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Cirrhotic liver failure

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https://www.readbyqxmd.com/read/28345155/a-nomogram-for-predicting-prognostic-value-of-inflammatory-response-biomarkers-in-decompensated-cirrhotic-patients-without-acute-on-chronic-liver-failure
#1
Y-J Cai, J-J Dong, J-Z Dong, Y Chen, Z Lin, M Song, Y-Q Wang, Y-P Chen, K-Q Shi, M-T Zhou
BACKGROUND: Inflammation plays a vital role in liver cirrhosis progression and prognosis. AIM: To investigate the prognostic significance of inflammatory response markers in decompensated cirrhotic patients without acute-on-chronic liver failure (ACLF). METHODS: Independent predictors were identified using multivariate Cox model and then assembled into a nomogram to predict survival. Concordance index (C-index) and time-dependent receiver operating characteristics (td-ROC) analysis were adopted to evaluate and compare the performance of nomogram, model for end-stage liver disease (MELD) scores, MELD-Na and Chronic Liver Failure-consortium score for acute decompensated (CLIF-C ADs)...
March 26, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28341896/role-of-conservative-management-in-tubercular-abdominal-cocoon-a-case-series
#2
Vishal Sharma, Harshal S Mandavdhare, Surinder S Rana, Harjeet Singh, Amit Kumar, Rajesh Gupta
BACKGROUND: Sclerosing encapsulating peritonitis (Abdominal cocoon) is an uncommon cause of intestinal obstruction and tuberculosis is an important etiology. Appropriate management of this entity is still uncertain. METHODS: We did a retrospective analysis of patients with abdominal cocoon who were seen over a two year period at a tertiary care center in North India. We included patients with tubercular abdominal cocoon (TAC) who were managed primarily with antitubercular therapy in the present report...
March 24, 2017: Infection
https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#3
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28293094/competing-risk-analysis-on-outcome-after-hepatic-resection-of-hepatocellular-carcinoma-in-cirrhotic-patients
#4
Alessandro Cucchetti, Carlo Sposito, Antonio Daniele Pinna, Davide Citterio, Matteo Cescon, Marco Bongini, Giorgio Ercolani, Christian Cotsoglou, Lorenzo Maroni, Vincenzo Mazzaferro
AIM: To investigate death for liver failure and for tumor recurrence as competing events after hepatectomy of hepatocellular carcinoma. METHODS: Data from 864 cirrhotic Child-Pugh class A consecutive patients, submitted to curative hepatectomy (1997-2013) at two tertiary referral hospitals, were used for competing-risk analysis through the Fine and Gray method, aimed at assessing in which circumstances the oncological benefit from tumour removal is greater than the risk of dying from hepatic decompensation...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28283328/carnosine-ameliorates-liver-fibrosis-and-hyperammonemia-in-cirrhotic-rats
#5
Akram Jamshidzadeh, Reza Heidari, Zahra Latifpour, Mohammed Mehdi Ommati, Narges Abdoli, Somayeh Mousavi, Negar Azarpira, Azita Zarei, Mahdi Zarei, Behnam Asadi, Mojgan Abasvali, Yasaman Yeganeh, Faezeh Jafari, Arastoo Saeedi, Asma Najibi, Elnaz Mardani
AIM: Chronic liver injury and cirrhosis leads to liver failure. Hyperammonemia is a deleterious consequence of liver failure. On the other hand, oxidative stress seems to play a pivotal role in the pathogenesis of liver fibrosis as well as in the cytotoxic mechanism of ammonia. There is no promising therapeutic agent against ammonia-induced complications. The present study was conducted to evaluate the role of carnosine (CA) administration on liver pathological changes, elevated plasma ammonia, and its consequent events in cirrhotic rats...
