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Spontaneous peritonitys

Byron DuBois, David Mobley, Jeffrey F B Chick, Ravi N Srinivasa, Chad Wilcox, Joshua Weintraub
PURPOSE: To report the effect of partial splenic embolization (PSE) on hematological indices and the procedure's safety in pre- and post-liver transplant (LT) patients. MATERIALS AND METHODS: A single-center retrospective study evaluating all patients who underwent PSE over a 16-year period was performed. Inclusion criteria were splenomegaly confirmed by imaging and at least one of the following cytopenias: hemoglobin ≤10 g/dL, WBC count ≤1500 μL-1 , or platelet count ≤100,000 μL-1 ...
November 27, 2018: Clinical Imaging
Pia Montanucci, Teresa Pescara, Alessia Alunno, Onelia Bistoni, Giuseppe Basta, Riccardo Calafiore
BACKGROUND: Our previous in vitro demonstration of the immunoregulatory effects of microencapsulated hUCMS on human peripheral blood mononuclear cells (PBMCs) extracted from patients with recent onset, type 1 diabetes mellitus (DM), prompted us to test our product for xenograft (TX) in non obese diabetic (NOD) mice with spontaneous DM. METHODS: We transplanted microencapsulated hUCMS into the peritoneal cavity of NOD mice with either severe or mild DM. Blood glucose (BG) levels were monitored following TX, in either basal or upon glucose stimulation...
December 15, 2018: Xenotransplantation
Denis Dissegna, Massimo Sponza, Edmondo Falleti, Carlo Fabris, Alessandro Vit, Paolo Angeli, Salvatore Piano, Annarosa Cussigh, Sara Cmet, Pierluigi Toniutto
OBJECTIVES: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding. MATERIALS AND METHODS: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled...
December 13, 2018: European Journal of Gastroenterology & Hepatology
Fahimeh Varzideh, Sara Pahlavan, Hassan Ansari, Majid Halvaei, Sawa Kostin, Mohammad-Sadegh Feiz, Hamid Latifi, Nasser Aghdami, Thomas Braun, Hossein Baharvand
Human cardiomyocytes (CM) differentiated from pluripotent stem cells (PSCs) are relatively immature when generated in two-dimensional (2D) in vitro cultures, which limits their biomedical applications. Here, we devised a strategy to enhance maturation of human CM in vitro by assembly of three-dimensional (3D) cardiac organoids (CO) containing human embryonic stem cell-derived cardiac progenitor cells (hESC-CPCs), endothelial cells (ECs), and mesenchymal stem cells (MSCs). In contrast to corresponding 2D cultures, 3D CO not only developed into structures containing spontaneously beating CM, but also showed enhanced maturity as indicated by increased expressions of sarcomere and ion channel genes and reduced proliferation...
November 27, 2018: Biomaterials
Alberto Enrico Maraolo, Antonio Riccardo Buonomo, Emanuela Zappulo, Riccardo Scotto, Biagio Pinchera, Ivan Gentile
INTRODUCTION: Historically, spontaneous bacterial peritonitis (SBP) has represented one of the most frequent and relevant infectious complications of advanced liver disease, and this is still valid today. Nevertheless, in recent years the role of fungi as causative pathogens of primary peritonitis in patients with cirrhosis has become not negligible. Another issue is linked with the traditional distinction, instrumental in therapeutic choice, between community-acquired and nosocomial forms, according to the onset...
December 3, 2018: Reviews on Recent Clinical Trials
Christoph Sossou, Chaitanya Pal, Jose R Bustillo
This is a case of a 38-year-old female with latent TB complicated by disseminated peritoneal TB with associated spontaneous abortion, who was initially thought to have an ovarian neoplasm, prompting extensive workup. Laparoscopy with biopsy later confirmed the patient's condition; she was initiated on the appropriate therapy and had a full recovery.
2018: Case Reports in Infectious Diseases
Chee Yik Chang, Wei Chieng Pui, Khamisah Abdul Kadir, Balbir Singh
BACKGROUND: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria. CASE PRESENTATION: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P...
December 4, 2018: Malaria Journal
Amanda Cheung, Sajal Tanna, Michael G Ison
Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i...
