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https://www.readbyqxmd.com/read/28544398/prediction-of-long-term-clinical-outcome-in-a-diverse-chronic-hepatitis-b-population-role-of-the-page-b-score
#1
Willem P Brouwer, Adriaan J van der Meer, Andre Boonstra, Elisabeth P C Plompen, Suzan D Pas, Robert J de Knegt, Rob A de Man, Fiebo J W Ten Kate, Harry L A Janssen, Bettina E Hansen
BACKGROUND & AIMS: An abundance of non-invasive scores have been associated with fibrosis and hepatocellular carcinoma (HCC) development. We aimed to compare the prognostic ability of these scores in relation to liver histology in chronic hepatitis B (CHB) patients. METHODS: Liver biopsies from treatment-naïve CHB patients at one tertiary care centre were scored by a single hepato-pathologist. Laboratory values at liver biopsy were used to calculate the PAGE-B, REACH-B, GAG-HCC, CU-HCC, and FIB-4 scores...
May 24, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28543549/review-article-recent-insights-into-clinical-decision-making-in-severe-alcoholic-hepatitis
#2
REVIEW
P D J Dunne, E H Forrest
BACKGROUND: Alcoholic hepatitis is a severe acute manifestation of alcoholic liver disease with a high mortality. Management of patients with this condition has been a matter of controversy for many years; however, recent clinical studies have sought to improve the clinical approach to these patients. AIM: To use these recent studies in order to guide clinical management. METHODS: A MeSH search of Medline was performed to specifically identify recent studies which influenced clinical diagnosis, assessment and management of alcoholic hepatitis...
May 21, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28542299/preoperative-cardiac-troponin-level-is-associated-with-all-cause-mortality-of-liver-transplantation-recipients
#3
Jungchan Park, Seung Hwa Lee, Sangbin Han, Hyun Sook Jee, Suk-Koo Lee, Gyu-Seong Choi, Gaab Soo Kim
This study was aimed to evaluate the association between preoperative high-sensitivity cardiac troponin I (hs-cTnI) level and mortality in patients undergoing liver transplantation (LT). From January 2011 to May 2016, preoperative hs-cTnI level was measured in consecutive 487 patients scheduled for LT. Patients with elevated preoperative hs-cTnI were compared with those who had normal level. The primary outcome was all-cause death in follow-up period of 30 days to 1 year after operation. Of the 487 patients, 58 (11...
2017: PloS One
https://www.readbyqxmd.com/read/28542110/pneumonia-after-liver-transplantation
#4
Stephanie A K Angarita, Tara A Russell, Fady M Kaldas
PURPOSE OF REVIEW: Pneumonia occurs in 8-23% of patients after liver transplantation and contributes considerably to their morbidity and mortality. With the increasing acuity of liver transplantation patients in the current era, pneumonias, particularly ventilator-associated pneumonias, and multidrug-resistant pathogens, are of growing concern. RECENT FINDINGS: Postliver transplantation pneumonia cause varies with the timing of infection. In the early period (<1 month postliver transplantation), nosocomial pneumonias, including ventilator-associated pneumonias and multidrug-resistant species are most common...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#5
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#6
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28521870/the-use-of-statins-alone-or-in-combination-with-pioglitazone-and-other-drugs-for-the-treatment-of-non-alcoholic-fatty-liver-disease-non-alcoholic-steatohepatitis-and-related-cardiovascular-risk-an-expert-panel-statement
#7
REVIEW
Vasilios G Athyros, Theodore K Alexandrides, Helen Bilianou, Evangelos Cholongitas, Michael Doumas, Emmanuel S Ganotakis, John Goudevenos, Moses S Elisaf, Georgios Germanidis, Olga Giouleme, Asterios Karagiannis, Charalambos Karvounis, Niki Katsiki, Vasilios Kotsis, Jannis Kountouras, Evangelos Liberopoulos, Christos Pitsavos, Stergios Polyzos, Loukianos S Rallidis, Dimitrios Richter, Apostolos G Tsapas, Alexandros D Tselepis, Konstantinos Tsioufis, Konstantinos Tziomalos, Themistoklis Tzotzas, Themistoklis G Vasiliadis, Charalambos Vlachopoulos, Dimitri P Mikhailidis, Christos Mantzoros
Non-alcoholic fatty liver disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. It is closely related to the epidemic of obesity, metabolic syndrome or type 2 diabetes mellitus (T2DM). NAFLD can cause liver inflammation and progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis or hepatocellular cancer (HCC). Nevertheless, cardiovascular disease (CVD) is the most common cause of death in NAFLD/NASH patients...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28517024/treatment-of-severe-alcoholic-hepatitis-past-present-and-future
#8
REVIEW
Nicolas Lanthier, Peter Stärkel
Alcoholic hepatitis manifests as a clinical syndrome characterized by recent jaundice and liver function deterioration in an actively drinking patient. The principal cause of alcoholic hepatitis is alcoholic steatohepatitis defined histologically by the coexistence of steatosis, hepatocyte ballooning and satellitosis. While non-severe alcoholic hepatitis usually responds to alcohol abstinence, severe alcoholic hepatitis, identified by Maddrey scoring ≥ 32, has a bad prognosis and is traditionally treated by a 28-day course of prednisone therapy...
