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Cirrhotic ascites

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https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#1
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29452544/can-combined-blood-neutrophil-to-lymphocyte-ratio-and-c-reactive-protein-be-used-for-diagnosis-of-spontaneous-bacterial-peritonitis
#2
N Mousa, T Besheer, A Abdel-Razik, M Hamed, A G Deiab, T Sheta, W Eldars
BACKGROUND AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is diagnosed by the presence of ≥250 polymorphonuclear neutrophils (PMN)/mm 3 in the ascites and the absence of surgically treatable cause of intra-abdominal infection. Blood neutrophil lymphocytic ratio (NLR) is an inexpensive and simple test for inflammation. C-reactive protein (CRP) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of combined blood NLR and CRP as a non-invasive test for SBP diagnosis...
February 16, 2018: British Journal of Biomedical Science
https://www.readbyqxmd.com/read/29451181/the-use-of-nonselective-beta-blockers-is-a-risk-factor-for-portal-vein-thrombosis-in-cirrhotic-patients
#3
Rosa Zampino, Rita Lebano, Nicola Coppola, Margherita Macera, Anna Grandone, Luca Rinaldi, Ilario De Sio, Antonella Tufano, Gianfranca Stornaiuolo, Luigi E Adinolfi, Emanuele Durante-Mangoni, Gaeta G Battista, Alferio Niglio
Background/Aim: A reduction in portal vein inflow velocity seems to predispose to the emergence of portal vein thrombosis (PVT). Nonselective β-blockers (NSBBs), used to prevent variceal bleeding, may increase the development of PVT by reducing portal vein inflow velocity. In this retrospective case-control study, we evaluated the risk factors and clinical features of a first event of PVT in 130 cirrhotics, 19 (15%) with (PVT group) and 111 (85%) without PVT (non-PVT group). Patients and Methods: Patient evaluation and NNBB treatment were carried out according to the AASLD guidelines...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29429910/natural-history-of-patients-with-non-cirrhotic-portal-hypertension-comparison-with-patients-with-compensated-cirrhosis
#4
Stefania Gioia, Silvia Nardelli, Chiara Pasquale, Ilaria Pentassuglio, Valeria Nicoletti, Francesca Aprile, Manuela Merli, Oliviero Riggio
BACKGROUND: The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients. AIM: To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis. METHODS: The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up...
January 31, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29427728/intra-arterial-idarubicin_lipiodol-without-embolization-in-hepatocellular-carcinoma-the-lida-b-phase-i-trial
#5
Boris Guiu, Jean-Louis Jouve, Antonin Schmitt, Anne Minello, Franck Bonnetain, Christophe Cassinotto, Lauranne Piron, Jean-Pierre Cercueil, Romaric Loffroy, Marianne Latournerie, Maëva Wendremaire, Côme Lepage, Mathieu Boulin
BACKGROUND & AIMS: Idarubicin has high cytotoxicity on hepatocellular carcinoma (HCC) cells, high hepatic extraction ratio and high lipophilicity leading to stable emulsions with lipiodol. A dose-escalation phase I trial of idarubicin_lipiodol (without embolization) was conducted in cirrhotic patients with HCC to estimate the maximum-tolerated dose (MTD) and to assess safety, efficacy, pharmacokinetics, and health-related quality of life. METHODS: Patients underwent two sessions of treatment with a transarterial idarubicin_lipiodol emulsion without embolization...
February 7, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29411667/prognosis-of-patients-with-ascites-after-pleurx-insertion-an-observational-study
#6
Agnete Nordheim Riedel, Nina Kimer, Lise Hobolth, Lise Lotte Gluud
OBJECTIVE: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites. METHODS: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period. RESULTS: We included 25 patients with cirrhosis-related ascites (7 in PleurX group) and 17 with malignant ascites (14 in PleurX group)...
February 7, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29406040/community-or-healthcare-associated-bacterial-infections-increase-long-term-mortality-in-patients-with-acute-decompensation-of-cirrhosis
#7
Hong Zhao, Yu Shi, Huihui Dong, Jianhua Hu, Xuan Zhang, Meifang Yang, Jun Fan, Weihang Ma, Jifang Sheng, Lanjuan Li
BACKGROUND: The aim of the present study was to determine the specific role of different types of bacterial infections (BIs) on the prognosis of cirrhotic patients with acute decompensation (AD). METHODS: We performed a prospective, observational cohort study consisting of 492 cirrhotic patients with AD at our center from February 2014 to March 2015. Clinical, laboratory and survival data were collected. The relationship between BIs and mortality was analyzed. RESULTS: BIs were identified in 157 of 492 patients at the time of admission or during the hospital stay...
