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Cirrhotic ascites

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https://www.readbyqxmd.com/read/28688177/renal-vein-dilation-predicts-the-poor-outcome-in-patients-with-refractory-cirrhotic-ascites
#1
Naoki Matsumoto, Masahiro Ogawa, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Takao Miura, Hiroshi Nakagawara, Shunichi Matsuoka, Mitsuhiko Moriyama, Hirotoshi Fujikawa
BACKGROUND & AIMS: Renal venous hypertension is known to be associated with worsening of renal function in patients with decompensated heart failure. Intra-abdominal hypertension including cirrhotic ascites also leads to renal venous hypertension. We aimed to clarify the effect of renal venous hypertension on cirrhotic ascites. METHODS: Two hepatologists measured the left renal vein diameter in 142 consecutive patients with refractory cirrhotic ascites using non-contrast computed tomography...
July 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28688141/incidence-predictive-factors-and-impacts-of-acute-kidney-injury-in-cirrhotic-patients-hospitalized-for-cellulitis
#2
Ana Garcia Garcia de Paredes, Luis Tellez, Miguel Angel Rodriguez-Gandia, Javier Martinez, Enrique Rodriguez De Santiago, Lara Aguilera Castro, Francisco Gea, Agustín Albillos
BACKGROUND & AIMS: Cellulitis is a common infection in patients with cirrhosis but its impact on progression of liver disease has been hardly addressed. This study examines the incidence of acute kidney injury (AKI), predictive factors, and its impacts on mortalilty in cirrhotic patients hospitalized for cellulitis. METHODS: Retrospective data from cirrhotic patients hospitalized for cellulitis over the period January 2006 to September 2015 were analyzed. AKI was defined according to revised criteria of the International Club of Ascites...
July 8, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28663673/spontaneous-bacterial-peritonitis-by-burkholderia-cepacia-complex-a-rare-difficult-to-treat-infection-in-decompensated-cirrhotic-patients
#3
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/28661458/adipokines-in-liver-cirrhosis
#4
REVIEW
Christa Buechler, Elisabeth M Haberl, Lisa Rein-Fischboeck, Charalampos Aslanidis
Liver fibrosis can progress to cirrhosis, which is considered a serious disease. The Child-Pugh score and the model of end-stage liver disease score have been established to assess residual liver function in patients with liver cirrhosis. The development of portal hypertension contributes to ascites, variceal bleeding and further complications in these patients. A transjugular intrahepatic portosystemic shunt (TIPS) is used to lower portal pressure, which represents a major improvement in the treatment of patients...
June 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28660157/comment-on-ascitic-fluid-analysis-in-the-differential-diagnosis-of-ascites-focus-on-cirrhotic-ascites
#5
Furqan Ahmed
No abstract text is available yet for this article.
June 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28647833/the-evaluation-of-the-right-inferior-phrenic-artery-diameter-in-cirrhotic-patients
#6
Kaan Esen, Yuksel Balci, Sermin Tok, Enver Ucbilek, Engin Kara, Omer Kaya
PURPOSE: The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients. METHODS: CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group...
June 24, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28645737/alfapump-system-vs-large-volume-paracentesis-for-refractory-ascites-a-multicenter-randomized-controlled-study
#7
Christophe Bureau, Danielle Adebayo, Mael Chalret de Rieu, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rosi, Stewart MacDonald, Massimo Malago, Maria Stepanova, Zobair M Younossi, Claudia Trepte, Randall Watson, Oleg Borisenko, Sun Sun, Neil Inhaber, Rajiv Jalan
BACKGROUND AND AIMS: Patients with refractory ascites (RA) require repeated large volume paracenteses (LVP), which involves frequent hospital visits and is associated with poor quality-of-life. This study assessed safety and efficacy of an automated, low-flow pump (alfapump [AP]) compared with LVP [SoC]. METHODS: Randomized, controlled trial, in 7 centers, with 6M patient observation. Primary outcome was time to first LVP. Secondary outcomes included paracentesis requirement, safety, health-related quality-of-life (HRQoL), and survival...
