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https://www.readbyqxmd.com/read/28340509/liver-transplant-lt-recipients-with-nonalcoholic-steatohepatitis-nash-have-lower-risk-hepatocellular-carcinoma-hcc
#1
Sara M Lewin, Neil Mehta, R Kate Kelley, John P Roberts, Francis Y Yao, Danielle Brandman
BACKGROUND: Liver transplantation is a well-established treatment for HCC in carefully selected patients. Risk factors for tumors with poor prognostic features on explant have not been well described in a national cohort. METHODS: We performed a retrospective cohort study of adult LT recipients with HCC transplanted from 4/8/12 (when explant pathology in UNOS became available) until 9/30/2014. We evaluated the association between listing diagnosis and other demographic factors with tumor features on explant using logistic regression...
March 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28333129/protection-against-oxidative-stress-mediated-by-the-nrf2-keap1-axis-is-impaired-in-primary-biliary-cholangitis
#2
Urszula Wasik, Małgorzata Milkiewicz, Agnieszka Kempinska-Podhorodecka, Piotr Milkiewicz
In response to oxidative stress, nuclear factor (erythroid-derived 2)-like2 (Nrf2) induces expression of cytoprotective genes. The Nrf2 pathway is controlled by microRNAs and Kelch-like ECH-associated protein1 (Keap1). Nrf2 is stabilized when Keap1 is degraded through the autophagy pathway in a p62-dependent manner. The inhibition of autophagy causes protein accumulation, and Keap1 is inactivated by binding to p62. We investigated the role of the Nrf2/Keap1 axis in the amelioration of oxidative stress in primary biliary cholangitis (PBC)...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28331804/infected-ascites-distinguishing-secondary-peritonitis-from-spontaneous-bacterial-peritonitis-in-a-cirrhotic-patient-with-classic-symptoms
#3
Marvin Louis Roy Lu, Akanksha Agarwal, Josh Sloan, Aaron Kosmin
INTRODUCTION: Spontaneous bacterial peritonitis can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection. However, oftentimes this is unapparent and other clinical clues need to be sought after to make the right diagnosis. CASE: A 64-year-old woman was admitted because of three days of worsening diffuse abdominal pain and distention. She was morbidly obese and had a history of non-alcoholic steatohepatitis (NASH) cirrhosis...
2017: IDCases
https://www.readbyqxmd.com/read/28331419/falsely-elevated-serum-vitamin-b12-levels-were-associated-with-the-severity-and-prognosis-of-chronic-viral-liver-disease
#4
Takaaki Sugihara, Masahiko Koda, Toshiaki Okamoto, Kenichi Miyoshi, Tomomitsu Matono, Kenji Oyama, Keiko Hosho, Jun-Ichi Okano, Hajime Isomoto, Yoshikazu Murawaki
BACKGROUND: Vitamin B12 is stored primarily in the liver, and highly elevated serum vitamin B12 levels occur in acute hepatitis and severe alcoholic liver disease. We evaluated the relationship between vitamin B12 levels and liver disease severity and long term prognosis in patients with chronic viral hepatitis and cirrhosis. METHODS: We enrolled 90 patients (57 men, 33 women) with chronic viral hepatitis and cirrhosis who admitted to our hospital as a prospective cohort study...
March 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28326651/current-activities-and-future-directions-of-comprehensive-hepatitis-control-measures-in-japan-a-supportive-role-of-hepatitis-information-center-in-building-a-solid-foundation
#5
Noriko Oza, Hiroshi Isoda, Toshiki Ono, Tatsuya Kanto
In Japan, hepatitis B or C virus infection has been a major health issue. For the prevention of liver-related deaths, multifaceted strategies have been taken against hepatitis virus. In Fiscal Year (FY) 2002, nationwide screening for hepatitis was started as a part of health examinations provided by municipal governments. From FY2007, the hepatitis treatment network has been strengthened by the nationwide establishment of regional government-based hepatitis treatment systems, comprising linked regional core centers, specialized institutions for hepatitis treatment, primary care physicians and regional governments...
March 21, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28319169/high-meld-score-and-extended-operating-time-predict-prolonged-initial-icu-stay-after-liver-transplantation-and-influence-the-outcome
#6
Panagiota Stratigopoulou, Andreas Paul, Dieter P Hoyer, Stylianos Kykalos, Fuat H Saner, Georgios C Sotiropoulos
BACKGROUND: The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS: We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS: Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay...
