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https://www.readbyqxmd.com/read/29218046/tlr2-expression-in-peripheral-cd4-t-cells-promotes-th17-response-and-is-associated-with-disease-aggravation-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#1
Chunli Xu, Yinping Lu, Xin Zheng, Xuemei Feng, Xuecheng Yang, Joerg Timm, Jun Wu, Baoju Wang, Mengji Lu, Dongliang Yang, Jia Liu
Th17 responses have been shown to play crucial roles in the pathogenesis of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF). The mechanism underlying the enhanced Th17 responses in these patients remains largely unclear. Here we investigated toll-like receptors (TLRs) expression in peripheral T cells and their roles in Th17 cell differentiation and disease aggravation in ACLF patients. 18 healthy subjects (HS), 20 chronic HBV-infected (CHB) patients, and 26 ACLF patients were enrolled and examined for TLRs expression in peripheral blood mononuclear cells (PBMCs)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29201359/rationale-for-and-approach-to-preoperative-opioid-weaning-a-preoperative-optimization-protocol
#2
REVIEW
Heath McAnally
The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29200007/disruption-of-the-gut-liver-axis-in-the-pathogenesis-of-acute-on-chronic-liver-failure
#3
Tao Zhang, Kewei Sun, Ya Wang, Lei Huang, Ren Lang, Wei Jiang
Acute-on-chronic liver failure (ACLF) is characterized by organ failure mediated by acute decompensation of cirrhosis. Recent studies have highlighted the importance of the gut-liver axis (GLS) and its association with ACLF pathogenesis. In this review, we discuss the mechanisms related to the alteration of the GLA and their involvement in ACLF pathogenesis and suggest some possible therapeutic options that could modulate the GLA dysfunction. This knowledge may provide information useful for the design of therapeutic strategies for gut dysbiosis and its complications in ACLF...
December 1, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29193717/is-venous-blood-gas-performed-in-the-emergency-department-predictive-of-outcome-during-acute-on-chronic-hypercarbic-respiratory-failure
#4
Lisa Domaradzki, Sahithi Gosala, Khaled Iskandarani, Andry Van de Louw
BACKGROUND: during acute on chronic hypercarbic respiratory failure (AHRF), arterial pH is associated with non-invasive ventilation (NIV) failure and mortality. Venous blood gas (VBG) has been proposed as a substitute for arterial blood gas, based on a good agreement between venous and arterial values. We assessed the predictive value of admission VBG on intubation rate, NIV failure and mortality during AHRF. METHODS: retrospective chart review of inpatients admitted between 2009 and 2015 with AHRF who had VBG performed on admission...
November 28, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29184085/diverse-changes-of-circulating-fibroblast-growth-factor-21-levels-in-hepatitis-b-virus-related-diseases
#5
Liang Wu, Qingchun Pan, Guangyu Wu, Lingling Qian, Jing Zhang, Lei Zhang, Qichen Fang, Guoqing Zang, Yudong Wang, George Lau, Huating Li, Weiping Jia
Fibroblast growth factor 21 (FGF21), a stress-induced hormone in the liver, has been shown the protective functions in pathological conditions. The study investigated the association of circulating FGF21 with hepatitis B virus (HBV) infection and its related diseases. Serum FGF21 levels were measured in 33 acute hepatitis B (AHB), 75 chronic hepatitis B (CHB) and 66 CHB patients with advanced liver diseases including liver cirrhosis, acute-on-chronic liver failure (ALCF) and hepatocellular carcinoma (HCC) together with 200 age- and BMI-matched healthy controls...
November 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29183359/acute-on-chronic-bilateral-subdural-hematoma-presenting-with-acute-complete-flaccid-paraplegia-and-urinary-retention-mimicking-an-acute-spinal-cord-injury-a-case-report
#6
H M M T B Herath, Anne Thushara Matthias, Aruna Kulatunga
BACKGROUND: A subdural hematoma refers to a collection of blood between the dura and the arachnoid membranes and is classified into acute, sub acute and chronic. Subdural hematoma has been referred to as the "great neurologic imitator" as it can mimic many neurological conditions. CASE PRESENTATION: Forty-three year old Sri Lankan female presented 2 weeks following traumatic head injury with bilateral flaccid complete paraplegia and urinary retention. Her non-contrast computer tomography of the brain revealed bilateral acute, chronic subdural hematomas...
