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decompensated liver disease

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https://www.readbyqxmd.com/read/29768734/in-vitro-efficacy-of-pro-and-anticoagulant-strategies-in-compensated-and-acutely-ill-patients-with-cirrhosis
#1
Ton Lisman, Simone Kleiss, Vishal C Patel, Caleb Fisher, Jelle Adelmeijer, Sarah Bos, Arjuna Singanayagam, Sidsel Hyldgaard Stoy, Debbie L Shawcross, William Bernal
BACKGROUND & AIMS: A simultaneous decline in pro- and anticoagulant drivers in patients with liver diseases results in a 'rebalanced' hemostatic system, even in acutely ill patients. Nevertheless, both bleeding and thrombotic events are common. Here, we explored efficacy of pro- and antihemostatic strategies in compensated and acutely ill cirrhotics which may be unpredictable given the profound hemostatic changes. METHODS: We tested the effects in vitro of the addition of clinically relevant doses of commonly used pro- and antihemostatic strategies in plasma from healthy individuals (n=30) and patients with compensated (n=18) and acutely decompensated cirrhosis (n=18), and acute-on-chronic liver failure (n=10)...
May 16, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29765787/liver-failure-and-conjugated-hyperbilirubinemia-in-a-preterm-neonate-role-of-early-ivig-and-exchange-transfusion
#2
Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29762630/acute-on-chronic-liver-failure-in-china-rationale-for-developing-a-patient-registry-and-baseline-characteristics
#3
Wen-Yi Gu, Bao-Yan Xu, Xin Zheng, Jinjun Chen, Xian-Bo Wang, Yan Huang, Yan-Hang Gao, Zhong-Ji Meng, Zhi-Ping Qian, Feng Liu, Xiao-Bo Lu, Jia Shang, Hai Li, Shao-Yang Wang, Xin Sun, Hai Li
Definitions and descriptions of acute-on-chronic liver failure (ACLF) vary between Western and Eastern types, and alcoholism and hepatitis B virus(HBV) are the main etiologies, respectively. To determine whether there are unified diagnostic criteria and common treatment programs for different etiologies of ACLF, a multicenter prospective cohort with the same inclusion criteria and disease indicators as those used in the European CANONIC (Chronic liver failure-ACLF in Cirrhosis) study is urgently needed in Asia, where the prevalence of HBV is high...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29761173/liver-enriched-transcription-factor-expression-relates-to-chronic-hepatic-failure-in-humans
#4
Jorge Guzman-Lepe, Eduardo Cervantes-Alvarez, Alexandra Collin de l'Hortet, Yang Wang, Wendy M Mars, Yoshinao Oda, Yuki Bekki, Masahiro Shimokawa, Huanlin Wang, Tomoharu Yoshizumi, Yoshihiko Maehara, Aaron Bell, Ira J Fox, Kazuki Takeishi, Alejandro Soto-Gutierrez
The mechanisms by which the liver fails in end-stage liver disease remain elusive. Disruption of the transcription factor network in hepatocytes has been suggested to mediate terminal liver failure in animals. However, this hypothesis remains unexplored in human subjects. To study the relevance of transcription factor expression in terminal stages of chronic liver failure in humans, we analyzed the expression of liver-enriched transcription factors (LETFs) hepatocyte nuclear factor (HNF)4α, HNF1α, forkhead box protein A2 (FOXA2), CCAAT/enhancer-binding protein (CEBP)α, and CEBPβ...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#5
Mona Haj, Mary Hart, Don C Rockey
Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. The primary outcome was inpatient mortality with focus on cirrhosis-related complications: non-bleeding esophageal varices, variceal hemorrhage, ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS)...
May 14, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29753360/prediction-of-health-utility-scores-in-patients-with-chronic-hepatitis-c-using-the-chronic-liver-disease-questionnaire-hepatitis-c-version-cldq-hcv
#6
Maria Stepanova, Issah Younossi, Andrei Racila, Zobair M Younossi
BACKGROUND: Preference-based health utilities are used in economic analyses of disease burden and health care interventions. When specifically designed instruments cannot be applied, mapping algorithms for non-preference-based instruments can be used for prediction of health utility scores. OBJECTIVES: To develop a mapping algorithm for the Chronic Liver Disease Questionnaire-Hepatitis C Version (CLDQ-HCV), the hepatitis C virus-specific quality-of-life instrument...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29753085/effects-of-virologic-response-to-treatment-on-short-and-long-term-outcomes-of-patients-with-chronic-hbv-infection-and-decompensated-cirrhosis
#7
Jeong Won Jang, Jong Young Choi, Young Seok Kim, Jeong-Ju Yoo, Hyun Young Woo, Sung Kyu Choi, Chung Hwan Jun, Chang Hyeong Lee, Joo Hyun Sohn, Won Young Tak, Yu Rim Lee, Kwang-Hyub Han
BACKGROUND & AIMS: Little is known about the effects of antiviral therapy on short- and long-term survival of patients with hepatitis B virus (HBV)-related decompensated cirrhosis. We aimed to determine whether a maintained virologic response (MVR, defined as persistent undetectable HBV DNA during therapy) associates with short-term (6-month) and long-term (6-120 months) survival of patients with decompensated cirrhosis. METHODS: We performed a 10-year observation analysis using data from the Epidemiology and Natural History of Liver Cirrhosis study of patients with decompensated liver cirrhosis in Korea...
