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JOURNAL ARTICLE
Ryan A Hoffman, Oscar Covarrubias, Andrew Green, E Scott Paxton
CASE: A 71-year-old woman presented with post-traumatic arthritis 11 months after open reduction and internal fixation for a left proximal humerus fracture (PHF) dislocation. After revision to reverse total shoulder arthroplasty (rTSA), the patient's left upper extremity was found to be avascular. An emergent thrombectomy was performed with restoration of arterial flow after removal of an acute-on-chronic axillary artery thrombus. CONCLUSION: Although rare, as rTSA becomes more common for management of PHF, incidence of associated vascular injuries is likely to rise...
April 1, 2024: JBJS Case Connector
#2
JOURNAL ARTICLE
Jihye Lim, Jung Hee Kim, Sung-Eun Kim, Seul Ki Han, Tae Hyung Kim, Hyung Joon Yim, Young Kul Jung, Do Seon Song, Eileen L Yoon, Hee Yeon Kim, Seong Hee Kang, Young Chang, Jeong-Ju Yoo, Sung Won Lee, Jung Gil Park, Ji Won Park, Soung Won Jeong, Ki Tae Suk, Moon Young Kim, Sang Gyune Kim, Won Kim, Jae Young Jang, Jin Mo Yang, Dong Joon Kim
BACKGROUND AND AIM: The Model for End-Stage Liver Disease (MELD) is a reliable prognostic tool for short-term outcome prediction in patients with end-stage liver disease. MELD 3.0 was introduced to enhance the predictive accuracy. This study assessed the performance of MELD 3.0, in comparison to MELD and MELD-Na, in patients with alcoholic liver cirrhosis. METHODS: This multicenter prospective cohort study comprised patients with alcoholic cirrhosis admitted for acute deterioration of liver function in the Republic of Korea between 2015 and 2019...
May 8, 2024: Journal of Gastroenterology and Hepatology
#3
JOURNAL ARTICLE
Caroline Jackson, Kristen Carlin, Niviann Blondet, Ian Jordan, Larissa Yalon, Patrick J Healey, Jordan M Symons, Shina Menon
Patients with acute liver failure (ALF) and acute on chronic liver failure (ACLF) have significant morbidity and mortality. They require extracorporeal blood purification modalities like continuous renal replacement therapy (CRRT) and therapeutic plasma exchange (TPE) as a bridge to recovery or liver transplantation. Limited data are available on the outcomes of patients treated with these therapies. This is a retrospective single-center study of 23 patients from 2015 to 2022 with ALF/ACLF who underwent CRRT and TPE...
May 8, 2024: European Journal of Pediatrics
#4
Rabia Rukhshan, Chioma Eliogu, Anuja Mistry, Simran Brar, Arshad Ali Mohd, Lela Ruck
Pyoderma Gangrenosum (PG) is a distinctive dermatologic condition characterized by recurrent inflammatory ulcers, often manifesting with violaceous borders and undermined edges. We describe a 40-year-old male who presented with acute on chronic necrotic ulcer of the left index finger following foreign body penetration. Despite multiple emergency department visits and treatments for presumed recurrent cellulitis, including various debridements, his condition persisted without symptomatic relief. A high index of clinical suspicion, due to recurrent presentations and potential pathergy, prompted an excision biopsy which confirmed Pyoderma Gangrenosum (PG)...
April 2024: Curēus
#5
REVIEW
Kohilan Gananandan, Signe Wiese, Søren Møller, Rajeshwar P Mookerjee
The prevalence of cirrhotic cardiomyopathy (CCM) has been reported as high as 60%-70% in patients with liver cirrhosis and is associated with various negative outcomes. There has been a growing understanding of CCM over recent years. Indeed, the development of imaging techniques has enabled new diagnostic criteria to be proposed by the Cirrhotic Cardiomyopathy Consortium. However, important unanswered questions remain over pathophysiological mechanisms, optimal diagnostic modalities and potential treatment options...