February 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29399286/toll-like-receptor-4-polymorphisms-and-bacterial-infections-in-patients-with-cirrhosis-and-ascites
#8
Edilmar Alvarado-Tapias, Carlos Guarner-Argente, Elida Oblitas, Elisabet Sánchez, Silvia Vidal, Eva Román, Mar Concepción, Maria Poca, Cristina Gely, Oana Pavel, Juan Camilo Nieto, Cándido Juárez, Carlos Guarner, Germán Soriano
AIM: To assess the relationship between the presence of toll-like receptor 4 (TLR4) polymorphisms and bacterial infections in cirrhotic patients with ascites. METHODS: We prospectively included consecutive patients with cirrhosis and ascites hospitalized during a 6-year period. Patients with human immunodeficiency virus (HIV) infection or any other immunodeficiency, patients with advanced hepatocellular carcinoma (beyond Milan's criteria) or any other condition determining poor short-term prognosis, and patients with a permanent urinary catheter were excluded...
January 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/29389068/tolvaptan-in-chinese-cirrhotic-patients-with-ascites-a-randomized-placebo-controlled-phase-2-trial
#9
Yongfeng Wang, Jieting Tang, Tao Han, Huiguo Ding, Weijiang Ye, Maorong Wang, Jun Cheng, Yongping Yang, Chengwei Chen, Qing Xie, Qing Mao, Junqi Niu, Zhenghua Wang, Zhong Wei, Yingxuan Chen, Minde Zeng, Yimin Mao
AIM: To evaluate tolvaptan as a novel therapeutic option for Chinese patients with liver cirrhosis-associated ascites in a phase 2 clinical trial. METHODS: This randomized, double-blind, placebo-controlled, multicenter trial was conducted in patients with insufficient responses to combination therapies of an oral loop diuretic and an aldosterone antagonist. Reduction in body weight and abdominal circumference, increase in 24-h cumulative urine volume, and improvement in serum sodium from baseline to end of treatment in the 15 mg and the 30 mg tolvaptan groups were compared to those in the placebo group...
February 1, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29388229/betablockers-do-not-increase-efficacy-of-band-ligation-in-primary-prophylaxis-but-they-improve-survival-in-secondary-prophylaxis-of-variceal-bleeding
#10
N Pfisterer, C Dexheimer, E-M Fuchs, T Bucsics, P Schwabl, M Mandorfer, I Gessl, L Sandrieser, L Baumann, F Riedl, B Scheiner, T Pachofszky, W Dolak, C Schrutka-Kölbl, A Ferlitsch, M Schöniger-Hekele, M Peck-Radosavljevic, M Trauner, C Madl, T Reiberger
BACKGROUND: Endoscopic band ligation (EBL) is used for primary (PP) and secondary prophylaxis (SP) of variceal bleeding. Current guidelines recommend combined use of non-selective beta-blockers (NSBBs) and EBL for SP, while in PP either NSBB or EBL should be used. AIM: To assess (re-)bleeding rates and mortality in cirrhotic patients receiving EBL for PP or SP for variceal bleeding. METHODS: (Re-)bleeding rates and mortality were retrospectively assessed with and without concomitant NSBB therapy after first EBL in PP and SP...
February 1, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29384797/clarifying-the-role-of-c-reactive-protein-as-a-bacterial-infection-predictor-in-decompensated-cirrhosis
#11
David N Perdigoto, Pedro N Figueiredo, Luís F Tomé
INTRODUCTION: Bacterial infections are frequent in cirrhosis and may induce other deleterious complications. Ultrasensitive C-reactive protein (US-CRP), like other acute-phase proteins, is often considered useful in predicting bacterial infection in decompensated cirrhosis. However, US-CRP's reliability remains inconclusive, as inflammation in cirrhosis causes US-CRP synthesis independently of infection. The aim of this study was to clarify US-CRP's role as an infection predictor in decompensated cirrhosis...
January 30, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29383775/diagnostic-validity-of-flow-cytometry-vs-manual-counting-of-polymorphonuclear-leukocytes-in-spontaneous-bacterial-peritonitis
#12
Heba Ahmed Osman, Sanaa Shaker Aly, Eman M Salah-Eldin, Muhammad Abbas El-Masry, Mohammed H Hassan
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is frequently occurring infection among patients with liver cirrhosis, defined by polymorphonuclear (PMN) leukocytic count ≥250 cell/mm3 with or without a positive ascitic fluid (AF) bacterial culture. So, this study aimed to investigate the diagnostic value of flow cytometry versus manual counting of ascitic fluid PMNL in cirrhotic patients, with clinical suspicion of SBP. METHODS: A hospital-based cross-sectional study was carried out on 320 cirrhotic patients with clinical suspicion of SBP...
January 31, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29350570/benefits-of-laparoscopic-approach-for-resection-of-liver-tumors-in-cirrhotic-patients
#13
Fabien Le Roux, Lionel Rebibo, Cyril Cosse, Denis Chatelain, Eric Nguyen-Khac, Rachid Badaoui, Jean-Marc Regimbeau
INTRODUCTION: Liver resection in cirrhotic patients is associated with increased morbidity and mortality. The objective of this study was to compare short-term results of laparoscopic resection (LR) and open surgery (OS) for minor liver resection in patients with hepatocellular carcinoma (HCC) hepatocellularcarcinoma on nontumor cirrhotic liver (HCC/F4) and patients with colorectal cancer liver metastases (CRLMs) colorectal liver metastases on healthy liver (CRLM/F0). MATERIALS AND METHODS: Between January 2005 and December 2014, all patients undergoing liver resection (n = 754) were included in this study...