November 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29172397/favorable-effect-of-corticosteroids-in-treating-acute-on-chronic-liver-failure-underlying-chronic-hepatitis-b
#7
Hyeji Kim, Jung Hyun Kwon, Yong Hee Kim, Soon Woo Nam, Jong Yul Lee, Jeong Won Jang
Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function...
November 27, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/29170103/gamma-glutamyl-transpeptidase-to-platelet-ratio-predicts-the-prognosis-in-hbv-associated-acute-on-chronic-liver-failure
#8
Longgen Liu, Qing Lan, Lin Lin, Jianchun Lu, Chunyan Ye, Qian Tao, Manman Cui, Shuqin Zheng, Junxiu Zhang, Yuan Xue
BACKGROUND: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new noninvasive marker for assessing liver fibrosis. We aimed to evaluate the performance of GPR for prediction of 90-day mortality in patients with acute-on-chronic liver failure (ACLF). METHODS: A total of 355 patients with HBV-associated ACLF were enrolled from two clinical centers and divided into training group (n=210) and validation group (n=145). Potential risk factors for 90-day mortality were analyzed...
November 20, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29164410/increased-batf-expression-is-associated-with-the-severity-of-liver-damage-in-patients-with-chronic-hepatitis-b
#9
Li-Yuan Wang, Yu-Chen Fan, Jing Zhao, Xiang-Fen Ji, Kai Wang
T helper (Th) 17 cells have a critical role in the pathogenesis of chronic hepatitis B virus (HBV) infection, and basic leucine zipper transcription factor, ATF-like (BATF) is a newly identified transcriptional factor regulating the differentiation of Th17 cells. However, its precise role in patients with chronic hepatitis B remains unclear. Sixty chronic hepatitis B (CHB) patients, twenty-two acute-on-chronic hepatitis B liver failure (ACHBLF) patients and seventeen healthy controls were included in our study...
November 21, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/29156683/shycd-induces-ape1-ref-1-subcellular-localization-to-regulate-the-p53-apoptosis-signaling-pathway-in-the-prevention-and-treatment-of-acute-on-chronic-liver-failure
#10
Jianxin Diao, Haiye Li, Wei Huang, Wenxiao Ma, Huan Dai, Yawei Liu, Ming Wang, He Yu Hua, Jinying Ou, Xiaomin Sun, Xuegang Sun, Yungao Yang
Background & Aims: San huang yin chi decoction(SHYCD) is derived from the yin chen hao decoction, a well-known and canonical Chinese medicine formula from the "Treatise on Febrile Diseases". Over the past decade, SHYCD has been used to treat and prevent the liver cirrhosis and liver failure. In the present study, we investigated the effects of SHYCD for acute on chronic liver failure(ACLF) and explored its potential mechanism. an ACLF rat model, which induced by carbon tetrachloride (CCl4) combined with D-galactosamine (D-GalN) and lipopolysaccharide(LPS), was used and confirmed by B-ultrasound analysis...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29152491/acute-on-chronic-pancreatitis-in-a-young-female
#11
Pavan Kumar, Saket Kumar, Abhijit Chandra
No abstract text is available yet for this article.
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29149510/transferrin-as-a-predictor-of-survival-in-cirrhosis
#12
André Viveiros, Armin Finkenstedt, Benedikt Schaefer, Mattias Mandorfer, Bernhard Scheiner, Konrad Lehner, Moritz Tobiasch, Thomas Reiberger, Herbert Tilg, Michael Edlinger, Heinz Zoller
BACKGROUND AND AIMS: Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are MELD-independent predictors of mortality in patients with acute on chronic liver failure or decompensated cirrhosis. The aim of this study was to evaluate the prognostic utility of serum iron parameters in relation to markers of liver function and immune activation...
