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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/28632958/decreased-portal-vein-velocity-is-predictive-of-the-development-of-portal-vein-thrombosis-a-matched-case-control-study
#1
Jonathan G Stine, Jennifer Wang, Puja M Shah, Curtis K Argo, Nicolas Intagliata, Andre Uflacker, Stephen H Caldwell, Patrick G Northup
BACKGROUND & AIMS: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. METHODS: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed...
June 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28614777/increased-circulating-endocan-in-patients-with-cirrhosis-relation-to-bacterial-infection-and-severity-of-disease
#2
J Zuwala-Jagiello, K Simon, M Kukla, E Murawska-Cialowicz, J Gorka-Dynysiewicz, E Grzebyk, M Pazgan-Simon
Life expectancy of patients with liver cirrhosis is closely linked to the degree of liver dysfunction and the occurrence of bacterial infection. An early diagnosis of infection helps to initiate adequate and timely measures and improves outcome of cirrhotic patients. Endocan is a newly recognized biomarker of sepsis. However, there have been no studies of the trends in endocan levels in cirrhotic patients with bacterial infection and their associations with markers of infection and inflammation. This study sought to assess the diagnostic value of serum levels of endocan, procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in 126 patients with cirrhosis: 51 with decompensated infected cirrhosis, 56 with decompensated uninfected and 19 with compensated uninfected cirrhosis at inclusion...
April 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28611262/relative-adrenal-insufficiency-is-associated-with-the-clinical-outcome-in-patients-with-stable-decompensated-cirrhosis
#3
Evangelos Cholongitas, Ioannis Goulis, Eirini Pagkalidou, Anna Haidich, Apostolos Karagiannis, Theodora Nakouti, Chrysoula Pipili, Theodora Oikonomou, Spyros Gerou, Evangelos Akriviadis
BACKGROUND: The clinical impact of relative adrenal insufficiency (AI) on patients with stable decompensated cirrhosis (DeCi) has not been yet elucidated. AIM: Explore the association between AI and outcome [death or liver transplantation (LT)] in patients with DeCi. MATERIAL AND METHODS: Patients with DeCi presenting no active complication have been included. Clinical and laboratory data, including serum levels of corticosteroid-binding globulin (CBG), interleukin (IL)-1b, IL-6 and tumor necrosis factor (TNFα) were recorded in each participant...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28611258/independent-predictors-of-mortality-and-resource-utilization-in-viral-hepatitis-related-hepatocellular-carcinoma
#4
Pegah Golabi, Thomas Jeffers, Zahra Younoszai, Munkhzul Otgonsuren, Mehmet Sayiner, Alita Mishra, Chapy Venkatesan, Zobair Younossi
INTRODUCTION: Hepatitis B (HBV) and C viruses (HCV) are important causes of hepatocellular carcinoma (HCC). Our aim was to assess mortality and resource utilization of patients with HCC-related to HBV and HCV. MATERIAL AND METHODS: National Cancer Institute's Surveillance, Epidemiology and End Results (SEER)-Medicare linked database (2001-2009) was used. Medicare claims included patient demographic information, diagnoses, treatment, procedures, ICD-9 codes, service dates, payments, coverage status, survival data, carrier claims, and Medicare Provider Analysis and Review (MEDPAR) data...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28606043/a-study-of-extrapyramidal-manifestations-accompanying-decompensated-viral-hepatic-cirrhosis-patients
#5
Samia Ashour, Ahmed Gaber, Osama Aboelfotoh Aly, Saeed Hashem, Mohamed Salama, Ali Shalash
Despite the high prevalence of viral hepatic cirrhosis all over the world, the characteristic motor features of related Parkinsonism (extrapyramidal manifestations) are not well described. The current study aimed to characterize such disorder in a sample of Egyptian patients with chronic viral liver disease (CLD), and their clinical correlates. METHODS: Ninety-six (96) patients with CLD were examined for presence of extrapyramidal signs. Parkinsonism was assessed using the UPDRS-III scale and its sub scores...
June 12, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28604569/use-of-four-factor-prothrombin-complex-concentrate-in-the-reversal-of-warfarin-induced-and-nonvitamin-k-antagonist-related-coagulopathy
#6
Hannah Young, Jeremy L Holzmacher, Richard Amdur, Stephen Gondek, Babak Sarani, Mary E Schroeder
: To evaluate the efficacy of international normalized ratio (INR) reversal using four-factor prothrombin complex concentrate (4F-PCC) in nonmedication-induced coagulopathy. We performed a single-site, retrospective cohort study of patients receiving off-label use of 4F-PCC. Cohorts included liver dysfunction if they had acute liver decompensation or cirrhosis without other causative factors of liver failure such as sepsis, coagulopathy of acute sepsis (CAS) if they had documentation of sepsis and no underlying liver disorder, known factor deficiencies, or medication-induced coagulopathy, or warfarin if they were taking warfarin...