May 7, 2024: Liver International: Official Journal of the International Association for the Study of the Liver
#6
Rita Chorba, Collin Hu, Jess Feldtmann
BACKGROUND: Clinical assessment of triceps brachii tendon tears is challenging, and conventional imaging methods have limitations. Timely surgical referral is important in high-grade tears to maximize patient outcomes, and musculoskeletal ultrasound (MSK US) can be used at the time of clinical examination to identify such injuries requiring advanced imaging and orthopedic referral. HYPOTHESIS/PURPOSE: The purpose of this case report is to describe how MSK US was used to facilitate advanced imaging and timely orthopedic referral for a patient presenting to a physical therapist with a high-grade triceps tendon avulsion...
2024: International Journal of Sports Physical Therapy
#7
Ebenezer Akomea-Agyin, Kwabena Agbedinu, Charles Kofi Dally, Fareeda Galley, Emmanuel Osei Kankam, Gabriel Edudzi Banini
INTRODUCTION: Congenital causes of duodenal obstruction can be grouped into intrinsic and extrinsic causes. The degree of obstruction caused by such etiologies determines the severity and timing of symptom presentation. Early neonatal diagnosis is common in patients with etiologies that present with high degrees of obstruction such as atresia whereas etiologies that cause lesser degrees of obstruction such as malrotation and duodenal stenosis can go undiagnosed into adulthood. PRESENTATION OF CASE: We report a case of a 24-year-old female who presented with acute on chronic abdominal pain with bilious vomiting...
April 30, 2024: International Journal of Surgery Case Reports
#8
JOURNAL ARTICLE
Johannes Hartig, Vera Nickl, Christoph Vollmuth, Simon Weiner, Mirko Pham, Jens Volkmann, Maximilian U Friedrich, Ekkehard Kunze, Chi Wang Ip
Pupillary assessment is a quintessential part of the clinical examination in neuro-intensive care patients because it provides insight into the integrity of midbrain reflex arcs. Abnormal pupils, particularly anisocoria and later bilateral fixed mydriasis, are classically used to assess expansive intracranial processes because they are frequently considered early indicators of transtentorial midbrain compression due to elevated intracranial pressure. Complex ocular motor deficits mapping to the midbrain are rarely described in the setting of high transtentorial pressure...
May 28, 2024: Neurology
#9
JOURNAL ARTICLE
Mikhael Giabicani, Pauline Joly, Stéphanie Sigaut, Clara Timsit, Pauline Devauchelle, Fédérica Dondero, François Durand, Pierre Antoine Froissant, Myriam Lamamri, Audrey Payancé, Aymeric Restoux, Olivier Roux, Tristan Thibault-Sogorb, Shantha Ram Valainathan, Mickaël Lesurtel, Pierre-Emmanuel Rautou, Emmanuel Weiss
BACKGROUND & AIMS: Major bleeding events during orthotopic liver transplantation (OLT) are associated with poor outcomes. The proportion of this risk related to portal hypertension is unclear. Hepatic venous pressure gradient (HVPG) is the gold standard for estimating portal hypertension. The aim of this study was to analyze the ability of HVPG to predict intraoperative major bleeding events during OLT in patients with cirrhosis. METHODS: We retrospectively analyzed a prospective database including all patients with cirrhosis who underwent OLT between 2010 and 2020 and had liver and right heart catheterizations as part of their pre-transplant assessment...
June 2024: JHEP reports: innovation in hepatology
#10
REVIEW
Yoann Aubry, Michel Dosch, Marc Y Donath
BACKGROUND: Amiodarone-induced thyroid dysfunction (AIT) is a side-effect associated with the use of Amiodarone for the treatment of refractory arrythmias. Resulting hyperthyroidism can precipitate cardiac complications, including cardiac ischemia and myocardial infarction, although this has only been described in a few case reports. CASE PRESENTATION: We present here a clinical scenario involving a 66-year-old male Caucasian patient under Amiodarone for atrial fibrillation, who developed AIT...
