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https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#1
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29663944/repair-of-a-large-ventral-hernia-in-a-rhesus-macaque-macaca-mulatta-by-using-an-abdominal-component-separation-technique
#2
Steve J Kempton, Jacqueline S Israel, Saverio Capuano Iii, Samuel O Poore
Here we present a 32-y-old rhesus macaque (Macaca mulatta) with a large recurrent ventral incisional hernia. The initial surgery included midline celiotomy for treatment of endometriosis, in which the animal developed a hernia that was repaired with interposition of mesh. Hernia recurrence at 1 y resulted in a defect measuring 7 × 13 cm, with loss of abdominal domain. Skin breakdown was noted with areas of exposed mesh through the skin with associated acute on chronic infection. Clinically, the animal was lethargic, not eating, and failing to thrive...
April 2, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29659382/tenofovir-versus-entecavir-for-the-treatment-of-acute-on-chronic-liver-failure-due-to-reactivation-of-chronic-hepatitis-b-with-genotypes-b-and-c
#3
Yue-Meng Wan, Yu-Hua Li, Zhi-Yuan Xu, Hua-Mei Wu, Ying Xu, Xi-Nan Wu, Jin-Hui Yang
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) can be triggered by reactivation of chronic hepatitis B (CHB). Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are now the most potent antiviral agents for CHB. This study aimed to compare the short-term safety and efficacy of TDF with ETV in the treatment of ACLF due to reactivation of CHB [hepatitis B virus (HBV)-ACLF]. PATIENTS AND METHODS: In total, 67 consecutive patients with HBV-ACLF were divided into TDF group (n=32) receiving daily TDF (300 mg/d) and ETV group (n=35) receiving daily ETV (0...
April 13, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#4
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29649629/qingchangligan-formula-alleviates-acute-liver-injury-by-attenuating-extracellular-histone-associated-inflammation
#5
Lan Ding, Xiangying Zhang, Li Li, Chunyan Gou, Xiaolan Luo, Yang Yang, Tao Wen, Xiuhui Li
Qingchangligan formula (QCLGF) is a traditional Chinese medicine that has exhibited remarkable clinical efficacy for patients with acute-on-chronic liver failure (ACLF). However, the hepatoprotective mechanisms of QCLGF are not completely understood. Extracellular histones were recently identified as the novel inflammatory mediators involved in the pathogenesis of acute liver injury. This study aimed to investigate whether QCLGF provides hepatoprotection by targeting extracellular histones. We showed that QCLGF significantly improved the survival rate of the ConA-treated mice, ameliorated hepatotoxicity, and markedly decreased the levels of extracellular histones and the associated cytokines...
April 9, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29629907/incidence-admission-rates-and-predictors-and-economic-burden-of-adult-emergency-visits-for-acute-pancreatitis-data-from-the-national-emergency-department-sample-2006-to-2012
#6
Sushil K Garg, Shashank Sarvepalli, James P Campbell, Itegbemie Obaitan, Dupinder Singh, Fateh Bazerbachi, Rajeshwar Singh, Madhusudhan R Sanaka
INTRODUCTION: Acute pancreatitis (AP) is the most common gastroenterology-related reason for hospital admission, and a major source of morbidity and mortality in the United States. This study examines the National Emergency Database Sample, a large national database, to analyze trends in emergency department (ED) utilization and costs, risk factors for hospital admission, and associated hospital costs and length of stay (LOS) in patients presenting with AP. METHODS: The National Emergency Database Sample (2006 to 2012) was evaluated for trends in ED visits, ED charges, hospitalization rates, hospital charges, and hospital LOS in patients with primary diagnosis of AP (further subcategorized by age and etiology)...
April 6, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29627486/association-of-red-blood-cell-distribution-width-with-severity-of-hepatitis-b-virus-related-liver-diseases
#7
Xiude Fan, Huan Deng, Xiqiang Wang, Siqi Fu, Zitong Liu, Jiao Sang, Xiaoge Zhang, Na Li, Qunying Han, Zhengwen Liu
BACKGROUND: Red blood cell distribution width (RDW) has been indicated to be an inflammatory indicator in a variety of diseases. However, no consistent conclusions regarding it's relevance to hepatitis B virus (HBV) -related liver diseases have been made. This meta-analysis was conducted to assess the significance of RDW in HBV-related liver diseases. METHODS: A comprehensive literature review was conducted using PubMed, Embase, and China National Knowledge Infrastructure (CNKI) through August 20, 2017 to identify studies that reported the association between RDW and HBV-related liver diseases...