June 9, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#7
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28601846/nadph-oxidase-depletion-in-neutrophils-from-patients-with-cirrhosis-and-restoration-via-toll-like-receptor-7-8-activation
#8
Loïc Rolas, Abdelali Boussif, Emmanuel Weiss, Philippe Lettéron, Oualid Haddad, Jamel El-Benna, Pierre-Emmanuel Rautou, Richard Moreau, Axel Périanin
OBJECTIVE: Cirrhosis downregulates phagocyte oxidant production via their antibacterial superoxide-generating system, NADPH oxidase (NOX2) and increases patients' susceptibility to infection and mortality rate. To explore novel biochemical parameters that explain susceptibility to infections, we investigated the expression of NOX2 and partners in neutrophils of patients with severe alcoholic cirrhosis and have provided a novel approach to restore superoxide production capacity in patients' neutrophils and blood...
June 10, 2017: Gut
https://www.readbyqxmd.com/read/28600202/pathophysiology-of-liver-fibrosis-and-the-methodological-barriers-to-the-development-of-anti-fibrogenic-agents
#9
Katrin Böttcher, Massimo Pinzani
Liver fibrosis and cirrhosis resulting from long-standing liver damage represents a major health care burden worldwide. To date, there is no anti-fibrogenic agent available, making liver transplantation the only curative treatment for decompensated cirrhotic liver disease. Liver fibrosis can result from different underlying chronic liver disease, such as chronic viral infection, excessive alcohol consumption, fatty liver disease or autoimmune liver diseases. It is becoming increasingly recognised that as a result from different pathogenic mechanisms liver fibrosis must be considered as many different diseases for which individual treatment strategies need to be developed...
June 6, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28598793/croi-2017-highlights-of-advances-in-viral-hepatitis-and-liver-fibrosis
#10
Anne F Luetkemeyer, David L Wyles
At the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington, hepatitis C virus (HCV) infection was a major focus in the context of HIV-associated liver disease. Well-tolerated direct-acting antiviral (DAA) regimens have enabled effective treatment of the populations that are hardest to cure, including those with decompensated cirrhosis, and many studies examined the impact of HCV cure on hepatitis and extrahepatic outcomes. Scaling up access to DAA, and the impact that their universal availability can have on reducing prevalence were key topics...
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28595541/evaluating-the-role-of-interleukin-12-b-gene-polymorphism-in-prediction-of-disease-progression-in-patients-with-chronic-hepatitis-c-virus-infection
#11
Nadia Elwan, Khalda Amr, Sahar Elyamany, Walaa Elkhalawany, Shaimaa Soliman, Mohamed Ziada, Sherief Abd-Elsalam
Background &Aims: Cell-mediated immunity plays a critical role in viral clearance and disease progression during Hepatitis C virus (HCV) infection. Interleukin (IL)-12 is a cytokine that has been shown to be a potent antiviral cytokine. The aim of this work is to investigate the association of IL-12 B gene polymorphism with the progression of liver disease in chronic HCV patients. METHODS: This cross sectional study was carried out in tropical medicine department, Tanta university hospital, Egypt, on 120 chronic HCV patients with various stages of liver disease and 30 healthy subjects served as control...
June 5, 2017: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/28589869/-hepatopulmonary-syndrome-a-consideration-in-patients-with-liver-disease-accompanied-by-dyspnoea-and-hypoxaemia
#12
P V van Hirtum, G P Bootsma, R A de Man, C Th B M van Deursen, P I Bonta, M D de Kruif
BACKGROUND: Hepatopulmonary syndrome is a severe complication of liver disease, with greatly increased mortality. The syndrome is characterized by increased blood-flow, intrapulmonary vasodilatation and angiogenesis, leading to effects including the formation of shunts. This leads to a decrease in arterial oxygen pressure. Liver transplantation is the only effective treatment. CASE DESCRIPTION: A 74-year-old woman with cirrhosis of the liver attended the pulmonary outpatients' clinic with progressive dyspnoea, which worsened if she sat upright from a lying position (platypnoea)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28588751/protein-tolerance-to-standard-and-high-protein-meals-in-patients-with-liver-cirrhosis
#13
Octavio Campollo, Dirk Sprengers, Gitte Dam, Hendrik Vilstrup, Neil McIntyre
AIM: To investigate the plasma amino acid response and tolerance to normal or high protein meals in patients with cirrhosis. METHODS: The plasma amino acid response to a 20 g mixed protein meal was compared in 8 biopsy-proven compensated cirrhotic patients and 6 healthy subjects. In addition the response to a high protein meal (1 g/kg body weight) was studied in 6 decompensated biopsy-proven cirrhotics in order to evaluate their protein tolerance and the likelihood of developing hepatic encephalopathy (HE) following a porto-caval shunt procedure...