May 9, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29746540/patients-with-stage-3-compared-to-stage-4-liver-fibrosis-have-lower-frequency-of-and-longer-time-to-liver-disease-complications
#8
Page Axley, Sandhya Mudumbi, Shabnam Sarker, Yong-Fang Kuo, Ashwani Singal
BACKGROUND AND AIMS: Advanced liver fibrosis is an important predictor of liver disease progression and mortality, and current guidelines recommend screening for complications of cirrhosis once patients develop F3 fibrosis. Our study compared liver disease progression and survival in patients with stage 3 (F3) and stage 4 (F4) fibrosis on liver biopsy. METHODS: Retrospective study of patients with F3 or F4 on liver biopsy followed for development of liver disease complications (variceal bleeding, ascites, and hepatic encephalopathy); hepatocellular carcinoma, and survival (overall and transplant free survival)...
2018: PloS One
https://www.readbyqxmd.com/read/29743795/prevalence-and-impact-of-bacterial-infections-in-children-with-liver-disease-a-prospective-study
#9
Rishi Bolia, Anshu Srivastava, Rungmei Marak, Surender K Yachha, Ujjal Poddar
Background and aims: Risk of infections is increased in patients with Acute Liver Failure (ALF) and Decompensated Chronic Liver Disease (DCLD). We evaluated the frequency, site, type and risk-factors for bacterial infections in children with ALF and DCLD and its effect on outcome. Methods: ALF or DCLD children were enrolled prospectively. Clinical and laboratory details were recorded. Cultures (blood, urine and ascites) and chest X-ray were done at admission followed by weekly surveillance cultures...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#10
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29740031/higher-risk-of-hepatocellular-carcinoma-in-hispanic-patients-with-hepatitis-c-cirrhosis-and-metabolic-risk-factors
#11
Alina Wong, An Le, Mei-Hsuan Lee, Yu-Ju Lin, Pauline Nguyen, Sam Trinh, Hansen Dang, Mindie H Nguyen
The effect of metabolic syndrome on chronic liver diseases other than non-alcoholic fatty liver disease has not been fully elucidated. Our goal was to evaluate if metabolic syndrome increased the risk of liver-related complications, specifically hepatocellular carcinoma (HCC) and decompensation, in cirrhotic chronic hepatitis C (CHC) patients. We conducted a retrospective cohort study of 3503 consecutive cirrhotic CHC patients seen at Stanford University from 1997-2015. HCC developed in 238 patients (8-year incidence 21%) and hepatic decompensation in 448 patients (8-year incidence 61%)...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29739046/albumin-bilirubin-score-predicts-short-term-mortality-in-patients-with-hepatitis-b-virus-related-decompensated-cirrhosis
#12
Xiao T Qi
BACKGROUND: The albumin-bilirubin (ALBI) score is a new index for assessing the severity of liver dysfunction. Hepatitis B virus (HBV) related decompensated cirrhosis (HBV-DeCi) has a high short-term mortality rate. The purpose of this study was to elucidate the prognostic role of the ALBI score in patients with HBV-DeCi. METHODS: This retrospective study included 81 patients who had been diagnosed with HBV-DeCi. All patients were followed up with for at least 2 months, and the relationships between prognosis and ALBI score were analysed...
May 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29737582/wisteria-floribunda-agglutinin-positive-human-mac-2-binding-protein-in-decompensated-cirrhosis
#13
Haruki Uojima, Hisashi Hidaka, Yoshiaki Tanaka, Tomoyoshi Inoue, Mie Onoue, Naohisa Wada, Kousuke Kubota, Takahide Nakazawa, Akitaka Shibuya, Tomoaki Fujikawa, Tsuyoshi Nakayama, Hiroki Yamanoue, Ji Hyun Sung, Makoto Kako, Wasaburo Koizumi
BACKGROUND AND AIM: An assay for Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA+ -M2BP) has been reported as a useful non-invasive marker for the evaluation of the staging of fibrosis in several chronic liver diseases. However, available data on the effect of WFA+ -M2BP level in decompensated cirrhosis patients was limited. It is important that these investigations can validate the diagnostic utility of WFA+ -M2BP in the full range of patients with liver cirrhosis...
