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Portal hypertension

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https://www.readbyqxmd.com/read/28223722/to-screen-or-not-to-screen-celiac-antibodies-in-liver-diseases
#1
REVIEW
Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon
Celiac disease (CD) is a systemic immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. The typical symptoms are anemia, diarrhea, fatigue, weight loss, and abdominal pain. CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension and liver cirrhosis. We evaluate recommendations for active screening for CD in patients with liver diseases, and the effect of a gluten-free diet in these different settings...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223261/use-of-transabdominal-ultrasound-guided-transjugular-portal-vein-puncture-on-radiation-dose-in-transjugular-intrahepatic-portosystemic-shunt-formation
#2
Aniket N Tavare, Andrew Wigham, Anastasia Hadjivassilou, Abdulrahman Alvi, Anthie Papadopoulou, Antony Goode, Nick Woodward, David Patch, Dominic Yu, Neil Davies
PURPOSE: Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose. METHODS: We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded...
February 22, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28223101/non-invasive-evaluation-of-portal-hypertension-using-ultrasound-elastography
#3
REVIEW
Annalisa Berzigotti
Portal hypertension (PH) leads to serious complications such as bleeding from gastro-esophageal varices, ascites and porto-systemic encephalopathy in patients with chronic liver disease (CLD). Since the gold-standard methods for assessing PH and its complications (measurement of hepatic venous pressure gradient, HVPG; endoscopy), are invasive expensive and not available at all centers, non-invasive methods have been increasingly investigated in the last 20 years. The present review focuses on the role of ultrasound elastography, a novel group of non-invasive techniques able to measure stiffness in target organs, to identify the presence, severity and risk of complications of PH...
February 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28220780/bacterial-infections-change-natural-history-of-cirrhosis-irrespective-of-liver-disease-severity
#4
Elena Dionigi, Matteo Garcovich, Mauro Borzio, Gioacchino Leandro, Avik Majumdar, Aikaterini Tsami, Vasiliki Arvaniti, Davide Roccarina, Massimo Pinzani, Andrew K Burroughs, James O'Beirne, Emmanuel A Tsochatzis
OBJECTIVES: We assessed the prognostic significance of infections in relation to current prognostic scores and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis. METHODS: We included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 h over a 2-year period. Diagnosis of infection was based on positive cultures or strict established criteria. We used competing risk analysis and propensity score matching for data analysis...
February 21, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28217250/advanced-non-alcoholic-steatohepatitis-cirrhosis-a-high-risk-population-for-pre-liver-transplant-portal-vein-thrombosis
#5
Jonathan G Stine, Curtis K Argo, Shawn J Pelletier, Daniel G Maluf, Stephen H Caldwell, Patrick G Northup
AIM: To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS: Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m(2), hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28216976/correlation-of-transient-elastography-with-hepatic-venous-pressure-gradient-in-patients-with-cirrhotic-portal-hypertension-a-study-of-326-patients-from-india
#6
Ashish Kumar, Noor Muhammad Khan, Shrihari Anil Anikhindi, Praveen Sharma, Naresh Bansal, Vikas Singla, Anil Arora
AIM: To study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension. METHODS: This retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28213942/pge2-ep4-attenuated-mucosal-injury-via-%C3%AE-arr1-src-egfr-mediated-proliferation-in-portal-hypertensive-gastropathy
#7
Siwei Tan, Xiaoliang Chen, Minyi Xu, Xiaoli Huang, Huiling Liu, Jie Jiang, Yu Lu, Xiaojie Peng, Bin Wu
BACKGROUND AND PURPOSE: Portal hypertensive gastropathy (PHG) is a serious complication of liver cirrhosis and a potential cause of bleeding in patients associated with cirrhosis. Suppressed mucosal epithelial proliferation is a crucial pathological characteristic of PHG. Our studies demonstrated an important role of prostaglandin E2 (PGE2 ) and its E-type prostanoid 4 (EP4 ) receptor in the promotion of mucosal proliferation. However, whether β-arrestin1 (β-arr1), a well-established mediator of G-protein-coupled receptors (GPCRs), is involved in the PGE2 /EP4 -mediated mucosal proliferation complex in PHG remains unclear...
February 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28211305/helicobacter-pylori-on-portal-hypertension-related-hepatic-encephalopathy
#8
Jannis Kountouras, Stergios A Polyzos, Panagiotis Katsinelos, Dimitri Tzivras, Marina Boziki, Emmanuel Gavalas, Christos Zavos, Elizabeth Vardaka, Iordanis Romiopoulos, Sotiris Anastasiadis, Elena Tsiaousi, Constantinos Kountouras, Georgia Xiromerisiou, Georgia Deretzi
No abstract text is available yet for this article.
