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Ascites in cirrhosis

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https://www.readbyqxmd.com/read/29150405/cirrhosis-with-ascites-in-the-last-year-of-life-a-nationwide-analysis-of-factors-shaping-costs-health-care-use-and-place-of-death-in-england
#1
Benjamin Hudson, Jeff Round, Brendan Georgeson, Andrew Pring, Karen Forbes, Catherine Anne McCune, Julia Verne
BACKGROUND: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life. METHODS: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life...
November 14, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29149171/risk-factors-for-hospitalizations-among-patients-with-cirrhosis-a-prospective-cohort-study
#2
Shari S Rogal, Viyan Udawatta, Imo Akpan, Akshata Moghe, Alexis Chidi, Amit Shetty, Eva Szigethy, Klaus Bielefeldt, Andrea DiMartini
This study was designed to assess unique baseline factors associated with subsequent hospitalizations in a cohort of outpatients with cirrhosis. A cohort of 193 patients with cirrhosis was recruited from an outpatient liver disease clinic at a single, tertiary medical center. Comorbidities, prescription medications, liver disease symptoms and severity, and psychiatric and pain symptoms were assessed at baseline using validated instruments. Inflammatory markers were measured using standardized Luminex assays...
2017: PloS One
https://www.readbyqxmd.com/read/29127060/granulocyte-colony-stimulating-factor-and-autologous-cd133-positive-stem-cell-therapy-in-liver-cirrhosis-realistic-an-open-label-randomised-controlled-phase-2-trial
#3
Philip Noel Newsome, Richard Fox, Andrew L King, Darren Barton, Nwe-Ni Than, Joanna Moore, Christopher Corbett, Sarah Townsend, James Thomas, Kathy Guo, Diana Hull, Heather A Beard, Jacqui Thompson, Anne Atkinson, Carol Bienek, Neil McGowan, Neil Guha, John Campbell, Dan Hollyman, Deborah Stocken, Christina Yap, Stuart John Forbes
BACKGROUND: Results of small-scale studies have suggested that stem-cell therapy is safe and effective in patients with liver cirrhosis, but no adequately powered randomised controlled trials have been done. We assessed the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) and haemopoietic stem-cell infusions in patients with liver cirrhosis. METHODS: This multicentre, open-label, randomised, controlled phase 2 trial was done in three UK hospitals and recruited patients with compensated liver cirrhosis and MELD scores of 11·0-15·5...
November 7, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29108189/-guidelines-on-the-management-of-ascites-and-complications-in-cirrhosis
#4
(no author information available yet)
No abstract text is available yet for this article.
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#5
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
November 6, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29105115/randomised-clinical-study-the-effects-of-oral-taurine-6-day%C3%A2-g-vs-placebo-daily-on-portal-hypertension
#6
R Schwarzer, D Kivaranovic, M Mandorfer, R Paternostro, D Wolrab, B Heinisch, T Reiberger, M Ferlitsch, C Gerner, M Trauner, M Peck-Radosavljevic, A Ferlitsch
BACKGROUND: The amino sulphonic acid taurine reduces oxidative endoplasmatic reticulum stress and inhibits hepatic stellate cell activation, which might lead to reduction of portal pressure in cirrhosis. AIM: To assess the haemodynamic effects of taurine supplementation in patients with cirrhosis and varices. METHODS: Patients with hepatic venous pressure gradient (HVPG) ≥12 mm Hg were included in this prospective proof of concept study...
November 3, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29098551/ascites-neutrophil-gelatinase-associated-lipocalin-identifies-spontaneous-bacterial-peritonitis-and-predicts-mortality-in-hospitalized-patients-with-cirrhosis
#7
Giuseppe Cullaro, Grace Kim, Marcus R Pereira, Robert S Brown, Elizabeth C Verna
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a marker of both tissue injury and infection. Urine NGAL levels strongly predict acute kidney injury and mortality in patients with cirrhosis, but ascites NGAL is not well characterized. We hypothesized that ascites NGAL level is a marker of spontaneous bacterial peritonitis (SBP) and mortality risk in patients with cirrhosis. METHODS: Hospitalized patients with cirrhosis and ascites undergoing diagnostic paracentesis were prospectively enrolled and followed until death or discharge...
