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Portal hypertension

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https://www.readbyqxmd.com/read/28079668/noninvasive-assessment-of-portal-hypertension-and-detection-of-esophageal-varices-in-cirrhosis-state-of-the-art
#1
Ana C de Oliveira
Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#2
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28079234/evaluation-of-endoscopic-secondary-prophylaxis-in-children-and-adolescents-with-esophageal-varices
#3
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Eleonora Druve Tavares Fagundes, Paulo Fernando Souto Bittencourt, Alice Mendes Moura, Simone Diniz Carvalho
BACKGROUND: - Bleeding of esophageal varices is the main cause of morbidity and mortality in children and adults with portal hypertension and there are few studies involving secondary prophylaxis in children and adolescents. OBJECTIVE: - To evaluate the efficacy of endoscopic secondary prophylaxis in prevention of upper gastrointestinal bleeding in children and adolescents with esophageal varices. METHODS: - This is a prospective analysis of 85 patients less than 18 years of age with or without cirrhosis, with portal hypertension...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28072750/upper-gastrointestinal-ectopic-variceal-bleeding-treated-with-various-endoscopic-modalities-case-reports-and-literature-review
#4
Sang Woo Park, Eunae Cho, Chung Hwan Jun, Sung Kyu Choi, Hyun Soo Kim, Chang Hwan Park, Jong Sun Rew, Sung Bum Cho, Hee Joon Kim, Mingui Han, Kyu Man Cho
RATIONALE: Ectopic variceal bleeding is a rare (2-5%) but fatal gastrointestinal bleed in patients with portal hypertension. Patients with ectopic variceal bleeding manifest melena, hematochezia, or hematemesis, which require urgent managements. Definitive therapeutic modalities of ectopic varices are not yet standardized because of low incidence. Various therapeutic modalities have been applied on the basis of the experiences of experts or availability of facilities, with varying results...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070962/transjugular-intrahepatic-portosystemic-shunt-indications-complications-survival-and-its-use-as-a-bridging-therapy-to-liver-transplant-in-western-australia
#5
Puraskar Pateria, Gary P Jeffrey, George Garas, Jonathan Tibballs, John Ferguson, Luc Delriviere, Yi Huang, Leon A Adams, Gerry MacQuillan
INTRODUCTION: Insertion of transjugular intrahepatic portosystemic shunt (TIPS) is an established therapeutic option to treat the complications of portal hypertension. The purpose of this study is to review the experience of a single Australian institute with TIPS and evaluation of result to emphasize the indication, aetiology of portal hypertension, prognostic factors, complications and survival. Use of TIPS as a bridge to liver transplantation was also analysed. METHOD: A retrospective cohort study of patients treated with TIPS at The Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, over a period of 12 years...
January 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28069787/bilateral-indwelling-pleural-catheter-for-hepatic-hydrothorax
#6
Rossella D'Amato, Luisa E Eiroa González, Ana Isabel Hernández Méndez
A 68-year-old man with alcoholic liver cirrhosis and portal hypertension was admitted due to ascites. Bilateral severe hepatic hydrothorax did not resolve despite sodium restriction, and diuretic treatment, requiring repeated thoracentesis for relief of dyspnoea. Curative options, as transjugular intrahepatic portosystemic shunt and liver transplantation were both contraindicated. An attempt of pleurodesis was ineffective. Bilateral insertion of tunnelled pleural catheter allowed symptom control and home discharge...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28066855/spectrum-of-small-bowel-mucosal-abnormalities-identified-by-capsule-endoscopy-in-patients-with-portal-hypertension-of-varied-etiology
#7
T S Chandrasekar, Gokul Bollu Janakan, Viveksandeep Thoguluva Chandrasekar, Raja Yogesh Kalamegam, Sathiamoorthy Suriyanarayanan, Prasad Menta Sanjeevaraya
BACKGROUND: Bleeding from small intestinal ectopic varices and persistent anemia caused by portal hypertensive enteropathy (PHE) can be very challenging. Capsule endoscopy (CE) is one of the best noninvasive modalities in identifying such lesions. AIM: The aims of this study are to study the prevalence of small-bowel changes related to portal hypertension (PHT) and to correlate them with the observations related to the effects of portal hypertension in the esophagus, stomach, and colon...
