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Ascites in cirrhosis

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https://www.readbyqxmd.com/read/29350402/effectiveness-and-safety-of-original-and-generic-sofosbuvir-for-the-treatment-of-chronic-hepatitis-c-a-real-world-study
#1
Sebastián Marciano, Leila Haddad, María Virginia Reggiardo, Mirta Peralta, Cecilia Vistarini, Mónica Marino, Valeria Inés Descalzi, Claudia D'Amico, Sebastián Figueroa Escuti, Luis Alejandro Gaite, Roberto Pérez Ravier, Cristina Longo, Silvia Mabel Borzi, Omar Andrés Galdame, Fernando Bessone, Hugo Alberto Fainboim, Silvia Frías, Mariano Cartier, Adrián Carlos Gadano
We report the first real-world prospective multicenter cohort study that evaluated the effectiveness and safety of original or generic sofosbuvir-based regimens in patients with chronic hepatitis C in Latin America. The main endpoints were assessment of sustained virological response and serious adverse events rates. A total of 321 patients with chronic hepatitis C treated with the following regimens were included: sofosbuvir plus daclatasvir for 12 (n = 34) or 24 (n = 135) weeks, sofosbuvir plus daclatasvir plus ribavirin for 12 (n = 84) or 24 (n = 56) weeks, or sofosbuvir plus ribavirin for 12 (n = 8) or 24 (n = 2) weeks...
January 19, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#2
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29330279/rare-cause-of-isolated-severe-coagulation-failure-in-cirrhosis-traditional-healing-with-fenugreek
#3
Cyriac A Philips, Philip Augustine
Patients with cirrhosis develop decompensation events during the natural history of the disease that encompass ascites, variceal bleeding, hepatic encephalopathy and jaundice. Coagulation failure, defined using the international normalised ratio, even though not a decompensation event, is important in patients with stratifying cirrhosis into those who require liver transplantation for long-term survival. Isolated coagulation failure in cirrhosis is rare and usually occurs with use of anticoagulants in the setting of vascular diseases...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29317174/elective-endoscopic-variceal-ligation-is-not-a-risk-factor-for-bacterial-infection-in-patients-with-liver-cirrhosis
#4
Sergio Maimone, Francesca Saffioti, Roberto Filomia, Gaia Caccamo, Carlo Saitta, Socrate Pallio, Pierluigi Consolo, Sara Sabatini, Krizia Sitajolo, Maria Stella Franzè, Irene Cacciola, Giovanni Raimondo, Giovanni Squadrito
BACKGROUND: Patients with cirrhosis are at high risk of bacterial infections. Invasive procedures are generally believed to increase this susceptibility. AIMS: We investigated the incidence of bacterial infections in cirrhotic patients undergoing elective endoscopic variceal ligation (EVL). METHODS: We enrolled 60 consecutive cirrhotic patients who underwent a total number of 112 elective EVL procedures. One to seven bands were applied at each session until variceal eradication...
December 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#5
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29316565/transjugular-intrahepatic-portosystemic-shunt-in-patients-with-portal-hypertension-patency-depends-on-coverage-and-interventionalist-s-experience
#6
Matthias Buechter, Paul Manka, Guido Gerken, Ali Canbay, Sandra Blomeyer, Axel Wetter, Jens Altenbernd, Alisan Kahraman, Jens M Theysohn
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice in decompensated portal hypertension. TIPS revision due to thrombosis or stenosis increases morbidity and mortality. Our aim was to investigate patient- and procedure-associated risk factors for TIPS-revision. PATIENTS AND METHODS: We retrospectively evaluated 189 patients who underwent the TIPS procedure. Only patients who required TIPS revision within 1 year (Group I, 34 patients) and patients who did not require re-intervention within the first year (Group II [control group], 54 patients) were included...
