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https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#1
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
March 2017: Gut
https://www.readbyqxmd.com/read/26309362/fluid-resuscitation-in-acute-pancreatitis-normal-saline-or-lactated-ringer-s-solution
#2
COMPARATIVE STUDY
Michal Lipinski, Alicja Rydzewska-Rosolowska, Andrzej Rydzewski, Grazyna Rydzewska
AIM: To investigate whether administration of Ringer's solution (RL) could have an impact on the outcome of acute pancreatitis (AP). METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women, mean age 51.2 years (range, 19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior (Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study...
August 21, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/21645639/lactated-ringer-s-solution-reduces-systemic-inflammation-compared-with-saline-in-patients-with-acute-pancreatitis
#3
RANDOMIZED CONTROLLED TRIAL
Bechien U Wu, James Q Hwang, Timothy H Gardner, Kathryn Repas, Ryan Delee, Song Yu, Benjamin Smith, Peter A Banks, Darwin L Conwell
BACKGROUND & AIMS: Aggressive fluid resuscitation is recommended for initial management of acute pancreatitis. We performed a randomized controlled trial to evaluate the impact of a goal-directed fluid resuscitation protocol on systemic inflammation in patients with acute pancreatitis. We then determined the impact of resuscitation with lactated Ringer's solution, compared with normal saline. METHODS: We performed a randomized controlled trial of 40 patients with acute pancreatitis at 3 New England hospitals from May 2009-February 2010...
August 2011: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28119010/diagnosis-and-treatment-of-ascites
#4
Emmanuel A Tsochatzis, Alexander L Gerbes
No abstract text is available yet for this article.
January 21, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/24530646/bacterial-infections-in-cirrhosis-a-position-statement-based-on-the-easl-special-conference-2013
#5
Rajiv Jalan, Javier Fernandez, Reiner Wiest, Bernd Schnabl, Richard Moreau, Paolo Angeli, Vanessa Stadlbauer, Thierry Gustot, Mauro Bernardi, Rafael Canton, Agustin Albillos, Frank Lammert, Alexander Wilmer, Rajeshwar Mookerjee, Jordi Vila, Rita Garcia-Martinez, Julia Wendon, José Such, Juan Cordoba, Arun Sanyal, Guadalupe Garcia-Tsao, Vicente Arroyo, Andrew Burroughs, Pere Ginès
Bacterial infections are very common and represent one of the most important reasons of progression of liver failure, development of liver-related complications, and mortality in patients with cirrhosis. In fact, bacterial infections may be a triggering factor for the occurrence of gastrointestinal bleeding, hypervolemic hyponatremia, hepatic encephalopathy, kidney failure, and development of acute-on-chronic liver failure. Moreover, infections are a very common cause of repeated hospitalizations, impaired health-related quality of life, and increased healthcare costs in cirrhosis...
June 2014: Journal of Hepatology
https://www.readbyqxmd.com/read/27246107/evidence-based-clinical-practice-guidelines-for-liver-cirrhosis-2015
#6
REVIEW
Hiroshi Fukui, Hidetsugu Saito, Yoshiyuki Ueno, Hirofumi Uto, Katsutoshi Obara, Isao Sakaida, Akitaka Shibuya, Masataka Seike, Sumiko Nagoshi, Makoto Segawa, Hirohito Tsubouchi, Hisataka Moriwaki, Akinobu Kato, Etsuko Hashimoto, Kojiro Michitaka, Toshikazu Murawaki, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
July 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27670600/risk-and-predictors-of-variceal-bleeding-in-cirrhosis-patients-receiving-primary-prophylaxis-with-non-selective-beta-blockers
#7
Richa Shukla, Jennifer Kramer, Yumei Cao, Jun Ying, Aylin Tansel, Annette Walder, Shailesh Advani, Hashem B El-Serag, Fasiha Kanwal
OBJECTIVES: Prior studies have demonstrated the efficacy of non-selective beta-blockers (NSBB) in preventing first variceal bleeding in patients with cirrhosis. However, little is known about the overall effectiveness of NSBB in routine clinical care. METHODS: We conducted a retrospective cohort study of cirrhotic patients without prior bleeding who initiated a NSBB (propranolol, nadolol) at any Veterans Administration facility between 2008 and 2013. The primary outcome was variceal bleeding within 12 months...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27801884/changing-concepts-of-cirrhotic-coagulopathy
#8
REVIEW
Armando Tripodi, Massimo Primignani, Pier M Mannucci, Stephen H Caldwell
The state of clinical art of the coagulopathy of cirrhosis changed considerably over the last decade. Until 2005, cirrhosis was considered as the epitome of the hemorrhagic coagulopathies and the abnormal hemostasis tests associated with the disease were corrected with infusion of fresh frozen plasma or platelets to minimize the risk of bleeding. Since that time, a great deal of work has been done and there is now a change of paradigm. The prothrombin time once considered as an isolated measure of bleeding risk was rejected, and cirrhosis shifted from a purely hemorrhagic construct to a mixed and thrombosis-prone paradigm...
November 1, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#9
REVIEW
Daniel S Strand, Daejin Kim, David A Peura
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease...
