Read by QxMD icon Read

Decompensated cirrhosis

Anne Liu, An Le, Jian Zhang, Chris Wong, Clifford Wong, Linda Henry, Mindie H Nguyen
OBJECTIVES: Data on liver and non-liver co-morbidities in chronic hepatitis B (CHB) patients are limited. This study analyzes the prevalence of co-morbidities in a multicenter CHB cohort evaluated over 15 years. METHODS: This study included 2734 consecutive adult American CHB patients from a university medical center and several community primary care clinics. Data were analyzed by time periods (patients in each time period were unique without overlapping): 2000-2005 (n = 885), 2006-2010 (n = 888), and 2011-2015 (n = 961)...
March 14, 2018: Clinical and Translational Gastroenterology
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
O El-Sherif, Z G Jiang, E B Tapper, K C Huang, A Zhong, A Osinusi, M Charlton, M Manns, N H Afdhal, K Mukamal, J McHutchison, D M Brainard, N Terrault, M P Curry
BACKGROUND & AIMS: Treatment with direct-acting antiviral (DAA) agents can reduce model for end-stage liver disease and Child-Pugh-Turcotte (CPT) scores in patients with decompensated cirrhosis caused by hepatitis C virus (HCV). However, many of these patients still die or require liver transplantation. We collected data on baseline features of patients and aimed to develop a scoring system to predict response to DAA therapy. METHODS: We performed a retrospective analysis of data from 4 trials of the effects of sofosbuvir-based therapy in patients with HCV-associated decompensated cirrhosis (502 of CPT class B and 120 of CPT class C)...
March 10, 2018: Gastroenterology
Michele Barone, Endrit Shahini, Andrea Iannone, Maria Teresa Viggiani, Valeria Corvace, Mariabeatrice Principi, Alfredo Di Leo
BACKGROUND: A critical flicker frequency (CFF) ≤39 Hz identifies cirrhotic patients with minimal hepatic encephalopathy (mHE) and predicts the risk of both overt hepatic encephalopathy (oHE) and mortality in patients with previous episodes of decompensation and/or oHE. AIMS: Herein, we evaluated the effectiveness of CFF in predicting the first episode of oHE and survival in cirrhotics who had never experienced an episode of oHE. METHODS: Our cohort study of 134 patients and 150 healthy subjects were examined...
January 31, 2018: Digestive and Liver Disease
Erik Mogalian, Diana M Brainard, Anu Osinusi, Lisa Moorehead, Bernard Murray, Kah Hiing John Ling, Robert Perry, Craig Curtis, Eric Lawitz, Kenneth Lasseter, Thomas Marbury, Anita Mathias
BACKGROUND: The pharmacokinetics and safety of velpatasvir, a potent pangenotypic hepatitis C virus NS5A inhibitor, were evaluated in two hepatic impairment studies: a phase I study in hepatitis C virus-uninfected subjects and a phase III study (ASTRAL-4) in hepatitis C virus-infected patients. METHODS: In the phase I study, subjects with moderate or severe hepatic impairment (Child-Pugh-Turcotte Class B or C), and demographically matched subjects with normal hepatic function received a single dose of velpatasvir 100 mg...
March 8, 2018: Clinical Pharmacokinetics
Barbara Kimbell, Scott A Murray, Heidi Byrne, Andrea Baird, Peter C Hayes, Alastair MacGilchrist, Anne Finucane, Patricia Brookes Young, Ronan E O'Carroll, Christopher J Weir, Marilyn Kendall, Kirsty Boyd
BACKGROUND: Liver disease is an increasing cause of death worldwide but palliative care is largely absent for these patients. AIM: We conducted a feasibility trial of a complex intervention delivered by a supportive care liver nurse specialist to improve care coordination, anticipatory care planning and quality of life for people with advanced liver disease and their carers. DESIGN: Patients received a 6-month intervention (alongside usual care) from a specially trained liver nurse specialist...
March 1, 2018: Palliative Medicine
Jasmohan S Bajaj, Leroy R Thacker, Andrew Fagan, Melanie B White, Edith A Gavis, Phillip B Hylemon, Robert Brown, Chathur Acharya, Douglas M Heuman, Michael Fuchs, Swati Dalmet, Masoumeh Sikaroodi, Patrick M Gillevet
BACKGROUND: Cirrhosis is associated with gut microbial changes, but current 16S rDNA techniques sequence both dead and live bacteria. We aimed to determine the rRNA content compared with DNA from the same stool sample to evaluate cirrhosis progression and predict hospitalizations. METHODS: Cirrhotics and controls provided stool for RNA and DNA analysis. Comparisons were made between cirrhotics/controls and within cirrhosis (compensated/decompensated, infected/uninfected, renal dysfunction/not, rifaximin use/not) with respect to DNA and RNA bacterial content using linear discriminant analysis...
