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Liver in sepsis

Runkuan Yang, Shengtao Zhu, Soeren Erik Pischke, Hakon Haugaa, Xiaoping Zou, Tor Inge Tonnessen
BACKGROUND: Obstructive jaundice (OJ) patients with cholangitis are prone to sepsis; however, the underlying mechanisms are still not clear and need to be clarified. METHODS: Analyzing all available published data related to the title of this article. RESULTS: OJ leads to absence of gut luminal bile and accumulation of hepatic and circulating bile acids. Absence of gut luminal bile deprives the gut from its antiinflammatory, endotoxin-binding, bacteriostatic, mucosal-trophic, epithelial tight-junction maintaining, and gut motility-regulating effects, leading to gut bacterial overgrowth, mucosal atrophy, mucosal tight-junction loss, and gut motility dysfunction...
August 2018: Journal of Surgical Research
Zhixiang Xie, Zhuangbo Guo, Jianfeng Liu
BACKGROUND Whey acidic protein/four-disulfide core domain 21 (Wfdc21), also known as Lnc-DC, it has been reported to be correlated with immune response. However, the role of Wfdc21 in the pathogenesis of sepsis is still unknown. In the present study, we aimed to investigate the role of Wfdc21 in the pathogenesis of sepsis. MATERIAL AND METHODS The cecal ligation and puncture (CLP)-induced sepsis model was established in Balb/c mice. Animals were euthanized 4, 8, 16, or 24 h after CLP. The glycogen distribution in the kidney and liver was checked by Periodic acid-Schiff (PAS) staining...
June 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Gunadi, Timotheus Allen Gunawan, Galih Widiyanto, Amalia Yuanita, Nenny Sri Mulyani, Akhmad Makhmudi
OBJECTIVES: Recently, a scoring system has been developed to predict which patients with biliary atresia (BA) who underwent a Kasai procedure should be considered for liver transplant. Here, we applied the scoring system to predict the survival of BA patients following the Kasai procedure at Dr. Sardjito Hospital, Yogyakarta, Indonesia from January 2012 to January 2016. RESULTS: There were 26 patients, of whom 14 were males and 12 females. Outcomes of BA patients after the Kasai surgery were 15 survived and 11 died...
June 13, 2018: BMC Research Notes
Sujay Kulkarni, Mithun Sharma, Padaki N Rao, Rajesh Gupta, Duvvuru N Reddy
Aims: We studied in-hospital predictors of mortality of acute on chronic liver failure (ACLF) in Indian patients. Methods: Patients admitted to the intensive care unit of our institute fulfilling the definition of ACLF based on the Asia-Pacific Association for Study of Liver Disease (APASL) consensus were included. Complete history and medical evaluation to assess the etiology of underlying liver cirrhosis and to identify the acute precipitating insult of worsening liver function was done...
June 2018: Journal of Clinical and Experimental Hepatology
Pulkit Sethi, Manoj Thillai, Binoj Sivasankarapillai Thankamonyamma, Shweta Mallick, Unnikrishnan Gopalakrishnan, Dinesh Balakrishnan, Ramachandran Narayana Menon, Sudhindran Surendran, Puneet Dhar, Sudheer Othiyil Vayoth
Background: In living donor liver transplantation (LDLT), graft-to-recipient weight ratio (GRWR) > 0.8% is perceived as the critical graft size. This lower limit of GRWR (0.8%) has been challenged over the last decade owing to the surgical refinements, especially related to inflow and outflow modulation techniques. Our aim was to compare the recipient outcome in small-for-size (GRWR < 0.8) versus normal-sized grafts (GRWR > 0.8) and to determine the risk factors for mortality when small-for-size grafts (SFSG) were used...
June 2018: Journal of Clinical and Experimental Hepatology
Yong-Kun Wan, Hui-Hui Li, Lin Zuo, Xiao-Li Wang, Li-Yuan Wang, Wen-Xin He, Hui Jiang, Shou-Xiang Wang, Jie Sheng, Min Zhang, Hai-Chun Qian, Fang-Fang Yang, Hong Xie, Shi-Fang Gao, Qiang Fang, Xiao-di Yang, Mu-Ling Liu
OBJECTIVE: To observe the effect of Schistosoma japonicum cysteine protease inhibitor (rSjCystatin) for treatment of lipopolysaccharide (LPS)-induced sepsis in mice. METHODS: After a week of adaptive feeding, 54 BALB/c mice were randomly divided into normal control group (group A), sepsis group (group B), and rSjCystatin intervention group (group C). The mice in group A received an intraperitoneal injection of PBS (100 µL), and those in groups B and C were injected with PBS (100 µL) containing LPS (10 mg/kg); the mice in group C were also intraperitoneally injected with 25 µg sjCystatin in 100 µL PBS 30 min after LPS injection...