May 2, 2024: Journal of Medical Case Reports
#11
REVIEW
Dechun Feng, Seonghwan Hwang, Adrien Guillot, Yang Wang, Yukun Guan, Cheng Chen, Luca Maccioni, Bin Gao
Alcohol-associated hepatitis (AH) is an acute-on-chronic liver injury that occurs in patients with chronic alcohol-associated liver disease (ALD). Patients with severe AH have high short-term mortality and lack effective pharmacological therapies. Inflammation is believed to be one of the key factors promoting AH progression and has been actively investigated as therapeutic targets over the last several decades, but no effective inflammatory targets have been identified so far. In this review, we discuss how inflammatory cells and the inflammatory mediators produced by these cells contribute to the development and progression of AH with focus on neutrophils and macrophages...
April 30, 2024: Cellular and Molecular Gastroenterology and Hepatology
#12
JOURNAL ARTICLE
Nicolas Weiss, Simona Tripon, Maxime Mallet, Françoise Imbert-Bismut, Mehdi Sakka, Dominique Bonnefont-Rousselot, Philippe Sultanik, Sarah Mouri, Marika Rudler, Dominique Thabut
BACKGROUND: Hepatic encephalopathy (HE) is highly prevalent in patients with liver diseases. The pathophysiology of HE is centered on the synergic role of hyperammonemia and systemic inflammation. However, some data suggest altered functioning of the blood-brain barrier (BBB). Assessing BBB function is challenging in clinical practice and at the bedside. Protein-S-100 Beta (PS100-Beta) could be a useful peripheral marker of BBB permeability in HE. This study aimed to assess plasmatic PS100-Beta levels in a prospective cohort of patients admitted to the intensive care unit (ICU) with decompensated cirrhosis with and without overt HE...
April 2024: J Intensive Med
#13
JOURNAL ARTICLE
Abu Bakar H Bhatti, Syeda F Qasim, Zamrood Zamrood, Shahzad Riyaz, Nusrat Y Khan, Haseeb H Zia, Muslim Atiq
BACKGROUND AND OBJECTIVES: Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality without liver transplantation (LT). The selection criteria for LT in these patients are not well defined. The objective of this study was to determine factors associated with post-transplant survival in ACLF. METHODS: This was a single-center retrospective study of patients who underwent living donor liver transplantation (LDLT) for ACLF between 2012 and 2022...
2024: Journal of Clinical and Experimental Hepatology
#14
JOURNAL ARTICLE
Rui Song, Xiaohao Wang, Zhao Li, Hongyu Wu, Jiahe Tan, Junyi Tan, Hanlu Li, Teng Zeng, Hong Ren, Zhiwei Chen
BACKGROUND: Malnutrition, despite being a common complication, is often neglected in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The objective of this study was to develop a simplified nutritional prognostic score to accurately predict mortality in HBV-ACLF patients. METHODS: In this multicenter retrospective study, clinical data from 530 HBV-ACLF patients were used to create a new prognostic score, which was then validated in two external cohorts ( n = 229 and 248)...
2024: Frontiers in Nutrition
#15
Jessica Vo, Raymond Hayler, Alex Tyler, Kurt Verschuer
Hirschprung's disease is a congenital disorder characterized by aganglionic bowel, usually diagnosed in infancy. Here, we present a unique case of Hirschprung's disease diagnosed in a 29-year-old female with acute on chronic constipation. As part of her work up, a computerized tomography of her abdomen and pelvis revealed large, bilateral dermoid cysts. A diagnostic and therapeutic colonoscopy allowed manual disimpaction and decompression of her bowel, as well as biopsy attainment. Histopathology revealed absence of ganglionic cells on haematoxylin and eosin stain and calretinin immunostaining...
April 2024: Journal of Surgical Case Reports
#16
JOURNAL ARTICLE
Ankur Jindal, Hitesh Singh, Guresh Kumar, Vinod Arora, Manoj Kumar Sharma, Rakhi Maiwall, V Rajan, Harsh Vardhan Tewathia, Chitranshu Vasishtha, Shiv Kumar Sarin
BACKGROUND AND AIMS: Terlipressin infusion is effective in hepatorenal syndrome (HRS-AKI). However, its efficacy for HRS-AKI resolution in acute-on-chronic liver failure (ACLF) patients has been suboptimal. Progression of AKI is rapid in ACLF. We investigated whether early initiation of terlipressin(eTerli) can improve response rates. METHODS: Consecutive ACLF patients with stage II/III AKI despite albumin resuscitation (40 g) were randomized to receive terlipressin at 2 mg/24 h plus albumin at 12 h (ET, n = 35) or at 48 h as standard therapy (ST, n = 35)...
