2,192 results match your criteria Spontaneous Bacterial Peritonitis


Safety and Efficacy of Rifaximin in Prophylaxis of Spontaneous Bacterial Peritonitis: Is this time to abandon fluoroquinolones for prevention of spontaneous bacterial peritonitis? : A Systematic Review.

Curr Drug Targets 2018 Sep 24. Epub 2018 Sep 24.

Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Tanta. Egypt.

Aim: The role of rifaximin in the prevention of spontaneous bacterial peritonitis(SBP) is not well studied. The aim of this meta-analysis was to evaluate the role of rifaximin in the prevention of SBP.

Methods: A computerized literature search for relevant clinical trials was conducted during August 2017. Read More

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September 2018
3.02 Impact Factor

Long-term administration of human albumin improves survival in patients with cirrhosis and refractory ascites.

Liver Int 2018 Sep 19. Epub 2018 Sep 19.

Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED, University of Padova, Padova, Italy.

Background And Aims: In patients with liver cirrhosis, the clinical benefit of the treatment with human albumin for ascites is debated, and no data are available regarding refractory ascites. In this study, in patients with cirrhosis and refractory ascites, we assessed the effect of long-term albumin administration on emergent hospitalization and mortality.

Methods: Seventy patients with cirrhosis and refractory ascites, followed at the Unit of Internal Medicine and Hepatology, University and General Hospital of Padova, Italy, were included into the study. Read More

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September 2018

Clinical impact of microbiome in patients with decompensated cirrhosis.

World J Gastroenterol 2018 Sep;24(34):3813-3820

First Department of Internal Medicine, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece.

Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. Read More

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September 2018
1 Read

Impaired neutrophil extracellular traps and inflammatory responses in the peritoneal fluid of patients with liver cirrhosis.

Scand J Immunol 2018 Aug 27:e12714. Epub 2018 Aug 27.

CIINDE, Departamento de Fisiología, Universidad de Guadalajara/, Instituto Dermatológico de Jalisco. Guadalajara, Jalisco, México.

Liver cirrhosis (LC) is an inflammatory process associated with impaired functions in adaptive and innate immune responses at both systemic and local levels, also referred as Cirrhosis Associated Immune Dysfunction (CAID). In this study we evaluated the functionality of neutrophils from ascitic fluid (AF) of patients with hepatic cirrhosis by testing their ability to generate neutrophil extracellular traps (NETs) in vitro. To further determine the activation state of neutrophils, expression of the activation markers CD66b, CD69 and CD80 on these cells was analyzed by flow cytometry. Read More

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August 2018
1 Read

Hepatorenal syndrome.

Nat Rev Dis Primers 2018 Sep 13;4(1):23. Epub 2018 Sep 13.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Hepatorenal syndrome (HRS) is a form of kidney function impairment that characteristically occurs in cirrhosis. Recent changes in terminology have led to acute HRS being referred to as acute kidney injury (AKI)-HRS and chronic HRS as chronic kidney disease (CKD)-HRS. AKI-HRS is characterized by a severe impairment of kidney function owing to vasoconstriction of the renal arteries in the absence of substantial abnormalities in kidney histology. Read More

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September 2018
2 Reads

Acute-on-Chronic Liver Failure vs. Traditional Acute Decompensation of Cirrhosis.

J Hepatol 2018 Sep 6. Epub 2018 Sep 6.

Inserm Unité 1149, Centre de Recherche sur l'inflammation (CRI), Paris, France; UMR S_1149, Université Paris Diderot, Paris, France; The EASL-CLIF Consortium, European Foundation-CLIF, Barcelona, Spain; Départment Hospitalo-Universitaire (DHU) UNITY, Service d'Hépatologie, Hôpital Beaujon, AP-HP, Clichy, France; Laboratoire d'Excellence (Labex) Inflamex, CUE Sorbonne Paris Cité, Paris, France.

