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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/28731786/high-post-treatment-%C3%AE-fetoprotein-levels-and-aspartate-aminotransferase-to-platelet-ratio-index-predict-hepatocellular-carcinoma-in-hepatitis-c-virus-decompensated-cirrhotic-patients-with-sustained-virological-response-after-antiviral-therapy
#1
Fanpu Ji, Rui Zhou, Wenjun Wang, Dan Bai, Caini He, Zhifang Cai, Yuan Shen, Shengbang Wang, Hong Deng, Zongfang Li
Although eradication of hepatitis C virus (HCV) decreases the risk of hepatocellular carcinoma (HCC) development, a considerable level of risk remains in cirrhotic patients with advanced liver disease. Yet, data for the effect of serum markers on HCC development in this population after viral eradication are still lacking. Seventy-eight consecutive patients with HCV infection and decompensated cirrhosis were administered interferon-based regimens at our hospital between August 2008 and December 2013. Thirty-four achieved sustained virological response and were enrolled in the study...
July 21, 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/28728560/patient-oriented-education-and-medication-management-intervention-for-people-with-decompensated-cirrhosis-study-protocol-for-a-randomized-controlled-trial
#2
Kelly L Hayward, Jennifer H Martin, W Neil Cottrell, Antara Karmakar, Leigh U Horsfall, Preya J Patel, David D Smith, Katharine M Irvine, Elizabeth E Powell, Patricia C Valery
BACKGROUND: People with decompensated cirrhosis require complex medical care and are often prescribed an intricate and frequently changing medication and lifestyle regimen. However, many patients mismanage their medications or have poor comprehension of their disease and self-management tasks. This can lead to harm, hospitalization, and death. METHODS/DESIGN: A patient-oriented education and medication management intervention has been developed for implementation at a tertiary hospital hepatology outpatient center in Queensland, Australia...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28719013/in-an-era-of-highly-effective-treatment-hepatitis-c-screening-of-the-general-population-of-the-united-states-for-hepatitis-c-should-be-considered
#3
Zobair Younossi, Deidre Blissett, Rob Blissett, Linda Henry, Youssef Younossi, Rachel Beckerman, Sharon Hunt
BACKGROUND AND AIMS: Hepatitis C virus (HCV) treatment with all oral direct acting antiviral agents (DAA's) achieve sustained virologic response (SVR) rates of 98%. Re-assessment of general US population screening for HCV is imperative. This study compared the cost-effectiveness (CE) of three HCV screening strategies: screen all (SA), screen Birth Cohort (BCS), and screen high risks (HRS). METHODS: Using a previous designed decision-analytic Markov model, estimations of the natural history of HCV and CE evaluation of the three HCV screening strategies over a lifetime horizon in the US population was undertaken...
July 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28706365/obstetric-outcome-in-women-with-chronic-liver-disease
#4
Pinky Jena, C N Sheela, Rao Preethi Venkatachala, Harshad Devarbhavi
AIM: This study determines the prevalence, causes and outcome of pregnancy in women with chronic liver diseases in a tertiary level teaching institute in Southern India. METHODS: Retrospective analysis of case records was carried out between December 2010 and May 2015 in the departments of Obstetrics and Gynecology and Gastroenterology including pregnant women diagnosed to have chronic liver diseases prenatally or during pregnancy. RESULTS: The frequency of chronic liver disease in pregnancy was 50 among 10,823 deliveries (0...
August 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28704381/sofosbuvir-based-treatment-of-chronic-hepatitis-c-genotype-3-infections-a-scandinavian-real-life-study
#5
Olav Dalgard, Ola Weiland, Geir Noraberg, Lars Karlsen, Lars Heggelund, Martti Färkkilâ, Ulla Balslev, Erika Belard, Anne Øvrehus, Mette Skalshøi Kjær, Henrik Krarup, Birgit Thorup Røge, Sofie Hallager, Lone G Madsen, Alex Lund Laursen, Martin Lagging, Nina Weis
BACKGROUND AND AIMS: Chronic hepatitis C virus (HCV) genotype 3 infection with advanced liver disease has emerged as the most challenging to treat. We retrospectively assessed the treatment outcome of sofosbuvir (SOF) based regimes for treatment of HCV genotype 3 infections in a real life setting in Scandinavia. METHODS: Consecutive patients with chronic HCV genotype 3 infection were enrolled at 16 treatment centers in Denmark, Sweden, Norway and Finland. Patients who had received a SOF containing regimen were included...
