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https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#1
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with Glasgow-Blatchford score >7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28632135/evaluation-of-the-branched-chain-amino-acid-to-tyrosine-ratio-prior-to-treatment-as-a-prognostic-predictor-in-patients-with-liver-cirrhosis
#2
Toru Ishikawa, Michitaka Imai, Masayoshi Ko, Hiroki Sato, Yujiro Nozawa, Tomoe Sano, Akito Iwanaga, Keiichi Seki, Terasu Honma, Toshiaki Yoshida
This study evaluated whether the branched-chain amino acid-to-tyrosine ratio (BTR) is a prognostic predictive factor in patients with liver cirrhosis by determining the relationship of the BTR with event-free survival in a retrospective, observational cohort study. The medical records of patients with liver cirrhosis who visited our institution from February 2000 to May 2012 were examined. Events due to liver cirrhosis were defined as death, worsening of esophageal and/or gastric varices, hepatocellular carcinoma, and liver failure...
June 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28630805/dermatitis-herpetiformis-as-the-initial-presentation-of-primary-biliary-cholangitis-in-a-male-with-gluten-sensitivity
#3
Cyriac Philips, Rajaguru Paramaguru, Divya A Indiran, Philip Augustine
Celiac disease is commonly associated with elevated liver enzymes that normalize on a gluten-free diet. Celiac disease is rarely described in patients with primary biliary cholangitis. Dermatitis herpetiformis is the skin manifestation of the celiac disease that is very rarely associated with primary biliary cirrhosis. We present the case of a 62-year-old man who presented with severe chronic pruritus, in whom a diagnosis of primary biliary cholangitis was made initially. However, in the presence of atypical skin lesions, not confirming to chronic cholestasis, an in-depth evaluation including histopathological examination led to the diagnosis of dermatitis herpetiformis associated with gluten sensitivity...
May 14, 2017: Curēus
https://www.readbyqxmd.com/read/28628033/nonalcoholic-fatty-liver-disease-with-cirrhosis-increases-familial-risk-for-advanced-fibrosis
#4
Cyrielle Caussy, Meera Soni, Jeffrey Cui, Ricki Bettencourt, Nicholas Schork, Chi-Hua Chen, Mahdi Al Ikhwan, Shirin Bassirian, Sandra Cepin, Monica P Gonzalez, Michel Mendler, Yuko Kono, Irine Vodkin, Kristin Mekeel, Jeffrey Haldorson, Alan Hemming, Barbara Andrews, Joanie Salotti, Lisa Richards, David A Brenner, Claude B Sirlin, Rohit Loomba
BACKGROUND: The risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease and cirrhosis (NAFLD-cirrhosis) is unknown and needs to be systematically quantified. We aimed to prospectively assess the risk of advanced fibrosis in first-degree relatives of probands with NAFLD-cirrhosis. METHODS: This is a cross-sectional analysis of a prospective cohort of 26 probands with NAFLD-cirrhosis and 39 first-degree relatives. The control population included 69 community-dwelling twin, sib-sib, or parent-offspring pairs (n = 138), comprising 69 individuals randomly ascertained to be without evidence of NAFLD and 69 of their first-degree relatives...
June 19, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28626882/quantitative-proteome-analysis-of-plasma-microparticles-for-the-characterization-of-hcv-induced-hepatic-cirrhosis-and-hepatocellular-carcinoma
#5
Raghda Saad Zaghloul Taleb, Pacint Moez, Doreen Younan, Martin Eisenacher, Matthias Tenbusch, Barbara Sitek, Thilo Bracht
Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumor and a leading cause of cancer-related deaths worldwide. Cirrhosis induced by hepatitis-C virus (HCV) infection is the most critical risk factor for HCC. However, the mechanism of HCV-induced carcinogenesis is not fully understood. Plasma microparticles (PMP) contribute to numerous physiological and pathological processes and contain proteins whose composition correlates to the respective pathophysiological conditions. Given this fact, we analyzed PMP from 22 HCV-induced cirrhosis patients, 16 HCV-positive HCC patients with underlying cirrhosis and 18 healthy controls...
