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Ascites in cirrhosis

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https://www.readbyqxmd.com/read/28213164/carvedilol-use-is-associated-with-improved-survival-in-patients-with-liver-cirrhosis-and-ascites
#1
Rohit Sinha, Khalida A Lockman, Nethmee Mallawaarachchi, Marcus Robertson, John N Plevris, Peter C Hayes
BACKGROUND AND AIMS: Carvedilol, a non-selective beta-blocker (NSBB) with additional anti-alpha 1 receptor activity, is a potent portal hypotensive agent. It has been used as prophylaxis against variceal bleed. However, its safety in decompensated liver cirrhosis with ascites is still disputed. In this study, we examined whether long-term use of carvedilol in the presence of ascites is a risk factor for mortality. METHODS: This was a single-centre retrospective analysis of 325 consecutive patients with liver cirrhosis and ascites presenting to our Liver Unit between 1(st) of January 2009 to 31(st) August 2012...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28195341/left-ventricular-systolic-function-is-associated-to-sympathetic-nervous-activity-and-markers-of-inflammation-in-cirrhosis
#2
Raquel Yotti, Cristina Ripoll, Yolanda Benito, Maria Vega Catalina, Jaime Elízaga, Diego Rincón, Francisco Fernández-Avilés, Javier Bermejo, Rafael Bañares
: An accurate evaluation of cardiac function in patients with cirrhosis remains a challenge. We used robust echocardiographic indices to characterize LV systolic function and its relationship to activation of the sympathetic nervous system (SNS) and inflammation in 59 patients cirrhosis and 59 age-matched controls. Aditionally, in eleven patients we withdrew betablockers and diuretics and used phenylephrine and albumin infusion to evaluate the response to acute afterload and preload changes (interventional substudy)...
February 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28185616/tuberculous-peritonitis
#3
Urvashi Vaid, Gregory C Kane
Tuberculous peritonitis is rare in the United States but continues to be reported to occur in certain high-risk populations, which include patients with AIDS or cirrhosis, patients on continuous ambulatory peritoneal dialysis, recent immigrants from areas of high endemicity, and those who are immunosuppressed. The diagnosis of this disease requires a high clinical index of suspicion and should be considered in the differential of ascites with a lymphocyte predominance and serum-ascitic albumin gradient of <1...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28173830/large-hepatocellular-carcinoma-in-a-non-cirrhotic-liver-with-peritoneal-and-omental-metastasis-in-a-healthy-man-a-case-report
#4
H M M T B Herath, Aruna Kulatunga
BACKGROUND: Liver cancer is the second leading cause of cancer death in men worldwide. Hepatocellular carcinoma usually develops in the setting of cirrhosis or chronic inflammation. Major risk factors for developing hepatocellular carcinoma are chronic hepatitis B or C virus infection, alcoholic cirrhosis, and nonalcoholic fatty liver disease. The most frequent locations for hepatocellular carcinoma to metastasize are the lungs, portal vein, bones, and regional lymph nodes. CASE PRESENTATION: A 41-year-old Sri Lankan man presented with progressive abdominal distension and on examination was found to have a palpable irregular mass in the left lobe of his liver with moderate ascites...
February 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28169486/hepatic-vena-cava-syndrome-new-concept-of-pathogenesis
#5
REVIEW
Santosh Man Shrestha, Masayoshi Kage, Byung Boong Lee
Hepatic vena cava syndrome (HVCS) also known as membranous obstruction of inferior vena cava was considered a rare congenital disease and included under Budd Chiari syndrome. It is now recognized as a bacterial infection induced disease related to poor hygienic living condition. Localized thrombophlebitis of IVC at the site close to hepatic veins (HV) outlets is the initial lesion which converts on resolution into stenosis or complete obstruction, the circulatory equilibrium being maintained by development of cavo-caval collateral anastomosis...
February 7, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#6
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28143894/analysis-of-glycero-lysophospholipids-in-gastric-cancerous-ascites
#7
Shigenobu Emoto, Makoto Kurano, Kuniyuki Kano, Keisuke Matsusaki, Hiroharu Yamashita, Masako Nishikawa, Koji Igarashi, Hitoshi Ikeda, Junken Aoki, Joji Kitayama, Yutaka Yatomi
Lysophosphatidic acid (LysoPA) has been proposed to be involved in the pathogenesis of various cancers. Moreover, glycero-lysophospholipids other than LysoPA are now emerging as novel lipid mediators. Therefore, we aimed to elucidate the possible involvement of glycero-lysophospholipids in the pathogenesis of gastric cancer by measuring glycero-LPLs, autotaxin, and phosphatidylserine-specific phospholipase A1 (PS-PLA1) in ascites obtained from patients with gastric cancer and those with cirrhosis (as a control)...
