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Ascites in cirrhosis

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https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#1
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533907/novel-treatment-options-for-portal-hypertension
#2
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
#3
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...
May 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28520878/can-oesophagectomy-be-performed-for-patients-with-oesophageal-carcinoma-and-concomitant-liver-cirrhosis-a-retrospective-study-based-on-a-propensity-matched-cohort
#4
Zhi-Qiang Wang, Han-Yu Deng, Yu-Shang Yang, Yun Wang, Yang Hu, Yong Yuan, Wen-Ping Wang, Long-Qi Chen
OBJECTIVES: For patients with oesophageal carcinoma and concomitant liver cirrhosis, the safety profile and postoperative prognosis of oesophagectomy are not clearly established due to the lack of relevant studies with large sample sizes. Our objective was to explore the surgical indications and postoperative prognosis in patients with oesophageal carcinoma and liver cirrhosis. METHODS: A total of 2226 patients with oesophageal carcinoma underwent curative oesophagectomy (37 with liver cirrhosis and 2189 without) in our department from April 2008 to September 2013...
May 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28514703/bacterial-infections-and-hepatic-encephalopathy-in-liver-cirrhosis-prophylaxis-and-treatment
#5
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/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#6
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28502130/diagnostic-and-prognostic-values-of-monocyte-chemotactic-protein-1-in-ascitic-fluid-of-patients-with-spontaneous-bacterial-peritonitis
#7
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
#8
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...
May 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28501004/adipose-derived-mesenchymal-stem-cells-slow-disease-progression-of-acute-on-chronic-liver-failure
#9
Carlos Gilsanz, Maria-Angeles Aller, Sherezade Fuentes-Julian, Isabel Prieto, Alejandro Blázquez-Martinez, Salvador Argudo, Jorge Fernández-Delgado, Jose Beleña, Jaime Arias, María P De Miguel
A serious complication of chronic hepatic insufficiency is acute-on-chronic liver failure, a recognized syndrome characterized by acute decompensation of cirrhosis and organ/system failure. We investigated the use of adipose-derived mesenchymal stem cells (AD-MSCs) in an experimental model of acute-on-chronic liver failure, developed by microsurgical extrahepatic cholestasis in rats. Rats undergoing microsurgical extrahepatic cholestasis were treated by intraparenchymal liver injection of human or rat AD-MSCs, undifferentiated or previously differentiated in vitro toward the hepatocyte lineage...
May 10, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28494541/-new-therapeutic-paradigm-and-concepts-for-patients-with-cirrhotic-refractory-ascites
#10
S Z Wang, H G Ding
The activation of renin-angiotensin-aldosterone-vasopressin system is a key factor in the formation of ascites due to splanchnic vasodilation in cirrhosis. In theory, aldosterone antagonists, contraction of blood vessels, vasopressin V2 receptor, and angiotensin receptor antagonists are important targets for the prevention and treatment of cirrhotic ascites. The 15%-20% of patients with cirrhotic ascites that show no response to at least one week's treatment with potent diuretics (spironolactone 160 mg/d combined with furosemide 80 mg/d) are considered to have refractory ascites...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28494539/-current-status-and-perspectives-of-diagnosis-and-treatment-of-complications-related-to-liver-cirrhosis
#11
Y M Nan
Liver cirrhosis is the severe period of chronic liver diseases, especially decompensated liver cirrhosis and its complications, such as ascites, esophagogastric variceal bleeding, hepatic encephalopathy, acute kidney injury, and hepatocellular carcinoma, which greatly affect patients' quality of life and even threaten their lives. Early prevention and treatment of the causes of development and progression and pathogenic mechanism may slow down or reverse liver cirrhosis and its severe complications. Once the disease progresses to portal hypertension and related complications, it is very important to select preventive measures for acute exacerbation of different complications, as well as the methods and timing for treatment in acute stage, which may help to save patients' lives and improve their prognosis...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28489830/-clinical-and-laboratory-characteristics-of-patients-with-pulmonary-hypertension-and-pulmonary-vascular-complications-hospitalized-at-the-instituto-nacional-de-salud-del-ni%C3%A3-o
#12
Alexis Jose Ormeño Julca, Carlos Melchor Alvarez Murillo, Pedro Miguel Amoretti Alvino, Angel Aladino Florian Florian, Rosa Aurora Castro Johanson, Maria Danisa Celi Perez, Olga Rocío Huamán Prado
The hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHN) are distinct pulmonary vascular complications of portal hypertension (PHT) and are associated with increased morbidity and mortality. OBJECTIVES: To describe the clinical and laboratory characteristics of patients with pulmonary hypertension and pulmonary vascular complications hospitalized at the Instituto Nacional de Salud del Niño. MATERIALS AND METHODS: We included patients with HTP hospitalized from January 2012 to June 2013 and that during its evolution progressed with SHP or HTPP...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28486857/liver-to-abdominal-area-ratio-for-predicting-the-in-hospital-mortality-in-advanced-liver-cirrhosis
#13
Fan Gao, Ran Wang, Han Deng, Feifei Hou, Fernando Gomes Romeiro, Xingshun Qi
OBJECTIVES: To identify the value of liver-to-abdominal area ratio (LAAR) score for predicting the in-hospital mortality in advanced cirrhotic patients. METHODS: All cirrhotic patients with Child-Pugh class B or C who were admitted between July 2012 and June 2014 and underwent abdominal-pelvic CT scans were considered in this retrospective observational study. The association of LAAR with in-hospital death was calculated. Receiver operating characteristic curve analysis was performed...
