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https://www.readbyqxmd.com/read/28730699/elevated-cardiac-troponin-t-in-cirrhotic-patients-with-emergency-care-admissions-is-associated-with-mortality
#1
Mayada Elnegouly, Katrin Umgelter, Wajima Safi, Alexander Hapfelmeier, Roland M Schmid, Andreas Umgelter
BACKGROUND & AIMS: Mortality of cirrhotic patients after emergency care admission is high and prognostic factors can help in prioritizing patients. The aim of our study was to assess the association between levels of cardiac Troponin T (cTnT) and one-year mortality in patients with liver cirrhosis without known cardiac disease, who were admitted to the emergency department (ED). METHODS: All patients with cirrhosis presented to the ED from October 2009 until August 2015 who had an initial cTnT value measured with the first lab-panel were retrospectively analyzed with a follow-up of 365 days...
July 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28724791/mitochondrial-dna-enriched-microparticles-promote-acute-on-chronic-alcoholic-neutrophilia-and-hepatotoxicity
#2
Yan Cai, Ming-Jiang Xu, Erik H Koritzinsky, Zhou Zhou, Wei Wang, Haixia Cao, Peter St Yuen, Ruth A Ross, Robert A Star, Suthat Liangpunsakul, Bin Gao
Over the last several years, one of the major advances in the field of alcoholic liver disease research was the discovery that binge alcohol consumption induced neutrophilia and hepatic neutrophil infiltration in chronically ethanol-fed mice and human subjects with excessive alcohol use (EAU); however, the underlying mechanisms remain obscure. Here, we demonstrated that chronic EAU patients with a history of recent excessive drinking (EAU + RD) had higher serum levels of mitochondrial DNA (mtDNA)-enriched microparticles (MPs) than EAU without recent drinking (EAU - RD) and healthy controls, which correlated positively with circulating neutrophils...
July 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28706962/posttransplant-lymphoproliferative-disorder-of-the-small-bowel-as-an-unexpected-cause-of-iron-deficiency-anemia-decades-after-heart-transplantation
#3
Amanda Siegel, Justin Boike, Itishree Trivedi, Rena Yadlapati
Although rare, gastrointestinal posttransplant lymphoproliferative disorder (PTLD) can lead to abdominal pain or gastrointestinal bleeding in patients with a history of solid-organ transplantation. We describe a case of isolated gastrointestinal PTLD in a patient who presented with acute on chronic iron deficiency anemia 26 years after heart transplant. A comprehensive endoscopic evaluation with video capsule endoscopy and small bowel enteroscopy revealed a large cratered ulceration in the small bowel with abnormal mucosal changes, which led to the diagnosis of PTLD...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#4
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28700328/additional-n-glycosylation-mutation-in-the-major-hydrophilic-region-of-hepatitis-b-virus-s-gene-is-a-risk-indicator-for-hepatocellular-carcinoma-occurrence-in-patients-with-coexistence-of-hbsag-anti-hbs
#5
Yan Qiao, Shanshan Lu, Zhihui Xu, Xiaodong Li, Kai Zhang, Yan Liu, Li Zhao, Rongjuan Chen, Lanlan Si, Shumei Lin, Dongping Xu, Jin Li
The study aimed to determine the association of additional N-glycosylation mutations in the major hydrophilic region (MHR) of hepatitis B virus (HBV) S gene with hepatocellular carcinoma (HCC) occurrence in HBsAg/anti-HBs coexistent patients. A total of 288 HBsAg/anti-HBs coexistent patients and 490 single HBsAg-positive patients were enrolled, including 193 with HCC, 433 with chronic hepatitis B (CHB), and 152 with acute-on-chronic liver failure (ACLF). The HBV S genes were amplified from serum and sequenced...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28694199/initiation-of-non-invasive-ventilation-for-sleep-related-hypoventilation-disorders-advanced-modes-and-devices
#6
REVIEW
Bernardo J Selim, Lisa Wolfe, John M Coleman, Naresh Dewan
Although non-invasive ventilation (NIV) has been used since the 1960's in the polio epidemic, the development of modern bilevel PAP devices did not become a reality until the 1990's. Over the last 25 years bilevel PAP technology options have exponentially increased. The number of patients receiving this treatment both in the acute setting as well as at home is steadily growing. However, a knowledge gap exists in the way these device settings are adjusted to achieve synchrony and match patient's unique respiratory failure physiology...
