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    2138 results match your criteria Spontaneous Bacterial Peritonitis

    1 OF 43

    Purtscher-like retinopathy: A rare ocular finding in nephrotic syndrome.
    Oman J Ophthalmol 2018 Jan-Apr;11(1):42-45
    Department of Ophthalmology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
    In this report, we present a case of Purtscher-like retinopathy in a 12-year-old male child with nephrotic syndrome. He was a known case of steroid-dependent nephrotic syndrome, frequent relapser with spontaneous bacterial peritonitis, who presented with complaints of difficulty in vision in both eyes. The fundus examination showed multiple cotton-wool spots and Purtscher fleckens centered around the optic nerve head with superficial retinal hemorrhages in both eyes. Read More

    Arq Gastroenterol 2018 Jan-Mar;55(1):23-27
    Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, RS, Brasil.
    Background: Spontaneous bacterial peritonitis is a serious complication in cirrhotic patients, and changes in the microbiological characteristics reported in the last years are impacting the choice of antibiotic used for treatment.

    Objective: The aim of the present study is to evaluate the changes in the epidemiology and bacterial resistance of the germs causing spontaneous bacterial peritonitis over three different periods over 17 years.

    Methods: All cirrhotic patients with spontaneous bacterial peritonitis and positive culture of ascites fluid were retrospectively studied in a reference Hospital in Southern Brazil. Read More

    Follow-up Creatinine Level Is an Important Predictive Factor of In-hospital Mortality in Cirrhotic Patients with Spontaneous Bacterial Peritonitis.
    J Korean Med Sci 2018 Mar 19;33(12):e99. Epub 2018 Mar 19.
    Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
    Background: Spontaneous bacterial peritonitis (SBP) is one of the severe complications of liver cirrhosis. Early detection of high-risk patients is essential for prognostic improvement. The aim of this study is to investigate the predictive factors related to in-hospital mortality in patients with SBP. Read More

    Budd-Chiari Syndrome Diagnosed in a Patient Listed for Liver Transplant and Considered to be Contraindicated for the Operation.
    Exp Clin Transplant 2018 Mar;16(Suppl 1):158-161
    From the Department of Hepatology National Scientific Center for Oncology and Transplantology, Astana, Kazakhstan; and the Clinic of Hepatology, Gastroenterology, and Nutrition, Astana, Kazakhstan.
    We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly. Read More

    Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review.
    World J Hepatol 2018 Feb;10(2):254-266
    Department of Physiology, Tokai University School of Medicine, Isehara 2591193, Japan.
    Spontaneous bacterial (SBP) and spontaneous fungal peritonitis (SFP) can be a life-threatening infection in patients with liver cirrhosis (LC) and ascites. One of the possible mechanisms of developing SBP is bacterial translocation. Although the number of polymorphonuclear cells in the culture of ascitic fluid is diagnostic for SBP, secondary bacterial peritonitis is necessary to exclude. Read More

    Predicting mortality in patients with spontaneous bacterial peritonitis using routine inflammatory and biochemical markers.
    Eur J Gastroenterol Hepatol 2018 Mar 8. Epub 2018 Mar 8.
    Department of Gastroenterology, Istanbul School of Medicine, Istanbul University.
    Objectives: Spontaneous bacterial peritonitis (SBP) is a common and high-mortality infectious complication of patients with cirrhosis. New inflammatory markers are associated with morbidity/mortality in various diseases. The aim of our study was to find the 30-day mortality rate of SBP and their predictors. Read More

    D-alanyl-D-alanine-Modified Gold Nanoparticles Form a Broad-Spectrum Sensor for Bacteria.
    Theranostics 2018 4;8(5):1449-1457. Epub 2018 Feb 4.
    CAS Center for Excellence in Nanoscience, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, Beijing Engineering Research Center for BioNanotechnology, National Center for NanoScience and Technology, ZhongGuanCun BeiYiTiao, Beijing, 100190, China.
    Rapid and facile detection of pathogenic bacteria is challenging due to the requirement of large-scale instruments and equipment in conventional methods. We utilize D-amino acid as molecules to selectively target bacteria because bacteria can incorporate DADA in its cell wall while mammalian cells or fungi cannot.We show a broad-spectrum bacterial detection system based on D-amino acid-capped gold nanoparticles (AuNPs). Read More

    Homocysteine: a new diagnostic marker in spontaneous bacterial peritonitis.
    Eur J Gastroenterol Hepatol 2018 Mar 2. Epub 2018 Mar 2.
    Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
    Background And Aims: The diagnosis of spontaneous bacterial peritonitis (SBP) depends primarily on a polymorphonuclear leukocyte cell count more than 250/mm. This method is invasive, and not diagnostic in all variants of SBP; we aimed to assess serum homocysteine as a precise indicative marker for the diagnosis of all variants of SBP.

