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https://www.readbyqxmd.com/read/28420029/interlobar-artery-resistive-index-predicts-acute-on-chronic-liver-failure-syndrome-in-cirrhotic-patients-with%C3%A2-acute-decompensation
#1
Pablo A Solís-Muñoz, Christopher Willars, Julia Wendon, George Auzinger, Michael A Heneghan, Maria De la Flor-Robledo, José A Solís-Herruzo
Introduction Patients with acutely decompensated (AD) cirrhosis are at risk for developing acute-on-chronic liver failure (ACLF) syndrome. This syndrome is associated with a high short-term mortality rate. The aim of our study was to identify reliable early predictors of developing ACLF in cirrhotic patients with AD. Patients and Methods We assessed 84 cirrhotic patients admitted for AD without ACLF on admission. We performed routine blood testing and detailed ultrasound Doppler studies of systemic arteries and mayor abdominal veins and arteries...
April 18, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28393476/development-of-predisposition-injury-response-organ-failure-model-for-predicting-acute-kidney-injury-in-acute-on-chronic-liver-failure
#2
Rakhi Maiwall, Shiv Kumar Sarin, Suman Kumar, Priyanka Jain, Guresh Kumar, Ajeet Singh Bhadoria, Richard Moreau, Chandan Kumar Kedarisetty, Zaigham Abbas, Deepak Amarapurkar, Ankit Bhardwaj, Chhagan Bihari, Amna Subhan Butt, Albert Chan, Yogesh Kumar Chawla, Ashok Chowdhury, RadhaKrishan Dhiman, Abdul Kadir Dokmeci, Hasmik Ghazinyan H, Saeed Sadiq Hamid, Dong Joon Kim, Piyawat Komolmit, George K Lau, Guan Huei Lee, Laurentius A Lesmana, Mamun Al-Mahtab, Rajendra Prasad Mathur, Suman Lata Nayak, Qin Ning, Viniyendra Pamecha, Diana Alcantara-Payawal, Archana Rastogi, Salimur Rahman, Mohamed Rela, Vivek A Saraswat, Samir Shah, Gamal Shiha, Barjesh Chander Sharma, Manoj Kumar Sharma, Kapil Sharma, Soek Siam Tan, Shivendra Singh Chandel, Chitranshu Vashishtha, Zeeshan A Wani, Man-Fung Yuen, Osamu Yokosuka
BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury(AKI) in ACLF. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting AKI in a multi-centric cohort of ACLF patients. PATIENTS AND METHODS: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of ACLF patients (n=997) RESULTS: Factors significant for P component were serum creatinine[(≥2mg/dl)OR 4...
April 10, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28381383/serum-soluble-st2-is-a-promising-prognostic-biomarker-in-hbv-related-acute-on-chronic-liver-failure
#3
Shao-Wen Jiang, Peng Wang, Xiao-Gang Xiang, Rui-Dong Mo, Lan-Yi Lin, Shi-San Bao, Jie Lu, Qing Xie
BACKGROUND: The IL-33/ST2 axis is involved in the pathogenesis of many diseases such as autoimmune diseases, cancer, and heart failure. However, studies of the IL-33/ST2 pathway in HBV-related acute-on-chronic liver failure (HBV-ACLF) are lacking. The present study aimed to determine the prognostic role of serum IL-33/soluble ST2 (sST2) in HBV-ACLF. METHODS: Serum levels of IL-33 and sST2 in healthy controls (HC, n=18), chronic hepatitis B (CHB, n=27) and HBV-ACLF (n=51) patients at the 1st and 4th week after enrollment were detected using ELISA, and clinical data were collected...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28376624/autochthonous-acute-hepatitis-e-an-increasingly-frequent-diagnosis-clinical-epidemiological-analysis-of-our-experience
#4
Luzdivina Monteserín Ron, Marcos Jiménez Palacios, Pedro Linares Torres, Aleida Miguel Peña, Begoña Álvarez Cuenllas, María Isabel Fernández-Natal, Emilio Valverde Romero, Francisco Jorquera Plaza
BACKGROUND: In Europe, acute hepatitis caused by the hepatitis E virus (HEV) traditionally was an infection found in people who had travelled to endemic zones, mainly Asia and Africa. However, a growing number of sporadic autochthonous cases are now being diagnosed in the Western world. OBJECTIVE: To analyze the cases of acute HEV hepatitis diagnosed in our setting, with the identification of the clinical-epidemiological characteristics. MATERIAL AND METHODS: We included the cases of acute HEV hepatitis diagnosed (positive anti-HEV IgM and/or HEV RNA present in serum) between January 2008 and December 2014...
