Search Our Scientific Publications & Authors

BMJ Case Rep 2019 Feb 13;12(2). Epub 2019 Feb 13.

Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA.

Dig Dis Sci 2019 Feb 14. Epub 2019 Feb 14.

Liver Center, Beth Israel Deaconess Medical Center, 110 Francis St, LMOB 8E, Boston, MA, 02215, USA.

Objectives: There are few studies addressing the impact of cephalosporin and quinolone resistance on hospital length of stay and mortality in spontaneous bacterial peritonitis (SBP). We aim to describe the shifting epidemiology of SBP at our institution and its impact on clinical outcomes.

Methods: We performed a single-center retrospective cohort study of all cases of SBP from 2005 to 2015 at a transplant center. Read More

J Infect Chemother 2019 Feb 6. Epub 2019 Feb 6.

Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.

Bacterial peritonitis, an infection of the ascitic fluid, can be classified etiologically as spontaneous or secondary bacterial peritonitis. The former is mainly caused by portal hypertension and its subsequent effects, whereas the latter is caused by the direct dissemination of bacteria into the peritoneal cavity. Previous reports have described some distinguishing features of these two entities. Read More

Hepatol Int 2019 Feb 8. Epub 2019 Feb 8.

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.

Background: Current knowledge suggests that proton pump inhibitors (PPIs) are associated with an increased risk of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). These conditions and PPI use are related to gut microbiota. The aim of this study is to research the changes in gut microbiota caused by PPI in patients with chronic liver disease. Read More

Am J Emerg Med 2019 Jan 25. Epub 2019 Jan 25.

Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States of America.

Study Objective: To determine the sensitivity of a highly sensitive bedside leukocyte esterase reagent strip (RS) for detection of spontaneous bacterial peritonitis (SBP) in emergency department (ED) ascites patients undergoing paracentesis.

Methods: We conducted a prospective, observational cohort study of ED ascites patients undergoing paracentesis at two academic facilities. Two practitioners, blinded to each other's results, did a bedside RS analysis of the peritoneal fluid in each patient and documented the RS reading at 3-min according to manufacturer-specified colorimetric strip reading as either "negative", "trace", "small", or "large". Read More

J Hepatol 2019 Feb 2. Epub 2019 Feb 2.

Dept. of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Italy.

J Hepatol 2019 Feb 1. Epub 2019 Feb 1.

Infectious Diseases Unit, IRCCS "San Matteo", Pavia, Italy; Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Pavia, Italy. Electronic address:

Intern Emerg Med 2019 Jan 31. Epub 2019 Jan 31.

Tropical Medicine Department, Faculty of Medicine, Zagazig University Hospitals, Zagazig, Egypt.

The influence of vitamin D, 25-hydroxyvitamin D (25(OH)D), deficiency on hepatitis C virus (HCV)-related cirrhosis had been poorly elucidated especially in patients with hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). We aimed to investigate the association between vitamin D deficiency and the risk of SBP or HE, including the mortality rate. Serum 25(OH)D levels were prospectively determined in 135 patients. Read More

World J Hepatol 2019 Jan;11(1):74-85

Department of Internal Medicine, the Queen's Medical Center, Honolulu, HI 968132, United States.

Background: Chronic liver disease and cirrhosis is the 12 leading cause of death in the United States. Patients with decompensated-cirrhosis, especially with hepatic encephalopathy/coma (HC), have a higher rate of early readmission and contribute to higher healthcare cost.

Aim: To evaluate the national inpatient trends of discharges, mortalities and financial impacts associated with four common conditions of cirrhosis. Read More

Clin Transl Gastroenterol 2019 Jan;10(1):e00002

Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.

Objectives: Common nucleotide-binding oligomerization domain containing 2 (NOD2) gene variants have been associated with bacterial infections (BIs) in cirrhosis, in particular, spontaneous bacterial peritonitis, and mortality. Our aim was to evaluate the independent association of NOD2 variants with BI according to the decompensation stage.

Methods: Consecutive patients with cirrhosis in 2 academic medical centers were included and genotyped for the NOD2 variants p. Read More

BMJ Open 2019 Jan 29;9(1):e025664. Epub 2019 Jan 29.

