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Spontaneous bacterial peritonitis

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https://www.readbyqxmd.com/read/28740354/nosocomial-spontaneous-bacterial-peritonitis-antibiotic-treatment-in-the-era-of-multi-drug-resistance-pathogens-a-systematic-review
#1
Marco Fiore, Alberto Enrico Maraolo, Ivan Gentile, Guglielmo Borgia, Sebastiano Leone, Pasquale Sansone, Maria Beatrice Passavanti, Caterina Aurilio, Maria Caterina Pace
AIM: To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODS: A literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15(th) of November 2016, using the following search strategy: "spontaneous" AND "peritonitis". RESULTS: The initial search through electronic databases retrieved 2556 records...
July 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28737869/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-1-pathophysiology-diagnostic-evaluation-hospitalization-criteria-treatment-nutritional-management
#2
REVIEW
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamsch, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Álvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28721347/peliosis-hepatis-complicating-pregnancy-a-rare-entity
#3
Muhammad Osama Butt, Nasir Hassan Luck, Syed Mujahid Hassan, Zaigham Abbas, Muhammed Mubarak
Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28703134/genetic-variants-underlying-vitamin-d-metabolism-and-vdr-tgf%C3%AE-1-smad3-interaction-may-impact-on-hcv-progression-a-study-based-on-dbgap-data-from-the-halt-c-study
#4
Laura A de Azevedo, Ursula Matte, Themis R da Silveira, Mário R Álvares-da-Silva
Vitamin D deficiency is prevalent in liver disease and vitamin D has been shown to decrease hepatic fibrosis through an anti-TGFβ-1/SMAD3 effect mediated by the vitamin D receptor. Thus, we hypothesized that genetic variants involved in vitamin D metabolism and/or VDR/TGFβ-1/SMAD3 interaction could impact on the progression of chronic HCV. We obtained or imputed genotypes for 40 single nucleotide polymorphisms (SNPs) located in genes implicated in vitamin D metabolism from the HALT-C cohort via dbGaP. The HALT-C study followed 692 chronic HCV patients over 4 years, evaluating clinical outcomes including worsening of fibrosis, hepatic decompensation (gastric/esophageal bleeding, CTP>7, ascites, spontaneous bacterial peritonitis and encephalopathy), development of hepatocellular carcinoma, and liver death...
July 13, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#5
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28687809/genetic-variants-of-traf6-modulate-peritoneal-immunity-and-the-risk-of-spontaneous-bacterial-peritonitis-in-cirrhosis-a-combined-prospective-retrospective-study
#6
Martina Mai, Sven Stengel, Eihab Al-Herwi, Jack Peter, Caroline Schmidt, Ignacio Rubio, Andreas Stallmach, Tony Bruns
Alterations of the innate immunity contribute to the development of spontaneous bacterial peritonitis (SBP) in liver cirrhosis. Given its role in immune signaling, antimicrobial function, and macrophage differentiation, we hypothesized that genetic polymorphisms of TRAF6 modulate the risk of SBP. Thus, we determined theTRAF6 haplotype in 432 patients with cirrhosis and ascites using the haplotype-tagging single nucleotide polymorphisms rs331457 and rs5030419. In addition, peritoneal macrophages were immunomagnetically isolated and characterized...
July 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28670052/imaging-and-clinical-predictors-of-spontaneous-bacterial-peritonitis-diagnosed-by-ultrasound-guided-paracentesis
#7
Andrew Sideris, Pooja Patel, Hearns W Charles, James Park, David Feldman, Amy R Deipolyi
Spontaneous bacterial peritonitis (SBP) is a potentially life-threatening complication of ascites diagnosed by paracentesis. We determined predictors of SBP to facilitate patient selection. The 301 paracenteses performed in 119 patients (51 women, 68 men) from July to November 2015 were retrospectively reviewed. Presentation, lab data, depth of the deepest ascites pocket on ultrasound, total volume of ascites removed, absolute neutrophil count, and complications were studied. Of 301 paracenteses, 16 (5%) diagnosed SBP...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28663673/spontaneous-bacterial-peritonitis-by-burkholderia-cepacia-complex-a-rare-difficult-to-treat-infection-in-decompensated-cirrhotic-patients
#8
Sunil Taneja, Pramod Kumar, Vikas Gautam, Ajay Duseja, Virendra Singh, Radha K Dhiman, Yogesh Chawla
INTRODUCTION: Burkholderia cepacia complex (Bcc) is non-fermenting Gram-negative bacillus and has been rarely reported to cause spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis. OBJECTIVE: This study was done to evaluate the clinical presentation of cirrhotic patients with SBP due to Bcc and to determine its impact on clinical outcome. METHODS: This is a retrospective, observational study conducted during the period from 1st January 2013 through 31st March 2015...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28652407/arginine-methylation-regulates-c-myc-dependent-transcription-by-altering-promoter-recruitment-of-the-acetyltransferase-p300
#9
Irina Tikhanovich, Jie Zhao, Brian Bridges, Sean Kumer, Ben Roberts, Steven A Weinman
Protein arginine methyltransferase 1 (PRMT1) is an essential gene controlling about 85% of total cellular arginine methylation in proteins. We have previously shown that PRMT1 is an important regulator of innate immune responses and that it is required for M2 macrophage differentiation. c-Myc is a transcription factor that is critical in regulating cell proliferation and also regulates the M2 transcriptional program in macrophages. Here, we sought to determine whether c-Myc in myeloid cells is regulated by PRMT1-dependent arginine methylation...
