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https://www.readbyqxmd.com/read/29051476/independent-factors-predicting-postoperative-30-day-mortality-in-101-infants-following-liver-transplantation
#1
Chan Woo Cho, Sanghoon Lee, Jong Man Kim, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh, Suk-Koo Lee
BACKGROUND Liver transplantation (LT) in infants is a challenging procedure. This study was designed to identify risk factors of 30-day mortality of infant LT recipients. MATERIAL AND METHODS A total of 101 infants treated between May 1997 and March 2015 were assigned to one of two groups, a deceased infant group (n=9) or a live infant group (n=92), according to their mortality status at 30 days after LT. RESULTS Patient characteristics of height, weight, preoperative total bilirubin, creatinine clearance, primary diagnosis, and graft-to-recipient weight ratio (GRWR) were significantly different between the two groups...
October 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29045957/-clinical-characteristics-of-neonatal-fungal-sepsis-in-neonatal-intensive-care-unit
#2
X Zhang, X F Ru, Y Wang, X Li, T Sang, Q Feng
OBJECTIVE: To study the characteristics of neonatal fungal sepsis and the difference between bacterial sepsis and fungal sepsis. To improve the understanding of neonatal fungal sepsis. METHODS: Clinical data of neonatal fungal sepsis in neonatal intensive care unit (NICU) were collected from 2011 to 2016 in Peking University first Hospital. The clinical characteristics were analyzed retrospectively. The difference between neonatal fungal sepsis and bacterial sepsis was also analyzed...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29044759/liver-transplant-length-of-stay-los-index-a-novel-predictive-score-for-hospital-length-of-stay-following-liver-transplantation
#3
Abbas Rana, Ellen D Witte, Karim J Halazun, Gagan K Sood, Ayse L Mindikoglu, Norman Sussman, John M Vierling, Michael L Kueht, N Thao N Galvan, Ronald T Cotton, Christine A O'Mahony, John A Goss
An index to predict hospital length of stay after liver transplantation could address unmet clinical needs. Length of stay is an important surrogate for hospital costs and efforts to limit stays can preserve our healthcare resources. Here, we devised a scoring system that predicts hospital length of stay following liver transplantation. We used univariate and multivariate analyses on 73,635 adult liver transplant recipient data and identified independent recipient and donor risk factors for prolonged hospital stay (> 30 days)...
October 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29033481/adverse-drug-reaction-monitoring-in-patients-on-antiretroviral-therapy-in-a-tertiary-care-hospital-in-eastern-india
#4
Shatavisa Mukherjee, Nikhil Era, Bibhuti Saha, Santanu Kumar Tripathi
BACKGROUND: Besides unparalleled benefits, highly active antiretroviral therapy is also associated with wide range of potential adverse drug reactions (ADRs), which hinders treatment adherence. The present study was thus designed to monitor and explore the pattern of occurrence of ADRs to various antiretroviral therapy (ART) regimens in a tertiary care ART setup. MATERIALS AND METHODS: A prospective, observational clinical study was carried out in the outpatient setting of nodal ART center of Eastern India...
May 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29026876/avoiding-icu-admission-by-using-a-fast-track-protocol-is-safe-in-selected-adult-to-adult-live-donor-liver-transplant-recipients
#5
Juan Echeverri, Nicolas Goldaracena, Akhil Kant Singh, Gonzalo Sapisochin, Nazia Selzner, Mark S Cattral, Paul D Greig, Les Lilly, Ian D McGilvray, Gary A Levy, Anand Ghanekar, Eberhard L Renner, David R Grant, Stuart A McCluskey, Markus Selzner
BACKGROUND: We evaluated patient characteristics of live donor liver transplant (LDLT) recipients undergoing a fast-track protocol without intensive care unit (ICU) admission versus LDLT patients receiving posttransplant ICU care. METHODS: Of the 153 LDLT recipients, 46 patients were included in our fast-track protocol without ICU admission. Both, fast-tracked patients and ICU-admitted patients were compared regarding donor and patient characteristics, perioperative characteristics, and postoperative outcomes and complications...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29025380/early-tracheostomy-reduces-time-of-mechanical-ventilation-in-respiratory-high-risk-patients-after-liver-transplant
#6
Sebastian Cammann, Kai Timrott, Florian W R Vondran, Harald Schrem, Frank Lehner, Jürgen Klempnauer, Wolfgang Knitsch, Moritz Kleine
OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29023905/cholangiopathy-in-critically-ill-patients-surviving-beyond-the-intensive-care-period-a-multicentre-survey-in-liver-units
#7
L Laurent, C Lemaitre, A Minello, A Plessier, G Lamblin, A Poujol-Robert, A Gervais-Hasenknopf, E-A Pariente, P Belenotti, N Mostefa-Kara, P Sogni, M Legrand, J-M Cournac, F Tamion, G Savoye, P Bedossa, D-C Valla, V Vilgrain, O Goria
BACKGROUND: The outcome of cholangiopathy developing in intensive care unit (ICU) is not known in patients surviving their ICU stay. AIM: To perform a survey in liver units, in order to clarify the course of cholangiopathy after surviving ICU stay. METHODS: The files of the liver units affiliated to the French network for vascular liver disease were screened for cases of ICU cholangiopathy developing in patients with normal liver function tests on ICU admission, and no prior history of liver disease...