Division of Medicine, University College London, London, UK.

Introduction: Use of albumin therapy is recommended for management of disease complications in cirrhosis. The effectiveness of albumin to prevent specific disease complications and death, however, is less clear.

Methods And Analysis: We will search Medline (Ovid), Embase (Ovid), Cochrane Hepato-Biliary Controlled Trials Register and Cochrane Central Register of Controlled Trials for published reports on randomised controlled trials and observational studies on the effectiveness of intravenous albumin therapy to prevent spontaneous bacterial peritonitis, renal dysfunction and death in cirrhotic patients. Read More

Eur J Gastroenterol Hepatol 2019 Jan 28. Epub 2019 Jan 28.

Departments of Tropical Medicine.

Background And Objective: Spontaneous bacterial peritonitis (SBP) is a common bacterial infection with life-threatening sequelae in cirrhotic ascites. The purpose of this retrospective cohort study was to recognize the predictors of SBP to build up a noninvasive system to exclude or establish an episode of SBP.

Patients And Methods: Of 1194 consecutive patients with cirrhotic ascites, only 966 patients were enrolled in this study. Read More

Am J Gastroenterol 2019 Jan 23. Epub 2019 Jan 23.

University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Objectives: Antibiotic prophylaxis is recommended for prevention of the first episode of spontaneous bacterial peritonitis (SBP; primary prophylaxis 1°) and subsequent episodes (secondary prophylaxis 2°). We aimed to compare outcomes in cirrhotic inpatients on 1° vs 2° SBP prophylaxis.

Methods: Data from North American Consortium for the Study of End-Stage Liver Disease were evaluated for cirrhosis details, reasons for admission/medications, inpatient course recorded, and outcomes over 90 days. Read More

New Microbes New Infect 2019 Mar 18;28:1-5. Epub 2018 Dec 18.

)Department of Microbiology, University Hospital of Larissa, Larissa, Greece.

Spontaneous bacterial peritonitis (SBP) is often difficult to diagnose because bacteria in ascites cannot be detected accurately by conventional culture. In this study, we evaluated the use of broad-range 16S rRNA PCR, applied either directly to a total of 32 ascitic fluids (AFs) or to the AF vial cultures, after a long incubation of 14 days; the results were compared with those of AF vial cultures. was isolated in four of 32 AF vial cultures (12. Read More

Hepat Med 2019 14;11:13-22. Epub 2019 Jan 14.

Liver Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,

Spontaneous bacterial peritonitis is the most frequent bacterial infection in patients with cirrhosis. The reported incidence varies between 7% and 30% in hospitalized patients with cirrhosis and ascites, representing one of their main complications. Outcomes in patients with spontaneous bacterial peritonitis are poor since acute kidney injury, acute-on-chronic liver failure, and death occur in as much as 54%, 60%, and 40% of the patients, respectively, at midterm. Read More

Hepatol Int 2019 Jan 18;13(1):1-21. Epub 2019 Jan 18.

Department of Pathogen Biology, Peking University Health Science Center, Beijing, China.

The Chinese Society of Hepatology developed the current guidelines for the Management of Ascites and Its Related Complications in Cirrhosis based on the published evidences and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of cirrhotic ascites emphasizing a step-wise approach with the first-, second-, and third-line therapy. For refractory ascites, vasoconstrictors and albumin are recommended for splanchnic vasodilation and selective vasopressin (V2) receptor antagonists for moderate-to-severe hyponatremia. Read More

IDCases 2019 8;15:e00489. Epub 2019 Jan 8.

Pediatric Infectious Diseases Unit - Santa Casa de São Paulo, São Paulo, Brazil.

Spontaneous bacterial peritonitis is an uncommon manifestation of invasive pneumococcal disease and frequently occurs when an underlying hepatic disease is present. Bacterial identification through culture can be particularly challenging in patients with prior or concurrent antimicrobial use. DNA amplification detects very few copies of target DNA under ideal conditions in CSF or pleural effusion and, therefore, can be useful in selected infections. Read More

Transplant Proc 2019 Jan - Feb;51(1):41-43. Epub 2018 Jun 30.