July 7, 2017: Chest
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#7
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28688141/incidence-predictive-factors-and-impacts-of-acute-kidney-injury-in-cirrhotic-patients-hospitalized-for-cellulitis
#8
Ana Garcia Garcia de Paredes, Luis Tellez, Miguel Angel Rodriguez-Gandia, Javier Martinez, Enrique Rodriguez De Santiago, Lara Aguilera Castro, Francisco Gea, Agustín Albillos
BACKGROUND & AIMS: Cellulitis is a common infection in patients with cirrhosis but its impact on progression of liver disease has been hardly addressed. This study examines the incidence of acute kidney injury (AKI), predictive factors, and its impacts on mortalilty in cirrhotic patients hospitalized for cellulitis. METHODS: Retrospective data from cirrhotic patients hospitalized for cellulitis over the period January 2006 to September 2015 were analyzed. AKI was defined according to revised criteria of the International Club of Ascites...
July 8, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28688140/pro-acute-on-chronic-liver-failure
#9
REVIEW
Elsa Solà, Pere Ginès
No abstract text is available yet for this article.
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28682037/-cardio-pulmonary-renal-interactions
#10
Sara Samoni, Faeq Husain-Syed, Silvia De Rosa, Claudio Ronco
Over the past decade, understanding about feedback mechanisms involving the heart, lung and kidney is significantly improved. Each organ injury may trigger hemodynamic, neuro-hormonal and cellular pathway that may damage diverse organs. Recurrent acute on chronic injury may lead to the advanced stage of disease. On the other hand, chronic pathological conditions may decrease functional reserve leading to a high susceptibility to acute injury. Assessment of functional reserve and dosage of novel biomarkers may allow an early diagnosis and treatment...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28681347/new-concepts-on-the-clinical-course-and-stratification-of-compensated-and-decompensated-cirrhosis
#11
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis has been typically described by a compensated and a decompensated state based on the absence or, respectively, the presence of any of bleeding, ascites, encephalopathy or jaundice. More recently, it has been recognized that increasing portal hypertension and several major clinical events are followed by a marked worsening in prognosis, and disease states have been proposed accordingly in a multistate model. The development of multistate models implies the assessment of the probabilities of more than one possible outcome from each disease state...
July 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28676943/aberrant-gstp1-promoter-methylation-predicts-poor-prognosis-of-acute-on-chronic-hepatitis-b-pre-liver-failure
#12
Chen-Yang Qiao, Feng Li, Yue Teng, Jing Zhao, Na Hu, Yu-Chen Fan, Kai Wang
It has been demonstrated that glutathione-S-transferase P1 (GSTP1) could protect cells from DNA damage mediated by oxidizing agents or electrophiles in hepatic inflammatory response. Our study evaluated the methylation status and the predictive value for prognosis of GSTP1 promoter region in patients with acute-on-chronic hepatitis B pre-liver failure (pre-ACHBLF). Methylation status of GSTP1 promoter in peripheral blood mononuclear cells (PBMCs) and plasma was measured in 103 patients with pre-ACHBLF, 80 patients with chronic hepatitis B (CHB) and 30 healthy controls (HCs) by methylation-specific polymerase chain reaction...
July 4, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/28667037/a-programmed-cell-death-1-haplotype-is-associated-with-clearance-of-hepatitis-b-virus
#13
Zhouhua Hou, Qing Zhou, Menghou Lu, Deming Tan, Xuwen Xu
PURPOSE: Programmed cell death 1 (PD-1) is an important immune checkpoint of T cells response and plays a critical role in chronic hepatitis B virus (HBV) infection. The purpose of this study was to investigate the associations between PD-1 polymorphisms and susceptibility and disease progression of chronic HBV infection. METHODS: In this case-control study, 299 cases with chronic HBV infection comprised of 99 asymptomatic carriers (ASCs), 96 patients with chronic hepatitis B (CHB), and 104 patients with HBV-related acute on chronic liver failure (HBV-ACLF) were enrolled...