April 5, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28374414/systemic-inflammatory-response-syndrome-in-acute-on-chronic-liver-failure-relevance-of-golden-window-a-prospective-study
#5
A Choudhury, M Kumar, B C Sharma, R Maiwall, V Pamecha, R Moreau, Y K Chawla, A Duseja, M Mahtab, S Rahman, S S Hamid, A S Butt, W Jafri, S S Tan, H Devarbhavi, D Amarapurkar, Q Ning, C E Eapen, Ashish Goel, D J Kim, H Ghazinian, G Shiha, G H Lee, Z Abbas, D A Payawal, A K Dokmeci, M F Yuen, L A Lesmana, Ajit Sood, A Chan, G K Lau, J I Dong Jia, Z Duan, Yu Chen, O Yokosuka, P Jain, A S Bhadoria, G Kumar, S K Sarin
BACKGROUND: SIRS is an early marker of sepsis and ongoing inflammationand has been reported in large proportion of ACLF patients. Whether sepsis is the cause or the result of liver failure is unclear and is vital to know. To address this, we investigated the course and outcome of ACLF patients without SIRS/sepsis. METHODS: Consecutive ACLF patients were monitored for the development of SIRS/sepsis and associated complications and followed till 90 days, liver transplant or death...
April 3, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28370357/allogeneic-bone-marrow-derived-mesenchymal-stromal-cells-for-hbv-related-acute-on-chronic-liver-failure-a-randomized-controlled-trial
#6
Bing-Liang Lin, Jun-Feng Chen, Wei-Hong Qiu, Ke-Wei Wang, Dong-Ying Xie, Xiao-Yong Chen, Qiu-Li Liu, Liang Peng, Jian-Guo Li, Yong-Yu Mei, Wei-Zhen Weng, Yan-Wen Peng, Hui-Juan Cao, Jun-Qiang Xie, Shi-Bin Xie, Andy Peng Xiang, Zhi-Liang Gao
Mortality from hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) is high due to limited treatment options. Preclinical and clinical investigations have proved that treatment with mesenchymal stromal cells (MSCs) is beneficial for recovery from liver injury. We hypothesized that the outcome of HBV-related ACLF would be improved by MSC treatment. From 2010 to 2013, 110 patients with HBV-related ACLF were enrolled in this open label non-blinded randomized controlled study. The control group (N=54) was treated with standard medical therapy (SMT) only...
April 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28358016/plasma-apolipoprotein-a-v-predicts-long-term-survival-in-chronic-hepatitis-b-patients-with-acute-on-chronic-liver-failure
#7
En-Qiang Chen, Meng-Lan Wang, Dong-Mei Zhang, Ying Shi, Do-Bo Wu, Li-Bo Yan, Ling-Yao Du, Ling-Yun Zhou, Hong Tang
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition, and the lipid metabolism disorder is common in the development of this disease. This prospective observational study aimed to define the characteristics of plasma apolipoprotein A-V (apoA-V) in long-term outcome prediction of HBV-ACLF, and a total of 330 HBV-ACLF patients were included and followed for more than 12 months. In this cohort, the 4-week, 12-week, 24-week and 48-week cumulative mortality of HBV-ACLF was 18...
March 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28353081/gastrointestinal-manifestations-of-melioidosis-a-single-center-experience
#8
Nitin Jagtap, Harshal Shah, Anuradha Kancharla, Manu Tandan, Partha Pal, Sundeep Lakhtakia, Mohan Ramchandani, D N Reddy
Melioidosis, being increasing, is reported from India. Gastrointestinal manifestations are typically reported as unusual cause of liver and/or splenic abscess. We aimed to describe various gastrointestinal manifestation of melioidosis in the present study. We retrospectively collected data of culture positive melioidosis cases from hospital database during August 2014-October 2016 at Asian Institute of Gastroenterology, Hyderabad. A total of nine culture positive cases (8 male) of melioidosis with median age of 40 years (range 23-66) were analyzed...