March 7, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28270654/a-proposed-physiopathological-pathway-to-hyperammonemic-encephalopathy-in-a-non-cirrhotic-patient-with-fibrolamellar-hepatocellular-carcinoma-without-ornithine-transcarbamylase-otc-mutation
#6
Rodrigo C Surjan, Elizabeth S Dos Santos, Tiago Basseres, Fabio F Makdissi, Marcel A Machado
BACKGROUND Hyperammonemic encephalopathy is a potentially fatal condition that may progress to irreversible neuronal damage and is usually associated with liver failure or portosystemic shunting. However, other less common conditions can lead to hyperammonemia in adults, such as fibrolamellar hepatocellular carcinoma. Clinical awareness of hyperammonemic encephalopathy in patients with normal liver function is paramount to timely diagnosis, but understanding the underlying physiopathology is decisive to initiate adequate treatment for complete recovery...
March 8, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28261694/impact-of-clinically-significant-portal-hypertension-on-surgical-outcomes-for-hepatocellular-carcinoma-in-patients-with-compensated-liver-cirrhosis-a-propensity-score-matching-analysis
#7
Chul Woo Jang, Hyung Jun Kwon, Horyon Kong, Heontak Ha, Young Seok Han, Jae Min Chun, Sang Geol Kim, Yun Jin Hwang
BACKGROUNDS/AIMS: The roles of portal hypertension (PHT) on the postoperative course after hepatectomy are still debated. The aim of this study was to evaluate surgical outcomes of hepatectomy in patients with PHT. METHODS: Data from 152 cirrhotic patients who underwent hepatectomy for hepatocellular carcinoma (HCC) were collected retrospectively. Patients were divided into two groups according to the preoperative presence of PHT as follows: 44 patients with PHT and 108 without PHT...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28245727/cirrhotic-cardiomyopathy-is-there-any-correlation-between-the-stage-of-cardiac-impairment-and-the-severity-of-liver-disease
#8
Rania Hammami, Mouna Boudabbous, Jihen Jdidi, Fatma Trabelsi, Fakher Mroua, Rahma Kallel, Ali Amouri, Dorra Abid, Nabil Tahri, Leila Abid, Samir Kammoun
Cirrhotic cardiomyopathy is associated with poor prognosis and risk of acute heart failure after liver transplantation or interventional procedures. We aimed to assess the relationship between the severity of cardiac impairment and hepatic disease. Eighty patients and eighty controls underwent echocardiography, tissue Doppler imaging and speckle tracking measures. We assess the correlation between echocardiographic parameters and Child and MELD scores. Systolic parameters function (s wave, p < 0.001) and global longitudinal strain (p < 0...
December 2017: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/28241780/thromboelastometry-versus-standard-coagulation-tests-versus-restrictive-protocol-to-guide-blood-transfusion-prior-to-central-venous-catheterization-in-cirrhosis-study-protocol-for-a-randomized-controlled-trial
#9
Leonardo Lima Rocha, Camila Menezes Souza Pessoa, Ary Serpa Neto, Rogerio Ruscitto do Prado, Eliezer Silva, Marcio Dias de Almeida, Thiago Domingos Correa
BACKGROUND: Liver failure patients have traditionally been empirically transfused prior to invasive procedures. Blood transfusion is associated with immunologic and nonimmunologic reactions, increased risk of adverse outcomes and high costs. Scientific evidence supporting empirical transfusion is lacking, and the best approach for blood transfusion prior to invasive procedures in cirrhotic patients has not been established so far. The aim of this study is to compare three transfusion strategies (routine coagulation test-guided - ordinary or restrictive, or thromboelastometry-guided) prior to central venous catheterization in critically ill patients with cirrhosis...
