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https://www.readbyqxmd.com/read/28738434/-perception-of-the-liver-allocation-system-by-different-stakeholders
#1
Christine Englschalk, Markus Guba
The German Transplant Law is the legal basis of the liver allocation system in Germany and is specified by the guidelines of the German Medical Association. These guidelines are based on current medical knowledge. The procedure of developing these guidelines was formalised and made transparent.This survey with 502 participants examines how four current aspects of the allocation system are perceived by different stakeholders (medical staff, patients on the liver transplant list or already transplanted, medical students and non-medical university personnel and students)...
July 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28737869/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-1-pathophysiology-diagnostic-evaluation-hospitalization-criteria-treatment-nutritional-management
#2
REVIEW
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamsch, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Álvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28726361/risk-of-spontaneous-fungal-peritonitis-sfp-in-hospitalized-cirrhotic-patients-with-ascites-a-systematic-review-of-observational-studies-and-meta-analysis
#3
Marco Fiore, Paolo Chiodini, Vincenzo Pota, Pasquale Sansone, Maria B Passavanti, Sebastiano Leone, Caterina Aurilio, Maria C Pace
INTRODUCTION: Spontaneous Fungal Peritonitis (SFP) is an infection of ascitic fluid occurring in cirrhotic patients. SFP prevalence varies from 0 to 41% of patients with spontaneous peritonitis (SP) and a positive ascitic fluid culture. Cirrhotic patients with SFP who fail to show improvement with empirical antibiotic therapy, before the identification of the fungal pathogen, have high mortality (89.5-100%). Although the weight of the disease is so dramatic, more recent guidelines on infections in cirrhosis do not consider SFP management...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28721080/a-cost-analysis-of-a-broad-spectrum-antibiotic-therapy-in-the-empirical-treatment-of-health-care-associated-infections-in-cirrhotic-patients
#4
Cristina Lucidi, Vincenza Di Gregorio, Giancarlo Ceccarelli, Mario Venditti, Oliviero Riggio, Manuela Merli
BACKGROUND: Early diagnosis and appropriate treatment of infections in cirrhosis are crucial. As new guidelines in this context, particularly for health care-associated (HCA) infections, would be needed, we performed a trial documenting whether an empirical broad-spectrum antibiotic therapy is more effective than the standard one for these infections. Because of the higher daily cost of broad-spectrum than standard antibiotics, we performed a cost analysis to compare: 1) total drug costs, 2) profitability of hospital admissions...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28720415/assessment-of-cirrhotic-liver-enhancement-with-multiphasic-computed-tomography-using-a-faster-injection-rate-late-arterial-phase-and-weight-based-contrast-dosing
#5
Kathleen Eddy, Andreu F Costa
PURPOSE: This study aimed to update our liver computed tomography (CT) protocol according to published guidelines, and to quantitatively evaluate the effect of these modifications. METHODS: The modified liver CT protocol employed a faster injection rate (5 vs 3 mL/s), later arterial phase (20-second vs 10-second postbolus trigger), and weight-based dosing of iodinated contrast (1.7 mL/kg vs 100 mL fixed dose). Liver and vascular attenuation values were measured on CTs of patients with cirrhosis from January to September 2015 (old protocol, n = 49) and from October to December 2015 (modified protocol, n = 31)...
