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https://www.readbyqxmd.com/read/28811718/chronic-liver-failure-consortium-acute-on-chronic-liver-failure-and-acute-decompensation-scores-predict-mortality-in-brazilian-cirrhotic-patients
#1
Rafael Veiga Picon, Franciele Sabadin Bertol, Cristiane Valle Tovo, Ângelo Zambam de Mattos
AIM: To validate prognostic scores for acute decompensation of cirrhosis and acute-on-chronic liver failure in Brazilian patients. METHODS: This is a prospective cohort study designed to assess the prognostic performance of the chronic liver failure-consortium (CLIF-C) acute decompensation score (CLIF-C AD) and CLIF-C acute-on-chronic liver failure score (CLIF-C ACLF), regarding 28-d and 90-d mortality, as well as to compare them to other prognostic models, such as Model for End-Stage Liver Disease (MELD), MELD Sodium (MELD-Na), Child-Pugh (CP) score, and the CLIF-C Organ Failure score (CLIF-C OF)...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28809733/circulating-levels-of-pentraxin-3-ptx3-in-patients-with-liver-cirrhosis
#2
Janaína L Narciso-Schiavon, Jéssica G Pereira, Telma Erotides Silva, Emília T O Bansho, Edelton F Morato, José T Pinheiro, Letícia Muraro-Wildner, Maria Luiza Bazzo, Esther Buzaglo Dantas-Corrêa, Leonardo L Schiavon
BACKGROUND: Despite the circulating levels of PTX3 were related to the severity of various diseases, there are no studies investigating its role in patients with liver cirrhosis. We aimed to study PTX3 levels in patients with liver cirrhosis. MATERIAL AND METHODS: A prospective cohort study included 130 patients hospitalized for acute decompensation of liver cirrhosis, 29 stable cirrhotic outpatients and 32 healthy controls evaluated in a tertiary hospital in Southern Brasil...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28808210/acute-on-chronic-liver-failure-recent-update
#3
Azeem Alam, Ka Chun Suen, Daqing Ma
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28808200/acute-on-chronic-liver-failure-recent-update
#4
Azeem Alam, Ka Chun Suen, Daqing Ma
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
July 13, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28780608/sx-ella-stent-danis-effectively-controls-refractory-variceal-bleed-in-patients-with-acute-on-chronic-liver-failure
#5
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/28733221/incidence-predictors-and-outcomes-of-acute-on-chronic-liver-failure-in-outpatients-with-cirrhosis
#6
Salvatore Piano, Marta Tonon, Elia Vettore, Marialuisa Stanco, Chiara Pilutti, Antonietta Romano, Sara Mareso, Carmine Gambino, Alessandra Brocca, Antonietta Sticca, Silvano Fasolato, Paolo Angeli
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is the most life-threatening complication of cirrhosis. Prevalence and outcomes of ACLF have been recently described in hospitalized patients with cirrhosis. However, no data is currently available on the prevalence and the risk factors of ACLF in outpatients with cirrhosis. The aim of this study was to evaluate incidence, predictors and outcomes of ACLF in a large cohort of outpatients with cirrhosis. METHODS: 466 patients with cirrhosis consecutively evaluated in a tertiary hospital outpatient clinic were included and followed up until death and/or liver transplantation for a mean of 45±44 months...
July 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28730699/elevated-cardiac-troponin-t-in-cirrhotic-patients-with-emergency-care-admissions-is-associated-with-mortality
#7
Mayada Elnegouly, Katrin Umgelter, Wajima Safi, Alexander Hapfelmeier, Roland M Schmid, Andreas Umgelter
BACKGROUND & AIMS: Mortality of cirrhotic patients after emergency care admission is high and prognostic factors can help in prioritizing patients. The aim of our study was to assess the association between levels of cardiac Troponin T (cTnT) and one-year mortality in patients with liver cirrhosis without known cardiac disease, who were admitted to the emergency department (ED). METHODS: All patients with cirrhosis presented to the ED from October 2009 until August 2015 who had an initial cTnT value measured with the first lab-panel were retrospectively analyzed with a follow-up of 365 days...
July 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28714072/survival-of-patients-with-cirrhosis-and-acute-peptic-ulcer-bleeding-compared-with-variceal-bleeding-using-current-first-line-therapies
#8
Alba Ardevol, Gemma Ibañez-Sanz, Joaquim Profitos, Carles Aracil, Josep M Castellvi, Edilmar Alvarado, Alba Cachero, Diana Horta, Josep Miñana, Bárbara Gomez-Pastrana, Oana Pavel, Eva Dueñas, Meritxell Casas, Montserrat Planella, Jose Castellote J, Candid Villanueva
The presence of cirrhosis increases the mortality of patients with peptic ulcer bleeding (PUB). Both acute variceal bleeding (AVB) and PUB are associated with substantial mortality in cirrhosis. This multicenter cohort study was performed to assess whether the mortality of cirrhotic patients with PUB is different from that of those with AVB. Patients with cirrhosis and acute gastrointestinal bleeding were consecutively included and treated with somatostatin and PPI infusion from admission and with antibiotic prophylaxis...