March 29, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28350742/short-article-impact-of-genetic-variation-in-the-vasopressin-1a-receptor-on-the-development-of-organ-failure-in-patients-admitted-for-acute-decompensation-of-liver-cirrhosis
#9
Annarein J C Kerbert, Jelte J Schaapman, Johan J van der Reijden, Àlex Amorós Navarro, Aiden McCormick, Bart van Hoek, Vicente Arroyo, Pere Ginès, Rajiv Jalan, Victor Vargas, Rudolf Stauber, Hein W Verspaget, Minneke J Coenraad
BACKGROUND: Vasopressin receptor-mediated vasoconstriction is considered to be involved in the pathogenesis of organ failure in acute-on-chronic liver failure (ACLF). PATIENTS AND METHODS: We studied the association between six single nucleotide polymorphisms (SNPs) of the vasopressin 1a receptor gene and the development of organ failure in 826 patients admitted for acute decompensation of liver cirrhosis (n=641) or ACLF (n=185). RESULTS: No associations were found for SNPs with the presence of circulatory or renal failure...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28348465/impact-of-hepatic-and-extrahepatic-insults-on-the-outcome-of-acute-on-chronic-liver-failure
#10
Tarana Gupta, Radha K Dhiman, Sahaj Rathi, Swastik Agrawal, Ajay Duseja, Sunil Taneja, Yogesh Chawla
BACKGROUND: To study the differences in outcome and predictors of mortality in acute-on-chronic liver failure (ACLF) precipitated by hepatic or extrahepatic insults. METHODS: Consecutive patients of cirrhosis with acute decompensation were prospectively included and followed up for 90 days from admission. ACLF was defined based on chronic liver failure (CLIF) acute-on-chronic liver failure in cirrhosis (CANONIC study) criteria. Acute worsening due to acute viral hepatitis A and E, hepatitis B flare, alcoholic hepatitis, autoimmune hepatitis flare, or drug-induced liver injury were categorized as hepatic ACLF and that due to bacterial infection, upper gastrointestinal bleed or surgery as extrahepatic ACLF...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28345155/a-nomogram-for-predicting-prognostic-value-of-inflammatory-response-biomarkers-in-decompensated-cirrhotic-patients-without-acute-on-chronic-liver-failure
#11
Y-J Cai, J-J Dong, J-Z Dong, Y Chen, Z Lin, M Song, Y-Q Wang, Y-P Chen, K-Q Shi, M-T Zhou
BACKGROUND: Inflammation plays a vital role in liver cirrhosis progression and prognosis. AIM: To investigate the prognostic significance of inflammatory response markers in decompensated cirrhotic patients without acute-on-chronic liver failure (ACLF). METHODS: Independent predictors were identified using multivariate Cox model and then assembled into a nomogram to predict survival. Concordance index (C-index) and time-dependent receiver operating characteristics (td-ROC) analysis were adopted to evaluate and compare the performance of nomogram, model for end-stage liver disease (MELD) scores, MELD-Na and Chronic Liver Failure-consortium score for acute decompensated (CLIF-C ADs)...
March 26, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28304106/therapeutic-plasma-exchange-versus-double-plasma-molecular-absorption-system-in-hepatitis-b-virus-infected-acute-on-chronic-liver-failure-treated-by-entercavir-a-prospective-study
#12
Yue-Meng Wan, Yu-Hua Li, Zhi-Yuan Xu, Jing Yang, Li-Hong Yang, Ying Xu, Jin-Hui Yang
BACKGROUND: Therapeutic plasma exchange (TPE) and double plasma molecular absorption system (DPMAS) were two extracorporeal liver support systems. Few studies compared their efficacy profile. OBJECTIVE: This study was to compare the efficacy of TPE and DPMAS on acute-on-chronic liver failure (ACLF) caused by hepatitis B virus (HBV-ACLF). METHODS: 60 HBV-ACLF patients were enrolled and prospectively studied. All patients received entecavir therapy, and were assigned to TPE group (n = 33) and DPMAS group (n = 27)...
March 17, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28303605/performance-of-scoring-systems-to-predict-mortality-of-patients-with-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#13
Yi-Xiang Zheng, Xiao Zhong, Ya-Jun Li, Xue-Gong Fan
BACKGROUND: Acute-on-chronic liver failure (ACLF) has characteristic feature of multisystem organ failure, rapid progression and low early transplant-free survival. AIM: We performed a meta-analysis to determine the accuracy of five scoring systems in predicting mortality of ACLF patients. METHODS: A systematic database search was performed and retrieved articles were graded according to methodological quality. Collated data was meta-analyzed by hierarchical summarized receiver operating characteristic (HSROC) model and bivariate model to evaluate the diagnostic accuracy of scoring systems RESULT: Of 4223 studies identified, 26 studies involving 4732 ACLF patients were included...
