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Spontaneous peritonitys

Sergio Béjar-Serrano, Pablo Del Pozoe, Margarita Fernández-de la Varga, Salvador Benlloch
INTRODUCTION: Infections in cirrhotic patients caused by multidrug-resistant bacteria are currently increasing and are associated with greater morbidity and mortality. OBJECTIVES: To assess the epidemiology, risk factors and prognoses of infections caused by multidrug-resistant bacterial infections in cirrhotic patients. PATIENTS AND METHODS: Retrospective study on patients with liver cirrhosis who developed an infection during hospitalisations between July 2014 and August 2016 at our centre (Hospital Universitari i Politècnic La Fe, Valencia, Spain)...
October 17, 2018: Gastroenterología y Hepatología
Haidi K Ramadan, Nahed A Makhlouf, Amal A Mahmoud, Mohamed Abd Elrhman, Muhammad Abbas El-Masry
BACKGROUND: Vitamin D plays a role in innate and acquired immunity. The risk for bacterial infections is increased in cirrhotic patients due to low levels of vitamin D. This study aimed to determine serum 25-(OH) vitamin D levels among cirrhotic patients in the presence and absence of infections and correlate this level with liver disease severity. METHODS: This cross-sectional analytic study recruited 87 hospitalised cirrhotic patients who were divided into the following groups: group with evidence of infection (45 cases) and group without infection (42 cases)...
October 11, 2018: Clinics and Research in Hepatology and Gastroenterology
Michelle Herberts, Bradley Hicks, Muhammad Rizwan Sohail, Anil Jagtiani
A 70-year-old man with a history of hepatic cirrhosis presented with abdominal discomfort and distention. Physical examination revealed abdominal distention, positive fluid wave and abdominal tenderness. Due to concerns for spontaneous bacterial peritonitis (SBP), paracentesis was performed. Fluid analysis revealed 5371 total nucleated cells with 48% neutrophils. Ceftriaxone was then initiated for the treatment of SBP. Bacterial cultures of the fluid, however, grew Cl ostridium difficile Therefore, metronidazole was added...
October 12, 2018: BMJ Case Reports
Terry Cheuk-Fung Yip, Henry Lik-Yuen Chan, Yee-Kit Tse, Kelvin Long-Yan Lam, Grace Chung-Yan Lui, Vincent Wai-Sun Wong, Grace Lai-Hung Wong
OBJECTIVES: Antiviral treatment modifies the natural history of chronic hepatitis B (CHB)-related cirrhosis as reflected by improving Model for End-Stage Liver Disease (MELD) score over time. We evaluated the impact of on-treatment change of MELD score on clinical outcomes in patients with CHB-related cirrhosis. METHODS: Cirrhotic CHB patients who received entecavir and/or tenofovir disoproxil fumarate for at least 6 months in Hong Kong between 2005 and 2016 were identified...
October 12, 2018: American Journal of Gastroenterology
Abdul Badran, Matthew J Shepard, Alexander Ksendzovsky, Roger Murayi, Christina Hayes, DeeDee Smart, Prashant Chittiboina
Low-pressure hydrocephalus (LPH) is a rare clinical diagnosis, characterized by neurologic decline and ventriculomegaly that persists despite normal to low intracranial pressure. LPH is typically managed by negative-pressure drainage via ventriculostomy, followed by low-resistance shunt insertion. We present the case of a middle-aged man with a history of hemangioblastomatosis who had spontaneous subarachnoid hemorrhage. He was treated with a ventriculoperitoneal shunt and then underwent resection of a Meckel's cave hemangioblastoma and whole brain irradiation...
October 1, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Roman Maslennikov, Chavdar Pavlov, Vladimir Ivashkin
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) was detected in cirrhosis in many studies. The aim is to perform a systematic review and meta-analysis on the prevalence of SIBO in cirrhosis and on the relationship of SIBO with features of cirrhosis. METHODS: PUBMED search (until 14 January 2018) was performed. Specific search terms were: '(cirrhosis) AND (SIBO OR bacterial overgrowth)'. Studies not relating to cirrhosis or SIBO, animal studies, and non-original articles were excluded...
October 4, 2018: Hepatology International
Steven L Flamm, Kevin D Mullen, Zeev Heimanson, Arun J Sanyal
Background: Cirrhosis-related complications are associated with poor prognosis. With our analyses, we examined the potential benefit of rifaximin in reducing the risk of developing cirrhosis-related complications. Methods: Adults with cirrhosis and hepatic encephalopathy (HE) in remission were randomly assigned to receive rifaximin 550 mg twice daily or placebo for 6 months with concomitant lactulose permitted. Post hoc analyses examined time to cirrhosis-related complications (HE, spontaneous bacterial peritonitis (SBP), variceal bleeding, acute kidney injury/hepatorenal syndrome)...
