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https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#1
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
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
#2
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
#3
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/28302165/bilateral-adrenal-hemorrhage-in-the-background-of-escherichia-coli-sepsis-a-case-report
#4
Jahanzaib Khwaja
BACKGROUND: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection. It can have devastating consequences, including bilateral adrenal hemorrhage, particularly in patients at high thrombotic risk, such as those with antiphospholipid syndrome and those on long-term anticoagulation. CASE PRESENTATION: A 49-year-old white woman re-presented to hospital with a history suggestive of sepsis. She had a medical background of primary antiphospholipid syndrome on lifelong warfarin...
March 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#5
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28297793/-research-advances-in-diagnosis-and-treatment-of-liver-failure-in-2016
#6
F J Yang, L Peng, Y Y Liu, Z L Gao, T Han, J R Huang
Liver failure has various clinical types, a complex pathogenesis, and rapid disease progression, as well as a high mortality rate. Liver failure caused by hepatitis B virus infection is the most common type in China with severe conditions, various complications, and a mortality rate as high as 40%-90%. Invasive fungal disease secondary to acute-on-chronic liver failure can affect patients' prognosis and increase mortality rate. This article introduces the research advances in hepatitis B-related liver failure, artificial liver, and invasive fungal disease secondary to acute-on-chronic liver failure in 2016...
February 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28297776/-value-of-thromboelastography-in-evaluating-coagulation-function-and-prognosis-in-patients-with-acute-on-chronic-liver-failure
#7
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
#8
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
#9
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...
March 14, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28292360/acute-on-chronic-liver-failure-causes-clinical-characteristics-and-predictors-of-mortality
#10
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/28286788/primary-hepatic-amyloidosis-presenting-as-acute-on-chronic-liver-failure
#11
Madhumita Premkumar, Devaraja Rangegowda, Tanmay Vyas, Anand Kulkarni, Shrruti Grover, Rakhi Mahiwall, Shiv Kumar Sarin
Systemic amyloidosis of amyloid light chain associated protein (AL), also called primary amyloidosis, frequently involves the liver, but rarely causes clinically apparent liver disease. The more common presentation is with acute renal failure. Hepatomegaly and mild elevation of alkaline phosphatase are the most common clinical and biochemical findings, respectively. We report a case of systemic amyloidosis of AL that clinically presented as acute-on-chronic liver failure and resulted in a fatal clinical course in a 56-year-old man...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28283440/a-meld-based-nomogram-for-predicting-3-month-mortality-of-patients-with-acute-on-chronic-hepatitis-b-liver-failure
#12
Rui-Cong Chen, Xiao-Dong Wang, Jin-Zhong Dong, Zhuo Lin, Jian-Min Wu, Yi-Jing Cai, Ke-Qing Shi
BACKGROUND: Acute-on-chronic hepatitis B liver failure (ACHBLF) is associated with poor short-term prognosis. The aim of the present study was to construct and validate a model for end-stage liver disease (MELD)-based nomogram for the 3-month mortality estimation for patients with ACHBLF. METHODS: A total of 551 patients with ACHBLF were prospectively enrolled from 2 independent medical centers and divided into 2 cohorts of training and validation, respectively...
March 7, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28282579/interleukin-23-mediates-the-pathogenesis-of-lps-galn-induced-liver-injury-in-mice
#13
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/28273905/nkg2d-modulates-aggravation-of-liver-inflammation-by-activating-nk-cells-in-hbv-infection
#14
Yadong Wang, Wei Wang, Chuan Shen, Yong Wang, Mingjing Jiao, Weiyan Yu, Hongzhu Yin, Xiaobo Shang, Qianfei Liang, Caiyan Zhao
Hepatitis B virus (HBV) infection is thought to be an immune-mediated liver disease. The mechanisms underlying natural killer (NK) cell group 2D receptor (NKG2D) that activates NK cells and participates in anti-HBV immunity and immunopathology has not been thoroughly elucidated. Peripheral NKG2D(+) and IFN-γ(+) NK cells frequencies and intrahepatic NKG2D and IFN-γ mRNA and protein expressions were determined in HBV-infected patients. Levels of NKG2D and IFN-γ mRNA and protein in NK cells, co-cultured with HBV-replicating HepG2 cells with or without NKG2D blockade, were analyzed...
December 2017: Scientific Reports
https://www.readbyqxmd.com/read/28272079/natural-history-and-treatment-outcomes-of-severe-autoimmune-hepatitis
#15
Nikhil Sonthalia, Pravin M Rathi, Samit S Jain, Ravindra G Surude, Ashok R Mohite, Sunil V Pawar, Qais Contractor
GOALS: The aim of this study was to analyze the natural history and treatment outcomes of autoimmune hepatitis (AIH) variants presenting with severe-AIH. BACKGROUND: Severe acute presentation is an uncommon manifestation of AIH, and it remains poorly characterized. MATERIALS AND METHODS: We included 101 patients with AIH from January 2011 to December 2015. Patients were classified as seropositive-AIH and seronegative-AIH. Patients with acute liver failure, acute-on-chronic liver failure, and severe acute hepatitis were defined as severe-AIH patients...
March 7, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28258180/rare-case-of-severe-serotonin-syndrome-leading-to-bilateral-compartment-syndrome
#16
Verena Clarissa Samara, Judith Warner
The term 'serotonin syndrome' describes a constellation of symptoms caused by serotonergic overstimulation. Its characteristic clinical presentation consists of encephalopathy, neuromuscular signs and autonomic hyperactivity. After removal of the offending agent, the clinical course is usually self-limited but can occasionally lead to severe symptoms. We report the case of a 68-year-old woman who presented emergently with encephalopathy. Home medications included paroxetine and dextroamphetamine/amphetamine...
March 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28254101/electroacupuncture-assisted-craniotomy-on-an-awake-patient
#17
Amritpal Sidhu, Trushna Murgahayah, Vairavan Narayanan, Hari Chandran, Vicknes Waran
Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28248918/stroke-associated-with-varicella-zoster-vasculopathy-a-clinicoradiological-profile-of-3-patients
#18
Pradeep K Maurya, Dinkar Kulshreshtha, Ajai K Singh, Anup K Thacker
INTRODUCTION: Varicella zoster (VZ) vasculopathy is a rare but well recognized cause of stroke. In the absence of zoster rash and infection in remote past, the disease can pose diagnostic challenge. We report 3 cases of anterior circulation stroke occurring in close temporal relation to VZ. Their clinical, radiologic, and angiographic features are discussed. CASE REPORT: Of the 3 patients, 2 had stroke within a span of 4 to 6 weeks of herpes zoster ophthalmicus while the third patient had zoster of cervical dermatome...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248208/extracorporeal-liver-support-systems-in-paediatric-liver-failure
#19
Vandana Jain, Anil Dhawan
Extracorporeal liver support systems (ELSS), encompassing artificial and bio-artificial devices, have been used for decades, with the aim of supporting patients with acute liver failure (ALF) and acute-on chronic liver failure (AoCLF), as a bridge to recovery (ALF only) or liver transplantation (LT), in an era of organ donation shortage. Although biochemical efficacy has been consistently demonstrated by these devices, translation into clinical and survival benefits has been unclear, due to study limitations and lack of reliable prognostic scoring in liver failure...
December 21, 2016: Journal of Pediatric Gastroenterology and Nutrition
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...
February 17, 2017: Gastroenterología y Hepatología
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