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Cirrhotic ascites

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https://www.readbyqxmd.com/read/28416232/experience-in-real-clinical-practice-with-new-direct-acting-antivirals-in-chronic-hepatitis-c
#1
Fernando Manuel Jiménez-Macías, Manuel Cabanillas-Casafranca, Marta Maraver-Zamora, Gema Romero-Herrera, Federico García-García, Antonio Correia-Varela-Almeida, Ana Cabello-Fernández, Manuel Ramos-Lora
INTRODUCTION AND OBJECTIVE: Inclusion of direct-acting antivirals into clinical practice in patients with chronic HCV (CHC) has been a milestone in medicine. PATIENTS AND METHODS: Analytical, prospective study, involving 126 patients with chronic HCV treated with direct-acting antivirals. Efficacy and safety of treatment and factors associated with failure treatment were evaluated. RESULTS: Age 54±10. Male (70%). Cirrhosis (60%). Distribution according to genotypes: G1a (31%), G1b (42%); G3 (14%); G4 (13%)...
April 14, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28403123/influence-of-genetic-variations-in-the-sod1-gene-on-the-development-of-ascites-and-spontaneous-bacterial-peritonitis-in-decompensated-liver-cirrhosis
#2
Sebastian Schwab, Jennifer Lehmann, Philipp Lutz, Christian Jansen, Beate Appenrodt, Frank Lammert, Christian P Strassburg, Ulrich Spengler, Hans-Dieter Nischalke, Jonel Trebicka
BACKGROUND: The balance between generation and elimination of reactive oxygen species by superoxide dismutase (SOD) is crucially involved in the pathophysiology of liver cirrhosis. Reactive oxygen species damage cells and induce inflammation/fibrosis, but also play a critical role in immune defense from pathogens. As both processes are involved in the development of liver cirrhosis and its complications, genetic variation of the SOD1 gene was investigated. PATIENTS AND METHODS: Two SOD1 single nucleotide polymorphisms (rs1041740 and rs3844942) were analyzed in 49 cirrhotic patients undergoing liver transplantation...
April 11, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402708/diagnosing-sarcopenia-in-male-patients-with-cirrhosis-by-dual-energy-x-ray-absorptiometry-estimates-of-appendicular-skeletal-muscle-mass
#3
Giliane Belarmino, Maria Cristina Gonzalez, Priscila Sala, Raquel Susana Torrinhas, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque, Rosa Maria R Pereira, Valéria F Caparbo, Eduardo Ferrioli, Karina Pfrimer, Lucas Damiani, Steven B Heymsfield, Dan L Waitzberg
BACKGROUND: Ascites in cirrhotic patients interfere with accurate assessment of skeletal muscle when diagnosing sarcopenia. We hypothesized measurement of appendicular skeletal muscle index (ASMI) with dual-energy x-ray absorptiometry (DXA) improves the diagnosis of sarcopenia in cirrhotic patients as ASMI does not include the fluid-filled abdominal compartment. OBJECTIVE: To evaluate if ASMI is influenced by ascites, lower limb edema (LLE) and predicts mortality alone or combined with handgrip strength (HGS) in cirrhotic patients...