October 2018: Seminars in Respiratory and Critical Care Medicine
Kapil Rajwani, Brett E Fortune, Robert S Brown
Gastrointestinal (GI) bleeding and ascites are two significant clinical events that frequently present in critically ill patients with chronic liver failure or decompensated cirrhosis. GI bleeding in patients with cirrhosis, particularly portal hypertensive-associated bleeding, carries a high short-term mortality (15-25%) and requires early initiation of a vasoactive agent and antibiotics as well as timely endoscopic management. Conservative transfusion strategies and adequate airway protection are also imperative to assist in bleeding control...
October 2018: Seminars in Respiratory and Critical Care Medicine
Tegan Ormston, Sarah Martin, Daniel G Croagh
No abstract text is available yet for this article.
November 28, 2018: ANZ Journal of Surgery
Edyta Kawka, Janusz Witowski, Pilar C Sandoval, Andras Rudolf, Angela Rynne Vidal, Manuel Lopez Cabrera, Achim Jörres
BACKGROUND: Epithelial-to-mesenchymal transition (EMT) of human peritoneal mesothelial cells (HPMCs) contributes to fibrotic thickening of the peritoneum that develops in patients on peritoneal dialysis (PD). The process is thought to be largely mediated by transforming growth factor-beta (TGF-β). As TGF-β has also been implicated in senescence of HPMCs, we have performed an exploratory study to examine if senescent HPMCs can undergo EMT. METHODS: Omentum-derived HPMCs were rendered senescent by repeated passages in culture...
November 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Sa Paul Chubb, Robin A Williams
Biochemical testing of peritoneal and pleural fluids is carried out widely, although the range of tests likely to be useful is limited in comparison to the repertoire of tests available in a modern biochemistry laboratory. Fluids accumulate when pathological processes cause an imbalance between hydrostatic pressure gradients, capillary membrane permeability and lymphatic capacity, resulting in protein-poor transudates or inflammatory exudates. In peritoneal fluid, albumin is the most useful test, for the calculation of the serum-ascites albumin gradient; protein and LDH have a role regarding risk and diagnosis of spontaneous bacterial peritonitis and amylase may be useful in diagnosing fluid accumulation due to pancreatitis...
May 2018: Clinical Biochemist. Reviews
Gitte Dam, Hendrik Vilstrup, Per Kragh Andersen, Lars Bossen, Hugh Watson, Peter Jepsen
BACKGROUND & AIMS: Many patients with cirrhosis use proton pump inhibitors (PPI). We aimed to determine their effects on the risk and prognosis of infections in patients with cirrhosis and ascites. METHODS: We used data from three 1-year trials of satavaptan treatment of ascites (N=1198) to compare incidence and 90-day mortality of first-time infections between users and nonusers of PPI. With standard and marginal structural Cox models we adjusted for differences in gender, age, cirrhosis etiology, MELD score, serum albumin, lactulose use, severity of ascites, and history of spontaneous bacterial peritonitis or variceal bleeding...
November 25, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Philip G Ferstl, Mona Müller, Natalie Filmann, Michael Hogardt, Volkhard Aj Kempf, Thomas A Wichelhaus, Christian M Lange, Johannes Vermehren, Stefan Zeuzem, Claudia Reinheimer, Oliver Waidmann
Background and aims: Spontaneous bacterial peritonitis (SBP) is a severe complication of decompensated cirrhosis. The prevalence of multidrug-resistant organisms (MDROs) in patients with cirrhosis is increasing. Identification of patients at risk for SBP due to MDROs (ie, SBP with the evidence of MDROs or Stenotrophomonas maltophilia in ascitic culture, MDRO-SBP) is crucial to the early adaptation of antibiotic treatment in such patients. We therefore investigated whether MDROs found in ascitic cultures can also be found in specimens determined by noninvasive screening procedures...
