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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/29158853/diagnosis-and-treatment-of-autoimmune-liver-diseases-in-a-tertiary-referral-center-in-cuba
#1
Marlen Ivón Castellanos Fernández, Deyanira la Rosa Hernández, Diego Enrique Cabrera Eugenio, Wilson Palanca, Zaily Dorta Guridi, Licet González Fabián
Background: Autoimmune liver diseases (AILD) comprise a set of entities characterized by tissue damage as a result of the loss of self-tolerance. There are few reports of AILD from Caribbean countries. Objectives: The aim of our study was to investigate the clinical patterns, laboratory findings, and immunologic features, treatment responses, and prognoses of AILD in adult patients at a Cuban tertiary referral center. Methods: A prospective study was conducted at the National Institute of Gastroenterology in Havana, Cuba, from May 2012 to April 2016...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29152988/value-and-innovation-of-direct-acting-antivirals-long-term-health-outcomes-of-the-strategic-plan-for-the-management-of-hepatitis-c-in-spain
#2
Juan Turnes, Raquel Domínguez-Hernández, Miguel Ángel Casado
OBJECTIVE: To assess the long-term healthcare costs and health outcome in association with the access to new direct-acting antivirals (DAAs), during the first year of the National Strategic Plan for Chronic Hepatitis C (SPCHC) in patients with chronic hepatitis C (CHC) in Spain. METHODS: A decision tree and a lifetime Markov model were developed to simulate the natural history, morbidity, and mortality of a cohort of 51,900 patients with CHC before (pre-DAA strategy) and after (post-DAA strategy) access to DAA, following SPCHC approval...
November 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29152767/development-and-validation-of-a-primary-sclerosing-cholangitis-specific-patient-reported-outcomes-instrument-the-psc-pro
#3
Zobair M Younossi, Arian Afendy, Maria Stepanova, Andrei Racila, Fatema Nader, Rachel Gomel, Ricky Safer, William R Lenderking, Anne Skalicky, Leah Kleinman, Robert P Myers, G Mani Subramanian, John G McHutchison, Cynthia Levy, Christopher L Bowlus, Kris Kowdley, Andrew J Muir
BACKGROUND: PSC is a chronic liver disease associated with inflammation and biliary fibrosis that leads to cholangitis, cirrhosis, and impaired quality of life. Our objective was to develop and validate a PSC-specific PRO instrument. METHODS: We developed a 42-item PSC PRO instrument that contains 2 modules (Symptoms and Impact of Symptoms), and conducted external validation. Reliability and validity were evaluated using clinical data and a battery of other validated instruments...
November 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29152039/hepatic-hydrothorax-an-update-and-review-of-the-literature
#4
REVIEW
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29151365/effectiveness-of-direct-acting-antiviral-therapy-for-hepatitis-c-in-difficult-to-treat-patients-in-a-safety-net-health-system-a-retrospective-cohort-study
#5
Christina Yek, Carolina de la Flor, John Marshall, Cindy Zoellner, Grace Thompson, Lisa Quirk, Christian Mayorga, Barbara J Turner, Amit G Singal, Mamta K Jain
BACKGROUND: Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C (HCV) treatment, but real-world effectiveness among vulnerable populations, including uninsured patients, is lacking. This study was conducted to characterize the effectiveness of DAAs in a socioeconomically disadvantaged and underinsured patient cohort. METHODS: This retrospective observational study included all patients undergoing HCV treatment with DAA-based therapy between April 2014 and June 2016 at a large urban safety-net health system (Parkland Health and Hospital System, Dallas, TX, USA)...
November 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29149510/transferrin-as-a-predictor-of-survival-in-cirrhosis
#6
André Viveiros, Armin Finkenstedt, Benedikt Schaefer, Mattias Mandorfer, Bernhard Scheiner, Konrad Lehner, Moritz Tobiasch, Thomas Reiberger, Herbert Tilg, Michael Edlinger, Heinz Zoller
BACKGROUND AND AIMS: Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are MELD-independent predictors of mortality in patients with acute on chronic liver failure or decompensated cirrhosis. The aim of this study was to evaluate the prognostic utility of serum iron parameters in relation to markers of liver function and immune activation...