April 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28392947/nuclear-imaging-to-detect-diaphragmatic-perforation-as-a-rare-complication-of-microwave-ablation
#4
Stephanie Cull, Gebran Khneizer, Abhishek Krishna, Razi Muzaffar, Sameer Gadani, Zafar Jamkhana
Acquired diaphragmatic perforation leading to massive hepatic hydrothorax and respiratory failure is a rare complication of microwave ablation (MWA) of hepatocellular carcinoma (HCC). Imaging modalities to detect pleuroperitoneal communication remain poorly described. We report a nuclear imaging technique used to efficiently diagnose and locate diaphragmatic defects. A 57-year-old male with cirrhosis and HCC presented with respiratory distress after undergoing MWA of a HCC lesion. He was admitted to the intensive care unit for noninvasive positive pressure ventilator support...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28386572/spontaneous-fungal-peritonitis-in-ascites-of-cardiac-origin
#5
Yuchen Wang, Seema Gandhi, Bashar M Attar
Spontaneous fungal peritonitis (SFP) is an infrequent but severe complication most commonly described in patients with liver cirrhosis. We present the first case of culture-proven SFP occurring in cardiogenic ascites. The diagnosis of SFP was clinically challenging as the initial ascites was consistent with the more common diagnosis of spontaneous bacterial peritonitis (SBP). The patient did not respond to antibacterial therapy, however, and the final diagnosis was only made with positive ascitic cultures that grew Candida glabrata...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28383303/early-hospital-readmissions-and-mortality-in-patients-with-decompensated-cirrhosis-enrolled-in-a-large-national-health-insurance-administrative-database
#6
Steven J Scaglione, Leanne Metcalfe, Stephanie Kliethermes, Ivan Vasilyev, Rebecca Tsang, Allyce Caines, Shaham Mumtaz, Vik Goyal, Asra Khalid, David Shoham, Talar Markossian, Amy Luke, Howard Underwood, Scott J Cotler
BACKGROUND: Patients with decompensated cirrhosis have high rates of morbidity and mortality and frequently require hospital admission. Few studies have examined early readmission as an indicator of 90 day and overall mortality. Analysis of large databases is needed to evaluate the association between early readmission and mortality in decompensated cirrhosis. METHODS: We analyzed 5 years of private, employer-based, health insurance claims data associated with HealthCare Services Corporation on 13...
April 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28382951/nosocomial-and-community-acquired-spontaneous-bacterial-peritonitis-in-patients-with-liver-cirrhosis-in-china-comparative-microbiology-and-therapeutic-implications
#7
Lei Shi, Dan Wu, Lei Wei, Suxia Liu, Peng Zhao, Bo Tu, Yangxin Xie, Yanan Liu, Xinhua Wang, Liying Liu, Xin Zhang, Zhe Xu, Fusheng Wang, Enqiang Qin
Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 311) and the nosocomial SBP (n = 264) groups exhibited significant differences in clinical symptoms (P < 0...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28364815/challenges-in-renal-failure-treatment-before-liver-transplant
#8
REVIEW
Fabrizio Fabrizi, Piergiorgio Messa
Acute kidney injury (AKI) is common in patients with cirrhosis and ascites on the waiting list for liver transplant. Hepatorenal syndrome (HRS) is an important cause of AKI among cirrhotics. A dynamic definition of AKI in patients with cirrhosis has been introduced and changed the diagnosis criteria. Liver transplantation remains the better option but the medical management of HRS has changed. Terlipressin plus albumin is currently the gold standard. Surgery and liver or kidney support systems have been recommended...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28362879/prediction-of-diuretic-response-to-tolvaptan-by-a-simple-readily-available-spot-urine-na-k-ratio
#9
Yasuyuki Komiyama, Masayuki Kurosaki, Hiroyuki Nakanishi, Yuka Takahashi, Jun Itakura, Yutaka Yasui, Nobuharu Tamaki, Hitomi Takada, Mayu Higuchi, Tomoyuki Gotou, Youhei Kubota, Kenta Takaura, Tsuguru Hayashi, Wann Oh, Mao Okada, Nobuyuki Enomoto, Namiki Izumi
BACKGROUND: Tolvaptan is vasopressin type 2 receptor antagonist that inhibits water reabsorption. It is used in combination with standard diuretics to treat ascites unresponsive to standard diuretic therapy or hyponatremia because of liver cirrhosis. This study evaluated the effectiveness and safety of tolvaptan in clinical practice and aimed to determine the factors related to its effectiveness. METHODS: Tolvaptan was administered to 88 consecutive cirrhotic patients with ascites unresponsive to standard diuretic therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28348101/in-hospital-mortality-in-cirrhotic-patients-with-end-stage-renal-disease-treated-with-hemodialysis-versus-peritoneal-dialysis-a-nationwide-study
#10
Mark A Nader, Rodrigo Aguilar, Prabin Sharma, Parasuram Krishnamoorthy, Serban Dragoi, Judit Gordon-Cappitelli, Wen Shen, Chanigan Nilubol, Ping Li, Michael Lipkowitz
♦ Background: Cirrhotic patients often develop end-stage renal disease (ESRD) requiring renal replacement therapy in the form of hemodialysis (HD) or peritoneal dialysis (PD). Studies comparing the outcomes and difference in in-hospital mortality between these 2 groups, particularly among those with ascites, are sparse. We set our objective to determine the dialysis modality with a better in-hospital survival rate among cirrhotic patients with ESRD (ESRD-cirrhosis). ♦ Methods: Data was extracted from the 2005 to 2012 Nationwide Inpatient Sample (NIS)...
