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Ascites in cirrhosis

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https://www.readbyqxmd.com/read/28331804/infected-ascites-distinguishing-secondary-peritonitis-from-spontaneous-bacterial-peritonitis-in-a-cirrhotic-patient-with-classic-symptoms
#1
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
#2
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/28318147/effects-of-alfapump-system-on-kidney-and-circulatory-function-in-patients-with-cirrhosis-and-refractory-ascites
#3
Elsa Solà, Santiago Sanchez-Cabús, Ezequiel Rodriguez, Chiara Elia, Raquel Cela, Rebeca Moreira, Elisa Pose, Jordi Sánchez-Delgado, Nuria Cañete, Manuel Morales-Ruiz, Francisco Campos, Jaume Balust, Mónica Guevara, Juan Carlos García-Valdecasas, Pere Ginès
The alfapump system has been proposed as a new treatment for the management of refractory ascites. The system removes ascites from the peritoneal cavity to urinary bladder, producing a continuous low-volume paracentesis. AIM: To investigate the effects of treatment with the alfapump system on kidney and circulatory function in patients with cirrhosis and refractory ascites. METHODS: Prospective study including 10 patients with cirrhosis and refractory ascites. Primary outcomes were changes in glomerular filtration rate (GFR), as assessed by isotopic techniques, and changes in circulatory function assessed by arterial pressure, cardiac output and activity of vasoconstrictor systems...
March 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28302000/expanded-criteria-for-hepatocellular-carcinoma-in-liver-transplant
#4
Mehmet Haberal, Aydıncan Akdur, Gökhan Moray, Gülnaz Arslan, Figen Özçay, Haldun Selçuk, Handan Özdemir
OBJECTIVES: Hepatocellular carcinoma is the sixth most common cancer worldwide and is the third highest cause of malignancy-related death. Because of its typically late diagnosis, median survival is approximately 6 to 20 months, with 5-year survival of < 12%. Hepatocellular carcinoma typically arises in the background of cirrhosis, with liver transplant regarded as the optimal therapy for selected patients. Initially, orthotopic liver transplant was limited to patients with extensive unresectable tumors, resulting in uniformly dismal outcomes due to high tumor recurrence rates...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28297771/-advances-in-basic-and-clinical-research-on-liver-cirrhosis-in-2016
#5
C Gu, M Y Song, W J Sun, X Y Xu, C Q Yang, D F Chen
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28296047/non-selective-beta-blockers-are-not-associated-with-increased-mortality-in-cirrhotic-patients-with-ascites
#6
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 2011-2014 were retrospectively evaluated. Cox regression and competing risk analysis 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/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#7
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28281514/-ultrasound-elastography-of-the-liver-for-assessing-the-risk-of-complications-of-its-cirrhosis-of-different-etiologies
#8
N Yu Stukova, Yu A Kucheryavyi, E A Maevskaya, I V Maev
AIM: To study the results of dynamic liver ultrasound elastography (LUE) in assessing the risk of complications of liver cirrhosis (LC) of different etiologies and to elaborate a monitoring program for estimation of the predictive value of elastography in patients with LC. SUBJECTS AND METHODS: A total of 194 patients with LC of different etiologies, including 56 patients with alcoholic cirrhosis, 48 with LC and an outcome of nonalcoholic fatty liver disease, 53 with LC and an outcome of chronic hepatitis C, 23 with LC and an outcome of chronic hepatitis B, and 14 with an outcome of coinfection with hepatitis B and D viruses, were examined...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28280398/interrelationship-of-hepatitis-c-virus-genotypes-with-patient-characteristics-in-bahrain
#9
Maheeba A Abdulla, Eman A Murad, Hend A Aljenaidi, Duha R Aljowder, Omar Ik Aljeeran, Eman Farid, Jehad R Al Qamish
AIM: Hepatitis C virus (HCV) shows genotype-based variation in prevalence across geographical regions. This study was conducted to understand the clinical interrelationship of HCV genotypes with patient characteristics. METHODS: Medical records of 122 patients positive for HCV RNA test collected during 2013 and 2014 were included for analysis. Only adults were included in the study. HCV RNA extraction and genotyping was done as part of the routine diagnostic requirements...
2017: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/28279089/advanced-nurse-practitioner-led-abdominal-therapeutic-paracentesis
#10
Neal Aplin
Liver disease is a common cause of death in England and Wales, and ascites is associated with a 50% mortality rate. Most patients who present with ascites have underlying liver cirrhosis, and often require therapeutic paracentesis for symptomatic relief. This article describes a competency framework that was developed to enable advanced nurse practitioners to perform therapeutic paracentesis in an ambulatory care unit.
