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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
#1
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
https://www.readbyqxmd.com/read/28221721/esogastric-pressure-measurement-to-assist-noninvasive-ventilation-indication-and-settings-in-infants-with-hypercapnic-respiratory-failure-a-pilot-study
#2
Guillaume Mortamet, Sonia Khirani, Alessandro Amaddeo, Guillaume Emeriaud, Sylvain Renolleau, Brigitte Fauroux
OBJECTIVE: Noninvasive ventilation (NIV) in usually set on clinical parameters. The aim of the study was to assess the value of esophageal (PES ) and gastric pressure (PGAS ) measurements for the indication and optimal settings of NIV in infants with hypercapnic respiratory failure in whom the efficacy of NIV was uncertain on clinical noninvasive parameters. DESIGN: A retrospective study. PATIENT-SUBJECT SELECTION: PES and PGAS measurements were performed in seven infants <2 years old admitted in the Pediatric Intensive Care Unit for an acute or acute-on-chronic hypercapnic respiratory failure...
February 21, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28210759/-acute-on-chronic-liver-failure-a%C3%A2-diagnostic-and-therapeutic-challenge-for-intensive-care
#3
REVIEW
P Hübener, G Braun, V Fuhrmann
Acute-on-chronic liver failure (ACLF) is an emerging clinical syndrome in patients with underlying liver disease that is usually triggered by one or multiple insults and characterized by progressive hepatic and nonhepatic organ failure, a significant risk of infections, and high short-term mortality rates. Despite our incomplete understanding of the underlying pathophysiology, ACLF requires timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors as well as the prevention of complications to improve the prognosis of affected patients...
February 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#4
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28208933/a-rare-case-report-of-hepatic-subcapsular-pseudocyst-of-pancreas
#5
Noor Topno, Sandeep Ghosh, Arup Baruah
A pancreatic pseudocyst arises as a result of acute or chronic pancreatitis, pancreatic trauma, or obstruction of the pancreatic duct by a neoplasm. Most of the pseudocysts are located within the head and the body of the pancreas but 20% are extra-pancreatic. We report a case of a 33-year-old gentleman presenting with acute on chronic alcoholic pancreatitis with hepatic sub-capsular pseudocyst involving left lobe of liver, with intra-cystic bleed was successfully treated with Ultrasonography (USG) guided drainage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28195876/development-and-validation-of-a-prognostic-model-for-acute-on-chronic-hepatitis-b-liver-failure
#6
Fangyuan Gao, Le Sun, Xieqiong Ye, Yao Liu, Huimin Liu, Mingfan Geng, Xiaoshu Li, Xue Yang, Yuxin Li, Rui Wang, Jialiang Chen, Gang Wan, Yuyong Jiang, Xianbo Wang
AIM: The CANONIC study proposed the Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF) prognostic model at the European Association for the Study of the Liver-CLIF diagnosis. This study aimed to develop and validate a prognostic model for predicting the short-term mortality of hepatitis B virus (HBV) ACLF as defined by the Asia-Pacific Association for the Study of the Liver. PATIENTS AND METHODS: A retrospective cohort of 381 HBV ACLF patients and a prospective cohort of 192 patients were included in this study...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28195608/proximal-hamstring-tendinosis-and-partial-ruptures
#7
Ashley N Startzman, Oliver Fowler, Dominic Carreira
Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28194045/deregulation-of-regulatory-t-cells-in-acute-on-chronic-liver-failure-a-rat-model
#8
Shunlan Ni, Shanshan Li, Naibin Yang, Xinyue Tang, Shengguo Zhang, Danping Hu, Mingqin Lu
Aims. Acute-on-chronic liver failure (ACLF) and acute liver failure (ALF) are similar in many respects during their acute exacerbation; however, ACLF generally has a poorer prognosis. We aimed to investigate the role and dynamic changes of regulatory T cell (Treg) and T helper 17 (Th17) cell proportions during ACLF progress. Methods. All rats were classified into two groups randomly: ACLF group and ALF group (control group). The rat model of ACLF was preestablished by intraperitoneal injection of carbon tetrachloride for 2 months...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28185839/hypermethylation-of-the-galectin-3-promoter-is-associated-with-poor-prognosis-of-acute-on-chronic-hepatitis-b-liver-failure
#9
Jing Zhao, Yu-Chen Fan, Xin-Yuan Liu, Ze-Hua Zhao, Feng Li, Kai Wang
BACKGROUND AND AIMS: The possible role of galectin-3 in acute-on-chronic hepatitis B liver failure (ACHBLF) remains unknown. This study aimed to determine the methylation status of the galectin-3 promoter in patients with ACHBLF and analyze its prognostic value. METHODS: The methylation status of the galectin-3 promoter in patients with ACHBLF, chronic hepatitis B (CHB) and healthy controls (HCs) was determined by methylation-specific polymerase chain reaction (MSP)...