January 9, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29315697/fractional-excretion-of-urea-a-simple-tool-for-the-differential-diagnosis-of-acute-kidney-injury-in-cirrhosis
#7
Kavish R Patidar, Le Kang, Jasmohan S Bajaj, Daniel Carl, Arun J Sanyal
Current approaches to determine the cause of acute kidney injury (AKI) in patients with cirrhosis are suboptimal. The aim of this study was to determine the utility of fractional excretion of urea (FEUrea) for the differential diagnosis of AKI in cirrhotic patients. A retrospective analysis was performed in patients (n=50) with cirrhosis and ascites admitted with AKI. Using adjudicated etiology assessment as the reference standard, receiver operating curves (ROC) and optimal cutoff, sensitivity (Sn) and specificity (Sp) for the diagnosis of prerenal azotemia (PRA), type 1 hepatorenal syndrome (HRS) and acute tubular necrosis (ATN) was derived...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#8
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29311402/atypical-abdominal-pain-in-a-patient-with-liver-cirrhosis
#9
Liz Toapanta-Yanchapaxi, Eid-Lidt Guering, Ignacio García-Juárez
The causes of abdominal pain in patients with liver cirrhosis and ascites are well-known but occasionally, atypical causes arise. We report the case of a patient with a ruptured, confined abdominal aortic aneurysm.
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29310725/increased-number-of-eosinophils-in-ascites-is-associated-with-intestinal-anisakidosis
#10
K Okumura, T Kubota, A K Lefor, A Saito, K Mizokami
The aim of this study was to evaluate the association between eosinophils in ascites and the diagnosis of intestinal anisakidosis in patients with peritoneal signs on physical examination. We reviewed retrospectively 16 patients diagnosed with intestinal anisakidosis, evaluated between 2012 and 2015. All patients had ingested raw anchovies. The analysis of ascites fluid in ten of these patients was compared with that of 15 patients with ascites and other abdominal pathology (except liver cirrhosis). All patients had an increased number of white blood cells in the ascites fluid...
January 9, 2018: Journal of Helminthology
https://www.readbyqxmd.com/read/29290909/influence-of-proton-pump-inhibitors-in-the-development-of-spontaneous-bacterial-peritonitis
#11
Suelen A S Miozzo, Jorge A John, Marcelo C Appel-da-Silva, Isabella A Dossin, Cristiane V Tovo, Angelo A Mattos
AIM: To investigate whether the use of proton pump inhibitors (PPIs) increases the incidence of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. METHODS: An historical cohort study was carried out in cirrhotic outpatients with ascites followed in a specialized clinic at a tertiary hospital in Southern Brazil. Patient charts were reviewed to collect information on the variables of interest as the use of PPIs. Primary outcome was defined as development of SBP during the study period...
December 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#12
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29285115/quantification-of-ascites-based-on-abdomino-pelvic-computed-tomography-scans-for-predicting-the-in-hospital-mortality-of-liver-cirrhosis
#13
Ran Wang, Xingshun Qi, Xiaozhong Guo
Ascites is among the most common complications of liver cirrhosis and is associated with a high mortality rate. The present retrospective study aimed to evaluate the potential correlation between in-hospital mortality of liver cirrhosis and volume of ascites. Patients with liver cirrhosis who were admitted to the General Hospital of Shenyang Military Region (Shenyang, China) between June 2012 and June 2014 and underwent axial abdomino-pelvic computed tomography (CT) scans were retrospectively reviewed. The volume of ascites was approximated using a five-point method, and diagnostic accuracy was expressed by the area under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs)...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29278428/outcomes-after-multiple-courses-of-granulocyte-colony-stimulating-factor-and-growth-hormone-in-decompensated-cirrhosis-randomized-trial
#14
Nipun Verma, Amritjyot Kaur, Ratiram Sharma, Ashish Bhalla, Navneet Sharma, Arka De, Virendra Singh
BACKGROUND AND AIM: Decompensated cirrhosis carries a high mortality. Liver transplantation (LT) is the treatment of choice; however, the limited availability of donor organs has resulted in high waitlist mortality. The present study investigated the impact of multiple courses of granulocyte-colony stimulating factor (G-CSF) with or without growth hormone (GH) in these patients. METHODS: Sixty-five patients with decompensated cirrhosis were randomized to standard medical therapy (SMT) plus G-CSF 3 monthly plus GH daily (group A; n=23) or SMT plus G-CSF (group B; n=21) or SMT alone (group C; n=21)...