    Patients And Methods: A total 323 consecutive ascitic patients were registered in this prospective work. Read More

    Early linezolid-associated lactic acidosis in a patient with Child's class C liver cirrhosis and end stage renal disease.
    J Infect Chemother 2018 Mar 1. Epub 2018 Mar 1.
    Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7 Chung Shan S. Rd., Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, 33 Linsen South Road, Taipei, Taiwan. Electronic address:
    Linezolid, an oxazolidinone antibiotic, does not required dose adjustment in patients with Child's class A and B liver cirrhosis. The dose adjustment data for Child's class C liver cirrhosis is inadequate. We reported a case of Child's class C liver cirrhosis, in which lactic acidosis, an adverse effect related to prolonged use, occurred only after two weeks of linezolid treatment. Read More

    Clinical impact of healthcare-associated acquisition in cirrhotic patients with community-onset spontaneous bacterial peritonitis.
    Korean J Intern Med 2018 Mar 5. Epub 2018 Mar 5.
    Divisions of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    Background/aims: Healthcare-associated (HCA) infection is a recently suggested new category of community-onset infections. The implications of HCA infections in terms of diagnosis, treatment, and outcomes of spontaneous bacterial peritonitis (SBP) are not well understood. We sought to delineate the differences between community-acquired (CA) SBP and HCA SBP with specific interest in the antimicrobial resistance of causative microorganisms and outcomes. Read More

    Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA.
    Dig Dis Sci 2018 Feb 26. Epub 2018 Feb 26.
    Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite 423, Baltimore, MD, 21287, USA.
    Background And Aim: Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis and is associated with significant morbidity and mortality. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized patients presenting with SBP.

    Methods: The Nationwide Inpatient Sample was queried for all hospitalizations involving SBP from 2006 to 2014 using the International Classification of Disease-9-CM Code. Read More

    Can combined blood neutrophil to lymphocyte ratio and C-reactive protein be used for diagnosis of spontaneous bacterial peritonitis?
    Br J Biomed Sci 2018 Feb 16:1-5. Epub 2018 Feb 16.
    c Faculty of Medicine, Medical Microbiology and Immunology Department , Mansoura University , Mansoura , Egypt.
    Background And Objective: Spontaneous bacterial peritonitis (SBP) is diagnosed by the presence of ≥250 polymorphonuclear neutrophils (PMN)/mmin the ascites and the absence of surgically treatable cause of intra-abdominal infection. Blood neutrophil lymphocytic ratio (NLR) is an inexpensive and simple test for inflammation. C-reactive protein (CRP) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. Read More

    Infections complicating cirrhosis.
    Liver Int 2018 Feb;38 Suppl 1:126-133
    Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED, University of Padova, Padova, Italy.
    Patients with cirrhosis have a high risk of bacterial infections. Bacterial infections induce systemic inflammation that may lead to organ failure and acute-on-chronic liver failure (ACLF) resulting in a high risk of short term mortality. The early diagnosis and treatment of bacterial infections is essential to improve the patient's prognosis. Read More

    Prognosis of patients with ascites after PleurX insertion: an observational study.
    Scand J Gastroenterol 2018 Mar 7;53(3):340-344. Epub 2018 Feb 7.
    a Gastro Unit, Medical Division , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.
    Objective: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites.

    Methods: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period. Read More

    Toll-like receptor 4 polymorphisms and bacterial infections in patients with cirrhosis and ascites.
    World J Hepatol 2018 Jan;10(1):124-133
    Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona 08025, Spain.
    Aim: To assess the relationship between the presence of toll-like receptor 4 (TLR4) polymorphisms and bacterial infections in cirrhotic patients with ascites.

