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Portal hypertension

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https://www.readbyqxmd.com/read/29158886/noninvasive-evaluation-of-portal-hypertension-using-a-supervised-learning-technique
#1
Mindaugas Marozas, Romanas Zykus, Andrius Sakalauskas, Limas Kupčinskas, Arūnas Lukoševičius
Portal hypertension (PHT) is a key event in the evolution of different chronic liver diseases and leads to the morbidity and mortality of patients. The traditional reliable PHT evaluation method is a hepatic venous pressure gradient (HVPG) measurement, which is invasive and not always available or acceptable to patients. The HVPG measurement is relatively expensive and depends on the experience of the physician. There are many potential noninvasive methods to predict PHT, of which liver transient elastography is determined to be the most accurate; however, even transient elastography lacks the accuracy to be a perfect noninvasive diagnostic method of PHT...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29152039/hepatic-hydrothorax-an-update-and-review-of-the-literature
#2
REVIEW
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29150327/diagnostic-accuracy-of-point-shear-wave-elastography-in-the-detection-of-portal-hypertension-in-pediatric-patients
#3
M Burak Özkan, M C Bilgici, E Eren, G Caltepe
PURPOSE: The purpose of this study was to determine the usefulness of point shear wave elastography (p-SWE) of the liver and spleen for the detection of portal hypertension in pediatric patients. MATERIALS AND METHODS: The study consisted of 38 healthy children and 56 pediatric patients with biopsy-proven liver disease who underwent splenic and liver p-SWE. The diagnostic performance of p-SWE in detecting clinically significant portal hypertension was assessed using receiver operating characteristic (ROC) curves...
November 14, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29145760/non-cirrhotic-portal-hypertension-associated-with-multicentric-castleman-s-disease-a-case-report
#4
Ana Luísa Pinto, Marília Gomes, Maria Augusta Cipriano, Maria Letícia Ribeiro
No abstract text is available yet for this article.
November 17, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29142474/clinical-features-of-alcoholic-hepatitis-in-latinos-and-caucasians-a-single-center-experience
#5
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
AIM: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29130338/colonic-hydrogen-sulfide-produces-portal-hypertension-and-systemic-hypotension-in-rats
#6
Tomasz Huc, Halina Jurkowska, Maria Wróbel, Kinga Jaworska, Maksymilian Onyszkiewicz, Marcin Ufnal
Hydrogen sulfide, a toxic gas, at low concentrations is also a biological mediator in animals. In the colon, hydrogen sulfide is produced by intestinal tissues and gut sulfur bacteria. Gut-derived molecules undergo liver metabolism. Portal hypertension is one of the most common complications contributing to the high mortality in liver cirrhosis. We hypothesized that the colon-derived hydrogen sulfide may affect portal blood pressure. Sprague-Dawley rats were maintained either on tap water (controls) or on water solution of thioacetamide to produce liver cirrhosis (CRH-R)...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29124669/shunt-occlusion-for-portosystemic-shunt-syndrome-related-refractory-hepatic-encephalopathy-a-single-center-experience-in-21-patients-from-kerala
#7
Cyriac Abby Philips, Lijesh Kumar, Philip Augustine
INTRODUCTION: Large spontaneous portosystemic shunts (SPSS) are seen in a subset of patients with liver disease and medically refractory recurrent/persistent hepatic encephalopathy (MRHE). Shunt occlusion has been shown to improve clinical outcomes. METHODS: We retrospectively analyzed patient characteristics, SPSS attributes, procedural features, baseline clinical and investigational parameters, neurological outcomes, adverse effects (procedure and portal hypertension related), and risk factors predicting outcomes in liver disease patients undergoing shunt occlusion procedure for MRHE...
November 10, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29123879/direct-intrahepatic-portocaval-shunt-for-refractory-hepatic-hydrothorax-a-case-report
#8
Yo Kawahara, Yoshihiro Tanaka, Naoaki Isoi, Kohsuke Hatanaka, Kentaro Yamada, Masayoshi Yamamoto, Teppei Okamura, Tatsumi Kaji, Toshihisa Sakamoto, Daizoh Saitoh, Hisashi Ikeuchi
Case: A 64-year-old man with complaints of dyspnea and orthopnea secondary to a hepatic hydrothorax refractory to diuretic medication underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure to decrease the portal vein pressure. The TIPS procedure failed due to severe liver stiffness. Direct intrahepatic portocaval shunt (DIPS), a modified TIPS procedure that directly inserts a stent from the inferior vena cava to the portal vein, was successfully carried out. Outcome: The DIPS procedure significantly decreased the patient's pleural effusion and respiratory symptoms...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122545/portal-hypertension-and-unexplained-diarrhea-in-an-80-year-old-man
#9
Danse Bi, Thomas M Malikowski, Seth Sweetser
No abstract text is available yet for this article.
November 6, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29122309/the-keys-to-successful-tips-in-patients-with-portal-vein-thrombosis-and-cavernous-transformation
#10
S Lombardo, J J Espejo, M E Pérez-Montilla, L J Zurera, Á González-Galilea
Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization...
November 6, 2017: Radiología
https://www.readbyqxmd.com/read/29121925/advances-and-challenges-in-cirrhosis-and-portal-hypertension
#11
Annalisa Berzigotti
BACKGROUND: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required. DISCUSSION: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice...