June 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28634518/role-of-albumin-in-cirrhosis-from-a-hospitalist-s-perspective
#8
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/28614081/spontaneous-fungal-peritonitis-a-rare-but-severe-complication-of-liver-cirrhosis
#9
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/28611511/first-quarter-century-of-laparoscopic-liver-resection
#10
REVIEW
Zenichi Morise, Go Wakabayashi
The beginnings of laparoscopic liver resection (LLR) were at the start of the 1990s, with the initial reports being published in 1991 and 1992. These were followed by reports of left lateral sectionectomy in 1996. In the years following, the procedures of LLR were expanded to hemi-hepatectomy, sectionectomy, segmentectomy and partial resection of posterosuperior segments, as well as the parenchymal preserving limited anatomical resection and modified anatomical (extended and/or combining limited) resection procedures...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28603226/infections-in-patients-affected-by-liver-cirrhosis-an-update
#11
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/28593001/teaching-echoscopy-for-the-early-diagnosis-of-ascites-in-cirrhosis-assessment-of-an-objective-structured-clinical-examination-osce
#12
Salmi Andrea, Lanzani Giovanna, Campagnola Pietro, Frulloni Luca
INTRODUCTION: We assessed the efficacy of a brief, 8-h teaching program, using an objective structured clinical examination (OSCE) for the use of a pocket ultrasound device (echoscope) focused on bed side diagnosis of subclinical ascites in chronic liver disease. PATIENTS AND METHODS: Ten cirrhotic patients, five with subclinical ascites and five without, were selected during ultrasound examination performed with a high performance equipment for screening of hepatocellular carcinoma...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28588180/impact-of-adrenocortical-insufficiency-on-biochemical-parameters-in-haemodynamically-stable-cirrhotic-patients-with-ascites
#13
H Ahmed, M R Karim, R K Paul, M Chowdhury, M S Alam, F Rahman, M A Rouf
Cirrhosis has many complications regardless of the aetiology. Among them, adrenal insufficiency is recently identified entity. A prospective cohort study was done to evaluate the biochemical impact of adrenocortical insufficiency in haemodynamically stable, non-septic, cirrhotic patients with ascites and had been performed at the inpatient of GHPD department, BIRDEM, Dhaka from April 2011 to March 2012. A total of fifty three (53) patients fulfilling inclusion criteria were included in the study. Patients were divided into two groups: Group A (patients of normal adrenal function) and Group B (patients of insufficient adrenal function) and those were followed up for the next 6 months...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28579346/combined-spontaneous-bacterial-empyema-and-peritonitis-in-cirrhotic-patients-with-ascites-and-hepatic-hydrothorax
#14
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 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28533907/novel-treatment-options-for-portal-hypertension
#15
Philipp Schwabl, Wim Laleman
Portal hypertension is most frequently associated with cirrhosis and is a major driver for associated complications, such as variceal bleeding, ascites or hepatic encephalopathy. As such, clinically significant portal hypertension forms the prelude to decompensation and impacts significantly on the prognosis of patients with liver cirrhosis. At present, non-selective β-blockers, vasopressin analogues and somatostatin analogues are the mainstay of treatment but these strategies are far from satisfactory and only target splanchnic hyperemia...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28532189/non-selective-beta-blocker-treatment-does-not-impact-on-kidney-function-in-cirrhotic-patients-with-varices
#16
Bernhard Scheiner, Diego Parada-Rodriguez, Theresa Bucsics, Philipp Schwabl, Mattias Mandorfer, Nikolaus Pfisterer, Florian Riedl, Wolfgang Sieghart, Arnulf Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Thomas Reiberger
GOALS AND BACKGROUND: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress. STUDY: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs. without NSBB therapy...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28525199/-pleuroperitoneal-communication-pleural-effusion-subsequent-to-the-initiation-of-peritoneal-dialysis-about-a-case
#17
E De Plaen, A Therasse, E Lebrun, F Mestrez, L Binet, J Lemaitre
We report the case of a patient with pleural effusion occurring after initiation of a peritoneal dialysis. This phenomenon is favoured by the existence of a pleuroperitoneal communication. The latter is described at the origin of other diseases like catamenial pneumothorax and pleural effusion in connection with cirrhotic ascites. We describe this rare complication of peritoneal dialysis in order to draw attention of nephrologists, pulmonologists and surgeons.
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28514703/bacterial-infections-and-hepatic-encephalopathy-in-liver-cirrhosis-prophylaxis-and-treatment
#18
REVIEW
Damian Piotrowski, Anna Boroń-Kaczmarska
Infections are common among patients with liver cirrhosis. They occur more often in cirrhotic patient groups than in the general population and result in higher mortality. One reason for this phenomenon is bacterial translocation from the intestinal lumen that occurs as a consequence of intestinal bacterial overgrowth, increased permeability and decreased motility. The most common infections in cirrhotic patients are spontaneous bacterial peritonitis and urinary tract infections, followed by pneumonia, skin and soft tissue infections...
May 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28502130/diagnostic-and-prognostic-values-of-monocyte-chemotactic-protein-1-in-ascitic-fluid-of-patients-with-spontaneous-bacterial-peritonitis
#19
Naglaa El-Toukhy, Sherin M Emam
Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotics with ascites. Monocyte chemotactic protien-1 (MCP-1) is a chemotactic factor for monocytes/macrophages, and it activates lymphocytes and neutrophils during infection. This study aimed to evaluate the role of MPC-1 in the pathogenesis of SBP and assess its prognostic value and correlation to disease severity. The study included ninety patients with liver cirrhosis and ascites. Patients were divided into 2 groups: Group I including 45 ascetic patients with SBP (polymorph nuclear cell count (PMN) >= 250 cell/mm3 in ascitic fluid), and Group II including 45 ascetic patients without SBP...
June 2016: Egyptian Journal of Immunology
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#20
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
August 2017: Digestive Diseases and Sciences
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