November 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29142479/medication-beliefs-predict-medication-adherence-in-ambulatory-patients-with-decompensated-cirrhosis
#7
Kelly L Hayward, Patricia C Valery, Jennifer H Martin, Antara Karmakar, Preya J Patel, Leigh U Horsfall, Caroline J Tallis, Katherine A Stuart, Penny L Wright, David D Smith, Katharine M Irvine, Elizabeth E Powell, W Neil Cottrell
AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), perceptions of illness and medicines (Brief Illness Perception Questionnaire), and quality of life (Chronic Liver Disease Questionnaire) were examined...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29142474/clinical-features-of-alcoholic-hepatitis-in-latinos-and-caucasians-a-single-center-experience
#8
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
AIM: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29136329/follow-up-of-sustained-virologic-responders-with-hepatitis-c-and-advanced-liver-disease-after-interferon-ribavirin-free-treatment
#9
Karin Kozbial, Stephan Moser, Ramona Al-Zoairy, Remy Schwarzer, Christian Datz, Rudolf Stauber, Hermann Laferl, Michael Strasser, Sandra Beinhardt, Albert Friedrich Stättermayer, Michael Gschwantler, Heinz Zoller, Andreas Maieron, Ivo Graziadei, Michael Trauner, Petra Steindl-Munda, Harald Hofer, Peter Ferenci
BACKGROUND: The introduction of direct-acting antivirals (DAA) has increased sustained virological response (SVR) rates in patients with advanced liver disease and chronic hepatitis C(CHC)infection. At present, data on clinical outcome and long-term durability of viral eradication after successful DAA therapy are scarce. AIM: To evaluate the long-term success of viral eradication in patients with advanced fibrosis or cirrhosis treated with DAAs. METHODS: Five hundred and fifty one patients with advanced fibrosis (n=158) or liver cirrhosis (CPS-A:317,CPS-B/C:76) and SVR after interferon and ribavirin-free DAA therapy treated between October 2013 and April 2016 were studied with a median follow-up of 65...
November 14, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29135373/high-dose-of-silymarin-in-patients-with-decompensated-liver-disease-a-randomized-controlled-trial
#10
Waleed Fouad Fathalah, Mohamed AbdAllah Abdel Aziz, Neveen Helmy Abou El Soud, Maissa El Said El Raziky
Hepatitis C virus (HCV) is a major public health problem being the most common cause of chronic liver disease in Egypt. HCV-induced decompensated liver cirrhosis patients have a median survival of 2 years even with currently used new treatments. Silymarin is the most commonly used herbal product in chronic liver disease for its anti-inflammatory, antiviral, antioxidant, and antifibrotic effects. The aim of this study was to assess the effects of silymarin in high dose on the clinical and biochemical status of chronic HCV-associated decompensated liver cirrhosis...
November 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/29135030/hepatitis-c-virus-clearance-in-older-adults
#11
Antonio Massimo Ippolito, Angelo Iacobellis, Michele Milella, Fabio Conti, Vincenzo Messina, Maria Rosa Valvano, Grazia Anna Niro, Filomena Morisco, Michele Barone, Antonio Patrizio Termite, Giuseppina Brancaccio, Angelo Andriulli
OBJECTIVES: To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS: Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREMENTS: We investigated the efficacy, safety, and global clinical effect of treatment with different combinations of direct antiviral agents (DAAs)...
November 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#12
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29128051/the-natural-history-of-nonalcoholic-fatty-liver-disease-an-evolving-view
#13
REVIEW
Christina C Lindenmeyer, Arthur J McCullough
Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease worldwide, and its clinical and economic burden will continue to grow with parallel increases in rates of obesity, diabetes, and the metabolic syndrome. Evolving understanding of the natural history of NAFLD suggests that these patients are at risk for disease progression to steatohepatitis, fibrosis, and cirrhosis. Recent studies also suggest that these patients are at elevated risk for cardiovascular-, malignancy-, and liver-related morbidity and mortality, although their risk for progression, decompensation, and hepatocellular carcinoma may be less than that of patients with alternative causes of chronic liver disease...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#14
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29125261/hepatitis-b-and-liver-transplantation
#15
Alberto Ferrarese, Alberto Zanetto, Francesco P Russo
Liver transplantation (LT) is the only effective treatment for hepatitis B-virus (HBV) related end stage liver disease, even if the outcome of these patients, has significantly improved after introduction of effective and well tolerated nucleos/tide analogues (NUC). Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line therapeutic option in patients with HBV decompensated cirrhosis. After LT, the development of hepatitis B immunoglobulin (HBIG) in the early 1990s change dramatically the prognosis of these patients by reducing the incidence of HBV recurrence and increasing survival rate...
