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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#1
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29330279/rare-cause-of-isolated-severe-coagulation-failure-in-cirrhosis-traditional-healing-with-fenugreek
#2
Cyriac A Philips, Philip Augustine
Patients with cirrhosis develop decompensation events during the natural history of the disease that encompass ascites, variceal bleeding, hepatic encephalopathy and jaundice. Coagulation failure, defined using the international normalised ratio, even though not a decompensation event, is important in patients with stratifying cirrhosis into those who require liver transplantation for long-term survival. Isolated coagulation failure in cirrhosis is rare and usually occurs with use of anticoagulants in the setting of vascular diseases...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29328556/coronary-artery-disease-in-decompensated-patients-undergoing-liver-transplantation-evaluation
#3
Samarth S Patel, Eiman Nabi, Luis Guzman, Antonio Abbate, Chandra Bhati, Richard T Stravitz, Trevor Reichman, Scott C Matherly, Carolyn Driscoll, Hannah Lee, Velimir A Luketic, Richard K Sterling, Arun J Sanyal, Vaishali Patel, Marlon Levy, Mohammad Shadab Siddiqui
Coronary artery disease (CAD) is an important contributor to morbidity and mortality in patients undergoing liver transplantation (LT). However, the current literature is limited by sampling bias and non-definitive assessment of CAD. AIM: The current study examines the prevalence of CAD via per protocol coronary angiography and its relationship to etiology of liver disease in patients undergoing LT evaluation (LTE). METHODS: Data on 228 patients was prospectively collected who had coronary angiography as part of LTE between 2011-2014...
January 12, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29325277/-effect-of-fuzheng-huayu-capsules-on-survival-rate-of-patients-with-liver-cirrhosis
#4
X J Ge, C Q Zhao, L M Xu
Objective: To investigate the effect of Fuzheng Huayu capsules on the survival rate of patients with liver cirrhosis. Methods: A retrospective analysis was performed for the clinical data of the patients with various types of liver cirrhosis who were hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2006 to December 31, 2008. The data collected for these patients included their basic information, diagnosis and treatment, and results of laboratory examination...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29325274/-an-interpretation-of-2017-easl-clinical-practice-guidelines-the-diagnosis-and-management-of-patients-with-primary-biliary-cholangitis
#5
Y Han, Y Chen
Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease and may progress to liver fibrosis, liver cirrhosis, decompensated cirrhosis, and even end-stage liver disease without effective treatment. The diagnosis of PBC is mainly based on the biochemical parameters indicating cholestatic hepatitis and the presence of specific autoantibody in circulation. The goals of the treatment and management of PBC are to prevent the development of end-stage liver disease, to improve related clinical symptoms, and to improve patients' quality of life...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29322599/non-invasive-evaluation-of-portal-hypertension-using-shear-wave-elastography-analysis-of-two-algorithms-combining-liver-and-spleen-stiffness-in-191-patients-with-cirrhosis
#6
L Elkrief, M Ronot, F Andrade, M Dioguardi Burgio, T Issoufaly, M Zappa, O Roux, J Bissonnette, A Payancé, D Lebrec, C Francoz, O Soubrane, D Valla, F Durand, V Vilgrain, L Castera, P-E Rautou
BACKGROUND: Two algorithms based on sequential measurements of liver and spleen stiffness using two-dimensional shearwave elastography (2D-SWE) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] ≥10 mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy. AIM: To validate externally these algorithms in a large cohort of patients with cirrhosis. METHODS: One hundred and ninety-one patients with stable cirrhosis (Child-Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D-SWE at the time of HVPG measurement were included...
January 11, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#7
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29316565/transjugular-intrahepatic-portosystemic-shunt-in-patients-with-portal-hypertension-patency-depends-on-coverage-and-interventionalist-s-experience
#8
Matthias Buechter, Paul Manka, Guido Gerken, Ali Canbay, Sandra Blomeyer, Axel Wetter, Jens Altenbernd, Alisan Kahraman, Jens M Theysohn
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice in decompensated portal hypertension. TIPS revision due to thrombosis or stenosis increases morbidity and mortality. Our aim was to investigate patient- and procedure-associated risk factors for TIPS-revision. PATIENTS AND METHODS: We retrospectively evaluated 189 patients who underwent the TIPS procedure. Only patients who required TIPS revision within 1 year (Group I, 34 patients) and patients who did not require re-intervention within the first year (Group II [control group], 54 patients) were included...