November 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29118563/cardiac-dysfunction-as-an-early-predictor-of-portal-hypertension-in-chronic-hepatitis-c
#12
Cecilia Marconi, Mattia Bellan, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Lisa Franzosi, Mario Pirisi
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29116341/shear-wave-liver-elastography
#13
Richard G Barr
Chronic liver disease is a substantial world-wide problem. Its major consequence is increasing deposition of fibrous tissue within the liver leading to the development of cirrhosis with its consequences of portal hypertension, hepatic insufficiency, and hepatocellular carcinoma. The stage of liver fibrosis is important to determine prognosis, surveillance, prioritize for treatment, and potential for reversibility. The process of fibrosis is dynamic and regression of fibrosis is possible with treatment of the underlying conditions...
November 7, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29113028/restoration-of-a-healthy-intestinal-microbiota-normalizes-portal-hypertension-in-a-rat-model-of-nonalcoholic-steatohepatitis
#14
Teresa García-Lezana, Imma Raurell, Miren Bravo, Manuel Torres-Arauz, María Teresa Salcedo, Alba Santiago, Andreu Schoenenberger, Chaysavanh Manichanh, Joan Genescà, María Martell, Salvador Augustin
Portal hypertension (PH) drives most of the clinical complications in chronic liver diseases. However, its progression in nonalcoholic steatohepatitis (NASH) and its association with the intestinal microbiota (IM) has been scarcely studied. Our aim was to investigate the role of IM in the mechanisms leading to PH in early NASH. The experimental design was divided in two stages: Stage 1: Sprague-Dawley rats were fed for 8 weeks with high-fat diet and high-glucose/fructose syrup (HFGFD) or control diet/water (CD)...
November 7, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29113006/transjugular-portal-vein-recanalization-with-creation-of-intrahepatic-portosystemic-shunt-pvr-tips-in-patients-with-chronic-non-cirrhotic-non-malignant-portal-vein-thrombosis
#15
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
Purpose To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). Methods This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1)...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29112083/characteristics-of-liver-disease-in-100-individuals-with-joubert-syndrome-prospectively-evaluated-at-a-single-center
#16
Anna Strongin, Theo Heller, Dan Doherty, Ian A Glass, Melissa A Parisi, Joy Bryant, Peter Choyke, Baris Turkbey, Kailash Daryanani, Deniz Yildirimli, Meghana Vemulapalli, Jim C Mullikin, May C Malicdan, Thierry Vilboux, William A Gahl, Meral Gunay-Aygun
BACKGROUND & AIMS: Joubert Syndrome (JS) is a rare, inherited, ciliopathy defined by cerebellar and brainstem malformations and is variably associated with liver, kidney, and ocular dysfunction. This study characterizes the hepatic findings in JS and identifies factors associated with probable portal hypertension. METHODS: 100 individuals with JS were prospectively evaluated at the National Institutes of Health Clinical Center. Laboratory tests, imaging, and DNA sequencing were performed...
November 3, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29111320/clinical-states-of-cirrhosis-and-competing-risks
#17
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis is mostly determined by the progressive increase of portal hypertension, hyperdynamic circulation, bacterial translocation and activation of systemic inflammation. Different disease states without a predictable sequence but with increasing death risk, related to the progression of these mechanisms may be recognized by hemodynamic or clinical characteristics, encompassing compensated and decompensated cirrhosis and a late decompensated state. Acute on chronic liver failure may occur either in decompensated or in compensated cirrhosis and is always associated with a high short term mortality...
October 27, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29110990/transjugular-intrahepatic-portosystemic-shunt-as-a-bridge-to-non-hepatic-surgery-in-cirrhotic-patients-with-severe-portal-hypertension-a-systematic-review
#18
REVIEW
Eylon Lahat, Chetana Lim, Prashant Bhangui, Liliana Fuentes, Michael Osseis, Toufic Moussallem, Chady Salloum, Daniel Azoulay
BACKGROUND: Portal hypertension (PHTN) increases the risk of non-hepatic surgery in cirrhotic patients. This first systematic review analyzes the place of transjugular intrahepatic portosystemic shunt (TIPS) in preparation for non-hepatic surgery in such patients. METHODS: Medline, EMBASE, and Scopus databases were searched from 1990 to 2017 to identify reports on outcomes of non-hepatic surgery in cirrhotic patients with PHTN prepared by TIPS. Feasibility of TIPS and the planned surgery, and the short- and long-term outcomes of the latter were assessed...
October 27, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29110825/long-term-outlook-in-biliary-atresia
#19
Arun Kelay, Mark Davenport
The oldest survivors from the Kasai portoenterostomy originate in Sendai, Japan and are approaching their 60th birthday. These represent the tip of an expanding cohort of adults born with this previously fatal condition. Increasingly transition to adult-biased hepatologists and physicians will be the expectation of many with this condition. However unlike their usual patients with alcohol, drugs, virally mediated liver disease these are different with different expectations of health and quality of life. Cure is not on the cards for most of these and they survive still with impaired bile flow and increased liver fibrosis and cirrhosis with the threat of cholangitis and portal hypertension still apparent...
October 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29110128/endoscopic-treatments-for-portal-hypertension
#20
REVIEW
Gin-Ho Lo
Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy is superior to vasoconstrictor or endoscopic therapy alone for control of acute esophageal variceal hemorrhage. After control of acute variceal bleeding, combination of banding ligation and beta-blockers is generally recommended to prevent variceal rebleeding...
November 7, 2017: Hepatology International
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