May 18, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28515853/qt-prolongation-is-associated-with-increased-mortality-in-end-stage-liver-disease
#9
Sun Moon Kim, Bennet George, Diego Alcivar-Franco, Charles L Campbell, Richard Charnigo, Brian Delisle, Jonathan Hundley, Yousef Darrat, Gustavo Morales, Samy-Claude Elayi, Alison L Bailey
AIM: To determine the prevalence of QT prolongation in a large series of end stage liver disease (ESLD) patients and its association to clinical variables and mortality. METHODS: The QT interval was measured and corrected for heart rate for each patient, with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females. Multiple clinical variables were evaluated including sex, age, serum sodium, international normalized ratio, creatinine, total bilirubin, beta-blocker use, Model for End-Stage Liver Disease (MELD), MELD-Na, and etiology of liver disease...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28515845/diagnosis-of-morbid-obesity-may-not-impact-healthcare-utilization-for-orthotopic-liver-transplantation-a-propensity-matched-study
#10
Joshua R Peck, Nicholas Latchana, Anthony Michaels, Adam J Hanje, Alice Hinton, Elmahdi A Elkhammas, Sylvester M Black, Khalid Mumtaz
AIM: To study mortality, length of stay, and total charges in morbidly obese adults during index hospitalization for orthotopic liver transplantation. METHODS: The Nationwide Inpatient Sample was queried to obtain demographics, healthcare utilization, post orthotopic liver transplantation (OLT) complications, and short term outcomes of OLT performed from 2003 to 2011 (n = 46509). We divided patients into those with [body mass index (BMI) ≥ 40] and without (BMI < 40) morbid obesity...
April 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28515843/emerging-concepts-in-alcoholic-hepatitis
#11
REVIEW
Phoenix Fung, Nikolaos Pyrsopoulos
Severe alcoholic hepatitis is implicated as a costly, worldwide public health issue with high morbidity and mortality. The one-month survival for severe alcoholic hepatitis is low with mortality rates high as 30%-50%. Abstinence from alcohol is the recommended first-line treatment. Although corticosteroids remain as the current evidence based option for selected patients with discriminant function > 32, improvement of short-term survival rate may be the only benefit. Identification of individuals with risk factors for the development of severe alcoholic hepatitis may provide insight to the diverse clinical spectrum and prognosis of the disease...
April 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28512923/the-braden-scale-a-standard-tool-for-assessing-pressure-ulcer-risk-predicts-early-outcomes-after-liver-transplantation
#12
Vinay Sundaram, Jane Lim, Danielle M Tholey, Sentia Iriana, Irene Kim, Vignan Manne, Nicholas N Nissen, Andrew S Klein, Tram T Tran, Walid S Ayoub, Barry Schlansky
The Braden Scale is a standardized tool to assess pressure ulcer risk, that is reported for all hospitalized patients in the United States (US) per requirements of the Center for Medicare and Medicaid Services. Previous data has shown the Braden Scale can predict both frailty and mortality risk in patients with decompensated cirrhosis. Our aim was to evaluate the association of Braden Scale score with short-term outcomes after liver transplantation (LT). We performed a retrospective cohort study of deceased-donor LT recipients at two centers, and categorized them according to the Braden Scale at hospital admission as low (>18), moderate (16-18), or high risk (<16) for pressure ulcer...
May 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#13
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28512394/successful-endoscopic-management-of-late-biliary-cast-syndrome-in-a-liver-transplant-recipient-a-case-report
#14
Manuel Alejandro Mahler, Federico Marcaccio, Jean-Marc Dumonceau, Carlos Macías Gómez
Biliary cast syndrome (BCS) is an unusual complication of liver transplantation (LT). The pathophysiology is not known, and it is thought to develop because of mucosal damage in the bile duct related to obstruction, ischemia, or bacterial infection. It occurs in 2.5-18% of LT patients and is associated with increased graft failure, need for retransplantation, and mortality. Here we report on a case of BCS of late appearance after LT who was successfully treated by endoscopic means.