January 9, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29314093/hospice-care-in-medicare-patients-with-primary-liver-cancer-the-impact-on-resource-utilisation-and-mortality
#9
N Fukui, P Golabi, M Otgonsuren, L de Avila, H Bush, Z M Younossi
BACKGROUND: Few studies have assessed the impact of hospice care in patients with primary liver cancer. AIM: To examine the determinants of hospice care and its effects on resource utilisation and survival among Medicare beneficiaries with primary liver cancer. METHODS: We utilised the Surveillance, Epidemiology and End result Registry (SEER) database from 2002 to 2009 for this cross-sectional study. A total of 3385 patients with primary liver cancer were included...
January 3, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29306043/safety-and-effectiveness-of-ledipasvir-and-sofosbuvir-with-or-without-ribavirin-in-treatment-experienced-patients-with-genotype-1-hepatitis-c-virus-infection-and-cirrhosis
#10
Joseph K Lim, Ann Marie Liapakis, Mitchell L Shiffman, Anna S Lok, Stefan Zeuzem, Norah A Terrault, James S Park, Charles S Landis, Mohamed Hassan, Joel Gallant, Alexander Kuo, Paul J Pockros, Monika Vainorius, Lucy Akushevich, Larry Michael, Michael W Fried, David R Nelson, Ziv Ben-Ari
BACKGROUND & AIMS: We aimed to evaluate the safety and effectiveness of 12 or 24 weeks treatment with ledipasvir and sofosbuvir, with or without ribavirin, in treatment-experienced patients with hepatitis C virus (HCV) genotype 1 infection and cirrhosis in routine clinical practice. Patients were followed in a multi-center, prospective, observational cohort study (HCV-TARGET). METHODS: We collected data from 667 treatment-experienced adults with chronic genotype 1 HCV infection who began treatment with ledipasvir and sofosbuvir, with or without ribavirin, from 2011 through September 15, 2016, according to the regional standards of care, at academic (n=39) and community (n=18) centers in the United States, Canada, Germany, and Israel...
January 3, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29290908/liver-decompensation-predicts-ribavirin-overexposure-in-hepatitis-c-virus-patients-treated-with-direct-acting-antivirals
#11
Viola Guardigni, Lorenzo Badia, Matteo Conti, Matteo Rinaldi, Rita Mancini, Pierluigi Viale, Gabriella Verucchi
AIM: To determine whether ribavirin (RBV) concentrations differ according to cirrhosis stage among cirrhotic patients treated with interferon-free regimens. METHODS: We included patients with hepatitis C virus and cirrhosis [Child-Pugh (CP) A or B], Glomerular Filtration Rate ≥ 60 mL/min, who started therapy with DAAs and weight-based RBV between October 2014 and February 2016. RBV plasma levels were assessed during the treatment. We focused our analysis on the first 8 wk of therapy...
December 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#12
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29288595/inpatient-hospital-burden-of-hepatitis-c-diagnosed-patients-with-decompensated-cirrhosis
#13
Scott A McDonald, Hamish A Innes, Esther Aspinall, Peter C Hayes, Maryam Alavi, Heather Valerio, David J Goldberg, Sharon J Hutchinson
BACKGROUND & AIMS: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. METHODS: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland...
December 30, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29283168/corrigendum-statins-reduce-the-risk-of-cirrhosis-and-its-decompensation-in-chronic-hepatitis-b-patients-a-nationwide-cohort-study
#14
Yi-Wen Huang, Chia-Long Lee, Sien-Sing Yang, Szu-Chieh Fu, Yun-Yi Chen, Ting-Chuan Wang, Jui-Ting Hu, Ding-Shinn Chen
This corrects the article DOI: 10.1038/ajg.2016.179.
