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Peritonitis NOT "spontaneous bacterial peritonitis"

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https://www.readbyqxmd.com/read/28953058/albumin-use-in-patients-with-cirrhosis-in-france-results-of-the-albu-live-survey-a-case-for-better-easl-guidelines-diffusion-and-or-revision
#1
Armand Garioud, Jean-François Cadranel, Arnaud Pauwels, Jean-Baptiste Nousbaum, Thierry Thévenot, Thong Dao, Alexandre Louvet, Philippe Sogni, Nathalie Talbodec, Teresa M Antonini, Christophe Bureau, Dominique Thabut, Laure Elkrief, Vincent Jouannaud, Gilles Macaigne, Brigitte Bernard-Chabert, Hortensia Lison, Laurent Alric, Nicolas Carbonell, Héléne Labadie, Xavier Amiot, Armand Abergel, Bertrand Hanslik, Vincent Leroy, Victor De Lédinghen, Jacques Denis
INTRODUCTION: The use of human albumin for the management of cirrhosis has increased. Recommendations have been published for therapeutic paracentesis (TP), spontaneous bacterial peritonitis (SBP), and type 1 hepatorenal syndrome (HRS). The goal of this survey was to assess the prescription practices of French hepatogastroenterologists. METHODS: All hepatogastroenterologists were contacted. The questionnaire evaluated (1) the use of albumin in validated indications and (2) the prescription of albumin for nonvalidated clinical situations...
August 4, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28919607/impact-of-adrenocortical-insufficiency-on-clinical-parameters-in-haemodynamically-stable-cirrhotic-patients-with-ascites
#2
H Ahmed, M R Karim, R K Paul, M Chowdhury, M S Alam, A Saha, F Rahman, M A Rouf
Cirrhosis has many complications regardless of the aetiology. Complications include splenomegaly, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma and also linked to abnormalities in the endocrine system, including abnormal sex hormone metabolism, thyroid disease, osteoporosis, and, most recently identified, adrenal insufficiency. This prospective cohort study was done to evaluate the impact of adrenocortical insufficiency on clinical parameters in haemodynamically stable cirrhotic patients with ascites and had been performed at the inpatient of GHPD Department, BIRDEM, Dhaka, Bangladesh from April 2011 to March 2012...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#3
Junjun Cai, Mengchen Zhang, Tao Han, Hui-Qing Jiang
Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Once admitted, clinical data including first infection site, type (community-acquired, healthcare-associated, or nosocomial), and second infection occurrence during hospitalization were collected. The outcome was mortality within 90 days...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28836723/rifaximin-treatment-is-associated-with-reduced-risk-of-cirrhotic-complications-and-prolonged-overall-survival-in-patients-experiencing-hepatic-encephalopathy
#4
S H Kang, Y B Lee, J-H Lee, J Y Nam, Y Chang, H Cho, J-J Yoo, Y Y Cho, E J Cho, S J Yu, M Y Kim, Y J Kim, S K Baik, J-H Yoon
BACKGROUND: Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth. AIM: To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications. METHODS: We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non-HCC cohort) and 621 patients with HCC (the HCC cohort)...
November 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28792999/clinical-features-of-refractory-ascites-in-outpatients
#5
Wanda Regina Caly, Rodrigo Martins Abreu, Bernardo Bitelman, Flair José Carrilho, Suzane Kioko Ono
OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month...
July 2017: Clinics
https://www.readbyqxmd.com/read/28687809/genetic-variants-of-traf6-modulate-peritoneal-immunity-and-the-risk-of-spontaneous-bacterial-peritonitis-in-cirrhosis-a-combined-prospective-retrospective-study
#6
Martina Mai, Sven Stengel, Eihab Al-Herwi, Jack Peter, Caroline Schmidt, Ignacio Rubio, Andreas Stallmach, Tony Bruns
Alterations of the innate immunity contribute to the development of spontaneous bacterial peritonitis (SBP) in liver cirrhosis. Given its role in immune signaling, antimicrobial function, and macrophage differentiation, we hypothesized that genetic polymorphisms of TRAF6 modulate the risk of SBP. Thus, we determined theTRAF6 haplotype in 432 patients with cirrhosis and ascites using the haplotype-tagging single nucleotide polymorphisms rs331457 and rs5030419. In addition, peritoneal macrophages were immunomagnetically isolated and characterized...