Unit of Hepatobiliary Surgery and Liver Transplantation, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto Maimónides de Investigación Biomédica de Córdoba, University Hospital Reina Sofía, Córdoba, Spain.

Background: Guidelines for the management of refractory ascites (RA) recommend transjugular intrahepatic portosystemic shunting (TIPS), diuretics, and paracentesis as the main strategies, discouraging use of surgical peritoneovenous shunts (PVSs). However, PVSs, including both Denver (DS) or saphenoperitoneal (SPS) modalities, may still have indications. Herein we report our experience with PVSs in the context of modern surgical and anesthetic management. Read More

Acta Gastroenterol Belg 2018 Oct-Dec;81(4):509-516

Department of Oncology, University of Health Sciences Antalya Training and Research Hospital, Antalya; Turkey.

Objective: To evaluate the utility of B-mode gray-scale histogram analysis in the management of patients with infected cirrhotic ascites.

Methods: A total of 97 patients (mean(SD) age : 66.8(14. Read More

J Clin Transl Hepatol 2018 Dec 18;6(4):372-376. Epub 2018 Jul 18.

Hepatology and Gastroenterology department, National Liver Institute, Menoufia University, Egypt.

Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and a prognostic model to predict it is needed. This study was designed to test the ability of different laboratory tests and the new scoring system by Wehmeyer and colleagues (consisting of age, C-reactive protein (CRP) and platelet count) to predict it. Three-hundred patients admitted to the National Liver Institute, University of Menoufia, Egypt (2015-2016) with liver cirrhosis and ascites were included in our study. Read More

World J Hepatol 2018 Dec;10(12):892-897

Unidad de Hígado, Hospital Privado de Rosario, Rosario 2000, Argentina.

Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial infections in high-risk subgroups of patients with cirrhosis has been the standard of care for decades. Patients with prophylaxis indications include those at risk for a first episode of spontaneous bacterial peritonitis (SBP) due to a low ascitic fluid protein count and impaired liver and kidney function, patients with a prior episode of SBP and those with an episode of gastrointestinal bleeding. Read More

Clin Exp Hepatol 2018 Dec 3;4(4):247-252. Epub 2018 Dec 3.

Pediatric Department, Quesna Central Hospital, Ministry of Health, Menoufia, Egypt.

Aim Of The Study: We aimed to assess the utility and rapidity of granulocyte elastase (GE) latex immunoassay and leukocyte esterase (LE) reagent strips for the diagnosis of spontaneous bacterial peritonitis (SBP) in hepatic children with ascites.

Material And Methods: This study included 80 ascitic fluid (AF) samples from 45 patients with chronic liver diseases. They were divided into 2 groups (SBP and non-SBP groups). Read More

Clin Exp Hepatol 2018 Dec 3;4(4):224-231. Epub 2018 Dec 3.

Department of Hepatology and Infectious Diseases, Wrocław Medical University, Poland.

Spontaneous bacterial peritonitis (SBP) is one of the most common bacterial infections in patients with liver cirrhosis and it significantly contributes to the deterioration of the prognosis and increased risk of mortality. Previous data suggested that the most common pathogens causing SBP are G-negative aerobic bacteria and treatment recommended by the international guidelines (EASL, AASLD) is highly effective. In recent years, due to the widespread use of antibiotic prophylaxis and the increased frequency of hospitalization along with the use of invasive procedures in patients with cirrhosis, the involvement of Gram-positive cocci and multi-drug resistant bacteria in the etiology of SBP is increasing. Read More

Ann Hepatol 2018 Oct;17(6):933-939

School of Medicine, Tzu Chi University, Hualien, Taiwan.

Introduction And Aim: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection in patients with cirrhosis. However, it is unknown whether patients with SBP and cirrhosis who do not have active gastrointestinal bleeding have a poorer prognosis if treated with proton pump inhibitors (PPI).

Material And Methods: We used the Taiwan National Health Insurance Database to identify 858 patients with SBP and cirrhosis who were administered PPIs and hospitalized between January 1, 2010, and December 31, 2013. Read More

J Korean Med Sci 2018 Dec 7;33(52):e335. Epub 2018 Dec 7.

Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Background: Spontaneous bacterial peritonitis (SBP) is a serious infectious complication in patients with liver cirrhosis. However, information about prognosis of SBP in hepatocellular carcinoma (HCC) patients is limited. We investigated the clinical course of SBP in HCC patients. Read More

Eur J Gastroenterol Hepatol 2018 Dec 14. Epub 2018 Dec 14.

Liver Unit.

Objective: Few studies carried out more than 20 years ago have evaluated spontaneous bacterial peritonitis (SBP) recurrence in patients receiving secondary antibiotic prophylaxis. These studies reported a 1-year recurrence rate of 20-26%. Changes in the bacteriology of SBP over the last few years might have negative effects on secondary prophylaxis. Read More

Clin Imaging 2018 Nov 27;54:71-77. Epub 2018 Nov 27.

Department of Radiology, Division of Vascular and Interventional Radiology, Columbia University Medical Center, 177 Fort Washington Ave, Milstein Hospital - 4 Hudson North, New York, NY 10032, United States of America.

Purpose: To report the effect of partial splenic embolization (PSE) on hematological indices and the procedure's safety in pre- and post-liver transplant (LT) patients.

Materials And Methods: A single-center retrospective study evaluating all patients who underwent PSE over a 16-year period was performed. Inclusion criteria were splenomegaly confirmed by imaging and at least one of the following cytopenias: hemoglobin ≤10 g/dL, WBC count ≤1500 μL, or platelet count ≤100,000 μL. Read More

Eur J Gastroenterol Hepatol 2018 Dec 13. Epub 2018 Dec 13.

Hepatology and Liver Transplant Unit, Department of Medical Area (DAME).

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding.

Materials And Methods: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled. Read More

Clin Res Hepatol Gastroenterol 2018 Oct 24. Epub 2018 Oct 24.

Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy. Electronic address:

Rev Recent Clin Trials 2018 Dec 3. Epub 2018 Dec 3.

Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131, Naples. Italy.

Introduction: Historically, spontaneous bacterial peritonitis (SBP) has represented one of the most frequent and relevant infectious complications of advanced liver disease, and this is still valid today. Nevertheless, in recent years the role of fungi as causative pathogens of primary peritonitis in patients with cirrhosis has become not negligible. Another issue is linked with the traditional distinction, instrumental in therapeutic choice, between community-acquired and nosocomial forms, according to the onset. Read More

Semin Respir Crit Care Med 2018 Oct 28;39(5):578-587. Epub 2018 Nov 28.

Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i. Read More

Semin Respir Crit Care Med 2018 Oct 28;39(5):566-577. Epub 2018 Nov 28.

Division of Gastroenterology and Hepatology, Center for Liver Diseases and Transplantation, Weill Cornell Medical College, New York, New York.

Gastrointestinal (GI) bleeding and ascites are two significant clinical events that frequently present in critically ill patients with chronic liver failure or decompensated cirrhosis. GI bleeding in patients with cirrhosis, particularly portal hypertensive-associated bleeding, carries a high short-term mortality (15-25%) and requires early initiation of a vasoactive agent and antibiotics as well as timely endoscopic management. Conservative transfusion strategies and adequate airway protection are also imperative to assist in bleeding control. Read More

Clin Biochem Rev 2018 May;39(2):39-50

Biochemistry Department, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.

Biochemical testing of peritoneal and pleural fluids is carried out widely, although the range of tests likely to be useful is limited in comparison to the repertoire of tests available in a modern biochemistry laboratory. Fluids accumulate when pathological processes cause an imbalance between hydrostatic pressure gradients, capillary membrane permeability and lymphatic capacity, resulting in protein-poor transudates or inflammatory exudates. In peritoneal fluid, albumin is the most useful test, for the calculation of the serum-ascites albumin gradient; protein and LDH have a role regarding risk and diagnosis of spontaneous bacterial peritonitis and amylase may be useful in diagnosing fluid accumulation due to pancreatitis. Read More

Liver Int 2018 Nov 25. Epub 2018 Nov 25.

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Background & Aims: Many patients with cirrhosis use proton pump inhibitors. We aimed to determine their effects on the risk and prognosis of infections in patients with cirrhosis and ascites.

