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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/27932133/metabolic-syndrome-after-liver-transplantation-five-year-prevalence-and-risk-factors
#1
F García-Pajares, I Peñas-Herrero, R Sánchez-Ocaña, R Torrres-Yuste, M Cimavilla-Román, A Carbajo-López, C Almohalla-Alvarez, B Pérez-Saborido, E Muñoz-Conejero, M Gonzalez-Sagrado, A Caro-Patón, G Sánchez-Antolín
Survival after orthotopic liver transplantation (OLT) has increased over the last decades, focusing on the metabolic complications that contribute to patient morbidity and mortality. The aim of our study was to describe the prevalence of metabolic syndrome (MS), its components, and its associated factors in patients who underwent OLT in a hospital in Spain. From November 2001 to January 2014, we performed 415 transplantations in 386 patients. We analyzed 204 patients with a minimum follow-up of 1 year (77.6% were male and the mean age was 54...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930559/sofosbuvir-and-ribavirin-in-acute-hepatitis-c-infected-patient-with-decompensated-cirrhosis
#2
Hui Liu, Tong Zhang, Yan Yan
BACKGROUND: The treatment of chronic hepatitis C virus infection has been revolutionized by the advent of direct-acting antiviral agents. However, evidence of its effects on patients with acute hepatitis C (AHC) virus infection is limited. CASE SUMMARY: We report the case of a patient with decompensated cirrhosis induced by autoimmune liver disease, whose condition rapidly deteriorated following AHC virus infection. The patient received sofosbuvir and ribavirin combination treatment for 12 weeks...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930386/granulocyte-colony-stimulating-factor-improves-survival-of-patients-with-decompensated-cirrhosis-a-randomized-controlled-trial
#3
Ritesh Prajapati, Anil Arora, Praveen Sharma, Naresh Bansal, Vikas Singla, Ashish Kumar
BACKGROUND: Liver transplantation is the only curative option for patients with decompensated cirrhosis; however, many patients die while awaiting transplantation. Granulocyte colony-stimulating factor (GCSF) has shown promising results in improving outcomes in patients with advanced liver disease. We evaluated the efficacy of GCSF in patients with decompensated cirrhosis in an open-labeled randomized-controlled trial. METHODS: Consecutive patients with decompensated cirrhosis were randomized to receive either GCSF 300 μg twice daily for 5 days plus standard medical therapy (SMT) (GCSF+SMT group) or SMT alone (SMT alone group)...
December 7, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27925386/interferon-free-therapies-for-patients-with-chronic%C3%A2-hepatitis-c-genotype-3-infection-a-systematic-review
#4
Vicente Gimeno-Ballester, María Buti, Ramón San Miguel, Mar Riveiro, Rafael Esteban
INTRODUCTION: Treatment of hepatitis C virus (HCV) infection with genotype 3 remains a challenge. The HCV elimination rate with direct acting antivirals (DAAs) is lower than the values reported for other HCV genotypes. In addition, genotype 3 infected patients have a higher risk of disease progression and hepatocellular carcinoma. The aim of this study was to review the relevant literature concerning treatment of HCV genotype 3 patients with interferon-free regimens. MATERIAL AND METHODS: A literature search was conducted in the PubMed/Medline, Embase, and Web of Science electronic databases...
December 7, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27923694/neuropsychiatric-performance-in-patients-with-cirrhosis-who-is-normal
#5
REVIEW
Sara Montagnese, Michele De Rui, Paolo Angeli, Piero Amodio
Normal neuropsychiatric performance in cirrhosis has been traditionally defined by the absence of any degree of hepatic encephalopathy (HE) and/or the absence of psychometric or neurophysiological abnormalities, by comparison with reference data from the healthy population. It is our impression that as our understanding and management of end-stage liver disease continues to change, the concept of normal neuropsychiatric performance may also need updating. This review explores novel and possibly more pragmatic interpretations of neuropsychiatric "normality" by comparison with top personal performance, in terms of risk of overt HE/brain failure and in relation with events such as liver transplantation, decompensation, acute-on-chronic liver failure (ACLF) and Transjugular Intrahepatic Portal-systemic Shunt (TIPS) placement...
December 3, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27922855/liver-stiffness-predicts-variceal-bleeding-in-hiv-hcv-coinfected-patients-with-compensated-cirrhosis
#6
Nicolás Merchante, Antonio Rivero-Juárez, Francisco Téllez, Dolores Merino, Maria José Ríos-Villegas, Guillermo Ojeda-Burgos, Mohamed Omar, Juan Macías, Antonio Rivero, Monserrat Pérez-Pérez, Miguel Raffo, Inmaculada López-Montesinos, Manuel Márquez-Solero, Maria Amparo Gómez-Vidal, Juan A Pineda
BACKGROUND: A liver stiffness (LS) < 21 kPa has a high negative predictive value (NPV) to exclude the presence of esophageal varices (EV) at risk of bleeding in HIV/HCV-coinfected patients. Consequently, upper gastrointestinal endoscopy (UGE) for the screening of EV could be avoided in these patients. However, this strategy has not been widely accepted due to concerns about its safety. OBJECTIVE: To assess the ability of LS to predict the risk of portal hypertensive gastrointestinal bleeding (PHGB) in HIV/HCV-coinfected patients with compensated cirrhosis...
