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Acute on chronic liver failure

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https://www.readbyqxmd.com/read/29440324/natural-history-clinical-manifestations-and-pathogenesis-of-hepatitis-a
#1
Eui-Cheol Shin, Sook-Hyang Jeong
Hepatitis A virus (HAV) is transmitted by the fecal-oral route and is a major cause of acute viral hepatitis. The clinical manifestations of HAV infection range from asymptomatic infection to acute liver failure (ALF), but do not include progression to chronic hepatitis. Risk factors for severe acute hepatitis A are older age (>40 years) and preexisting liver disease. Some patients may show atypical clinical features such as relapsing hepatitis, prolonged cholestasis, or extrahepatic manifestations. Almost all hepatitis A patients spontaneously recover with supportive care...
February 12, 2018: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/29435276/serum-osteopontin-is-a-predictor-of-prognosis-for-hbv-associated-acute-on-chronic-liver-failure
#2
Longgen Liu, Jianchun Lu, Chunyan Ye, Lin Lin, Shuqin Zheng, Hongyu Zhang, Qing Lan, Yuan Xue
Acute-on-chronic liver failure (ACLF) is a syndrome with a high rate of short-term mortality, and clinically it is important to identify patients at high risk of mortality. The present study evaluated the value of osteopontin (OPN) in the prediction of 90-day mortality in patients with ACLF. A total of 54 patients with HBV-associated ACLF were enrolled, and serum OPN levels were determined in a prospective, observational study design. Survival analysis was performed using Kaplan-Meier curves, and multivariate Cox proportional hazards regression was used to analyze independent risk factors of mortality...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29427501/infections-complicating-cirrhosis
#3
REVIEW
Salvatore Piano, Alessandra Brocca, Sara Mareso, Paolo Angeli
Patients with cirrhosis have a high risk of bacterial infections. Bacterial infections induce systemic inflammation that may lead to organ failure and acute-on-chronic liver failure (ACLF) resulting in a high risk of short term mortality. The early diagnosis and treatment of bacterial infections is essential to improve the patient's prognosis. However, in recent years, the spread of multidrug resistant (MDR) bacterial infections has reduced the efficacy of commonly used antibiotics such as third generation cephalosporins...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29406986/was-ugo-foscolo-1778-1827-affected-by-alpha-1-antitrypsin-deficiency
#4
A Perciaccante, C Negri, A Coralli, P Charlier, O Appenzeller, R Bianucci
Niccolò Ugo Foscolo (1778-1827), known as Ugo, is one of the masters of the Italian poetry. A writer and a revolutionary, he embraced the ideals of the French Revolution and took part in the stormy political discussions, which the fall of the Republic of Venice had provoked. Despite his poor health, Foscolo lived an adventurous life serving as a volunteer in the Guardia Nazionale and in the Napoleonic army. Following Napoleon's fall (1814), he went into voluntary exile in early 1815. He reached London in Sept...
February 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29406040/community-or-healthcare-associated-bacterial-infections-increase-long-term-mortality-in-patients-with-acute-decompensation-of-cirrhosis
#5
Hong Zhao, Yu Shi, Huihui Dong, Jianhua Hu, Xuan Zhang, Meifang Yang, Jun Fan, Weihang Ma, Jifang Sheng, Lanjuan Li
BACKGROUND: The aim of the present study was to determine the specific role of different types of bacterial infections (BIs) on the prognosis of cirrhotic patients with acute decompensation (AD). METHODS: We performed a prospective, observational cohort study consisting of 492 cirrhotic patients with AD at our center from February 2014 to March 2015. Clinical, laboratory and survival data were collected. The relationship between BIs and mortality was analyzed. RESULTS: BIs were identified in 157 of 492 patients at the time of admission or during the hospital stay...
