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https://www.readbyqxmd.com/read/29780579/managing-portal-hypertension-in-patients-with-liver-cirrhosis
#1
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/29779314/-impact-of-psoas-muscle-index-on-early-postoperative-mortality-and-complications-after-liver-transplantation
#2
J C Hou, H Zheng, Z Qiang, Y M Zhang, W T Jiang, W Gao, J Z Cai, J J Zhang, Z Y Shen
Objective: To investigate the relationship between psoas muscle index (PMI) and early postoperative survival rate and the incidence of complications after liver transplantation in adults. Methods: The clinical data of 225 patients (male, n =184; female, n =41) underwent liver transplantation at the Organ Transplantation Department of First Central Clinic Institute of Tianjin Medical University from January 2014 to December 2016 were analyzed, retrospectively.Original disease: hepatitis B liver cirrhosis(44 cases), hepatitis C cirrhosis(10 cases), autoimmune liver cirrhosis(29 cases), other benign liver diseases(24 cases), liver cirrhosis with liver cancer(116 cases), hilar cholangiocarcinoma(1 case) and hepatic vascular sarcoma(1 case)...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29774155/is-de-novo-hepatocellular-carcinoma-after-transjugular-intrahepatic-portosystemic-shunt-increased
#3
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/29773783/cholesteryl-ester-storage-disease-fatal-outcome-without-causal-therapy-in-a-female-patient-with-the-preventable-sequelae-of-progressive-liver-disease-after-many-years-of-mild-symptoms
#4
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29768330/risk-factors-for-osteoporosis-in-liver-cirrhosis-patients-measured-by-transient-elastography
#5
Jian-Ping Zheng, Hai-Xiong Miao, Shao-Wei Zheng, Wei-le Liu, Chu-Qun Chen, Hao-Bo Zhong, Sheng-Fa Li, Yong-Ping Fang, Chun-Han Sun
Osteoporosis or osteopenia is a common complication in patients with cirrhosis, but little is known about the risk factors for the occurrence of osteoporosis.Patients with liver cirrhosis due to chronic virus infection and alcoholic abuse were enrolled. Bone mineral density (BMD) was determined using dual-energy x-ray absorptiometry (DXA). Osteoporosis was diagnosed according to WHO criteria. The severity of liver stiffness was measured by Fibroscan. Demographic data, such as age, gender, weight, height, and body mass index (BMI), were collected...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766815/old-and-new-treatments-for-pediatric-autoimmune-hepatitis
#6
Silvia Nastasio, Giuseppe Maggiore, Marco Sciveres, Lorenza Matarazzo
Autoimmune hepatitis is a rare inflammatory disease of the liver that most frequently affects children and young adults. It is a multifactorial disease of unknown etiology, characteristically progressive in nature, and if left untreated, may lead to cirrhosis and terminal liver failure. It has been known for several decades now that immunosuppressive treatment convincingly alters the outcome of most patients with autoimmune hepatitis and as such it should be started as soon as diagnosis is made. Primary goals of treatment are: normalization of hepatocellular function, extinction of the hepatic necroinflammatory process, and maintenance of a stable remission, thus preventing progression to cirrhosis and its complications...
May 16, 2018: Current Pediatric Reviews
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/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#8
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29762873/l-ornithine-l-aspartate-for-prevention-and-treatment-of-hepatic-encephalopathy-in-people-with-cirrhosis
#9
REVIEW
Ee Teng Goh, Caroline S Stokes, Sandeep S Sidhu, Hendrik Vilstrup, Lise Lotte Gluud, Marsha Y Morgan
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis and has high associated morbidity and mortality. The condition is classified as overt if it is clinically apparent or minimal if only evident though psychometric testing. The exact pathogenesis of this syndrome is unknown although ammonia is thought to play a key role. L-ornithine L-aspartate has ammonia-lowering properties and may, therefore, benefit people with cirrhosis and hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of L-ornithine L-aspartate versus placebo, no intervention, or other active interventions in people with cirrhosis and hepatic encephalopathy...
