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https://www.readbyqxmd.com/read/30372514/carvedilol-versus-traditional-non-selective-beta-blockers-for-adults-with-cirrhosis-and-gastroesophageal-varices
#1
REVIEW
Antony P Zacharias, Rebecca Jeyaraj, Lise Hobolth, Flemming Bendtsen, Lise Lotte Gluud, Marsha Y Morgan
BACKGROUND: Non-selective beta-blockers are recommended for the prevention of bleeding in people with cirrhosis, portal hypertension and gastroesophageal varices. Carvedilol is a non-selective beta-blocker with additional intrinsic alpha1 -blocking effects, which may be superior to traditional, non-selective beta-blockers in reducing portal pressure and, therefore, in reducing the risk of upper gastrointestinal bleeding. OBJECTIVES: To assess the beneficial and harmful effects of carvedilol compared with traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices...
October 29, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/30357792/-the-devascularisation-procedure-for-the-treatment-of-fundic-and-oesophageal-varices-in-portal-hypertension-a-retrospective-analysis-of-55-cases
#2
Marcus Overhaus, Lydia Garcia Park, Rolf Fimmers, Tim R Glowka, Cornelius van Beekum, Steffen Manekeller, Jörg C Kalff, Nico Schaefer, Tim Vilz
BACKGROUND: The most dangerous complication of portal hypertension is the formation of oesophageal varices, as the risk of bleeding is up to 80%. In order to reduce pressure reduction in the portosystemic circulation and as secondary prophylaxis, the TIPSS procedure has proven successful. In patients with portal vein thrombosis, portosystemic shunt surgery is possible to reduce the risk of variceal bleeding. However, if thrombosis of the mesentericoportal axis or hepatic encephalopathy is imminent, interventional or surgical creation of a portosystemic shunt is contraindicated...
October 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/30295853/portal-hypertension-oesophageal-varices-caput-medusae
#3
S Nagasaki, S Nishiguchi, J Branch
No abstract text is available yet for this article.
October 5, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/30270689/clinical-characteristics-of-patients-with-liver-cirrhosis-and-spontaneous-portosystemic-shunts-detected-by-ultrasound-in-a-tertiary-care-and-transplantation-centre
#4
Michael Lipinski, Michael Saborowski, Benjamin Heidrich, Dina Attia, Philipp Kasten, Michael P Manns, Michael Gebel, Andrej Potthoff
OBJECTIVES: The clinical relevance of spontaneous portosystemic shunts detected by ultrasound is insufficiently investigated. The aim of this retrospective study was to assess the frequency and clinical relevance of spontaneous portosystemic shunts in patients with liver cirrhosis. METHODS: We evaluated portosystemic shunts, liver cirrhosis and spleen size by ultrasound in 982 patients with liver cirrhosis and correlated these with laboratory results, clinical data and the incidence of clinical endpoint deaths, liver transplantation and the development of HCC during the follow-up period (mean 1...
September 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/30236768/ace-i-allele-is-associated-with-more-severe-portal-hypertension-in-patients-with-liver-cirrhosis-a-pilot-study
#5
Brigida E Annicchiarico, Concetta Santonocito, Massimo Siciliano, Margherita Scapaticci, Donatella Guarino, Carmine Di Stasi, Maria E Riccioni, Enrico Di Stasio, Ettore Capoluongo, Antonio Gasbarrini
BACKGROUND: In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed. AIM: The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure...
August 28, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/30215362/emerging-non-invasive-approaches-for-diagnosis-and-monitoring-of-portal-hypertension
#6
REVIEW
Xiaolong Qi, Annalisa Berzigotti, Andres Cardenas, Shiv Kumar Sarin
Clinically significant portal hypertension is associated with an increased risk of developing gastro-oesophageal varices and hepatic decompensation. Hepatic venous pressure gradient measurement and oesophagogastroduodenoscopy are the gold-standard methods for assessing clinically significant portal hypertension (hepatic venous pressure gradient ≥10 mm Hg) and gastro-oesophageal varices, respectively. However, invasiveness, cost, and feasibility limit their widespread use, especially if repeated and serial evaluations are required to assess the efficacy of pharmacotherapy...