January 9, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28064299/idiopathic-duodenal-varix-presenting-as-a-massive-upper-gastrointestinal-bleeding-a-case-report
#8
N H Zubaidah, J H Asraf, L Lee, T Gee
Ectopic variceal bleeding is both a diagnostic dilemma and a therapeutic challenge, especially when it is located in the third part of the duodenum. Varix is rare in the absence of cirrhosis or portal hypertension. Because the diagnosis of this condition is usually delayed, treatment is administered late resulting in high morbidity and mortality rate. We report a case of a 61-year-old lady with an idiopathic duodenal varix presenting as an upper gastrointestinal bleeding.
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28060975/-prevalence-of-cardiovascular-risk-factors-in-a-rural-aymara-population-from-northern-chile
#9
Pablo Vargas M, Stephanie Saavedra P, María Virginia Araya A, Khanty Loyola A, Patricio Huerta G, Mariana Silva A, Scarlett Araya C, Willybaldo Saavedra A, Pilar Portales P, Willybaldo Saavedra P
BACKGROUND: Some rural non-Caucasian ethnic groups have genetic protective factors for the development of chronic non-communicable diseases. Studies performed in Mapuche and Aymara ethnic groups in Chile, found significantly lower prevalence rates. Aymaras are the second most common ethnic population in Chile. AIM: To determine the prevalence of cardiovascular risk factors in a native Aymara ethnic population. MATERIAL AND METHODS: We studied 276 native Aymara people with a median age of 53 years (63% women), registered in the rural clinics of Camiña and Putre...
September 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28060241/disease-reversibility-in-patients-with-posthepatitis-c-cirrhosis-is-the-point-of-no-return-the-same-before-and-after-liver-transplantation-a-review
#10
Carmen Vinaixa, Simone I Strasser, Marina Berenguer
Liver fibrosis can regress in patients with chronic hepatitis in whom the underlying cause of liver damage is adequately treated. Studies documenting this benefit have been mostly performed in the setting of viral hepatitis, particularly hepatitis C virus (HCV), where sustained viral response (SVR) has been unequivocally shown to result in histological and clinical improvement. With the advent of the new interferon (IFN)-free regimens, highly effective and safe even in those historically considered "difficult to treat and cure patients", additional benefits have been documented in patients treated at advanced stages of disease, including improvement in liver function with hepatic "re-compensation", reduction of portal hypertension, and eventually avoidance of liver transplantation (LT)...
January 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28058764/diagnosis-and-treatment-guidelines-for-aberrant-portal-hemodynamics
#11
Fuminori Moriyasu, Yoshihiro Furuichi, Atsushi Tanaka, Hajime Takikawa, Hiroshi Yoshida, Isao Sakaida, Katsutoshi Obara, Makoto Hashizume, Masayoshi Kage, Satoko Ohfuji, Seigo Kitano, Seiji Kawasaki, Shigehiro Kokubu, Shoichi Matsutani, Susumu Eguchi, Susumu Shiomi, Tetsuhito Kojima, Yoshihiko Maehara, Yukio Kuniyoshi
Idiopathic portal hypertension (IPH), causing aberrant portal hemodynamics, is a disease with an as yet unidentified cause and no treatment has been established so far. The Japanese research group on IPH in Japan was set up in 1975 by the Ministry of Health, Labour and Welfare, furthermore extra-hepatic portal obstruction (EHO) and Budd-Chiari syndrome (BCS) have been added to the research subjects and further work has continued. The aims of the research group are to accurately evaluate the current status of the three diseases in Japan, elucidate the disease aetiology and pathogenesis, and develop new treatments...
