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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/28338458/hepatitis-b-in-solid-organ-transplant-procedures-other-than-liver
#1
Dina Halegoua-De Marzio, Jonathan M Fenkel, Cataldo Doria
Transplant is often the best treatment available for patients with end-stage organ failure. Hepatitis B virus infection in transplant procedures other than liver is a major concern because it can be a significant cause of morbidity and mortality after transplant. Due to the increased risk of hepatic complications, such as fibrosing cholestatic hepatitis or histologic deterioration after transplant, systematic use of nucleoside or nucleotide analogues shortly before or at the time of transplant is recommended (tenofovir or entecavir are preferable to lamivudine) in all patients, whatever the baseline histologic evaluation...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28338174/the-impact-of-rifaximin-in-the-prevention-of-bacterial-infections-in-cirrhosis
#2
M Mariani, V Zuccaro, S F A Patruno, L Scudeller, P Sacchi, A Lombardi, M Vecchia, P Columpsi, P Marone, G Filice, R Bruno
OBJECTIVE: Bacterial infections are a leading factor in the progression from compensated to decompensated cirrhosis, with consequent worsening of the prognosis, and concerted efforts have been made to reduce infections and improve the survival rate of these patients. We retrospectively investigated the rate of infections in hospitalized cirrhotic patients under treatment with rifaximin. PATIENTS AND METHODS: We enrolled 649 patients whose clinical and personal data, prescribed therapy, microbiological findings and laboratory tests were collected from previous discharge letters and our institution database...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28335998/point-shear-wave-elastography-to-evaluate-and-monitor-changing-portal-venous-pressure-in-patients-with-decompensated-cirrhosis
#3
Hao Han, Jian Yang, Yu-Zheng Zhuge, Ming Zhang, Min Wu
This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with portal venous pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP...
March 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#4
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319996/oral-direct-acting-agent-therapy-for-hepatitis-c-virus-infection-a-systematic-review
#5
Oluwaseun Falade-Nwulia, Catalina Suarez-Cuervo, David R Nelson, Michael W Fried, Jodi B Segal, Mark S Sulkowski
Background: Rapid improvements in hepatitis C virus (HCV) therapy have led to the approval of multiple oral direct-acting antiviral (DAA) regimens by the U.S. Food and Drug Administration (FDA) for treatment of chronic HCV infection. Purpose: To summarize published literature on the efficacy and safety of oral DAAs for treatment of persons with chronic HCV infection. Data Sources: MEDLINE and EMBASE from inception through 1 November 2016. Study Selection: 42 English-language studies from controlled and single-group registered clinical trials of adults with HCV infection that evaluated at least 8 weeks of an FDA-approved interferon-free HCV regimen that included at least 2 DAAs...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28318053/statins-decrease-the-risk-of-decompensation-in-hbv-and-hcv-related-cirrhosis-a-population-based-study
#6
Fu-Ming Chang, Yen-Po Wang, Hui-Chu Lang, Chia-Fen Tsai, Ming-Chih Hou, Fa-Yauh Lee, Ching-Liang Lu
BACKGROUND & AIM: Statin decreased the risk of decompensation and mortality in veteran patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in general population or cirrhosis with other causes, such as hepatitis B virus (HBV) infection and alcohol, remains unknown. Statin also decreased the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients already with cirrhosis...
March 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28316844/aspergillus-pericarditis-with-tamponade-in-a-renal-transplant-patient
#7
Sylvia Biso, Rapeepat Lekkham, Antoinette Climaco
Aspergillus pericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28295923/effect-of-viral-suppression-on-hepatic-venous-pressure-gradient-in-hepatitis-c-with-cirrhosis-and-portal-hypertension
#8
Nezam Afdhal, Gregory T Everson, Jose Luis Calleja, Geoffrey W McCaughan, Jaime Bosch, Diana M Brainard, John G McHutchison, Shampa De-Oertel, Di An, Michael Charlton, Rajender K Reddy, Tarik Asselah, Edward Gane, Michael P Curry, Xavier Forns
BACKGROUND&AIMS: Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. METHODS: Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mmHg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period...