June 19, 2017: Proteomics. Clinical Applications
https://www.readbyqxmd.com/read/28624334/seasonality-and-autoimmune-diseases-the-contribution-of-the-four-seasons-to-the-mosaic-of-autoimmunity
#6
REVIEW
Abdulla Watad, Shir Azrielant, Nicola Luigi Bragazzi, Kassem Sharif, Paula David, Itay Katz, Gali Aljadeff, Mariana Quaresma, Galya Tanay, Mohammad Adawi, Howard Amital, Yehuda Shoenfeld
Autoimmune diseases (ADs) are a heterogeneous groups of diseases that occur as a results of loss of tolerance to self antigens. While the etiopathogeneis remain obscure, different environmental factors were suggested to have a role in the development of autoimmunity, including infections, low vitamin D levels, UV radiation, and melatonin. Interestingly, such factors possess seasonal variation patterns that could influence disease development, severity and progression. Vitamin D levels which reach a nadir during late winter and early spring is correlated with increased disease activity, clinical severity as well as relapse rates in several disease entities including multiple sclerosis (MS), non-cutaneous flares of systemic lupus erythematosus (SLE), psoriasis, and rheumatoid arthritis (RA)...
June 14, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28624134/efficacy-of-response-guided-directly-observed-pegylated-interferon-and-self-administered-ribavirin-for-people-who-inject-drugs-with-hepatitis-c-virus-genotype-2-3-infection-the-activate-study
#7
Jason Grebely, Olav Dalgard, Evan B Cunningham, Behzad Hajarizadeh, Graham R Foster, Philip Bruggmann, Brian Conway, Markus Backmund, Geert Robaeys, Tracy Swan, Janaki Amin, Philippa S Marks, Sophie Quiene, Tanya L Applegate, Martin Weltman, David Shaw, Adrian Dunlop, Margaret Hellard, Julie Bruneau, Håvard Midgard, Stefan Bourgeois, Cornelia Staehelin, Gregory J Dore
BACKGROUND: There are few data on treatment for hepatitis C virus (HCV) infection among people with ongoing injecting drug use. This study evaluated the efficacy of response-guided therapy for chronic HCV genotypes 2/3 infection among people with ongoing injecting drug use or receiving opioid substitution therapy (OST). A secondary aim was to identify predictors of HCV treatment response. METHODS: ACTIVATE was a multicentre clinical trial recruited between 2012 and 2014...
June 14, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28614231/incidence-prevalence-and-natural-history-of-primary-sclerosing-cholangitis-in-the-united-kingdom
#8
Huifang Liang, Sudhakar Manne, Jesse Shick, Trevor Lissoos, Paul Dolin
Primary sclerosing cholangitis (PSC) is a rare obliterative fibrotic condition of the bile ducts. We assessed PSC epidemiology and natural history within the UK Clinical Practice Research Datalink (CPRD).Incidence and natural history of PSC were evaluated in a retrospective cohort study using linkage of CPRD, Hospital Episode Statistics, and Office for National Statistics data. Data from age, sex, and general practice-matched population controls provided a context for the incident PSC patients. Liver disease other than PSC was defined as autoimmune hepatitis, hepatitis, hepatomegaly, liver failure, cirrhosis, portal hypertension, cholangiocarcinoma, or hepatobiliary cancer...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614198/the-almost-normal-liver-biopsy-presentation-clinical-associations-and-outcome
#9
Thomas W Czeczok, John S Van Arnam, Laura D Wood, Michael S Torbenson, Taofic Mounajjed
Liver biopsies obtained for abnormal liver enzymes or unexplained ascites occasionally appear histologically almost normal. The differential diagnosis for these cases is challenging because literature addressing this topic is lacking. We aimed to establish a differential diagnosis and determine clinical associations and outcomes for almost-normal liver biopsies. Ninety-seven histologically almost-normal liver biopsies were collected from 2 institutions. All cases lacked significant inflammation, fatty change, biliary tract disease, vascular disease, nodular regenerative hyperplasia, iron overload, inherited metabolic or storage disorder, viral hepatitis, or fibrosis...