May 8, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29735785/alcohol-consumption-influences-clinical-outcome-in-patients-admitted-to-a-referral-center-for-liver-disease
#14
Suyan G R Dos Santos, Angelo A Mattos, Marcela M Guimarães, Bibiana de S Boger, Gabriela P Coral
INTRODUCTION AND AIM: Excessive alcohol consumption is a public health concern worldwide and has been associated with high mortality rates. This study aimed to determine the prevalence of alcohol consumption and its influence on the prognosis of hospitalized cirrhotic patients in a tertiary care hospital. MATERIAL AND METHODS: We reviewed the medical records of all patients with hepatic cirrosis admitted between January 2009 and December 2014, in a referral center for liver disease in southern Brazil...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735784/sofosbuvir-based-therapy-in-the-pre-liver-transplant-setting-the-canadian-national-experience
#15
Bandar Al-Judaibi, Benson Thomas, Philip Wong, Amine Benmassaoud, Jo-Hua Chen, M Katherine Dokus, Trana Hussaini, Marc Bilodeau, Kelly W Burak, Paul Marotta, Eric M Yoshida
INTRODUCTION AND AIM: Sofosbuvir (SOF)-based regimen has been shown to have high efficacy even in patients with decompensated cirrhosis. Treated patients may experience various degrees of hepatic recovery ranging from stabilization of liver function, to removal from liver transplant wait lists. The frequency of these occurrences in larger transplant eligible patient populations is unknown. The aim of this study was to assess the efficacy of SOF-based therapy in HCV infected transplant eligible patients and to evaluate short term changes in liver function and the effect on their liver transplant status...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29733831/fibrosis-severity-as-a-determinant-of-cause-specific-mortality-in-patients-with-advanced-nonalcoholic-fatty-liver-disease
#16
Eduardo Vilar-Gomez, Luis Calzadilla-Bertot, Vincent Wai-Sun Wong, Marlen Castellanos, Rocio Aller-de la Fuente, Mayada Metwally, Mohammed Eslam, Licet Gonzalez-Fabian, María Alvarez-Quiñones Sanz, Antonio Felix Conde-Martin, Bastiaan De Boer, Duncan McLeod, Anthony Wing Hung Chan, Naga Chalasani, Jacob George, Leon A Adams, Manuel Romero-Gomez
BACKGROUND & AIMS: Little is known about the natural course of nonalcoholic fatty liver disease (NAFLD) with advanced fibrosis. We describe long-term outcomes and evaluate the effects of clinical and histologic parameters on disease progression in patients with advanced NAFLD. METHODS: We conducted a multi-national study of 458 patients with biopsy-confirmed NAFLD with bridging fibrosis (F3, n=159) or compensated cirrhosis (222 patients with Child-Turcotte-Pugh [CTP] scores of A5 and 77 patients with scores of A6), evaluated from April 1995 through November 2013 and followed until December 2016, death, or liver transplantation at hepatology centers in Spain, Australia, Hong Kong, and Cuba...
May 4, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29730473/the-intensive-care-unit-icu-course-and-outcome-in-acute-on-chronic-liver-failure-are-comparable-to-other-populations
#17
Philippe Meersseman, Lies Langouche, Johannie du Plessis, Hannelie Korf, Michaël Mekeirele, Wim Laleman, Frederik Nevens, Alexander Wilmer, Greet Van den Berghe, Schalk W van der Merwe
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short term mortality. Whether the outcome in ACLF patients admitted to the ICU with organ failure differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS: From the large prospective EPaNIC randomized control trial database (n=4640), 133 patients were identified with cirrhosis of whom 71 fulfilled the CLIF criteria for ACLF...
May 3, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29729174/-substantiation-of-complex-intensive-treatment-of-hepatic-failure-complicated-by-encephalopathy
#18
Mikhaylo M Ivachevsky, Vitalina V Ivachevska
OBJECTIVE: Introduction: Thesis is devoted to the optimization of complex intensive therapy of hepatic insufficiency, complicated by encephalopathy. The aim: Optimization of treatment efficacy in patients with hepatic insufficiency complicated by encephalopathy. PATIENTS AND METHODS: Materials and methods: The results of complex examination and treatment of 73 patients with hepatic insufficiency have been studied and analyzed in this work. The study included patients who had been hospitalized with liver encephalopathy, which developed on the background of hepatic failure, cirrhosis of the liver in particular...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29729119/palliative-care-in-end-stage-liver-disease-time-to-do-better
#19
REVIEW
Chiara Mazzarelli, Wendy M Prentice, Michael A Heneghan, Luca S Belli, Kosh Agarwal, Mary D Cannon
Optimal involvement of palliative care services in the management of patients with decompensated cirrhosis and end-stage liver disease is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease...
May 5, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29721243/opportunistic-infections-in-end-stage-liver-disease
#20
Michele Bartoletti, Maddalena Giannella, Sara Tedeschi, Pierluigi Viale
Liver cirrhosis is the 10th most common cause of death in Western world and infection is associated with a high morbidity and mortality, and represents the leading cause of acute liver decompensation. Patients with end-stage liver disease exhibit an important impairment of immune system. This condition, called cirrhosis-associated immune dysfunction, summarizes both local and systemic immune system alterations in liver cirrhosis that play a pivotal role in determining both the high incidence of infections and the ominous infections related mortality in this population...
March 29, 2018: Infectious Disease Reports
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