March 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28297776/-value-of-thromboelastography-in-evaluating-coagulation-function-and-prognosis-in-patients-with-acute-on-chronic-liver-failure
#14
Y L Zeng, F Gao, J F Wei, H R Hou, X Jin, G G Ding, H Yin, J Shang, Y Kang
Objective: To investigate the coagulation function in patients with acute-on-chronic liver failure (ACLF) patients using thromboelastography (TEG), and to comprehensively and dynamically evaluate patients' bleeding and coagulation status. Methods: The clinical data of ACLF patients were collected, and TEG was used to evaluate whole blood clotting kinetics in these patients. Routine biochemical parameters were measured, and complications were evaluated. The t-test was used for comparison of continuous data, the chi-square test was used for comparison of categorical data, and the Pearson correlation coefficient was used for correlation analysis...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28296656/severity-and-outcome-of-acute-on-chronic-liver-failure-is-dependent-on-the-etiology-of-acute-hepatic-insults-analysis-of-368-patients
#15
Shalimar, Saurabh Kedia, Soumya J Mahapatra, Baibaswata Nayak, Deepak Gunjan, Bhaskar Thakur, Subrat K Acharya
BACKGROUND: Acute-on-chronic liver failure (ACLF) may be precipitated by various hepatic insults. The present study evaluated the outcomes of ACLF with different acute insults. PATIENTS AND METHODS: A total of 368 ACLF patients were included. Data collected included etiologies of acute hepatic insult and underlying chronic liver disease, and organ failure. Model for end-stage liver disease (MELD), chronic liver failure consortium (CLIF)-C ACLF, and acute physiology and chronic health evaluation (APACHE) II scores were calculated...
March 14, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28293919/-extracorporeal-liver-support-of-liver-failure
#16
Hans Ulrich Gerth, Michele Pohlen, Hermann Pavenstädt, Hartmut Schmidt
Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28292360/acute-on-chronic-liver-failure-causes-clinical-characteristics-and-predictors-of-mortality
#17
Abbas Ali Tasneem, Nasir Hassan Luck
OBJECTIVE: To determine the causes, characteristics and predictors of mortality in patients with acute-on-chronic liver failure (ACLF). STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, from July 2014 to June 2016. METHODOLOGY: All patients with acute-on-chronic liver disease (ACLD) with ages > 12 were included...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28282579/interleukin-23-mediates-the-pathogenesis-of-lps-galn-induced-liver-injury-in-mice
#18
Suxia Bao, Qiang Zhao, Jianming Zheng, Ning Li, Chong Huang, Mingquan Chen, Qi Cheng, Mengqi Zhu, Kangkang Yu, Chenghai Liu, Guangfeng Shi
BACKGROUND: Interleukin-23 (IL-23) is required for T helper 17 (Th17) cell responses and IL-17 production in hepatitis B virus infection. A previous study showed that the IL-23/IL-17 axis aggravates immune injury in patients with chronic hepatitis B virus infection. However, the role of IL-23 in acute liver injury remains unclear. OBJECTIVE: The purpose of this study was to determine the role of the inflammatory cytokine IL-23 in lipopolysaccharide/d-galactosamine (LPS/GalN)-induced acute liver injury in mice...
March 7, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28249358/clinical-characteristics-and-prognostic-factors-of-liver-cirrhosis-patients-with-systemic-inflammatory-response-syndrome
#19
Danhong Yang, Yuanjun Xie, Hongying Pan, Yichen Huang, Yining Dai, Yongxi Tong, Meijuan Chen
Current assessment of prognostic factors in cirrhosis patients with SIRS is not accurate. There are few reports in the literature, which makes it difficult to determine an indication for cirrhosis patients with SIRS.To study the clinical characteristics in cirrhosis with SIRS and investigate its prognostic factors,we analysed 285 consecutive cirrhosis patients with SIRS and .their database were evaluated retrospectively.Data were compared in patients with/without SIRS during hospitalization.Univariate and multivariate Cox regression analyses were performed separately for cirrhotic patients with SIRS to assess predictive factors for 90-day mortality...
March 1, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28222896/comparison-of-the-prognostic-value-of-chronic-liver-failure-consortium-scores-and-traditional-models-for-predicting-mortality-in-patients-with-cirrhosis
#20
Artur Gião Antunes, Cristina Teixeira, Ana Margarida Vaz, Cláudio Martins, Patrícia Queirós, Ana Alves, Francisco Velasco, Bruno Peixe, Ana Paula Oliveira, Horácio Guerreiro
BACKGROUND AND AIM: Recently, the European Association for the Study of the Liver - Chronic Liver Failure (CLIF) Consortium defined two new prognostic scores, according to the presence or absence of acute-on-chronic liver failure (ACLF): the CLIF Consortium ACLF score (CLIF-C ACLFs) and the CLIF-C Acute Decompensation score (CLIF-C ADs). We sought to compare their accuracy in predicting 30- and 90-day mortality with some of the existing models: Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD-Na, integrated MELD (iMELD), MELD to serum sodium ratio index (MESO), Refit MELD and Refit MELD-Na...
April 2017: Gastroenterología y Hepatología
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