December 26, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29278428/outcomes-after-multiple-courses-of-granulocyte-colony-stimulating-factor-and-growth-hormone-in-decompensated-cirrhosis-randomized-trial
#15
Nipun Verma, Amritjyot Kaur, Ratiram Sharma, Ashish Bhalla, Navneet Sharma, Arka De, Virendra Singh
BACKGROUND AND AIM: Decompensated cirrhosis carries a high mortality. Liver transplantation (LT) is the treatment of choice; however, the limited availability of donor organs has resulted in high waitlist mortality. The present study investigated the impact of multiple courses of granulocyte-colony stimulating factor (G-CSF) with or without growth hormone (GH) in these patients. METHODS: Sixty-five patients with decompensated cirrhosis were randomized to standard medical therapy (SMT) plus G-CSF 3 monthly plus GH daily (group A; n=23) or SMT plus G-CSF (group B; n=21) or SMT alone (group C; n=21)...
December 26, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29274189/the-incidence-and-predictors-of-hbv-relapse-after-cessation-of-tenofovir-therapy-in-chronic-hepatitis-b-patients
#16
Chien-Hung Chen, Yao-Chun Hsu, Sheng-Nan Lu, Chao-Hung Hung, Jing-Houng Wang, Chuan-Mo Lee, Tsung-Hui Hu
This study investigates the incidences and predictors of hepatitis B virus (HBV) relapse after tenofovir disoproxil fumarate (TDF) therapy in hepatitis B e antigen (HBeAg)-positive and -negative patients. We retrospectively recruited 143 chronic hepatitis B (CHB) patients without cirrhosis (39 HBeAg-positive and 104 HBeAg-negative patients) who were previously treated with TDF and had post-treatment follow-up for at least 6 months (median: 55, IQR 36-85 weeks). All the patients fulfilled the stopping criteria of APASL 2012...
December 23, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29240010/well-preserved-renal-function-in-children-with-untreated-chronic-liver-disease
#17
Ulla B Berg, Antal Németh
OBJECTIVES: Based on studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease. Therefore we investigated renal function in our children with chronic liver disease. METHODS: In a retrospective study of 277 children with chronic liver disease, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol...
December 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29235260/functional-polymorphisms-of-innate-immunity-receptors-are-not-risk-factors-for-the-non-sbp-type-bacterial-infections-in-cirrhosis
#18
Tamas Dinya, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, Boglárka Balogh, David Tornai, Peter Antal-Szalmas, Andrea Sumegi, Hajnalka Andrikovics, Andras Bors, Attila Tordai, Maria Papp
BACKGROUND&AIMS: Pattern recognition receptors (PRRs) have a key role in the innate host defense. Functional polymorphisms of various PRRs have been established to contribute to an increased susceptibility to spontaneous bacterial peritonitis (SBP). Their role in the development of cirrhosis-associated bacterial infections (BI), beyond SBP or progressive disease course related to pathological bacterial translocation (BT) remains unknown. METHODS: 349 patients with cirrhosis were genotyped for common NOD2 (R702W, G908R and L1007PfsinsC), TLR2 (-16934T>A), and TLR4 (D299G) variants...
December 13, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29234199/prevalence-and-characteristics-of-hepatitis-delta-virus-infection-in-a-tertiary-hospital-setting-in-cameroon
#19
Henry N Luma, Servais A F B Eloumou, Cécile Okalla, Olivier Donfack-Sontsa, Ruth Koumitana, Agnes Malongue, Georges B Nko'Ayissi, Dominique N Noah
Background/Aims: Hepatitis B virus (HBV) and hepatitis D virus (HDV) coinfection is associated with more severe liver disease than HBV alone. More knowledge on the epidemiology and clinical impact of HDV-infected individuals is needed in Cameroon.We aimed at determining the frequency of anti-HDV antibody testing in hepatitis B surface antigen (HBsAg) positive patients, the proportion of anti-HDV positivity, and the characteristics of anti-HDV positive compared to anti-HDV negative patients in a tertiary hospital setting in Cameroon...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#20
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
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