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https://www.readbyqxmd.com/read/28820885/diagnostic-efficacy-of-noninvasive-liver-fibrosis-indexes-in-predicting-portal-hypertension-in-patients-with-cirrhosis
#1
Le Wang, Yuemin Feng, Xiaowen Ma, Guangchuan Wang, Hao Wu, Xiaoyu Xie, Chunqing Zhang, Qiang Zhu
BACKGROUND: Recent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated. AIMS: To evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. METHODS: A total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade...
2017: PloS One
https://www.readbyqxmd.com/read/28814595/bleeding-ectopic-duodenal-varix-use-of-a-new-microvascular-plug-mvp-device-along-with-transjugular-intrahepatic-portosystemic-shunt-tipss
#2
Richa Bhardwaj, Gaurav Bhardwaj, Erik Bee, Raffi Karagozian
Ectopic varices (ECV) occur along the gastrointestinal (GI) tract outside the common variceal sites and represent 2%-5% of all GI variceal bleeds with mortality rates up to 40%. Management is challenging because of inaccessibility and increased risk of rebleeding. We report what is to our knowledge the first clinical use of a new microvascular plug (MVP) with transjugular intrahepatic portosystemic shunt (TIPSS) for a bleeding duodenal varix (DV). A 68-year-old man presented with melena. Endoscopy demonstrated a grade II varix in the second part of the duodenum with red wale sign...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814423/portal-hypertension-and-its-management-in-children
#3
REVIEW
Tassos Grammatikopoulos, Patrick James McKiernan, Anil Dhawan
Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28805258/impact-of-beta-blockers-on-cardiopulmonary-exercise-testing-in-patients-with-advanced-liver-disease
#4
M P Wallen, A Hall, K A Dias, J S Ramos, S E Keating, A J Woodward, T L Skinner, G A Macdonald, R Arena, J S Coombes
BACKGROUND: Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta-blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. AIM: To determine the effect of beta-blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease...
August 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28801510/therapeutic-options-for-bleeding-oesophageal-varices-cyanoacrylate-and-balloon-occluded-retrograde-obliteration-brto
#5
Helena L Frischtak, Jessica P Davis, Neeral L Shah
A 56-year-old male with cirrhosis presented with acute bleeding from cardiofundal gastroesophageal varices (GOV) and was treated with endoscopic cyanoacrylate glue. Glue therapy achieved stabilisation of the patient in the emergent setting. Three months later, the patient suffered rebleeding. At that time, he underwent retreatment with balloon-occluded retrograde obliteration (BRTO), with no recurrence at a follow-up of 14 months.Available treatments for bleeding GOV include methods to (a) directly obstruct the varices (endoscopic variceal ligation , sclerotherapy and cyanoacrylate glue, BRTO) or to (b) decrease portal pressure (surgical portacaval shunts; transportal intrahepatic portosystemic shunt)...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28799522/sustained-virological-response-by-direct-antiviral-agents-in-hcv-leads-to-an-early-and-significant-improvement-of-liver-fibrosis
#6
Marcello Persico, Valerio Rosato, Andrea Aglitti, Davide Precone, Mariano Corrado, Antonio De Luna, Filomena Morisco, Silvia Camera, Alessandro Federico, Marcello Dallio, Ernesto Claar, Nicola Caporaso, Mario Masarone
BACKGROUND: Direct Antiviral Agents (DAA) demonstrated high efficacy among HCV-infected patients in registered trials. Nevertheless, the impact of these therapies on liver stiffness measurement(LSM) and liver functionality in "real-life" is not well-known. Aim of the present study was to evaluate the SVR impact on LSM and clinical parameters of DAA-therapy on a real-life population of HCV patients with F3/F4 fibrosis. METHODS: 749 HCV genotype 1-4 patients with F3/F4 hepatitis undergoing antiviral therapy, were consecutively enrolled in four centers of Hepatology of Italy...
August 11, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28798285/is-the-aims-65-score-useful-in-prepdicting-clinical-outcomes-in-korean-patients-with-variceal-and-nonvariceal-upper-gastrointestinal-bleeding
#7
Jung Wan Choe, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
Background/Aims: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods: We retrospectively evaluated 286 patients with UGIB who visited emergency department...
August 14, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28797992/an-unusual-cause-of-dysphagia-after-gastric-variceal-bleeding
#8
Ankur Jindal
No abstract text is available yet for this article.