Methods: We used data from three 1-year trials of satavaptan treatment of ascites (N = 1198) to compare incidence and 90-day mortality of first-time infections between users and nonusers of proton pump inhibitors. Read More

Infect Drug Resist 2018 2;11:2047-2061. Epub 2018 Nov 2.

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt am Main, Germany,

Background And Aims: Spontaneous bacterial peritonitis (SBP) is a severe complication of decompensated cirrhosis. The prevalence of multidrug-resistant organisms (MDROs) in patients with cirrhosis is increasing. Identification of patients at risk for SBP due to MDROs (ie, SBP with the evidence of MDROs or in ascitic culture, MDRO-SBP) is crucial to the early adaptation of antibiotic treatment in such patients. Read More

Pediatr Clin North Am 2019 02;66(1):73-85

Division of Pediatric Nephrology, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, 2015 Uppergate Drive Northeast, Atlanta, GA 30322-1015, USA.

Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia. Minimal change disease, the most common cause in childhood, generally responds to corticosteroids, although most patients experience disease relapses. Focal segmental glomerulosclerosis is usually resistant to corticosteroids and carries a significant risk of kidney failure, necessitating renal transplantation. Read More

Aliment Pharmacol Ther 2018 Dec 11;48(11-12):1271-1281. Epub 2018 Nov 11.

Section Hepatology, Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany.

Background: Loss of skeletal muscle mass is a recognised complication with a prognostic impact in patients with cirrhosis.

Aim: To explore in a retrospective analysis which muscle compartment most reliably predicts the occurrence of cirrhosis-associated complications and if there are gender-related differences.

Methods: 795 patients with cirrhosis listed for liver transplantation between 2001 and 2014 met the inclusion and exclusion criteria including an abdominal CT scan (±200). Read More

IDCases 2018 9;14:e00430. Epub 2018 Aug 9.

Wellstar Atlanta Medical Center, United States.

We are presenting a case of spontaneous bacterial peritonitis (SBP) monomicrobial non-neutrocytic bacterascites (MNS) in a patient with malignant ascites secondary to cholangiocarcinoma who underwent peritoneal catheter placement. peritonitis is uncommon, with cancer patients at a higher risk. infection should be suspected in susceptible patients once there is no response to empiric antibacterial or if the initial culture report shows gram positive bacilli, the antibacterial of choice is ampicillin. Read More

Hernia 2018 Nov 8. Epub 2018 Nov 8.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

Purpose: Incisional hernia is a complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing incisional hernia because of immunosuppression. The purpose of this study was to evaluate incisional hernia after liver transplantation and to identify risk factors for hernia formation in those patients. Read More

Bull Emerg Trauma 2018 Oct;6(4):363-366

Department of Emergency Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Spontaneous bacterial peritonitis (SBP) is a complication of liver cirrhosis with adverse effect on patient prognosis. Early diagnosis and treatment is highly important, especially in patients without remarkable manifestations. We designed this study to determine the prevalence of SBP among afebrile cirrhotic patients and identify high-risk subgroups in a referral center in southern Iran. Read More

South Med J 2018 Nov;111(11):660-665

From the South Texas Veterans Health Care System, and the Department of Pharmacotherapy, University of Texas, Austin.

Cirrhosis affects millions of people around the world and is associated with increased morbidity and mortality. Spontaneous bacterial peritonitis (SBP) is a common complication of liver disease with cirrhosis and accounts for up to 30% of infections in patients with cirrhosis. Patients with a history of SBP and those deemed to be at high risk often are prescribed antibiotics to reduce the incidence of SBP. Read More

J Hepatol 2019 Mar 2;70(3):398-411. Epub 2018 Nov 2.

European Foundation of Chronic Liver Failure (EF-Clif), Barcelona, Spain.

Background & Aims: Antibiotic resistance has been increasingly reported in patients with decompensated cirrhosis in single-center studies. Prospective investigations reporting broad epidemiological data are scarce. We aimed to analyze epidemiological changes in bacterial infections in patients with decompensated cirrhosis. Read More

Ann Intensive Care 2018 Oct 29;8(1):99. Epub 2018 Oct 29.

Intensive Care Unit, Louis Mourier Hospital, AP-HP, 178 rue des renouillers, 92700, Colombes, France.