November 10, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/29123424/liver-related-morbidity-and-mortality-in-patients-with-chronic-hepatitis-c-and-cirrhosis-with-and-without-sustained-virologic-response
#16
Sofie Hallager, Steen Ladelund, Peer Brehm Christensen, Mette Kjær, Birgit Thorup Roege, Karin Elmegaard Grønbæk, Erika Belard, Toke S Barfod, Lone Galmstrup Madsen, Jan Gerstoft, Britta Tarp, Henrik Bygum Krarup, Nina Weis
Background: Chronic hepatitis C (CHC) causes liver cirrhosis in 5%-20% of patients, leading to increased morbidity and mortality. This study aimed to estimate liver-related morbidity and mortality among patients with CHC and cirrhosis in Denmark with and without antiviral treatment and sustained virologic response (SVR). Furthermore we aimed to estimate the rate of hepatocellular carcinoma (HCC) and decompensation associated with certain prognostic factors. Materials and methods: Patients with CHC and cirrhosis registered in the Danish Database for Hepatitis B and C were eligible...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/29121925/advances-and-challenges-in-cirrhosis-and-portal-hypertension
#17
Annalisa Berzigotti
BACKGROUND: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required. DISCUSSION: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice...
November 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29119705/on-treatment-changes-of-liver-stiffness-at-week-26-could-predict-2-year-clinical-outcomes-in-hbv-related-compensated-cirrhosis
#18
Shanshan Wu, Yuanyuan Kong, Hongxin Piao, Wei Jiang, Wen Xie, Yongpeng Chen, Lungen Lu, Anlin Ma, Shibin Xie, Huiguo Ding, Jia Shang, Xuqing Zhang, Bo Feng, Tao Han, Xiaoyuan Xu, Lijuan Huo, Jilin Cheng, Hai Li, Xiaoning Wu, Jialing Zhou, Yameng Sun, Xiaojuan Ou, Hui Zhang, Hong You, Jidong Jia
BACKGROUND & AIMS: It is unclear whether liver stiffness measurement (LSM) dynamic changes after anti-HBV treatment could predict the risk of liver related events (LREs), particularly in patients with HBV-related compensated cirrhosis. METHODS: Treatment-naïve patients with HBV-related compensated cirrhosis were enrolled. All patients were under entecavir-based anti-viral therapy, and followed up every 26 weeks for two years. The association between LSM and LREs were analyzed by Cox proportional hazard model and Harrell C-index analysis...
November 8, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29119412/association-of-helicobacter-pylori-with-the-risk-of-hepatic-encephalopathy
#19
Karn Wijarnpreecha, Supavit Chesdachai, Charat Thongprayoon, Veeravich Jaruvongvanich, Patompong Ungprasert, Wisit Cheungpasitporn
BACKGROUND/OBJECTIVES: Hepatic encephalopathy is the common manifestation of decompensated cirrhosis. The association between Helicobacter pylori (H. pylori) infection and hepatic encephalopathy has been shown in many epidemiologic studies. This meta-analysis was conducted to summarize all available studies to estimate the association between H. pylori infection and hepatic encephalopathy. METHODS: A comprehensive literature review was conducted using MEDLINE and EMBASE database through March 2017 to identify studies that reported the association between H...
December 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29112338/palliative-care-in-decompensated-cirrhosis-a-review
#20
Karl M Langberg, Jennifer M Kapo, Tamar H Taddei
Decompensated cirrhosis is an illness that causes tremendous suffering. The incidence of cirrhosis is increasing and rates of liver transplant, the only cure, remain stagnant. Palliative care is focused on improving quality of life for patients with serious illness by addressing advanced care planning, alleviating physical symptoms and providing emotional support to the patient and family. Palliative care is used infrequently in patients with decompensated cirrhosis. The allure of transplant as a potential treatment option for cirrhosis, misperceptions about the role of palliative care and difficulty predicting prognosis in liver disease are potential contributors to the underutilization of palliative care in this patient population...
November 7, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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