March 10, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28293093/clinical-features-and-natural-history-of-cryptogenic-cirrhosis-compared-to-hepatitis-c-virus-related-cirrhosis
#9
Luca Rinaldi, Fabio Nascimbeni, Mauro Giordano, Chiara Masetti, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Stefano Ballestri, Dante Romagnoli, Rosa Zampino, Riccardo Nevola, Enrica Baldelli, Natalina Iuliano, Valerio Rosato, Amedeo Lonardo, Luigi Elio Adinolfi
AIM: To characterize natural history of cryptogenic cirrhosis (CC) and compare its clinical features and outcomes to those of hepatitis C virus (HCV)-related cirrhosis. METHODS: A prospective cohort of 102 consecutive patients at their first diagnosis of CC were enrolled in this study. The clinical data and outcomes were compared to an age- and Child-Pugh class-matched cohort of 110 patients with HCV-related cirrhosis. Diagnosis of cirrhosis was based on compatible clinical and laboratory parameters, ultrasound/endoscopic parameters and, whenever possible, on histological grounds and transient elastography...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#10
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28288193/nonalcoholic-fatty-liver-disease-and-increased-risk-of-1-year-all-cause-and-cardiac-hospital-readmissions-in-elderly-patients-admitted-for-acute-heart-failure
#11
Filippo Valbusa, Stefano Bonapace, Davide Agnoletti, Luca Scala, Cristina Grillo, Pietro Arduini, Emanuela Turcato, Alessandro Mantovani, Giacomo Zoppini, Guido Arcaro, Christopher Byrne, Giovanni Targher
Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period...
2017: PloS One
https://www.readbyqxmd.com/read/28285648/branched-chain-amino-acids-alleviate-hepatic-steatosis-and-liver-injury-in-choline-deficient-high-fat-diet-induced-nash-mice
#12
Takashi Honda, Masatoshi Ishigami, Fangqiong Luo, Ma Lingyun, Yoji Ishizu, Teiji Kuzuya, Kazuhiko Hayashi, Isao Nakano, Tetsuya Ishikawa, Guo-Gang Feng, Yoshiaki Katano, Tomoya Kohama, Yasuyuki Kitaura, Yoshiharu Shimomura, Hidemi Goto, Yoshiki Hirooka
BACKGROUND: For successful treatment for nonalcoholic steatohepatitis (NASH), it may be important to treat the individual causative factors. At present, however, there is no established treatment for this disease. Branched-chain amino acids (BCAAs) have been used to treat patients with decompensated cirrhosis. AIM: In order to elucidate the mechanisms responsible for the effects of BCAAs on hepatic steatosis and disease progression, we investigated the effects of BCAA supplementation in mice fed a choline-deficient high-fat diet (CDHF), which induces NASH...
April 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28285495/pharmacological-interventions-for-acute-hepatitis-c-infection-an-attempted-network-meta-analysis
#13
REVIEW
Maria Kalafateli, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hepatitis C virus (HCV) is a single-stranded RNA (ribonucleic acid) virus that has the potential to cause inflammation of the liver. The traditional definition of acute HCV infection is the first six months following infection with the virus. Another commonly used definition of acute HCV infection is the absence of HCV antibody and subsequent seroconversion (presence of HCV antibody in a person who was previously negative for HCV antibody). Approximately 40% to 95% of people with acute HCV infection develop chronic HCV infection, that is, have persistent HCV RNA in their blood...
March 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28281236/simultaneous-liver-transplantation-and-sleeve-gastrectomy-prohibitive-combination-or-a-necessity
#14
Eviatar Nesher, Eytan Mor, Amir Shlomai, Michal Naftaly-Cohen, Renana Yemini, Alexander Yussim, Marius Brown, Andrei Keidar
Previously, many morbidly obese (MO) patients were denied liver transplantation (LT) because of the higher operative risk. However, nowadays, 5 and 10 years graft survival is the rule, and patients whose lives can be prolonged with LT are dying of obesity-related comorbidities. Recent experience suggests that weight reduction in MO liver transplant recipients would improve their long-term survival. The bariatric surgery before LT is contraindicated for patients with decompensated cirrhosis, while post-transplant intervention is associated with increased technical difficulty...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28273410/cost-effectiveness-analysis-of-ledipasvir-sofosbuvir-in-patients-with-chronic-hepatitis-c-treatment-of-patients-with-absence-or-mild-fibrosis-compared-to-patients-with-advanced-fibrosis
#15
M Buti, R Domínguez-Hernández, I Oyagüez, M A Casado, R Esteban
OBJECTIVE: To evaluate the cost-effectiveness of Ledipasvir/Sofosbuvir (LDV/SOF) in treatment-naïve patients with chronic hepatitis C (CHC) genotype 1 (GT1) in the absence or mild fibrosis (F0-F1) versus advanced fibrosis (F2-F4), from the perspective of the Spanish Health System. METHODS: A Markov model was developed to simulate disease progression, estimating costs and outcomes [life years gained, (LYG), and quality adjusted life years, (QALY)] derived from starting with LDV/SOF in patients with F0-F1 compared with F2-F4...