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28510341/living-donor-liver-transplantation-for-patients-older-than-age-70-years-a-single-center-experience
#15
J H Kwon, Y I Yoon, G W Song, K H Kim, D B Moon, D H Jung, G C Park, E Y Tak, V A Kirchner, S G Lee
Over the past two decades, the age of liver transplantation (LT) recipients has been increasing. We reviewed our experience with LT for patients aged 70 years or older (range: 70-78) and investigated the feasibility of performing LT, especially living donor LT (LDLT), for older patients. We retrospectively reviewed the medical records of 25 patients (15 LDLT recipients, 10 DDLT recipients), aged 70 years or older who underwent LT from January 2000 to April 2016. Their perioperative morbidity rate was 28.0% and the in-hospital mortality rate was 16...
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28509578/the-burden-of-hepatorenal-syndrome-among-commercially-insured-and-medicare-patients-in-the-united-states
#16
J Bradford Rice, Alan G White, Philip Galebach, Kevin M Korenblat, Aneesha Wagh, Belinda Lovelace, George J Wan, Khurram Jamil
BACKGROUND: This study evaluated the characteristics healthcare resource utilization (HCRU), and costs, from the payer perspective, of hepatorenal syndrome (HRS) patients covered by commercial and Medicare insurance. Mortality was assessed as a secondary outcome. METHODS: Patients were identified from claims databases of commercially-insured (OptumHealth Care Solutions, Inc.) in 1998-2014 and Medicare beneficiaries in 2009-2013 (5% Standard Analytic Files). At the time of their first inpatient admission ("index date") with an HRS diagnosis (ICD-9 code 572...
May 16, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28509350/high-sodium-continuous-veno-venous-hemodialysis-with-regional-citrate-anticoagulation-and-online-dialysate-generation-in-patients-with-acute-liver-failure-and-cerebral-edema
#17
Tamim Hamdi, Lenar Yessayan, Jerry Yee, Balazs Szamosfalvi
INTRODUCTION: Acute liver failure is associated with a high mortality rate. Induction of plasma hypertonicity with mannitol or hypertonic saline remains the cornerstone in the management of resultant cerebral edema. Significant disadvantages of this approach include poor or unpredictable control of serum sodium concentration and volume expansion, among others. METHODS: We used high sodium continuous veno-venous hemodialysis with regional citrate anticoagulation and online dialysate generation to accurately control the serum sodium in eleven patients with acute liver failure, renal failure, and cerebral edema...
May 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28506447/effects-of-continuous-use-of-probiotics-before-liver-transplantation-a-randomized-double-blind-placebo-controlled-trial
#18
Michał Grąt, Karolina M Wronka, Zbigniew Lewandowski, Karolina Grąt, Maciej Krasnodębski, Jan Stypułkowski, Wacław Hołówko, Łukasz Masior, Irena Kosińska, Michał Wasilewicz, Joanna Raszeja-Wyszomirska, Sławomir Rejowski, Emil Bik, Waldemar Patkowski, Marek Krawczyk
BACKGROUND & AIMS: Although there is increasing evidence for the benefits of probiotics in patients with liver diseases, data on the benefits of pre-LT administration of probiotics are lacking. The aim of this study was to evaluate the effects of continuous administration of probiotics before liver transplantation (LT) on pre- and post-transplant patient outcomes. METHODS: In this randomized, double-blind, and placebo-controlled trial adult cirrhotic patients listed for LT received a 4-strain probiotic preparation or placebo daily from enrollment until LT...
May 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28503555/surgical-options-for-intrahepatic-cholangiocarcinoma
#19
REVIEW
Kui Wang, Han Zhang, Yong Xia, Jian Liu, Feng Shen
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer, accounting for 10-15% of primary hepatic malignancy. The incidence and cancer-related mortality of ICC continue to increase worldwide. At present, hepatectomy is still the most effective treatment for ICC patients to achieve long-term survival, although its overall efficacy may not be as good as that for patients with hepatocellular carcinoma (HCC) due to the unique pathogenesis and clinical-pathological profiles of ICC. Viral infection, lithiasis and metabolic factors may all be associated with the pathogenesis of ICC...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28502331/risk-factors-and-outcomes-of-acute-kidney-injury-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#20
Wei Yuan, Yu-Yi Zhang, Zheng-Guo Zhang, Ying Zou, Hong-Zhou Lu, Zhi-Ping Qian
BACKGROUND: Acute kidney injury (AKI) is common in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF); however, few studies concerning the risk factors and recovery patterns of renal function have been published. MATERIALS AND METHODS: A retrospective analysis of 150 patients with HBV-ACLF was performed. The occurrence, risk factors and functional recovery of AKI among patients with HBV-ACLF were investigated. RESULTS: A total of 90 patients (60%) with HBV-ACLF developed AKI...
May 2017: American Journal of the Medical Sciences
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