlying disease should be the objective of the nonsurgical management of cirrhotic PHT. Chronic viral hepatitis is the major etiology of cirrhosis and PHT. In cirrhotic patients with chronic hepatitis B virus infection, antiviral therapies can suppress viral replication, ameliorate hepatic inflammation, regress fibrosis, and restore liver functional reserve...
July 12, 2017: Hepatology International
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#8
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28696845/decompensated-cirrhosis-and-sickle-cell-disease-case-reports-and-review-of-the-literature
#9
Roberta D'Ambrosio, Marco Maggioni, Maria F Donato, Pietro Lampertico, Maria D Cappellini, Giovanna Graziadei
Although its prevalence is unknown, liver involvement by sickle cell disease is not uncommon and encompasses different clinical spectra including non cholestatic and cholestatic disorders. Few data have been provided on chronic sickle cell intrahepatic cholestasis (SCIC) clinical course, although cirrhosis has been reported in sickle cell disease. However, no effective therapeutic approaches have been recognized either to prevent or treat this condition. Here we present two cases of adult sickle cell disease patients with decompensated cirrhosis...
March 2017: Hemoglobin
https://www.readbyqxmd.com/read/28688177/renal-vein-dilation-predicts-the-poor-outcome-in-patients-with-refractory-cirrhotic-ascites
#10
Naoki Matsumoto, Masahiro Ogawa, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Takao Miura, Hiroshi Nakagawara, Shunichi Matsuoka, Mitsuhiko Moriyama, Hirotoshi Fujikawa
BACKGROUND & AIMS: Renal venous hypertension is known to be associated with worsening of renal function in patients with decompensated heart failure. Intra-abdominal hypertension including cirrhotic ascites also leads to renal venous hypertension. We aimed to clarify the effect of renal venous hypertension on cirrhotic ascites. METHODS: Two hepatologists measured the left renal vein diameter in 142 consecutive patients with refractory cirrhotic ascites using non-contrast computed tomography...
July 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28686307/characteristics-of-liver-transplant-candidates-delisted-following-recompensation-and-predictors-of-such-delisting-in-alcohol-related-liver-disease-a-case-control-study
#11
Authors Aloysious D Aravinthan, Andrew S Barbas, Adam C Doyle, Mahmood Tazari, Gonzalo Sapisochin, Mark S Cattral, Anand Ghanekar, Ian D McGilvray, Markus Selzner, Paul D Greig, Mamatha Bhat, Nazia Selzner, David R Grant, Leslie B Lilly, Eberhard L Renner
Whether and when recovery beyond the need for transplant may occur in patients listed for decompensation remains unclear. This study aimed to investigate the characteristics of patients delisted following recompensation. Seventy-seven patients who were listed between 2005 and 2015 for decompensation, but later delisted following recompensation were included. Alcohol-related liver disease (ALD) was the underlying etiology in the majority (n=47, 61%). Listing characteristics of these patients were compared with those of decompensated ALD patients who either underwent deceased donor liver transplantation or died on the waiting list...
July 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28684103/late-hepatitis-b-and-c-diagnosis-in-relation-to-disease-decompensation-and-hepatocellular-carcinoma-development
#12
Hasina Samji, Amanda Yu, Margot Kuo, Maryam Alavi, Ryan Woods, Maria Alvarez, Gregory J Dore, Mark Tyndall, Mel Krajden, Naveed Z Janjua
BACKGROUND AND AIMS: We measured the timing of HBV and HCV diagnoses relative to detection of decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC) as an indicator of late hepatitis diagnosis. METHODS: HBV and HCV diagnoses were defined relative to the diagnosis of DC or HCC such that HBV/HCV diagnoses within two years prior, at the time of or after HCC or DC diagnosis were considered late. We performed multivariable logistic regression to assess factors associated with late HBV/HCV diagnoses among those with DC or HCC...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28681347/new-concepts-on-the-clinical-course-and-stratification-of-compensated-and-decompensated-cirrhosis
#13
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis has been typically described by a compensated and a decompensated state based on the absence or, respectively, the presence of any of bleeding, ascites, encephalopathy or jaundice. More recently, it has been recognized that increasing portal hypertension and several major clinical events are followed by a marked worsening in prognosis, and disease states have been proposed accordingly in a multistate model. The development of multistate models implies the assessment of the probabilities of more than one possible outcome from each disease state...
July 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28679676/economic-evaluation-of-a-community-based-diagnostic-pathway-to-stratify-adults-for-non-alcoholic-fatty-liver-disease-a-markov-model-informed-by-a-feasibility-study
#14
Lukasz Tanajewski, Rebecca Harris, David J Harman, Guruprasad P Aithal, Timothy R Card, Georgios Gkountouras, Vladislav Berdunov, Indra N Guha, Rachel A Elliott
OBJECTIVES: To assess the long-term cost-effectiveness of a risk stratification pathway, compared with standard care, for detecting non-alcoholic fatty liver disease (NAFLD) in primary care. SETTING: Primary care general practices in England. PARTICIPANTS: Adults who have been identified in primary care to have a risk factor for developing NAFLD, that is, type 2 diabetes without a history of excessive alcohol use. INTERVENTION: A community-based pathway, which uses transient elastography and hepatologists to stratify patients at risk of NAFLD, has been implemented and demonstrated to be feasible (NCT02037867)...