May 9, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28485829/lercanidipine-induced-chylous-ascites-case-report-and-literature-review
#14
J E Basualdo, I A Rosado, M I Morales, N Fernández-Ros, A Huerta, F Alegre, M F Landecho, J F Lucena
WHAT IS KNOWN AND OBJECTIVE: Chylous ascites is a rare condition. The most frequent causes are lymphomas, solid malignancies, abdominal trauma and cirrhosis. Isolated case reports describe the relationship between calcium channel blockers (CCB) and chyloperitoneum. Lercanidipine is a third-generation dihydropyridine with low rate of adverse events. We describe a case of lercanidipine-induced chylous ascites. CASE SUMMARY: An 80-year-old white female with hypertension treated with lercanidipine, developed chylous ascites and abdominal pain after the dosage of the CCB was doubled...
May 9, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28485641/characterization-of-ascites-in-cardiac-cirrhosis-the-value-of-ascitic-fluid-protein-to-screen-for-concurrent-cardiac-cirrhosis
#15
Yuchen Wang, Bashar M Attar, Seema Gandhi, Palashkumar Jaiswal, Sara Bedsore, Neethi Paranji, Sachit Sharma
Abstracts Objectives: Cardiogenic ascites has been well described regarding its pathophysiology and fluid characteristics in prior literatures. However, ascites in patients with cardiac cirrhosis has not been characterized as a separate entity despite its unique pathophysiology and clinical aspects. This study aims to describe the fluid profile of ascites of cardiac cirrhosis and explore the utility of ascitic fluid protein (AFP) to predict concurrent cardiac cirrhosis. METHODS AND MATERIALS: We retrospectively selected and reviewed samples from the patients with cardiogenic ascites with and without concurrent cardiac cirrhosis...
May 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28484121/endovascular-treatment-of-concomitant-obstructions-of-a-denver-drainage-catheter-and-superior-vena-cava-in-a-patient-with-liver-cirrhosis
#16
Chih-Hung Lai, Wei-Chun Chang, Tsun-Jui Liu, Wen-Lieng Lee, Chieh-Shou Su
With the increased use of intravascular catheters and devices, they have become the major non-malignant cause of superior vein cava (SVC) syndrome. We report a patient with liver cirrhosis who had received a peritoneovenous drainage catheter for refractory ascites, and then developed SVC syndrome because of concomitant occlusions of both the SVC and the drainage catheter. The patient regained patency of both the occluded vessel and the drainage catheter through percutaneous transluminal venoplasty, and there was dramatic improvement of clinical symptoms and good performance of the drainage catheter...
May 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28468020/novel-approaches-to-reducing-the-risk-of-variceal-hemorrhage
#17
Frederik Nevens
BACKGROUND: Complications of advanced liver disease occur at the moment of clinical significant portal hypertension. Nitric oxide (NO) dysfunction and fibrosis play an important role in the pathophysiology of PH, but other mechanisms are also involved. Non-selective beta blockers (NSBB) stay the cornerstone in the primary and secondary prevention of variceal bleeding, but their safety in advanced cirrhosis has been recently debated and new drugs are under investigation. Transjugular intrahepatic portosystemic shunt and balloon tamponade are the standard therapy in case of refractory variceal bleeding, but both interventions have drawbacks...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28468013/translating-our-current-understanding-of-ascites-management-into-new-therapies-for-patients-with-cirrhosis-and-fluid-retention
#18
Elisa Pose, Andres Cardenas
Ascites is the most common complication associated with cirrhosis resulting in poor quality of life, high risk of development of other complications of cirrhosis, increased morbidity and mortality associated with surgical interventions, and poor long-term outcome. Patients with cirrhosis and a first onset of ascites, have a probability of survival of 85% during the first year and 56% at 5 years without liver transplantation. Ascites is caused due to increased renal sodium retention as a result of increased activity of the renin-angiotensin-aldosterone system in response to marked vasodilation of the splanchnic circulation...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28464883/late-presentation-of-chronic-viral-hepatitis-for-medical-care-a-consensus-definition
#19
Stefan Mauss, Stanislas Pol, Maria Buti, Erika Duffell, Charles Gore, Jeffrey V Lazarus, Hilje Logtenberg-van der Grient, Jens Lundgren, Antons Mozalevskis, Dorthe Raben, Eberhard Schatz, Stefan Wiktor, Jürgen K Rockstroh
INTRODUCTION: We present two consensus definitions of advanced and late stage liver disease being used as epidemiological tools. These definitions can be applied to assess the morbidity caused by liver diseases in different health care systems. We focus is on hepatitis B and C virus infections, because effective and well tolerated treatments for both of these infections have greatly improved our ability to successfully treat and prevent advanced and late stage disease, especially if diagnosed early...
May 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28464346/review-article-maximising-quality-of-life-while-aspiring-for-quantity-of-life-in-end-stage-liver-disease
#20
REVIEW
R A Bhanji, E J Carey, K D Watt
BACKGROUND: With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed. AIMS: Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD...
May 2, 2017: Alimentary Pharmacology & Therapeutics
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