2017: PloS One
https://www.readbyqxmd.com/read/28702738/impact-of-etiological-treatment-on-prognosis
#6
REVIEW
Chien-Wei Su, Ying-Ying Yang, Han-Chieh Lin
Portal hypertension (PHT) is a frequent and severe complication of cirrhosis. PHT may lead to the development of various complications with high mortality. Liver transplantation is the gold standard as a surgical curative treatment for end-stage liver disease. Theoretically, etiological treatment focusing on the pathophysiology of the underlying disease should be the objective of the nonsurgical management of cirrhotic PHT. Chronic viral hepatitis is the major etiology of cirrhosis and PHT. In cirrhotic patients with chronic hepatitis B virus infection, antiviral therapies can suppress viral replication, ameliorate hepatic inflammation, regress fibrosis, and restore liver functional reserve...
July 12, 2017: Hepatology International
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#7
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28696845/decompensated-cirrhosis-and-sickle-cell-disease-case-reports-and-review-of-the-literature
#8
Roberta D'Ambrosio, Marco Maggioni, Maria F Donato, Pietro Lampertico, Maria D Cappellini, Giovanna Graziadei
Although its prevalence is unknown, liver involvement by sickle cell disease is not uncommon and encompasses different clinical spectra including non cholestatic and cholestatic disorders. Few data have been provided on chronic sickle cell intrahepatic cholestasis (SCIC) clinical course, although cirrhosis has been reported in sickle cell disease. However, no effective therapeutic approaches have been recognized either to prevent or treat this condition. Here we present two cases of adult sickle cell disease patients with decompensated cirrhosis...
March 2017: Hemoglobin
https://www.readbyqxmd.com/read/28687550/sofosbuvir-velpatasvir-a-single-tablet-treatment-for-hepatitis-c-infection-of-all-genotypes
#9
REVIEW
Misty M Miller
PURPOSE: The pharmacology, pharmacokinetics, interaction potential, efficacy, and safety of the newest direct-acting antiviral (DAA) medication for the treatment of chronic hepatitis C are reviewed. SUMMARY: Nonstructural proteins 5A (NS5A) and 5B (NS5B) are key drivers of hepatitis C virus (HCV) replication. Velpatasvir, an inhibitor of NS5A, was coformulated with the NS5B inhibitor sofosbuvir to provide a single-tablet combination DAA (Epclusa, Gilead Sciences)...
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28684103/late-hepatitis-b-and-c-diagnosis-in-relation-to-disease-decompensation-and-hepatocellular-carcinoma-development
#10
Hasina Samji, Amanda Yu, Margot Kuo, Maryam Alavi, Ryan Woods, Maria Alvarez, Gregory J Dore, Mark Tyndall, Mel Krajden, Naveed Z Janjua
BACKGROUND AND AIMS: We measured the timing of HBV and HCV diagnoses relative to detection of decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC) as an indicator of late hepatitis diagnosis. METHODS: HBV and HCV diagnoses were defined relative to the diagnosis of DC or HCC such that HBV/HCV diagnoses within two years prior, at the time of or after HCC or DC diagnosis were considered late. We performed multivariable logistic regression to assess factors associated with late HBV/HCV diagnoses among those with DC or HCC...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28681347/new-concepts-on-the-clinical-course-and-stratification-of-compensated-and-decompensated-cirrhosis
#11
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis has been typically described by a compensated and a decompensated state based on the absence or, respectively, the presence of any of bleeding, ascites, encephalopathy or jaundice. More recently, it has been recognized that increasing portal hypertension and several major clinical events are followed by a marked worsening in prognosis, and disease states have been proposed accordingly in a multistate model. The development of multistate models implies the assessment of the probabilities of more than one possible outcome from each disease state...