January 19, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29317174/elective-endoscopic-variceal-ligation-is-not-a-risk-factor-for-bacterial-infection-in-patients-with-liver-cirrhosis
#14
Sergio Maimone, Francesca Saffioti, Roberto Filomia, Gaia Caccamo, Carlo Saitta, Socrate Pallio, Pierluigi Consolo, Sara Sabatini, Krizia Sitajolo, Maria Stella Franzè, Irene Cacciola, Giovanni Raimondo, Giovanni Squadrito
BACKGROUND: Patients with cirrhosis are at high risk of bacterial infections. Invasive procedures are generally believed to increase this susceptibility. AIMS: We investigated the incidence of bacterial infections in cirrhotic patients undergoing elective endoscopic variceal ligation (EVL). METHODS: We enrolled 60 consecutive cirrhotic patients who underwent a total number of 112 elective EVL procedures. One to seven bands were applied at each session until variceal eradication...
December 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29315697/fractional-excretion-of-urea-a-simple-tool-for-the-differential-diagnosis-of-acute-kidney-injury-in-cirrhosis
#15
Kavish R Patidar, Le Kang, Jasmohan S Bajaj, Daniel Carl, Arun J Sanyal
Current approaches to determine the cause of acute kidney injury (AKI) in patients with cirrhosis are suboptimal. The aim of this study was to determine the utility of fractional excretion of urea (FEUrea) for the differential diagnosis of AKI in cirrhotic patients. A retrospective analysis was performed in patients (n=50) with cirrhosis and ascites admitted with AKI. Using adjudicated etiology assessment as the reference standard, receiver operating curves (ROC) and optimal cutoff, sensitivity (Sn) and specificity (Sp) for the diagnosis of prerenal azotemia (PRA), type 1 hepatorenal syndrome (HRS) and acute tubular necrosis (ATN) was derived...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29303883/are-third-generation-cephalosporins-still-the-empirical-antibiotic-treatment-of-community-acquired-spontaneous-bacterial-peritonitis-a-systematic-review-and-meta-analysis
#16
Marco Fiore, Ivan Gentile, Alberto E Maraolo, Sebastiano Leone, Vittorio Simeon, Paolo Chiodini, Maria C Pace, Thierry Gustot, Fabio S Taccone
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common complication among cirrhotic patients. Guidelines recommend third-generation cephalosporins (3GCs) as empiric antibiotic therapy (EAT) of SBP. Recently, a broad-spectrum EAT was shown to be more effective than cephalosporins in the treatment of nosocomial spontaneous bacterial peritonitis (N-SBP); however, the prevalence of 3GCs-resistant bacteria is high in the nosocomial setting and broad-spectrum EAT cannot be used in all cases of SBP...
January 4, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29290909/influence-of-proton-pump-inhibitors-in-the-development-of-spontaneous-bacterial-peritonitis
#17
Suelen A S Miozzo, Jorge A John, Marcelo C Appel-da-Silva, Isabella A Dossin, Cristiane V Tovo, Angelo A Mattos
AIM: To investigate whether the use of proton pump inhibitors (PPIs) increases the incidence of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. METHODS: An historical cohort study was carried out in cirrhotic outpatients with ascites followed in a specialized clinic at a tertiary hospital in Southern Brazil. Patient charts were reviewed to collect information on the variables of interest as the use of PPIs. Primary outcome was defined as development of SBP during the study period...
December 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#18
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29285598/diagnosis-of-budd-chiari-syndrome
#19
Morgane Van Wettere, Onorina Bruno, Pierre-Emmanuel Rautou, Valérie Vilgrain, Maxime Ronot
Budd-Chiari syndrome (BCS) is defined by clinical and laboratory signs associated with partial or complete impairment of hepatic venous drainage in the absence of right heart failure or constrictive pericarditis. Primary BCS is the most frequent type and is a complication of hypercoagulable states, in particular myeloproliferative neoplasms. Secondary BCS involves tumor invasion or extrinsic compression. Most patients present with chronic BCS including a non-cirrhotic, dysmorphic, chronic liver disease with various degrees of fibrosis deposition...
December 28, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29285115/quantification-of-ascites-based-on-abdomino-pelvic-computed-tomography-scans-for-predicting-the-in-hospital-mortality-of-liver-cirrhosis
#20
Ran Wang, Xingshun Qi, Xiaozhong Guo
Ascites is among the most common complications of liver cirrhosis and is associated with a high mortality rate. The present retrospective study aimed to evaluate the potential correlation between in-hospital mortality of liver cirrhosis and volume of ascites. Patients with liver cirrhosis who were admitted to the General Hospital of Shenyang Military Region (Shenyang, China) between June 2012 and June 2014 and underwent axial abdomino-pelvic computed tomography (CT) scans were retrospectively reviewed. The volume of ascites was approximated using a five-point method, and diagnostic accuracy was expressed by the area under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs)...
December 2017: Experimental and Therapeutic Medicine
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