March 27, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28331804/infected-ascites-distinguishing-secondary-peritonitis-from-spontaneous-bacterial-peritonitis-in-a-cirrhotic-patient-with-classic-symptoms
#11
Marvin Louis Roy Lu, Akanksha Agarwal, Josh Sloan, Aaron Kosmin
INTRODUCTION: Spontaneous bacterial peritonitis can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection. However, oftentimes this is unapparent and other clinical clues need to be sought after to make the right diagnosis. CASE: A 64-year-old woman was admitted because of three days of worsening diffuse abdominal pain and distention. She was morbidly obese and had a history of non-alcoholic steatohepatitis (NASH) cirrhosis...
2017: IDCases
https://www.readbyqxmd.com/read/28321276/phase-angle-obtained-by-bioelectrical-impedance-analysis-independently-predicts-mortality-in-patients-with-cirrhosis
#12
Giliane Belarmino, Maria Cristina Gonzalez, Raquel S Torrinhas, Priscila Sala, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque, Rosa Maria R Pereira, Valéria F Caparbo, Graziela R Ravacci, Lucas Damiani, Steven B Heymsfield, Dan L Waitzberg
AIM: To evaluate the prognostic value of the phase angle (PA) obtained from bioelectrical impedance analysis (BIA) for mortality prediction in patients with cirrhosis. METHODS: In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker (PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models...
March 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28314307/post-hepatectomy-refractory-ascites-in-cirrhotic-patients-with-hepatocellular-carcinoma-risk-factor-analysis-to-overcome-this-problematic-complication
#13
Shinji Itoh, Hideaki Uchiyama, Yasuharu Ikeda, Kazutoyo Morita, Noboru Harada, Keishi Sugimachi, Hirofumi Kawanaka, Daisuke Korenaga, Tomoharu Yoshizumi, Kenji Takenaka, Yoshihiko Maehara
BACKGROUND: Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28298943/hepatic-vein-transit-time-of-second-generation-ultrasound-contrast-agent-new-tool-in-the-assessment-of-portal-hypertension
#14
Siciliani Luisa, Giovanna Vitale, Anna Rita Sorbo, Pompili Maurizio, Rapaccini Gian Lodovico
PURPOSE: It has been demonstrated that Doppler waveform of the hepatic vein (normally triphasic) is transformed into a biphasic or monophasic waveform in cirrhotic patients. The compressive mechanism of liver tissue has been considered up till now the cause of this change. Moreover, cirrhotics show, after USCA injection, a much earlier HVTT due to intrahepatic shunts. Our aim was to prospectively evaluate the correlation between Doppler pattern of hepatic vein and HVTT of a second-generation USCA; we also correlated HVTT with the most common indexes of portal hypertension...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28296047/non-selective-beta-blockers-are-not-associated-with-increased-mortality-in-cirrhotic-patients-with-ascites
#15
Simona Onali, Maria Kalafateli, Avik Majumdar, Rachel Westbrook, James O'Beirne, Gioacchino Leandro, David Patch, Emmanuel A Tsochatzis
BACKGROUND & AIMS: Controversy exists on the impact of non-selective beta-blockers (NSBBs) on survival in patients with ascites. We assessed whether NSBB treatment affects survival in a cohort of 316 consecutive patients with ascites undergoing evaluation for liver transplantation. METHODS: Consecutive patients with cirrhosis and ascites assessed for liver transplantation between 2011 and 2014 were retrospectively evaluated. Competing risk Cox regression analysis in the whole population and in propensity score matched patients were performed to identify predictors of survival...