In this Grand Round presentation, the case of a woman with acute decompensation of cirrhosis due to spontaneous bacterial peritonitis is described. She subsequently developed liver failure, type 1 hepatorenal syndrome, severe hepatic encephalopathy, and respiratory failure requiring mechanical ventilation. Her critical illness raised several clinical and ethical dilemmas regarding prognosis, therapeutic options, and futility of care. Read More

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September 2018
1 Read

Spontaneous bacterial empyema: an elusive diagnosis in a patient with cirrhosis.

BMJ Case Rep 2018 Aug 29;2018. Epub 2018 Aug 29.

Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA.

Hepatic hydrothorax refers to the presence of a pleural effusion (usually >500 mL) in a patient with cirrhosis in whom other causes of pleural effusion, such as cardiopulmonary causes, pleural disease or malignancy have been excluded. It is seen in 5%-10% of patients with end-stage liver disease. A subset of these patients can develop infection of the hepatic hydrothorax, called spontaneous bacterial empyema. Read More

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August 2018
2 Reads

Hepatogenous Diabetes: An Underestimated Problem of Liver Cirrhosis.

Authors:
Ramesh Kumar

Indian J Endocrinol Metab 2018 Jul-Aug;22(4):552-559

Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India.

The prevalence of diabetes mellitus in cirrhotic patients is much higher than that in the general population. Two types of diabetes are usually seen in patients with cirrhosis: type 2 diabetes mellitus and hepatogenous diabetes (HD). The HD is an acquired condition which is believed to be caused by impaired insulin clearance and pancreatic β-cell dysfunction in cirrhotic patients. Read More

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August 2018
6 Reads

[Hyponatremia in Liver Cirrhosis].

Korean J Gastroenterol 2018 Aug;72(2):74-78

Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.

Hyponatremia is a commonly observed complication that is related to hypoalbuminemia and portal hypertension in patients with advanced liver cirrhosis. Hyponatremia in patients with liver cirrhosis is mostly dilutional hyponatremia and is defined when the serum sodium concentration is below 130 meq/L. The risk of complications increases significantly in cirrhotic patients with hyponatremia, which includes spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic encephalopathy. Read More

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August 2018
8 Reads

[Spontaneous Bacterial Peritonitis].

Authors:
Do Seon Song

Korean J Gastroenterol 2018 Aug;72(2):56-63

Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Spontaneous bacterial peritonitis (SBP) is defined as bacterial infections that occur in patients with cirrhosis and ascites without any significant intraperitoneal infection, accounting for approximately 10-30% of bacterial infections in hospitalized patients. SBP develops in patients with liver cirrhosis because bacterial translocations are increased by changes in the intestinal bacteria and mucosal barriers. In addition, the decreased host immune response cannot remove the bacteria and their products. Read More

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August 2018
6 Reads

Effects of Long-term Norfloxacin Therapy in Patients with Advanced Cirrhosis.

Gastroenterology 2018 Aug 22. Epub 2018 Aug 22.

Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Beaujon, Département Hospitalo-Universitaire (DHU) UNITY, Service d'Hépatologie, Clichy.

Background & Aims: There is debate over the effects of long-term oral fluoroquinolone therapy in patients with advanced cirrhosis. We performed a randomized controlled trial to evaluate the effects of long-term treatment with the fluoroquinolone norfloxacin on survival of patients with cirrhosis.

Methods: We performed a double-blind trial of 291 patients with Child-Pugh class C cirrhosis who had not received recent fluoroquinolone therapy; the study was performed at 18 clinical sites in France from April 2010 through November 2014. Read More

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August 2018
4 Reads

D-dimer level in liver transplant recipients on the first day after surgery is correlated with postoperative thrombosis recurrence.

J Clin Lab Anal 2018 Aug 13:e22646. Epub 2018 Aug 13.

Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Objective: This study aimed to investigate the relationship between plasma D-dimer level, preoperative complications, and thrombosis in liver transplant recipients.

Methods: The clinical data of 525 liver transplant recipients with end-stage liver disease (ESLD) in the First Affiliated Hospital of Zhejiang University from October 2012 to December 2015 were retrospectively analyzed. The patients were grouped based on thrombosis before and after surgery to determine the risk factors for postoperative thrombosis recurrence. Read More

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August 2018
1 Read

Combination of PCT, sNFI and dCHC for the diagnosis of ascites infection in cirrhotic patients.

BMC Infect Dis 2018 Aug 10;18(1):389. Epub 2018 Aug 10.

Clinical Diagnostic Centre, 302 Military Hospital of China, Beijing, 100039, People's Republic of China.

Background: It is difficult to diagnose ascites infection early in cirrhotic patients. The present study was to create and evaluate a new bioscore combined with PCT, sNFI and dCHC in the diagnosis of ascites infection in cirrhotic patients.

Methods: Two hundred and fifty-nine consecutive patients were enrolled; of which 51 patients were culture-positive spontaneous bacterial peritonitis (culture-positive SBP) and 58 patients were culture-negative SBP. Read More

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August 2018
2.61 Impact Factor

Infectious endocarditis in the case of cirrhosis: where do we stand?

Eur J Gastroenterol Hepatol 2018 Aug 6. Epub 2018 Aug 6.

Department of Hepato-Gastroenterology, GHPSO, Creil, France.

Bacterial infections are common in the case of cirrhosis and represent a major cause of morbidity and mortality. The most frequent infections are spontaneous bacterial peritonitis, urinary tract infection, and pneumonia, but few data on infectious endocarditis are available. Infectious endocarditis is a rare event, and diagnosis can be made at all stages of Child-Pugh classification. Read More

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August 2018
2 Reads

Accuracy of calprotectin using the Quantum Blue Reader for the diagnosis of spontaneous bacterial peritonitis in liver cirrhosis.

Hepatol Res 2018 Aug 7. Epub 2018 Aug 7.

Department of Hepatology, University Hospital of Besançon, Besançon, France.

Aim: We aimed to evaluate the accuracy of the dosage of calprotectin in ascitic fluid (AF) using the Quantum Blue assay, for the prompt diagnosis of spontaneous bacterial peritonitis (SBP).

Methods: We prospectively collected 236 AF samples from 119 cirrhotic patients hospitalized in two French centers between May 2016 and May 2017. Bloody and chylous/cloudy AF, and secondary peritonitis were excluded. Read More

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August 2018
1 Read

Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.

Can J Gastroenterol Hepatol 2018 10;2018:3015891. Epub 2018 Jul 10.

Research Department, Chief of the Medical Direction of "Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado" (ISSSTE), Mexico City 14050, Mexico.

Background And Aim: Variceal bleeding is the second most important precipitating factor related to the development of episodic hepatic encephalopathy; but to date there are no recommendations to prevent this complication. The aim of this study was to compare if primary prophylaxis with lactulose or L-ornithine L-aspartate or rifaximin, in cirrhotic patients with variceal bleeding, is better than placebo for avoiding the development of hepatic encephalopathy.

Methods: A randomized, double-blind, placebo-controlled clinical trial (ClinicalTrials. Read More

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July 2018
1 Read

Current and emerging pharmacotherapy for the treatment of bacterial peritonitis.

Expert Opin Pharmacother 2018 Aug 2;19(12):1317-1325. Epub 2018 Aug 2.

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

Introduction: Spontaneous bacterial peritonitis (SBP) is the quintessential model of bacterial infection in cirrhotic patients. In these particularly frail subjects, infections clearly worsen prognosis increasing substantially mortality. Furthermore, treatment of SBP has become more challenging because of the growing impact of multidrug-resistant (MDR) bacteria. Read More

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Proton Pump Inhibitors: Risks and Rewards and Emerging Consequences to the Gut Microbiome.

