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https://www.readbyqxmd.com/read/28433982/acute-on-chronic-gastrointestinal-bleeding-a-unique-clinical-entity
#1
Don C Rockey, Adam C Hafemeister, Joan S Reisch
Gastrointestinal bleeding is defined in temporal-spatial terms-as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined 'acute on chronic' gastrointestinal bleeding. We prospectively identified all patients who underwent endoscopic evaluation for any form of gastrointestinal bleeding at a University Hospital. Acute on chronic bleeding was defined as the presence of new symptoms or signs of acute bleeding in the setting of chronic bleeding, documented as iron deficiency anemia...
April 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28433485/in-hospital-mortality-in-cirrhotic-patients-at-a-tertiary-care-center
#2
R Zubieta-Rodríguez, J Gómez-Correa, R Rodríguez-Amaya, K A Ariza-Mejia, N A Toloza-Cuta
INTRODUCTION: Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. AIMS: To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28426800/neutrophil-lymphocyte-ratio-predicts-short-term-mortality-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure-treated-with-an-artificial-liver-support-system
#3
Zeng Fan, Chen EnQiang, Du Ling Yao, Yan LiBo, Li Hong, Bai Lang, Feng Ping, Tang Hong
AIM: Hepatitis B virus-related acute-on-chronic liver failure has high short-term mortality. Artificial liver support systems (ALSS) may improve outcome and avoid liver transplantation, but predicting short-term prognosis in such patients is difficult. This study aimed to determine whether the neutrophil-lymphocyte ratio (NLR), an inflammation marker, predicted mortality in patients treated with ALSS. METHODS: A total of 560 patients with hepatitis B virus-related acute-on-chronic liver failure were enrolled, 338 were treated with ALSS and the others treated with standard of care(SOC)...
2017: PloS One
https://www.readbyqxmd.com/read/28425670/electroencephalographic-patterns-of-lithium-poisoning-a-study-of-the-effect-concentration-relationships-in-the-rat
#4
Anne-Sophie Hanak, Isabelle Malissin, Joël Poupon, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
OBJECTIVES: Lithium overdose may result in encephalopathy and electroencephalographic abnormalities. Three poisoning patterns have been identified based on the ingested dose, previous treatment duration and renal function. Whether the severity of lithium-induced encephalopathy depends on the poisoning pattern has not been established. We designed a rat study to investigate lithium-induced encephalopathy and correlate its severity to plasma, erythrocyte, cerebrospinal fluid and brain lithium concentrations previously determined in rat models mimicking human poisoning patterns...
April 20, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28422322/pentraxin-3-modulates-lps-induced-inflammatory-response-and-attenuates-liver-injury
#5
Luis Perea, Mar Coll, Lucia Sanjurjo, Delia Blaya, Adil El Taghdouini, Daniel Rodrigo-Torres, José Altamirano, Isabel Graupera, Beatriz Aguilar-Bravo, Marta Llopis, Julia Vallverdú, Joan Caballeria, Leo A van Grunsven, Maria-Rosa Sarrias, Pere Ginès, Pau Sancho-Bru
Acute-on-chronic liver injury is characterized by an important inflammatory response frequently associated with endotoxemia. In this context, acute phase proteins such as Pentraxin-3 (PTX3) are released, however, little is known about their role in chronic liver disease. The aim of this study was to elucidate the role of PTX3 in liver injury. Role of PTX3 was evaluated in cultured human cells, liver tissue slices and mice with acute-on-chronic liver injury. PTX3 expression was assessed in tissue and serum samples from 54 patients with alcoholic hepatitis (AH)...
April 19, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28420029/interlobar-artery-resistive-index-predicts-acute-on-chronic-liver-failure-syndrome-in-cirrhotic-patients-with%C3%A2-acute-decompensation
#6
Pablo A Solís-Muñoz, Christopher Willars, Julia Wendon, George Auzinger, Michael A Heneghan, Maria De la Flor-Robledo, José A Solís-Herruzo
Introduction Patients with acutely decompensated (AD) cirrhosis are at risk for developing acute-on-chronic liver failure (ACLF) syndrome. This syndrome is associated with a high short-term mortality rate. The aim of our study was to identify reliable early predictors of developing ACLF in cirrhotic patients with AD. Patients and Methods We assessed 84 cirrhotic patients admitted for AD without ACLF on admission. We performed routine blood testing and detailed ultrasound Doppler studies of systemic arteries and mayor abdominal veins and arteries...