June 13, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28610476/budd-chiari-syndrome-with-upper-gastrointestinal-hemorrhage-characteristic-and-long-term-outcomes-of-endovascular-treatment
#10
Peng-Li Zhou, Gang Wu, Xin-Wei Han, Lei Yan, Wen-Guang Zhang
Purpose To identify the characteristics and evaluate the long-term outcomes of endovascular treatment of Budd-Chiari syndrome with upper gastrointestinal hemorrhage. Methods Forty-seven consecutive Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage were referred for the treatment with percutaneous transluminal balloon angioplasty, and subsequently underwent follow-up. Data were retrospectively collected and follow-up observations were performed at 1, 2, 2-5, and 5-8 years postoperatively. Results Cirrhosis was presented in 16 patients, and splenoportography reviewed obvious varices in 18 patients...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28608619/efficacy-and-safety-of-daclatasvir-based-antiviral-therapy-in-hcv-recurrence-after-liver-transplantation-role-of-cirrhosis-and-genotype-3-a-multi-centre-cohort-study
#11
Magdalena Salcedo, Martín Prieto, Lluís Castells, Juan Manuel Pascasio, Jose Luis Montero Alvarez, Inmaculada Fernández, Gloria Sánchez-Antolín, Luisa González-Diéguez, Miguel García-Gonzalez, Alejandra Otero, Sara Lorente, Maria Dolores Espinosa, Milagros Testillano, Antonio González, Jose Castellote, Fernando Casafont, Maria-Carlota Londoño, Jose Antonio Pons, Esther Molina Pérez, Valentín Cuervas-Mons, Sonia Pascual, Jose Ignacio Herrero, Isidoro Narváez, Carmen Vinaixa, Jordi Llaneras, Jose Manuel Sousa, Rafael Bañares
BACKGROUND & AIMS: Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. METHODS: A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28602220/inhibition-of-microrna-24-increases-liver-fibrosis-by-enhanced-menin-expression-in-mdr2-mice
#12
Chad Hall, Laurent Ehrlich, Fanyin Meng, Pietro Invernizzi, Francesca Bernuzzi, Terry C Lairmore, Gianfranco Alpini, Shannon Glaser
BACKGROUND: Liver transplantation remains the primary treatment for primary sclerosing cholangitis (PSC). Mdr2(-/-) mice provide a reliable in vivo model of PSC and develop characteristic biliary inflammation and fibrosis. We tested the hypothesis that the tumor suppressor protein menin is implicated in the progression of liver fibrosis and that menin expression can be regulated in the liver via microRNA-24 (miR-24). MATERIALS AND METHODS: Menin expression was measured in human PSC and Mdr2(-/-) mice...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28599618/hiv-coinfected-patients-respond-worse-to-direct-acting-antiviral-based-therapy-against-chronic-hepatitis-c-in-real-life-than-hcv-monoinfected-individuals-a-prospective-cohort-study
#13
Karin Neukam, Luis E Morano-Amado, Antonio Rivero-Juárez, María Mancebo, Rafael Granados, Francisco Téllez, Antonio Collado, María J Ríos, Ignacio de Los Santos-Gil, Sergio Reus-Bañuls, Francisco Vera-Méndez, Paloma Geijo-Martínez, Marta Montero-Alonso, Marta Suárez-Santamaría, Juan A Pineda
OBJECTIVE: HIV/HCV-coinfected patients and hepatitis C virus (HCV) monoinfected subjects are thought to respond equally to direct-acting antiviral (DAA)-based therapy despite the lack of data derived from clinical trials. This study is aimed to evaluate the impact of HIV coinfection on the response to DAA-based treatment against HCV infection in the clinical practice. PATIENTS AND METHODS: In a prospective multicohort study, patients who initiated DAA-based therapy at the Infectious Disease Units of 33 hospitals throughout Spain were included...
May 2017: HIV Clinical Trials
https://www.readbyqxmd.com/read/28586894/association-between-cirrhosis-and-stroke-in-a-nationally-representative-cohort
#14
Neal S Parikh, Babak B Navi, Yecheskel Schneider, Arun Jesudian, Hooman Kamel
Importance: Cirrhosis is associated with hemorrhagic and thrombotic extrahepatic complications. The risk of cerebrovascular complications is less well understood. Objective: To investigate the association between cirrhosis and various stroke types. Design, Setting, and Participants: We performed a retrospective cohort study using inpatient and outpatient Medicare claims data from January 1, 2008, through December 31, 2014, for a random 5% sample of 1 618 059 Medicare beneficiaries older than 66 years...
June 5, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28586195/ex-vivo-cell-based-screening-platform-for-modulators-of-hepatosteatosis
#15
Shan Yu, Emily Chen, Lance Sherwood, Mitchell Hull, Ashley K Woods, Matthew S Tremblay
Nonalcoholic fatty liver disease (NAFLD) is the result of the ectopic accumulation of lipids in hepatic cells and is the early stage of liver diseases including fibrosis, cirrhosis, and hepatocellular carcinoma. While some mechanisms of aberrant lipid storage are understood, unbiased phenotypic drug screening holds the potential to identify new therapeutic small molecule mechanisms that reverse lipid accumulation in hepatic cells and prevent disease progression. Immortalized hepatocyte cell lines are often used as in vitro models of hepatocyte function, including in the study of lipid accumulation...