March 8, 2018: JCI Insight
Emma Nilsson, Harald Anderson, Konstantina Sargenti, Stefan Lindgren, Hanne Prytz
OBJECTIVES: Liver cirrhosis is characterized by a silent phase until decompensation, which is defined by onset of ascites, variceal bleeding, or encephalopathy. Although it is presumed that the survival of decompensated patients is the same regardless of when decompensation occurs, data to support this are scarce. We aimed to study the impact of time of decompensation on the clinical course and survival of patients with cirrhosis in a large population-based cohort. MATERIALS AND METHODS: We used medical registries to define a 10-year cohort of 1317 patients with incident liver cirrhosis in the Scania region of Sweden...
March 7, 2018: Scandinavian Journal of Gastroenterology
Vikash Reebye, Kai-Wen Huang, Vivian Lin, Sheba Jarvis, Pedro Cutilas, Stephanie Dorman, Simona Ciriello, Pinelopi Andrikakou, Jon Voutila, Pal Saetrom, Paul J Mintz, Isabella Reccia, John J Rossi, Hans Huber, Robert Habib, Nikos Kostomitsopoulos, David C Blakey, Nagy A Habib
Liver diseases are a growing epidemic worldwide. If unresolved, liver fibrosis develops and can lead to cirrhosis and clinical decompensation. Around 5% of cirrhotic liver diseased patients develop hepatocellular carcinoma (HCC), which in its advanced stages has limited therapeutic options and negative survival outcomes. CEPBA is a master regulator of hepatic function where its expression is known to be suppressed in many forms of liver disease including HCC. Injection of MTL-CEBPA, a small activating RNA oligonucleotide therapy (CEBPA-51) formulated in liposomal nanoparticles (NOV340- SMARTICLES) upregulates hepatic CEBPA expression...
March 7, 2018: Oncogene
Giuliano Ramadori, Patrizia Bosio, Federico Moriconi, Ihtzaz A Malik
BACKGROUND: After orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC), recurrent HCC mostly develops within 2 years. All cases of de novo HCC described so far occurred later than 2 years after OLT. Prevention of post-transplantation HCC has usually been tried to achieve by curing or controlling recurrent liver disease. This has been rationale for treatment with interferon (IFN)/ribavirin of HCV-recurrence in patients after OLT, transplanted for advanced HCV-induced liver disease and/or HCC...
March 6, 2018: BMC Cancer
Zixin Shu, Wenwen Liu, Huikun Wu, Mingzhong Xiao, Deng Wu, Ting Cao, Meng Ren, Junxiu Tao, Chuhua Zhang, Tangqing He, Xiaodong Li, Runshun Zhang, Xuezhong Zhou
BACKGROUND AND OBJECTIVE: Liver disease is a multifactorial complex disease with high global prevalence and poor long-term clinical efficacy and liver disease patients with different comorbidities often incorporate multiple phenotypes in the clinic. Thus, there is a pressing need to improve understanding of the complexity of clinical liver population to help gain more accurate disease subtypes for personalized treatment. METHODS: Individualized treatment of the traditional Chinese medicine (TCM) provides a theoretical basis to the study of personalized classification of complex diseases...
February 22, 2018: Computer Methods and Programs in Biomedicine
Mireia Miquel, Montserrat Clèries, Mercedes Vergara, Emili Vela
BACKGROUND: Cirrhosis is a chronic disease with high morbidity and mortality. Few studies have evaluated healthcare resource use in patients with cirrhosis. OBJECTIVE: We aimed to describe the point prevalence of cirrhosis on 31 December 2012 and the population-level distribution of healthcare resource use and expenditures in a non-selected population of patients with cirrhosis, stratified by whether their disease was compensated or decompensated, and by comorbidity burden...
March 3, 2018: BMJ Open
Wankyo Chung, Changik Jo, Woo Jin Chung, Dong Joon Kim
BACKGROUND: Liver cirrhosis is known to have low survival rate, and its assessment in relation with other fatal diseases will help us design appropriate health interventions. This study compares the mortality of liver cirrhosis with that of five major cancers (lung, colorectal, stomach, liver, and breast cancers). METHODS AND RESULTS: We used the National Health Insurance Service-National Sample Cohort (NHIS-NSC) which provides data for 1,025,340 representative samples of the 46,605,433 people in Korea from 2002 to 2010...
March 1, 2018: Hepatology International
Jeffrey Berinstein, Alisa Likhitsup, Sai Charan Vedula, Hari Conjeevaram
Cryptococcal peritonitis is an under-recognized disease that is an important cause of mortality in end-stage liver disease. We report a 43-year old male with decompensated cirrhosis secondary to refractory autoimmune hepatitis on immunosuppression with hepatocellular carcinoma who developed cryptococcal peritonitis. The patient subsequently developed ischemic bowel and multisystem organ failure secondary to abdominal compartment syndrome, leading to rapid deterioration and death. Frequently, these patients experience delays in diagnosis and treatment, which leads to a rapid and high mortality...