Nutr Clin Pract 2018 Oct 2;33(5):614-624. Epub 2018 Aug 2.

Department of Gastroenterology and Hepatology, Center for Human Nutrition, Diegstive Disease and Survery Institute, Cleveland Clinic, Cleveland, Ohio, USA.

In recent years, proton pump inhibitors (PPIs) have been criticized for their various adverse interactions and side effects, creating a dilemma among practitioners regarding their use. Our goal is to review the proper use and possible side effects that might be caused by or associated with PPI use. Conclusions were drawn based on the evidence supporting or refuting short-term and long-term adverse events associated with PPI use. Read More

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October 2018
3 Reads

A safety review of proton pump inhibitors to treat acid-related digestive diseases.

Expert Opin Drug Saf 2018 Aug 23;17(8):785-794. Epub 2018 Jul 23.

b Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties , University of Genoa , Genoa , Italy.

Introduction: Proton pump inhibitors (PPIs) have become the first choice medical treatment of acid-related disease and, as with any pharmacological agent, they have been reported to be associated with some adverse events mainly linked to their chronic use. The most important postulated harms are represented by serum electrolyte alterations, vitamin B12 and iron deficiency, gastric tumors, enteric infections, spontaneous bacterial peritonitis, pneumonia, ischemic heart attacks, bone fractures, chronic kidney disease, dementia, and Alzheimer disease. Specific pathophysiological mechanisms have been identified for some of them and not for other manifestations. Read More

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August 2018
1 Read

Assessing adherence to current national guidelines for appropriate albumin use at an academic medical center.

Pharm Pract (Granada) 2018 Apr-Jun;16(2):1190. Epub 2018 Jun 30.

Pharmacy Program Coordinator, Residency Program Director. Banner University Medical Center South. Tucson, AZ (United States).

Objective: To assess adherence to current national guidelines for appropriate albumin use at an academic medical center.

Methods: This retrospective chart review of 150 randomly selected patients prescribed and administered at least one dose of albumin was conducted in an urban academic medical center to evaluate the adherence of albumin orders to current national guidelines. Inclusion criteria consisted of discharged patients at least 18-years-old admitted to the intensive care unit or medical/surgical unit from September 1, 2015 to August 31, 2016. Read More

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June 2018
1 Read

Use of prokinetic agents or antibiotics is associated with the occurrence of spontaneous bacterial peritonitis in cirrhotic patients.

J Chin Med Assoc 2018 Jul 12. Epub 2018 Jul 12.

Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address:

Background: Prokinetics have been shown to improve intestinal bacterial overgrowth and dysmotility in cirrhotic patients. Antibiotics are suggested for high risk patients for prophylaxis of spontaneous bacterial peritonitis (SBP). However, limited studies have investigated the association of SBP and these medications. Read More

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Bacterascites: A study of clinical features, microbiological findings, and clinical significance.

Liver Int 2018 Jul 11. Epub 2018 Jul 11.

Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

Background: Knowledge about bacterascites is limited and management guidelines are based on small patient series. The purpose of this study was to add further insight into the clinical characteristics, microbiological findings, and prognosis of patients diagnosed with bacterascites.

Methods: Retrospective analysis of patients with advanced chronic liver disease diagnosed with bacterascites and SBP between January 2003 and August 2016. Read More

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July 2018
6 Reads

Paracentesis in cirrhotics is associated with increased risk of 30-day readmission.

World J Hepatol 2018 Jun;10(6):425-432

Division of Gastroenterology, Hepatology and Nutrition, the Ohio State Wexner Medical Center, Columbus, OH 43210, United States.

Aim: To determine the readmission rate, its reasons, predictors, and cost of 30-d readmission in patients with cirrhosis and ascites.