April 5, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29623264/bacterial-infection-and-predictors-of-mortality-in-patients-with-autoimmune-liver-disease-associated-acute-on-chronic-liver-failure
#8
Xuan Zhang, Ping Chen, Hainv Gao, Shaorui Hao, Meifang Yang, Hong Zhao, Jianhua Hu, Weihang Ma, Lanjuan Li
Objective: To date, few studies are available on autoimmune liver disease-associated acute-on-chronic liver failure (ACLF). The aim of this study is to investigate bacterial infection and predictors of mortality in these patients. Methods: We retrospectively studied patients with autoimmune liver disease from August 2012 to August 2017. Clinical data of the patients were retrieved for analysis. Results: There were 53 ACLF patients and 53 patients without ACLF in this study...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29611203/stabilisation-of-acute-on-chronic-liver-failure-patients-before-liver-transplantation-predicts-post-transplant-survival
#9
P Huebener, M R Sterneck, K Bangert, A Drolz, A W Lohse, S Kluge, L Fischer, V Fuhrmann
BACKGROUND: Acute-on-chronic liver failure (ACLF) is a severe complication of liver cirrhosis associated with excess short-term mortality rates. Orthotopic liver transplantation (OLT) is a potentially life-saving therapeutic modality for acute-on-chronic liver failure patients, but selection of transplant candidates with an acceptable post-transplant outcome is difficult. OBJECTIVE: To assess the risk of liver transplantation in patients with ACLF, and to determine parameters that predict post-transplant survival in this patient cohort...
April 2, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29602672/serum-levels-of-mirna-in-patients-with-hepatitis-b-virus-associated-acute-on-chronic-liver-failure
#10
Ya Wen, Shi-Fang Peng, Lei Fu, Xiao-Yu Fu, Da-Xian Wu, Bing-Jie Liu, De-Ming Tan, Yi Ouyang
BACKGROUND: Hepatitis B virus (HBV)-associated acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition and its exact pathophysiology and progression remain unclear. The present study aimed to assess the role of serum miRNAs in the evaluation of HBV-ACLF and to develop a model to predict the outcomes for ACLF. METHODS: Serum was collected from 41 chronic hepatitis B and 55 HBV-ACLF patients in addition to 30 chronic asymptomatic HBV carriers as controls...
March 13, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29602096/clinical-burden-of-hepatitis-e-virus-infection-in-a-tertiary-care-center-in-flanders-belgium
#11
Lien Cattoir, Frederik Van Hoecke, Tom Van Maerken, Eveline Nys, Inge Ryckaert, Matthias De Boulle, Anja Geerts, Xavier Verhelst, Isabelle Colle, Veronik Hutse, Vanessa Suin, Magali Wautier, Steven Van Gucht, Hans Van Vlierberghe, Elizaveta Padalko
BACKGROUND: Hepatitis E virus (HEV) infection is increasingly recognized as a cause of hepatitis in developed countries. A high HEV IgG seroprevalence in humans and pigs is reported as well as sporadic clinical cases of autochtonous HEV but there are currently no data available on the clinical burden of HEV in Belgium. OBJECTIVES: The objective of the current study was to evaluate the actual clinical burden of HEV infections in our tertiary care center in Flanders, Belgium...
March 19, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29601930/liposome-supported-peritoneal-dialysis-in-the-treatment-of-severe-hyperammonemia-an-investigation-on-potential-interactions
#12
Giovanna Giacalone, Simon Matoori, Valentina Agostoni, Vincent Forster, Meriam Kabbaj, Sarah Eggenschwiler, Martin Lussi, Andrea De Gottardi, Nicola Zamboni, Jean-Christophe Leroux
Peritoneal dialysis (PD) performed with transmembrane pH-gradient liposomes was reported to efficiently remove ammonia from the body, representing a promising alternative to current standard-of-care for patients with severe hepatic encephalopathy. In this study, we further characterized the properties of liposome-supported peritoneal dialysis (LSPD) by 1) assessing its in-use stability in the presence of ascitic fluids from liver-disease patients; 2) investigating its interactions with drugs that are commonly administered to acute-on-chronic liver failure patients; and 3) analyzing the in vivo extraction profile of LSPD...
March 27, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29599900/metabolomics-from-liver-chiromancy-to-personalized-precision-medicine-in-advanced-chronic-liver-disease
#13
REVIEW
Bogdan Procopet, Petra Fischer, Oana Farcau, Horia Stefanescu
Currently there is a lack of accurate biomarkers for diagnosis and prognosis in advanced liver diseases. Either the occurrence of first decompensation, or diagnosis of acute on chronic liver failure, severe alcoholic hepatitis, or hepatocellular carcinoma (HCC), none of the available biomarkers are satisfactory. Metabolomics is the newest of omics, being much closer than the others to the actual phenotype and pathologic changes that characterizes a certain condition. It deals with a much wider spectrum of low molecular weight bio-compounds providing a powerful platform for discovering novel biomarkers and biochemical pathways to improve diagnostic, prognostication and therapy...
March 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/29577030/eus-guided-gall-bladder-drainage-in-severe-liver-disease-a-single-center-experience-in-critically-ill-cirrhotics
#14
Kapil Dev Jamwal, Manoj Kumar Sharma, Rakhi Maiwall, Barjesh Kumar Sharma, Shiv Kumar Sarin
Background and Aims : Acute calculous cholecystitis with impending gall bladder perforation in severe liver diseases including decompensated cirrhosis and acute-on-chronic liver failure (ACLF) is difficult to manage, due to the procedures such as cholecystectomy and per cutaneous cholecystostomy being associated with high risk and complications in these patients. Methods : Four cases of severe liver disease with acute calculous cholecystitis who presented to the Institute of Liver and Biliary Sciences (New Delhi, India) for further management were included in the study if they underwent endoscopic ultrasound-guided gall bladder drainage (EUS-GBD)...