    Methods: We prospectively included consecutive patients with cirrhosis and ascites hospitalized during a 6-year period. Patients with human immunodeficiency virus (HIV) infection or any other immunodeficiency, patients with advanced hepatocellular carcinoma (beyond Milan's criteria) or any other condition determining poor short-term prognosis, and patients with a permanent urinary catheter were excluded. Read More

    Clarifying the role of C-reactive protein as a bacterial infection predictor in decompensated cirrhosis.
    Eur J Gastroenterol Hepatol 2018 Jan 30. Epub 2018 Jan 30.
    Department of Gastroenterology, Coimbra University Hospital Centre.
    Introduction: Bacterial infections are frequent in cirrhosis and may induce other deleterious complications. Ultrasensitive C-reactive protein (US-CRP), like other acute-phase proteins, is often considered useful in predicting bacterial infection in decompensated cirrhosis. However, US-CRP's reliability remains inconclusive, as inflammation in cirrhosis causes US-CRP synthesis independently of infection. Read More

    Diagnostic validity of flow cytometry vs manual counting of polymorphonuclear leukocytes in spontaneous bacterial peritonitis.
    J Clin Lab Anal 2018 Jan 31. Epub 2018 Jan 31.
    Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, South Valley University, Qena, Egypt.
    Background: Spontaneous bacterial peritonitis (SBP) is frequently occurring infection among patients with liver cirrhosis, defined by polymorphonuclear (PMN) leukocytic count ≥250 cell/mmwith or without a positive ascitic fluid (AF) bacterial culture. So, this study aimed to investigate the diagnostic value of flow cytometry versus manual counting of ascitic fluid PMNL in cirrhotic patients, with clinical suspicion of SBP.

    Methods: A hospital-based cross-sectional study was carried out on 320 cirrhotic patients with clinical suspicion of SBP. Read More

    Von Willebrand factor indicates bacterial translocation, inflammation, and procoagulant imbalance and predicts complications independently of portal hypertension severity.
    Aliment Pharmacol Ther 2018 Apr 29;47(7):980-988. Epub 2018 Jan 29.
    Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
    Background: Elevated plasma von Willebrand factor antigen (vWF) has been shown to indicate the presence of clinically significant portal hypertension, and thus, predicts the development of clinical events in patients with cirrhosis.

    Aim: To investigate the impact of bacterial translocation and inflammation on vWF, as well as the association between vWF and procoagulant imbalance. Moreover, we assessed whether vWF predicts complications of cirrhosis, independent of the severity of portal hypertension. Read More

    Expression of microRNAs in the ascites of patients with peritoneal carcinomatosis and peritonitis.
    Cancer Cytopathol 2018 Jan 23. Epub 2018 Jan 23.
    Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.
    Background: Peritoneal carcinomatosis (PCA) has a prognostic role in patients with gastrointestinal cancers. The differential diagnosis may be challenging due to the low sensitivity of cytology. Although microRNAs (miRNAs) have been a focus of various specimens and diseases, to the best of the authors' knowledge only limited knowledge exists regarding ascites. Read More

    Profile, risk factors and outcome of acute kidney injury in paediatric acute-on-chronic liver failure.
    Liver Int 2018 Jan 11. Epub 2018 Jan 11.
    Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
    Background & Aims: There are no studies on acute kidney injury in paediatric acute-on-chronic liver failure. This study was planned with aim to describe the clinical presentation and outcome of acute kidney injury among paediatric acute-on-chronic liver failure patients.

    Methods: Data of all children 1-18 years of age presenting with acute chronic liver failure (Asia pacific association for the study of the liver definition) was reviewed. Read More

    Intestinal Dysbiosis Secondary to Proton-Pump Inhibitor Use.
    Digestion 2018 6;97(2):195-204. Epub 2018 Jan 6.
    Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
    Background: Gut dysbiosis associated with the use of proton-pump inhibitors (PPIs) has been found to lead to the occurrence of infectious and inflammatory adverse events. A longitudinal observational cohort study has demonstrated the heightened risk of death associated with PPI use.

