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Portal hypertension

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https://www.readbyqxmd.com/read/29782618/liver-targeted-therapies-for-hepatocellular-carcinoma-prior-to-transplant-contemporary-management-strategies
#1
Mustafa Nazzal, Sameer Gadani, Abdullah Said, Mandy Rice, Obi Okoye, Ahmad Taha, Krista L Lentine
Hepatocellular carcinoma (HCC) is an aggressive neoplastic disease that has been rapidly increasing in incidence. It usually occurs in the background of liver disease, and cirrhosis. Definitive therapy requires surgical resection. However, in majority of cases surgical resection is not tolerated, especially in the presence of portal hypertension and cirrhosis. Orthotopic liver transplant (OLT) in well selected candidates has been accepted as a viable option. Due to a relative scarcity of donors compared to the number of listed recipients, long waiting times are anticipated...
April 2018: Glob Surg
https://www.readbyqxmd.com/read/29781346/distribution-characteristics-of-cells-in-splenomegaly-due-to-hepatitis-b-related-cirrhotic-portal-hypertension-and-their-clinical-importance
#2
Xiaoyu Han, Yunfu Lv, Yejuan Li, Jie Deng, Qingan Qiu, Ning Liu, Shuya Zhao, Caixian Liao
Objectives To investigate peripheral cytopenia in patients with splenomegaly due to hepatitis B-related cirrhotic portal hypertension (HBRCPH) by comparing blood cell counts from enlarged spleens with peripheral blood. Methods This prospective study involved patients undergoing splenectomy at the Nangfang Hospital from June 2013 to December 2015. Blood cell counts from peripheral blood were compared with those from splenic blood taken during splenectomies. Results Clinical data were available from 30 patients...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29780579/managing-portal-hypertension-in-patients-with-liver-cirrhosis
#3
REVIEW
Tilman Sauerbruch, Robert Schierwagen, Jonel Trebicka
Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous...
2018: F1000Research
https://www.readbyqxmd.com/read/29774155/is-de-novo-hepatocellular-carcinoma-after-transjugular-intrahepatic-portosystemic-shunt-increased
#4
A Hüsing-Kabar, T Meister, M Köhler, W Domschke, I Kabar, C Wilms, B Hild, H H Schmidt, H S Heinzow
Background: Portal hypertension is a major complication of liver cirrhosis. Transjugular intrahepatic portosystemic shunt is effective in treatment of portal hypertension. However, decreased parenchymal portal venous flow after transjugular intrahepatic portosystemic shunt insertion favours ischaemic liver injury which has been discussed to induce hepatocarcinogenesis causing hepatocellular cancer. Aim: This study aimed to explore the association between transjugular intrahepatic portosystemic shunt placement and the development of hepatocellular cancer...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29770770/adjustable-diameter-tips-in-the-pediatric-patient-the-constrained-technique
#5
Brandon C Perry, Eric J Monroe, Giridhar Shivaram
Placement of transjugular intrahepatic portosystemic shunt (TIPS) is necessary in children with portal hypertension complicated by variceal bleeding or ascites. However, placement of adult-sized endografts may be problematic due to the smaller anatomy of pediatric patients. On the other hand, placement of fixed diameter smaller stents have the corresponding problem of not accommodating future growth of the child. We describe a novel method to create an adjustable diameter TIPS as a technical solution to these problems...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29770667/-clinical-characteristics-of-16-newly-discovered-advanced-schistosomiasis-patients-in-dongpo-district-meishan-city-sichuan-province
#6
Zhou Zhi, Xu Jia, Zhang Yi
OBJECTIVE: To understand the clinical characteristics of newly discovered advanced schistosomiasis patients in Dongpo District, Meishan City, Sichuan Province, so as to provide the reference for enhancing the clinicians' awareness for diagnosis and treatment of this disease and improving the therapeutic effect. METHODS: The data of medical records and schedule of case survey of 16 newly discovered advanced schistosomiasis patients in Dongpo District, Meishan City, Sichuan Province were collected and analyzed...
