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Liver cirrhosis

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https://www.readbyqxmd.com/read/29913531/volumetric-laser-endomicroscopy-in-the-biliary-and-pancreatic-ducts-a-feasibility-study-with-histological-correlation
#1
Juan E Corral, Omar Y Mousa, Murli Krishna, Iris J M Levink, Khela R Pursell, Mohammad Afsh, Paul T Kröner, Denise M Harnois, Herbert C Wolfsen, Michael B Wallace, Frank J Lukens
BACKGROUND:  Volumetric laser endomicroscopy (VLE) provides circumferential images 3 mm into the biliary and pancreatic ducts. We aimed to correlate VLE images with the normal and abnormal microstructure of these ducts. METHODS: Samples from patients undergoing hepatic or pancreatic resection were evaluated. VLE images were collected using a low-profile VLE catheter inserted manually into the biliary and pancreatic ducts ex vivo. Histological correlation was assessed by two unblinded investigators...
June 18, 2018: Endoscopy
https://www.readbyqxmd.com/read/29913280/emricasan-improves-liver-function-in-patients-with-cirrhosis-and-high-model-for-end-stage-liver-disease-scores-compared-with-placebo
#2
Catherine T Frenette, Giuseppe Morelli, Mitchell L Shiffman, R Todd Frederick, Raymond A Rubin, Michael B Fallon, Jason T Cheng, Matt Cave, Saira A Khaderi, Omar Massoud, Nikolaos Pyrsopoulos, James S Park, James M Robinson, Mason Yamashita, Alfred P Spada, Jean L Chan, David T Hagerty
BACKGROUND & AIMS: Caspase-mediated apoptosis and inflammation contribute to progression of liver disease. Emricasan is a pan-caspase inhibitor that reduced serum markers of apoptosis and liver inflammation in patients with hepatitis C and non-alcoholic steatohepatitis (NASH). METHODS: We performed a multicenter study of 86 patients with cirrhosis (Child-Pugh class A or B; mean score, 6.9; 38% with alcohol-associated cirrhosis, 29% with HCV-associated cirrhosis, and 23% with NASH) and model for end-stage liver disease (MELD) scores of 11-18 (mean, 12...
June 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29913090/oral-chemotherapy-for-the-treatment-of-hepatocellular-carcinoma
#3
Shun Yamamoto, Shunsuke Kondo
Many clinical trials have been conducted with chemotherapies in patients with advanced hepatocellular carcinoma (HCC). However, few agents have shown efficacy. It is thought that the efficacy of some agents might have resulted from the heterogeneity of tumors, insufficient dosages due to liver cirrhosis, and post-therapy effects. In recent years, immune checkpoint inhibitors have shown promising clinical activity and safety in patients with advanced HCC. Areas covered: The authors provide an overview of chemotherapies used for the treatment of HCC, including ongoing trials...
June 18, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29912761/inadequate-hepatocellular-carcinoma-screening-in-patients-with-nonalcoholic-steatohepatitis-cirrhosis
#4
Elizabeth Aby, Jennifer Phan, Emily Truong, Jonathan Grotts, Sammy Saab
BACKGROUND: Nonalcoholic steatohepatitis (NASH) is a common cause of liver disease which can progress to cirrhosis and hepatocellular carcinoma (HCC). American Association for the Study of Liver Diseases (AASLD) guidelines recommend abdominal ultrasound, with or without serum alpha-fetoprotein, every 6 months for HCC surveillance in cirrhotic patients. GOALS: Describe HCC surveillance rates in NASH cirrhosis compared with hepatitis C (HCV) cirrhosis and the impact of surveillance on tumor size, treatment, and mortality...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29912757/dietary-interventions-in-liver-cirrhosis
#5
Chu Kion Yao, James Fung, Natural Hoi Sing Chu, Victoria Ping Yi Tan