May 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
John D Lyons, Ching-Wen Chen, Zhe Liang, Wenxiao Zhang, Deena B Chihade, Eileen M Burd, Alton B Farris, Mandy L Ford, Craig Coopersmith
Patients with cancer who develop sepsis have a markedly higher mortality than patients who were healthy prior to the onset of sepsis. Potential mechanisms underlying this difference have previously been examined in two preclinical models of cancer followed by sepsis. Both pancreatic cancer/pneumonia and lung cancer/cecal ligation and puncture (CLP) increase murine mortality, associated with alterations in lymphocyte apoptosis and intestinal integrity. However, pancreatic cancer/pneumonia decreases lymphocyte apoptosis and increases gut apoptosis while lung cancer/CLP increases lymphocyte apoptosis and decreases intestinal proliferation...
June 8, 2018: Shock
Francesco Porta, Licia Peruzzi, Roberto Bonaudo, Silvia Pieretti, Marta Busso, Enrico Cocchi, Alessandra Conio, Veronica Pagliardini, Marco Spada
Severe urea cycle defects (UCDs), organic acidemias (OAs), and maple syrup urine disease (MSUD) are life-threatening disorders presenting in the first days of life. Renal replacement therapy (RRT) is an emergency option in affected newborns, mostly performed as ultima ratio. We report our 10-year experience using emergency RRT in newborns with UCDs, OAs, and MSUD. Twelve newborns (8 with UCDs, 2 with methylmalonic acidemia, and 2 with MSUD) underwent emergency RRT. The overall survival rate to RRT was 58.3%...
June 10, 2018: Nephrology
Rajiv Ranjan Singh, Rama Walia, Naresh Sachdeva, Ashish Bhalla, Akash Singh, Virendra Singh
AIM: Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites. METHODS: The study included 66 consecutive non-septic cirrhosis patients with ascites. RAI was defined by a delta cortisol lower than 9 μg/dL and/or a peak cortisol lower than 18 μg/dL. RESULTS: Sixty-six patients with cirrhosis and ascites were studied...
May 23, 2018: Digestive and Liver Disease
Demet Demirkol, Umay Kavgacı, Burcu Babaoğlu, Serhan Tanju, Banu Oflaz Sözmen, Suda Tekin
BACKGROUND: The aim of this case report is to discuss diagnostic workup and clinical management of cytomegalovirus reactivation in a critically ill immunocompetent pediatric patient. CASE PRESENTATION: A 2-year-old white boy who had no medical history presented with respiratory distress and fever. His Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction scores were 20 and 11, respectively. Our preliminary diagnosis was multiple organ dysfunction secondary to sepsis...
June 11, 2018: Journal of Medical Case Reports
Liam Byrne, Nchafatso G Obonyo, Sara D Diab, Kimble R Dunster, Margaret R Passmore, Ai-Ching Boon, Louise See Hoe, Sanne Pedersen, Mohd Hashairi Fauzi, Leticia Pretti Pimenta, Frank Van Haren, Christopher M Anstey, Louise Cullen, John-Paul Tung, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Fluid resuscitation is widely considered a life saving intervention in septic shock however recent evidence has questioned both its safety and efficacy in sepsis. This study sought to compare fluid resuscitation with vasopressors with vasopressors alone in a hyperdynamic model of ovine endotoxemia. METHODS: Endotoxemic shock was induced in sixteen sheep after which they received fluid resuscitation with 40mls/kg of 0.9% saline or commenced haemodynamic support with protocolized noradrenaline and vasopressin...
June 8, 2018: American Journal of Respiratory and Critical Care Medicine
Natalia Mandiá, Alejandro Pérez-Muñuzuri, Olalla López-Suárez, Carolina López-Sanguos, Adolfo Bautista-Casanovas, Mariá-Luz Couce
INTRODUCTION: Hereditary multiple intestinal atresia associated with severe combined immunodeficiency (MIA-SCID) is a very rare disease caused by deleterious mutations in the tetratricopeptide repeat domain-containing protein 7A gene TTC7A. It is characterized by intestinal obstruction, sepsis, and a poor prognosis. Insights into phenotype-genotype correlations could help to guide genetic counseling and increase our knowledge of the natural history of this disease. CASE PRESENTATION: We report the case of a newborn in which his fetal magnetic resonance imaging showed jejunal atresia and microcolon and an abdominal x-ray at birth confirmed intestinal obstruction...