February 27, 2017: Trials
https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#10
Katharina Staufer, Kevin Roedl, Danijel Kivaranovic, Andreas Drolz, Thomas Horvatits, Susanne Rasoul-Rockenschaub, Christian Zauner, Michael Trauner, Valentin Fuhrmann
BACKGROUND & AIMS: Current guidelines discourage renal replacement therapy (RRT) in critically ill cirrhotics in the lack of liver transplant (LT) options. This study aimed to identify patients who benefit from RRT in the short and long-term. METHODS: Critically ill cirrhotics were included over a time period of 6 years (y) and followed for at least 1y. CLIF-C ACLF, CLIF-SOFA, SOFA and MELD scores on admission, 24h prior to RRT, 24h and 48h after start of RRT were analyzed for their predictive value of ICU-mortality...
February 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28179096/long-term-efficacy-and-safety-of-switching-from-lamivudine-adefovir-to-tenofovir-disoproxil-fumarate-in-virologically-suppressed-patients
#11
Massimo Fasano, Paolo Maggi, Armando Leone, Anna Volpe, Jose Ramon Fiore, Gioacchino Angarano, Teresa Antonia Santantonio
BACKGROUND AND AIM: Tenofovir disoproxil fumarate (TDF) is recommended as first-line monotherapy for nucleos(t)ide (NA)-naïve chronic hepatitis B (CHB) patients and as a second-line rescue therapy for NA-experienced patients with a previous treatment failure. However, data regarding the efficacy of TDF monotherapy in patients with lamivudine resistance (LAM-R) successfully treated with LAM+adefovir (ADV) are limited. Herein, the efficacy and safety of switching from LAM+ADV to TDF monotherapy in clinical practice have been evaluated...
January 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28177543/changes-in-liver-stiffness-measurements-and-fibrosis-scores-following-sofosbuvir-based-treatment-regimens-without-interferon
#12
Aisha Elsharkawy, Shereen Abdel Alem, Rabab Fouad, Maissa El Raziky, Wafaa El Akel, Mahmoud Abdo, Omnia Tantawi, Mohamed AbdAllah, Marc Bourliere, Gamal Esmat
BACKGROUND AND AIM: Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis however early changes in non-invasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. AIM: To evaluate changes of Transient elastography values as well as FIB-4 and AST to platelet ratio index in patients (APRI) treated with sofosbuvir- based treatment regimen...
February 8, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28165154/predictors-of-treatment-efficacy-and-alt-non-normalization-with-sofosbuvir-ribavirin-therapy-for-patients-with-hepatitis-c-virus-genotype-2
#13
Takao Watanabe, Yoshio Tokumoto, Kouji Joko, Kojiro Michitaka, Norio Horiike, Yoshinori Tanaka, Fujimasa Tada, Yoshiyasu Kisaka, Seiji Nakanishi, Takashi Nonaka, Kazuhiko Yamauchi, Masashi Hirooka, Masanori Abe, Yoichi Hiasa
AIM: The tolerability and efficacy of sofosbuvir and ribavirin in patients infected with hepatitis C virus (HCV) genotype 2 were investigated under actual clinical conditions. METHODS: A total of 208 patients with chronic HCV genotype 2 infection were treated with sofosbuvir 400 mg and ribavirin (weight-based dosing) for 12 weeks. Treatment discontinuation and sustained virological response 12 (SVR12) were evaluated. Moreover, factors associated with SVR12, hemoglobin decreasing to less than 10 g/dL during treatment, and alanine aminotransferase (ALT) non-normalization after treatment were evaluated...
February 6, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28161470/hepatocellular-carcinoma-decreases-the-chance-of-successful-hepatitis-c-virus-therapy-with-direct-acting-antivirals
#14
Stacey Prenner, Lisa B VanWagner, Steven L Flamm, Riad Salem, Robert J Lewandowski, Laura Kulik
BACKGROUND: The approval of all-oral direct acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) has led to the expansion of therapy to include patients with cirrhosis who have hepatocellular carcinoma (HCC). Data on the use of DAA's in HCV+ patients with HCC is limited. The aim of this study was to assess the efficacy of all oral-DAA regimens in HCV+ cirrhotic patients who have or had HCC compared to those without HCC. METHODS: We conducted a retrospective cohort study of all cirrhotic patients who were treated for HCV with DAA's at our institution between January 2014 and November 2015...