March 11, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28271564/acute-kidney-injury-predicts-mortality-in-cirrhotic-patients-with-gastric-variceal-bleeding
#16
Yun-Cheng Hsieh, Kuei-Chuan Lee, Ping-Hsien Chen, Chien-Wei Su, Ming-Chih Hou, Han-Chieh Lin
BACKGROUND & AIM: The International Club of Ascites (ICA) recently proposed a new definition of AKI in cirrhotic patients. We evaluated the ICA-AKI criteria and their association with the prognosis of cirrhotic patients with gastric variceal bleeding (GVB). METHODS: A retrospective cohort study using prospective database of cirrhotic patients hospitalized with the first presentation of acute GVB at Taipei Veterans General Hospital from April 2007 to December 2010 was performed to evaluate the development of AKI...
March 8, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28231412/impact-of-family-history-of-metabolic-traits-on-severity-of-non-alcoholic-steatohepatitis-related-cirrhosis-a-cross-sectional-study
#17
Ajeet S Bhadoria, Chandan K Kedarisetty, Chhagan Bihari, Guresh Kumar, Ankur Jindal, Ankit Bhardwaj, Varsha Shasthry, Tanmay Vyas, Jaya Benjamin, Shvetank Sharma, Manoj K Sharma, Shiv K Sarin
BACKGROUND & AIMS: Familial aggregation of metabolic traits with fatty liver disease is well documented. However, there is scarcity of data regarding such association with non-alcoholic steatohepatitis (NASH)-related cirrhosis. This study was aimed to explore the association of family history of metabolic traits with severity of cirrhosis. METHODS: In a cross-sectional study, all consecutive patients with NASH-related cirrhosis presenting to our tertiary care centre were included...
February 23, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28230738/clinical-implications-of-20-hydroxyeicosatetraenoic-acid-in-the-kidney-liver-lung-and-brain-an-emerging-therapeutic-target
#18
REVIEW
Osama H Elshenawy, Sherif M Shoieb, Anwar Mohamed, Ayman O S El-Kadi
Cytochrome P450-mediated metabolism of arachidonic acid (AA) is an important pathway for the formation of eicosanoids. The ω-hydroxylation of AA generates significant levels of 20-hydroxyeicosatetraenoic acid (20-HETE) in various tissues. In the current review, we discussed the role of 20-HETE in the kidney, liver, lung, and brain during physiological and pathophysiological states. Moreover, we discussed the role of 20-HETE in tumor formation, metabolic syndrome and diabetes. In the kidney, 20-HETE is involved in modulation of preglomerular vascular tone and tubular ion transport...
February 20, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28223101/non-invasive-evaluation-of-portal-hypertension-using-ultrasound-elastography
#19
REVIEW
Annalisa Berzigotti
Portal hypertension (PH) leads to serious complications, such as bleeding from gastroesophageal varices, ascites and portosystemic encephalopathy in patients with chronic liver disease (CLD). Gold standard methods for assessing PH and its complications include the measurement of hepatic venous pressure gradient and endoscopy; however, these are invasive, expensive and not available at all centres. Therefore, non-invasive alternatives have been the subject of extensive investigation over the last 20years. The present review focuses on the role of ultrasound elastography - a novel group of non-invasive techniques used to measure stiffness in target organs...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28203285/automated-low-flow-ascites-pump-for-the-treatment-of-cirrhotic-patients-with-refractory-ascites
#20
REVIEW
Guido Stirnimann, Vanessa Banz, Federico Storni, Andrea De Gottardi
Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump(®)) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder...
February 2017: Therapeutic Advances in Gastroenterology
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