    Summary: We evaluated meta-analyses to determine the association between PPI use and infectious and inflammatory diseases. Read More

    Prognostic factors of liver cirrhosis mortality after a first episode of spontaneous bacterial peritonitis. A multicenter study.
    Rev Esp Enferm Dig 2018 Feb;110(2):94-101
    Unidad de Hepatología. Servicio Aparato Digestivo, Hospital Universitari Parc Taulí - Sabadell.
    Introduction: Spontaneous bacterial peritonitis is an infectious complication with a negative impact on survival of patients with cirrhosis.

    Objective: To analyze the short- and long-term survival after a first episode of bacterial peritonitis and the associated prognostic factors.

    Patients And Methods: This was a retrospective, multicenter study of patients admitted to hospital for spontaneous bacterial peritonitis between 2008 and 2013. Read More

    The first episode of spontaneous bacterial peritonitis is a threat event in children with end-stage liver disease.
    Eur J Gastroenterol Hepatol 2018 Mar;30(3):323-327
    Pediatric Liver Transplantation Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
    Objective: Studies on native liver survival (NLS) after the first episode of spontaneous bacterial peritonitis (SBP) are rare. Our objective was to evaluate NLS in children up to 1 year after SBP.

    Methods: A historical cohort study of 18 children followed after the first episode of SBP was conducted. Read More

    Are third-generation cephalosporins still the empirical antibiotic treatment of community-acquired spontaneous bacterial peritonitis? A systematic review and meta-analysis.
    Eur J Gastroenterol Hepatol 2018 Mar;30(3):329-336
    Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
    Background: Spontaneous bacterial peritonitis (SBP) is a common complication among cirrhotic patients. Guidelines recommend third-generation cephalosporins (3GCs) as empiric antibiotic therapy (EAT) of SBP. Recently, a broad-spectrum EAT was shown to be more effective than cephalosporins in the treatment of nosocomial spontaneous bacterial peritonitis (N-SBP); however, the prevalence of 3GCs-resistant bacteria is high in the nosocomial setting and broad-spectrum EAT cannot be used in all cases of SBP. Read More

    Influence of proton pump inhibitors in the development of spontaneous bacterial peritonitis.
    World J Hepatol 2017 Dec;9(35):1278-1285
    Graduate Program in Medicine, Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre CEP 90430-080, Brazil.
    Aim: To investigate whether the use of proton pump inhibitors (PPIs) increases the incidence of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites.

    Methods: An historical cohort study was carried out in cirrhotic outpatients with ascites followed in a specialized clinic at a tertiary hospital in Southern Brazil. Patient charts were reviewed to collect information on the variables of interest as the use of PPIs. Read More

    The emergency medicine evaluation and management of the patient with cirrhosis.
    Am J Emerg Med 2017 Dec 23. Epub 2017 Dec 23.
    The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States.
    Background: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Read More

    Prediction of Fungal Infection Development and Their Impact on Survival Using the NACSELD Cohort.
    Am J Gastroenterol 2017 Dec 19. Epub 2017 Dec 19.
    Baylor University Medical Center, Dallas, Texas, USA.
    Objectives: Bacterial infections are associated with negative outcomes in cirrhosis but fungal infections are being increasingly recognized. The objective of this study is to define risk factors for fungal infection development and impact on 30-day survival.

    Methods: In a large, multi-center cirrhotic inpatient cohort, demographics, cirrhosis details, intensive care unit (ICU), organ failures/acute-on-chronic liver failure (ACLF), and 30-day survival were compared between patients without infections and with bacterial infections alone, with those with fungal infections. Read More

    Trends in Hospitalization, Acute Kidney Injury, and Mortality in Patients With Spontaneous Bacterial Peritonitis.
    J Clin Gastroenterol 2017 Dec 15. Epub 2017 Dec 15.
    Department of Internal Medicine, Division of Gastroenterology, East Tennessee State University, Johnson City, TN.
    Goals: The purpose of our study was to evaluate trends of hospitalization, acute kidney injury (AKI) and mortality in cirrhotic patients with spontaneous bacterial peritonitis (SBP).

    Background: SBP is a frequent bacterial infection in cirrhotic patients leading to increased morbidity and mortality.