June 26, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28648390/clinical-and-microbiological-characteristics-of-unusual-manifestations-of-invasive-pneumococcal-disease
#10
Adrian Sousa, Maria Teresa Pérez-Rodríguez, Andrés Nodar, Lucía Martínez-Lamas, Francisco Jose Vasallo, Maximiliano Álvarez-Fernández, Manuel Crespo
INTRODUCTION: Invasive pneumococcal disease (IPD) typically presents as bacterial pneumonia, meningitis or primary bacteraemia. However, Streptococcus pneumoniae can produce infection at any level of the body (endocarditis, arthritis, spontaneous bacterial peritonitis, etc.), which is also known as unusual IPD (uIPD). There are very limited data available about the clinical and microbiological profile of these uncommon manifestations of pneumococcal disease. Our aim was to analyse clinical forms, microbiological profile, epidemiology and prognosis of a cohort of patients with unusual invasive pneumococcal disease (uIPD)...
June 22, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#11
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28634518/role-of-albumin-in-cirrhosis-from-a-hospitalist-s-perspective
#12
REVIEW
Saqib Walayat, Daniel Martin, Jaymon Patel, Umair Ahmed, Muhammad N Asghar, Aparna U Pai, Sonu Dhillon
Albumin, a negatively charged globular protein encoded on chromosome 4, is one of the most abundant proteins in the plasma and accounts for approximately 75% of plasma oncotic pressure. The role of albumin in the management of various disease states has shown to be beneficial historically. Low serum albumin is a predictor of mortality and poor outcomes. In cirrhotics undergoing paracentesis, albumin infusion prevents rapid re-accumulation of ascitic fluid while simultaneously decreasing the risk of post-paracentesis related circulatory dysfunction...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28622509/antibacterial-nucleoside-analog-inhibitor-of-bacterial-rna-polymerase
#13
Sonia I Maffioli, Yu Zhang, David Degen, Thomas Carzaniga, Giancarlo Del Gatto, Stefania Serina, Paolo Monciardini, Carlo Mazzetti, Paola Guglierame, Gianpaolo Candiani, Alina Iulia Chiriac, Giuseppe Facchetti, Petra Kaltofen, Hans-Georg Sahl, Gianni Dehò, Stefano Donadio, Richard H Ebright
Drug-resistant bacterial pathogens pose an urgent public-health crisis. Here, we report the discovery, from microbial-extract screening, of a nucleoside-analog inhibitor that inhibits bacterial RNA polymerase (RNAP) and exhibits antibacterial activity against drug-resistant bacterial pathogens: pseudouridimycin (PUM). PUM is a natural product comprising a formamidinylated, N-hydroxylated Gly-Gln dipeptide conjugated to 6'-amino-pseudouridine. PUM potently and selectively inhibits bacterial RNAP in vitro, inhibits bacterial growth in culture, and clears infection in a mouse model of Streptococcus pyogenes peritonitis...
June 15, 2017: Cell
https://www.readbyqxmd.com/read/28614081/spontaneous-fungal-peritonitis-a-rare-but-severe-complication-of-liver-cirrhosis
#14
Marta Gravito-Soares, Elisa Gravito-Soares, Sandra Lopes, Graça Ribeiro, Pedro Figueiredo
INTRODUCTION AND AIM: Spontaneous bacterial peritonitis is the most common infectious complication in cirrhosis. Spontaneous fungal peritonitis is rare and remains unknown. In this work, spontaneous fungal peritonitis as well as risk factors and prognosis are characterized. PATIENTS AND METHODS: A retrospective case-control study of 253 consecutive admissions by peritonitis in cirrhotic patients was carried out between 2006 and 2015. Comparison of patients with spontaneous fungal peritonitis (cases) and spontaneous bacterial peritonitis with positive microbiologic ascitic fluid culture (controls) was performed...