October 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/30212817/treatment-of-oesophageal-varices-in-liver-cirrhosis
#7
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
https://www.readbyqxmd.com/read/30186822/predictive-value-of-a-noninvasive-serological-hepatic-fibrosis-scoring-system-in-cirrhosis-combined-with-oesophageal-varices
#8
Feiyue Zhang, Tong Liu, Pan Gao, Sujuan Fei
Objective: In recent years, the noninvasive serological scoring system has become a research hotspot in predicting hepatic fibrosis and has achieved good results. However, it has rarely been applied to the prediction of oesophageal varices. The aim of the study was to evaluate the predictive value of the four following scoring systems in cirrhosis combined with oesophageal varices: aspartate and platelet ratio index (APRI), aspartate aminotransferase-alanine aminotransferase ratio (AAR), FIB-4, and S index...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/30154473/publisher-correction-alcoholic-liver-disease
#9
Helmut K Seitz, Ramon Bataller, Helena Cortez-Pinto, Bin Gao, Antoni Gual, Carolin Lackner, Philippe Mathurin, Sebastian Mueller, Gyongyi Szabo, Hidekazu Tsukamoto
The originally published article contained an error in figure 8 part a, in which cut off values for F3 fibrosis, cirrhosis, and screening for oesophageal varices and HCC were incorrectly presented as <8 kPa, <12.5 kPa and <20 kPa, respectively. These cut off values have been corrected in the HTML and PDF versions of the manuscript to >8 kPa for F3 fibrosis, >12.5 kPa for cirrhosis and >20 kPa for screening for oesophageal varices and HCC.
August 28, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/30073663/surgical-portosystemic-shunts-versus-devascularisation-procedures-for-prevention-of-variceal-rebleeding-in-people-with-hepatosplenic-schistosomiasis
#10
REVIEW
Chikwendu J Ede, Dimitrinka Nikolova, Martin Brand
BACKGROUND: Hepatosplenic schistosomiasis is an important cause of variceal bleeding in low-income countries. Randomised clinical trials have evaluated the outcomes of two categories of surgical interventions, shunts and devascularisation procedures, for the prevention of variceal rebleeding in people with hepatosplenic schistosomiasis. The comparative overall benefits and harms of these two interventions are unclear. OBJECTIVES: To assess the benefits and harms of surgical portosystemic shunts versus oesophagogastric devascularisation procedures for the prevention of variceal rebleeding in people with hepatosplenic schistosomiasis...
August 3, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/30023058/non-invasive-tests-for-the-detection-of-oesophageal-varices-in-compensated-cirrhosis-systematic-review-and-meta-analysis
#11
REVIEW
Sarmed S Sami, David Harman, Krish Ragunath, Dankmar Böhning, Julie Parkes, Indra Neil Guha
Introduction: Conclusive data on the accuracy and clinical applicability of non-invasive screening tests for oesophageal varices (OV) in patients with compensated cirrhosis remain lacking. We conducted this study to identify currently available tests, estimate their diagnostic performance and then exemplify how these could be utilized in clinical practice. Materials and methods: A systematic literature search was performed to identify all primary studies that reported accuracy using oesophagogastroduodenoscopy (OGD) as the gold standard...
July 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29904721/surveillance-for-portal-hypertension-in-the-course-of-liver-cirrhosis
#12
REVIEW
Anna Piekarska, Ewa K Berkan, Kamila M Wójcik
Non-invasive liver fibrosis assessment techniques are under development for evaluating the severity of liver disease and portal hypertension. The paper presents practical arrangements for the diagnosis and treatment of portal hypertension in patients with chronic liver disease, established in the Baveno VI Consensus Workshop for diagnosis and treatment of portal hypertension. Currently, the diagnostic standard of liver disease severity is transient elastography, which can identify patients with clinically significant portal hypertension (liver stiffness > 20 kPa)...
June 2018: Clinical and experimental hepatology
https://www.readbyqxmd.com/read/29729368/a-combined-model-based-on-spleen-stiffness-measurement-and-baveno-vi-criteria-to-rule-out-high-risk-varices-in-advanced-chronic-liver-disease
#13
Antonio Colecchia, Federico Ravaioli, Giovanni Marasco, Agostino Colli, Elton Dajti, Anna Rita Di Biase, Maria Letizia Bacchi Reggiani, Annalisa Berzigotti, Massimo Pinzani, Davide Festi
BACKGROUND & AIMS: Recently, Baveno VI guidelines suggested that esophagogastroduodenoscopy (EGD) can be avoided in patients with compensated advanced chronic liver disease (cACLD) who have a liver stiffness measurement (LSM) <20 kPa and platelet count >150,000/mm3 . We aimed to: assess the performance of spleen stiffness measurement (SSM) in ruling out patients with high-risk varices (HRV); validate Baveno VI criteria in a large population and assess how the sequential use of Baveno VI criteria and SSM could safely avoid the need for endoscopy...