December 5, 2016: AIDS
https://www.readbyqxmd.com/read/27922484/adherence-to-follow-up-and-treatment-recommendations-in-greek-and-immigrant-patients-with-chronic-hepatitis-b-in-greece
#7
Theodoros Voulgaris, John Vlachogiannakos, Panagiota Ioannidou, Maria-Vasiliki Papageorgiou, Evi Zampeli, Dimitrios Karagiannakis, Anastasia Georgiou, Afroditi Papazoglou, George Karamanolis, George V Papatheodoridis
BACKGROUND/AIM: Immigrants have multiple barriers to access to health care systems. We evaluated the adherence to follow-up and treatment recommendations of chronic hepatitis B virus (HBV) Greek and immigrant patients. METHODS: In total, 1001 consecutive adult patients with chronic HBV infection who visited our clinics for the first time between 2002 and 2011 were included. All patients born outside Greece were considered immigrants. Diagnosis was considered to be complete if patients could be classified into HBeAg-positive chronic hepatitis B (CHB), inactive carriers, HBeAg-negative CHB, or decompensated cirrhosis...
December 2, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27920982/clinical-implications-of-paracoccus-yeeii-bacteremia-in-a-patient-with-decompensated-cirrhosis
#8
Jordan Sack, David R Peaper, Pramod Mistry, Maricar Malinis
Infections in patients with cirrhosis are common among those who develop variceal hemorrhage. Prophylactic antimicrobial treatment with third generation cephalosporins is recommended in patients with advanced cirrhosis and gastrointestinal hemorrhage. However no infectious source is identified in up to 50% of patients with cirrhosis and clinical sepsis. We report the first case of Paracoccus yeeii bacteremia in a patient with decompensated cirrhosis who presented with variceal hemorrhage. This rare gram negative organism that occurs naturally in the soil has been difficult to isolate until recent technological advances and may not be susceptible to third generation cephalosporins...
2017: IDCases
https://www.readbyqxmd.com/read/27917877/ascites-neutrophil-function-is-significantly-impaired-in-patients-with-decompensated-cirrhosis-but-can-be-restored-by-autologous-plasma-incubation
#9
Cornelius Engelmann, Christina Becker, Andreas Boldt, Toni Herta, Albrecht Boehlig, Katrin Splith, Moritz Schmelzle, Niklas Mueller, Sandra Krohn, Hans-Michael Tautenhahn, Michael Bartels, Ulrich Sack, Thomas Berg
Systemic immune cell dysfunction is a typical feature of liver diseases and increases the risk of bacterial infection, especially spontaneous bacterial peritonitis. We evaluated functional properties of neutrophil granulocytes in blood and ascites of patients both with and without decompensated cirrhosis. We collected blood and ascites samples from 63 patients with cirrhosis and eight without cirrhosis. Phagocytosis activity (PA) and oxidative burst activity (OBA) were evaluated after ex vivo stimulation with E...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27915967/liver-transplant-can-resolve-severe-neuropsychiatric-manifestations-of-wilson-disease-a-case-report
#10
Gregory Walker, Trana Hussaini, Robert Stowe, Silke Cresswell, Eric M Yoshida
Although liver transplant for decompensated cirrhosis secondary to Wilson disease is well accepted, the use of transplant for patients with severe neurologic manifestations of this condition remains controversial, and these can be perceived as a contraindication. Here, we describe a 45-year-old woman who presented with an incidental hepatocellular carcinoma at the time of transplant. The patient had severe neurologic manifestations of Wilson disease pretransplant, including dysarthria, hyperreflexia, asymmetrical ataxia, tremor, bradyphrenia, and shuffling gait...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#11
P Schwabl, M Mandorfer, S Steiner, B Scheiner, D Chromy, M Herac, T Bucsics, H Hayden, K Grabmeier-Pfistershammer, A Ferlitsch, G Oberhuber, M Trauner, M Peck-Radosavljevic, T Reiberger
BACKGROUND: HIV/HCV co-infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT). AIM: To assess the effects of interferon-free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV-coinfected patients with PHT. METHODS: Twenty-two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon-free regimens were included...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#12
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27906468/optimal-timing-of-hepatitis-c-treatment-for-patients-on-the-liver-transplant-waiting-list
#13
Jagpreet Chhatwal, Sumeyye Samur, Brian Kues, Turgay Ayer, Mark S Roberts, Fasiha Kanwal, Chin Hur, Drew Michael S Donnell, Raymond T Chung
: The availability of oral direct-acting antiviral (DAAs) has altered the hepatitis C virus (HCV) treatment paradigm for both pre- and post-liver transplant (LT) patients. There is a perceived trade-off between pre- versus post-LT treatment of HCV-treatment may improve liver function but potentially decrease the likelihood of a necessary LT. Our objective was to identify LT-eligible patients with decompensated cirrhosis who would benefit (and not benefit) from pre-LT treatment based on their MELD scores...