    Materials And Methods: A total of 4,840,643 patients hospitalized with cirrhosis from 2005 to 2014 were identified using the Nationwide Inpatient Sample database, of which 115,359 (2. Read More

    Functional polymorphisms of innate immunity receptors are not risk factors for the non-SBP type bacterial infections in cirrhosis.
    Liver Int 2017 Dec 13. Epub 2017 Dec 13.
    Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
    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. Read More

    Echocardiographic and Electrocardiographic Predictors of Adverse Outcomes in Spontaneous Bacterial Peritonitis.
    J Clin Exp Hepatol 2017 Dec 15;7(4):321-327. Epub 2017 May 15.
    Department of Cardiology, Einstein Medical Center, Philadelphia, PA, USA.
    Background: Patients with cirrhosis who develop Spontaneous Bacterial Peritonitis (SBP) suffer from cirrhotic cardiomyopathy which is characterized by impaired contractility in response to stress despite a relatively normal resting cardiac output. We hypothesized that electrocardiographic and echocardiographic information would help prognosticate patients developing SBP in addition to existing scoring systems.

    Methods: Cirrhotic patients admitted to Einstein Medical Center from 01/01/2005 to 6/30/2012 for SBP, and did not receive a transplant within one year, were included. Read More

    An Insight into Antibiotic Resistance to Bacterial Infection in Chronic Liver Disease.
    J Clin Exp Hepatol 2017 Dec 15;7(4):305-309. Epub 2017 May 15.
    Institute of Liver Disease and Transplantation, Global Health City, Chennai 600100, India.
    Background: End stage liver disease leads to immune dysfunction which predisposes to infection. There has been a rise in antibiotic resistant infections in these patients. There is scanty data f from India or idea regarding the same. Read More

    Impact of Acute Kidney Injury on Mortality of Patients Hospitalized for Complications of Cirrhosis.
    J Clin Exp Hepatol 2017 Dec 13;7(4):290-299. Epub 2017 May 13.
    The Institute for Digestive Health and Liver Disease, Mercy Medical Center, Baltimore, United States.
    Background/aims: The mortality of hospitalized patients for complications of cirrhosis is very high. We examined the independent predictors of mortality, particularly the impact of increments in creatinine, in 339 consecutive patients (636 admissions) who were admitted for complications of cirrhosis.

    Methods: Clinical characteristics, biochemical parameters including serum creatinine levels at various time intervals, and mortality data were recorded for all admissions. Read More

    Spontaneous bacteremia and spontaneous bacterial peritonitis share similar prognosis in patients with cirrhosis: a cohort study.
    Hepatol Int 2017 Dec 9. Epub 2017 Dec 9.
    Liver Unit, Hospital Italiano, Juan Domingo Perón 4190, 1181ACH, Buenos Aires, Argentina.
    Background And Aims: Spontaneous bacteremia is a poorly characterized infection in patients with cirrhosis. We compared the incidence of mortality and acute kidney injury in patients with spontaneous bacterial peritonitis and spontaneous bacteremia, and identified risk factors for mortality and acute kidney injury in patients with spontaneous bacteremia.

    Methods: We performed a retrospective cohort study of patients with cirrhosis and spontaneous bacteremia or spontaneous bacterial peritonitis from 2008 to 2016 at Hospital Italiano, Buenos Aires. Read More

    Low ascitic fluid total protein levels is not associated to the development of spontaneous bacterial peritonitis in a cohort of 274 patients with cirrhosis.
    Scand J Gastroenterol 2018 Feb 7;53(2):200-205. Epub 2017 Dec 7.
    a Gastro Unit 360, Medical Division , Copenhagen University Hospital , Hvidovre , Denmark.
    Background: Spontaneous bacterial peritonitis (SBP) is a complication to decompensated cirrhosis. Fluoroquinolones may prevent SBP. However, predictive markers for SBP are wanted. Read More

    What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?
    Turk J Gastroenterol 2017 12;28(Suppl 1):S57-S60
    Division of Rheumatology, Department of Internal Medicine, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
    The meta-analyses of observational studies (OBS) showed the risk of any fracture and hip fracture slightly increased with proton pump inhibitor (PPI) treatment depending on the dose and regardless of time. This was not observed with histamine-2 receptor antagonists (H2RA). The risk of bacterial overgrowth and spontaneous bacterial peritonitis were increased with PPI therapy, but not with H2RA. Read More

    Clinical features of alcoholic hepatitis in latinos and caucasians: A single center experience.
    World J Gastroenterol 2017 Oct;23(40):7274-7282
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, United States.
    Aim: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians.

