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Cirrhotic ascites

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https://www.readbyqxmd.com/read/29049216/fondaparinux-is-effective-for-acute-portal-vein-thrombosis-in-decompensated-cirrhotic-patients
#1
Zhi-Hao Zhang, Jing-Wen Zhang, Ping He, Yan Zhou, Chang-Yu Sun
Portal vein thrombosis (PVT) is a rare but serious complication in the decompensated stage of cirrhosis, and recurrent upper gastrointestinal bleeding and refractory ascites can occur in such patients. In decompensated cirrhotic patients, the application of conventional anticoagulant therapy is limited due to severe coagulation disorders, thrombocytopenia, and history of gastrointestinal bleeding.In this study, we sought to investigate the effect of fondaparinux on acute PVT in decompensated cirrhotic patients...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29043000/effect-of-entecavir-in-the-treatment-of-patients-with-hepatitis-b-virus-related-compensated-and-decompensated-cirrhosis
#2
Xiao-Dong Gai, Wei-Feng Wu
Chronic hepatitis B virus (CHB) infection is a burden on global healthcare and is associated with a higher risk of serious sequelae, including cirrhosis and hepatocellular carcinoma. The clinical application of entecavir as a treatment for CHB has produced positive outcomes, and so is an attractive form of pharmacological therapy. However, little data exists comparing the safety and efficacy of entecavir for the treatment of hepatitis B virus (HBV)-related compensated, and decompensated cirrhosis, respectively...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29026464/evaluation-of-doppler-ultrasonography-in-the-diagnosis-of-transjugular-intrahepatic-portosystemic-shunt-dysfunction-a-prospective-study
#3
Charlotte Nicolas, Amélie Le Gouge, Louis d'Alteroche, Jean Ayoub, Monica Georgescu, Vincent Vidal, Denis Castaing, Jean-Pierre Cercueil, Patrick Chevallier, Jérôme Roumy, Hervé Trillaud, Louis Boyer, Vincent Le Pennec, Christophe Perret, Bruno Giraudeau, Jean-Marc Perarnau, Stic-Tips Group
AIM: To prospectively evaluate the performance of Doppler-ultrasonography (US) for the detection of transjugular intrahepatic portosystemic shunt (TIPS) dysfunction within a multicenter cohort of cirrhotic patients. METHODS: This study was conducted in 10 french teaching hospitals. After TIPS insertion, angiography and liver Doppler-US were carried out every six months to detect dysfunction (defined by a portosystemic gradient ≥ 12 mmHg and/or a stent stenosis ≥ 50%)...
September 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28994887/hepatic-hydrothorax-about-a-hospital-serie-of-63-cases
#4
Leila Mouelhi, Oussama Daboussi, Nadia Cheffi, Kaouther El Jery, Yosra Said, Sana Khedher, Mohamed Salem, Radhouane Dabbèche, Fatma Houissa, Taoufik Najjar
BACKGROUND: Hepatic hydrothorax is a less common complication of cirrhosis with an estimated prevalence of 10- 15%. In the vast majority of cases, ascites are also present but significant pleural effusion may develop in patients without ascites. Hepatic hydrothorax is associated with cirrhosis whatever its etiology. The prognosis of hepatic hydrothorax remains unclear and is closely related to available therapeutic options. The aim of our study is to determine the prevalence of hydrothorax in cirrhotic patients, detail its clinical and therapeutic characteristics, and study the evolutive profile of cirrhotic patients with hydrothorax by comparing it to those without hydrothorax...
December 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28979154/risks-of-peg-tube-placement-in-patients-with-cirrhosis-associated-ascites
#5
Yasir Al-Abboodi, Ali Ridha, Matthew Fasullo, Tarek H Naguib
This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. We then examined multiple factors including sex, race, chronic illness including hypertension, congestive heart failure, and others and their influence on the inpatient mortality of all cirrhotic patients who had PEG placement...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28968053/improving-the-identification-and-monitoring-of-cirrhosis
#6
Margaret G Keane, Charles Hensher, Stephen P Pereira
Morbidity and mortality associated with cirrhosis are on the increase. In a recent UK cohort study the incidence of cirrhosis increased by 50.6% between 1998 and 2009. Although all causes of liver disease increased during this period, this trend was primarily attributed to rising levels of alcohol misuse and obesity. Cirrhosis generally results from chronic liver damage over many years. It is characterised by fibrosis and nodularity of the parenchyma, which interferes with the synthetic, metabolic and excretory functions of the liver...