January 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/27786365/portal-hypertensive-bleeding-in-cirrhosis-risk-stratification-diagnosis-and-management-2016-practice-guidance-by-the-american-association-for-the-study-of-liver-diseases
#10
Guadalupe Garcia-Tsao, Juan G Abraldes, Annalisa Berzigotti, Jaime Bosch
No abstract text is available yet for this article.
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27864004/beta-adrenergic-blockade-and-decompensated-cirrhosis
#11
REVIEW
Thomas Reiberger, Mattias Mandorfer
Non-selective betablockers (NSBBs) remain the cornerstone of medical treatment of portal hypertension. The evidence for their efficacy to prevent variceal bleeding is derived from prospective trials, which largely excluded patients with refractory ascites and renal failure. In parallel to the increasing knowledge on portal hypertension-induced changes in systemic hemodynamics, cardiac function, and renal perfusion, emerging studies have raised concerns about harmful effects of NSBBs. Clinicians are facing an ongoing controversy on the use of NSBBs in patients with advanced cirrhosis...
November 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27783916/hepatic-encephalopathy
#12
REVIEW
Eelco F M Wijdicks
No abstract text is available yet for this article.
October 27, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27773805/pathophysiology-evaluation-and-management-of-chronic-watery-diarrhea
#13
REVIEW
Michael Camilleri, Joseph H Sellin, Kim E Barrett
Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties...
February 2017: Gastroenterology
https://www.readbyqxmd.com/read/26845610/%C3%A2-report-of-the-baveno-vi-consensus-workshop
#14
EDITORIAL
Andres Cardenas, Angela Mendez-Bocanegra
No abstract text is available yet for this article.
March 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27236146/%C3%A2-hepatorenal-syndrome-current-concepts-related-to-diagnosis-and-management
#15
REVIEW
Ángelo Zambam de Mattos, Angelo Alves de Mattos, Nahum Méndez-Sánchez
 Renal failure in cirrhotic patients is a very severe condition. Hepatorenal syndrome has the worst prognosis among all causes of kidney failure in such patients. Hepatorenal syndrome is diagnosed especially in cirrhotic patients with ascites who develop loss renal function, despite diuretic suspension and volume expansion with albumin and for whom other causes of kidney injury have been excluded. Patients with hepatorenal syndrome should be treated with a vasoconstrictor in combination with albumin as a bridge to receiving a liver transplant...
July 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27493115/%C3%A2-efficacy-and-safety-of-ursodeoxycholic-acid-in-patients-with-intrahepatic-cholestasis-of-pregnancy
#16
Antonín Parízek, Patrik Simják, Andrej Cerný, Alena Sestinová, Anna Zdenková, Martin Hill, Michaela Dusková, Radovan Vlk, Zuzana Kokrdová, Michal Koucký, Libor Vítek
UNLABELLED:  Background and aims. Patients with intrahepatic cholestasis of pregnancy (ICP) benefit from ursodeoxycholic acid (UDCA) treatment. Since there is still certain reluctance to use UDCA in pregnant women, mainly due to warnings in the official SPC information in respective drug leaflets, our objective was to assess the efficacy and safety of UDCA during pregnancy. MATERIAL AND METHODS: Our retrospective multicentric study was performed on 191 consecutive pregnant women with ICP treated with UDCA...
September 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27305194/clinical-practice-upper-gastrointestinal-bleeding-due-to-a-peptic-ulcer
#17
REVIEW
Loren Laine
No abstract text is available yet for this article.
June 16, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27325300/evidence-based-clinical-practice-guidelines-for-gastroesophageal-reflux-disease-2015
#18
REVIEW
Katsuhiko Iwakiri, Yoshikazu Kinoshita, Yasuki Habu, Tadayuki Oshima, Noriaki Manabe, Yasuhiro Fujiwara, Akihito Nagahara, Osamu Kawamura, Ryuichi Iwakiri, Soji Ozawa, Kiyoshi Ashida, Shuichi Ohara, Hideyuki Kashiwagi, Kyoichi Adachi, Kazuhide Higuchi, Hiroto Miwa, Kazuma Fujimoto, Motoyasu Kusano, Yoshio Hoshihara, Tatsuyuki Kawano, Ken Haruma, Michio Hongo, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015...
August 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27401791/how-to-diagnose-nafld-in-2016
#19
E Bugianesi, C Rosso, H Cortez-Pinto
No abstract text is available yet for this article.
September 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27515775/sarcopenia-from-mechanism-to-diagnosis-and-treatment-in-liver-disease
#20
REVIEW
Srinivasan Dasarathy, Manuela Merli
Sarcopenia or loss of skeletal muscle mass is the major component of malnutrition and is a frequent complication in cirrhosis that adversely affects clinical outcomes. These include survival, quality of life, development of other complications and post liver transplantation survival. Radiological image analysis is currently utilized to diagnose sarcopenia in cirrhosis. Nutrient supplementation and physical activity are used to counter sarcopenia but have not been consistently effective because the underlying molecular and metabolic abnormalities persist or are not influenced by these treatments...
December 2016: Journal of Hepatology
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