January 22, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28130881/transplantation-of-hepatocytes-from-genetically-engineered-pigs-into-baboons
#10
Hayato Iwase, Hong Liu, Eva Schmelzer, Mohamed Ezzelarab, Martin Wijkstrom, Hidetaka Hara, Whayoung Lee, Jagjit Singh, Cassandra Long, Eric Lagasse, Jörg C Gerlach, David K C Cooper, Bruno Gridelli
BACKGROUND: Some patients with acute or acute-on-chronic hepatic failure die before a suitable human liver allograft becomes available. Encouraging results have been achieved in such patients by the transplantation of human hepatocyte progenitor cells from fetal liver tissue. The aim of the study was to explore survival of hepatocytes from genetically engineered pigs after direct injection into the spleen and other selected sites in immunosuppressed baboons to monitor the immune response and the metabolic function and survival of the transplanted hepatocytes...
January 28, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28130311/genome-wide-association-study-identi%C3%AF-es-hla-dr-variants-conferring-risk-of-hbv-related-acute-on-chronic-liver-failure
#11
Wenting Tan, Jie Xia, Yunjie Dan, Mengying Li, Shide Lin, Xingnan Pan, Huifen Wang, Yingzi Tang, Nana Liu, Shun Tan, Ming Liu, Weiwei He, Weihua Zhang, Qing Mao, Yuming Wang, Guohong Deng
OBJECTIVE: Acute-on-chronic liver failure (ACLF) is an extreme condition after severe acute exacerbation of chronic hepatitis B; however, the underlying genetic factors involved in its onset and progression are currently unclear. DESIGN: We carried out a genome-wide association study among 399 HBV-related ACLFs (cases) and 401 asymptomatic HBV carriers (AsCs, as controls) without antiviral treatment. The initial findings were replicated in four independent case-control sets (a total of 901 ACLFs and 1686 AsCs)...
January 27, 2017: Gut
https://www.readbyqxmd.com/read/28121031/impact-of-preoperative-infection-on-outcome-after-liver-transplantation
#12
V R Bertuzzo, M Giannella, A Cucchetti, A D Pinna, A Grossi, M Ravaioli, M Del Gaudio, F Cristini, P Viale, M Cescon
BACKGROUND: Bacterial infection in patients with liver failure can lead to a dramatic clinical deterioration. The indications for liver transplantation and outcome in these patients is still controversial. METHODS: All adult patients who underwent liver transplantation between 1 January 2010 and 31 December 2015 were selected from an institutional database. Characteristics of the donors and recipients, and clinical, biochemical and surgical parameters were retrieved from the database...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28114127/management-of-chronic-kidney-disease-patients-in-the-intensive-care-unit-mixing-acute-and-chronic-illness
#13
Silvia De Rosa, Sara Samoni, Gianluca Villa, Claudio Ronco
Patients with chronic kidney disease (CKD) are at high risk for developing critical illness and for admission to intensive care units (ICU). 'Critically ill CKD patients' frequently develop an acute worsening of renal function (i.e. acute-on-chronic, AoC) that contributes to long-term kidney dysfunction, potentially leading to end-stage kidney disease (ESKD). An integrated multidisciplinary effort is thus necessary to adequately manage the multi-organ damage of those kidney patients and contemporaneously reduce the progression of kidney dysfunction when they are critically ill...