July 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28679676/economic-evaluation-of-a-community-based-diagnostic-pathway-to-stratify-adults-for-non-alcoholic-fatty-liver-disease-a-markov-model-informed-by-a-feasibility-study
#12
Lukasz Tanajewski, Rebecca Harris, David J Harman, Guruprasad P Aithal, Timothy R Card, Georgios Gkountouras, Vladislav Berdunov, Indra N Guha, Rachel A Elliott
OBJECTIVES: To assess the long-term cost-effectiveness of a risk stratification pathway, compared with standard care, for detecting non-alcoholic fatty liver disease (NAFLD) in primary care. SETTING: Primary care general practices in England. PARTICIPANTS: Adults who have been identified in primary care to have a risk factor for developing NAFLD, that is, type 2 diabetes without a history of excessive alcohol use. INTERVENTION: A community-based pathway, which uses transient elastography and hepatologists to stratify patients at risk of NAFLD, has been implemented and demonstrated to be feasible (NCT02037867)...
July 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28678688/flood-syndrome-spontaneous-umbilical-hernia-rupture-leaking-ascitic-fluid-a-case-report
#13
Emilie T Nguyen, Leah A Tudtud-Hans
INTRODUCTION: We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. CASE PRESENTATION: A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28675370/early-spontaneous-graft-intra-and-perihepatic-hematoma-after-liver-transplantation
#14
Cristian Lupaşcu, Oana Apopei, Nutu Vlad, Ciprian Vasiluta, Ana-Maria Trofin, Mihai Zabara, Alexandra Vornicu, Corina Lupaşcu-Ursulescu, Mioara Nitu, Felicia Crumpei, Vladislav Braşoveanu, Irinel Popescu
Hematoma of the graft is a life threatening complication of liver transplantation (LT) and there has been no overt conclusion in the literature about optimal management except in scarcely reported cases. It may be either intrahepatic or subcapsular, then again it may develop spontaneously or following parenchimal injuries or transhepatic percutaneous invasive manoeuvers. In this report we describe a rare case of large spontaneous graft intra- and perihepatic hematoma. A 62 year-old man underwent a whole graft orthotopic liver transplantation (OLT) for decompensated chronic liver disease due to alcoholic cirrhosis...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28673658/long-term-hepatotoxicity-of-yttrium-90-radioembolization-as-treatment-of-metastatic-neuroendocrine-tumor-to%C3%A2-the%C3%A2-liver
#15
Yu-Kai Su, Rosewell V Mackey, Ahsun Riaz, Vanessa L Gates, Al B Benson, Frank H Miller, Vahid Yaghmai, Ahmed Gabr, Riad Salem, Robert J Lewandowski
PURPOSE: To determine long-term hepatotoxicity of yttrium-90 ((90)Y) radioembolization in patients treated for metastatic neuroendocrine tumor (mNET) and evaluate if imaging and laboratory findings of cirrhosis-like morphology are associated with clinical symptoms. MATERIALS AND METHODS: Retrospective review from 2003 to 2016 was performed for patients with mNET treated with (90)Y glass microspheres. Fifty-four patients with > 2 year follow-up were stratified into unilobar (n = 15) vs whole-liver (n = 39) treatment...
June 30, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28671712/rifaximin-has-minor-effects-on-bacterial-composition-inflammation-and-bacterial-translocation-in-cirrhosis-a-randomized-trial
#16
Nina Kimer, Julie S Pedersen, Juliette Tavenier, Jeffrey E Christensen, Troels M Busk, Lise Hobolth, Aleksander Krag, Waleed Abu Al-Soud, Martin S Mortensen, Søren J Sørensen, Søren Møller, Flemming Bendtsen
BACKGROUND & AIMS: Decompensated cirrhosis is characterized by disturbed haemodynamics, immune dysfunction, and high risk of infections. Translocation of viable bacteria and bacterial products from the gut to the blood is considered a key driver in this process. Intestinal decontamination with rifaximin may reduce bacterial translocation (BT) and decrease inflammation. In a randomized, placebo-controlled trial investigated the effects of rifaximin on inflammation and BT in decompensated cirrhosis...