April 17, 2018: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29766730/-splanchnic-vein-thrombosis
#7
Sylva Lajzová, Radek Kroupa, Alena Buliková, Šárka Bohatá, Barbora Packová, Michal Šenkyřík
Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29761167/phenotypic-spectrum-and-diagnostic-pitfalls-of-abcb4-deficiency-depending-on-age-of-onset
#8
Stephanie Barbara Schatz, Christoph Jüngst, Verena Keitel-Anselmo, Ralf Kubitz, Christina Becker, Patrick Gerner, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, Daniel Wenning, Stephan Gehring, Stefan Arens, Dirk Bretschneider, Dirk Grothues, Guido Engelmann, Frank Lammert, Ulrich Baumann
Genetic variants in the adenosine triphosphate-binding cassette subfamily B member 4 ( ABCB4 ) gene, which encodes hepatocanalicular phosphatidylcholine floppase, can lead to different phenotypes, such as progressive familial intrahepatic cholestasis (PFIC) type 3, low phospholipid-associated cholelithiasis, and intrahepatic cholestasis of pregnancy. The aim of this multicenter project was to collect information on onset and progression of this entity in different age groups and to assess the relevance of this disease for the differential diagnosis of chronic liver disease...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29761165/a-real-world-observational-cohort-of-patients-with-primary-biliary-cholangitis-target-primary-biliary-cholangitis-study-design-and-rationale
#9
Cynthia Levy, Christopher L Bowlus, Elizabeth Carey, Julie M Crawford, Karen Deane, Marlyn J Mayo, W Ray Kim, Michael W Fried
Primary biliary cholangitis (PBC) is a rare chronic cholestatic liver disease that may progress to biliary cirrhosis if left untreated. The first-line therapy for PBC is ursodeoxycholic acid (UDCA). Unfortunately, 1 of 3 patients does not respond to UDCA. These patients are at risk for developing clinical events, including cirrhosis, complications of portal hypertension, hepatocellular carcinoma, liver transplant, or death. Recently, the U.S. Food and Drug Administration approved obeticholic acid to be used in certain patients with PBC...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29758336/grand-rounds-hepatic-manifestations-of-telomere-biology-disorders
#10
REVIEW
Mrinal M Patnaik, Patrick S Kamath, Douglas A Simonetto
Clinical Case A 51 year old Caucasian male was referred for evaluation of variceal bleeding. Laboratory tests were remarkable for mild thrombocytopenia and moderate alkaline phosphatase elevation. Synthetic liver function was well preserved. Abdominal computed tomography scan revealed moderate splenomegaly, gastric varices, and normal hepatic contour. A transjugular liver biopsy was performed revealing findings of nodular regenerative hyperplasia (NRH) with no significant fibrosis or necroinflammatory activity...
May 11, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29751198/price-to-pay-portal-vein-arterialization-for-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-a-case-report
#11
Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-Iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can't be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son...
May 2, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29748815/improved-hemodynamic-and-liver-function-in-portal-hypertensive-cirrhotic-rats-after-administration-of-b-pseudocatenulatum-cect-7765
#12
Isabel Gómez-Hurtado, Pedro Zapater, Kevin Portune, Oriol Juanola, Anabel Fernández-Iglesias, José M González-Navajas, Jordi Gracia-Sancho, Yolanda Sanz, Rubén Francés
PURPOSE: Evaluating whether changes in gut microbiota induced by a bifidobacterial strain may have an effect on the hepatic vascular function in portal hypertensive cirrhotic rats. METHODS: Bile duct ligation (BDL) was performed in rats. A subgroup of animals received B. pseudocatenulatum CECT7765 (109  cfu/daily ig.) for 1 week prior to laparotomy. Hemodynamic, biochemical and inflammatory markers were evaluated. Ileal microbiota composition was identified. Statistical analysis was performed...
May 10, 2018: European Journal of Nutrition
https://www.readbyqxmd.com/read/29745475/metabolic-disorders-across-hepatocellular-carcinoma-in-italy
#13
Filomena Morisco, Maria Guarino, Maria Rosa Valvano, Francesco Auriemma, Fabio Farinati, Edoardo G Giannini, Francesca Ciccarese, Francesco Tovoli, Gian Ludovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Rodolfo Sacco, Giuseppe Cabibbo, Martina Felder, Luisa Benvengù, Antonio Gasbarrini, Gianluca Svegliati Baroni, Francesco Giuseppe Foschi, Elisabetta Biasini, Alberto Masotto, Roberto Virdone, Fabio Marra, Nicola Caporaso, Franco Trevisani
BACKGROUND: Metabolic disorders are well known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its etiology. METHODS: We analyzed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analyzed: BMI, diabetes, arterial hypertension, hypercholesterolemia and hypertriglyceridemia...
May 10, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29743803/portal-hypertension-in-a-patient-with-recurrent-pancreatic-cancer-after-radiotherapy-and-systemic-chemotherapy
#14
Xingshun Qi, Ji Feng, Xiaodong Shao, Ying Xu, Hongyu Li, Xiaozhong Guo
No abstract text is available yet for this article.
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29738332/anesthetic-care-of-2-siblings-with-neonatal-ichthyosis-and-sclerosing-cholangitis-syndrome-case-reports
#15
Céline Khalifa, Geoffrey Boliaki Botombe, Xavier Stephenne, Francis Veyckemans
We report for the first time the anesthetic management of 2 sisters suffering from neonatal ichthyosis and sclerosing cholangitis syndrome. They both presented with neonatal cholestatic jaundice and ichthyosis. The first was admitted for orthotopic liver transplantation at the age of 1 year, and the second patient underwent open pyeloplasty for a pyeloureteric junction syndrome at the age of 4 years. These 2 case reports highlight that, except for the potential difficulties with securing the catheters, dressings and endotracheal tube to the skin, the anesthetic implications of neonatal ichthyosis and sclerosing cholangitis syndrome are mainly related to the liver disease: cirrhosis and portal hypertension...