July 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#7
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28611262/relative-adrenal-insufficiency-is-associated-with-the-clinical-outcome-in-patients-with-stable-decompensated-cirrhosis
#8
Evangelos Cholongitas, Ioannis Goulis, Eirini Pagkalidou, Anna Haidich, Apostolos Karagiannis, Theodora Nakouti, Chrysoula Pipili, Theodora Oikonomou, Spyros Gerou, Evangelos Akriviadis
BACKGROUND: The clinical impact of relative adrenal insufficiency (AI) on patients with stable decompensated cirrhosis (DeCi) has not been yet elucidated. AIM: Explore the association between AI and outcome [death or liver transplantation (LT)] in patients with DeCi. MATERIAL AND METHODS: Patients with DeCi presenting no active complication have been included. Clinical and laboratory data, including serum levels of corticosteroid-binding globulin (CBG), interleukin (IL)-1b, IL-6 and tumor necrosis factor (TNFα) were recorded in each participant...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28603226/infections-in-patients-affected-by-liver-cirrhosis-an-update
#9
Tiziana Ascione, Giusy Di Flumeri, Giovanni Boccia, Francesco De Caro
Patients with liver cirrhosis present an increased incidence of infections. The main cause has been founded in alterations of the enteric flora and of the intestinal barrier probably due to portal hypertension, in addition to a reticulo-endothelial system dysfunction. Furthermore, those living with cirrhosis can report a high predisposition to sepsis and septic shock, due to the excessive response of pro-inflammatory cytokines and a complessive hemodynamic derangement. By the analysis in the experimental model of the cirrhotic rat, it was demonstrated that radio-labelled Escherichia coli given by the oral route resulted in the location of the bacteria in the gut, the ascitic fluid and mesenteric lymph nodes, a phenomenon known as bacterial translocation...
June 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28597106/relative-ascites-polymorphonuclear-cell-count-indicates-bacterascites-and-risk-of-spontaneous-bacterial-peritonitis
#10
Philipp Lutz, Felix Goeser, Dominik J Kaczmarek, Stefan Schlabe, Hans Dieter Nischalke, Jacob Nattermann, Achim Hoerauf, Christian P Strassburg, Ulrich Spengler
BACKGROUND AND AIMS: Absolute polymorphonuclear (PMN) counts in ascites define spontaneous bacterial peritonitis (SBP), a severe form of bacterial infection in liver cirrhosis. Bacterascites, another form of ascites infection, can progress to SBP or may resolve spontaneously but is not reflected by absolute PMN counts. We investigated whether the relative ascites PMN count (the absolute PMN count divided by the absolute leukocyte count) provides additional information to detect bacterascites or predict SBP...
June 9, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28579346/combined-spontaneous-bacterial-empyema-and-peritonitis-in-cirrhotic-patients-with-ascites-and-hepatic-hydrothorax
#11
Anwar Mohamed, Mohammed Atef, Ayman Alsebaey, Mahmoud Musa Elhabshy, Mohsen Salama
BACKGROUND AND STUDY AIMS: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM. PATIENTS AND METHODS: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm(3)) and SBEM (positive pleural fluid culture and neutrophils >250/mm(3) or negative pleural fluid culture and neutrophils >500/mm(3) with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT)...
June 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28540466/drug-utilization-evaluation-of-albumin-in-a-teaching-hospital-of-mashhad-iran-an-interventional-pre-post-design-study
#12
Farzaneh Zolfagharian, Saba Ghazanfari, Sepideh Elyasi, Paria Iraji, Mohammad Reza Saberi, Nasser Vahdati-Mashhadian, Amir Hooshang Mohammadpour
Background Albumin is a protein colloidal solution with limited availability and high cost. It should be used in such approved indications as paracentesis, extensive burn, spontaneous bacterial peritonitis, and nephrotic syndrome. Objectives The aim of this study was to evaluate and compare the appropriateness of albumin usage before and after an evidence-based guideline. Setting Four wards of Imam Reza Hospital, Mashhad, Iran. Method An interventional pre-post design study was performed on 2 groups of patients; in gGroup 1 as a preparation phase group in 6 months from February 2015 to July 2015 and Group 2 as an interventional group from September 2015 to February 2016...