2017: PloS One
https://www.readbyqxmd.com/read/28318861/medical-comorbidities-impact-the-episode-of-care-reimbursements-of-total-hip-arthroplasty
#7
Samuel Rosas, Karim G Sabeh, Leonard T Buller, Tsun Yee Law, Martin W Roche, Victor H Hernandez
BACKGROUND: Total hip arthroplasty (THA) costs are a source of great interest in the currently evolving health care market. The initiation of a bundled payment system has led to further research into costs drivers of this commonly performed procedure. One aspect that has not been well studied is the effect of comorbidities on the reimbursements of THA. The purpose of this study was to determine if common medical comorbidities affect these reimbursements. METHODS: A retrospective, level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary THA between 2007 and 2015...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318147/effects-of-alfapump-system-on-kidney-and-circulatory-function-in-patients-with-cirrhosis-and-refractory-ascites
#8
Elsa Solà, Santiago Sanchez-Cabús, Ezequiel Rodriguez, Chiara Elia, Raquel Cela, Rebeca Moreira, Elisa Pose, Jordi Sánchez-Delgado, Nuria Cañete, Manuel Morales-Ruiz, Francisco Campos, Jaume Balust, Mónica Guevara, Juan Carlos García-Valdecasas, Pere Ginès
The alfapump system has been proposed as a new treatment for the management of refractory ascites. The system removes ascites from the peritoneal cavity to urinary bladder, producing a continuous low-volume paracentesis. AIM: To investigate the effects of treatment with the alfapump system on kidney and circulatory function in patients with cirrhosis and refractory ascites. METHODS: Prospective study including 10 patients with cirrhosis and refractory ascites. Primary outcomes were changes in glomerular filtration rate (GFR), as assessed by isotopic techniques, and changes in circulatory function assessed by arterial pressure, cardiac output and activity of vasoconstrictor systems...
March 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28318046/hepatitis-c-virus-induced-ccl5-secretion-from-macrophages-activates-hepatic-stellate-cells
#9
Reina Sasaki, Pradip B Devhare, Robert Steele, Ranjit Ray, Ratna B Ray
Hepatitis C virus (HCV) mediated chronic liver disease is a serious health problem around the world, and often causes fibrosis/cirrhosis, and hepatocellular carcinoma (HCC). The mechanism of liver disease progression during HCV infection is still unclear, although inflammation is believed to be an important player in disease pathogenesis. We previously reported that macrophages including Kupffer cells exposed to HCV induce proinflammatory cytokines. These secreted cytokines may activate hepatic stellate cells (HSCs) towards fibrosis...
March 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28316312/partial-splenic-artery-embolization-to-treat-hypersplenism-secondary-to-hepatic-cirrhosis-a-meta-analysis
#10
Yun-Bing Wang, Jian-Ying Zhang, Fan Zhang, Yong Zhao, Jian-Ping Gong
This meta-analysis aimed to explore the effectiveness of partial spleen arterial embolization (PSAE) in the treatment of hypersplenism secondary to hepatic cirrhosis. PubMed, Embase, Cochrane Library, Wan Fang, CNKI, Vip, and CBM databases were searched for randomized controlled trials, cohort studies, and case-control studies that compared PSAE with splenectomy in the treatment of hypersplenism secondary to hepatic cirrhosis from their inception to July 25, 2015. Statistical analysis was conducted in Cochrane Network RevMan v5...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28299343/polymorphisms-of-il12rb2-may-affect-the-natural-history-of-primary-biliary-cholangitis-a-single-centre-study
#11
Urszula Wasik, Ewa Wunsch, Gary L Norman, Eirini I Rigopoulou, Dimitrios P Bogdanos, Piotr Milkiewicz, Małgorzata Milkiewicz
Background. Recent GWAS in primary biliary cholangitis (PBC) showed strong associations with SNPs located within interleukin-12 receptor (IL12R) beta-2 (IL12RB2) gene. Aims. We assessed whether genetic variation of IL12RB2 is associated with laboratory and clinical features of PBC. Methods. Genomic DNA was isolated from 306 patients with PBC and 258 age/gender-matched controls. PBC-specific anti-mitochondrial antibodies (AMA) were tested in all subjects by ELISA. Two SNPs, rs3790567 and rs6679356, of IL12RB2 were genotyped using the MGB-TaqMan SNP assay...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28299213/cervical-spinal-cord-compression-a-rare-presentation-of-hepatocellular-carcinoma
#12
Puvanalingam Ayyadurai, Kanthi Rekha Badipatla, Chukwunonso Chime, Shiva Arjun, Pavithra Reddy, Masooma Niazi, Suresh Kumar Nayudu
Hepatocellular carcinoma (HCC) is the most common primary malignancy of liver. Distant metastasis to various organs is well known. Skeletal metastasis is also reported to various locations. Vertebral metastasis has been reported mostly to thoracic spine. However, cervical spinal cord involvement leading to cord compression has been reported very rarely in literature. We present a case of 58-year-old male with liver cirrhosis presenting as neck pain. Further work-up revealed metastatic HCC to cervical spinal cord resulting in acute cord compression...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28295923/effect-of-viral-suppression-on-hepatic-venous-pressure-gradient-in-hepatitis-c-with-cirrhosis-and-portal-hypertension
#13
Nezam Afdhal, Gregory T Everson, Jose Luis Calleja, Geoffrey W McCaughan, Jaime Bosch, Diana M Brainard, John G McHutchison, Shampa De-Oertel, Di An, Michael Charlton, Rajender K Reddy, Tarik Asselah, Edward Gane, Michael P Curry, Xavier Forns
BACKGROUND&AIMS: Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. METHODS: Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mmHg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period...