January 31, 2017: Journal of Lipid Research
https://www.readbyqxmd.com/read/28134718/living-with-liver-cirrhosis-a-vulnerable-life
#8
Carola Fagerström, Gunilla Hollman Frisman
Liver cirrhosis is a chronic liver disease. Patients with liver cirrhosis need to manage the symptoms of the disease and possible complications. Symptoms due to ascites, encephalopathy, and/or varices are hard to manage and live with. Self-care is necessary for coping with the symptoms and for improving the patient's life situation. The aim of this study was to explore the areas of life situation and self-care among patients suffering from liver cirrhosis with complications. Interviews with patients with liver cirrhosis (n = 13), seven women and six men (46-70 years), were performed...
January 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28134306/bacterial-translocation-aggravates-ccl4-induced-liver-cirrhosis-by-regulating-cd4-t-cells-in-rats
#9
Haiyan Shi, Longxian Lv, Hongcui Cao, Haifeng Lu, Ning Zhou, Jiezuan Yang, Haiyin Jiang, Huihui Dong, Xinjun Hu, Wei Yu, Xiawei Jiang, Beiwen Zheng, Lanjuan Li
Bacterial translocation (BT) is thought to play an important role in the development of liver cirrhosis, but the mechanisms have not been fully explored. This study aims to investigate the distribution of Treg (CD3(+)CD4(+)CD25(+)Foxp3(+)), Th17 (CD3(+)CD4(+)IL-17(+)), and Th1 (CD3(+)CD4(+)IFN-γ(+)) cells in the intestinal lamina propria, liver and blood and to explore their relationships with BT. Cirrhotic rats with ascites were induced by CCl4. We found that there were lower levels of total protein and albumin, lower albumin/globulin ratio, lower body weight and higher spleen weight and ascites volume in cirrhotic rats with than without BT...
January 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28130311/genome-wide-association-study-identi%C3%AF-es-hla-dr-variants-conferring-risk-of-hbv-related-acute-on-chronic-liver-failure
#10
Wenting Tan, Jie Xia, Yunjie Dan, Mengying Li, Shide Lin, Xingnan Pan, Huifen Wang, Yingzi Tang, Nana Liu, Shun Tan, Ming Liu, Weiwei He, Weihua Zhang, Qing Mao, Yuming Wang, Guohong Deng
OBJECTIVE: Acute-on-chronic liver failure (ACLF) is an extreme condition after severe acute exacerbation of chronic hepatitis B; however, the underlying genetic factors involved in its onset and progression are currently unclear. DESIGN: We carried out a genome-wide association study among 399 HBV-related ACLFs (cases) and 401 asymptomatic HBV carriers (AsCs, as controls) without antiviral treatment. The initial findings were replicated in four independent case-control sets (a total of 901 ACLFs and 1686 AsCs)...
January 27, 2017: Gut
https://www.readbyqxmd.com/read/28130066/timing-affects-measurement-of-portal-pressure-gradient-after-placement-of-transjugular-intrahepatic-porto-systemic-shunts-in-patients-with-portal-hypertension
#11
Gilberto Silva-Junior, Fanny Turon, Anna Baiges, Eira Cerda, Ángeles García-Criado, Annabel Blasi, Ferran Torres, Virginia Hernandez-Gea, Jaume Bosch, Juan Carlos Garcia-Pagan
BACKGROUND & AIMS: A reduction in portal pressure gradient (PPG) to below 12 mmHg after placement of a transjugular intrahepatic porto-systemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values - this could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained...
January 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28121521/transjugular-intrahepatic-portosystemic-shunts-in-patients-with-cirrhosis-with-refractory-ascites-comparison-of-clinical-outcomes-by-using-8-and-10-mm-ptfe-covered-stents
#12
Roberto Miraglia, Luigi Maruzzelli, Fabio Tuzzolino, Ioannis Petridis, Mario D'Amico, Angelo Luca
Purpose To compare the efficacy and complications of transjugular intrahepatic portosystemic shunt (TIPS) creation performed by using a 10-mm or an 8-mm-diameter polytetrafluoroethylene (PTFE)-covered stent in a consecutive series of patients with cirrhosis with refractory ascites (RA). Materials and Methods The institutional review board approved this retrospective study and informed consent was waived. One hundred seventy-one patients with RA (mean age, 58.7 years ± 10.3; 95% confidence interval [CI]: 57...