May 15, 2018: Cochrane Database of Systematic Reviews
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
#10
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/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#11
Mona Haj, Mary Hart, Don C Rockey
Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. The primary outcome was inpatient mortality with focus on cirrhosis-related complications: non-bleeding esophageal varices, variceal hemorrhage, ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS)...
May 14, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29757897/coagulation-defects-in-the-cirrhotic-patient-undergoing-liver-transplantation
#12
Arabesque Parker, Constantine J Karvellas
Patients with cirrhosis undergoing liver transplantation have unique challenges with regard to the prevention and management of thrombosis and hemorrhage. Patients with cirrhosis have an unstable balance of the coagulation system due to defects in both prothrombotic and antithrombotic components. These changes make laboratory monitoring challenging, prophylaxis against bleeding and thrombosis controversial, and therapy for the same uncertain. When cirrhotic patients undergo liver transplantation they frequently have significant transfusion requirements...
May 7, 2018: Transplantation
https://www.readbyqxmd.com/read/29755014/diagnosis-of-cirrhosis-in-patients-with-chronic-hepatitis-c-genotype-4-role-of-abcb11-genotype-polymorphism-and-plasma-bile-acid-levels
#13
Tarek Besheer, Mona Arafa, Mohamed Abd El-Maksoud, Hatem Elalfy, Amany Hasson, Khaled Zalata, Wagdi Elkashef, Heba Elshahawy, Doaa Raafat, Wafaa Elemshaty, Eman Elsayed, Hosam Zaghloul, Ahmed Abdel Razek, Mahmoud El-Bendary
BACKGROUND/AIMS: Chronic hepatitis C (CHC)-related mortality generally results from cirrhosis and subsequent complications. We aimed to investigate the potential role of plasma bile acid levels and ABCB11 1331T > C (V444A, rs2287622) (ATP-binding cassette subfamily B, member 11) gene polymorphism in fibrosis prediction in CHC genotype 4 patients. MATERIALS AND METHODS: This case control study included 85 healthy control and the following 225 subjects: 170 adult patients infected with hepatitis C virus (HCV) and categorized into three groups according to liver biopsy; no fibrosis group (F0) (n=33), early fibrosis group (F1-F2) (n=61), and advanced fibrosis group (F3-F4) (n=76)...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29753085/effects-of-virologic-response-to-treatment-on-short-and-long-term-outcomes-of-patients-with-chronic-hbv-infection-and-decompensated-cirrhosis
#14
Jeong Won Jang, Jong Young Choi, Young Seok Kim, Jeong-Ju Yoo, Hyun Young Woo, Sung Kyu Choi, Chung Hwan Jun, Chang Hyeong Lee, Joo Hyun Sohn, Won Young Tak, Yu Rim Lee, Kwang-Hyub Han
BACKGROUND & AIMS: Little is known about the effects of antiviral therapy on short- and long-term survival of patients with hepatitis B virus (HBV)-related decompensated cirrhosis. We aimed to determine whether a maintained virologic response (MVR, defined as persistent undetectable HBV DNA during therapy) associates with short-term (6-month) and long-term (6-120 months) survival of patients with decompensated cirrhosis. METHODS: We performed a 10-year observation analysis using data from the Epidemiology and Natural History of Liver Cirrhosis study of patients with decompensated liver cirrhosis in Korea...
May 9, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29751946/anatomic-versus-non-anatomic-resection-for-hepatocellular-carcinoma-a-systematic-review-and-meta-analysis
#15
REVIEW
Dimitrios Moris, Diamantis I Tsilimigras, Ioannis D Kostakis, Ioannis Ntanasis-Stathopoulos, Kevin N Shah, Evangelos Felekouras, Timothy M Pawlik
OBJECTIVE: The relative benefit of anatomic resection (AR) versus non-anatomic resection (NAR) of HCC remains poorly defined. We sought to evaluate the available evidence on oncologic outcomes, as well as the clinical efficacy and safety of AR versus NAR performed as the primary treatment for HCC patients. MATERIAL AND METHODS: A systematic review and meta-analysis was conducted using Medline, ClinicalTrials.gov and Cochrane library through April 15th, 2017. Only clinical studies comparing AR versus NAR were deemed eligible...