April 18, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#7
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413389/a-case-of-right-atrial-obliteration-caused-by-intracardiac-extension-of-hepatocellular-carcinoma
#8
Meredith Barrett, Benjamin L Viglianti, Christopher A Hanson, Richard J Schildhouse
As the fifth most common malignancy worldwide, hepatocellular carcinoma (HCC) is a frequently encountered clinical entity. Symptomatology associated with the diagnosis includes hepatic dysfunction and pain from capsular spread. Additionally, due to its propensity for vascular spread, extrahepatic intravascular involvement can also be seen. We present a unique case of intracardiac involvement of HCC. Originally diagnosed as acute on chronic heart failure, echocardiography revealed the symptom source - tumor obliteration of the right atrium...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28412296/impact-of-higher-order-heme-degradation-products-on-hepatic-function-and-hemodynamics
#9
Raphael A Seidel, Thierry Claudel, Franziska A Schleser, Navin K Ojha, Matthias Westerhausen, Sandor Nietzsche, Christoph Sponholz, Frans Cuperus, Sina M Coldewey, Stefan H Heinemann, Georg Pohnert, Michael Trauner, Michael Bauer
BACKGROUND& AIMS: While, traditionally, biliverdin and bilirubin are considered end products of heme catabolism, there is evidence for further degradation to diverse bioactive products. As such, Z-BOX A and Z-BOX B arise upon oxidation with unknown implications for hepatocellular function and integrity. We studied the impact of Z-BOX A and B on hepatic functions and explored their alterations in health and cholestatic conditions. METHODS: Functional implications and mechanisms were investigated in rats, hepatocytic HepG2 and HepaRG cells, human immortalized hepatocytes, and isolated perfused livers...
April 12, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28398942/acute-on-chronic-anterolateral-tibiofibular-joint-dislocation-in-a-child
#10
Jeewanjit S Gill, Amal Al-Shibli, Victor Istasy, Rodrick Lim
Tibiofibular joint injury in children is an uncommon injury. It is usually associated with acute injuries in sports that involve aggressive twisting of the knee, such as soccer and snowboarding. We present a case of a 17-year-old male adolescent who sustained an acute dislocation of the anterolateral tibiofibular joint with routine ambulation, who had a chronic history of subluxation. To our knowledge, this has not been previously reported. The diagnosis requires a high level of awareness and suspicion, and plain radiographs may aid in the diagnosis especially if contralateral comparison views are obtained...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28395784/acute-mesenteric-ischemia-part-i-incidence-etiologies-and-how-to-improve-early-diagnosis
#11
REVIEW
Jussi M Kärkkäinen, Stefan Acosta
Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28393476/development-of-predisposition-injury-response-organ-failure-model-for-predicting-acute-kidney-injury-in-acute-on-chronic-liver-failure
#12
Rakhi Maiwall, Shiv Kumar Sarin, Suman Kumar, Priyanka Jain, Guresh Kumar, Ajeet Singh Bhadoria, Richard Moreau, Chandan Kumar Kedarisetty, Zaigham Abbas, Deepak Amarapurkar, Ankit Bhardwaj, Chhagan Bihari, Amna Subhan Butt, Albert Chan, Yogesh Kumar Chawla, Ashok Chowdhury, RadhaKrishan Dhiman, Abdul Kadir Dokmeci, Hasmik Ghazinyan H, Saeed Sadiq Hamid, Dong Joon Kim, Piyawat Komolmit, George K Lau, Guan Huei Lee, Laurentius A Lesmana, Mamun Al-Mahtab, Rajendra Prasad Mathur, Suman Lata Nayak, Qin Ning, Viniyendra Pamecha, Diana Alcantara-Payawal, Archana Rastogi, Salimur Rahman, Mohamed Rela, Vivek A Saraswat, Samir Shah, Gamal Shiha, Barjesh Chander Sharma, Manoj Kumar Sharma, Kapil Sharma, Soek Siam Tan, Shivendra Singh Chandel, Chitranshu Vashishtha, Zeeshan A Wani, Man-Fung Yuen, Osamu Yokosuka
BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury(AKI) in ACLF. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting AKI in a multi-centric cohort of ACLF patients. PATIENTS AND METHODS: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of ACLF patients (n=997) RESULTS: Factors significant for P component were serum creatinine[(≥2mg/dl)OR 4...