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28796076/factors-affecting-mortality-and-resource-use-for-hospitalized-patients-with-cirrhosis-a-population-based-study
#9
Phunchai Charatcharoenwitthaya, Ngamphol Soonthornworasiri, Khemajira Karaketklang, Kittiyod Poovorawan, Wirichada Pan-Ngum, Watcharasak Chotiyaputta, Tawesak Tanwandee, Kamthorn Phaosawasdi
Hospitalizations for advanced liver disease are costly and associated with significant mortality. This population-based study aimed to evaluate factors associated with in-hospital mortality and resource use for the management of hospitalized patients with cirrhosis.Mortality records and resource utilization for 52,027 patients hospitalized with cirrhosis and/or complications of portal hypertension (ascites, hepatic encephalopathy, variceal bleeding, spontaneous bacterial peritonitis, or hepatorenal syndrome) were extracted from a nationally representative sample of Thai inpatients covered by Universal Coverage Scheme during 2009 to 2013...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28795558/cheap-flexible-and-thermal-sensitive-paper-sensor-through-writing-with-ionic-liquids-containing-pencil-leads
#10
Saijun Sun, Zhilong Duan, Xun Wang, Gan Lai, Xinyue Zhang, Hao Wei, Lianhe Liu, Ning Ma
The flexible and portable paper-based sensors have a broad potential application in electronic detection and devices. In this work, a flexible thermoresponsive paper sensor was reported by writing on A4 paper with composite pencil leads which contain thermoresponsive pyrene-based ionic liquid [Pyrmim](+)[Br](-). The [Pyrmim](+)[Br](-) was transferred onto the A4 paper surface with graphite by pencil writing for the facile preparation of thermal-sensitive paper chips. The as-prepared paper sensor was very sensitive to the NIR irradiation and warm objects...
August 21, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28792357/management-of-left-renal-vein-compression-in-patients-presenting-left-gonadal-vein-reflux
#11
Javier Leal Monedero, Santiago Zubicoa Ezpeleta, Michel Perrin
Background Compression of left renal vein is an atypical cause of reflux in pelvic veins resulting in pelvic varices that in turn causes frequently lower limb varices in many cases. Methods A monocentric study was undertaken to report the treatment and five-year follow up of patients presenting left renal vein compression. Embolization of refluxive gonadal/pelvic veins was performed generally as the initial procedure. Left renal vein stenting was performed in patients presenting haematuria, severe lumbar pain or persistent pelvic/lower limb varices after embolization...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28791885/shunt-preserving-disconnection-of-the-portal-to-systemic-circulation-in-patients-with-hepatic-encephalopathy
#12
Osamu Ikeda, Seijiro Inoue, Yoshitaka Tamura, Yo-Ichi Yamashita, Hideo Baba, Yukihiro Inomata, Yasuyuki Yamashita
Background Portosystemic shunt obliteration by surgical or interventional radiological techniques can be effective for patients with hepatic encephalopathy (HE) although this approach is often associated with accumulation of ascites and/or formation of esophageal varices. Purpose To evaluate the clinical efficacy and safety of shunt-preserving disconnection of the portosystemic circulation (SPDPS) in patients with HE. Material and Methods Nine patients with HE and a splenorenal shunt were treated by SPDPS: eight underwent selective coil embolization of the splenic vein and one underwent stent-graft closure of the shunt...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28791845/diagnosis-and-treatment-of-pelvic-congestion-syndrome-single-centre-experiences
#13
Tadeusz A Dorobisz, Jerzy S Garcarek, Jacek Kurcz, Krzysztof Korta, Andrzej T Dorobisz, Przemysław Podgórski, Jan Skóra, Piotr Szyber
BACKGROUND: One of the underestimated causes of chronic pelvic pain (CPP) in women may be pelvic congestion syndrome (PCS) that is defined as the presence of varicose of ovarian and pelvic veins associated with chronic pain in the region of the pelvis. This pain is present longer than 6 months and intensifies with prolonged standing, coitus and menstruation. The disease constitutes a diagnostic as well as therapeutic problem, thus posing a challenge for the clinician. Transcatheter ovarian vein embolization might be a safe and effective option for PCS treatment...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28790540/the-effect-of-adolescent-idiopathic-scoliosis-on-the-occurrence-of-varicose-veins-on-lower-extremities
#14
Goran Talic, Luka Talic, Djurdjica Stevanovic-Papica, Tatjana Nozica-Radulovic, Snjezana Novakovic-Bursac
INTRODUCTION: Scoliosis is a complex three-dimensional spine deformity with the frontal plane deflexion (side-shift) of the series of vertebra from the midline and with torque deformity of vertebra, ribs, and the entire trunk towards the apex of curve. Chronic venous diseases present a group of pathological conditions caused by the increased venous pressure. The venous pressure may be increased due to genetics, ligament laxity, general obesity, injuries, and changes in biomechanics of spine and lower extremities, etc...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28780608/sx-ella-stent-danis-effectively-controls-refractory-variceal-bleed-in-patients-with-acute-on-chronic-liver-failure
#15
Rakhi Maiwall, Kapil Dev Jamwal, Ankit Bhardwaj, Ajeet Singh Bhadoria, Jaswinder Singh Maras, Guresh Kumar, Ankur Jindal, Ashok Choudhury, Lovkesh Anand, Amrish Sahney, Awinash Kumar, Manoj Kumar Sharma, Barjesh Chander Sharma, Shiv Kumar Sarin
BACKGROUND AND AIMS: Almost 10% of bleeding episodes are refractory to combination of vasoactive agent and endotherapy, and are associated with a mortality up to 50%. Severity of liver disease and high portal pressure are mainly responsible for it. TIPS cannot be used in these patients due to high MELD score. We aimed to evaluate the efficacy of self-expandable DE stents for control of refractory variceal bleeds in patients with ACLF. METHODS: Acute-on-chronic liver failure patients (n = 88, mean age 47...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28776495/platelet-count-to-splenic-diameter-ratio-and-other-noninvasive-markers-as-predictors-of-esophageal-varices-in-patients-with-liver-cirrhosis
#16
Zubia Jamil, Maryam Malik, Asghar Aurangzeb Durrani
BACKGROUND/AIMS: Endoscopy as a screening modality for esophageal varices is becoming difficult because of its invasiveness, cost, and increased burden of liver cirrhosis. This study aims to determine the diagnostic accuracy of simple and noninvasive markers in detecting esophageal varices. MATERIALS AND METHODS: Four variables (platelet count, portal vein diameter, splenic diameter, and ratio of platelet count to splenic diameter PC/SD] ratio) were studied in 150 cirrhotic patients...