May 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28663678/a-dynamic-definition-of-acute-kidney-injury-does-not-improve-prognosis-assessment-in-acutely-decompensated-patients-with-cirrhosis
#14
Sebastián Marciano, Ezequiel Mauro, Melisa Dirchwolf, María Emilia Debernardi, Diego Giunta, Vanina Pagotto, Liliana Rojas, Adrián Gadano
BACKGROUND/OBJECTIVES: to compare the prognostic accuracy for 28 and 90-day transplant-free mortality of a modified CLIF-SOFA score (including a dynamic definition of acute kidney injury) with that of the classic CLIF-SOFA score and KDIGO score for acute kidney injury in patients with acute decompensation of cirrhosis. METHODS: A retrospective analysis of all admissions of acutely decompensated patients with cirrhosis was carried out from January 2012 to December 2014...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28660146/bile-cast-nephropathy-in-patients-with-acute-kidney-injury-due-to-hepatorenal-syndrome-a-postmortem-kidney-biopsy-study
#15
Suman Lata Nayak, Manoj Kumar, Chhagan Bihari, Archana Rastogi
Background and Aims: The role of bile cast nephropathy (BCN) in pathogenesis of hepatorenal syndrome (HRS) in decompensated cirrhosis and acute on chronic liver failure (ACLF) is unknown. This study aimed to determine the frequency of BCN detected on postmortem renal biopsy among patients with decompensated cirrhosis and ACLF who had been admitted with acute kidney injury due to HRS (HRA-AKI) and expired during that hospitalization. Methods: One-hundred-twenty-seven postmortem renal biopsies with adequate size (>1 cm in length) were included for analysis...
June 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28657371/hmgb1-is-a-promising-therapeutic-target-for-acute-liver-failure
#16
Tetsu Yamamoto, Yoshitsugu Tajima
Although acute liver failure (ALF) is a rare disease, it continues to have high mortality and morbidity rates due to its many causes. High mobility group box 1 (HMGB1), originally reported as a ubiquitous non-histone chromosomal protein, is a multi-functional protein with varying functions depending on its location, such as in the nucleus, cytoplasm and extracellular space. The role of extracellular HMGB1 as an inflammatory mediator has been well studied, and the elevation of serum HMGB1 has been reported in several diseases that are closely associated with ALF...
July 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28655410/update-on-acute-on-chronic-liver-failure
#17
Cristina Solé, Elsa Solà
Acute-on-chronic liver failure (ACLF) is a recently defined syndrome characterised by acute decompensation of chronic liver disease, associated with organ failures and high mortality. ACLF is a common condition and may affect up to 30% of patients admitted to hospital for cirrhosis complications. Bacterial infections, alcoholism and reactivation of viral hepatitis are the most common precipitating factors in ACLF, although in up to 40% of patients no precipitating factor can be identified. Although the pathophysiology of ACLF is not completely understood, the presence of an excessive inflammatory response appears to play a key role...
June 24, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28654858/reference-values-of-lithium-in-postmortem-femoral-blood
#18
Carl Söderberg, Emma Wernvik, Anna K Jönsson, Henrik Druid
INTRODUCTION: The main recipients of lithium, people diagnosed with bipolar disorder, show an increased mortality in both natural and unnatural causes of death. Based on international data persons diagnosed with bipolar disorder comprise 2.3-9.6% of all suicidal deaths. In cases of suicide among those suffering from bipolar disorder, 17-53% are due to fatal intoxications. Diagnosing fatal intoxications is often challenging, particularly when the reference information needed to interpret the concentration of a drug is lacking or scarce...
June 15, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28650101/con-acute-on-chronic-liver-failure
#19
REVIEW
John O'Grady
No abstract text is available yet for this article.
June 26, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28646630/characteristics-of-systemic-inflammation-in-hepatitis-b-precipitated-aclf-differentiate-it-from-no-aclf
#20
Wei Wu, Huadong Yan, Hong Zhao, Wenjie Sun, Qiao Yang, Jifang Sheng, Yu Shi
BACKGROUND & AIMS: Patients with severe exacerbation of chronic hepatitis B (SE-CHB) are at risk of developing acute-on-chronic liver failure (ACLF). Systemic inflammation (SI) is a major driver of ACLF. The aim of this study was to identify characteristics of SI in hepatitis B-precipitated-ACLF (HB-ACLF), which may be distinct from No-ACLF patients with SE-CHB. METHODS: Two cohorts of patients with SE-CHB were enrolled in two tertiary hospitals. The associations between circulating leucocyte counts/subsets and ACLF progression and prognoses were analysed in Cohort A...
June 24, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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