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Esophageal varices

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https://www.readbyqxmd.com/read/28820885/diagnostic-efficacy-of-noninvasive-liver-fibrosis-indexes-in-predicting-portal-hypertension-in-patients-with-cirrhosis
#1
Le Wang, Yuemin Feng, Xiaowen Ma, Guangchuan Wang, Hao Wu, Xiaoyu Xie, Chunqing Zhang, Qiang Zhu
BACKGROUND: Recent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated. AIMS: To evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. METHODS: A total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade...
2017: PloS One
https://www.readbyqxmd.com/read/28799522/sustained-virological-response-by-direct-antiviral-agents-in-hcv-leads-to-an-early-and-significant-improvement-of-liver-fibrosis
#2
Marcello Persico, Valerio Rosato, Andrea Aglitti, Davide Precone, Mariano Corrado, Antonio De Luna, Filomena Morisco, Silvia Camera, Alessandro Federico, Marcello Dallio, Ernesto Claar, Nicola Caporaso, Mario Masarone
BACKGROUND: Direct Antiviral Agents (DAA) demonstrated high efficacy among HCV-infected patients in registered trials. Nevertheless, the impact of these therapies on liver stiffness measurement(LSM) and liver functionality in "real-life" is not well-known. Aim of the present study was to evaluate the SVR impact on LSM and clinical parameters of DAA-therapy on a real-life population of HCV patients with F3/F4 fibrosis. METHODS: 749 HCV genotype 1-4 patients with F3/F4 hepatitis undergoing antiviral therapy, were consecutively enrolled in four centers of Hepatology of Italy...
August 11, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28798285/is-the-aims-65-score-useful-in-prepdicting-clinical-outcomes-in-korean-patients-with-variceal-and-nonvariceal-upper-gastrointestinal-bleeding
#3
Jung Wan Choe, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
Background/Aims: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods: We retrospectively evaluated 286 patients with UGIB who visited emergency department...
August 14, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28791885/shunt-preserving-disconnection-of-the-portal-to-systemic-circulation-in-patients-with-hepatic-encephalopathy
#4
Osamu Ikeda, Seijiro Inoue, Yoshitaka Tamura, Yo-Ichi Yamashita, Hideo Baba, Yukihiro Inomata, Yasuyuki Yamashita
Background Portosystemic shunt obliteration by surgical or interventional radiological techniques can be effective for patients with hepatic encephalopathy (HE) although this approach is often associated with accumulation of ascites and/or formation of esophageal varices. Purpose To evaluate the clinical efficacy and safety of shunt-preserving disconnection of the portosystemic circulation (SPDPS) in patients with HE. Material and Methods Nine patients with HE and a splenorenal shunt were treated by SPDPS: eight underwent selective coil embolization of the splenic vein and one underwent stent-graft closure of the shunt...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28776495/platelet-count-to-splenic-diameter-ratio-and-other-noninvasive-markers-as-predictors-of-esophageal-varices-in-patients-with-liver-cirrhosis
#5
Zubia Jamil, Maryam Malik, Asghar Aurangzeb Durrani
BACKGROUND/AIMS: Endoscopy as a screening modality for esophageal varices is becoming difficult because of its invasiveness, cost, and increased burden of liver cirrhosis. This study aims to determine the diagnostic accuracy of simple and noninvasive markers in detecting esophageal varices. MATERIALS AND METHODS: Four variables (platelet count, portal vein diameter, splenic diameter, and ratio of platelet count to splenic diameter PC/SD] ratio) were studied in 150 cirrhotic patients...
August 4, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28776387/the-baveno-vi-criteria-for-predicting-esophageal-varices-validation-in-real-life-practice
#6
Mafalda Sousa, Sónia Fernandes, Luísa Proença, Ana Paula Silva, Sónia Leite, Joana Silva, Ana Ponte, Jaime Rodrigues, João Carlos Silva, João Carvalho
BACKGROUND AND AIMS: According to the Baveno VI consensus, patients with liver stiffness < 20 kPa and a platelet count > 150,000 ul have very low risk of clinically significant varices and do not need a screening endoscopy. The aim of this study was to evaluate non-invasive methods as predictors of esophageal varices according to the Baveno VI recommendations, in real life clinical practice. METHODS: Retrospective evaluation of patients with chronic liver disease who underwent transient elastography between January 2013 and December 2015...
