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Refractory ascites

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https://www.readbyqxmd.com/read/28693208/efficacy-and-safety-of-sox-chemotherapy-with-or-without-surgery-in-afp-producing-advanced-gastric-cancer
#1
Zhu Li, Xu Hou, Juan Chen, Huidong Sun, Yuetang Mi, Yongling Sui, Yuhong Li, Jiaping Xie, Yingli Qiao, Xiaofeng Lei, Xiaoshuang Che, Jun Liu
The present study investigated the clinical efficacy of S-1 plus oxaliplatin (SOX) regimen, with or without surgery in α-fetoprotein-producing gastric cancer (APGC) with liver metastasis. A total of 24 patients with APGC treated at the Liaocheng People's Hospital between January 2011 and December 2013 were retrospectively reviewed. Clinical efficacy and patient safety were compared between the two groups. The median progression-free survival (PFS) and overall survival (OS) in the SOX group were 6.5 [95% confidence interval (CI), 4...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28688177/renal-vein-dilation-predicts-the-poor-outcome-in-patients-with-refractory-cirrhotic-ascites
#2
Naoki Matsumoto, Masahiro Ogawa, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Takao Miura, Hiroshi Nakagawara, Shunichi Matsuoka, Mitsuhiko Moriyama, Hirotoshi Fujikawa
BACKGROUND & AIMS: Renal venous hypertension is known to be associated with worsening of renal function in patients with decompensated heart failure. Intra-abdominal hypertension including cirrhotic ascites also leads to renal venous hypertension. We aimed to clarify the effect of renal venous hypertension on cirrhotic ascites. METHODS: Two hepatologists measured the left renal vein diameter in 142 consecutive patients with refractory cirrhotic ascites using non-contrast computed tomography...
July 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28681347/new-concepts-on-the-clinical-course-and-stratification-of-compensated-and-decompensated-cirrhosis
#3
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis has been typically described by a compensated and a decompensated state based on the absence or, respectively, the presence of any of bleeding, ascites, encephalopathy or jaundice. More recently, it has been recognized that increasing portal hypertension and several major clinical events are followed by a marked worsening in prognosis, and disease states have been proposed accordingly in a multistate model. The development of multistate models implies the assessment of the probabilities of more than one possible outcome from each disease state...
July 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28676515/peritoneal-dialysis-catheters-to-treat-refractory-non-malignant-ascites
#4
Jay Hingwala, Reid Whitlock, Sara Dunsmore, Sean Armstrong, Navdeep Tangri, Paul Komenda
Refractory non-malignant ascites is associated with significant morbidity. Serial, large-volume paracentesis is a common treatment. Tunneled peritoneal dialysis (PD) catheters are an effective treatment for refractory malignant ascites, but there are limited data on complications and effectiveness for non-malignant ascites. We reviewed all 13 PD catheter insertions between 2010 - 2015 for this indication at our center. The median catheter survival time was 146 days. No complications occurred during catheter insertion, and no mechanical complications occurred after catheter insertion...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28661095/protein-concentration-of-refractory-ascites-in-cancer-patients-is-reflected-by-the-presence-and-severity-of-peritoneal-and-liver-metastasis
#5
Yosuke Yamada, Akinori Yamaguchi, Makoto Harada, Yukifumi Kurasawa, Yuuta Hara, Daiki Yamazaki, Satoshi Fujita, Kosuke Sonoda, Tomoe Masuda, Aiko Yamada, Yohei Ogawa, Koji Hashimoto, Yuji Kamijo
Ascites total protein concentration (A-TP) affects the performance of cell-free and concentrated ascites reinfusion therapy (CART). As the factors determining A-TP remain unclear, we examined peritoneal and liver metastasis. Among 98 patients who received CART, 68 with cancer, ascites from no other apparent cause, and complete CT and A-TP data were recruited. Sixty-six patients (97%) with peritoneal and/or liver metastasis on CT were divided into the peritoneal metastasis group (PM group), peritoneal and liver metastasis group (PM + LM group), and liver metastasis group (LM group)...
June 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28661089/immunological-analysis-and-generation-of-dendritic-cells-from-lavage-fluid-obtained-by-cell-free-and-concentrated-ascites-reinfusion-therapy
#6
Masahiro Ogasawara, Mamiko Miyashita, Michio Iida, Takashi Fukuhara
Cell-free and concentrated ascites reinfusion therapy (CART) is an effective treatment for patients with refractory ascites. Cellular components such as cancer cells and blood cells are removed and discarded. The aim of this study was to investigate the alteration of immune cells in lavage fluid and the generation of dendritic cells (DCs) from lavage fluid obtained by CART. Flow cytometry analysis showed a trend toward immunosuppression and impairment in innate immunity in lavage fluid. Immature DCs with downregulation of CD14 and increased antigen-uptake were generated by culturing monocytes obtained from lavage fluid with GM-CSF and IL4...