April 18, 2024: Digestive Diseases and Sciences
#17
Sayan Malakar, Nishant Shah, Ankit Mishra, Vipin Pandey, Vivek V Shirol, Naganath K Wodeyar, Prabhat Verma, Sai Prathap, Kartik Balankhe, Ramnawal Rao, Uday C Ghoshal
Acute viral hepatitis E (HEV) is the most common form of acute viral hepatitis in India. It is associated with self-limiting disease in most cases. However, the chronic form of HEV is also being increasingly recognized. Other viral infections like the hepatitis A virus (HAV) have been implicated in inciting autoimmune hepatitis. HEV infection has been associated with the formation of circulating liver-directed autoantibodies, however autoimmune liver disease following acute HEV infection has been rarely reported...
March 2024: Curēus
#18
JOURNAL ARTICLE
Shaohua Shi, Minghui Zhang, Xuliang Chen, Zhuoyi Wang, Songming Ding, Zhitao Chen, Yu Yang, Shusen Zheng
No abstract text is available yet for this article.
April 17, 2024: Chinese Medical Journal
#19
Yotsapon Thewjitcharoen, Peachaphol Chongvoranond, Soontaree Nakasatien, Sirinate Krittiyawong, Thep Himathongkam
Metformin-associated vitamin B12 deficiency is a well-established side effect, especially in patients taking higher doses of metformin or who have existing risk factors. Severe deficiency causes a wide range of systemic disorders. Gait instability, which leads to frequent falling, is usually an underrecognized side effect. Older patients are more likely to develop chronic subdural hematoma even with minor trauma. We present a case of 84-year-old man with type 2 diabetes mellitus with acute-on-chronic subdural hematoma from frequent falls...
April 2024: JCEM Case Rep
#20
JOURNAL ARTICLE
Jinxia Liu, Jane MacNaughtan, Annarein J C Kerbert, Theo Portlock, Javier Martínez Gonzalez, Yi Jin, Frederick Clasen, Abeba Habtesion, Huoyan Ji, Qin Jin, Alexandra Phillips, Francesco De Chiara, Ganesh Ingavle, Cesar Jimenez, Giacomo Zaccherini, Katherine Husi, Miguel Angel Rodriguez Gandia, Paul Cordero, Junpei Soeda, Lynda McConaghy, Jude Oben, Karen Church, Jia V Li, Haifeng Wu, Aarti Jalan, Pere Gines, Elsa Solà, Simon Eaton, Carrie Morgan, Michal Kowalski, Daniel Green, Amir Gander, Lindsey A Edwards, I Jane Cox, Helena Cortez-Pinto, Thomas Avery, Reiner Wiest, Francois Durand, Paolo Caraceni, Roberto Elosua, Joan Vila, Marco Pavesi, Vicente Arroyo, Nathan Davies, Rajeshwar P Mookerjee, Victor Vargas, Susan Sandeman, Gautam Mehta, Saeed Shoaie, Julian Marchesi, Agustín Albillos, Fausto Andreola, Rajiv Jalan
OBJECTIVE: Targeting bacterial translocation in cirrhosis is limited to antibiotics with risk of antimicrobial resistance. This study explored the therapeutic potential of a non-absorbable, gut-restricted, engineered carbon bead adsorbent, Yaq-001 in models of cirrhosis and acute-on-chronic liver failure (ACLF) and, its safety and tolerability in a clinical trial in cirrhosis. DESIGN: Performance of Yaq-001 was evaluated in vitro . Two-rat models of cirrhosis and ACLF, (4 weeks, bile duct ligation with or without lipopolysaccharide), receiving Yaq-001 for 2 weeks; and two-mouse models of cirrhosis (6-week and 12-week carbon tetrachloride (CCl4)) receiving Yaq-001 for 6 weeks were studied...
April 15, 2024: Gut
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