August 4, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28767684/application-of-chronic-liver-failure-sequential-organ-failure-assessment-score-for-the-predication-of-mortality-after-esophageal-variceal-hemorrhage-post-endoscopic-ligation
#7
Ming-Wun Wong, Ming-Jen Chen, Huan-Lin Chen, Yu-Chi Kuo, I-Tsung Lin, Chia-Hsien Wu, Yuan-Kai Lee, Chun-Han Cheng, Ming-Jong Bair
BACKGROUND: Esophageal variceal hemorrhage (EVH) is one of the high mortality complications in cirrhotic patients. Endoscopic variceal ligation (EVL) is currently the standard therapy for EVH. However, some patients have expired during hospitalization or survived shortly after management. AIM: To evaluate hospital and 6-week mortality by receiver operating characteristic (ROC) curve of chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score compared to a model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) class...
2017: PloS One
https://www.readbyqxmd.com/read/28765702/predictors-of-esophageal-varices-and-first-variceal-bleeding-in-liver-cirrhosis-patients
#8
Bledar Kraja, Iris Mone, Ilir Akshija, Adea Koçollari, Skerdi Prifti, Genc Burazeri
AIM: To assess "predictors" of esophageal varices (EV) and variceal bleeding using non-invasive markers in Albanian patients diagnosed with liver cirrhosis. METHODS: One hundred thirty-nine newly diagnosed cirrhotic patients without variceal bleeding were included in this analysis. Model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), platelet count to spleen diameter (PC/SD), fibrosis-4-index (FIB-4), fibrosis index (FI) and King's Score were measured for all participants...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28765688/impact-of-hepatitis-c-oral-therapy-in-portal-hypertension
#9
EDITORIAL
Diogo Libânio, Rui Tato Marinho
Chronic hepatitis C is a leading cause of morbidity and mortality, mainly related to fibrosis/cirrhosis and portal hypertension. Direct antiviral agents are highly effective and safe and can now cure > 90% of the patients. Sustained viral response (SVR) after interferon-based regimens has been associated with improvement in liver function, fibrosis and portal hypertension in a significant proportion of patients, although a point of no return seems to exist from which viral elimination is no longer capable of preventing portal hypertension progression and liver decompensation...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28763866/-effect-of-sclerotherapy-on-esophageal-varices-in-cirrhotic-patients-with-diabetes-a-prognostic-analysis
#10
L Y Niu, L L Yuan, N Zhu, R Zhang, Y Kang
No abstract text is available yet for this article.
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28763856/-endoscopic-ultrasonography-a-new-method-for-evaluation-diagnosis-and-treatment-of-portal-hypertension
#11
W Lu, S Li
Through a comprehensive scan of collateral circulation establishment in portal hypertension, endoscopic ultrasonography (EUS) can predict the risks of esophageal and gastric varices, variceal bleeding, recurrence after treatment, and rebleeding and guide and participate in the treatment of varices. With the help of these advantages, EUS provides an important reference for individualized treatment in patients with liver cirrhosis complicated by portal hypertension and can improve response rate and safety. As a new method for systematic evaluation, diagnosis, and treatment of portal hypertension, EUS has become a new research hotspot in recent years...
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28757342/rheumatoid-arthritis-treated-with-tocilizumab-in-two-patients-with-complicated-chronic-liver-disease-with-portal-hypertension
#12
Adamah Amouzougan, Delphine Dénarié, Hubert Marotte, Xavier Roblin, Thierry Thomas
Erosive, active rheumatoid arthritis in patients with portal hypertension combining esophageal varices and ascites complicating chronic liver disease poses serious management problems. Current literature does not provide any valid therapeutic management. We report the case of a woman and a man aged 52 and 66 years respectively having this combination of pathologies. Infusions of 4mg/kg of tocilizumab as monotherapy have produced a weaning from corticosteroids, both clinical and structural remission, with particular liver safety satisfactory at 10 and 18 months...
July 27, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28753701/reprocessing-of-single-use-endoscopic-variceal-band-ligation-devices-a-pilot-study
#13
Kavel Visrodia, Abdul Haseeb, Yuri Hanada, Kelly M Pennington, Magdalen Clemens, Paul J Pearce, Pritish K Tosh, Bret T Petersen, Mark D Topazian
Background and study aims The preferred management of bleeding esophageal varices includes endoscopic band ligation. Endoscopic ligation devices (ELDs) are expensive and designed for single use, limiting their uptake in developing countries. We aimed to assess the efficacy of reprocessing ELDs using terminal microbial cultures and adenosine triphosphate (ATP) testing. Materials and methods ELDs were recovered after clinical use and their components (cap, handle, and cord) were subjected to reprocessing...
July 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28752419/regional-variability-of-repeat-esophagogastroduodenoscopy-use-in-the-national-veteran-population
#14
Andrew J Gawron, Garrett Cole, Nan Hu, William K Thompson, John Fang, Matthew Samore
BACKGROUND: Esophagogastroduodenoscopy (EGD) procedures are performed frequently to evaluate gastrointestinal disease and symptoms. AIM: To determine regional practice variability of repeat EGDs in a national population. METHODS: The study sample included US Veterans with an outpatient index EGD from 1/1/2008 to 12/2010. We determined risk of repeat endoscopy from 1/2008 to 10/1/2014. A logistic regression model was used to assess the association between the odds of repeated EGD and patient demographics, ICD diagnostic codes, and geographic region...