April 2017: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/28203139/spontaneous-splenic-infarcts-in-a-cirrhotic-patient-with-primary-biliary-cirrhosis
#9
Fredy Nehme, Kyle Rowe, Ahmad Haris, Imad Nassif
Spontaneous splenic infarction has been rarely reported as a complication of cirrhosis and portal hypertension. We describe the case of a 67-year-old female with past medical history of primary biliary cirrhosis presenting for a 1-day history of left upper quadrant pain. Investigations were in favor of splenic infarcts secondary to portal hypertension. The patient improved with conservative management and no recurrence was noted on further follow-up. Splenic infarction must be kept in mind when a patient with cirrhosis presents with left upper quadrant abdominal pain without a clear source...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203136/massive-hemorrhage-from-ectopic-duodenal-varices-importance-of-a-multidisciplinary-approach
#10
Tyler House, Patrick Webb, Chad Baarson
Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28201851/the-design-of-clinical-trials-in-portal-hypertension
#11
Juan G Abraldes, Guadalupe Garcia-Tsao
Portal hypertension (PH) is the main consequence of cirrhosis and is responsible for the majority of its complications. Gastroesophageal varices and variceal hemorrhage are direct consequences of PH; therefore, most clinical trials in PH have been directed toward treating or preventing variceal hemorrhage. However, varices and variceal hemorrhage are not isolated events; they must be considered in the context of the presence (or absence) of other complications of cirrhosis/PH. Cirrhosis progresses across different stages, each with a different prognosis and pathophysiology and hence different therapeutic targets...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28193994/predictive-role-of-intraoperative-plasma-fibrinogen-for-postoperative-portal-venous-flow-in-living-donor-liver-transplantation
#12
Min Suk Chae, Chul Soo Park, Su A Oh, Sang Hyun Hong
BACKGROUND Previous studies have reported poor graft regeneration after living donor liver transplantation (LDLT) due to inappropriate portal venous flow (PVF). In this study, we investigated the perioperative factors affecting postoperative PVF after LDLT. MATERIAL AND METHODS The perioperative data of 366 LDLT patients were retrospectively reviewed. The average PVF on postoperative days 1, 3, and 5 was measured and dichotomized at a cut-off value for patient survival of 1,477 mL/min. Perioperative variables, including coagulation profiles, were compared between high and low postoperative PVF groups...
February 14, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28190786/survival-in-portopulmonary-hypertension-outcomes-of-the-united-kingdom-national-pulmonary-arterial-hypertension-registry
#13
Sasiharan Sithamparanathan, Arun Nair, Logan Thirugnanasothy, J Gerry Coghlan, Robin Condliffe, Konstantinos Dimopoulos, Charlie A Elliot, Andrew J Fisher, Sean Gaine, J Simon R Gibbs, Michael A Gatzoulis, Clive E Handler, Luke S Howard, Martin Johnson, David G Kiely, James L Lordan, Andrew J Peacock, Joanna Pepke-Zaba, Benjamin E Schreiber, Karen K K Sheares, Stephen J Wort, Paul A Corris
BACKGROUND: Portopulmonary hypertension (PoPH) is a rare condition associated with poor survival, and the effect of modern therapies that target pulmonary arterial hypertension (PAH) on long-term outcome is unknown. This study investigated the baseline characteristics and survival in the cohort of patients diagnosed with PoPH in the United Kingdom National Pulmonary Hypertension Service. METHODS: A retrospective review was conducted of all incident treatment-naïve patients with PoPH within the United Kingdom national registry diagnosed between January 2001 and December 2010...
December 31, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28187503/beneficial-and-harmful-effects-of-non-selective-beta-blockade-on-acute-kidney-injury-in-liver-transplant-candidates
#14
Sang Gyune Kim, Joseph J Larson, Ji Sung Lee, Therneau M Terry, W Ray Kim
Non-selective beta-blockers have played an important role in the prevention of portal hypertensive bleeding in cirrhotic patients. However, recent studies have suggested that non-selective beta-blockers may be harmful in some patients with end-stage liver disease. To evaluate the association between use of non-selective beta-blocker and the incidence of acute kidney injury (AKI). We conducted a nested case-control study in a cohort of liver transplant waitlist registrants. Each patient with AKI was matched to a control by the model for end-stage liver disease (MELD)-Na score, age, serum creatinine, and follow-up duration...