Methods: A retrospective analysis of the nationwide readmission database (NRD) was performed during the calendar year 2013. All adults cirrhotics with a diagnosis of ascites, spontaneous bacterial peritonitis, or hepatic encephalopathy were identified by ICD-9 codes. Read More

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June 2018
5 Reads

Homocysteine: a new diagnostic marker for spontaneous bacterial peritonitis?

Eur J Gastroenterol Hepatol 2018 08;30(8):902-903

Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

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August 2018
14 Reads

Daily Norfloxacin vs. Weekly Ciprofloxacin to Prevent Spontaneous Bacterial Peritonitis: A Randomized Controlled Trial.

Am J Gastroenterol 2018 Aug 27;113(8):1167-1176. Epub 2018 Jun 27.

Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.

Objectives: For the prevention of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites, norfloxacin 400 mg per day is recommended as a standard regimen. This study aims to investigate whether ciprofloxacin once weekly administration is not inferior to norfloxacin once daily administration for the prevention of SBP.

Methods: This is an investigator-initiated open-label randomized controlled trial conducted at seven tertiary hospitals in South Korea. Read More

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August 2018
2 Reads

Prevalence, predictors and impact of bacterial infection in acute on chronic liver failure patients.

Dig Liver Dis 2018 May 28. Epub 2018 May 28.

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India, India. Electronic address:

Background: Acute on chronic liver failure (ACLF) is associated with high short term mortality. We aimed to evaluate the prevalence, predictors and impact of bacterial infection in ACLF.

Methods: Consecutive hospitalized patients with cirrhosis and acute decompensation (AD), from January 2011-March 2017, were included. Read More

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May 2018
7 Reads
2.96 Impact Factor

Relative adrenal insufficiency in cirrhotic patients with ascites (hepatoadrenal syndrome).

Dig Liver Dis 2018 May 23. Epub 2018 May 23.

Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Aim: Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites.

Methods: The study included 66 consecutive non-septic cirrhosis patients with ascites. Read More

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May 2018
3 Reads
2.96 Impact Factor

Microbiology and antibiotic susceptibility patterns in spontaneous bacterial peritonitis: A study of two Dutch cohorts at a 10-year interval.

United European Gastroenterol J 2018 May 20;6(4):614-621. Epub 2017 Nov 20.

1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.

Background: Recent investigations suggest an increasing prevalence of Gram-positive and antibiotic-resistant bacteria causing spontaneous bacterial peritonitis (SBP), probably related to changes in antibiotic prescription patterns, in particular more widespread and long-term use of antibiotic prophylaxis with quinolones.

Objective: The primary objective of this study was to assess potential changes in the microbiology of SBP in two patient cohorts studied at a 10-year interval. Further aims were to study prognostic factors and outcome of SBP. Read More

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Bacterial Infections in Acute-on-Chronic Liver Failure.

Semin Liver Dis 2018 05 5;38(2):121-133. Epub 2018 Jun 5.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Acute-on-chronic liver failure (ACLF) is a newly recognized clinical syndrome characterized by preexisting chronic liver disease or cirrhosis with organ failure and high 28-day mortality (50-90%). Bacterial infections (BIs) play pivotal roles in the development and progression of ACLF either as a main precipitating event or a specific complication. The main organisms isolated as triggering ACLF are Gram-positive bacteria, followed by Gram-negative bacteria. Read More

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May 2018
1 Read

Clinical and bacteriological features and prognosis of ascitic fluid infection in Chinese patients with cirrhosis.

BMC Infect Dis 2018 Jun 4;18(1):253. Epub 2018 Jun 4.

The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, No.20 Dongda Street, Fengtai District, Beijing, 100071, China.

Background: Spontaneous bacterial peritonitis (SBP) and bacterascites (BA) represent frequent and serious complications in cirrhosis patients with ascites. However, few detailed data are available regarding the clinical and bacteriological feature of SBP or BA patients in China.