July 31, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28746314/outcome-of-endoscopic-variceal-band-ligation
#15
B Shrestha, S Kc, S Chaudhary, B K Basnet, A K Mandal, N S Poudyal
INTRODUCTION: Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices. METHODS: This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28744162/validity-of-an-automated-algorithm-using-diagnosis-and-procedure-codes-to-identify-decompensated-cirrhosis-using-electronic-health-records
#16
Mei Lu, Wadih Chacra, David Rabin, Loralee B Rupp, Sheri Trudeau, Jia Li, Stuart C Gordon
Viral hepatitis-induced cirrhosis can progress to decompensated cirrhosis. Clinical decompensation represents a milestone event for the patient with cirrhosis, yet there remains uncertainty regarding precisely how to define this important phenomenon. With the development of broader treatment options for cirrhotic hepatitis patients, efficient identification of liver status before evolving to decompensated cirrhosis could be life-saving, but research on the topic has been limited by inconsistencies across studies, populations, and case-confirmation methods...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28743491/individualized-risk-estimation-for-postoperative-morbidity-after-hepatectomy-the-humanitas-score
#17
Matteo Donadon, Andrea Fontana, Angela Palmisano, Luca Viganò, Fabio Procopio, Matteo Cimino, Daniele Del Fabbro, Guido Torzilli
BACKGROUND: Estimation of postoperative morbidity after hepatectomy remains challenging. The aim of this prospective study was to develop a surgical score to predict an individual risk of post-hepatectomy complications. METHODS: All consecutive patients scheduled for hepatectomy from February 2012 to September 2015 were included and randomly assigned into a derivation or validation cohort. We developed a score based on preoperative variables, and we tested them using multivariate analyses...
July 22, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28734831/effects-of-all-oral-anti-viral-therapy-on-hvpg-and-systemic-hemodynamics-in-patients-with-hepatitis-c-virus-associated-cirrhosis
#18
Sabela Lens, Edilmar Alvarado, Zoe Mariño, María-Carlota Londoño, Elba LLop, Javier Martinez, Jose Ignacio Fortea, Luís Ibañez, Xavier Ariza, Anna Baiges, Adolfo Gallego, Rafael Bañares, Angela Puente, Agustín Albillos, Jose Luís Calleja, Xavier Torras, Virginia Hernández-Gea, Jaume Bosch, Cándid Villanueva, Xavier Forns, Juan Carlos García-Pagán
BACKGROUND & AIMS: Patients with hepatitis C virus (HCV)-associated cirrhosis and clinical significant portal hypertension (CSPH, hepatic venous pressure gradient [HVPG] 10 mmHg or greater), despite achieving sustained virological response (SVR) to therapy, remain at risk of liver decompensation. We investigated hemodynamic changes following SVR in patients with CSPH and whether liver stiffness measurements (LSMs) can rule out the presence of CSPH. METHODS: We performed a multicenter prospective study of 226 patients with HCV-associated cirrhosis and CSPH who had SVR to interferon-free therapy at 6 Liver Units in Spain...
July 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28706863/non-functional-tricuspid-valve-disease
#19
REVIEW
Dale S Adler
Only 75% of severe tricuspid regurgitation is classified as functional, or related primarily to pulmonary hypertension, right ventricular dysfunction, or a combination of both. Non-functional tricuspid regurgitation occurs when there is damage to the tricuspid leaflets, chordae, papillary muscles, or annulus, independent of right ventricular dysfunction or pulmonary hypertension. The entities that cause non-functional tricuspid regurgitation include rheumatic and myxomatous disease, acquired and genetic connective tissue disorders, endocarditis, sarcoid, pacing, RV biopsy, blunt trauma, radiation, carcinoid, ergot alkaloids, dopamine agonists, fenfluramine, cardiac tumors, atrial fibrillation, and congenital malformations...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28704189/chronic-hepatitis-due-to-gluten-enteropathy-a-case-report
#20
Irina I Ivanova, Denitsa Y Dukova, Pavlina G Boikova, Lili S Grudeva, Ivan B Shalev, Iskren A Kotzev
BACKGROUND: Celiac disease is an immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals. CASE DESCRIPTION: A 45-year-old Caucasian woman presented with severe iron-deficient anemia and mild elevation of liver enzymes. Upper endoscopy was done in the context of evaluation of anemia, which revealed reduced duodenal folds and mosaic pattern of the mucosa, but also grade II esophageal varices and portal hypertensive gastropathy...
June 1, 2017: Folia Medica
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