July 15, 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/28718228/early-initiation-of-beta-blockers-following-primary-endoscopic-therapy-for-bleeding-oesophageal-varices-in-cirrhotics
#6
Adnan Salim, Kashif Malik, Muhammad Omer Farooq, Umair Butt, Arshad Kamal Butt, Altaf Alam
BACKGROUND AND AIMS: Beta-blockers provide secondary prophylaxis following endoscopic therapy for variceal bleeding. Guidelines recommend starting beta-blockers 6 days after endoscopy to prevent masking hemodynamic signs of re-bleeding. We aimed to see safety of earlier initiation of betablockers. METHODS: Cirrhotic patients with upper GI bleed were given intravenous vasoactive agents until undergoing endoscopy. Patients with only oesophageal varices as source of bleed were recruited...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28704381/sofosbuvir-based-treatment-of-chronic-hepatitis-c-genotype-3-infections-a-scandinavian-real-life-study
#7
Olav Dalgard, Ola Weiland, Geir Noraberg, Lars Karlsen, Lars Heggelund, Martti Färkkilâ, Ulla Balslev, Erika Belard, Anne Øvrehus, Mette Skalshøi Kjær, Henrik Krarup, Birgit Thorup Røge, Sofie Hallager, Lone G Madsen, Alex Lund Laursen, Martin Lagging, Nina Weis
BACKGROUND AND AIMS: Chronic hepatitis C virus (HCV) genotype 3 infection with advanced liver disease has emerged as the most challenging to treat. We retrospectively assessed the treatment outcome of sofosbuvir (SOF) based regimes for treatment of HCV genotype 3 infections in a real life setting in Scandinavia. METHODS: Consecutive patients with chronic HCV genotype 3 infection were enrolled at 16 treatment centers in Denmark, Sweden, Norway and Finland. Patients who had received a SOF containing regimen were included...
2017: PloS One
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#8
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28692443/a-single-test-combining-blood-markers-and-elastography-is-more-accurate-than-other-fibrosis-tests-in-the-main-causes-of-chronic-liver-diseases
#9
Alexandra Ducancelle, Vincent Leroy, Julien Vergniol, Nathalie Sturm, Brigitte Le Bail, Jean Pierre Zarski, Eric Nguyen Khac, Dominique Salmon, Victor de Ledinghen, Paul Calès
BACKGROUND AND GOAL: International guidelines suggest combining a blood test and liver stiffness measurement (LSM) to stage liver fibrosis in chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). Therefore, we compared the accuracies of these tests between the main etiologies of chronic liver diseases. STUDY: Overall, 1968 patients were included in 5 etiologies: CHC: 698, chronic hepatitis B: 152, human immunodeficiency virus/CHC: 628, NAFLD: 225, and alcoholic liver disease (ALD): 265...
August 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28688744/-screening-of-hepatocellular-carcinoma-in-patients-with-uncomplicated-cirrhosis-in-real-life-practices-survey-of-general-practionners-from-three-towns-of-seine-saint-denis-north-east-suburb-of-paris
#10
Nasséra Jiar, Jean-Luc Slama, Nathalie Ganne-Carrié
Cirrhosis is a frequent and severe pathology life threatening, due to the occurrence of complications including hepatocellular carcinoma. In order to assess the degree of conformity, of practices, with the French guidelines for the surveillance of patients with compensated cirrhosis and the primary prevention of complications, published in 2007, all general practitioners practicing in three towns from north-east suburb of Paris (Seine-Saint-Denis) representing a population pool of 186 286 inhabitants were asked during the first quarter of 2012 for the face-to-face administration of a standardized questionnaire...
July 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28687436/a-novel-fully-automated-system-for-quantification-of-hepatitis-b-virus-dna-using-magnetic-bead-based-method-combined-with-real-time-pcr
#11
Wen Jing Li, Hong Xing Xu, Dong Sheng Wu, Yuan Jian Wu, Wei Dong Xu
BACKGROUND: Hepatitis B virus (HBV) infection is a major global health problem and causes liver damage as cirrhosis of the liver or liver cancer. Development of an accurate, sensitive and reproducible detection method for detecting and monitoring HBV DNA is very necessary and urgent. OBJECTIVES: The aims were to evaluate the analytical performances of the fully automated Pre-NAT system comparing to domestic assay, and to explore the role of highly sensitive quantification of HBV DNA in the management of chronic HBV infection...