    Methods: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3. Read More

    Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis.
    World J Hepatol 2017 Oct;9(30):1166-1175
    Department of Anesthesiological, Surgical and Emergency Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
    Spontaneous bacterial peritonitis (SBP) is the most common infection in end-stage liver disease patients. SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mmwithout an evident intra-abdominal surgically treatable source. Several mechanisms contribute to SBP occurrence, including translocation of gut bacteria and their products, reduced intestinal motility provoking bacterial overgrowth, alteration of the gut's barrier function and local immune responses. Read More

    Effects of atorvastatin on portal hemodynamics and clinical outcomes in patients with cirrhosis with portal hypertension: a proof-of-concept study.
    Eur J Gastroenterol Hepatol 2018 Jan;30(1):54-59
    Departments of Hepatology.
    Background And Aim: Statins can modulate portal microvascular dynamics in patients with cirrhosis. We present data from a proof-of-concept study aimed at comparing combination of propranolol and atorvastatin versus propranolol alone in reducing portal pressure in patients with cirrhosis.

    Patients And Methods: In this open-label proof-of-concept study, 23 consecutive patients with cirrhosis were randomized into group A (incremental dose propranolol, n=12) or group B (atorvastatin 20 mg daily with propranolol in incremental dose, n=11). Read More

    Ascites Neutrophil Gelatinase-Associated Lipocalin Identifies Spontaneous Bacterial Peritonitis and Predicts Mortality in Hospitalized Patients with Cirrhosis.
    Dig Dis Sci 2017 12 2;62(12):3487-3494. Epub 2017 Nov 2.
    Center for Liver Disease and Transplantation, Columbia University Medical Center, 622 West 168th St., PH 14-105K, New York, NY, 10032, USA.
    Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a marker of both tissue injury and infection. Urine NGAL levels strongly predict acute kidney injury and mortality in patients with cirrhosis, but ascites NGAL is not well characterized. We hypothesized that ascites NGAL level is a marker of spontaneous bacterial peritonitis (SBP) and mortality risk in patients with cirrhosis. Read More

    Spontaneous peritonitis in critically ill cirrhotic patients: a diagnostic algorithm for clinicians and future perspectives.
    Ther Clin Risk Manag 2017 16;13:1409-1414. Epub 2017 Oct 16.
    Division of Anesthesia, Department of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy.
    Spontaneous peritonitis (SP) is the most common infection among decompensated end-stage liver disease patients. SP is the infection of ascitic fluid (neutrophil ascitic count ≥250/mL) without an alternative focus of abdominal infection. According to the causative agent, clinicians can make the diagnosis of spontaneous bacterial peritonitis or spontaneous fungal peritonitis. Read More

    Detection of bacterial DNA by in situ hybridization in patients with decompensated liver cirrhosis.
    BMC Gastroenterol 2017 Oct 17;17(1):106. Epub 2017 Oct 17.
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
    Background: Spontaneous bacterial peritonitis (SBP) is often difficult to diagnose because bacteria in ascites cannot be detected accurately by conventional culture. In situ hybridization (ISH) was previously developed for rapid detection of genes from bacteria phagocytized by neutrophils. SBP may develop after bacteria enter into the systemic circulation following bacterial translocation. Read More

    Systematic review with meta-analysis: rifaximin for the prophylaxis of spontaneous bacterial peritonitis.
    Aliment Pharmacol Ther 2017 Dec 9;46(11-12):1029-1036. Epub 2017 Oct 9.
    Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.
    Background: The primary and secondary prevention of spontaneous bacterial peritonitis (SBP) is recommended in high-risk patients with cirrhosis. Several studies evaluating the efficacy of rifaximin for SBP prophylaxis have yielded conflicting results. Rifaximin has the potential advantage of preventing bacterial overgrowth and translocation without the systemic side effects of broad-spectrum antibiotics. Read More

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