June 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28611262/relative-adrenal-insufficiency-is-associated-with-the-clinical-outcome-in-patients-with-stable-decompensated-cirrhosis
#15
Evangelos Cholongitas, Ioannis Goulis, Eirini Pagkalidou, Anna Haidich, Apostolos Karagiannis, Theodora Nakouti, Chrysoula Pipili, Theodora Oikonomou, Spyros Gerou, Evangelos Akriviadis
BACKGROUND: The clinical impact of relative adrenal insufficiency (AI) on patients with stable decompensated cirrhosis (DeCi) has not been yet elucidated. AIM: Explore the association between AI and outcome [death or liver transplantation (LT)] in patients with DeCi. MATERIAL AND METHODS: Patients with DeCi presenting no active complication have been included. Clinical and laboratory data, including serum levels of corticosteroid-binding globulin (CBG), interleukin (IL)-1b, IL-6 and tumor necrosis factor (TNFα) were recorded in each participant...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28603226/infections-in-patients-affected-by-liver-cirrhosis-an-update
#16
Tiziana Ascione, Giusy Di Flumeri, Giovanni Boccia, Francesco De Caro
Patients with liver cirrhosis present an increased incidence of infections. The main cause has been founded in alterations of the enteric flora and of the intestinal barrier probably due to portal hypertension, in addition to a reticulo-endothelial system dysfunction. Furthermore, those living with cirrhosis can report a high predisposition to sepsis and septic shock, due to the excessive response of pro-inflammatory cytokines and a complessive hemodynamic derangement. By the analysis in the experimental model of the cirrhotic rat, it was demonstrated that radio-labelled Escherichia coli given by the oral route resulted in the location of the bacteria in the gut, the ascitic fluid and mesenteric lymph nodes, a phenomenon known as bacterial translocation...
June 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28597106/relative-ascites-polymorphonuclear-cell-count-indicates-bacterascites-and-risk-of-spontaneous-bacterial-peritonitis
#17
Philipp Lutz, Felix Goeser, Dominik J Kaczmarek, Stefan Schlabe, Hans Dieter Nischalke, Jacob Nattermann, Achim Hoerauf, Christian P Strassburg, Ulrich Spengler
BACKGROUND AND AIMS: Absolute polymorphonuclear (PMN) counts in ascites define spontaneous bacterial peritonitis (SBP), a severe form of bacterial infection in liver cirrhosis. Bacterascites, another form of ascites infection, can progress to SBP or may resolve spontaneously but is not reflected by absolute PMN counts. We investigated whether the relative ascites PMN count (the absolute PMN count divided by the absolute leukocyte count) provides additional information to detect bacterascites or predict SBP...
June 9, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28584525/gastrointestinal-motility-disorders-and-their-clinical-implications-in-cirrhosis
#18
REVIEW
Eleni Theocharidou, Ameet Dhar, David Patch
Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28579346/combined-spontaneous-bacterial-empyema-and-peritonitis-in-cirrhotic-patients-with-ascites-and-hepatic-hydrothorax
#19
Anwar Mohamed, Mohammed Atef, Ayman Alsebaey, Mahmoud Musa Elhabshy, Mohsen Salama
BACKGROUND AND STUDY AIMS: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM. PATIENTS AND METHODS: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm(3)) and SBEM (positive pleural fluid culture and neutrophils >250/mm(3) or negative pleural fluid culture and neutrophils >500/mm(3) with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT)...
June 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28550391/gut-liver-axis-cirrhosis-and-portal-hypertension-the-chicken-and-the-egg
#20
Juan P Arab, Rosa M Martin-Mateos, Vijay H Shah
The term gut-liver axis is used to highlight the close anatomical and functional relationship between the intestine and the liver. The intestine has a highly specialized epithelial membrane which regulates transport across the mucosa. Due to dysbiosis, impairment of the intestinal barrier and altered immunity status, bacterial products can reach the liver through the portal vein, where they are recognized by specific receptors, activate the immune system and lead to a proinflammatory response. Gut microbiota and bacterial translocation play an important role in the pathogenesis of chronic liver diseases, including alcoholic and non-alcoholic fatty liver disease, cirrhosis, and its complications, such as portal hypertension, spontaneous bacterial peritonitis and hepatic encephalopaty...
May 26, 2017: Hepatology International
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