March 28, 2018: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29551705/hev-positive-blood-donations-represent-a-relevant-infection-risk-for-immunosuppressed-recipients
#15
Dirk Westhölter, Jens Hiller, Ulrike Denzer, Susanne Polywka, Francis Ayuk, Meike Rybczynski, Thomas Horvatits, Swantje Gundlach, Nicole Fischer, Marylyn M Addo, Sven Peine, Burkhard Göke, Ansgar W Lohse, Marc Lütgehetmann, Sven Pischke
BACKGROUND: Routine Hepatitis E Virus (HEV) testing of blood products has recently been implemented in Great-Britain and the Netherlands. The relevance of transfusion-transmitted HEV infections is still controversially discussed in Europe. METHODS: All blood donations at the University Medical Center Hamburg-Eppendorf were prospectively tested for HEV-RNA by pooled PCR from October 2016 to May 2017. Reactive samples were individually re-tested. Additionally, stored samples from previous donations of positive donors were tested to determine the duration of HEV-viremia...
March 15, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29551632/clinical-course-of-sporadic-acute-hepatitis-e-in-a-hepatitis-b-virus-endemic-region
#16
Li Liu, Di Xiao, Jin-Hong Yu, Rui Shen, Meng Wang, Qiang Li
OBJECTIVES: In China, the epidemic pattern of acute hepatitis E virus (HEV) infection has changed from waterborne outbreaks to foodborne sporadic cases. However, the clinical course of sporadic acute hepatitis E has not been well defined. METHODS: Consecutive AHE inpatients who were admitted to the Jinan Infectious Disease Hospital, Jinan, Shandong Province, between January 2003 and December 2014 were evaluated and followed. Demographic data, clinical manifestations, results of laboratory tests,and outcomes were recorded...
March 15, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29541484/acute-on-chronic-subdural-hematoma-in-a-patient-taking-red-clover-herbal-supplement-a-case-report
#17
Samuel Hall, Eleanor Walshe, Claudia Ajayi, Kevin Boyle, Colin Griffith
Background: Herbal supplements are commonly used, however, their side-effect profiles are poorly understood and not subject to the same scrutiny as prescribed medications. Some herbal supplements such as St Johns' Wort are accepted to interfere with clotting pathways, however others, including Red Clover have theoretical bleeding risks based on coumarin content with very little underlying evidence. Case Description: This case reports a 65-year-old woman who suffered a spontaneous acute-on-chronic subdural hemorrhage with a significant postoperative re-hemorrhage...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29524528/the-prognostic-value-of-acute-on-chronic-liver-failure-during-the-course-of-severe-alcoholic-hepatitis
#18
Thomas Sersté, Alexia Cornillie, Hassane Njimi, Marco Pavesi, Vicente Arroyo, Antonella Putignano, Laura Weichselbaum, Pierre Deltenre, Delphine Degré, Eric Trépo, Christophe Moreno, Thierry Gustot
BACKGROUND & AIMS: A better identification of factors predicting death is needed in alcoholic hepatitis. Acute-on-chronic liver failure (ACLF) occurs during the course of liver disease and can be identified when AH is diagnosed (prevalent ACLF, pACLF) or during follow-up (incidental ACLF, iACLF). This study analyzed the impact of ACLF on outcomes in AH and the role of infection in the onset of ACLF and death. METHODS: Patients admitted from July, 2006 to July, 2015 suffering from biopsy-proven severe (s)AH with a Maddrey discriminant function (mDF) ≥32 were included...
March 7, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29516616/epidural-abscess-during-a-spinal-cord-stimulator-trial-a-case-report
#19
Brian Wetherington, Talal W Khan
BACKGROUND: Spinal cord stimulation (SCS) can be beneficial for low back and radicular pain. A short trial of SCS evaluates the potential effectiveness of this therapy for a specific patient, while also decreasing the likelihood of a failed permanent implant. While rare, an epidural abscess is difficult to diagnose based on its nonspecific and unreliable clinical presentation. CASE: We present a case of an acute onset methicillin-sensitive Staphylococcus aureus epidural abscess 72-96 hours into a trial of a percutaneous spinal cord stimulator...
March 8, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29497824/acute-kidney-injury-in-children-with-chronic-liver-disease
#20
Akash Deep, Romit Saxena, Bipin Jose
Acute kidney injury (AKI) is a common accompaniment in patients with liver disease. The causes, risk factors, manifestations and management of AKI in these patients vary according to the liver disease in question (acute liver failure, acute-on-chronic liver failure, post-liver transplantation or metabolic liver disease). There are multiple causes of AKI in patients with liver disease-pre-renal, acute tubular necrosis, post-renal, drug-induced renal failure and hepatorenal syndrome (HRS). Definitions of AKI in liver failure are periodically revised and updated, but pediatric definitions have still to see the light of the day...
March 1, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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