July 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28700328/additional-n-glycosylation-mutation-in-the-major-hydrophilic-region-of-hepatitis-b-virus-s-gene-is-a-risk-indicator-for-hepatocellular-carcinoma-occurrence-in-patients-with-coexistence-of-hbsag-anti-hbs
#9
Yan Qiao, Shanshan Lu, Zhihui Xu, Xiaodong Li, Kai Zhang, Yan Liu, Li Zhao, Rongjuan Chen, Lanlan Si, Shumei Lin, Dongping Xu, Jin Li
The study aimed to determine the association of additional N-glycosylation mutations in the major hydrophilic region (MHR) of hepatitis B virus (HBV) S gene with hepatocellular carcinoma (HCC) occurrence in HBsAg/anti-HBs coexistent patients. A total of 288 HBsAg/anti-HBs coexistent patients and 490 single HBsAg-positive patients were enrolled, including 193 with HCC, 433 with chronic hepatitis B (CHB), and 152 with acute-on-chronic liver failure (ACLF). The HBV S genes were amplified from serum and sequenced...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#10
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28688141/incidence-predictive-factors-and-impacts-of-acute-kidney-injury-in-cirrhotic-patients-hospitalized-for-cellulitis
#11
Ana Garcia Garcia de Paredes, Luis Tellez, Miguel Angel Rodriguez-Gandia, Javier Martinez, Enrique Rodriguez De Santiago, Lara Aguilera Castro, Francisco Gea, Agustín Albillos
BACKGROUND & AIMS: Cellulitis is a common infection in patients with cirrhosis but its impact on progression of liver disease has been hardly addressed. This study examines the incidence of acute kidney injury (AKI), predictive factors, and its impacts on mortalilty in cirrhotic patients hospitalized for cellulitis. METHODS: Retrospective data from cirrhotic patients hospitalized for cellulitis over the period January 2006 to September 2015 were analyzed. AKI was defined according to revised criteria of the International Club of Ascites...
July 8, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28667037/a-programmed-cell-death-1-haplotype-is-associated-with-clearance-of-hepatitis-b-virus
#12
Zhouhua Hou, Qing Zhou, Menghou Lu, Deming Tan, Xuwen Xu
PURPOSE: Programmed cell death 1 (PD-1) is an important immune checkpoint of T cells response and plays a critical role in chronic hepatitis B virus (HBV) infection. The purpose of this study was to investigate the associations between PD-1 polymorphisms and susceptibility and disease progression of chronic HBV infection. METHODS: In this case-control study, 299 cases with chronic HBV infection comprised of 99 asymptomatic carriers (ASCs), 96 patients with chronic hepatitis B (CHB), and 104 patients with HBV-related acute on chronic liver failure (HBV-ACLF) were enrolled...
May 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28663673/spontaneous-bacterial-peritonitis-by-burkholderia-cepacia-complex-a-rare-difficult-to-treat-infection-in-decompensated-cirrhotic-patients
#13
Sunil Taneja, Pramod Kumar, Vikas Gautam, Ajay Duseja, Virendra Singh, Radha K Dhiman, Yogesh Chawla
INTRODUCTION: Burkholderia cepacia complex (Bcc) is non-fermenting Gram-negative bacillus and has been rarely reported to cause spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis. OBJECTIVE: This study was done to evaluate the clinical presentation of cirrhotic patients with SBP due to Bcc and to determine its impact on clinical outcome. METHODS: This is a retrospective, observational study conducted during the period from 1st January 2013 through 31st March 2015...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28660146/bile-cast-nephropathy-in-patients-with-acute-kidney-injury-due-to-hepatorenal-syndrome-a-postmortem-kidney-biopsy-study
#14
Suman Lata Nayak, Manoj Kumar, Chhagan Bihari, Archana Rastogi
Background and Aims: The role of bile cast nephropathy (BCN) in pathogenesis of hepatorenal syndrome (HRS) in decompensated cirrhosis and acute on chronic liver failure (ACLF) is unknown. This study aimed to determine the frequency of BCN detected on postmortem renal biopsy among patients with decompensated cirrhosis and ACLF who had been admitted with acute kidney injury due to HRS (HRA-AKI) and expired during that hospitalization. Methods: One-hundred-twenty-seven postmortem renal biopsies with adequate size (>1 cm in length) were included for analysis...