Methods: We retrospectively analyzed bacteriological and clinical characteristics of patients with SBP and BA at Beijing 302 Hospital in China from January 2012 to December 2015. Read More

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Ascitic fluid regulates the local innate immune response of patients with cirrhosis.

J Leukoc Biol 2018 May 31. Epub 2018 May 31.

Department of Immunology, Institut de Recerca and Hospital Santa Creu i Sant Pau, Barcelona, Spain.

Ascitic neutrophils from cirrhotic patients with spontaneous bacterial peritonitis (SBP) exhibit an impaired oxidative burst that could facilitate bacterial infection. However, the influence of the cell-free ascitic fluid of these patients on neutrophil function has not been investigated. To analyze this influence, we determined the ascitic levels of cytokines, resistin, and lactoferrin and their association with neutrophil function, disease severity score, and SBP resolution. Read More

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May 2018
1 Read

Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA.

J Glob Antimicrob Resist 2018 May 26;15:41-47. Epub 2018 May 26.

Department of Pharmacy Practice and Translational Research, Room 4025, University of Houston College of Pharmacy, 4849 Calhoun Road, Houston, TX 77204-5039, USA.

Objectives: The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.

Methods: This 1:1:4 case-case-control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016. Read More

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Plasma concentration of diamine oxidase (DAO) predicts 1-month mortality of acute-on-chronic hepatitis B liver failure.

Clin Chim Acta 2018 Sep 26;484:164-170. Epub 2018 May 26.

Department of Hepatology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan 250012, China; Institute of Hepatology, Shandong University, Wenhuaxi Road 107#, Jinan 250012, China. Electronic address:

Background: Acute-on-chronic hepatitis B liver failure (ACHBLF) has high 1-month mortality but it is difficult to predict. This present study was aimed to determine the diagnostic value of plasma diamine oxidase (DAO) in predicting the 1-month mortality of ACHBLF.

Methods: A total of 106 consecutive newly diagnosed ACHBLF patients were retrospectively collected. Read More

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September 2018

[Diagnosis and treatment of bacterial infection in patients with end-stage liver disease].

Authors:
W W Luo D Z Zhang

Zhonghua Gan Zang Bing Za Zhi 2018 Jan;26(1):10-12

Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University , Chongqing 400010, China.

Patients with end-stage liver disease have an increased risk of developing bacterial infections, resulting in an increase in the number of hospitalizations and medical expenses, a decline in the quality of life of patients, and an increased fatality rate. Bacterial infections in patients with end-stage liver disease is mainly due to the falling off the body's immune response causing respiratory infections, spontaneous bacterial peritonitis, urinary tract infections and gastrointestinal infections. The diagnosis of bacterial infection is more challenging because the occurrence of infection shows no typical symptoms and signs. Read More

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January 2018

Development of a novel clinical staging model for cirrhosis using the Nationwide Inpatient Sample.

J Investig Med 2018 Aug 14;66(6):992-997. Epub 2018 May 14.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of South Carolina, Charelston, South Carolina, USA.

Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. Read More

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August 2018
2 Reads

Grand Rounds: Alcoholic Hepatitis.

J Hepatol 2018 Aug 13;69(2):534-543. Epub 2018 Jun 13.

Division of gastroenterology and hepatology, Mayo Clinic, Rochester, MN, USA.

A 33-year-old Caucasian male was admitted to hospital with recent onset of jaundice of 2-3 weeks duration. He reported heavy use of alcohol for the last 10 years with the last drink a day prior to the onset of symptoms. At admission, he was alert and oriented to time, place, and person, and was deeply jaundiced. Read More

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August 2018
6 Reads

Multiple bacterial infections increase the risk of hepatic encephalopathy in patients with cirrhosis.

PLoS One 2018 10;13(5):e0197127. Epub 2018 May 10.

Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Objective: Patients with liver cirrhosis (LC) are at increased risk for bacterial infections. It is not fully understood how exposure to infections induces further development of hepatic encephalopathy (HE). This study estimated risks of infection associated with HE among patients with LC. Read More

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July 2018
4 Reads

Xuebijing Injection Combined with Antibiotics for the Treatment of Spontaneous Bacterial Peritonitis in Liver Cirrhosis: A Meta-Analysis.

Evid Based Complement Alternat Med 2018 19;2018:2989846. Epub 2018 Mar 19.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China.

Background And Aim: Spontaneous bacterial peritonitis (SBP) is one of the most common complications of liver cirrhosis. Antibiotics are the main treatment regimen of SBP. Traditional Chinese medicine Xuebijing injection has been used in such patients. Read More

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March 2018
2 Reads

Natural History of Cirrhosis of Liver after First Decompensation: A Prospective Study in India.

J Clin Exp Hepatol 2018 Mar 15;8(1):50-57. Epub 2017 Jun 15.

Department of Gastroenterology, Bombay Hospital & Medical Research Center, Mumbai, India.

Background And Aims: As liver cirrhosis is a dynamic condition, it is possible to improve survival in decompensated cirrhosis. Hence, we planned a prospective study to determine the natural history of cirrhosis after first decompensation.

Methods: We enrolled all patients of liver cirrhosis who presented with first episode of decompensation defined by the presence of ascites, either overt or detected by Ultrasonography (UD), Gastroesophageal Variceal Bleeding (GEVB), and Hepatic Encephalopathy (HE). Read More

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March 2018
4 Reads

Prevalence and Impact of Bacterial Infections in Children With Liver Disease-A Prospective Study.

J Clin Exp Hepatol 2018 Mar 14;8(1):35-41. Epub 2017 Sep 14.

Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Background And Aims: Risk of infections is increased in patients with Acute Liver Failure (ALF) and Decompensated Chronic Liver Disease (DCLD). We evaluated the frequency, site, type and risk-factors for bacterial infections in children with ALF and DCLD and its effect on outcome.

Methods: ALF or DCLD children were enrolled prospectively. Read More

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March 2018
1 Read

Alcohol Consumption Influences Clinical Outcome in Patients Admitted to a Referral Center for Liver Disease.

Ann Hepatol 2018 May-June;17(3):470-475. Epub 2018 Apr 9.

Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

Introduction And Aim: Excessive alcohol consumption is a public health concern worldwide and has been associated with high mortality rates. This study aimed to determine the prevalence of alcohol consumption and its influence on the prognosis of hospitalized cirrhotic patients in a tertiary care hospital.

Material And Methods: We reviewed the medical records of all patients with hepatic cirrosis admitted between January 2009 and December 2014, in a referral center for liver disease in southern Brazil. Read More

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April 2018
1 Read

Impact of Pretransplant Infections on Clinical Course in Liver Transplant Recipients.

Transplant Proc 2018 May;50(4):1153-1156

Department of Surgery, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.

Background: Uncontrolled infections are known to be an absolute contraindication for liver transplantation; however, the posttransplant prognosis of recipients treated for pretransplant infection is unclear. The aim of this study was to analyze pretransplant infections among liver transplant recipients and to determine their impact on posttransplant clinical outcomes.

Methods: This study retrospectively analyzed 357 subjects who had undergone living-donor liver transplantation between January 2008 and May 2014. Read More

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May 2018
1 Read

Nonselective Beta-Blockers Do Not Affect Survival in Cirrhotic Patients with Ascites.

Dig Dis Sci 2018 07 3;63(7):1737-1746. Epub 2018 May 3.

Gastroenterology Unit, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 1, 71100, Foggia, Italy.

Background: The role of nonselective beta-blockers in cirrhotic patients with ascites has been recently questioned; however, definitive evidence in this regard is still lacking.

Aims: To analyze published data on the influence of nonselective beta-blockers as compared to control group on survival of cirrhotic patients with ascites.