November 5, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27905173/hepatitis-c-virus-genotype-4-genotype-1-s-little-brother
#14
REVIEW
J Llaneras, M Riveiro-Barciela, M Buti, R Esteban
Treatment for hepatitis C virus genotype 4 infection has undergone a major advance over the past 5 years with the emergence of direct-acting antiviral agents. Previously, genotype 4 treatment had been limited to the combination of pegylated interferon and ribavirin, with low rates of sustained virological response. The combinations of new direct-acting agents have resulted in a radical improvement in hepatitis C therapy. Much of the currently available efficacy and safety information in the treatment of genotype 4 has been extrapolated through the results of genotype 1...
December 1, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27895394/concise-review-interferon-free-treatment-of-hepatitis-c-virus-associated-cirrhosis-and-liver-graft-infection
#15
REVIEW
Nina Weiler, Stefan Zeuzem, Martin-Walter Welker
Chronic hepatitis C is a major reason for development of cirrhosis and hepatocellular carcinoma and a leading cause for liver transplantation. The development of direct-acting antiviral agents lead to (pegylated) interferon-alfa free antiviral therapy regimens with a remarkable increase in sustained virologic response (SVR) rates and opened therapeutic options for patients with advanced cirrhosis and liver graft recipients. This concise review gives an overview about most current prospective trials and cohort analyses for treatment of patients with liver cirrhosis and liver graft recipients...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894795/histological-parameters-and-alcohol-abstinence-determine-long-term-prognosis-in-patients-with-alcoholic-liver-disease
#16
Carolin Lackner, Walter Spindelboeck, Johannes Haybaeck, Philipp Douschan, Florian Rainer, Luigi Terracciano, Josef Haas, Andrea Berghold, Ramon Bataller, Rudolf E Stauber
BACKGROUND & AIMS: Few data exist on predictors of long-term prognosis in patients with alcoholic liver disease (ALD). Most studies have only assessed short-term prognosis in patients with advanced ALD. We aimed to assess the prognostic impact of clinical, biochemical and histological parameters on long-term prognosis in patients with early/compensated and decompensated ALD. METHODS: Consecutive patients (n=192) with biopsy-proven liver disease due to alcohol abuse were analyzed retrospectively...
November 25, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27885753/prognosis-of-1169-hepatitis-c-chronically-infected-patients-with-decompensated-cirrhosis-in-the-predirect-acting-antiviral%C3%A2-era
#17
S A McDonald, H A Innes, E Aspinall, P C Hayes, M Alavi, H Valerio, D J Goldberg, S J Hutchinson
At a population level, little is known regarding the risk of liver- and nonliver-related mortality and hospitalization and the development of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-infected patients with decompensated cirrhosis (DC). This large-scale national record-linkage study estimates these outcomes following first hospital admission for DC. Record-linkages between national HCV diagnosis and clinical databases and the national inpatient hospital episode database and mortality register were conducted to follow-up the disease course of all identified HCV-diagnosed and chronically infected persons...
November 25, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27882776/benefits-of-long-term-therapy-with-nucleos-t-ide-analogues-in-treatment-na%C3%A3-ve-patients-with-chronic-hepatitis-b
#18
Lai Wei, Jia-Horng Kao
OBJECTIVE: To assess the benefits of long-term nucleos(t)ide analogue (NA) therapy in reducing the severity and progression of liver disease in treatment-naïve patients with chronic hepatitis B (CHB). SCOPE: As complications of CHB, such as hepatic decompensation and hepatocellular carcinoma (HCC), take a long time to develop in patients with less advanced disease, the long-term benefits of NA therapy in such patients are more difficult to prove than short- or medium-term benefits...
November 24, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27882182/disease-progression-in-chinese-patients-with-hepatitis-c-virus-rna-positive-infection-via-blood-transfusion
#19
Yan-Feng Pan, Yan Zheng, Tao Qin, Lei Feng, Qian Zhang, Xiao-Gong Ping, Yan-Ting Pan, Xiao-Ping Wang, Li Bai, Hua-Hua Li
The majority of patients with hepatitis C virus (HCV) in China were infected via blood transfusion prior to the year 1996. In this systematic retrospective cohort study, disease progression in 804 consecutive patients with transfusion-acquired HCV is investigated. In addition, the occurrence of compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma (HCC) is analyzed among these patients, along with the risk factors for disease progression. Patients with cirrhosis or HCC were classified as the serious development group (SD group) and the remaining patients with chronic hepatitis were classified as the hepatitis group (H group)...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27882051/glycated-hemoglobin-levels-in-patients-with-decompensated-cirrhosis
#20
Jeffrey Nadelson, Sanjaya K Satapathy, Satheesh Nair
Introduction. Aim of this study is to determine if HbA1c levels are a reliable predictor of glycemic control in patients with decompensated cirrhosis. Methods. 200 unique patients referred for liver transplantation at University of Tennessee/Methodist University Transplant Institute with a HbA1c result were included. Three glucose levels prior to the "measured" A1c (MA1c) were input into an HbA1c calculator from the American Diabetes Association website to determine the "calculated" A1c (CA1c). The differences between MA1c and CA1c levels were computed...
2016: International Journal of Endocrinology
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