November 2016: Practitioner
https://www.readbyqxmd.com/read/28943585/the-outcome-of-cirrhotic-patients-with-ascites-is-improved-by-the-normalization-of-the-serum-sodium-level-by-tolvaptan
#7
Tomomi Kogiso, Mutsuki Kobayashi, Kuniko Yamamoto, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Etsuko Hashimoto, Katsutoshi Tokushige
Objectives Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis. The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites and increases the serum sodium (Na) level. In this study, we investigated (i) whether or not correction of the Na level improves the prognosis of cirrhotic patients with ascites and (ii) predictors of normalization of the serum Na level after tolvaptan therapy. Methods This was a single-center retrospective study...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28943132/types-and-microbiological-spectrum-of-infections-in-patients-with-cirrhosis-a-single-centre-experience-in-upper-egypt
#8
Hussein El-Amin, Abeer M M Sabry, Rabab E Ahmed, Nahed A Makhlouf
BACKGROUND AND STUDY AIMS: Egypt has a high prevalence of hepatitis C virus (HCV) and high morbidity and mortality related to cirrhosis complications. Patients with cirrhosis have an increased risk of bacterial infections. Approximately 25-35% of cirrhotics had infections at admission or during hospitalisation. Data on infection among cirrhotics in Egypt are limited. This study aimed to determine the frequency and microbiological spectrum of infections in cirrhotics and possible risk factors...
September 21, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28940225/treatment-of-refractory-ascites-with-an-automated-low-flow-ascites-pump-in-patients-with-cirrhosis
#9
G Stirnimann, T Berg, L Spahr, S Zeuzem, S McPherson, F Lammert, F Storni, V Banz, J Babatz, V Vargas, A Geier, A Stallmach, C Engelmann, C Trepte, J Capel, A De Gottardi
BACKGROUND: Refractory ascites (RA) is a frequent complication of cirrhosis, requiring large volume paracentesis or placement of a transjugular intrahepatic portosystemic shunt (TIPSS). The automated low-flow ascites pump (alfapump, Sequana Medical AG, Zurich, Switzerland) is an innovative treatment option for patients with RA. AIM: To assess safety and efficacy of this treatment in patients with a contraindication to TIPSS. METHODS: Fifty-six patients (43 males; mean age 62 years) from centres in Germany, Switzerland, UK and Spain were included and followed for up to 24 months...
September 21, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28919607/impact-of-adrenocortical-insufficiency-on-clinical-parameters-in-haemodynamically-stable-cirrhotic-patients-with-ascites
#10
H Ahmed, M R Karim, R K Paul, M Chowdhury, M S Alam, A Saha, F Rahman, M A Rouf
Cirrhosis has many complications regardless of the aetiology. Complications include splenomegaly, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma and also linked to abnormalities in the endocrine system, including abnormal sex hormone metabolism, thyroid disease, osteoporosis, and, most recently identified, adrenal insufficiency. This prospective cohort study was done to evaluate the impact of adrenocortical insufficiency on clinical parameters in haemodynamically stable cirrhotic patients with ascites and had been performed at the inpatient of GHPD Department, BIRDEM, Dhaka, Bangladesh from April 2011 to March 2012...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28916401/cart-cell-free-and-concentrated-ascites-reinfusion-therapy-against-malignancy-related-ascites
#11
REVIEW
Tetsuya Ito, Norio Hanafusa
A standard strategy against ascites, a common symptom observed in cirrhotic and cancer patients, includes restriction of sodium intake and use of a diuretic. Paracentesis is a widely applied method against refractory ascites that do not react to such treatment. However, emerging fatigue and hemodynamic instability are possibly attributable to a loss of protein included in ascites. Cell-free and Concentrated Ascites Reinfusion Therapy (CART) is also applied against refractory ascites. CART comprises three processes...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28910501/serum-cystatin-c-level-is-an-excellent-predictor-of-mortality-in-patients-with-cirrhotic-ascites
#12
Yeon Seok Seo, Soo Young Park, Moon Young Kim, Sang Gyune Kim, Jun Yong Park, Hyung Joon Yim, Byoung Kuk Jang, Seung Ha Park, Ji Hoon Kim, Ki Tae Suk, Jin Dong Kim, Tae Yeob Kim, Eun Young Cho, Jun Sung Lee, Soung Won Jung, Jae Young Jang, Hyonggin An, Won Young Tak, Soon Koo Baik, Jae Seok Hwang, Young Seok Kim, Joo Hyun Sohn, Soon Ho Um
BACKGROUND/AIMS: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. METHODS: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1)...