February 1, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28114104/aki-clif-sofa-a-novel-prognostic-score-for-critically-ill-cirrhotic-patients-with-acute-kidney-injury
#15
Dan-Qin Sun, Chen-Fei Zheng, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Ke-Qing Shi, Xiao-Dong Wang, Ji-Dong Wang, Ming-Hua Zheng
Critically ill cirrhotic patients with acute kidney injury (AKI) are associated with high mortality rates. The aims of this study were to develop a specific prognostic score for critically ill cirrhotic patients with AKI, the acute kidney injury - Chronic Liver Failure - Sequential Organ Failure- Assessment score (AKI-CLIF-SOFA) score. This study focused on 527 cirrhotic patients with AKI admitted to intensive care unit and constructed a new scoring system, the AKI-CLIF-SOFA, which can be used to prognostically assess mortality in these patient population...
January 19, 2017: Aging
https://www.readbyqxmd.com/read/28110320/acute-on-chronic-liver-failure-recent-update
#16
Alam Azeem, Chun Suen Ka, Ma Daqing
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28101681/extended-liver-venous-deprivation-before-major-hepatectomy-induces-marked-and-very-rapid-increase-in-future-liver-remnant-function
#17
Boris Guiu, François Quenet, Laure Escal, Frédéric Bibeau, Lauranne Piron, Philippe Rouanet, Jean-Michel Fabre, Eric Jacquet, Alban Denys, Pierre-Olivier Kotzki, Daniel Verzilli, Emmanuel Deshayes
OBJECTIVE: The aim of this study was to assess the safety and efficacy of extended liver venous deprivation (eLVD), i.e. combination of right portal vein embolisation and right (accessory right) and middle hepatic vein embolisation before major hepatectomy for future remnant liver (FRL) functional increase. METHODS: eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2...
January 18, 2017: European Radiology
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#18
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-Model for End-Stage Liver Disease MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The 5-year graft and patient survival in the high-MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28078736/investigation-of-underlying-comorbidities-as-risk-factors-for-symptomatic-human-hepatitis-e-virus-infection
#19
S Zhang, C Chen, J Peng, X Li, D Zhang, J Yan, Y Zhang, C Lu, J Xun, W Li, Y Ling, Y Huang, L Chen
BACKGROUND: Symptomatic Hepatitis E virus (HEV) infection occurs in few infected subjects, and the risk factors are not completely known. AIM: To explore the risk factors for adverse clinical outcomes in acute HEV infections. METHODS: A large retrospective study was conducted. The baseline characteristics, clinical outcomes, and laboratory data of 512 acute HEV infection cases were analysed using logistic regression models. RESULTS: All patients exhibited autochthonous sporadic HEV infections, and most were elderly...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28058019/clinical-features-of-acute-hepatitis-e-super-infections-on-chronic-hepatitis-b
#20
Chong Chen, Shu-Ye Zhang, Dan-Dan Zhang, Xin-Yan Li, Yu-Ling Zhang, Wei-Xia Li, Jing-Jing Yan, Min Wang, Jing-Na Xun, Chuan Lu, Yun Ling, Yu-Xian Huang, Liang Chen
AIM: To examine the clinical features and risk factors for adverse outcomes in chronic hepatitis B (CHB) superimposed with hepatitis E virus (HEV). METHODS: This retrospective cohort study included 228 patients with acute HEV infection (showing clinical acute hepatitis symptomology and positivity for anti-HEV immunoglobulin M) with underlying CHB (confirmed by positivity for hepatitis B surface antigen and/or hepatitis B virus (HBV) DNA over 6 mo) who had been admitted to the Shanghai Public Health Clinical Center, which represents the regional tertiary hospital for infectious diseases in Shanghai city, China...
December 21, 2016: World Journal of Gastroenterology: WJG
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