June 16, 2017: ACS Chemical Biology
https://www.readbyqxmd.com/read/28586116/fecal-microbiota-transplant-from-a-rational-stool-donor-improves-hepatic-encephalopathy-a-randomized-clinical-trial
#16
Jasmohan S Bajaj, Zain Kassam, Andrew Fagan, Edith A Gavis, Eric Liu, I Jane Cox, Raffi Kheradman, Douglas Heuman, Jessica Wang, Thomas Gurry, Roger Williams, Masoumeh Sikaroodi, Michael Fuchs, Eric Alm, Binu John, Leroy R Thacker, Antonio Riva, Mark Smith, Simon D Taylor-Robinson, Patrick M Gillevet
Recurrent hepatic encephalopathy (HE) is a leading cause of readmission despite standard of care (SOC) associated with microbial dysbiosis. Fecal microbiota transplantation (FMT) may improve dysbiosis; however, it has not been studied in HE. We aimed to define whether FMT using a rationally-derived stool donor is safe in recurrent HE compared to SOC alone. An open-label, randomized clinical trial with a 5 month follow-up in outpatient cirrhotic men with recurrent HE on SOC was conducted with 1:1 randomization...
June 6, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28582320/hepatitis-e-viral-infection-in-solid-organ-transplant-patients
#17
Stanley Y Fang, Hyosun Han
PURPOSE OF REVIEW: The purpose of this chapter is to review the literature published in the past 10 years with focus to the best literatures published since 2015 regarding chronic hepatitis E virus (HEV) infection in patients who received solid organ transplantation. RECENT FINDINGS: Diagnosis of this disease relies primarily on identification of HEV RNA in serum and more recently in stool as way of predicting relapse and guide therapy duration. Current management focuses primarily on primary prevention and supportive care, because additional research is needed to identify efficacious pharmacologic therapy, though use of ribavirin has shown promise in case series in treatment of some genotypes...
June 2, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28581406/long-term-survival-analysis-of-stereotactic-ablative-radiotherapy-versus-liver-resection-for-small-hepatocellular-carcinoma
#18
Ting-Shi Su, Ping Liang, Jian Liang, Huan-Zhen Lu, Hua-Yan Jiang, Tao Cheng, Yong Huang, Yang Tang, Xin Deng
PURPOSE: To compare the efficacy of stereotactic ablative radiation therapy (SABR) versus liver resection for small hepatocellular carcinoma (HCC) ≤5 cm with Child-Pugh A cirrhosis. METHODS AND MATERIALS: This retrospective study included 117 patients with small HCCs with 1 or 2 nodules. Eighty-two patients received SABR (SABR group), and 35 patients underwent liver resection (resection group). Overall survival (OS) and progression-free survival (PFS) were analyzed...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28580726/the-first-case-of-domino-split-liver-transplantation-in-maple-syrup-urine-disease
#19
Uta Herden, Jun Li, Lutz Fischer, Florian Brinkert, Martin Blohm, René Santer, Bjoern Nashan, Enke Grabhorn
The enzymatic defect in MSUD results in accumulation of neurotoxic metabolites of BCAAs. LTX has shown to be a feasible strategy in patients non-responsive to diet. Because of sufficient enzyme activity in extrahepatic tissues in healthy people, the MSUD liver graft is a suitable domino organ. We present the first case of a technical challenging ex situ split of a MSUD domino organ transplanted into two pediatric recipients. The domino graft donor was a 21-year-old female (58 kg) suffering from MSUD with recurrent metabolic decompensation despite strict diet...
June 5, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28579679/yttrium-90-radioembolization-for-metastatic-colorectal-cancer-outcomes-by-number-of-lines-of-therapy
#20
REVIEW
Andrew Marsala, Edward W Lee, Siddharth A Padia
Metastatic colorectal cancer represents the most common liver malignancy, and imparts a very poor prognosis for those who develop this disease. Unlike primary liver tumors such as hepatocellular carcinoma, which largely develops in patients with underlying cirrhosis, most metastatic liver tumor patients have normal underlying liver function. Owing to this, most will succumb to tumoral replacement of the liver rather than from underlying liver dysfunction. Radioembolization represents a treatment modality that can be used in multiple fashions to treat one or both lobes of the liver...
June 2017: Seminars in Interventional Radiology
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