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https://www.readbyqxmd.com/read/29457836/deptor-suppresses-lipogenesis-and-ameliorates-hepatic-steatosis-and-acute-on-chronic-liver-injury-in-alcoholic-liver-disease
#1
Hanqing Chen, Feng Shen, Alex Sherban, Allison Nocon, Yu Li, Hua Wang, Ming-Jiang Xu, Xianliang Rui, Jinyan Han, Bingbing Jiang, Donghwan Lee, Na Li, Farnaz Keyhani-Nejad, Jian-Gao Fan, Feng Liu, Amrita Kamat, Nicolas Musi, Leonard Guarente, Pal Pacher, Bin Gao, Mengwei Zang
Alcoholic liver disease (ALD) is characterized by lipid accumulation and liver injury. However, how chronic alcohol consumption causes hepatic lipid accumulation remains elusive. The present study demonstrates that activation of the mechanistic target of rapamycin complex 1 (mTORC1) plays a causal role in alcoholic steatosis, inflammation and liver injury. Chronic-plus-binge ethanol feeding led to hyperactivation of mTORC1, as evidenced by increased phosphorylation of mTOR and its downstream kinase S6K1 in hepatocytes...
February 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29457046/acute-on-chronic-liver-failure-a-portuguese-single-center-reference-review
#2
Miguel Verdelho, Rui Perdigoto, João Machado, Élia Mateus, Paulo Marcelino, Rui Pereira, Philip Fortuna, Luís Bagulho, Luís Bento, Francisco Ribeiro, Fernando Nolasco, Américo Martins, Eduardo Barroso
Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of a patient with cirrhosis, frequently associated with multi-organ failure and a high short-term mortality rate. We present a retrospective study that aims to characterize the presentation, evolution, and outcome of patients diagnosed with ACLF at our center over the last 3 years, with a comparative analysis between the group of patients that had ACLF precipitated by infectious insults of bacterial origin and the group of those with ACLF triggered by a nonbacterial infectious insult; the incidence of acute kidney injury and its impact on the prognosis of ACLF was also analyzed...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29456711/value-of-the-albumin-bilirubin-score-in-the-evaluation-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure-liver-cirrhosis-and-hepatocellular-carcinoma
#3
Qing Lei, Yinhua Zhang, Changzheng Ke, Chunchun Yan, Ping Huang, Haixia Shen, Huiting Lei, Yue Chen, Jie Luo, Zhongji Meng
The aim of the present study was to investigate the value of the albumin-bilirubin (ALBI) score in the assessment of the disease conditions of hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF), HBV-related liver cirrhosis (HBV-LC) and HBV-related hepatocellular carcinoma (HBV-HCC). A total of 395 patients with HBV-ACLF, HBV-LC, or HBV-HCC were retrospectively studied. The ALBI, Child-Turcotte-Pugh (CTP), and Model for End-Stage Liver Disease (MELD) scores of the patients were calculated, and the relationships between the ALBI score and the CTP and MELD scores were investigated...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29435276/serum-osteopontin-is-a-predictor-of-prognosis-for-hbv-associated-acute-on-chronic-liver-failure
#4
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
#5
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/29406040/community-or-healthcare-associated-bacterial-infections-increase-long-term-mortality-in-patients-with-acute-decompensation-of-cirrhosis
#6
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
#7
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/29404183/effects-of-modes-obesity-and-body-position-on-non-invasive-positive-pressure-ventilation-success-in-the-intensive-care-unit-a-randomized-controlled-study
#8
Murat Türk, Müge Aydoğdu, Gül Gürsel
OBJECTIVES: Different outcomes and success rates of non-invasive positive pressure ventilation (NPPV) in patients with acute hypercapnic respiratory failure (AHRF) still pose a significant problem in intensive care units. Previous studies investigating different modes, body positioning, and obesity-associated hypoventilation in patients with chronic respiratory failure showed that these factors may affect ventilator mechanics to achieve a better minute ventilation. This study tried to compare pressure support (BiPAP-S) and average volume targeted pressure support (AVAPS-S) modes in patients with acute or acute-on-chronic hypercapnic respiratory failure...
January 2018: Turkish Thoracic Journal
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
#9
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
#10
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
#11
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/29380133/non-urgent-use-of-emergency-departments-populations-most-likely-to-overestimate-illness-severity
#12
Hans Andrews, Lawrence Kass
Patients' overestimation of their illness severity appears to contribute to the national epidemic of emergency department (ED) overcrowding. This study aims to elucidate which patient populations are more likely to have a higher estimation of illness severity (EIS). The investigator surveyed demographic factors of all non-urgent patients at an academic ED. The patients and physicians were asked to estimate the patients' illness severity using a 1-10 scale with anchors. The difference of these values was taken and compared across patient demographic subgroups using a 2-sample t-test...
January 29, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29372393/approach-to-the-diagnostic-workup-and-management-of-small-bowel-lesions-at-a-tertiary-care-center
#13
Jonathan Green, Christopher R Schlieve, Ann K Friedrich, Kevin Baratta, David H Ma, May Min, Krunal Patel, David Stein, David R Cave, Demetrius E Litwin, Mitchell A Cahan
BACKGROUND: Small bowel lesions (SBL) are rare, representing diagnostic and management challenges. The purpose of this cross-sectional study was to evaluate diagnostic modalities used and management practices of patients with SBL at an advanced endoscopic referral center. METHODS: We analyzed patients undergoing surgical management for SBL from 2005 to 2015 at a single tertiary care center. Patients were stratified into gastrointestinal bleed/anemia (GIBA) or obstruction/pain (OP)...
January 25, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29369242/long-term-prognosis-of-acute-on-chronic-liver-failure-survivors
#14
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
#15
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
#16
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/29353893/organ-dysfunctions-among-deaths-in-critically-ill-patients
#17
Leison Maharjan, Aarzoo Shah, Udaya Bajracharya, Gambhir Shrestha
BACKGROUND: Multiple organ failure is recognized as the final pathway preceding majority of deaths in intensive care unit. This study aims to find out the prevalence of organ dysfunctions/ failures in patients at the time of their demise irrespective of the underlying diseases in a tertiary care hospital. METHODS: This study was done in medical intensive care unit of Blue Cross Hospital. Medical records of all deceased patients in two years period were thoroughly reviewed retrospectively...
January 1, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29349919/analysis-of-follow-up-methods-of-vascular-access-and-patient-outcomes-in-hemodialysis-at-a-tertiary-care-hospital-in-china
#18
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
January 19, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29349407/endovascular-recanalization-of-occluded-superior-mesenteric-artery-using-retrograde-access-through-the-inferior-mesenteric-artery
#19
Eduardo Keller Saadi, Gustavo Oderich, Eduardo Medronha, Rodrigo Petersen Saadi, Marina Petersen Saadi, Cristiano Jaegger
Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29343867/improving-survival-of-acute-on-chronic-liver-failure-patients-complicated-with-invasive-pulmonary-aspergillosis
#20
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
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