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Spontaneous bacterial peritonitis

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https://www.readbyqxmd.com/read/28433104/wilson-disease-symptomatic-liver-therapy
#1
Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28403123/influence-of-genetic-variations-in-the-sod1-gene-on-the-development-of-ascites-and-spontaneous-bacterial-peritonitis-in-decompensated-liver-cirrhosis
#2
Sebastian Schwab, Jennifer Lehmann, Philipp Lutz, Christian Jansen, Beate Appenrodt, Frank Lammert, Christian P Strassburg, Ulrich Spengler, Hans-Dieter Nischalke, Jonel Trebicka
BACKGROUND: The balance between generation and elimination of reactive oxygen species by superoxide dismutase (SOD) is crucially involved in the pathophysiology of liver cirrhosis. Reactive oxygen species damage cells and induce inflammation/fibrosis, but also play a critical role in immune defense from pathogens. As both processes are involved in the development of liver cirrhosis and its complications, genetic variation of the SOD1 gene was investigated. PATIENTS AND METHODS: Two SOD1 single nucleotide polymorphisms (rs1041740 and rs3844942) were analyzed in 49 cirrhotic patients undergoing liver transplantation...
April 11, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28386572/spontaneous-fungal-peritonitis-in-ascites-of-cardiac-origin
#3
Yuchen Wang, Seema Gandhi, Bashar M Attar
Spontaneous fungal peritonitis (SFP) is an infrequent but severe complication most commonly described in patients with liver cirrhosis. We present the first case of culture-proven SFP occurring in cardiogenic ascites. The diagnosis of SFP was clinically challenging as the initial ascites was consistent with the more common diagnosis of spontaneous bacterial peritonitis (SBP). The patient did not respond to antibacterial therapy, however, and the final diagnosis was only made with positive ascitic cultures that grew Candida glabrata...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28382951/nosocomial-and-community-acquired-spontaneous-bacterial-peritonitis-in-patients-with-liver-cirrhosis-in-china-comparative-microbiology-and-therapeutic-implications
#4
Lei Shi, Dan Wu, Lei Wei, Suxia Liu, Peng Zhao, Bo Tu, Yangxin Xie, Yanan Liu, Xinhua Wang, Liying Liu, Xin Zhang, Zhe Xu, Fusheng Wang, Enqiang Qin
Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 311) and the nosocomial SBP (n = 264) groups exhibited significant differences in clinical symptoms (P < 0...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28361440/acid-suppressive-therapy-and-risk-of-infections-pros-and-cons
#5
REVIEW
Leon Fisher, Alexander Fisher
This narrative review summarises the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors and histamine-2 receptor antagonists, advocating a rationale balanced and individualised approach aimed to minimise any serious adverse consequences. It focuses on current controversies on the potential of ASDs to contribute to infections-bacterial, parasitic, fungal, protozoan and viral, particularly in the elderly, comprehensively and critically discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis, septicaemia and other)...
March 30, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28353081/gastrointestinal-manifestations-of-melioidosis-a-single-center-experience
#6
Nitin Jagtap, Harshal Shah, Anuradha Kancharla, Manu Tandan, Partha Pal, Sundeep Lakhtakia, Mohan Ramchandani, D N Reddy
Melioidosis, being increasing, is reported from India. Gastrointestinal manifestations are typically reported as unusual cause of liver and/or splenic abscess. We aimed to describe various gastrointestinal manifestation of melioidosis in the present study. We retrospectively collected data of culture positive melioidosis cases from hospital database during August 2014-October 2016 at Asian Institute of Gastroenterology, Hyderabad. A total of nine culture positive cases (8 male) of melioidosis with median age of 40 years (range 23-66) were analyzed...
March 29, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28350743/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#7
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28331804/infected-ascites-distinguishing-secondary-peritonitis-from-spontaneous-bacterial-peritonitis-in-a-cirrhotic-patient-with-classic-symptoms
#8
Marvin Louis Roy Lu, Akanksha Agarwal, Josh Sloan, Aaron Kosmin
INTRODUCTION: Spontaneous bacterial peritonitis can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection. However, oftentimes this is unapparent and other clinical clues need to be sought after to make the right diagnosis. CASE: A 64-year-old woman was admitted because of three days of worsening diffuse abdominal pain and distention. She was morbidly obese and had a history of non-alcoholic steatohepatitis (NASH) cirrhosis...
