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https://www.readbyqxmd.com/read/28734848/liver-resection-versus-radiofrequency-ablation-plus-transcatheter-arterial-chemoembolization-in-cirrhotic-patients-with-solitary-large-hepatocellular-carcinoma
#1
Antonio Saviano, Roberto Iezzi, Felice Giuliante, Lucia Salvatore, Caterina Mele, Alessandro Posa, Francesco Ardito, Anna Maria De Gaetano, Maurizio Pompili
PURPOSE: To compare liver resection (LR) with single-step, balloon-occluded RF ablation plus drug-eluting embolics transarterial chemoembolization in cirrhotic patients with single hepatocellular carcinoma (HCC) ≥ 3 cm. MATERIALS AND METHODS: From 2010 to 2014, 25 patients with compensated cirrhosis and single HCC ≥ 3 cm (median size 4.5 cm; range, 3.0-6.8 cm) not suitable for LR or liver transplantation were treated with RF ablation plus transarterial chemoembolization in a prospective observational single-center pilot study; all patients had complete tumor necrosis after treatment...
July 19, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28733221/incidence-predictors-and-outcomes-of-acute-on-chronic-liver-failure-in-outpatients-with-cirrhosis
#2
Salvatore Piano, Marta Tonon, Elia Vettore, Marialuisa Stanco, Chiara Pilutti, Antonietta Romano, Sara Mareso, Carmine Gambino, Alessandra Brocca, Antonietta Sticca, Silvano Fasolato, Paolo Angeli
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is the most life-threatening complication of cirrhosis. Prevalence and outcomes of ACLF have been recently described in hospitalized patients with cirrhosis. However, no data is currently available on the prevalence and the risk factors of ACLF in outpatients with cirrhosis. The aim of this study was to evaluate incidence, predictors and outcomes of ACLF in a large cohort of outpatients with cirrhosis. METHODS: 466 patients with cirrhosis consecutively evaluated in a tertiary hospital outpatient clinic were included and followed up until death and/or liver transplantation for a mean of 45±44 months...
July 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28726140/outcomes-following-laparoscopic-versus-open-major-hepatectomy-for-hepatocellular-carcinoma-in-patients-with-cirrhosis-a-propensity-score-matched-analysis
#3
Hong-Wei Xu, Fei Liu, Hong-Yu Li, Yong-Gang Wei, Bo Li
BACKGROUND: Laparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC) in patients with cirrhosis remains controversial due to limited reports in the literature. This study analyzed the perioperative and oncological outcomes of LMH for HCC with cirrhosis compared with open major hepatectomy (OMH). METHODS: A retrospective analysis of patients with cirrhosis who underwent major hepatectomy for HCC between January 2015 and January 2017 was performed. Patients were divided into the LMH group and the OMH group...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#4
Abimbola Adike, Mohanad Al-Qaisi, Noemi J Baffy, Heidi Kosiorek, Rahul Pannala, Bashar Aqel, Douglas O Faigel, M Edwyn Harrison
BACKGROUND: Cirrhosis is often accompanied by an elevated international normalized ratio (INR) due to a decrease in pro-coagulant factors. An elevated INR in cirrhosis is often interpreted as an increased risk of bleeding. There are a paucity of data in the literature on the use of INR to predict risk of gastrointestinal bleeding (GIB) following endoscopic retrograde cholangiopancreatography (ERCP) in patients with cirrhosis. The aims of the study were to determine if there is a correlation between INR and GIB following ERCP in patients with cirrhosis, and to determine if there is a difference in frequency of post-ERCP complications in patients with and without cirrhosis...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28722461/-disorders-of-water-and-electrolyte-metabolism-and-changes-in-acid-base-balance-in-patients-with-ascitic-liver-cirrhosis
#5
Halima Gottfriedová, Miroslava Horáčková, Milena Čáslavská, Julius Špičák, Otto Schück
In patients with advanced cirrhosis with ascites disorders of water and electrolyte metabolism are often present and they are associated with changes in acid-base balance. These changes can be very complicated, their diagnosis and treatment difficult. Dilutional hyponatremia is the most common disorder. Hyponatremia in these patients is associated with increased morbidity and mortality before and after liver transplantation. Other common disorders include hyperchloremic acidosis, hypokalemia, metabolic alkalosis, lactic acidosis, respiratory alkalosis...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28720429/stable-isotope-based-flux-studies-in-nonalcoholic-fatty-liver-disease
#6
REVIEW
Arthur McCullough, Stephen Previs, Takhar Kasumov
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is associated with the worldwide epidemics of obesity, diabetes and cardiovascular diseases. NAFLD ranges from benign fat accumulation in the liver (steatosis) to non-alcoholic steatohepatitis (NASH), and cirrhosis which can progress to hepatocellular carcinoma and liver failure. Mass spectrometry and magnetic resonance spectroscopy-coupled stable isotope-based flux studies provide new insights into the understanding of NAFLD pathogenesis and the disease progression...