July 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28675370/early-spontaneous-graft-intra-and-perihepatic-hematoma-after-liver-transplantation
#15
Cristian Lupaşcu, Oana Apopei, Nutu Vlad, Ciprian Vasiluta, Ana-Maria Trofin, Mihai Zabara, Alexandra Vornicu, Corina Lupaşcu-Ursulescu, Mioara Nitu, Felicia Crumpei, Vladislav Braşoveanu, Irinel Popescu
Hematoma of the graft is a life threatening complication of liver transplantation (LT) and there has been no overt conclusion in the literature about optimal management except in scarcely reported cases. It may be either intrahepatic or subcapsular, then again it may develop spontaneously or following parenchimal injuries or transhepatic percutaneous invasive manoeuvers. In this report we describe a rare case of large spontaneous graft intra- and perihepatic hematoma. A 62 year-old man underwent a whole graft orthotopic liver transplantation (OLT) for decompensated chronic liver disease due to alcoholic cirrhosis...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28669353/possible-gasoline-induced-chronic-liver-injury-due-to-occupational-malpractice-in-a-motor-mechanic-a-case-report
#16
Mahesh Lakmal Gunathilaka, Madunil Anuk Niriella, Nathasha Vihangi Luke, Chathura Lakmal Piyarathna, Rohan Chaminda Siriwardena, Arjuna Priyadarshin De Silva, Hithanadura Janaka de Silva
BACKGROUND: Hydrocarbon-induced occupational liver injury is a well-known clinical entity among petroleum industry workers. There are many types of hydrocarbon exposure, with inhalation being the most common. Hydrocarbon-induced occupational liver injury is a rarely suspected and commonly missed etiological agent for liver injury. We report a case of a non-petroleum industry worker with chronic liver disease secondary to hydrocarbon-induced occupational liver injury caused by chronic low-grade hydrocarbon ingestion due to occupational malpractice...
July 3, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28665498/enoxaparin-does-not-ameliorate-liver-fibrosis-or-portal-hypertension-in-rats-with-advanced-cirrhosis
#17
José I Fortea, Alexander Zipprich, Carolina Fernandez-Mena, Marta Puerto, Cristina R Bosoi, Jorge Almagro, Marcus Hollenbach, Juan Bañares, Belén Rodríguez-Sánchez, Emilia Cercenado, Marc-André Clément, Christopher F Rose, Rafael Bañares, Javier Vaquero, Cristina Ripoll
BACKGROUND & AIMS: Recent studies suggest that heparins reduce liver fibrosis and the risk of decompensation of liver disease. Here, we evaluated the effects of enoxaparin in several experimental models of advanced cirrhosis. METHODS: Cirrhosis was induced in male Sprague-Dawley (SD) rats by: i. Oral gavage with carbon tetrachloride (CCl4ORAL ), ii. Bile duct ligation (BDL), and iii. CCl4 inhalation (CCl4INH ). Rats received saline or enoxaparin s.c. (40 IU/Kg/d or 180 IU/Kg/d) following various protocols...
June 30, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28663680/hepatocellular-carcinoma-an-unusual-complication-of-longstanding-wilson-disease
#18
Deepak Gunjan, Shalimar, Neeti Nadda, Saurabh Kedia, Baibaswata Nayak, Shashi B Paul, Shivanand Ramachandra Gamanagatti, Subrat K Acharya
Wilson disease is caused by the accumulation of copper in the liver, brain or other organs, due to the mutation in ATP7B gene, which encodes protein that helps in excretion of copper in the bile canaliculus. Clinical presentation varies from asymptomatic elevation of transaminases to cirrhosis with decompensation. Hepatocellular carcinoma is a known complication of cirrhosis, but a rare occurrence in Wilson disease. We present a case of neurological Wilson disease, who later developed decompensated cirrhosis and hepatocellular carcinoma...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28660622/palliative-care-access-for-hospitalized-patients-with-end-stage-liver-disease-across-the-united-states
#19
Barret Rush, Keith R Walley, Leo Anthony Celi, Neil Rajoriya, Mayur Brahmania
OBJECTIVE: Patients with end-stage liver disease (ESLD) often have a high symptom burden. Historically, palliative care (PC) services have been underutilized in this population. We investigated the use of PC services in patients with ESLD hospitalized across the United States. METHODS: We utilized the Nationwide Inpatient Sample (NIS) to conduct a retrospective nationwide cohort analysis. All patients >18 years of age admitted with ESLD, defined as those with at least two liver decompensation events, were included in the analysis...
June 29, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28660146/bile-cast-nephropathy-in-patients-with-acute-kidney-injury-due-to-hepatorenal-syndrome-a-postmortem-kidney-biopsy-study
#20
Suman Lata Nayak, Manoj Kumar, Chhagan Bihari, Archana Rastogi
Background and Aims: The role of bile cast nephropathy (BCN) in pathogenesis of hepatorenal syndrome (HRS) in decompensated cirrhosis and acute on chronic liver failure (ACLF) is unknown. This study aimed to determine the frequency of BCN detected on postmortem renal biopsy among patients with decompensated cirrhosis and ACLF who had been admitted with acute kidney injury due to HRS (HRA-AKI) and expired during that hospitalization. Methods: One-hundred-twenty-seven postmortem renal biopsies with adequate size (>1 cm in length) were included for analysis...
June 28, 2017: Journal of Clinical and Translational Hepatology
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