Rev Esp Quimioter 2018 Dec 22;31(6):532-536. Epub 2018 Oct 22.

Marina Fernández Torres. Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla 25, 39008 Santander, Cantabria. Spain.

Objective: Spontaneous bacterial peritonitis (SBP) is a frequent and severe entity in patients with cirrhosis or ascites due to other causes. However, Listeria monocytogenes is a microorganism that has been scarcely identified as a causative agent of SBP.

Methods: In this study, a descriptive analysis of cases of L. Read More

Mediators Inflamm 2018 30;2018:1969108. Epub 2018 Sep 30.

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland.

Objectives: Ascites and spontaneous bacterial peritonitis (SBP) are among the most important complications of decompensated liver cirrhosis. In clinical practice, new inflammation biomarkers are needed for the early diagnosis of SBP, as well-known biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), or peripheral blood white blood cell (WBC) count, lack the required specificity and sensitivity. The aim of the study was to evaluate the significance of heparin-binding protein (HBP) in comparison to CRP, PCT, WBC, and D-dimers in the diagnosis of SBP. Read More

Acta Gastroenterol Belg 2018 Jul-Sep;81(3):404-409

Department of Gastroenterology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China.

Background And Study Aims: To investigate the relationship among fibrotic, haemostatic and endotoxic changes in patients with different degrees of liver cirrhosis.

Patients And Methods: Liver fibrotic markers, including hyaluronic acid (HA), Ccollagen IV (Col-IV), laminin (LN), and N-terminal pro-peptide of collagen type III (PIIINP), were determined by radioimmunoassay. A series of haemostatic tests, including prothrombin time (PT), international normalized ratio, activated partial thromboplastin time, antithrombin-III, thrombin time, fibrinogen, fibrin(ogen) degradation product and D-dimer were determined using an automatic coagulation analyszer. Read More

Visc Med 2018 Aug 27;34(4):261-268. Epub 2018 Jul 27.

Section Hepatology, Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany.

Introduction: Acute-on-chronic liver failure (ACLF) is associated with a high susceptibility to infections leading to complications and poor prognosis. The sensitized immune system overwhelmingly responds to invading bacteria leading to organ damage. After resolution of infection or prolonged disease duration, the phagocytic system becomes irresponsive with a reduced bacterial clearance capacity promoting secondary infection. Read More

Gastroenterol Hepatol 2018 Oct 17. Epub 2018 Oct 17.

Departamento de Gastroenterología, Hepatología y Unidad de Trasplante Hepático, Hospital Universitari y Politècnic La Fe, Valencia, España; Grupo Acreditado de Hepatología y Trasplante Hepático, Hospital Universitari i Politècnic La Fe, Valencia, España; Centro de Investigación Biomédica en Red del Área de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, España.

Introduction: Infections in cirrhotic patients caused by multidrug-resistant bacteria are currently increasing and are associated with greater morbidity and mortality.

Objectives: To assess the epidemiology, risk factors and prognoses of infections caused by multidrug-resistant bacterial infections in cirrhotic patients.

Patients And Methods: Retrospective study on patients with liver cirrhosis who developed an infection during hospitalisations between July 2014 and August 2016 at our centre (Hospital Universitari i Politècnic La Fe, Valencia, Spain). Read More

Clin Res Hepatol Gastroenterol 2019 Feb 11;43(1):51-57. Epub 2018 Oct 11.

Internal Medicine Department, Division of Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt. Electronic address:

Background: Vitamin D plays a role in innate and acquired immunity. The risk for bacterial infections is increased in cirrhotic patients due to low levels of vitamin D. This study aimed to determine serum 25-(OH) vitamin D levels among cirrhotic patients in the presence and absence of infections and correlate this level with liver disease severity. Read More

BMJ Case Rep 2018 Oct 12;2018. Epub 2018 Oct 12.

Department of Infectious Disease, Mayo Clinic, Rochester, Minnesota, USA.

A 70-year-old man with a history of hepatic cirrhosis presented with abdominal discomfort and distention. Physical examination revealed abdominal distention, positive fluid wave and abdominal tenderness. Due to concerns for spontaneous bacterial peritonitis (SBP), paracentesis was performed. Read More