Liver cirrhosis is associated with significant nutritional risks that often result in serious hepatic complications and poor survival rates. Diet is an important but underutilized aspect in the treatment modality of cirrhosis. Therefore, the aims of this review are to ascertain nutritional risks associated with its pathophysiology and to summarize existing evidence that support dietary recommendations for managing this patient population. Alterations in substrate utilization for energy production is a main feature of liver cirrhosis, resulting in increased catabolism of protein stores and a predisposition toward protein-energy malnutrition, even in the early stages of the disease...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29912756/hyperlipidemia-and-nonalcoholic-steatohepatitis-predispose-to-hepatocellular-carcinoma-development-without-cirrhosis
#6
Jennifer Phan, Vivian Ng, Alan Sheinbaum, Sam French, Gina Choi, Mohamed El Kabany, Francisco Durazo, Sammy Saab, Myron Tong, Ronald Busuttil, Steven-Huy Han
BACKGROUND: Hepatocellular carcinoma (HCC) accounts for 90% of primary hepatic malignancies. With the exception of chronic hepatitis B (CHB), other etiologies of chronic liver disease require progression to cirrhosis before HCC development. Case reports have described HCC in noncirrhotic patients with hepatitis C (HCV) and nonalcoholic fatty liver disease. GOAL: The aim of this study was to determine the prevalence of patients without cirrhosis and CHB who developed HCC among a large cohort of HCC patients and to identify independent variables that are associated with no cirrhosis among patients with HCC...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29912265/leptin-expression-and-gene-methylation-patterns-in-alcohol-dependent-patients-with-ethyltoxic-cirrhosis-normalization-after-liver-transplantation-and-implications-for-future-research
#7
P J Proskynitopoulos, M Rhein, E Jäckel, M P Manns, H Frieling, S Bleich, T Thum, T Hillemacher, A Glahn
Aims: Liver transplantation is the only curative treatment available for patients with end-stage alcoholic liver disease. As different studies showed a significant association between leptin plasma levels, gene methylation patterns and the extent of craving in alcohol-dependent patients, we investigated the effect of liver transplantation on leptin expression and promoter methylation. Short Summary: The present study shows that in alcohol-dependent patients with liver cirrhosis leptin is significantly higher before liver transplantation and decreases significantly after transplantation...
June 15, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/29911438/different-scoring-systems-to-predict-6-week-mortality-in-cirrhosis-patients-with-acute-variceal-bleeding-a-retrospective-analysis-of-202-patients
#8
Fang Wang, Shu Cui, Fengmei Wang, Fenghui Li, Fei Tang, Xu Zhang, Yanying Gao, Hongmin Lv
OBJECTIVE: Determine the optimal scoring system for evaluation of 6-week bleeding-related mortality in liver cirrhosis patients with acute variceal bleeding (AVB). Prediction effects of six scoring systems, AIMS65 score, Glasgow-Blatchford (GBS) score, full Rockall (FRS) score, the model for end-stage liver disease (MELD), the MELD-Na model and the Child-Turcotte-Pugh (CTP) score were analyzed in this study. METHODS: A total of 202 liver cirrhosis patients with AVB were enrolled between 1 January 2014, and 31 December 2014...
June 17, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29910857/obesity-is-not-associated-with-an-increased-risk-of-portal-vein-thrombosis-in-cirrhotic-patients
#9
Alan Zakko, Paul T Kroner, Rooma Nankani, Raffi Karagozian
Aim: To determine the impact of obesity on development of portal vein thrombosis in cirrhotic patients. Background: Cirrhosis is a known risk factor for portal vein thrombosis (PVT). Evidence also points to obesity as being a risk factor for venous thromboembolism. Limited information is available on how obesity impacts the development of PVT in cirrhotic patients. Methods: This was a retrospective cohort study using the 2013 National Inpatient Sample...
2018: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/29910856/hepatitis-d-virus-infection-in-kermanshah-west-of-iran-seroprevalence-and-viremic-infections
#10
Babak Sayad, Yosra Naderi, Seyed Moayed Alavian, Farid Najafi, Alireza Janbakhsh, Feyzollah Mansouri, Siavash Vaziri, Mandana Afsharian, Fatemeh Norooznezhad
Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah. Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR...