June 2018: Medicine (Baltimore)
Muzzafar Zaman, Kunal Chowdhary, Gurinder Kaur, Aliya Shah
Objectives: Amoebiasisis a common parasitic infection and fulminant amoebic colitis remains a very rare complication of this disease. The objective of the present study was to find the incidence and outcome of perforation peritonitis due to amoebic colitis in MMIMSR, Mullana, Ambala, India. Material and methods: 200 patients with perforation peritonitis were studied retrospectively, out of which 22 cases had colonic perforation, were selected over a period of five years, between 2012 to 2017, at MMIMSR Mullana...
March 2018: Mædica
Sophia Lionaki, Eystratios Tsakonas, Athina Androulaki, George Liapis, Panagiotis Panayiotidis, George Zavos, John N Boletis
This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function...
2018: Case Reports in Nephrology
Suzana Bojic, Jelena Kotur-Stevuljevic, Aleksandra Aleksic, Jasna Gacic, Lidija Memon, Sanja Simic-Ogrizovic
Background: The role of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in sepsis after major abdominal surgery and sepsis-associated organ dysfunction is unexplored. Materials and Methods: Fifty-three patients with sepsis after major abdominal surgery were compared to 50 operated and 50 nonoperated controls. MMP-9, TIMP-1, biomarkers of inflammation, kidney and liver injury, coagulation, and metabolic disorders were measured daily during 96 h following diagnosis of sepsis and once in controls...
2018: Disease Markers
Andrew McNeice, Ryan Scott, Gerard Patrick Rafferty, William Jonathan Cash, Graham Blake Turner
Hepatobiliary complications of hypoalimentation and parenteral nutrition (PN) are widely recognised. Hypoalimentation includes conditions such as anorexia nervosa (AN), obesity malnutrition and liver disease following bariatric surgery. Treatment of the underlying condition causing hypoalimentation can result in an improvement in liver dysfunction. Liver function test abnormalities are also commonly found in patients on PN, with the three main complications being steatosis, cholestasis and biliary system sludge/stones...
May 31, 2018: Irish Journal of Medical Science
Liu Yong-Jun, Sun Qing, Chen Juan, Chen Min-Ying, Ouyang Bin, Sun Hua-Dong, Nie Yao, Wang Ping-Ping, Ma Jie, Guan Xiang-Dong
BACKGROUND: To investigate the effect of biliary tract external drainage (BTED) on inflammatory mediators and pathomorphism of intestine, liver, and lung in septic rats. METHOD: 48 SD rats (n=8 per group) were randomized into six groups: control, sepsis, sepsis plus BTED, normal bile (obtained from 8 healthy rats) and septic bile infusion for 6 hours respectively to test the effects of BTED bile infusion on cytokines' expression and tissue injury in the intestine, liver, and lung of septic/normal rats...
May 25, 2018: Journal of Trauma and Acute Care Surgery
Chrysostomos V Aravanis, Alkistis Kapelouzou, Stylianos Vagios, Diamantis I Tsilimigras, Michalis Katsimpoulas, Demetrios Moris, Theano D Demesticha, Dimitrios Schizas, Alkiviadis Kostakis, Anastasios Machairas, Theodore Liakakos
OBJECTIVE: To investigate the expression of toll-like receptors (TLRs) in the liver of septic mouse model. MATERIALS AND METHODS: For this study seventy-two C57BL/6J mice were utilized. Sepsis was induced by cecal ligation and puncture (CLP) in the mice of the three septic (S) groups (euthanized at 24 hours, 48 hours and 72 hours). Sham (laparotomy)- operated mice constituted the control (C) groups (euthanized at 24, 48 and 72 hours). Blood samples were drawn and liver tissues were extracted and examined histologically...
May 30, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Xiaodong Li, Pei Wang, Changyu Yu, Xiaowei Yan, Jing Yin
Objective: To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Methods: Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Triantafyllos Doulias, Stefanie Quickert, Sebastien Weis, Ralf A Claus, Konstantina Kontopoulou, Evangelos J Giamarellos-Bourboulis, Michael Bauer, Ioannis M Koutelidakis
BACKGROUND: Controversial clinical findings of low-dose hydrocortisone supplementation in septic shock led us to investigate the impact of administration in lethal septic shock in adrenalectomized rats. MATERIALS AND METHODS: After preliminary experiments, to define the intravenous dose of hydrocortisone delivered in bilaterally adrenalectomized rats with serum cortisol level similar to sham rats, survival experiments were run in 75 rats after intraperitoneal challenge with Escherichia coli...
July 2018: Journal of Surgical Research
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