November 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#13
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29142477/modified-model-for-end-stage-liver-disease-improves-short-term-prognosis-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#14
Wei Chen, Jia You, Jing Chen, Qi Zheng, Jia-Ji Jiang, Yue-Yong Zhu
AIM: To investigate whether the short-term prognosis of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) could be improved by using a modified model for end-stage liver disease (MELD) including serum lactate. METHODS: This clinical study was conducted at the First Affiliated Hospital, Fujian Medicine University, China. From 2009 to 2015, 236 patients diagnosed with HBV-related ACLF at our center were recruited for this 3-month follow-up study...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29115798/acute-alcoholic-hepatitis-a-literature-review-and-proposal-of-treatment
#15
Gianni Testino, Silvia Leone
Severe acute alcoholic hepatitis (AAH) can lead to a clinical picture with a sixmonth mortality rate in more than 70% of cases. This clinical picture is characterized by: jaundice with a duration of less than three months, jaundice at the first failure event, serum bilirubin greater than 5 mg / dL, ratio AST / ALT> 2: 1, AST less than 500 IU / L, ALT <300 IU / L, neutrophil leukocytosis and a GGT increase. In addition, encephalopathy, fever, asthenia and coagulopathy may be present. Its onset may also be characterized by portalhypertensionrelated complications, particularly bleeding and hepatorenal syndrome...
November 7, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29113427/-clinical-application-of-mesenchymal-stem-cells-in-treatment-of-acute-on-chronic-liver-failure-and-related-research-advances
#16
L Y Feng, D Z Zhang
Acute-on-chronic liver failure is a syndrome characterized by acute exacerbation of chronic hepatitis, organ failure, and high mortality. Clinical treatment of acute-on-chronic liver failure included comprehensive medical treatment, artificial liver support system, and liver transplantation, but such methods have their own shortcomings and patients tend to have a poor prognosis. Mesenchymal stem cells (MSCs), as a new type of cell therapy, have wide sources and are easy to extract and culture. Many studies have shown that MSC treatment not only helps to achieve a high survival rate, but also has good tolerability and safety; therefore, the clinical value of MSCs has become a hot research topic...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29111320/clinical-states-of-cirrhosis-and-competing-risks
#17
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis is mostly determined by the progressive increase of portal hypertension, hyperdynamic circulation, bacterial translocation and activation of systemic inflammation. Different disease states without a predictable sequence but with increasing death risk, related to the progression of these mechanisms may be recognized by hemodynamic or clinical characteristics, encompassing compensated and decompensated cirrhosis and a late decompensated state. Acute on chronic liver failure may occur either in decompensated or in compensated cirrhosis and is always associated with a high short term mortality...
October 27, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29108199/-value-of-neutrophil-lymphocyte-ratio-in-predicting-hepatitis-b-related-liver-failure
#18
Y Fan, X Li, X F Zhou, D Z Zhang, X F Shi
Objective: To investigate the value of neutrophil-lymphocyte ratio (NLR) in predicting hepatitis B-related liver failure. Methods: A total of 349 subjects were enrolled, among whom 60 were healthy persons who underwent physical examination (group A), 111 had severe chronic hepatitis B (group B), 92 had decompensated hepatitis B cirrhosis (group C), and 86 had acute-on-chronic liver failure (ACLF) (group D). Routine blood test results, liver function parameters, and coagulation parameters were collected, and NLR was calculated...
October 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108188/-definition-and-diagnosis-of-acute-on-chronic-liver-failure-new-knowledge-and-implication
#19
W T Tan, G H Deng
Acute-on-chronic liver failure (ACLF) is a common critical and severe syndrome in patients with chronic liver diseases in China and other countries in the Asia-Pacific region. In recent years, both the Eastern and Western experts have defined ACLF as a new type of liver disease manifesting as a high 28-day mortality rate (>30%) and extensive systematic inflammatory response. ACLF has become a hot topic in the field of liver diseases. This article reviews the research advances in the definition and etiological spectrum of ACLF and discusses the inspirations of such new knowledge for future research...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108122/pyroptosis-by-caspase11-4-gasdermin-d-pathway-in-alcoholic-hepatitis
#20
Elena Khanova, Raymond Wu, Wen Wang, Rui Yan, Yibu Chen, Samuel W French, Cristina Llorente, Stephanie Q Pan, Qihong Yang, Yuchang Li, Raul Lazaro, Charles Ansong, Richard D Smith, Ramon Bataller, Timothy Morgan, Bernd Schnabl, Hidekazu Tsukamoto
Alcoholic hepatitis (AH) continues to be a disease with high mortality and no efficacious medical treatment. Although severe AH is presented as acute on chronic liver failure, what underlies this transition from chronic alcoholic steatohepatitis (ASH) to AH, is largely unknown. To address this question, unbiased RNA-seq and proteomic analyses were performed on livers of the recently developed AH mouse model which exhibits the shift to AH from chronic ASH upon weekly alcohol binge, and these results are compared with gene expression profiling data from AH patients...
November 6, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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