April 10, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28387980/immune-balance-in-hepatitis-b-infection-present-and-future-therapies
#13
REVIEW
Ashish Kumar Vyas, Ankur Jindal, Syed Hissar, Gayatri Ramakrishna, Nirupama Trehanpati
Chronic hepatitis B virus (HBV) infection affects millions of people worldwide and about half a million people die every year. India represents the second largest pool of chronic HBV infections with an estimated 40 million chronically infected patients. Persistence or clearance of HBV infection mainly depends upon host immune responses. Chronically infected individuals remain in immune tolerant phase unless HBV flares and leads to development of chronic active hepatitis or acute on chronic liver failure. Strategies based on inhibition of viral replication (nucleoside analogues) or immune modulation (Interferons) as monotherapy, or in combination in sequential therapies, are currently being used globally for reducing HBV viral load and mediating HBsAg clearance...
April 7, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28383031/serum-glycopatterns-as-novel-potential-biomarkers-for-diagnosis-of-acute-on-chronic-hepatitis-b-liver-failure
#14
Yaogang Zhong, Yonghong Guo, Xiawei Liu, Jiaxu Zhang, Tianran Ma, Jian Shu, Jiajun Yang, Jing Zhang, Zhansheng Jia, Zheng Li
Acute-on-chronic hepatitis B liver failure (ACHBLF) is an increasingly recognized distinct disease entity encompassing an acute deterioration of liver function in patients with cirrhosis, so little is known about the alterations of protein glycopatterns in serum with its development. We aimed to identify the alterations of serum glycopatterns in ACHBLF and probe the possibility of them as novel potential biomarkers for diagnosis of ACHBLF. As a result, there were 18 lectins (e.g., WFA, GSL-II, and PNA) to give significantly alterations of serum glycopatterns in ACHBLF compared with healthy controls (HC) (all p ≤ 0...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28381383/serum-soluble-st2-is-a-promising-prognostic-biomarker-in-hbv-related-acute-on-chronic-liver-failure
#15
Shao-Wen Jiang, Peng Wang, Xiao-Gang Xiang, Rui-Dong Mo, Lan-Yi Lin, Shi-San Bao, Jie Lu, Qing Xie
BACKGROUND: The IL-33/ST2 axis is involved in the pathogenesis of many diseases such as autoimmune diseases, cancer, and heart failure. However, studies of the IL-33/ST2 pathway in HBV-related acute-on-chronic liver failure (HBV-ACLF) are lacking. The present study aimed to determine the prognostic role of serum IL-33/soluble ST2 (sST2) in HBV-ACLF. METHODS: Serum levels of IL-33 and sST2 in healthy controls (HC, n=18), chronic hepatitis B (CHB, n=27) and HBV-ACLF (n=51) patients at the 1st and 4th week after enrollment were detected using ELISA, and clinical data were collected...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28376624/autochthonous-acute-hepatitis-e-an-increasingly-frequent-diagnosis-clinical-epidemiological-analysis-of-our-experience
#16
Luzdivina Monteserín Ron, Marcos Jiménez Palacios, Pedro Linares Torres, Aleida Miguel Peña, Begoña Álvarez Cuenllas, María Isabel Fernández-Natal, Emilio Valverde Romero, Francisco Jorquera Plaza
BACKGROUND: In Europe, acute hepatitis caused by the hepatitis E virus (HEV) traditionally was an infection found in people who had travelled to endemic zones, mainly Asia and Africa. However, a growing number of sporadic autochthonous cases are now being diagnosed in the Western world. OBJECTIVE: To analyze the cases of acute HEV hepatitis diagnosed in our setting, with the identification of the clinical-epidemiological characteristics. MATERIAL AND METHODS: We included the cases of acute HEV hepatitis diagnosed (positive anti-HEV IgM and/or HEV RNA present in serum) between January 2008 and December 2014...