October 11, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#8
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29018070/hypothermic-oxygenated-machine-perfusion-hope-for-orthotopic-liver-transplantation-of-human-liver-allografts-from-extended-criteria-donors-ecd-in-donation-after-brain-death-dbd-a-prospective-multicentre-randomised-controlled-trial-hope-ecd-dbd
#9
Zoltan Czigany, Wenzel Schöning, Tom Florian Ulmer, Jan Bednarsch, Iakovos Amygdalos, Thorsten Cramer, Xavier Rogiers, Irinel Popescu, Florin Botea, Jiří Froněk, Daniela Kroy, Alexander Koch, Frank Tacke, Christian Trautwein, Rene H Tolba, Marc Hein, Ger H Koek, Cornelis H C Dejong, Ulf Peter Neumann, Georg Lurje
INTRODUCTION: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29016288/efficacy-and-safety-of-liposomal-amphotericin-b-for-visceral-leishmaniasis-in-children-and-adolescents-at-a-tertiary-care-center-in-bihar-india
#10
Krishna Pandey, Biplab Pal, Niyamat Ali Siddiqui, Vidya Nand Rabi Das, Krishna Murti, Chandra Shekhar Lal, Neena Verma, Rajendra Babu, Vahab Ali, Rakesh Kumar, Pradeep Das
Liposomal amphotericin B is being used increasingly to reduce the burden of kala-azar from the Indian subcontinent. There are studies which have evaluated efficacy and safety of liposomal amphotericin B for visceral leishmaniasis in all age groups. However, the only study that specifically addressed treatment of childhood visceral leishmaniasis did not include all ages or document renal and liver function. We, therefore, felt it was important to reassess the efficacy and safety of single dose liposomal amphotericin B in children and adolescents...
September 5, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28987262/acute-liver-failure
#11
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Acute liver failure (ALF) is a life-threatening condition of heterogeneous etiology. Outcomes are better with early recognition and prompt initiation of etiology-specific therapy, intensive care protocols, and liver transplantation (LT). Prognostic scoring systems include the King's College Criteria and Model for End-stage Liver Disease score. Cerebral edema and intracranial hypertension are reasons for high morbidity and mortality; hypertonic saline is suggested for patients with a high risk for developing intracranial hypertension, and when it does, mannitol is recommended as first-line therapy...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28982391/the-impact-of-early-thromboelastography-directed-therapy-in-trauma-resuscitation
#12
Mohamed Mohamed, Karl Majeske, Gul R Sachwani, Kristin Kennedy, Mina Salib, Michael McCann
BACKGROUND: Conventional coagulation tests do not provide an accurate representation of the complex nature of trauma induced coagulopathy. Thrombelastography provides a prompt global overview of all dynamic sequential aspects of trauma induced coagulopathy. The objective of this study was to evaluate the impact of using thrombelastography on blood products utilization, crystalloids utilization, hospital, and intensive care using length of stay, and cost savings. METHODS: We retrospectively reviewed 134 patients (May of 2012 to February of 2015) meeting Class I trauma activation...
October 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28979533/alcoholic-liver-disease-on-the-intensive-care-unit-outcomes-and-prognostication
#13
James I Beck, Anca Staicu, Simon M Everett, Phil Jackson
BACKGROUND: Hospital admissions with decompensated chronic alcoholic liver disease have been increasing, leading to increased pressure on intensive care unit services. We aimed to determine the outcome and prognostic factors for patients with alcoholic liver disease requiring admission to intensive care unit. METHODS: This was a retrospective study over 5 years (January 2006-December 2010) of all intensive care unit admissions with alcoholic liver disease to either of the two Leeds Teaching Hospitals NHS Trust general intensive care units...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977663/quantitative-measurement-of-18f-fdg-pet-ct-uptake-reflects-the-expansion-of-circulating-plasmablasts-in-igg4-related-disease
#14
Alvise Berti, Emanuel Della-Torre, Francesca Gallivanone, Carla Canevari, Raffaella Milani, Marco Lanzillotta, Corrado Campochiaro, Giuseppe Alvise Ramirez, Emanuele Bozzalla Cassione, Enrica Bozzolo, Federica Pedica, Isabella Castiglioni, Paolo Giorgio Arcidiacono, Gianpaolo Balzano, Massimo Falconi, Luigi Gianolli, Lorenzo Dagna
Objective: [ 18 F]Fluorodeoxyglucose ( 18 F-FDG) PET/CT is increasingly used to assess organ involvement and response to treatment in IgG4-related disease (IgG4-RD), but clear correlations between 18 F-FDG uptake and disease activity have not been established yet. We aimed to correlate the intensity and distribution of 18 F-FDG uptake with validated clinical, serological and immunological parameters of IgG4-RD activity. Methods: Twenty patients with active IgG4-RD underwent a baseline 18 F-FDG PET/CT...