July 15, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28717971/subnetwork-mining-on-functional-connectivity-network-for-classification-of-minimal-hepatic-encephalopathy
#7
Daoqiang Zhang, Liyang Tu, Long-Jiang Zhang, Biao Jie, Guang-Ming Lu
Hepatic encephalopathy (HE), as a complication of cirrhosis, is a serious brain disease, which may lead to death. Accurate diagnosis of HE and its intermediate stage, i.e., minimal HE (MHE), is very important for possibly early diagnosis and treatment. Brain connectivity network, as a simple representation of brain interaction, has been widely used for the brain disease (e.g., HE and MHE) analysis. However, those studies mainly focus on finding disease-related abnormal connectivity between brain regions, although a large number of studies have indicated that some brain diseases are usually related to local structure of brain connectivity network (i...
July 17, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28717870/laparoscopic-liver-resections-for-hepatocellular-carcinoma-can-we-extend-the-surgical-indication-in-cirrhotic-patients
#8
Federica Cipriani, Corrado Fantini, Francesca Ratti, Roberto Lauro, Hadrien Tranchart, Mark Halls, Vincenzo Scuderi, Leonid Barkhatov, Bjorn Edwin, Roberto I Troisi, Ibrahim Dagher, Paolo Reggiani, Giulio Belli, Luca Aldrighetti, Mohammad Abu Hilal
BACKGROUND: Evidence on the value of laparoscopic liver resections (LLR) for hepatocellular carcinoma (HCC) and severe cirrhosis is still lacking. The aim of this study is to assess surgical and oncological outcomes of LLR in cirrhotic HCC patients. METHODS: The analysis included 403 LLR for HCC from seven European centres. 333 cirrhotic and 70 non-cirrhotic patients were compared. A matched comparison was performed between 100 Child-Pugh A and 25 Child-Pugh B patients...
July 17, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28710238/is-fch-pet-able-to-identify-foci-of-infection-superiorly-to-fdg-pet
#9
Liesel Elisabeth Hardy, Hannah Hessamodini, Michael Wallace, Roslyn Francis
We report a case of a brain abscess identified on fluorine-18 choline (FCH) positron emission tomography (PET) scan, which was not identified on fluorodeoxyglucose (FDG) PET scan. To our knowledge, there are no previous case reports of incidental brain abscess identified by FCH PET imaging. A 51-year-old man, with liver cirrhosis complicated by hepatocellular carcinoma (HCC) was enrolled in a research trial comparing HCC detection in FCH PET versus FDG PET. During the course of the trial, he underwent radiofrequency ablation (RFA) for HCC...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28707600/a-new-potent-ns5a-inhibitor-in-the-management-of-hepatitis-c-virus-ravidasvir
#10
Enas Hafez, Tamer Elbaz, Mohamed El Kassas, Gamal Esmat
Background: Chronic hepatitis C virus (HCV) is a worldwide health problem that can lead to liver cirrhosis, liver cell failure and numerous subsequent complications such as hepatocellular carcinoma. Till the near past, pegylated interferon was the standard of care therapy. However, it was associated with suboptimal success rates and many side effects. Thereafter, direct antiviral agents (DAA) appeared and played the key role in management of HCV. One of those recent DAA is ravidasvir. Summary: It is a potent NS5A inhibitor that was formerly known as PPI-668...
July 13, 2017: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/28706622/patient-understanding-of-liver-cirrhosis-and-improvement-using-multimedia-education
#11
Matthew A Goldsworthy, Waleed Fateen, Helene Thygesen, Mark A Aldersley, Ian A Rowe, Rebecca L Jones
OBJECTIVE: For patients to engage with the long-term management of liver cirrhosis, sufficient understanding of their condition is essential. The aim of this study was to assess baseline patient knowledge and to test whether a condition-specific multimedia screencast could improve this. DESIGN: Service quality improvement study. SETTING: A UK tertiary liver centre. Patients were recruited during 12 general hepatology outpatient clinics. PATIENTS: Fifty-two patients with liver cirrhosis were included...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28706365/obstetric-outcome-in-women-with-chronic-liver-disease
#12
Pinky Jena, C N Sheela, Rao Preethi Venkatachala, Harshad Devarbhavi
AIM: This study determines the prevalence, causes and outcome of pregnancy in women with chronic liver diseases in a tertiary level teaching institute in Southern India. METHODS: Retrospective analysis of case records was carried out between December 2010 and May 2015 in the departments of Obstetrics and Gynecology and Gastroenterology including pregnant women diagnosed to have chronic liver diseases prenatally or during pregnancy. RESULTS: The frequency of chronic liver disease in pregnancy was 50 among 10,823 deliveries (0...