June 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28655410/update-on-acute-on-chronic-liver-failure
#15
Cristina Solé, Elsa Solà
Acute-on-chronic liver failure (ACLF) is a recently defined syndrome characterised by acute decompensation of chronic liver disease, associated with organ failures and high mortality. ACLF is a common condition and may affect up to 30% of patients admitted to hospital for cirrhosis complications. Bacterial infections, alcoholism and reactivation of viral hepatitis are the most common precipitating factors in ACLF, although in up to 40% of patients no precipitating factor can be identified. Although the pathophysiology of ACLF is not completely understood, the presence of an excessive inflammatory response appears to play a key role...
June 24, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28646630/characteristics-of-systemic-inflammation-in-hepatitis-b-precipitated-aclf-differentiate-it-from-no-aclf
#16
Wei Wu, Huadong Yan, Hong Zhao, Wenjie Sun, Qiao Yang, Jifang Sheng, Yu Shi
BACKGROUND & AIMS: Patients with severe exacerbation of chronic hepatitis B (SE-CHB) are at risk of developing acute-on-chronic liver failure (ACLF). Systemic inflammation (SI) is a major driver of ACLF. The aim of this study was to identify characteristics of SI in hepatitis B-precipitated-ACLF (HB-ACLF), which may be distinct from No-ACLF patients with SE-CHB. METHODS: Two cohorts of patients with SE-CHB were enrolled in two tertiary hospitals. The associations between circulating leucocyte counts/subsets and ACLF progression and prognoses were analysed in Cohort A...
June 24, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28645736/liver-transplantation-in-the-most-severely-ill-cirrhotic-patients-a-multicenter-study-in-acute-on-chronic-liver-failure-grade-3
#17
Florent Artru, Alexandre Louvet, Isaac Ruiz, Eric Levesque, Julien Labreuche, Jose Ursic-Bedoya, Guillaume Lassailly, Sebastien Dharancy, Emmanuel Boleslawski, Gilles Lebuffe, Eric Kipnis, Philippe Ichai, Audrey Coilly, Eleonora De Martin, Teresa Maria Antonini, Eric Vibert, Samir Jaber, Astrid Herrerro, Didier Samuel, Alain Duhamel, Georges-Philippe Pageaux, Philippe Mathurin, Faouzi Saliba
BACKGROUND & AIMS: Liver transplantation (LT) for the most severely ill patients with cirrhosis, with multiple organ dysfunction (accurately assessed by the acute-on-chronic liver failure [ACLF] classification) remains controversial. We aimed to report the results of LT in patients with ACLF grade 3 and to compare these patients to non-transplanted patients with cirrhosis and multiple organ dysfunction as well as to patients transplanted with lower ACLF grade. METHODS: All patients with ACLF-3 transplanted in three liver intensive care units (ICUs) were retrospectively included...
June 21, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28641515/the-development-of-stem-cell-based-treatment-for-liver-failure
#18
Tiantian Zhu, Yuwen Li, Yusheng Guo, Chuanlong Zhu
Liver failure is a devastating clinical syndrome with a persistently mortality rate despite advanced care. According to the pathological histology, hepatic failure was divided into four categories: acute liver failure (ALF), subacute liver failure (SALF), acute - on - chronic liver failure (ACLF) and chronic liver failure (CLF). Orthotopic liver transplantation protected patients from hepatic failure. Yet, limitations including postoperative complications, high costs, and shortages of donor organs defect its application...
June 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28641354/-acute-liver-failure-acute-on-chronic-liver-failure-hepatorenal-syndrome-hepatopulmonary-syndrome-and-portopulmonary-hypertension-artificial-liver-support-on-the-icu
#19
Uwe Lodes, David Jacob, Frank Meyer
Background Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. Aim This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Method Narrative review with a selective literature review and representative case studies...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640516/damp-molecular-il-33-augments-monocytic-inflammatory-storm-in-hepatitis-b-precipitated-acute-on-chronic-liver-failure
#20
Xing X Du, Yu Shi, Ying Yang, Ye Yu, Hua G Lou, Fang F Lv, Zhi Chen, Qiao Yang
BACKGROUND & AIMS: Patients with acute-on-chronic liver failure (ACLF) usually exhibit defective monocyte function and excessive systemic inflammatory response. Interleukin-33 (IL-33) acts as a danger-associated molecular pattern (DAMP) to modulate immune response. However, the role of IL-33 in regulating monocyte function during hepatitis B-precipitated ACLF (HB-ACLF) in response to lipopolysaccharide (LPS) has not been clear. METHODS: In this study, the levels of IL-33/ST2 in blood and liver samples collected from patients with HB-ACLF, chronic hepatitis B (CHB) and normal controls and the associated of those findings with disease severity were analysed...
June 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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