April 5, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28374414/systemic-inflammatory-response-syndrome-in-acute-on-chronic-liver-failure-relevance-of-golden-window-a-prospective-study
#17
A Choudhury, M Kumar, B C Sharma, R Maiwall, V Pamecha, R Moreau, Y K Chawla, A Duseja, M Mahtab, S Rahman, S S Hamid, A S Butt, W Jafri, S S Tan, H Devarbhavi, D Amarapurkar, Q Ning, C E Eapen, Ashish Goel, D J Kim, H Ghazinian, G Shiha, G H Lee, Z Abbas, D A Payawal, A K Dokmeci, M F Yuen, L A Lesmana, Ajit Sood, A Chan, G K Lau, J I Dong Jia, Z Duan, Yu Chen, O Yokosuka, P Jain, A S Bhadoria, G Kumar, S K Sarin
BACKGROUND: SIRS is an early marker of sepsis and ongoing inflammationand has been reported in large proportion of ACLF patients. Whether sepsis is the cause or the result of liver failure is unclear and is vital to know. To address this, we investigated the course and outcome of ACLF patients without SIRS/sepsis. METHODS: Consecutive ACLF patients were monitored for the development of SIRS/sepsis and associated complications and followed till 90 days, liver transplant or death...
April 3, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28370357/allogeneic-bone-marrow-derived-mesenchymal-stromal-cells-for-hbv-related-acute-on-chronic-liver-failure-a-randomized-controlled-trial
#18
Bing-Liang Lin, Jun-Feng Chen, Wei-Hong Qiu, Ke-Wei Wang, Dong-Ying Xie, Xiao-Yong Chen, Qiu-Li Liu, Liang Peng, Jian-Guo Li, Yong-Yu Mei, Wei-Zhen Weng, Yan-Wen Peng, Hui-Juan Cao, Jun-Qiang Xie, Shi-Bin Xie, Andy Peng Xiang, Zhi-Liang Gao
Mortality from hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) is high due to limited treatment options. Preclinical and clinical investigations have proved that treatment with mesenchymal stromal cells (MSCs) is beneficial for recovery from liver injury. We hypothesized that the outcome of HBV-related ACLF would be improved by MSC treatment. From 2010 to 2013, 110 patients with HBV-related ACLF were enrolled in this open label non-blinded randomized controlled study. The control group (N=54) was treated with standard medical therapy (SMT) only...
April 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28363639/increased-expression-of-ctla4-by-t-cells-induced-by-b7-in-sera-reduces-adaptive-immunity-in-patients-with-acute-liver-failure
#19
Wafa Khamri, Robin D Abeles, Tie Zheng Hou, Amy E Anderson, Ahmed El-Masry, Evangelos Triantafyllou, Christine Bernsmeier, Fin S Larsen, Arjuna Singanayagam, Nobuaki Kudo, Lucia A Possamai, Fanny Lebosse, Georg Auzinger, William Bernal, Christopher Willars, Christopher J Weston, Giovanna Lombardi, Julia Wendon, Mark Thursz, Charalambos G Antoniades
BACKGROUND & AIMS: Patients with acute liver failure (ALF) have defects in innate immune responses to microbes (immuneparesis) and are susceptible to sepsis. Cytotoxic T-lymphocyte associated protein 4 (CTLA4), which interacts with the membrane receptor B7 (also called CD80 and CD86), is a negative regulator of T-cell activation. We collected T cells from patients with ALF and investigated whether inhibitory signals downregulate adaptive immune responses in patients with ALF. METHODS: We collected peripheral blood mononuclear cells from patients with ALF and controls from September 2013 through September 2015 (45 patients with ALF, 20 patients with acute-on-chronic liver failure, 15 patients with cirrhosis with no evidence of acute decompensation, 20 patients with septic shock but no cirrhosis or liver disease, and 20 healthy individuals)...
March 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28360976/langerhans-cell-histiocytosis-masquerading-as-acute-appendicitis-case-report-and-review
#20
Mohammad M Karimzada, Michele N Matthews, Samuel W French, Daniel DeUgarte, Dennis Y Kim
Langerhans cell histiocytosis (LCH) is a rare syndrome characterized by unifocal, multifocal unisystem, or disseminated/multi-system disease that commonly involves the bone, skin, lymph nodes, pituitary, or sometimes lung (almost exclusively in smokers) causing a variety of symptoms from rashes and bone lesions to diabetes insipidus or pulmonary infiltrates. We present a previously unreported case of gastrointestinal LCH as well as a novel characteristic lesion affecting the colon of a young woman who presented with signs and symptoms mimicking acute on chronic appendicitis...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
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