December 26, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29277282/evaluation-of-laboratory-tests-for-cirrhosis-and-for-alcohol-use-in-the-context-of-alcoholic-cirrhosis
#15
John B Whitfield, Steven Masson, Suthat Liangpunsakul, Jessica Hyman, Sebastian Mueller, Guruprasad Aithal, Florian Eyer, Dermot Gleeson, Andrew Thompson, Felix Stickel, Michael Soyka, Ann K Daly, Heather J Cordell, Tiebing Liang, Tatiana Foroud, Lawrence Lumeng, Munir Pirmohamed, Bertrand Nalpas, Camille Bence, Jean-Marc Jacquet, Alexandre Louvet, Romain Moirand, Pierre Nahon, Sylvie Naveau, Pascal Perney, Philippe Podevin, Paul S Haber, Helmut K Seitz, Christopher P Day, Philippe Mathurin, Timothy M Morgan, Devanshi Seth
Laboratory tests can play an important role in assessment of alcoholic patients, including for evaluation of liver damage and as markers of alcohol intake. Evidence on test performance should lead to better selection of appropriate tests and improved interpretation of results. We compared laboratory test results from 1578 patients between cases (with alcoholic cirrhosis; 753 men, 243 women) and controls (with equivalent lifetime alcohol intake but no liver disease; 439 men, 143 women). Comparisons were also made between 631 cases who had reportedly been abstinent from alcohol for over 60 days and 364 who had not...
February 2018: Alcohol
https://www.readbyqxmd.com/read/29250690/difficulty-in-positive-diagnosis-of-ascites-and-in-differential-diagnosis-of-a-pulmonary-tumor
#16
Mircea Cătălin ForŢofoiu, Dragoş Marian Popescu, Vlad Pădureanu, Aurelian Constantin Dobrinescu, Adrian Gabriel Dobrinescu, Adrian Mită, Maria Camelia Foarfă, Violeta Serenada Bălă, Anca Emanuela Muşetescu, Nina Ionovici, Maria ForŢofoiu
Ascites is the most frequent complication of cirrhosis and occurs only when the portal hypertension has already installed but ascites is caused by neoplasms, heart failure, tuberculosis, pancreatic illnesses, as well as other kind of affections. We describe the case of a 67-year-old patient, a retired person, without significant personal or familial history, nonsmoker, infrequent alcohol and coffee consumer with following chief complaints at onset: loss of appetite, weight loss, serious physical asthenia, delayed intestinal transit, diffuse abdominal pain and increase of abdominal circumference...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29250327/tolvaptan-is-effective-in-treating-patients-with-refractory-ascites-due-to-cirrhosis
#17
Toshiyuki Tahara, Kiyoto Mori, Mari Mochizuki, Ryoko Ishiyama, Marin Noda, Hitomi Hoshi, Alan Kawarai Lefor, Satoshi Shinozaki
The treatment of refractory ascites due to cirrhosis is a clinical challenge for hepatologists. Tolvaptan, a novel aquaporin modulator, was made available in Japan in 2013 for the treatment of patients with refractory ascites due to cirrhosis. Despite the potential of this drug, few reports are available regarding its clinical use. The aim of the present study was to clarify the efficacy of tolvaptan in patients with refractory ascites due to cirrhosis and to review the clinical outcomes of treatment. Medical records were retrospectively reviewed for 65 patients with refractory ascites due to cirrhosis who were treated daily with 7...
December 2017: Biomedical Reports
https://www.readbyqxmd.com/read/29235260/functional-polymorphisms-of-innate-immunity-receptors-are-not-risk-factors-for-the-non-sbp-type-bacterial-infections-in-cirrhosis
#18
Tamas Dinya, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, Boglárka Balogh, David Tornai, Peter Antal-Szalmas, Andrea Sumegi, Hajnalka Andrikovics, Andras Bors, Attila Tordai, Maria Papp
BACKGROUND&AIMS: Pattern recognition receptors (PRRs) have a key role in the innate host defense. Functional polymorphisms of various PRRs have been established to contribute to an increased susceptibility to spontaneous bacterial peritonitis (SBP). Their role in the development of cirrhosis-associated bacterial infections (BI), beyond SBP or progressive disease course related to pathological bacterial translocation (BT) remains unknown. METHODS: 349 patients with cirrhosis were genotyped for common NOD2 (R702W, G908R and L1007PfsinsC), TLR2 (-16934T>A), and TLR4 (D299G) variants...
December 13, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29234200/nutrition-and-muscle-in-cirrhosis
#19
REVIEW
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#20
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
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