2018: Therapeutic Advances in Gastroenterology
Sara Nasser, Konstantinos Lathouras, Katherine Nixon, Jeremy Campbell, Gary Stocks, Long Jiao, Christina Fotopoulou
OBJECTIVE: Evaluate postoperative hepatic-function in patients with advanced ovarian cancer (OC) who underwent extensive right upper-quadrant (RUQ) cytoreduction in primary, relapsed or interval settings. METHODS: We retrospectively reviewed all patients with OC who underwent liver resection, mobilization and/or diaphragmatic-stripping between 01/2013 and 12/2016. Postoperative liver enzyme function (LFTs), assessed by alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin (Bil), was correlated with postoperative complications...
September 29, 2018: Gynecologic Oncology
Nipun Verma, Shreya Singh, Sunil Taneja, Ajay Duseja, Virendra Singh, Radha K Dhiman, Arunaloke Chakrabarti, Yogesh K Chawla
AIMS: To study the prevalence, risk factors, role of serum biomarkers for diagnosis and impact of invasive fungal infections (IFI) in patients with acute on chronic liver failure (ACLF). METHODS: An analysis of IFI in patients with ACLF (EASL criteria) was conducted retrospectively. The diagnosis of IFI in clinically suspected patients was based on EORTC/MSG criteria. The demographic, clinical, laboratory details and outcomes were analyzed. RESULTS: Out of 264 patients with ACLF, 54 (20...
October 1, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Michael Lipinski, Michael Saborowski, Benjamin Heidrich, Dina Attia, Philipp Kasten, Michael P Manns, Michael Gebel, Andrej Potthoff
OBJECTIVES: The clinical relevance of spontaneous portosystemic shunts detected by ultrasound is insufficiently investigated. The aim of this retrospective study was to assess the frequency and clinical relevance of spontaneous portosystemic shunts in patients with liver cirrhosis. METHODS: We evaluated portosystemic shunts, liver cirrhosis and spleen size by ultrasound in 982 patients with liver cirrhosis and correlated these with laboratory results, clinical data and the incidence of clinical endpoint deaths, liver transplantation and the development of HCC during the follow-up period (mean 1...
September 29, 2018: Scandinavian Journal of Gastroenterology
Xiu-Jian Ma, Guo-Bin Zhang, Teng-Xian Guo, Cheng-Bei Li, Yu-Jia Chen, Li-Wei Zhang, Zhen Wu, Jun-Ting Zhang
The study aims to assess the management and maternal and fetal outcomes of pregnancies complicated by central nervous system (CNS) hemangioblastoma. Twenty-four female patients with CNS hemangioblastoma, who were pregnant in a tumor-burden status, were identified. Their medical charts, treatments, and follow-up materials were carefully reviewed. Of the included 24 CNS patients with hemangioblastoma (14 intracranial and 10 spinal hemangioblastomas), 5 patients (20.8%) were diagnosed with Von Hippel-Lindau disease (VHL)...
November 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Savitha Nagaraj, Muhammad H Khan, Farzana Afroza
An alarming 468,000 people are dependent on dialysis for their end-stage renal disease (ESRD) management in the United States alone. Peritoneal dialysis is a preferred type of dialysis over hemodialysis, considering its initial survival advantage, patient satisfaction, and cost-effectiveness. One of the rare complications of peritoneal dialysis is abdominal and peritoneal pseudocyst formation. Literature regarding the accurate medical management of such peritoneal pseudocysts is scarce. Adding to this, management of recurrent loculated, non-malignant peritoneal pseudocyst poses to be challenging especially when pseudocysts recur after the offending peritoneal dialysis catheter is removed...
July 24, 2018: Curēus
Tammo L Tergast, Hans Laser, Svetlana Gerbel, Michael P Manns, Markus Cornberg, Benjamin Maasoumy
INTRODUCTION: Type 2 diabetes mellitus (DM) is a frequent comorbidity among patients with liver cirrhosis. However, data regarding the impact of DM on spontaneous bacterial peritonitis (SBP) are quite limited. Our aim was to analyze the impact of DM and HbA1c values on the incidence of SBP and mortality in patients with liver cirrhosis and ascites. METHODS: A number of 475 consecutive patients with liver cirrhosis and ascites were analyzed. Presence of DM as well as HbA1c was assessed at the time of the first paracentesis...