January 25, 2017: Radiology
https://www.readbyqxmd.com/read/28110540/portal-vein-thrombosis-in-patients-with-cirrhosis-undergoing-elective-transjugular-intrahepatic-portosystemic-shunt
#13
Wan Yue-Meng, Yu-Hua Li, Hua-Mei Wu, Jing Yang, Li-Hong Yang, Ying Xu
Portal vein thrombosis (PVT) is a common complication in cirrhosis. The aim of this study was to determine risk factors for PVT, assess the efficacy of anticoagulant therapy, and evaluate the effects of PVT on patients with cirrhosis undergoing elective transjugular intrahepatic portosystemic shunt (TIPSS). A total of 101 patients with cirrhosis undergoing elective TIPSS were prospectively studied. After TIPSS, all patients received preventive therapy for PVT and were followed up at 3, 6, 12, and 24 months...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28107282/early-posthepatoportoenterostomy-predictors-of-native-liver-survival-in-biliary-atresia
#14
Scott Nightingale, Michael O Stormon, Edward V O'Loughlin, Albert Shun, Gordon Thomas, Eric I Benchimol, Andrew S Day, Susan Adams, Edward Shi, Chee Y Ooi, Binita M Kamath, Annie Fecteau, Jacob C Langer, Eve A Roberts, Simon C Ling, Vicky L Ng
OBJECTIVES: Most infants with biliary atresia (BA) require liver transplantation (LT) after hepatoportoenterostomy (HPE), including those who initially clear jaundice. The aim of the present study was to identify clinical and routine laboratory factors in infants with BA post-HPE that predict native liver survival at 2 years. METHODS: A retrospective cohort study was conducted in 217 patients with BA undergoing HPE in Sydney, Australia and Toronto, Canada between January 1986 and July 2009...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28102814/successful-induction-of-peritoneal-dialysis-in%C3%A2-a%C3%A2-patient-with-massive-hydrothorax-due-to%C3%A2-pleuroperitoneal-communication%C3%A2
#15
Takahiro Uchida, Yuji Yamada, Toshihiko Imakiire, Naoki Oshima, Hiroo Kumagai
A 74-year-old woman with liver cirrhosis and chronic kidney disease (CKD) who had complained of chronic abdominal distension due to prominent ascites presented with sudden dyspnea. Chest radiography showed massive right pleural effusion that shifted the mediastinum. Peritoneal scintigraphy using 99mTc-macroaggregated albumin revealed pleuroperitoneal communication (PPC). As her hydrothorax was refractory and frequent thoracentesis did not improve her respiratory distress, thoracoscopic surgery was performed for repair of the diaphragm defect...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28091405/evaluation-of-helicobacter-pylori-infection-in-patients-with-chronic-hepatic-disease
#16
Ju Huang, Jun Cui
BACKGROUND: The 13C urea breath test (13C-UBT) is the gold standard for detecting Helicobacter pylori infection. H. pylori pathogenesis in patients with hepatitis B virus (HBV) and related diseases remains obscure. We used 13C-UBT to detect H. pylori infection in patients with chronic HBV infection, HBV-related cirrhosis, HBV-related hepatic carcinoma, and other chronic hepatic diseases. METHODS: A total of 131 patients with chronic hepatitis B (HB), 179 with HBV-related cirrhosis, 103 with HBV-related hepatic carcinoma, 45 with HBV-negative hepatic carcinoma, and 150 controls were tested for H...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28090224/computerized-tomography-guided-paracentesis-an-effective-alternative-to-bedside-paracentesis
#17
Vinaya Gaduputi, Hassan Tariq, Chaitanya Chandrala, Sailaja Sakam, Naeem Abbas, Sridhar Chilimuri
BACKGROUND: Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#18
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#19
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28065374/predictive-value-of-ct-for-first-esophageal-variceal-bleeding-in-patients-with-cirrhosis-value-of-para-umbilical-vein-patency
#20
Paul Calame, Maxime Ronot, Sébastien Bouveresse, Jean-Paul Cervoni, Valérie Vilgrain, Éric Delabrousse
PURPOSE: To evaluate if the presence/size of a para-umbilical vein (PUV) on computed tomography (CT) are associated with a first esophageal variceal hemorrhage (EVH) in patients with cirrhosis and whether imaging features can help identify patients at increased risk of EVH. MATERIALS AND METHODS: From January 2010 to June 2012 patients with cirrhosis who underwent CT and upper gastrointestinal endoscopy within six months were included. The presence/size of PUV was noted...
February 2017: European Journal of Radiology
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