January 6, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28058552/complications-after-hepatectomy-for-hepatocellular-carcinoma-independently-shorten-survival-a-western-single-center-audit
#12
Alexandre Doussot, Chetana Lim, Eylon Lahat, Chady Salloum, Michael Osseis, Concepción Gómez Gavara, Eric Levesque, Cyrille Feray, Philippe Compagnon, Daniel Azoulay
BACKGROUND: The impact of postoperative complications (POCs) on long-term outcomes following hepatocellular carcinoma (HCC) resection remains to be ascertained. METHODS: All consecutive HCC resected at a single center were analyzed. Patients with POCs, classified according to Clavien classification, were compared to those without in terms of demographics, pathology, management, overall survival (OS), and disease-free survival (DFS). Independent prognostic factors of POCs were identified using multivariable regression models...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28052623/prevention-and-treatment-of-variceal-haemorrhage-in-2017
#13
REVIEW
Felix Brunner, Annalisa Berzigotti, Jaime Bosch
Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28051803/%C3%A2-observational-cohort-study-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips
#14
Michaela Routhu, Vaclav Safka, Sunil Kumar Routhu, Tomas Fejfar, Vaclav Jirkovsky, Antonin Krajina, Eva Cermakova, Ladislav Hosak
:  Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this study was to compare two groups of patients who did and did not develop overt HE after TIPS. We looked for differences between these groups before TIPS. MATERIALS AND METHODS: A study of 895 patients was conducted based on a retrospective analysis of clinical data...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28051788/%C3%A2-right-hepatic-lobe-resection-and-thrombocytopenia
#15
Abimbola Adike, Jorge Rakela, Christopher Czaplicki, Adyr Moss, Elizabeth Carey
 Thrombocytopenia has previously been reported after right lobe resection for organ donation. The mechanism(s) of low platelets after right hepatectomy is unclear and several hypotheses have been proposed including a decrease in thrombopoietin, and hepatic insufficiency resulting in relative portal hypertension following hepatic resection. However, there has previously not been any comparison between patients who undergo hepatic resection for neoplasia vs. for living organ donation. We compared platelet values in the postoperative period of patients who underwent right hepatectomy for living donation (n = 93) to those who underwent hepatectomy for neoplasia (n = 21)...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28045719/hepatic-histology-and-morphometric-measurements-in-idiopathic-extrahepatic-portal-vein-thrombosis-in-children-correlated-to-clinical-outcome-of-meso-rex-bypass
#16
Niramol Tantemsapya, Riccardo Superina, Deli Wang, Grace Kronauer, Peter F Whitington, Hector Melin-Aldana
OBJECTIVE: The aim of this study was to correlate clinical, histologic, and morphometric features of the liver in children with extrahepatic portal vein thrombosis (EHPVT), with surgical outcome after Meso-Rex bypass (MRB). BACKGROUND: Idiopathic EHPVT, a significant cause of portal hypertension, is surgically corrected by MRB. Correlation of histologic and morphometric features of the liver with outcome has not been reported in children. METHODS: We retrospectively reviewed clinical and intraoperative data of 45 children with idiopathic EHPVT...
December 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28043789/intrahepatic-upregulation-of-mrtf-a-signaling-contributes-to-increased-hepatic-vascular-resistance-in-cirrhotic-rats-with-portal-hypertension
#17
Lei Zheng, Jun Qin, Longci Sun, Liang Gui, Chihao Zhang, Yijun Huang, Wensheng Deng, An Huang, Dong Sun, Meng Luo
BACKGROUND: Portal hypertension in cirrhosis is mediated, in part, by increased intrahepatic resistance, reflecting massive structural changes associated with fibrosis and intrahepatic vasoconstriction. Activation of the Rho/MRTF/SRF signaling pathway is essential for the cellular regulatory network of fibrogenesis. The aim of this study was to investigate MRTF-A-mediated regulation of intrahepatic fibrogenesis in cirrhotic rats. METHODS: Portal hypertension was induced in rats via an injection of CCl4 oil...
December 30, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28032650/liver-capsule-portal-hypertension-and-varices-pathogenesis-stages-and-management
#18
Dennis L Shung, Guadalupe Garcia-Tsao
No abstract text is available yet for this article.
December 29, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28029328/when-what-and-why-of-perioperative-treatment-of-potentially-curable-pancreatic-adenocarcinoma
#19
Kimberly Perez, Thomas E Clancy, Joseph D Mancias, Michael H Rosenthal, Brian M Wolpin
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28025064/effects-of-nuclear-factor-e2-related-factor-2-heme-oxygenase-1-on-splanchnic-hemodynamics-in-experimental-cirrhosis-with-portal-hypertension
#20
Jun Qin, Yue He, Ming Duan, Meng Luo
OBJECTIVE: We explored the effects of Nuclear Factor-E2-related factor 2 (Nrf2) and Heme Oxygenase 1 (HO-1) on splanchnic hemodynamics in portal hypertensive rats. METHODS: Experimental cirrhosis with portal hypertension was induced by intraperitoneal injection of carbon tetrachloride. The expression of proteins was examined by immunoblotting. Hemodynamic studies were performed by radioactive microspheres. The vascular perfusion system was used to measure the contractile response of mesentery arterioles in rats...
December 23, 2016: Microvascular Research
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