July 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/28975653/analysis-of-skeletal-muscle-microcirculation-in-a-porcine-polytrauma-model-with-haemorrhagic-shock
#15
Zhi Qiao, Klemens Horst, Michel Teuben, Johannes Greven, Luxu Yin, Yannik Kalbas, René H Tolba, Hans-Christoph Pape, Frank Hildebrand, Roman Pfeifer
Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma...
October 3, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28971026/intensive-care-unit-issues-in-eclampsia-and-hellp-syndrome
#16
REVIEW
Melissa Teresa Chu Lam, Elizabeth Dierking
Preeclampsia, eclampsia and HELLP syndrome are life-threatening hypertensive conditions and common causes of ICU admission among obstetric patients The diagnostic criteria of preeclampsia include: 1) systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg on two occasions at least 4 hours apart and 2) proteinuria ≥300 mg/day in a woman with a gestational age of >20 weeks with previously normal blood pressures. Eclampsia is defined as a convulsive episode or altered level of consciousness occurring in the setting of preeclampsia, provided that there is no other cause of seizures...
July 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28970711/is-portal-venous-pressure-or-porto-systemic-gradient-really-a-harbinger-of-poor-outcomes-after-living-donor-liver-transplantation
#17
Amol Vijay Kanetkar, Dinesh Balakrishnan, Sudhindran Sudhindran, Puneet Dhar, Unnikrishnan Gopalakrishnan, Ramachandran Menon, Othiyil Vayoth Sudheer
BACKGROUND: Portal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP). METHODS: In 42 adult cirrhotics undergoing elective LDLT, PVP was measured by direct canulation of portal vein and porto systemic gradient (PSG) was obtained after subtracting CVP from PVP. None underwent portal inflow modulation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28968251/hypothermia-does-not-influence-liver-damage-and-function-in-a-porcine-polytrauma-model
#18
D Eschbach, K Horst, M Sassen, J Andruszkow, J Mohr, F Debus, N Vogt, T Steinfeldt, F Hildebrand, K Schöller, E Uhl, H Wulf, S Ruchholtz, H Pape, M Frink
BACKGROUND: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shockMETHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced...
September 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28965794/health-care-associated-infections-in-pre-transplant-liver-intensive-care-unit-perspectives-and-challenges
#19
Elham A Hassan, Nahla M Elsherbiny, Abeer S Abd El-Rehim, Asmaa M A Soliman, Asmaa O Ahmed
BACKGROUND: Health care-associated infections (HAIs) threaten patient's safety worldwide especially in the intensive care units (ICU). In end-stage liver disease (ESLD), the condition is much more complicated. Data regarding HAIs among ESLD patients is lacking. We aimed to assess the incidence of HAIs, risk factors, causative micro-organisms, antimicrobial susceptibilities and mortality rates among patients with end-stage liver disease (ESLD) admitted to pre-transplant liver intensive care unit (LICU)...
September 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28964834/combined-use-of-serum-gamma-glutamyl-transferase-level-and-ultrasonography-improves-prediction-of-perinatal-outcomes-associated-with-preeclamptic-pregnancy
#20
Juan Wu, Wei Zhou, Quanhua Li, Rui Yuan, Hezhou Li, Shihong Cui
INTRODUCTION: Serum gamma glutamyl transferase (GGT), produced and released mostly from the liver and bile duct, is an enzyme involved in response to oxidative stress, and has been used as a maker for prediction of cardiovascular events. Umbilical artery blood flow resistance index, e.g., the systolic/diastolic ratio (S/D ratio) as determined by ultrasound, has been used to assess the fetal intrauterine conditions. While changes of GGT and S/D ratio in preeclampsia are found to be associated with the risk for adverse perinatal outcome, the potential value of combined use of the two measurements for the prediction of adverse perinatal outcome has not been determined...
September 27, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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