August 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#13
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
August 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28449345/proton-pump-inhibitors-do-not-increase-the-risk-for-recurrent-spontaneous-bacterial-peritonitis-in-patients-with-cirrhosis
#14
Jung Hee Kim, Kyung Sook Lim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Poong-Lyul Rhee, Jae J Kim, Kwang Cheol Koh, Seung Woon Paik
BACKGROUND AND AIM: The present study aimed to assess the real impact of proton pump inhibitor (PPI) use on incidence of recurrent spontaneous bacterial peritonitis (SBP) in a homogenous population composed of cirrhotic patients with a previous SBP where differences related with SBP incidence between PPI users and non-users are less likely to exist. METHODS: This retrospective cohort study enrolled 307 cirrhotic patients taking diuretics for ascites control and had a previous SBP...
May 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28403123/influence-of-genetic-variations-in-the-sod1-gene-on-the-development-of-ascites-and-spontaneous-bacterial-peritonitis-in-decompensated-liver-cirrhosis
#15
Sebastian Schwab, Jennifer Lehmann, Philipp Lutz, Christian Jansen, Beate Appenrodt, Frank Lammert, Christian P Strassburg, Ulrich Spengler, Hans-Dieter Nischalke, Jonel Trebicka
BACKGROUND: The balance between generation and elimination of reactive oxygen species by superoxide dismutase (SOD) is crucially involved in the pathophysiology of liver cirrhosis. Reactive oxygen species damage cells and induce inflammation/fibrosis, but also play a critical role in immune defense from pathogens. As both processes are involved in the development of liver cirrhosis and its complications, genetic variation of the SOD1 gene was investigated. PATIENTS AND METHODS: Two SOD1 single nucleotide polymorphisms (rs1041740 and rs3844942) were analyzed in 49 cirrhotic patients undergoing liver transplantation...
July 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28386572/spontaneous-fungal-peritonitis-in-ascites-of-cardiac-origin
#16
Yuchen Wang, Seema Gandhi, Bashar M Attar
Spontaneous fungal peritonitis (SFP) is an infrequent but severe complication most commonly described in patients with liver cirrhosis. We present the first case of culture-proven SFP occurring in cardiogenic ascites. The diagnosis of SFP was clinically challenging as the initial ascites was consistent with the more common diagnosis of spontaneous bacterial peritonitis (SBP). The patient did not respond to antibacterial therapy, however, and the final diagnosis was only made with positive ascitic cultures that grew Candida glabrata...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28350743/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#17
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28297771/-advances-in-basic-and-clinical-research-on-liver-cirrhosis-in-2016
#18
REVIEW
C Gu, M Y Song, W J Sun, X Y Xu, C Q Yang, D F Chen
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28296047/non-selective-beta-blockers-are-not-associated-with-increased-mortality-in-cirrhotic-patients-with-ascites
#19
Simona Onali, Maria Kalafateli, Avik Majumdar, Rachel Westbrook, James O'Beirne, Gioacchino Leandro, David Patch, Emmanuel A Tsochatzis
BACKGROUND & AIMS: Controversy exists on the impact of non-selective beta-blockers (NSBBs) on survival in patients with ascites. We assessed whether NSBB treatment affects survival in a cohort of 316 consecutive patients with ascites undergoing evaluation for liver transplantation. METHODS: Consecutive patients with cirrhosis and ascites assessed for liver transplantation between 2011 and 2014 were retrospectively evaluated. Competing risk Cox regression analysis in the whole population and in propensity score matched patients were performed to identify predictors of survival...
March 11, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28239081/clinical-features-of-spontaneous-bacterial-peritonitis-a-10-year-experience-from-a-single-center
#20
Ha Young Na, Jeong Han Kim, Won Hyeok Choe, So Young Kwon, Byung Chul Yoo
Background/Aims: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. Methods: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. Results: Total 51 patients were enrolled...
February 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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