2018: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/29910108/prevalence-predictors-and-impact-of-bacterial-infection-in-acute-on-chronic-liver-failure-patients
#11
Shalimar, Gyanranjan Rout, Shekhar S Jadaun, Gyan Ranjan, Saurabh Kedia, Deepak Gunjan, Baibaswata Nayak, Subrat Kumar Acharya, Ajay Kumar, Arti Kapil
BACKGROUND: Acute on chronic liver failure (ACLF) is associated with high short term mortality. We aimed to evaluate the prevalence, predictors and impact of bacterial infection in ACLF. METHODS: Consecutive hospitalized patients with cirrhosis and acute decompensation (AD), from January 2011-March 2017, were included. Predictors of survival and infection were assessed. RESULTS: 572 patients with cirrhosis and AD were classified into 3 groups - no infection (group 1, n = 190, 33...
May 28, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29910011/misconceptions-preferences-and-barriers-to-alcohol-use-disorder-treatment-in-alcohol-related-cirrhosis
#12
Jessica L Mellinger, G Scott Winder, Melissa DeJonckheere, Robert J Fontana, Michael L Volk, Anna S F Lok, Frederic C Blow
BACKGROUND: While alcohol cessation improves mortality in alcoholic liver disease (ALD), many patients struggle to achieve abstinence. Our aim was to characterize ALD patients' preferences, misconceptions, and barriers to alcohol use treatment options. METHODS: This mixed-methods study included outpatients with a history of alcohol-related cirrhosis or alcoholic hepatitis recruited from a hepatology clinic for a survey or an in-depth semi-structured interview. We purposefully sampled men and women, compensated and decompensated patients to ensure adequate representation of gender and severity of liver disease for the qualitative interviews...
August 2018: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29909661/rectal-varices-due-to-chronic-inferior-mesenteric-vein-thrombosis-caused-by-external-compression-in-a-large-hiatus-hernia-containing-the-pancreas
#13
H A Rudman, M C Stott, M Y Loh, E C Clark
A 79-year-old woman presented with a large fresh rectal bleed. Computed tomography revealed that she had a large type IV hiatus hernia, which contained the stomach and pancreas. Compression of the inferior mesenteric vein and splenic vein had led to thrombosis within these vessels and retrograde flow within the inferior mesenteric vein. This had led to the formation of portosystemic rectal varices. Ectopic varices occasionally form in the rectum, often in the context of liver cirrhosis. At the time of writing, ours is the first reported case of portosystemic rectal varices formulated in response to obstruction of vessels within a hiatus hernia...
June 18, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29907790/comparison-of-two-protocols-of-carbon-tetrachloride-induced-cirrhosis-in-rats-improving-yield-and-reproducibility
#14
José I Fortea, Carolina Fernández-Mena, Marta Puerto, Cristina Ripoll, Jorge Almagro, Juan Bañares, José M Bellón, Rafael Bañares, Javier Vaquero
Despite being a cardinal experimental model, the induction of cirrhosis in rats by repeated exposure to carbon tetrachloride (CCl4) has low reproducibility. Here, we compared two models of cirrhosis induced by orogastric administration of CCl4 once (CCl4-1xWk) or twice a week (CCl4-2xWk) for 12 weeks in male Sprague-Dawley rats. Control rats received water instead of CCl4. Both CCl4 protocols similarly attenuated body weight gain (p < 0.01 vs. Control). Although both CCl4 protocols increased hepatic fibrosis, portal hypertension and splenomegaly, the magnitude of these alterations was higher and more consistent in CCl4-2xWk rats...
June 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29907502/functional-liver-image-guided-hepatic-therapy-flight-with-hepatobiliary-iminodiacetic-acid-hida-scans
#15
David E Long, Mark Tann, Ke Colin Huang, Gregory Bartlett, James O Galle, Yukie Furukawa, Mary Maluccio, John A Cox, Feng-Ming Spring Kong, Susannah G Ellsworth
PURPOSE: Hepatobiliary iminodiacetic acid (HIDA) scans provide global and regional assessments of liver function that can serve as a road map for functional avoidance in stereotactic body radiation therapy (SBRT) planning. Functional liver image guided hepatic therapy (FLIGHT), an innovative planning technique, is described and compared with standard planning using functional dose-volume histograms. Thresholds predicting for decompensation during follow up are evaluated. METHODS AND MATERIALS: We studied 17 patients who underwent HIDA scans before SBRT...