February 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29404528/acute-decompensation-boosts-hepatic-collagen-type-iii-deposition-and-deteriorates-experimental-and-human-cirrhosis
#6
Michael Praktiknjo, Jennifer Lehmann, Mette J Nielsen, Robert Schierwagen, Frank E Uschner, Carsten Meyer, Daniel Thomas, Christian P Strassburg, Flemming Bendtsen, Søren Møller, Aleksander Krag, Morten A Karsdal, Diana J Leeming, Jonel Trebicka
Patients with end-stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute-on-chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro-C3) and degradation (matrix metalloproteinase-degraded type III collagen [C3M]) markers in animal models and human disease...
February 2018: Hepatology communications
https://www.readbyqxmd.com/read/29391267/association-between-grade-of-acute-on-chronic-liver-failure-and-response-to-terlipressin-and-albumin-in-patients-with-hepatorenal-syndrome
#7
Salvatore Piano, Hartmut H Schmidt, Xavier Ariza, Alex Amoros, Antonietta Romano, Anna Hüsing-Kabar, Elsa Solà, Alexander Gerbes, Mauro Bernardi, Carlo Alessandria, Bernhard Scheiner, Marta Tonon, Miriam Maschmeier, Cristina Solè, Jonel Trebicka, Thierry Gustot, Frederik Nevens, Vicente Arroyo, Pere Gines, Paolo Angeli
BACKGROUND & AIMS: Type-1 hepatorenal syndrome (HRS) is the most high-risk type of renal failure in patients with cirrhosis. Terlipressin and albumin are effective treatments for type-1 HRS. However, the effects of acute on chronic liver failure (ACLF) grade on response to treatment are not clear. We aimed to identify factors associated with response to treatment with terlipressin and albumin in patients with type 1 HRS (reduction in serum level of creatinine to below 1.5 mg/dl at the end of treatment) and factors associated with death within 90 days of HRS diagnosis (90-day mortality)...
January 29, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29387913/the-ten-tips-to-manage-critically-ill-patients-with-acute-on-chronic-liver-failure
#8
Valentin Fuhrmann, Tony Whitehouse, Julia Wendon
No abstract text is available yet for this article.
January 31, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29383510/epidemiology-causes-evolution-and-outcome-in-a-single-center-cohort-of-1116-critically-ill-patients-with-hypoxic-hepatitis
#9
Astrid Van den Broecke, Laura Van Coile, Alexander Decruyenaere, Kirsten Colpaert, Dominique Benoit, Hans Van Vlierberghe, Johan Decruyenaere
BACKGROUND: Hypoxic hepatitis (HH) is a type of acute hepatic injury that is histologically characterized by centrilobular liver cell necrosis and that is caused by insufficient oxygen delivery to the hepatocytes. Typical for HH is the sudden and significant increase of aspartate aminotransferase (AST) in response to cardiac, circulatory or respiratory failure. The aim of this study is to investigate its epidemiology, causes, evolution and outcome. METHODS: The screened population consisted of all adults admitted to the intensive care unit (ICU) at the Ghent University Hospital between January 1, 2007 and September 21, 2015...
January 30, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29369242/long-term-prognosis-of-acute-on-chronic-liver-failure-survivors
#10
Eileen L Yoon, Tae Yeob Kim, Chang Hyeong Lee, Tae Hun Kim, Hyun Chin Cho, Sang Soo Lee, Sung Eun Kim, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Dong Hyun Sinn, Young Kul Jung, Hyung Joon Yim, Hyoung Su Kim, Joo Hyun Sohn, Jeong Han Kim, Won Hyeok Choe, Byung Seok Lee, Moon Young Kim, Soung Won Jeong, Eunhee Choi, Dong Joon Kim
GOALS: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). BACKGROUND: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. STUDY: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed...