December 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29091351/eptfe-tips-versus-repetitive-lvp-plus-albumin-for-the-treatment-of-refractory-ascites-in-patients-with-cirrhosis
#8
Theresa Bucsics, Sophie Hoffman, Johanna Grünberger, Maria Schoder, Wolfgang Matzek, Alexander Stadlmann, Mattias Mandorfer, Philipp Schwabl, Arnulf Ferlitsch, Markus Peck-Radosavljevic, Michael Trauner, Josef Karner, Franz Karnel, Thomas Reiberger
INTRODUCTION: Reduction of portal pressure by self-expandable polytetrafluoroethylene (ePTFE)-covered transjugular intrahepatic portosystemic shunts (TIPS) is a treatment option for refractory ascites. Data on clinical outcomes after ePTFE-TIPS versus repetitive large-volume paracentesis (LVP) plus albumin (A) administration for the treatment of patients with refractory ascites are limited. METHODS: Retrospective comparison of ePTFE-TIPS versus LVP+A in terms of (i) control of ascites, (ii) occurrence of overt hepatic encephalopathy (HE) and (iii) transplant-free survival in cirrhotic patients with refractory ascites...
November 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29091289/a-risk-score-to-predict-the-development-of-hepatic-encephalopathy-in-a-population-based-cohort-of-patients-with-cirrhosis
#9
Elliot B Tapper, Neehar Parikh, Neil Sengupta, Jessica Mellinger, David Ratz, Anna S Lok, Grace L Su
Over 40% of patients with cirrhosis will develop hepatic encephalopathy (HE). HE is associated with decreased survival, falls, motor vehicle accidents, and frequent hospitalization. Accordingly, we aimed to develop a tool to risk-stratify patients for HE development. We studied a population-based cohort of all patients with cirrhosis without baseline HE (N=1,979) from the Veterans Administration from Michigan, Indiana, and Ohio (1/1/2005-12/31/10) using demographic, clinical, laboratory, and pharmacy data. The primary outcome was the development of HE...
November 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29089785/partial-hepatectomy-for-spontaneous-tumor-rupture-in-patients-with-hepatocellular-carcinoma-a-retrospective-cohort-study
#10
Qian Zhu, Guo-Liang Qiao, Chang Xu, De-Liang Guo, Jie Tang, Rui Duan, Yun Li
BACKGROUND: The impact of ruptured hepatocellular carcinoma (HCC) on a patients outcome after hepatic resection remains insufficient. We aimed to identify the independent predictive factors of spontaneous tumor rupture (STR) for curative resection of HCC and to investigate the impact of STR of HCC on long-term survival after resection. PATIENTS AND METHODS: The clinicopathological parameters of 106 patients with ruptured HCC and 201 patients with non-ruptured HCC who underwent hepatic resection from 2007 to 2011 were investigated...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/29064029/the-portal-hypertension-syndrome-etiology-classification-relevance-and-animal-models
#11
REVIEW
Jaime Bosch, Yasuko Iwakiri
BACKGROUND: Portal hypertension is a key complication of portal hypertension, which is responsible for the development of varices, ascites, bleeding, and hepatic encephalopathy, which, in turn, cause a high mortality and requirement for liver transplantation. AIM: This review deals with the present day state-of-the-art preventative treatments of portal hypertension in cirrhosis according to disease stage. Two main disease stages are considered, compensated and decompensated cirrhosis, the first having good prognosis and being mostly asymptomatic, and the second being heralded by the appearance of bleeding or non-bleeding complications of portal hypertension...
October 24, 2017: Hepatology International
https://www.readbyqxmd.com/read/29059469/fat-free-muscle-mass-in-magnetic-resonance-imaging-predicts-acute-on-chronic-liver-failure-and-survival-in-decompensated-cirrhosis
#12
Michael Praktiknjo, Marius Book, Julian Luetkens, Alessandra Pohlmann, Carsten Meyer, Daniel Thomas, Christian Jansen, Andreas Feist, Johannes Chang, Jochen Grimm, Jennifer Lehmann, Christian P Strassburg, Juan Gonzalez Abraldes, Guido Kukuk, Jonel Trebicka
BACKGROUND: Muscle mass seems to be a prognostic marker in patients with liver cirrhosis. However, reported methods to quantify muscle mass are heterogeneous, consented cut-off values are missing and most studies used computed tomography (CT). This study evaluated fat-free muscle area as a marker of sarcopenia using magnetic resonance imaging (MRI) in decompensated cirrhotic patients with transjugular intrahepatic portosystemic shunt (TIPS). METHODS: The total erector spinae muscle area and the intramuscular fat tissue area were measured and subtracted to calculate the fat-free muscle area (FFMA) in 116 cirrhotic patients with TIPS and MRI...