May 7, 2018: A&A practice
https://www.readbyqxmd.com/read/29730740/congenital-portosystemic-shunts-diagnosis-and-treatment
#16
Stéphanie Franchi-Abella, Emmanuel Gonzales, Oanez Ackermann, Sophie Branchereau, Danièle Pariente, Florent Guérin
Congenital portosystemic shunts (CPSS) are rare vascular malformations that create an abnormal connection between portal and systemic veins resulting in complete or partial diversion of the portal flow away from the liver to the systemic venous system. Different anatomic types exist and several classifications have been proposed. They can be associated with other malformations especially cardiac and heterotaxia. The main complications include hepatic encephalopathy, liver tumors, portopulmonary hypertension, and pulmonary arteriovenous shunts...
May 5, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29729368/a-combined-model-based-on-spleen-stiffness-measurement-and-baveno-vi-criteria-to-rule-out-high-risk-varices-in-advanced-chronic-liver-disease
#17
Antonio Colecchia, Federico Ravaioli, Giovanni Marasco, Agostino Colli, Elton Dajti, Annarita Di Biase, Maria Letizia Bacchi Reggiani, Annalisa Berzigotti, Massimo Pinzani, Davide Festi
BACKGROUND & AIMS: Recently, Baveno VI guidelines suggested that esophagogastroduodenoscopy (EGD) can be avoided in patients with cACLD who have a liver stiffness measurement (LSM) < 20 kPa and platelet count >150,000/mm3 . We aimed to: assess the performance of spleen stiffness measurement (SSM) in ruling out patients with high-risk varices (HRV); validate Baveno VI criteria in a large population and assess how the sequential use of Baveno VI criteria and SSM could safely avoid the need for endoscopy...
May 2, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29728708/emricasan-a-pan-caspase-inhibitor-improves-survival-and-portal-hypertension-in-a-murine-model-of-common-bile-duct-ligation
#18
Akiko Eguchi, Yukinori Koyama, Alexander Wree, Casey D Johnson, Ryota Nakamura, Davide Povero, David Kneiber, Masahiko Tameda, Patricia Contreras, Al Spada, Ariel E Feldstein
Development of portal hypertension (PHT) is a central prognostic factor in patients with cirrhosis. Circulating microparticles (MPs) are released by hepatocytes in a caspase-dependent manner, are increased in circulation of patients with cirrhosis, and contribute to PHT via induction of impaired vasoconstrictor responses. Here, we tested the hypothesis that emricasan, a pan-caspase inhibitor, ameliorates PHT and reduction in release of MPs. We used a short-term and long-term protocol following common bile-duct ligation (BDL) in C57BL/6 mice (10 and 20 days, respectively)...
May 5, 2018: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/29724520/long-term-toxicity-after-transarterial-radioembolization-with-yttrium-90-using-resin-microspheres-for-neuroendocrine-tumor-liver-metastases
#19
Yuki Tomozawa, Younes Jahangiri, Priya Pathak, Kenneth J Kolbeck, Ryan C Schenning, John A Kaufman, Khashayar Farsad
PURPOSE: To evaluate long-term effects of yttrium-90 (90 Y) transarterial radioembolization (TARE) for unresectable hepatic metastases of neuroendocrine tumors (NETs). MATERIALS AND METHODS: Retrospective analysis of 93 patients (47 women, 46 men; mean age 59 y) who underwent resin-based 90 Y TARE was performed. Variables associated with overall survival were analyzed using univariate and multivariate models. Changes in serologic values and imaging characteristics were assessed with long-term follow-up...
April 30, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29723809/global-sensitivity-analysis-of-hepatic-venous-pressure-gradient-hvpg-measurement-with-a-stochastic-computational-model-of-the-hepatic-circulation
#20
Tianqi Wang, Fuyou Liang, Zunqiang Zhou, Xiaolong Qi
Hepatic venous pressure gradient (HVPG) is a widely employed surrogate of portal pressure gradient (PPG) in the diagnosis of portal hypertension (PHT). However, little is known about how HVPG measurement is affected by the complex vascular changes associated with PHT. In this study, we employed a computational method to quantitatively evaluate the sensitivity of HVPG measurement to various vascular factors involved in the development of sinusoidal PHT, aiming to provide a theoretical reference to guide the clinical application of HVPG measurement...
April 25, 2018: Computers in Biology and Medicine
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