February 1, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29369172/long-noncoding-rna-hypoxia-inducible-factor-1-alpha-antisense-rna-1-promotes-tumor-necrosis-factor-%C3%AE-induced-apoptosis-through-caspase-3-in-kupffer-cells
#11
Yanghe Wu, Jiguang Ding, Qingfeng Sun, Ke Zhou, Weiwei Zhang, Qingwei Du, Tingyan Xu, Wangwang Xu
Kupffer cells (KCs) play a crucial role in the pathogenesis of acute-on-chronic liver failure (ACLF) which is characterized by acute and severe disease in patients with preexisting liver disease and shows high mortality. Long noncoding RNAs (lncRNAs) are recently found to be involved in gene regulation. However, the mechanisms of how KCs are regulated by inflammatory factors, tumor necrosis factor-α (TNF-α), and whether lncRNAs are involved in the process remain largely unknown. Hence, we investigated the role of lncRNAs in the cytotoxicity of TNF-α on KCs...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29361652/proposed-diagnostic-criteria-for-acute-on-chronic-liver-failure-in-japan
#12
Satoshi Mochida, Nobuaki Nakayama, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa
To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, the Intractable Hepato-Biliary Disease Study Group of Japan performed a multicenter pilot survey for patients fulfilling the APASL, EASL-Clif Consortium, or Chinese Medical Association (CMA) diagnostic criteria for ACLF and found that the APASL criteria were suitable for screening Japanese patients with ACLF when patients whose conditions were triggered by gastrointestinal bleeding were included within the disease entity, while the EASL-Clif Consortium criteria were useful for classifying the severity of the patients' conditions...
January 23, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29350771/recombinant-relaxin-protects-liver-transplants-from-ischemia-damage-via-hepatocyte-glucocorticoid-receptor-from-bench-to-bedside
#13
Shoichi Kageyama, Kojiro Nakamura, Takehiro Fujii, Bibo Ke, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI) represents a major risk factor of early graft dysfunction and acute/chronic rejection as well as a key obstacle to expanding the donor pool in orthotopic liver transplantation (OLT). Although glucocorticoid receptor (GR) signaling may enhance cytoprotective programs, clinical use of glucocorticoid is limited due to adverse effects, while clinical relevance of GR-facilitated cytoprotection in OLT remains unknown. We aimed to evaluate the significance of hepatic GR in clinical OLT and verify the impact of recombinant human relaxin (rhRLX), which may function as GR agonist in tissue/disease-specific manner...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29343867/improving-survival-of-acute-on-chronic-liver-failure-patients-complicated-with-invasive-pulmonary-aspergillosis
#14
Jie Gao, Qing Zhang, Yuankui Wu, Ying Li, Tingting Qi, Congyan Zhu, Sijia Liu, Ruoxi Yu, Qinjun He, Weiqun Wen, Fuyuan Zhou, Yongpeng Chen, Jinjun Chen, Jinlin Hou
The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optimal voriconazole regimen for ACLF patients complicated with IPA. We retrospectively screened hospitalized ACLF patients in our hospital from July 2011 to April 2016, from which 20 probable IPA cases were diagnosed. Along with onsets of IPA, deteriorated diseases severity, especially lung conditions were found in those 20 ACLF patients...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29341965/osmotic-shifts-cerebral-edema-and-neurologic-deterioration-in-severe-hepatic-encephalopathy
#15
Eric Michael Liotta, Anna L Romanova, Bryan D Lizza, Laura J Rasmussen-Torvik, Minjee Kim, Brandon Francis, Rajbeer Singh Sangha, Timothy J Carroll, Daniel Ganger, Daniela P Ladner, Andrew M Naidech, James J Paparello, Shyam Prabhakaran, Farzaneh A Sorond, Matthew B Maas
OBJECTIVES: We sought to determine the effect of acute electrolyte and osmolar shifts on brain volume and neurologic function in patients with liver failure and severe hepatic encephalopathy. DESIGN: Retrospective analysis of brain CT scans and clinical data. SETTING: Tertiary care hospital ICUs. PATIENTS: Patients with acute or acute-on-chronic liver failure and severe hepatic encephalopathy. INTERVENTIONS: Clinically indicated CT scans and serum laboratory studies...