May 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28588180/impact-of-adrenocortical-insufficiency-on-biochemical-parameters-in-haemodynamically-stable-cirrhotic-patients-with-ascites
#14
H Ahmed, M R Karim, R K Paul, M Chowdhury, M S Alam, F Rahman, M A Rouf
Cirrhosis has many complications regardless of the aetiology. Among them, adrenal insufficiency is recently identified entity. A prospective cohort study was done to evaluate the biochemical impact of adrenocortical insufficiency in haemodynamically stable, non-septic, cirrhotic patients with ascites and had been performed at the inpatient of GHPD department, BIRDEM, Dhaka from April 2011 to March 2012. A total of fifty three (53) patients fulfilling inclusion criteria were included in the study. Patients were divided into two groups: Group A (patients of normal adrenal function) and Group B (patients of insufficient adrenal function) and those were followed up for the next 6 months...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28586179/improved-post-transplant-mortality-after-share-35-for-liver-transplantation
#15
Allison J Kwong, Aparna Goel, Ajitha Mannalithara, W Ray Kim
BACKGROUND AND AIMS: The Share 35 policy was implemented in June 2013 to improve equity in access to liver transplantation (LT) between patients with fulminant liver failure and those with cirrhosis and severe hepatic decompensation. The aim of this study was to assess post-LT outcomes after Share 35. METHODS: Relevant donor, procurement, and recipient data were extracted from the OPTN/UNOS database. All adult deceased donor LT from January 1, 2010 to March 31, 2016 were included in the analysis...
June 6, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28585556/beneficial-effects-of-statins-on-the-rates-of-hepatic-fibrosis-hepatic-decompensation-and-mortality-in-chronic-liver-disease-a-systematic-review-and-meta-analysis
#16
REVIEW
Sehrish Kamal, Muhammad Ali Khan, Ankur Seth, George Cholankeril, Deepansh Gupta, Utkarsh Singh, Faisal Kamal, Colin W Howden, Christopher Stave, Satheesh Nair, Sanjaya K Satapathy, Aijaz Ahmed
OBJECTIVES: Statins may improve outcomes in patients with chronic liver disease (CLD). We conducted a systematic review and meta-analysis to evaluate the impact of statins in the setting of CLD. METHODS: We searched several databases from inception to 17 October 2016 to identify comparative studies evaluating the role of statins in CLD. Outcomes of interest were the associations between statin use and progression of fibrosis, development of hepatic decompensation in cirrhosis, and mortality in CLD...
June 6, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28585554/interferon-free-therapy-in-elderly-patients-with-advanced-liver-disease
#17
Sabela Lens, Inmaculada Fernández, Sergio Rodríguez-Tajes, Vanessa Hontangas, Mercedes Vergara, Montserrat Forné, Jose Luis Calleja, Moisés Diago, Jordi Llaneras, Susana Llerena, Xavier Torras, Begoña Sacristán, Merce Roget, Conrado Manuel Fernández-Rodríguez, Mari Carmen Navascués, Javier Fuentes, Juan-José Sánchez-Ruano, Miguel-Ángel Simón, Federico Sáez-Royuela, Carmen Baliellas, Rosa Morillas, Xavier Forns
OBJECTIVES: Interferon-free therapies have an improved safety and efficacy profile. However, data in elderly patients, who have frequently advanced liver disease, associated comorbidities, and use concomitant medications are scarce. The im of this study was to assess the effectiveness and tolerability of all-oral regimens in elderly patients in real-life clinical practice. METHODS: Retrospective analysis of hepatitis C virus (HCV) patients aged ≥65 years receiving interferon-free regimens within the Spanish National Registry (Hepa-C)...
June 6, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28584852/immunological-predictors-of-nonresponse-to-directly-acting-antiviral-therapy-in-patients-with-chronic-hepatitis-c-and-decompensated-cirrhosis
#18
Kate Childs, Elliot Merritt, Aisling Considine, Alberto Sanchez-Fueyo, Kosh Agarwal, Marc Martinez-Llordella, Ivana Carey
BACKGROUND: Sustained virological response rates (SVRs) to directly acting antiviral (DAA) therapy for hepatitis C virus (HCV) are lower in decompensated cirrhosis. Markers of innate immunity predict nonresponse to interferon-based HCV treatment; however, whether they are associated with the response to DAAs in patients with decompensation is not known. METHODS: Information on demographics, adherence, viral kinetics, and resistance were gathered prospectively from a cohort with decompensated cirrhosis treated with 12 weeks of DAAs...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28584525/gastrointestinal-motility-disorders-and-their-clinical-implications-in-cirrhosis
#19
REVIEW
Eleni Theocharidou, Ameet Dhar, David Patch
Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28580726/the-first-case-of-domino-split-liver-transplantation-in-maple-syrup-urine-disease
#20
Uta Herden, Jun Li, Lutz Fischer, Florian Brinkert, Martin Blohm, René Santer, Bjoern Nashan, Enke Grabhorn
The enzymatic defect in MSUD results in accumulation of neurotoxic metabolites of BCAAs. LTX has shown to be a feasible strategy in patients non-responsive to diet. Because of sufficient enzyme activity in extrahepatic tissues in healthy people, the MSUD liver graft is a suitable domino organ. We present the first case of a technical challenging ex situ split of a MSUD domino organ transplanted into two pediatric recipients. The domino graft donor was a 21-year-old female (58 kg) suffering from MSUD with recurrent metabolic decompensation despite strict diet...
June 5, 2017: Pediatric Transplantation
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