January 24, 2017: Blood Purification
https://www.readbyqxmd.com/read/28110320/acute-on-chronic-liver-failure-recent-update
#14
Alam Azeem, Chun Suen Ka, Ma Daqing
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#15
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-Model for End-Stage Liver Disease MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The 5-year graft and patient survival in the high-MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28097250/spinal-cord-compression-from-wegener-s-granulomatosis-an-unusual-presentation
#16
Deb Roy, Prashanth J Rao, Kevin Phan, Ralph J Mobbs, Michael Selby
Wegener's granulomatosis (WG) causing spinal cord compression is very rare with only few cases reported in literature. We present a case report with review of literature. A 55-year-old lady with known WG presented with acute on chronic spinal cord compression. MRI scan revealed spinal cord compression anteriorly and posteriorly at T2-T5 level. Patient underwent urgent surgical decompression with excision of the posterior dural lesion with synthetic duraplasty. Patient made good neurological recovery. Histopathology revealed features consistent with WG...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28079670/impact-of-genetic-variation-in-the-vasopressin-1a-receptor-on-the-development-of-organ-failure-in-patients-admitted-for-acute-decompensation-of-liver-cirrhosis
#17
Annarein J C Kerbert, Jelte J Schaapman, Johan J van der Reijden, Àlex Amorós Navarro, Aiden McCormick, Bart van Hoek, Vicente Arroyo, Pere Ginès, Rajiv Jalan, Victor Vargas, Rudolf Stauber, Hein W Verspaget, Minneke J Coenraad
BACKGROUND: Vasopressin receptor-mediated vasoconstriction is considered to be involved in the pathogenesis of organ failure in acute-on-chronic liver failure (ACLF). PATIENTS AND METHODS: We studied the association between six single nucleotide polymorphisms (SNPs) of the vasopressin 1a receptor gene and the development of organ failure in 826 patients admitted for acute decompensation of liver cirrhosis (n=641) or ACLF (n=185). RESULTS: No associations were found for SNPs with the presence of circulatory or renal failure...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#18
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28073418/-current-status-and-perspectives-of-artificial-liver-for-treatment-of-acute-on-chronic-liver-failure
#19
J R Huang
This article briefly introduces the mechanisms and characteristics of several new artificial liver therapies, the advantages and disadvantages of different sites for placement of the drainage tube, and commonly used anticoagulation methods, as well as the prevention and treatment of common complications of the artificial liver support system. The future direction of development of artificial liver includes new regimens for "individualized treatment" based on patients' conditions, combination of non-biological artificial liver and biological active ingredients, and development of efficient and perfected hybrid bioartificial liver, which can further improve the therapeutic outcome of liver failure...
December 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28067752/efficacy-and-safety-of-lamivudine-versus-entecavir-for-treating-chronic-hepatitis-b-virus-related-acute-exacerbation-and-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#20
Kuang-Wei Huang, Ka-Wai Tam, Jiing-Chyuan Luo, Yi-Chun Kuan
BACKGROUND: Oral nucleos(t)ide analogs are recommended for patients with chronic hepatitis B virus (HBV)-related acute exacerbation (AE) and acute-on-chronic liver failure (ACLF). The efficacy and safety of administering entecavir (ETV) and lamivudine (LAM) to such patients remain unclear. METHODS: A comprehensive literature search was performed to select studies published before December 2015 on therapy involving ETV or LAM for chronic HBV-related AE with or without ACLF...
August 30, 2016: Journal of Clinical Gastroenterology
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