December 21, 2017: Curēus
Elias Tsiompanidis, Spyros I Siakavellas, Anastasios Tentolouris, Ioanna Eleftheriadou, Stamatia Chorepsima, Anastasios Manolakis, Konstantinos Oikonomou, Nikolaos Tentolouris
AIM: To examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy (CAN). METHODS: A total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram recordings were obtained and QT as well as corrected QT interval (QTc) and their dispersions (dQT, dQTc) were measured and calculated using a computer-based program. The diagnosis of CAN was based upon the battery of the tests proposed by Ewing and Clarke and the consensus statements of the American Diabetes Association...
February 15, 2018: World Journal of Gastrointestinal Pathophysiology
B Wang, K Agarwal, D Joshi
Chronic hepatitis B infection is a global public health problem associated with significant morbidity and mortality. Persistent infection may evolve to liver cirrhosis and hepatocellular carcinoma, and hepatitis B-related liver disease is a common indication for liver transplantation. Patients with advanced liver disease should be treated with antiviral therapy which may result in clinical improvement. The management of patients after liver transplant then focuses on preventing hepatitis B recurrence in the graft...
January 2018: Frontline Gastroenterology
Gonzalo Crespo, Núria Trota, Maria-Carlota Londoño, Ezequiel Mauro, Carme Baliellas, Lluís Castells, Jose Castellote, Jaume Tort, Xavier Forns, Miquel Navasa
BACKGROUND AND AIMS: The efficacy of direct-acting antivirals (DAA) has dramatically changed the prognosis of patients with chronic hepatitis C. We aimed to evaluate the impact of DAA therapy in the composition of the liver transplant (LT) waiting list and the early post-transplant survival. METHODS: We evaluated all patients admitted in the waiting list for a primary LT between 1/1/2008 and 31/12/2016 in Catalonia, Spain. Time span was divided into two periods according to the availability of different antiviral therapies: 2008-2013 (IFN-based therapies) and 2014-2016 (DAA)...
February 23, 2018: Journal of Hepatology
Zobair M Younossi, Atsushi Tanaka, Yuichiro Eguchi, Linda Henry, Rachel Beckerman, Masashi Mizokami
Hepatocellular carcinoma (HCC) is a serious complication of hepatitis B and (HBV) C virus (HCV) infection. Sustained virologic response (SVR) for HCV is associated with a reduction in cirrhosis, HCC and mortality and their associated costs. Japanese HCV patients are older with higher prevalence of HCC. Here we used a decision analytic Markov model to estimate the economic benefit of HCV cure by reducing HCC and DCC in Japan. A cohort of 10,000 HCV genotype 1b (GT1b) Japanese patients was modeled with a hybrid decision tree and Markov state-transition model capturing natural history of HCV over a lifetime horizon...
February 25, 2018: Journal of Viral Hepatitis
Astrid Ruiz-Margáin, Alessandra Pohlmann, Patrick Ryan, Robert Schierwagen, Luis A Chi-Cervera, Christian Jansen, Osvely Mendez-Guerrero, Nayelli C Flores-García, Jennifer Lehmann, Aldo Torre, Ricardo Ulises Macías-Rodríguez, Jonel Trebicka
OBJECTIVE: Acute-on-chronic liver failure (ACLF) develops in acute decompensation of cirrhosis and shows high mortality. In critically ill patients, early diagnosis of ACLF could be important for therapeutic decisions (e.g. renal replacement, artificial liver support, liver transplantation). This study evaluated fibroblast growth factor 21 (FGF21), as a marker of mitochondrial dysfunction in the context of ACLF. DESIGN: The study included 154 individuals (112 critically patients and 42 healthy controls) divided into a training and a validation cohort...
February 24, 2018: Liver Transplantation
Jonathan G Stine, Jennifer Wang, Scott L Cornella, Brian W Behm, Zachary Henry, Neeral L Shah, Stephen H Caldwell, Patrick G Northup
INTRODUCTION: Type-1 hepatorenal syndrome (HRS-1) portends a poor prognosis in patients with cirrhosis. Currently available medical therapies are largely ineffective, save for liver transplantation. We aimed to determine if pentoxifylline (PTX) therapy in addition to the standard of care of volume expansion with albumin and vasoconstriction with midodrine and octreotide (AMO) is safe and efficacious compared to AMO in HRS-1 treatment. MATERIAL AND METHODS: Hospitalized subjects with decompensated cirrhosis and HRS-1 were enrolled...
March 1, 2018: Annals of Hepatology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"