March 10, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28293379/clinical-features-histology-and-histogenesis-of-combined-hepatocellular-cholangiocarcinoma
#14
REVIEW
Shweta Gera, Mark Ettel, Gabriel Acosta-Gonzalez, Ruliang Xu
Combined hepatocellular-cholangiocarcinoma (CHC) is a rare tumor with poor prognosis, with incidence ranging from 1.0%-4.7% of all primary hepatic tumors. This entity will be soon renamed as hepato-cholangiocarcinoma. The known risk factors for hepatocellular carcinoma (HCC) have been implicated for CHC including viral hepatitis and cirrhosis. It is difficult to diagnose this tumor pre-operatively. The predominant histologic component within the tumor largely determines the predominant radiographic features making it a difficult distinction...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28293027/genetics-of-primary-sclerosing-cholangitis-and-pathophysiological-implications
#15
REVIEW
Xiaojun Jiang, Tom H Karlsen
Primary sclerosing cholangitis (PSC) is a chronic disease leading to fibrotic scarring of the intrahepatic and extrahepatic bile ducts, causing considerable morbidity and mortality via the development of cholestatic liver cirrhosis, concurrent IBD and a high risk of bile duct cancer. Expectations have been high that genetic studies would determine key factors in PSC pathogenesis to support the development of effective medical therapies. Through the application of genome-wide association studies, a large number of disease susceptibility genes have been identified...
March 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#16
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28282359/locoregional-therapy-with-curative-intent-versus-primary-liver-transplant-for-hepatocellular-carcinoma-systematic-review-and-meta-analysis
#17
A R Murali, S Patil, K T Phillips, M Voigt
BACKGROUND: Loco-regional therapy with curative intent (CLRT) followed by salvage liver transplant (SLT) in case of HCC recurrence is an alternative to primary liver transplant (LT) in selected patients with HCC. METHODS: We performed a systematic review and meta-analysis of studies comparing the survival of patients treated with CLRT versus LT, stratified by the stage of liver disease, extent of cancer, and whether SLT was offered or not. RESULTS: We included 48 studies involving 9835 patients (5736 patients with CLRT and 4119 patients with primary LT)...
March 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28281514/-ultrasound-elastography-of-the-liver-for-assessing-the-risk-of-complications-of-its-cirrhosis-of-different-etiologies
#18
N Yu Stukova, Yu A Kucheryavyi, E A Maevskaya, I V Maev
AIM: To study the results of dynamic liver ultrasound elastography (LUE) in assessing the risk of complications of liver cirrhosis (LC) of different etiologies and to elaborate a monitoring program for estimation of the predictive value of elastography in patients with LC. SUBJECTS AND METHODS: A total of 194 patients with LC of different etiologies, including 56 patients with alcoholic cirrhosis, 48 with LC and an outcome of nonalcoholic fatty liver disease, 53 with LC and an outcome of chronic hepatitis C, 23 with LC and an outcome of chronic hepatitis B, and 14 with an outcome of coinfection with hepatitis B and D viruses, were examined...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28281295/management-of-people-with-intermediate-stage-hepatocellular-carcinoma-an-attempted-network-meta-analysis
#19
REVIEW
Davide Roccarina, Avik Majumdar, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: There is significant uncertainty in the treatment of intermediate-stage hepatocellular carcinoma which is defined by the Barcelona Clinic Liver Cancer (BCLC) as hepatocellular carcinoma stage B with large, multi-nodular, Child-Pugh status A to B, performance status 0 to 2, and without vascular occlusion or extrahepatic disease. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of intermediate-stage hepatocellular carcinoma (BCLC stage B) through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28279536/clinical-characteristics-of-hepatocellular-carcinoma-in-spain-comparison-with-the-2008-2009-period-and-analysis-of-the-causes-of-diagnosis-out-of-screening-programs-analysis-of-686-cases-in-73-centers
#20
Carlos Rodríguez de Lope, María Reig, Ana Matilla, María Teresa Ferrer, Eva Dueñas, Beatriz Mínguez, Javier F Castroagudín, Inmaculada Ortiz, Sonia Pascual, José Luis Lledó, Adolfo Gallego, Juan I Arenas, Carles Aracil, Montserrat Forne, Carolina Muñoz, Fernando Pons, Margarita Sala, Mercedes Iñarrairaegui, Marta Martin-Llahi, Victoria Andreu, Carmen Garre, Paloma Rendón, Javier Fuentes, Javier Crespo, Manuel Rodríguez, Jordi Bruix, María Varela
BACKGROUND AND OBJECTIVE: In 2010 we published that 53% of cases of hepatocellular carcinoma (HCC) detected in Spain were diagnosed outside the context of standard screening programs, which consequently leads to lower survival rates. The aim of this study was to analyze the current situation and the causes of diagnosis out of screening programs. MATERIAL AND METHODS: Prospective registry of 73 second- and third-level Spanish healthcare centers carried out between October 1, 2014 and January 31, 2015...
March 6, 2017: Medicina Clínica
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