2017: IDCases
https://www.readbyqxmd.com/read/28297771/-advances-in-basic-and-clinical-research-on-liver-cirrhosis-in-2016
#9
C Gu, M Y Song, W J Sun, X Y Xu, C Q Yang, D F Chen
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28296047/non-selective-beta-blockers-are-not-associated-with-increased-mortality-in-cirrhotic-patients-with-ascites
#10
Simona Onali, Maria Kalafateli, Avik Majumdar, Rachel Westbrook, James O'Beirne, Gioacchino Leandro, David Patch, Emmanuel A Tsochatzis
BACKGROUND & AIMS: Controversy exists on the impact of non-selective beta-blockers (NSBBs) on survival in patients with ascites. We assessed whether NSBB treatment affects survival in a cohort of 316 consecutive patients with ascites undergoing evaluation for liver transplantation. METHODS: Consecutive patients with cirrhosis and ascites assessed for liver transplantation between 2011 and 2014 were retrospectively evaluated. Competing risk Cox regression analysis in the whole population and in propensity score matched patients were performed to identify predictors of survival...
March 11, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#11
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28239081/clinical-features-of-spontaneous-bacterial-peritonitis-a-10-year-experience-from-a-single-center
#12
Ha Young Na, Jeong Han Kim, Won Hyeok Choe, So Young Kwon, Byung Chul Yoo
Background/Aims: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. Methods: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. Results: Total 51 patients were enrolled...
February 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28233274/the-safety-of-appropriate-use-of-over-the-counter-proton-pump-inhibitors-an-evidence-based-review-and-delphi-consensus
#13
REVIEW
David A Johnson, Philip O Katz, David Armstrong, Henry Cohen, Brendan C Delaney, Colin W Howden, Peter Katelaris, Radu I Tutuian, Donald O Castell
The availability of over-the-counter (OTC) proton pump inhibitors (PPIs) for the short-term (2 weeks) management of frequent heartburn (≥2 days/week) has increased markedly, yet evidence-based recommendations have not been developed. A panel of nine international experts in gastroesophageal reflux disease developed consensus statements regarding the risks and benefits of OTC PPIs using a modified Delphi process. Consensus (based on ≥80% approval) was reached through multiple rounds of remote voting and a final round of live voting...
April 2017: Drugs
https://www.readbyqxmd.com/read/28213164/carvedilol-use-is-associated-with-improved-survival-in-patients-with-liver-cirrhosis-and-ascites
#14
Rohit Sinha, Khalida A Lockman, Nethmee Mallawaarachchi, Marcus Robertson, John N Plevris, Peter C Hayes
BACKGROUND & AIMS: Carvedilol, a non-selective beta-blocker (NSBB) with additional anti-alpha 1 receptor activity, is a potent portal hypotensive agent and has been used as prophylaxis against variceal bleeding. However, its safety in patients with decompensated liver cirrhosis and ascites is still disputed. In this study, we examined whether long-term use of carvedilol in patients with ascites is a risk factor for mortality. METHODS: A single-centre retrospective analysis of 325 consecutive patients with liver cirrhosis and ascites presenting to our Liver Unit between 1st of January 2009 to 31st August 2012 was carried out...
February 16, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#15
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28121848/beneficial-role-of-terlipressin-in-decompensated-cirrhotics-with-spontaneous-bacterial-peritonitis
#16
Alberto Ferrarese, Valerie Tikhonoff, Edoardo Casiglia, Patrizia Burra, Marco Senzolo
No abstract text is available yet for this article.
March 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#17
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
January 21, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28088889/-spontaneous-bacterial-peritonitis
#18
Bálint Velkey, Eszter Vitális, Zsuzsanna Vitális
Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#19
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27997972/changes-in-the-microbiome-in-cirrhosis-and-relationship-to-complications-hepatic-encephalopathy-spontaneous-bacterial-peritonitis-and-sepsis
#20
Jatinder Lachar, Jasmohan S Bajaj
Chronic liver disease with progression to decompensated cirrhosis and its associated complications, including hepatic encephalopathy, spontaneous bacterial peritonitis, and sepsis, is a leading cause of mortality and morbidity. The pathophysiology of decompensated cirrhosis, which is being intensively studied, leads to the development of gut microbiome changes causing dysbiosis. This is likely related to altered bile acid composition, with a subsequent increase in the relative abundance of potentially pathogenic bacteria that contributes to hepatic encephalopathy and leads to their translocation and the development of spontaneous bacterial peritonitis and bacteremia...
September 2016: Seminars in Liver Disease
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