September 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28895701/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-2-electrolyte-disturbances-nonelectrolyte-disturbances-therapeutic-options
#13
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamscha, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Alvarez
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 a pediatric patient 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 diagnostic and therapeutic aspects, and preventive care...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28883247/hepatic-and-gastric-involvement-in-a-case-of-systemic-sarcoidosis-presenting-with-rupture-of-esophageal-varices
#14
Hiroaki Saito, Masayasu Ohmori, Masaya Iwamuro, Takehiro Tanaka, Nozomu Wada, Tetsuya Yasunaka, Akinobu Takaki, Hiroyuki Okada
A 46-year-old woman presented with massive hematemesis, caused by the rupture of esophageal varices. The laboratory investigations showed pancytopenia, and imaging tests revealed hepatosplenomegaly and ascites. A diagnosis of systemic sarcoidosis was made based on biopsies of the liver, stomach, lungs, heart, and skin. Although fat deposition was predominant, non-caseating granuloma and cirrhotic changes were found in the liver. Non-caseating granuloma was also identified in a biopsy specimen from minute depressions of the gastric folds...
October 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28873293/the-role-of-midodrine-for-hypotension-outside-of-the-intensive-care-unit
#15
Lawrence B Gutman, Ben J Wilson
Midodrine is an oral, peripherally acting alpha-adrenergic agonist. After gaining Food and Drug Administration (FDA) approval in 1996 for orthostatic hypotension, its use has evolved to target vasoplegic conditions such as intradialytic hypotension in the end-stage renal disease population, refractory ascites in cirrhotic patients to support diuresis, and in hepatorenal syndrome. Upon oral ingestion, the drug undergoes enzymatic hydrolysis to an active metabolite, desglymidodrine. Its use has been well tolerated at 2...
August 23, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28864370/pro-brain-natriuretic-peptide-and-troponin-t-hypersensitivity-levels-correlate-with-the-severity-of-liver-dysfunction-in-liver-cirrhosis
#16
Jiancheng Zhao, Sai Li, Linan Ren, Xiaozhong Guo, Xingshun Qi
BACKGROUND: Increased pro-brain natriuretic peptide (pro-BNP) or troponin T-hypersensitivity (TnT-HSST) levels are common in liver cirrhosis. We conducted a retrospective observational study aimed to evaluate the correlation of pro-BNP and TnT-HSST levels with the clinical characteristics, laboratory data and in-hospital outcomes of patients with liver cirrhosis. MATERIALS AND METHODS: We selected cirrhotic patients admitted to our hospital between January 2011 and June 2014...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28845103/bacterial-translocation-markers-in-liver-cirrhosis
#17
REVIEW
Alexandra Alexopoulou, Danai Agiasotelli, Larisa E Vasilieva, Spyros P Dourakis
Bacterial translocation (BT) is an important mechanism in the development of infection in liver cirrhosis. The migration and colonization of bacteria and/or bacterial products from the bowel to mesenteric lymph nodes is a controlled process in healthy persons. Increased intestinal permeability, bacterial overgrowth and defect of gut-associated lymphatic tissue promote impaired BT in cirrhotics. We reviewed the reports on markers used for the evaluation of BT published between 1987 and 2016. We focused on the clinical consequences of BT in cirrhosis, as indicated by the values of the BT markers...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28792999/clinical-features-of-refractory-ascites-in-outpatients
#18
Wanda Regina Caly, Rodrigo Martins Abreu, Bernardo Bitelman, Flair José Carrilho, Suzane Kioko Ono
OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month...
July 2017: Clinics
https://www.readbyqxmd.com/read/28751810/effectiveness-of-tolvaptan-monotherapy-and-low-dose-furosemide-tolvaptan-combination-therapy-for-hepatoprotection-and-diuresis-in-a-rat-cirrhotic-model
#19
Norikazu Tanabe, Taro Takami, Koichi Fujisawa, Toshihiko Matsumoto, Naoki Yamamoto, Isao Sakaida
Spironolactone and furosemide, which are used to treat ascites associated with decompensated cirrhosis, are ineffective in treating refractory ascites. Hence, combination therapy with tolvaptan, a vasopressin V2 receptor antagonist, has been approved in Japan. Tolvaptan monotherapy and combination therapy with furosemide inhibit fibrosis in cardiac remodeling; hence, we examined these therapies in a rat cirrhotic model, including their usefulness in inhibiting hepatic fibrosis. In the present study, we used a model of hepatic fibrosis induced by a choline-deficient l-amino-acid-defined diet + diethylnitrosamine...
July 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28744162/validity-of-an-automated-algorithm-using-diagnosis-and-procedure-codes-to-identify-decompensated-cirrhosis-using-electronic-health-records
#20
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
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