June 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28645737/alfapump-system-vs-large-volume-paracentesis-for-refractory-ascites-a-multicenter-randomized-controlled-study
#7
Christophe Bureau, Danielle Adebayo, Mael Chalret de Rieu, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rosi, Stewart MacDonald, Massimo Malago, Maria Stepanova, Zobair M Younossi, Claudia Trepte, Randall Watson, Oleg Borisenko, Sun Sun, Neil Inhaber, Rajiv Jalan
BACKGROUND AND AIMS: Patients with refractory ascites (RA) require repeated large volume paracenteses (LVP), which involves frequent hospital visits and is associated with poor quality-of-life. This study assessed safety and efficacy of an automated, low-flow pump (alfapump [AP]) compared with LVP [SoC]. METHODS: Randomized, controlled trial, in 7 centers, with 6M patient observation. Primary outcome was time to first LVP. Secondary outcomes included paracentesis requirement, safety, health-related quality-of-life (HRQoL), and survival...
June 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28625694/the-incidence-of-chylous-ascites-after-liver-transplantation-and-the-proposal-of-a-diagnostic-and-management-protocol
#8
Toshiharu Matsuura, Yusuke Yanagi, Makoto Hayashida, Yoshiaki Takahashi, Koichiro Yoshimaru, Tomoaki Taguchi
BACKGROUND: No protocol has been established for the diagnosis and management of chylous ascites after liver transplantation (LT). In this study, we retrospectively reviewed our cases of posttransplant chylous ascites (PTCA) and aimed to propose a diagnostic and management protocol. PATIENTS AND METHODS: We retrospectively reviewed the clinical records of 96 LT recipients who underwent LT at our department. The incidence of PTCA and the associated risk factors were analyzed and our protocol for chylous ascites was evaluated...
June 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28623993/management-of-refractory-chylous-ascites-with-peritoneovenous-shunts
#9
Ying Huang, Peter Gloviczki, Audra A Duncan, Mark D Fleming, David J Driscoll, Manju Kalra, Gustavo S Oderich, Thomas C Bower
OBJECTIVE: The purpose of this study was to define outcome of treatments of refractory chylous ascites using peritoneovenous shunts (PVSs). METHODS: Clinical data of patients with refractory chylous ascites treated with PVSs between 1992 and 2015 were retrospectively reviewed. The primary end point was clinical benefit, defined as cured, improved, or poor results; secondary end points were complications and reinterventions. RESULTS: Seventeen patients (eight female [47%]; median age, 47 years [range, 19-78 years]) with refractory chylous ascites were studied...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28611269/the-role-of-tips-in-patients-with-refractory-ascites-and-portal-vein-thrombosis
#10
Paulina Chinchilla-López, Nashla Hamdan-Pérez, Jorge Guerrero-Ixtlahuac, Beatriz Barranco-Fragoso, Nahum Méndez-Sánchez
Nowadays the contraindication for Transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal vein thrombosis (PVT) had been modify. The experience and technology have reduce the complications for this procedure. We report a case of refractory ascites and portal vein thrombosis to emphasize the role of TIPS in the treatment for this condition.
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#11
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28590564/beta-blockers-in-patients-with-advanced-liver-disease-has-the-dust-settled
#12
REVIEW
Carlos Moctezuma-Velazquez, Sylvia Kalainy, Juan G Abraldes
Nonselective beta-blockers (NSBBs) have been the backbone for the treatment of portal hypertension in cirrhosis for the last 3 decades. A publication in 2010 of a prospective observational study suggested that NSBBs could increase mortality in patients with refractory ascites. This opened a controversy about the safety and efficacy of NSBBs in patients with advanced liver disease and led to the publication of a large corpus of observational data assessing the safety of NSBBs in patients with advanced cirrhosis...