March 8, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28273330/interventions-for-hereditary-haemochromatosis-an-attempted-network-meta-analysis
#16
REVIEW
Elena Buzzetti, Maria Kalafateli, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hereditary haemochromatosis is a genetic disorder related to proteins involved in iron transport, resulting in iron load and deposition of iron in various tissues of the body. This iron overload leads to complications including liver cirrhosis (and related complications such as liver failure and hepatocellular carcinoma), cardiac failure, cardiac arrhythmias, impotence, diabetes, arthritis, and skin pigmentation. Phlebotomy (venesection or 'blood letting') is the currently recommended treatment for hereditary haemochromatosis...
March 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28272163/real-world-efficacy-of-daclatasvir-and-sofosbuvir-with-and-without-ribavirin-in-hiv-hcv-co-infected-patients-with-advanced-liver-disease-in-a-french-early-access-cohort
#17
Karine Lacombe, Hélène Fontaine, Catherine Dhiver, Sophie Metivier, Eric Rosenthal, Teresa Antonini, Marc Antoine Valantin, Patrick Miailhes, Stanislas Harent, Dominique Batisse, Georges-Philippe Pageaux, Julie Chas, Hugues Aumaitre, Stephanie Dominguez, Thierry Allegre, Alain Lafeuillade, Eric Billaud, Pierre De Truchis, Philippe Perre, Vincent Leroy, Victor De Ledinghen, Philippe Sogni, Francois Dabis, Yue Zhao, Anne Filipovics, Larysa Fedchuk, Raoudha Akremi, Yacia Bennai, Dominique Salmon Ceron
BACKGROUND: Efficacious, well-tolerated direct antiviral agents have drastically changed the prognosis of hepatitis C virus (HCV) disease, but real-world data for oral treatments are limited in key populations such as human immunodeficiency virus (HIV)/HCV co-infection with advanced liver disease. Daclatasvir (DCV) efficacy and safety was assessed in the French "Autorisation Temporaire d'Utilisation" (ATU) program providing DCV ahead of market authorization to patients with advanced HCV disease without other treatment options...
March 6, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28261383/malnutrition-negatively-impacts-the-quality-of-life-of-patients-with-cirrhosis-an-observational-study
#18
Gabriela Rojas-Loureiro, Alfredo Servín-Caamaño, Elizabeth Pérez-Reyes, Luis Servín-Abad, Fátima Higuera-de la Tijera
AIM: To verify how malnutrition is related to health-related quality of life (HRQL) impairment in patients with cirrhosis. METHODS: Data was retrospectively abstracted from medical records and obtained by direct interview. We included patients with cirrhosis from any etiology, evaluated at the Liver Clinic from Gastroenterology Department in a tertiary healthcare center, from June 2014 to June 2016. Child-Pugh score, data about complications, and demographic, clinical and anthropometric characteristics of patients were obtained...
February 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28261380/adverse-effects-of-oral-antiviral-therapy-in-chronic-hepatitis-b
#19
REVIEW
Bircan Kayaaslan, Rahmet Guner
Oral nucleoside/nucleotide analogues (NAs) are currently the backbone of chronic hepatitis B (CHB) infection treatment. They are generally well-tolerated by patients and safe to use. To date, a significant number of patients have been treated with NAs. Safety data has accumulated over the years. The aim of this article is to review and update the adverse effects of oral NAs. NAs can cause class adverse effects (i.e., myopathy, neuropathy, lactic acidosis) and dissimilar adverse effects. All NAs carry a "Black Box" warning because of the potential risk for mitochondrial dysfunction...
February 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28260480/living-donor-liver-transplant-follow-up-a-singlecenter-experience
#20
Syed Mudassir Laeeq, Farina M Hanif, Nasir Hassan Luck, Rajesh Kumar Mandhwani, Jawed Iqbal, Syed Haider Mehdi
OBJECTIVES: Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. MATERIALS AND METHODS: Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded...
February 2017: Experimental and Clinical Transplantation
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