July 4, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/28677020/treatment-discontinuation-adherence-and-real-world-effectiveness-among-patients-treated-with-ledipasvir-sofosbuvir-in-the-united-states
#12
Amy Puenpatom, Michael Hull, Jeffrey McPheeters, Kay Schwebke
INTRODUCTION: Ledipasvir/sofosbuvir (LDV/SOF) for hepatitis C virus (HCV) treatment provides an oral interferon-free treatment regimen with high rates of sustained virologic response (SVR). This study assessed treatment discontinuation, factors associated with treatment completion, and real-world effectiveness. METHODS: Patients with HCV treated with LDV/SOF between October 2014 and June 2015 and enrolled in a large US health plan were identified. Expected treatment duration was calculated based on IDSA/AASLD treatment guidelines and US labels using data for genotype, initial treatment regimen, baseline cirrhosis, and prior treatments...
July 4, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28676020/current-and-potential-future-pharmacological-approaches-for-non-alcoholic-fatty-liver-disease
#13
Konstantinos Imprialos, Konstantinos Stavropoulos, Sofia Bouloukou, Georgios Kerpiniotis, Asterios Karagiannis, Michael Doumas
BACKGOUND: Non-alcoholic fatty liver disease (NAFLD) affects a large proportion of the general population. The disease ranges from simple steatosis, to non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma. Several drugs are used in daily clinical practice to manage the disease. However, data on their efficacy in liver histology are not consistent. AIM: We discuss current treatment options for NAFLD and NASH and preliminary results from novel drugs under investigation...
June 20, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28676019/statins-an-under-appreciated-asset-for-the-prevention-and-the-treatment-of-nafld-or-nash-and-the-related-cardiovascular-risk
#14
Vasilios G Athyros, Chrysa Boutari, Konstantinos Stavropoulos, Panagiotis Anagnostis, Konstantinos P Imprialos, Michael Doumas, Asterios Karagiannis
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease (30% of the general population) and up to 40% of cases advance to the more severe form of the disease: non-alcoholic steatohepatitis (NASH), which is causally related to cirrhosis and cardiovascular disease (CVD). There is no generally accepted effective treatment for NAFLD/NASH. The joint guidelines of the European Association for the Study of the Liver (EASL), the European Association for the Study of Diabetes (EASD) and the European Association for the Study of Obesity (EASO) suggest the "off label" use of pioglitazone in patients without type 2 diabetes mellitus (T2DM) and pioglitazone in subjects with T2DM or vitamin E or their combination for the treatment of NASH; however pioglitazone has considerable limitations: weight gain, bone fractures in women, and heart failure...
June 20, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28638828/surveillance-program-for-diagnosis-of-hcc-in-liver-cirrhosis-role-of-ultrasound-echo-patterns
#15
Maurizio Soresi, Antonino Terranova, Anna Licata, Antonietta Serruto, Giuseppe Montalto, Giuseppe Brancatelli, Lydia Giannitrapani
International guidelines suggest ultrasound surveillance for hepatocellular carcinoma (HCC) early diagnosis in liver cirrhosis (LC) patients, but 40% of nodules <2 cm escape detection. We investigated the existence of an ultrasound pattern indicating a higher risk of developing HCC in patients under surveillance. 359 patients with LC (Child-Pugh A-B8) underwent ultrasound screening (median follow-up 54 months, range 12-90 months), liver function tests, alpha-fetoprotein assay, and portal hypertension evaluation...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28634515/transarterial-chemoembolization-using-40-%C3%A2%C2%B5m-drug-eluting-beads-for-hepatocellular-carcinoma
#16
Giorgio Greco, Tommaso Cascella, Antonio Facciorusso, Roberto Nani, Rodolfo Lanocita, Carlo Morosi, Marta Vaiani, Giuseppina Calareso, Francesca G Greco, Antonio Ragnanese, Marco A Bongini, Alfonso V Marchianò, Vincenzo Mazzaferro, Carlo Spreafico
AIM: To assess the safety and efficacy of transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) using a new generation of 40 μm drug eluting beads in patients not eligible for curative treatment. METHODS: Drug eluting bead TACE (DEB-TACE) using a new generation of microspheres (embozene tandem, 40 μm) preloaded with 100 mg of doxorubicin was performed on 48 early or intermediate HCC patients with compensated cirrhosis. Response to therapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) guidelines applied to computed tomography or magnetic resonance imaging...