March 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28261693/risk-factors-of-postoperative-ascites-on-hepatic-resection-for-hepatocellular-carcinoma
#11
Seong Woon Choi, Woo Young Shin, Keon Young Lee, Seung Ik Ahn
BACKGROUNDS/AIMS: The aim of this study was to identify the risk factors of the development of large amounts of ascites (LA) after hepatic resection for hepatocellular carcinoma (HCC). METHODS: The medical records of 137 consecutive patients who underwent hepatic resection for HCC from January 2010 to December 2014 were retrospectively reviewed. Patients were divided into two groups: LA group, with ascites drainage >500 cc per day over 3 days (n=37) and control group (n=100)...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28260464/incisional-hernia-after-liver-transplant
#12
Ebru H Ayvazoglu Soy, Mahir Kirnap, Sedat Yildirim, Gokhan Moray, Mehmet Haberal
OBJECTIVES: An incisional hernia seriously burdens the quality of life after liver transplant. The incidence of incisional hernia after liver transplant is reported to be 4% to 20%. Here, we evaluated incisional hernias that occurred after adult liver transplant and incisional hernias intentionally made in infant liver transplant procedures. MATERIALS AND METHODS: Between December 1988 and May 2016, we performed 536 liver transplant procedures in 515 patients. Demographic features, surgical outcomes, and predisposing factors were evaluated...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260436/effectiveness-of-sofosbuvir-and-ribavirin-for-eradicating-hepatitis-c-virus-in-renal-transplant-recipients-in-pakistan-where-resources-are-scarce
#13
Farina Muhammad Hanif, S Mudassir Laeeq, Rajesh Kumar Mandhwani, Nasir Hassan Luck, Tahir Aziz, Syed Haider Mehdi
OBJECTIVES: Although direct-acting antiviral agents have revolutionized hepatitis C virus treatment, these novel agents are not widely available in the developing world. Further, no treatment recommendation for renal transplant recipients includes these agents. We aimed to evaluate the effectiveness of sofosbuvir and ribavirin, the only direct-acting antiviral agents available in Pakistan, in renal transplant recipients. MATERIALS AND METHODS: All renal transplant recipients receiving sofosbuvir and ribavirin from August 2015 to March 2016 were enrolled in the study...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28247572/long-term-outcome-of-chronic-hepatitis-c-chc-virus-infection-in-a-real-world-setting-the-german-lotos-study
#14
Heiner Wedemeyer, Jens Reimer, Petra Sandow, Dietrich Hueppe, Thomas Lutz, Kurt Gruengreiff, Joerg Goelz, Stefan Christensen, Heike Pfeiffer-Vornkahl, Ulrich Alshuth, Michael P Manns
BACKGROUND & AIMS: There are few large-scale, prospective studies comparing liver-associated events in treated and untreated patients with CHC managed in routine clinical practice. METHODS: Patients with CHC were prospectively enrolled in a non-interventional study. Data from patients with available documentation who had either achieved a sustained virological response, or were non-responders, relapsers, or had virological breakthrough following treatment with peginterferon alfa-2a ± ribavirin, or who had been diagnosed but never treated at least 3 years previously, and who remained under medical observation were analyzed...
March 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28245467/hospitalizations-due-to-cirrhosis-clinical-aspects-in-a-large-cohort-of-italian-patients-and-cost-analysis-report
#15
Marco Di Pascoli, Elena Ceranto, Paolo De Nardi, Daniele Donato, Angelo Gatta, Paolo Angeli, Patrizia Pontisso
BACKGROUND AND AIM: Liver cirrhosis is characterized by high morbidity and mortality rates. This study was addressed to evaluate the epidemiological and economic impact of cirrhosis on hospitalizations in a large population in Italy. METHODS: Epidemiological analysis was performed using hospital discharge sheets of 57,720 hospitalizations due to liver disease from 2006 to 2008, selected from the Veneto regional archive. In a sample of 100 randomly selected hospitalizations, a detailed cost analysis was performed and a comparison was made with sets of patients admitted for heart failure (HF) and chronic obstructive pulmonary disease (COPD)...
March 1, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28241370/evolution-of-laparoscopic-liver-surgery-as-standard-procedure-for-hcc-in-cirrhosis
#16
Daniel Seehofer, Robert Sucher, Moritz Schmelzle, Robert Öllinger, Andri Lederer, Timm Denecke, Eckart Schott, Johann Pratschke
Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed for HCC in Child-A cirrhosis at our center. Mean MELD score was 9 (6 - 12), and the mean LiMAx was 261 µg/h/kg (101 - 489). All resections were performed by conventional laparoscopy using 4 - 6 trocars...
February 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28239081/clinical-features-of-spontaneous-bacterial-peritonitis-a-10-year-experience-from-a-single-center
#17
Ha Young Na, Jeong Han Kim, Won Hyeok Choe, So Young Kwon, Byung Chul Yoo
Background/Aims: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. Methods: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. Results: Total 51 patients were enrolled...
February 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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
#18
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/28228886/transjugular-intrahepatic-portosystemic-shunt-for-chylous-ascites-in-a-patient-with-recurrent-cirrhosis-following-liver-transplantation
#19
Jason T Salsamendi, Francisco J Gortes, Prasoon P Mohan, Ji Fan, Govindarajan Narayanan
Chylous ascites (CA) is the extravasation of lipid-rich lymphatic fluid into the peritoneal space following trauma or obstruction of the lymphatic system. Refractory cases of cirrhosis-related CA may be amendable to transjugular intrahepatic portosystemic shunting (TIPS). We present a case of TIPS in the setting of refractory CA secondary to cirrhosis of a transplanted liver graft. Following TIPS, the patient reported immediate improvement in abdominal pain and no longer requires paracentesis. Our case suggests TIPS to be a safe and effective treatment option for CA in liver transplant patients with cirrhosis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28220780/bacterial-infections-change-natural-history-of-cirrhosis-irrespective-of-liver-disease-severity
#20
Elena Dionigi, Matteo Garcovich, Mauro Borzio, Gioacchino Leandro, Avik Majumdar, Aikaterini Tsami, Vasiliki Arvaniti, Davide Roccarina, Massimo Pinzani, Andrew K Burroughs, James O'Beirne, Emmanuel A Tsochatzis
OBJECTIVES: We assessed the prognostic significance of infections in relation to current prognostic scores and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis. METHODS: We included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 h over a 2-year period. Diagnosis of infection was based on positive cultures or strict established criteria. We used competing risk analysis and propensity score matching for data analysis...
February 21, 2017: American Journal of Gastroenterology
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