August 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29657612/deal-a-death-blow-hcc-in-cirrhotics-thrombotic-complications-their-frequency-characteristics-and-risk-factors
#14
Khalid Mahmood, Iftikhar Haider Naqvi, Aamer Mahmood, Syed Muhammad, Noor Muhammad
Introduction: The hepatocellular carcinoma (HCC), being the commonest primary cancer, holds the sixth slot in the list of common cancers worldwide. Thrombotic complications in the form of portal vein tumour thrombosis (PVTT) and bland portal vein thrombosis with HCC are common with a bad prognosis. Aim: The study aims to determine the demographic, clinical, and biochemical parameters of HCC patients. The study also compares the clinical and biochemical parameters among patients having HCC with and without thrombotic complication...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29504330/correlation-between-severity-of-portal-hypertensive-gastropathy-and-size-of-oesophageal-varices-in-cirrhotic-hepatitis-c-patients
#15
Khurram Saleem, Faisal Amin Baig, Mahwish Nida, Munaza Javed
BACKGROUND: Portal hypertension can lead to oesophageal varices (EV) and portal hypertensive gastropathy (PHG). The aim of this study is to determine the relationship between severity of Portal hypertensive gastropathy and size of oesophageal varices. METHODS: One hundred and ninety-five patients of hepatitis C positive chronic liver disease having oesophageal varices were assessed for severity of portal hypertensive gastropathy. RESULTS: Mild Portal Hypertensive Gastropathy was observed in 16 (8...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29467124/gastric-and-duodenal-ischaemia-after-transarterial-chemoembolisation-for-hepatocellular-carcinoma-an-unexpected-but-significant-complication
#16
Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#17
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29388229/betablockers-do-not-increase-efficacy-of-band-ligation-in-primary-prophylaxis-but-they-improve-survival-in-secondary-prophylaxis-of-variceal-bleeding
#18
N Pfisterer, C Dexheimer, E-M Fuchs, T Bucsics, P Schwabl, M Mandorfer, I Gessl, L Sandrieser, L Baumann, F Riedl, B Scheiner, T Pachofszky, W Dolak, C Schrutka-Kölbl, A Ferlitsch, M Schöniger-Hekele, M Peck-Radosavljevic, M Trauner, C Madl, T Reiberger
BACKGROUND: Endoscopic band ligation (EBL) is used for primary (PP) and secondary prophylaxis (SP) of variceal bleeding. Current guidelines recommend combined use of non-selective beta-blockers (NSBBs) and EBL for SP, while in PP either NSBB or EBL should be used. AIM: To assess (re-)bleeding rates and mortality in cirrhotic patients receiving EBL for PP or SP for variceal bleeding. METHODS: (Re-)bleeding rates and mortality were retrospectively assessed with and without concomitant NSBB therapy after first EBL in PP and SP...
April 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29177064/efficacy-of-capsule-endoscopy-in-patients-with-cirrhosis-for-the-diagnosis-of-upper-gastrointestinal-lesions-and-small-bowel-abnormalities-a-study-protocol-for-prospective-interventional-study
#19
Yoshinori Iwata, Hiroki Nishikawa, Hirayuki Enomoto, Kazunori Yoh, Akio Ishii, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
Introduction and aims: The role of capsule endoscopy (CE) in patients with liver cirrhosis (LC) has yet to be established; however, it is likely that it will remain a valuable diagnostic modality in several groups of patients with LC. The primary aims of the current prospective interventional study are to examine the prevalence for small bowel lesions and transit time of CE in the gastrointestinal tract in patients with LC with oesophageal varices (EVs) requiring endoscopic therapies...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29099778/upper-gastrointestinal-bleeding-in-children-a-tertiary-united-kingdom-children-s-hospital-experience
#20
Omar Nasher, David Devadason, Richard J Stewart
The aim of this study was to review the aetiology, presentation and management of these patients with upper gastrointestinal bleeding (UGIB) at a tertiary children's unit in the United Kingdom. This was a retrospective single-institution study on children (<16 years) who presented with acute UGIB over a period of 5 years using known International Classification of Diseases (ICD) codes. A total of 32 children (17 males, 15 females) were identified with a total median age at presentation of 5.5 years. The majority (24/32) of patients presented as an emergency...
November 3, 2017: Children
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