April 30, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29750389/delisting-hcv-infected-liver-transplant-candidates-who-improved-after-viral-eradication-outcome-2-years-after-delisting
#16
Giovanni Perricone, Christophe Duvoux, Marina Berenguer, Paolo A Cortesi, Carmen Vinaixa, Rita Facchetti, Chiara Mazzarelli, Susanne Rasoul-Rockenschaub, Silvia Martini, Cristina Morelli, Sara Monico, Riccardo Volpes, Georges-Philippe Pageaux, Stefano Fagiuoli, Luca S Belli
BACKGROUNDS AND AIMS: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation, results in substantial improvement of liver function allowing one in four patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). Aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular-carcinoma development, and clinical de-compensation requiring relisting...
May 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29748815/improved-hemodynamic-and-liver-function-in-portal-hypertensive-cirrhotic-rats-after-administration-of-b-pseudocatenulatum-cect-7765
#17
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/29747235/pure-laparoscopic-hepatectomy-with-augmented-reality-assisted-indocyanine-green-fluorescence-versus-open-hepatectomy-for-hepatocellular-carcinoma-with-liver-cirrhosis-a-propensity-analysis-at-a-single-center
#18
Tan To Cheung, Ka Wing Ma, Wong Hoi She, Wing Chiu Dai, Simon Hing Yin Tsang, Albert Chi Yan Chan, Kenneth Siu Ho Chok, Chung Mau Lo
INTRODUCTION: Laparoscopic hepatectomy is considered an acceptable treatment of choice in selected patients with primary hepatocellular carcinoma (HCC). Whether indocyanine green (ICG) immunofluorescence, a new technology, may improve surgery outcomes has yet to be tested. The aim of the present study was to investigate and compare the effect of ICG fluorescence imaging on the outcomes of pure laparoscopic hepatectomy and open hepatectomy for primary HCC with background cirrhosis. METHODS: From January 2015 to June 2016, 20 patients with HCC and liver cirrhosis underwent laparoscopic hepatectomy with ICG immunofluorescence...
May 10, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29746564/multiple-bacterial-infections-increase-the-risk-of-hepatic-encephalopathy-in-patients-with-cirrhosis
#19
Lan-Ting Yuan, Seng-Kee Chuah, Shih-Cheng Yang, Chih-Ming Liang, Cheng-Kun Wu, Wei-Chen Tai, Tsung-Hsing Hung, Seng-Howe Nguang, Jiunn-Wei Wang, Kuo-Lun Tseng, Ming-Kun Ku, Pin-I Hsu, Deng-Chyang Wu, Chien-Ning Hsu
OBJECTIVE: Patients with liver cirrhosis (LC) are at increased risk for bacterial infections. It is not fully understood how exposure to infections induces further development of hepatic encephalopathy (HE). This study estimated risks of infection associated with HE among patients with LC. METHODS: A nested case-control study of 14,428 adult patients with LC was performed using the population-based Longitudinal Health Insurance Database 2000 in Taiwan. Cases were cirrhotic patients who developed HE during follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29746540/patients-with-stage-3-compared-to-stage-4-liver-fibrosis-have-lower-frequency-of-and-longer-time-to-liver-disease-complications
#20
Page Axley, Sandhya Mudumbi, Shabnam Sarker, Yong-Fang Kuo, Ashwani Singal
BACKGROUND AND AIMS: Advanced liver fibrosis is an important predictor of liver disease progression and mortality, and current guidelines recommend screening for complications of cirrhosis once patients develop F3 fibrosis. Our study compared liver disease progression and survival in patients with stage 3 (F3) and stage 4 (F4) fibrosis on liver biopsy. METHODS: Retrospective study of patients with F3 or F4 on liver biopsy followed for development of liver disease complications (variceal bleeding, ascites, and hepatic encephalopathy); hepatocellular carcinoma, and survival (overall and transplant free survival)...
2018: PloS One
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