May 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28619403/practice-knowledge-and-barriers-for-screening-of-hepatocellular-carcinoma-among-high-risk-chinese-patients
#17
Kerui Xu, Shinobu Watanabe-Galloway, Fedja A Rochling, Jianjun Zhang, Paraskevi A Farazi, Hongyan Peng, Hongmei Wang, Jiangtao Luo
BACKGROUND: Hepatocellular carcinoma (HCC) is among the leading causes of cancer deaths in China. Considering its poor prognosis when diagnosed late, Chinese guidelines recommend biannual screening for HCC with abdominal ultrasound and serum α-fetoprotein (AFP) test for high-risk populations. OBJECTIVES: To investigate the practice, knowledge, and self-perceived barriers for HCC screening among high-risk hospital patients in China. METHODS: An interview-based questionnaire was conducted among Chinese patients with chronic hepatitis B and/or chronic hepatitis C infection from outpatient clinics at 2 tertiary medical institutions in Shanghai and Wuhan, China...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28609188/subtraction-images-of-gadoxetic-acid-enhanced-mri-effect-on-the-diagnostic-performance-for-focal-hepatic-lesions-in-patients-at-risk-for-hepatocellular-carcinoma
#18
Sang Hyun Choi, So Yeon Kim, Seung Soo Lee, Ju Hyun Shim, Jae Ho Byun, Seunghee Baek, Moon-Gyu Lee
OBJECTIVE: The purpose of this study is to evaluate the effect of subtraction images of gadoxetic acid-enhanced MRI on the image interpretation of focal hepatic lesions in patients at risk for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We retrospectively analyzed 255 malignant nodules from 233 patients with chronic hepatitis or liver cirrhosis (187 men and 46 women; mean age, 55.2 years) who underwent preoperative gadoxetic acid-enhanced MRI and surgical resection...
June 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28604569/use-of-four-factor-prothrombin-complex-concentrate-in-the-reversal-of-warfarin-induced-and-nonvitamin-k-antagonist-related-coagulopathy
#19
Hannah Young, Jeremy L Holzmacher, Richard Amdur, Stephen Gondek, Babak Sarani, Mary E Schroeder
: To evaluate the efficacy of international normalized ratio (INR) reversal using four-factor prothrombin complex concentrate (4F-PCC) in nonmedication-induced coagulopathy. We performed a single-site, retrospective cohort study of patients receiving off-label use of 4F-PCC. Cohorts included liver dysfunction if they had acute liver decompensation or cirrhosis without other causative factors of liver failure such as sepsis, coagulopathy of acute sepsis (CAS) if they had documentation of sepsis and no underlying liver disorder, known factor deficiencies, or medication-induced coagulopathy, or warfarin if they were taking warfarin...
June 9, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28604246/is-portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-related-to-short-course-prophylaxis-of-thromboembolism-a-monocentric-retrospective-analysis-about-an-infrequent-but-not-rare-complication-and-review-of-the-literature
#20
Francesco Caruso, Giovanni Cesana, Laura Lomaglio, Stefano Cioffi, Francesca Ciccarese, Matteo Uccelli, Stefano Olmi
BACKGROUND: Portomesenteric vein thrombosis (PMVT) is considered a rare and potentially fatal complication of bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) is one of the most performed bariatric procedures in the world. PMVT in LSG was first reported in 2009 by Berthet et al. in a thrombophilic patient. No data exist regarding the real prevalence of this complication specifically after LSG. METHODS: We examined retrospectively all the clinical records of patients who underwent LSG for morbid obesity from January 2011 to December 2016...
June 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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