July 3, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28669353/possible-gasoline-induced-chronic-liver-injury-due-to-occupational-malpractice-in-a-motor-mechanic-a-case-report
#17
Mahesh Lakmal Gunathilaka, Madunil Anuk Niriella, Nathasha Vihangi Luke, Chathura Lakmal Piyarathna, Rohan Chaminda Siriwardena, Arjuna Priyadarshin De Silva, Hithanadura Janaka de Silva
BACKGROUND: Hydrocarbon-induced occupational liver injury is a well-known clinical entity among petroleum industry workers. There are many types of hydrocarbon exposure, with inhalation being the most common. Hydrocarbon-induced occupational liver injury is a rarely suspected and commonly missed etiological agent for liver injury. We report a case of a non-petroleum industry worker with chronic liver disease secondary to hydrocarbon-induced occupational liver injury caused by chronic low-grade hydrocarbon ingestion due to occupational malpractice...
July 3, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28665532/characterization-of-body-composition-and-definition-of-sarcopenia-in-patients-with-alcoholic-liver-cirrhosis-a-computed-tomography-based-study
#18
Jaya Benjamin, Varsha Shasthry, Chetan Ramesh Kalal, Lovkesh Anand, Ankit Bhardwaj, Vanshja Pandit, Ankur Arora, Sasidharan Rajesh, Viniyendra Pamecha, Vikas Jain, Guresh Kumar, Anthony Lauria, Puneet Puri, Yogendra Kumar Joshi, Shiv Kumar Sarin
Alterations in body composition (BC) as loss of fat and muscle mass (sarcopenia) are associated with poor outcome in alcoholic liver cirrhosis (ALC). Prevalence of sarcopenia depends upon the method of assessment. Computed Tomography (CT) is a gold standard tool for assessing BC AIM: To characterize BC and define sarcopenia in ALC patients using CT METHODS: Single slice CT images at L3 vertebrae of healthy controls (HC) - organ transplant donors and ALC patients were analysed to give cross-sectional area of five skeletal muscles normalized for height -skeletal muscle index (SMI; cm(2) /m(2) ), area of subcutaneous (SAT;cm(2) ) and visceral adipose tissue (VAT;cm(2) )...
June 30, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28665498/enoxaparin-does-not-ameliorate-liver-fibrosis-or-portal-hypertension-in-rats-with-advanced-cirrhosis
#19
José I Fortea, Alexander Zipprich, Carolina Fernandez-Mena, Marta Puerto, Cristina R Bosoi, Jorge Almagro, Marcus Hollenbach, Juan Bañares, Belén Rodríguez-Sánchez, Emilia Cercenado, Marc-André Clément, Christopher F Rose, Rafael Bañares, Javier Vaquero, Cristina Ripoll
BACKGROUND & AIMS: Recent studies suggest that heparins reduce liver fibrosis and the risk of decompensation of liver disease. Here, we evaluated the effects of enoxaparin in several experimental models of advanced cirrhosis. METHODS: Cirrhosis was induced in male Sprague-Dawley (SD) rats by: i. Oral gavage with carbon tetrachloride (CCl4ORAL ), ii. Bile duct ligation (BDL), and iii. CCl4 inhalation (CCl4INH ). Rats received saline or enoxaparin s.c. (40 IU/Kg/d or 180 IU/Kg/d) following various protocols...
June 30, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28663680/hepatocellular-carcinoma-an-unusual-complication-of-longstanding-wilson-disease
#20
Deepak Gunjan, Shalimar, Neeti Nadda, Saurabh Kedia, Baibaswata Nayak, Shashi B Paul, Shivanand Ramachandra Gamanagatti, Subrat K Acharya
Wilson disease is caused by the accumulation of copper in the liver, brain or other organs, due to the mutation in ATP7B gene, which encodes protein that helps in excretion of copper in the bile canaliculus. Clinical presentation varies from asymptomatic elevation of transaminases to cirrhosis with decompensation. Hepatocellular carcinoma is a known complication of cirrhosis, but a rare occurrence in Wilson disease. We present a case of neurological Wilson disease, who later developed decompensated cirrhosis and hepatocellular carcinoma...
June 2017: Journal of Clinical and Experimental Hepatology
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