February 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28177946/transient-elastography-evaluation-of-hepatic-and-spleen-stiffness-in-patients-with-hepatosplenic-schistosomiasis
#15
Zulane S T Veiga, Cristiane A Villela-Nogueira, Flávia F Fernandes, Marta G Cavalcanti, Fátima A Figueiredo, João L Pereira, Gustavo H Pereira, Henrique S Moraes Coelho, José M Peralta, Carlos E Marques, Renata M Perez, Homero S Fogaça
BACKGROUND: Hepatosplenic schistosomiasis (HES) has not been evaluated by transient elastography so far and its correlation with ultrasound variables remains to be defined. AIMS: The aim of this study was to describe the parameters of liver and spleen stiffness in HES assessed by transient elastography in comparison with cirrhotics and controls evaluating its correlation with ultrasonographic data. PATIENTS AND METHODS: HES, hepatitis C virus-cirrhotic, and control patients were included in this sectional study...
February 7, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28166812/efficacy-of-high-intensity-focused-ultrasound-assisted-hepatic-resection-hifu-ar-on-blood-loss-reduction-in-patients-with-liver-metastases-requiring-hepatectomy-study-protocol-for-a-randomized-controlled-trial
#16
Aurélien Dupré, David Pérol, Ellen Blanc, Patrice Peyrat, Valéria Basso, Yao Chen, Jérémy Vincenot, Anthony Kocot, David Melodelima, Michel Rivoire
BACKGROUND: Liver resection is the only potentially curative treatment for colorectal liver metastases (LM). It is considered a safe procedure, but is often associated with blood loss during liver transection. Blood transfusions are frequently needed, but they are associated with increased morbidity and risk of recurrence. Many surgical devices have been developed to decrease blood loss. However, none of them has proven superior to the standard crushing technique. We developed a new, powerful intra-operative high-intensity focused ultrasound (HIFU) transducer which destroys tissue by coagulative necrosis...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28162981/caveolin-1-and-g-protein-coupled-receptor-kinase-2-coregulate-endothelial-nitric-oxide-synthase-activity-in-sinusoidal-endothelial-cells
#17
Songling Liu, Richard T Premont, Shweta Singh, Don C Rockey
Liver injury leads to a vasculopathy in which post-translational modifications of endothelial nitric oxide synthase (eNOS) lead to impaired nitric oxide synthesis. We hypothesized that caveolin 1 (CAV1), a well-known eNOS interactor, regulates eNOS activity in sinusoidal endothelial cells (SECs) via its interaction with G-protein-coupled receptor kinase-2 (GRK2) that also post-translationally modifies eNOS. Liver injury with portal hypertension was established using bile duct ligation in rats. CAV1 function was modified using a CAV1 scaffolding domain construct and cDNAs encoding wild-type CAV1, and CAV1 phosphorylation was increased in injured SECs, resulting in increased GRK2-CAV1 interaction and decreased eNOS activity...
February 2, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28162213/-clinicopathologic-features-of-hepatocellular-carcinoma-patients-surviving-more-than-10-years-after-radical-hepatectomy
#18
L Q Wu, Z S Wang, J Y Cao, W Y Hu, B Han, C D Sun, B Y Zhang, F B Qiu, S Zhang, J Y Yang, Z J Cui
Objective: To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy. Methods: Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ(2) test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28160419/adams-oliver-syndrome-review-of-the-literature-refining-the-diagnostic-phenotype
#19
Susan Hassed, Shibo Li, John Mulvihill, Christopher Aston, Susan Palmer
The Adams-Oliver syndrome (AOS) is defined as aplasia cutis congenita (ACC) with transverse terminal limb defects (TTLD). Frequencies of associated anomalies are not well characterized. Six causative genes have been identified: ARHGAP31, DOCK6, EOGT, RBPJ, NOTCH1, and DLL4. We review 385 previously described individuals (139 non-familial and 246 familial probands and family members) and add clinical data on 13 previously unreported individuals with AOS. In addition to ACC and TTLD, the most commonly associated anomalies included a wide variety of central nervous system (CNS) anomalies and congenital heart defects each seen in 23%...
February 4, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28153558/middle-east-respiratory-syndrome-coronavirus-mers-cov-outbreak-in-south-korea-2015-epidemiology-characteristics-and-public-health-implications
#20
K H Kim, T E Tandi, J W Choi, J M Moon, M S Kim
BACKGROUND: Since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea was reported on 20(th) May 2015, there have been 186 confirmed cases, 38 deaths and 16,752 suspected cases. Previously published research on South Korea's MERS outbreak was limited to the early stages, when few data were available. Now that the outbreak has ended, albeit unofficially, a more comprehensive review is appropriate. METHODS: Data were obtained through the MERS portal by the Ministry for Health and Welfare (MOHW) and Korea Centres for Disease Control and Prevention, press releases by MOHW, and reports by the MERS Policy Committee of the Korean Medical Association...
February 2017: Journal of Hospital Infection
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