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29341357/a-multicenter-pilot-survey-to-clarify-the-clinical-features-of-patients-with-acute-on-chronic-liver-failure-in-japan
#16
Nobuaki Nakayama, Hayato Uemura, Yoshihito Uchida, Tomoaki Tomiya, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa, Satoshi Mochida
AIMS: To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, a multicenter pilot survey was conducted to examine usefulness of oversea criteria in patients with chronic liver diseases manifesting acute decompensation. METHODS: Patients fulfilling the APASL, EASL or Chinese Medical Association (CMA) criteria for decompensation were enrolled from 8 institutes, and the clinical features were evaluated. RESULTS: Among 112 patients, 109 patients (97...
January 17, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29336434/acg-clinical-guideline-alcoholic-liver-disease
#17
Ashwani K Singal, Ramon Bataller, Joseph Ahn, Patrick S Kamath, Vijay H Shah
Alcoholic liver disease (ALD) comprises a clinical-histologic spectrum including fatty liver, alcoholic hepatitis (AH), and cirrhosis with its complications. Most patients are diagnosed at advanced stages and data on the prevalence and profile of patients with early disease are limited. Diagnosis of ALD requires documentation of chronic heavy alcohol use and exclusion of other causes of liver disease. Prolonged abstinence is the most effective strategy to prevent disease progression. AH presents with rapid onset or worsening of jaundice, and in severe cases may transition to acute on chronic liver failure when the risk for mortality, depending on the number of extra-hepatic organ failures, may be as high as 20-50% at 1 month...
January 16, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29336092/development-and-validation-of-a-scoring-system-to-predict-progression-to-acute-on-chronic-liver-failure-in-patients-with-acute-exacerbation-of-chronic-hepatitis-b
#18
Yi Ren, Lulu Liu, Ying Li, Fangwan Yang, Yihuai He, Yanping Zhu, Xinxin Hu, Shide Lin
AIM: The aim of this study was to develop and validate a scoring system to predict the progression to acute-on-chronic liver failure (ACLF) in patients with acute exacerbation (AE) of chronic hepatitis B (CHB). METHODS: The baseline characteristics of 474 patients with AE of CHB were retrospectively reviewed; 280 and 194 patients were randomly assigned to the derivation and validation cohorts, respectively. Univariate risk factors associated with ACLF development were entered into a multivariate logistic regression...
January 15, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29334786/acute-on-chronic-liver-failure-in-chronic-hepatitis-b-an-update
#19
Rui-Hong Zhao, Yu Shi, Hong Zhao, Wei Wu, Ji-Fang Sheng
Acute-on-chronic liver failure is a common pattern of end-stage liver disease in clinical practice and occurs frequently in patients with chronic hepatitis B or HBV-related cirrhosis. New progress in recent years leads to a better understanding of this disease. Areas covered: This review updates the current comprehensive knowledge about HBV-ACLF from epidemiological studies, experimental studies, and clinical studies and provide new insights into the definition, diagnostic criteria, epidemiology, nature history, pathogenesis, treatment and prognostication of HBV-ACLF...
January 16, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29325220/profile-risk-factors-and-outcome-of-acute-kidney-injury-in-paediatric-acute-on-chronic-liver-failure
#20
Bikrant B Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
BACKGROUND & AIMS: There are no studies on acute kidney injury in paediatric acute-on-chronic liver failure. This study was planned with aim to describe the clinical presentation and outcome of acute kidney injury among paediatric acute-on-chronic liver failure patients. METHODS: Data of all children 1-18 years of age presenting with acute chronic liver failure (Asia pacific association for the study of the liver definition) was reviewed. Acute kidney injury was defined as per Kidney Diseases-Improving Global Outcomes guidelines...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
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