August 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28589706/technical-performance-and-clinical-effectiveness-of-drop-type-with-adjustable-concentrator-cell-free-and-concentrated-ascites-reinfusion-therapy
#13
Yosuke Yamada, Makoto Harada, Akinori Yamaguchi, Yasuko Kobayashi, Takashi Chino, Takashi Minowa, Takashi Kosuge, Wataru Tsukada, Koji Hashimoto, Yuji Kamijo
Cell-free and concentrated ascites reinfusion therapy (CART) is a very useful treatment method for refractory ascites but is difficult for many hospitals to employ due to its need for specialized equipment. We have therefore developed drop-type with adjustable concentrator CART (DC-CART) that uses a drop-type filtration mechanism and requires only a simple pump and pressure monitor for its concentration process. Easy adjustment of ascites concentration is possible through a recirculation loop, and filter membrane washing is aided by DC-CART's external pressure-type filtration to enable the processing of any quality or quantity of ascites...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28583558/successful-treatment-of-a-patient-with-diffuse-portosplenomesenteric-thrombosis-using-a-pericholedochal-varix-for-portal-flow-reconstruction-during-deceased-donor-liver-transplantation-a-case-report
#14
Y-D Yu, D-S Kim, J-H Han, Y-I Yoon
Portal vein thrombosis remains a challenging issue in liver transplantation. When thrombectomy is not feasible due to diffuse portosplenomesenteric thrombosis, other modalities are adapted such as the use of a jump graft or portal tributaries or even multivisceral transplantation. For patients with diffuse thrombosis of the splanchnic venous system, a large pericholedochal varix can be a useful vessel for providing splanchnic blood flow to the graft and for relieving portal hypertension. We report our experience of successfully treating a patient with diffuse portosplenomesenteric thrombosis using a pericholedochal varix for portal flow reconstruction during deceased donor liver transplantation and eventually preventing unnecessary multivisceral transplantation...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28579587/direct-acting-antiviral-agents-improved-nephrotic-syndrome-associated-with-refractory-pleural-effusion-and-ascites-caused-by-hepatitis-c-virus-related-nephropathy-a-case-report
#15
Masatoshi Yamato, Kuniaki Arai, Hajime Takatori, Tetsuro Shimakami, Taro Yamashita, Yoshio Sakai, Tatsuya Yamashita, Eishiro Mizukoshi, Masao Honda, Shuichi Kaneko
A 74-year-old man with hepatitis C virus (HCV)-related cirrhosis was admitted because of dyspnea. Laboratory investigations revealed severe proteinuria (4.0g/day), low serum albumin level, and cryoglobulinemia. Computed tomography showed massive pleural effusion and ascites. Because these effusions were leaky and the hepatic reserve was relatively intact, we thought these were mainly caused by nephrotic syndrome. Renal biopsy revealed membranoproliferative glomerulonephritis with mesangial proliferation and excessive matrix deposition...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28550512/duplex-ultrasound-versus-clinical-surveillance-in-the-prediction-of-tips-malfunction-placed-for-refractory-ascites-is-ultrasound-surveillance-useful
#16
Shamar Young, Patrick Scanlon, Prashant Sherestha, Jafar Golzarian, Tina Sanghvi
PURPOSE: Since the advent of expanded polytetrafluoroethylene-covered stents and the improved patency they confer for transjugular intrahepatic portosystemic shunt (TIPS), the need to perform ultrasound surveillance has been debated. Prior reports have failed to separately evaluate patients who had TIPS placed for refractory ascites and variceal bleeding. The difference in morbidity from TIPS malfunction between these cohorts argues for distinction between the two. This retrospective review aims to determine whether Duplex ultrasound or return of symptoms more accurately predicts TIPS dysfunction...
May 26, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#17
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28532189/non-selective-beta-blocker-treatment-does-not-impact-on-kidney-function-in-cirrhotic-patients-with-varices
#18
Bernhard Scheiner, Diego Parada-Rodriguez, Theresa Bucsics, Philipp Schwabl, Mattias Mandorfer, Nikolaus Pfisterer, Florian Riedl, Wolfgang Sieghart, Arnulf Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Thomas Reiberger
GOALS AND BACKGROUND: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress. STUDY: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs. without NSBB therapy...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28523319/amyloidosis-a-rare-cause-of-refractory-heart-failure-in-a-young-female
#19
Irina Iuliana Costache, Claudia Florida Costea, Mihai Danciu, Victor Vlad Costan, Viviana Aursulesei, Gabriela FlorenŢa Dumitrescu, Mihaela Dana Turliuc, Anca Sava
Cardiac amyloidosis may occur in any type of systemic amyloidosis. The clinical picture is often characterized by restrictive cardiomyopathy. We report the case of a 41-year-old female patient admitted to the Department of Cardiology with clinical signs of right heart failure: congested jugular veins, hepatomegaly, peripheral edema, ascites associated with atrial fibrillation, low values of arterial blood pressure and oliguria. Echocardiographic findings were helpful for the diagnosis of cardiac amyloidosis: enlarged atrial cavities, normal size ventricles, thickened ventricular septum and posterior left ventricle wall with normal left ventricular ejection fraction, mitral and tricuspid regurgitation...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522234/tjalma-syndrome-pseudo-pseudo-meigs-as-initial-manifestation-of-juvenile-onset-systemic-lupus-erythematosus
#20
Alfonso Ragnar Torres Jiménez, Eunice Solís-Vallejo, Adriana Ivonne Céspedes-Cruz, Maritza Zeferino Cruz, Edna Zoraida Rojas-Curiel, Berenice Sánchez-Jara
Tjalma syndrome or pseudo-pseudo Meigs' syndrome is a clinical condition characterized by pleural effusion, ascites and elevated CA-125 with no associated benign or malignant ovarian tumor in a patient with systemic lupus erythematosus (SLE). Tjalma described the first case of a patient with SLE, pleural effusion, ascites and elevated CA-125. We report the first case in a 14-year old patient who presented with ascites and pleural effusion refractory to treatment and elevated CA-125, in the absence of an ovarian tumor, that warranted aggressive management...
May 15, 2017: Reumatología Clinica
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