May 1, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29906588/gamma-glutamyl-transpeptidase-to-cholinesterase-and-platelet-ratio-in-predicting-significant-liver-fibrosis-and-cirrhosis-of-chronic-hepatitis-b
#16
Danping Liu, Jian Li, Wei Lu, Yanbing Wang, Xinlan Zhou, Dan Huang, Xiufen Li, Rongrong Ding, Zhanqing Zhang
OBJECTIVE: To evaluate the performance of a new mathematical model gamma- glutamyl transpeptidase to cholinesterase and platelet ratio (GCPR) versus gamma- glutamyl transpeptidase to platelet ratio (GPR) in predicting significant fibrosis and cirrhosis of chronic hepatitis B (CHB). METHODS: A complete cohort of 2343 patients was divided into early and late cohort depending on the time of liver biopsy. With reference to the Scheuer standard, liver pathological stage ≥S2 and ≥S4 were defined as significant fibrosis and cirrhosis, respectively...
June 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29905848/uraemic-symptom-burden-and-clinical-condition-in-women-and-men-of-%C3%A2-65-years-of-age-with-advanced-chronic-kidney-disease-results-from-the-equal-study
#17
Moniek W M van de Luijtgaarden, Fergus J Caskey, Christoph Wanner, Nicholas C Chesnaye, Maurizio Postorino, Cynthia J Janmaat, Anirudh Rao, Claudia Torino, Marian Klinger, Christiane Drechsler, Olof Heimburger, Maciej Szymczak, Marie Evans, Friedo W Dekker, Kitty J Jager
Background: The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care. Methods: The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age  years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1...
June 13, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29905807/the-loss-of-function-s267f-variant-in-hbv-receptor-ntcp-reduces-human-risk-to-hbv-infection-and-disease-progression
#18
Ping An, Zheng Zeng, Cheryl A Winkler
Background: Sodium taurocholate cotransporting polypeptide (NTCP, SLC10A1) was recently identified as a hepatocyte receptor for infection of Hepatitis B virus (HBV). The natural S267F variant in NTCP causes a loss of HBV receptor function of NTCP. Objective: We assessed the association of S267F with HBV resistance, HBV infection clearance, and HBV-related cirrhosis and HCC. Methods: We tested the effects of S267F in 1117 Han Chinese patients with various HBV infection outcomes using multivariate logistic regression analysis...
June 14, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29905553/validation-of-clif-c-aclf-score-for-alcoholic-liver-cirrhosis
#19
N Slyvka, N Virstyuk, F Abdelrahman
The concept of acute-on-chronic liver failure (ACLF) covers acute deterioration of the liver function in patients with alcoholic cirrhosis (ALC) caused by secondary or extra-hepatic provoking factors (PF) leading to dysfunction of target organs. CLIF-C-ACLF score refers to the number of decompensated organs/systems and is recommended for predicting outcome in patients with ALC. Objective - to compare the diagnostic value of the Child-Pugh score and the CLIF-C-ACLF score for predicting short-term mortality in patients with ALC...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29904724/ombitasvir-paritaprevir-ritonavir-dasabuvir-ribavirin-in-hcv-genotype-1-infected-patients-who-failed-previous-protease-inhibitor-therapy
#20
Béla Hunyady, Margit Abonyi, Zsuzsanna Gerlei, Judit Gervain, Gábor Horváth, Viktor Jancsik, Gabriella Lengyel, Erzsébet Makkai, Alajos Pár, Zoltán Péter, Margit Pusztay, Pál Ribiczey, László Rókusz, Christoph Sarrazin, Ferenc Schneider, Simone Susser, Ferenc Szalay, István Tornai, Anna Tusnádi, Eszter Újhelyi, Klára Werling, Mihály Makara
Aim of the study: Combination of ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin (3DDA±RBV) therapy is shown to be effective in HCV genotype 1 (GT1) infected patients. However, sparse data exist in patients who failed previous boceprevir or telaprevir based therapies. Real life efficacy and safety of this combination were evaluated in HCV GT1b infected patients (mostly cirrhotics) with compensated liver disease who failed previous boceprevir or telaprevir based therapies more than a year before...
June 2018: Clinical and Experimental Hepatology
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