August 4, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28776387/the-baveno-vi-criteria-for-predicting-esophageal-varices-validation-in-real-life-practice
#17
Mafalda Sousa, Sónia Fernandes, Luísa Proença, Ana Paula Silva, Sónia Leite, Joana Silva, Ana Ponte, Jaime Rodrigues, João Carlos Silva, João Carvalho
BACKGROUND AND AIMS: According to the Baveno VI consensus, patients with liver stiffness < 20 kPa and a platelet count > 150,000 ul have very low risk of clinically significant varices and do not need a screening endoscopy. The aim of this study was to evaluate non-invasive methods as predictors of esophageal varices according to the Baveno VI recommendations, in real life clinical practice. METHODS: Retrospective evaluation of patients with chronic liver disease who underwent transient elastography between January 2013 and December 2015...
August 4, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28771618/proton-pump-inhibitor-therapy-did-not-increase-the-prevalence-of-small-bowel-injury-a-propensity-matched-analysis
#18
Atsuo Yamada, Ryota Niikura, Koutarou Maki, Masanao Nakamura, Hirotsugu Watabe, Mitsuhiro Fujishiro, Shiro Oka, Shunji Fujimori, Atsushi Nakajima, Naoki Ohmiya, Takayuki Matsumoto, Shinji Tanaka, Kazuhiko Koike, Choitsu Sakamoto
BACKGROUND: Previous studies have reported that the suppression of acid secretion by using proton pump inhibitors (PPIs) results in dysbiosis of the small-bowel microbiota, leading to exacerbated small-bowel injuries, including erosions and ulcers. This study was designed to assess the association between PPI therapy and small-bowel lesions after adjustment for the differences in baseline characteristics between users and non-users of PPIs. METHODS: We retrospectively studied patients suspected to be suffering from small-bowel diseases, who underwent capsule endoscopy between 2010 and 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28771543/population-based-prevalence-incidence-and-disease-burden-of-autoimmune-hepatitis-in-south-korea
#19
Bo Hyun Kim, Hwa Young Choi, Moran Ki, Kyung-Ah Kim, Eun Sun Jang, Sook-Hyang Jeong
BACKGROUND AND AIM: Little is known about population-based epidemiology and disease burden of autoimmune hepatitis (AIH). The aim of this study was to investigate the prevalence, incidence, comorbidity and direct medical cost of AIH in South Korea. METHODS: The data was from the nationwide, population-based National Health Insurance Service claims database and the Rare Intractable Disease registration program. Age and gender-specific prevalence rates were calculated, and data on comorbidity, diagnostic tests, prescribed drugs, and medical costs were retrieved for patients registered under the disease code K75...
2017: PloS One
https://www.readbyqxmd.com/read/28768371/minimal-hepatic-encephalopathy-identifies-patients-at-risk-of-faster-cirrhosis-progression
#20
Javier Ampuero, Carmina Montoliú, Macarena Simón-Talero, Virginia Aguilera, Raquel Millán, Celina Márquez, Rodrigo Jover, María Carmen Rico, Carmen Sendra, Miguel Ángel Serra, Manuel Romero-Gómez
BACKGROUND &AIM: Minimal hepatic encephalopathy (MHE) predicts poor prognosis and could reflect an advanced liver disease. We aimed to assess whether MHE could be a surrogate marker of a further liver disease. METHODS: Prospective multicenter study including 320 cirrhotic patients, followed for up to 5 years, which were classified at baseline in: compensated cirrhosis without (stage 1) and with varices (stage 2), one decompensating event (stage 3), any second decompensating event (stage 4)...
August 2, 2017: Journal of Gastroenterology and Hepatology
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