2018: Infection and Drug Resistance
Baccouch Seifeddine, Challakhi Amel, Talbi Ghofrane, Bacha Dhouha, Gharbi Lassaad, Bayar Rached, Khalfallah Mohamed Taher
Rupture of hydatid cyst of liver with intact proligerous membrane is rare. We report the case of a 63 year-old female patient presenting with right hypocondrium pain without fever or jaundice. Diagnostic imaging examination showed hydatid cyst in segment IV of liver associated with pelvic cystic lesion measuring 12 cm x 06 cm. Surgical exploration revealed ruptured unilocular hydatid cyst of the liver with intact proligerous membrane and free in the peritoneal cavity. This study aims to report a new case of intraperitoneal rupture of hydatid cyst of liver with intact proligerous membrane and to highlight the diagnostic and therapeutic difficulties due to this complication...
2018: Pan African Medical Journal
Chia-Shi Wang, Larry A Greenbaum
Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia. Minimal change disease, the most common cause in childhood, generally responds to corticosteroids, although most patients experience disease relapses. Focal segmental glomerulosclerosis is usually resistant to corticosteroids and carries a significant risk of kidney failure, necessitating renal transplantation. Nephrotic syndrome may also be secondary to gene mutations and systemic diseases such as lupus. Clinical evaluation involves distinguishing primary and secondary causes and monitoring for disease complications, including blood clots and serious infections such as spontaneous bacterial peritonitis...
February 2019: Pediatric Clinics of North America
A Rodrigues, A Duarte, A Marques, M Magalhães, R Camarneiro, R Silva, Á Ferreira, I Dionísio, L Val Flores, M Brito E Melo
INTRODUCTION: Spontaneous free perforation of the small bowel is unusual. There are many causes of spontaneous small bowel free perforation such as: immune-mediated or inflammatory, infections, drugs and biological agents, congenital, metabolic, vascular and neoplasm. A severe adverse effect of antipsychotic drugs is intestinal ischemia, which could lead to perforation. CASE PRESENTATION: The authors report the clinical case of a 42-year-old schizophrenic patient, smoker, medicated with clozapine 600 mg per day, admitted to the emergency room with diffuse abdominal pain...
November 1, 2018: International Journal of Surgery Case Reports
Alastair O'Brien
Intravenous albumin infusions have long been considered an important option in the treatment of patients with cirrhosis and ascites1 . Many studies have shown that 20% Human Albumin Solution (HAS) improves circulatory function2 and it is therefore recommended in international guidelines worldwide for use in hepatorenal syndrome (HRS), spontaneous bacterial peritonitis (SBP), as well as in preventing post paracentesis circulatory dysfunction following large volume paracentesis (LVP)3, 4 . Albumin has also been reported to have beneficial immunomodulatory and endothelial effects and therefore may have a particular beneficial role in sepsis5, 6 ...
November 17, 2018: Liver Transplantation
Cornelius Engelmann, Stefan Schob, Ines Nonnenmacher, Luise Werlich, Niklas Aehling, Sebastian Ullrich, Thorsten Kaiser, Sandra Krohn, Adam Herber, Robert Sucher, Michael Bartels, Alexey Surov, Dirk Hasenclever, Thomas Kahn, Daniel Seehofer, Michael Moche, Thomas Berg
BACKGROUND: Loss of skeletal muscle mass is a recognised complication with a prognostic impact in patients with cirrhosis. AIM: To explore in a retrospective analysis which muscle compartment most reliably predicts the occurrence of cirrhosis-associated complications and if there are gender-related differences. METHODS: 795 patients with cirrhosis listed for liver transplantation between 2001 and 2014 met the inclusion and exclusion criteria including an abdominal CT scan (±200)...
November 11, 2018: Alimentary Pharmacology & Therapeutics
Mohamed Eisa, Kibrewessen Tefera, Anahita Alvanpour
We are presenting a case of Listeria monocytogenes spontaneous bacterial peritonitis (SBP) monomicrobial non-neutrocytic bacterascites (MNS) in a patient with malignant ascites secondary to cholangiocarcinoma who underwent peritoneal catheter placement. Listeria peritonitis is uncommon, with cancer patients at a higher risk. Listeria infection should be suspected in susceptible patients once there is no response to empiric antibacterial or if the initial culture report shows gram positive bacilli, the antibacterial of choice is ampicillin...
2018: IDCases
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