August 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28704708/innate-immunity-related-pathogen-recognition-receptors-and-chronic-hepatitis-b-infection
#13
REVIEW
Reza Nosratabadi, Seyed Moayed Alavian, Mohammad Zare-Bidaki, Vahid Mohammadi Shahrokhi, Mohammad Kazemi Arababadi
Innate immunity consists of several kinds of pathogen recognition receptors (PRRs), which participate in the recognition of pathogens and consequently activation of innate immune system against pathogens. Recently, several investigations reported that PRRs may also play key roles in the induction/stimulation of immune system related complications in microbial infections. Hepatitis B virus (HBV), as the main cause of viral hepatitis in human, can induce several clinical forms of hepatitis B and also might be associated with hepatic complications such as cirrhosis and hepatocellular carcinoma (HCC)...
July 10, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28702738/impact-of-etiological-treatment-on-prognosis
#14
REVIEW
Chien-Wei Su, Ying-Ying Yang, Han-Chieh Lin
Portal hypertension (PHT) is a frequent and severe complication of cirrhosis. PHT may lead to the development of various complications with high mortality. Liver transplantation is the gold standard as a surgical curative treatment for end-stage liver disease. Theoretically, etiological treatment focusing on the pathophysiology of the underlying disease should be the objective of the nonsurgical management of cirrhotic PHT. Chronic viral hepatitis is the major etiology of cirrhosis and PHT. In cirrhotic patients with chronic hepatitis B virus infection, antiviral therapies can suppress viral replication, ameliorate hepatic inflammation, regress fibrosis, and restore liver functional reserve...
July 12, 2017: Hepatology International
https://www.readbyqxmd.com/read/28701025/epidemiology-of-hepatic-encephalopathy-in-german-hospitals-the-ephe-study
#15
Christian Labenz, Marcus-Alexander Wörns, Jörn M Schattenberg, Yvonne Huber, Peter Robert Galle, Joachim Labenz
Background Hepatic encephalopathy (HE) is a serious complication of liver cirrhosis. The proportion of patients with liver cirrhosis attending German hospitals suffering from HE is unknown. Methods In the first part of the study, data of 14 community hospitals and 5 university hospitals covering the years 2010 and 2011 were analyzed retrospectively for the DRG codes of liver cirrhosis and hepatic encephalopathy. In the second prospective part of the multicenter observational study, all patients with liver cirrhosis attending the departments of gastroenterology of 16 participating community hospitals within a study period of 3 months were included and screened for HE clinically according to the West Haven criteria (grades 1 - 4)...
July 12, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28698986/novelties-in-the-pathophysiology-and-management-of-portal-hypertension-new-treatments-on-the-horizon
#16
REVIEW
Seong Hee Kang, Moon Young Kim, Soon Koo Baik
Portal hypertension (PH) is responsible for the most severe complications of cirrhosis and leading cause of death and liver transplantation. The standard pharmacological treatment available for PH currently consists of the use of a non-selective beta-blocker. However, a significant proportion of patients do not respond to pharmacological treatment. This has led to the development of identifiable targets for the discovery of new horizons in PH treatment. Recently, there has been significant progress in understanding the mechanism behind PH, which is a product of increased hepatic vascular resistance including structural changes and functional change due to endothelial dysfunction...
July 11, 2017: Hepatology International
https://www.readbyqxmd.com/read/28698885/the-effect-of-self-management-training-on-self-efficacy-of-cirrhotic-patients-referring-to-transplantation-center-of-nemazee-hospital-a-randomized-controlled-clinical-trial
#17
Parisa Mansouri, Maryam Ghadami, Seid Saeed Najafi, Shahrzad Yektatalab
BACKGROUND: Cirrhosis is a chronic and progressive disease that causes various complications for patients due to disturbance of the liver's usual function. Self-efficacy refers to an individual's belief in one's ability to perform the necessary behaviors to achieve one's goals. Self-management is also an important criterion for long-term change in behavior. The present study aimed to investigate the effect of self-management training on self-efficacy of patients suffering from liver cirrhosis...
July 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#18
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#19
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28694331/transcriptional-elongation-control-of-the-hbv-cccdna-transcription-by-super-elongation-complex-sec-and-brd4
#20
Joel Celio Francisco, Qian Dai, Zhuojuan Luo, Yan Wang, Roxanne Hui-Heng Chong, Yee Joo Tan, Wei Xie, Guan-Huei Lee, Chengqi Lin
Chronic hepatitis B virus (HBV) infection can lead to liver cirrhosis and hepatocellular carcinoma. HBV reactivation during or after chemotherapy is a potentially fatal complication for cancer patients with chronic HBV infection. Transcription of HBV is a critical intermediate step of HBV life cycle. However, factors controlling the HBV transcription remain largely unknown. Here, we found that different P-TEFb complexes are involved in the transcription of the HBV viral genome. Both BRD4 and the Super Elongation Complex (SEC) bind to the HBV genome...
July 10, 2017: Molecular and Cellular Biology
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