September 24, 2018: Clinical and Translational Gastroenterology
Amr Menshawy, Omar Mattar, Kirolos Barssoum, Ammar M AboEl-Naga, Haitham Mohamed Salim, Ahmed Mesbah Fahmy Mohamed, Ahmed Elgebaly, Sherief Abd-Elsalam
AIM: The role of rifaximin in the prevention of spontaneous bacterial peritonitis(SBP) is not well studied. The aim of this meta-analysis was to evaluate the role of rifaximin in the prevention of SBP. METHODS: A computerized literature search for relevant clinical trials was conducted during August 2017. Data on Frequency of SBP, the success rate of prevention of SBP, mortality rate, hepatorenal syndrome, septic shock, hepatic encephalopathy, and GIT bleeding were extracted and pooled as risk ratio (RR) with their 95% confidence interval (CI) in a meta-analysis model...
September 24, 2018: Current Drug Targets
Marco Di Pascoli, Silvano Fasolato, Salvatore Piano, Massimo Bolognesi, Paolo Angeli
BACKGROUND & AIMS: In patients with cirrhosis, the clinical benefit of the treatment with human albumin for ascites is debated, and no data are available regarding refractory ascites. In this study, in patients with cirrhosis and refractory ascites, we assessed the effect of long-term albumin administration on emergent hospitalization and mortality. METHODS: Seventy patients with cirrhosis and refractory ascites, followed at the Unit of Internal Medicine and Hepatology, University and General Hospital of Padova, Italy, were included into the study...
September 19, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Theodora Oikonomou, George V Papatheodoridis, Michael Samarkos, Ioannis Goulis, Evangelos Cholongitas
Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. This altered microbiome along with small bowel bacterial overgrowth, through translocation across the gut, is associated with the development of decompensating complications. Studies have analyzed the correlation of certain bacterial families with the development of hepatic encephalopathy in cirrhotics...
September 14, 2018: World Journal of Gastroenterology: WJG
Juan Manuel Agraz-Cibrián, Vidal Delgado-Rizo, Jorge Enrique Segura-Ortega, Héctor Alfredo Maldonado-Gómez, José Francisco Zambrano-Zaragoza, Ma de Jesus Durán-Avelar, Norberto Vibanco-Perez, Mary Fafutis-Morris
Liver cirrhosis (LC) is an inflammatory process associated with impaired functions in adaptive and innate immune responses at both systemic and local levels, also referred as Cirrhosis Associated Immune Dysfunction (CAID). In this study we evaluated the functionality of neutrophils from ascitic fluid (AF) of patients with hepatic cirrhosis by testing their ability to generate neutrophil extracellular traps (NETs) in vitro. To further determine the activation state of neutrophils, expression of the activation markers CD66b, CD69 and CD80 on these cells was analyzed by flow cytometry...
August 27, 2018: Scandinavian Journal of Immunology
Pere Ginès, Elsa Solà, Paolo Angeli, Florence Wong, Mitra K Nadim, Patrick S Kamath
Hepatorenal syndrome (HRS) is a form of kidney function impairment that characteristically occurs in cirrhosis. Recent changes in terminology have led to acute HRS being referred to as acute kidney injury (AKI)-HRS and chronic HRS as chronic kidney disease (CKD)-HRS. AKI-HRS is characterized by a severe impairment of kidney function owing to vasoconstriction of the renal arteries in the absence of substantial abnormalities in kidney histology. Pathogenetic mechanisms involve disturbances in circulatory function due to a marked splanchnic arterial vasodilation, which triggers the activation of vasoconstrictor factors...
September 13, 2018: Nature Reviews. Disease Primers
Thierry Gustot, Richard Moreau
No abstract text is available yet for this article.
September 7, 2018: Journal of Hepatology
Francesca De Piano, Filippo Savoldi, Francesca Ruju, Mariacristina Ghioni, Vanna Zanagnolo, Stefania Rizzo
Abdominal non-tuberculous mycobacterial infection is a rare condition in healthy patients. When it occurs, it leads to the appearance of typical findings of peritoneal involvement, such as thickening of the peritoneal leaflets and the omentum, ascites and enlargement of lymph nodes and of mesenteric nodules. These findings may be misdiagnosed as tumour peritoneal implants. In case of spontaneous regression of the peritoneal involvement and ascites, as well as in the absence of malignancy, the suspicion of infectious disease, including abdominal nontuberculous mycobacterial infection, should be considered...
2018: Ecancermedicalscience
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