October 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29057245/a-case-report-of-congenital-glycogen-storage-liver-cirrhosis-treated-with-bone-marrow-derived-stem-cells
#13
Terek W Wehbe, Nassim H Abi Chahine, Abdul-Rahman A Annous, Mohammad A Ferri, Robert C Boulous, Majid F El-Mestrah
Liver cirrhosis represents a state of end-stage failure that is usually fatal. The condition results in liver dysfunction, recurrent ascites, encephalopathy, renal failure, splenomegaly, bleeding, and a poor quality of life in general. With the current severe shortage of donated organs, the only available treatment in the developing countries remains palliative care. We report a case of congenital metabolic liver cirrhosis due to glycogen storage disease diagnosed at age eight. The patient, a male, received bone marrow derived mononuclear cells (BMMC) at age 16 and again at age 17 with significant improvement of his biochemical liver function tests, ascites build-up, asthenia, splenomegaly and quality of life...
2017: Stem Cell Investigation
https://www.readbyqxmd.com/read/29054942/primary-hepatic-hemangioendothelioma-in-a-patient-with-budd-chiari-syndrome
#14
Preet Mukesh Shah, Vijay Waman Dhakre, Aabha Nagral
A 36-year-old woman was diagnosed with compensated cirrhosis of liver secondary to Budd-Chiari syndrome (BCS) and had undergone stenting of a thrombosed left hepatic vein. Eight months later, she presented with jaundice and right upper quadrant pain. CT revealed multiple focal lesions in the liver, which on biopsy proved to be hepatic hemangioendothelioma (HHE). Her liver disease and ascites progressively increased. Four months later, magnetic resonance cholangiopancreatography showed an advanced stage of HHE with infiltration of the common bile duct and vascular invasion with a blocked stent, with metastasis to the spleen and dorsolumbar vertebrae...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054902/chylous-ascites-in-a-patient-with-an-overlap-syndrome-a-surprising-response-to-rituximab
#15
Alexandra Daniel, Gianluca Bagnato, Edward Vital, Francesco Del Galdo
The authors present a case of a 51-year-old woman with clinical diagnosis of mixed connective tissue disease and overlap systemic lupus erythematosus features, with a 6-month history of progressive painless abdominal distension. On examination, evident signs of ascites were present. Both the abdominal-pelvic ultrasound and CT scan confirmed a large amount of ascites. A diagnostic paracentesis was performed, which revealed typical features of chylous ascites (CA). An extensive diagnostic work-up led by a multidisciplinary team was performed, excluding malignancy, cirrhosis, infectious, as well as cardiac and primary lymphatic causes...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29049233/pediatric-types-i-and-vi-choledochal-cysts-complicated-with-acute-pancreatitis-and-spontaneous-perforation-a-case-report-and-literature-review
#16
Ching-Chung Tsai, Po-Kai Huang, Hsien-Kuan Liu, Yu-Tsun Su, Ming-Chun Yang, Ming-Lun Yeh
RATIONALE: Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS: A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049216/fondaparinux-is-effective-for-acute-portal-vein-thrombosis-in-decompensated-cirrhotic-patients
#17
REVIEW
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
#18
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/29041907/detection-of-bacterial-dna-by-in-situ-hybridization-in-patients-with-decompensated-liver-cirrhosis
#19
Shingo Usui, Hirotoshi Ebinuma, Po-Sung Chu, Nobuhiro Nakamoto, Yoshiyuki Yamagishi, Hidetsugu Saito, Takanori Kanai
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is often difficult to diagnose because bacteria in ascites cannot be detected accurately by conventional culture. In situ hybridization (ISH) was previously developed for rapid detection of genes from bacteria phagocytized by neutrophils. SBP may develop after bacteria enter into the systemic circulation following bacterial translocation. Therefore, we performed ISH to identify bacteria in blood samples collected from patients with decompensated liver cirrhosis (LC)...
October 17, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29026875/ethylene-glycol-poisoning-should-not-contraindicate-liver-donation
#20
Alisha Burman, Christopher J E Watson, Vasilis Kosmoliaptsis
As the number of patients waiting to receive transplants increases, there is a need to explore all possible donation opportunities. In this case report, we describe the transplantation of a liver from a donor who died after ethylene glycol poisoning into a woman with alcoholic liver disease with cirrhosis and associated ascites. Donor management, including ethanol, fomepizol and haemodialysis, hastened clearance of ethylene glycol from the circulation, and after liver transplantation, the recipient exhibited no adverse effects suggestive of ethylene glycol toxicity, although recipient hepatic artery dissection and thrombosis necessitated retransplantation...
October 2017: Transplantation Direct
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