Methods: Computerized bibliographic search on the main databases was performed. Read More

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July 2018
4 Reads

Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review.

Authors:
Tracy MacIntosh

Cureus 2018 Mar 1;10(3):e2253. Epub 2018 Mar 1.

Emergency, Osceola Regional Medical Center.

Spontaneous bacterial peritonitis (SBP) has a high mortality rate; early antimicrobial therapy is essential for improving patient outcomes. Given that cirrhotic patients are often coagulopathic, the perceived risk of bleeding may prevent providers from performing a paracentesis and ruling out this potentially deadly disease. We examine the pathophysiology and risk factors for SBP, and current guidelines for its diagnosis and treatment. Read More

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March 2018
1 Read

A data-driven patient blood management strategy in liver transplantation.

Vox Sang 2018 May 1. Epub 2018 May 1.

Division of Transplantation, Department of Surgery, University of Washington, Seattle, WA, USA.

Background And Objectives: Blood utilization during liver transplant has decreased, but remains highly variable due to many complex surgical and physiologic factors. Previous models attempted to predict utilization using preoperative variables to stratify cases into two usage groups, usually using entire blood units for measurement. We sought to develop a practical predictive model using specific transfusion volumes (in ml) to develop a data-driven patient blood management strategy. Read More

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May 2018
7 Reads

[Spontaneous bacterial peritonitis and bacteraemia caused by meningococci serogroup W clonal complex 11].

Ugeskr Laeger 2018 Apr;180(16)

In recent years, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (SG-W) has been rising, in particular SG-W within clonal complex 11 (cc11), which has caused epidemics and is believed to cause severe and atypical IMD. This is a case report of spon-taneous bacterial peritonitis and bacteraemia caused by meningococci SG-W cc11 in a 60-year-old female with systemic lupus erythematosus in prolonged remission as her only risk factor. Antibiotic therapy was initiated at admission, and peritoneal lavage was performed. Read More

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April 2018
3 Reads

Spontaneous Bacterial Peritonitis due to in Cirrhosis.

Case Rep Gastrointest Med 2018 1;2018:5714053. Epub 2018 Mar 1.

Department of Medicine, University of California, San Francisco Medical Center, San Francisco, CA, USA.

species colonize the human gastrointestinal tract and are rarely pathogenic. We present a case involving a cirrhotic patient who presented with sepsis and was found to have peritoneal cultures demonstrating as the sole pathogen concerning for spontaneous bacterial peritonitis. Treatment was achieved with high-dose penicillin and clindamycin but the patient developed hepatorenal syndrome and died from acute renal failure. Read More

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March 2018
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Dose-dependent impact of proton pump inhibitors on the clinical course of spontaneous bacterial peritonitis.

Liver Int 2018 Sep 7;38(9):1602-1613. Epub 2018 May 7.

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.

Background & Aims: Spontaneous bacterial peritonitis is a severe complication in patients with cirrhosis leading to acute kidney injury, hepatic encephalopathy and a high mortality. In this study, we aimed to investigate the impact of proton pump inhibitors and the potential relevance of the taken dosage on the incidence and clinical course of spontaneous bacterial peritonitis.

Methods: Overall, 613 consecutive patients with decompensated cirrhosis were included. Read More

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September 2018
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Endoscopic ultrasound-guided coil or glue injection in post-cyanoacrylate gastric variceal re-bleed.

Indian J Gastroenterol 2018 03 9;37(2):153-159. Epub 2018 Apr 9.

Departments of Gastroenterology and Radiology, VPS Lakeshore Hospital and Research Centre, Kochi, 682 304, India.

Background And Aims: N-butyl-cyanoacrylate injection is recommended in bleeding/recently bled gastric varices. However, cyanoacrylate injection is associated with re-bleed in 25% to 50% of patients. Endoscopic ultrasound (EUS)-guided coil application is an emerging treatment modality for bleeding gastric varices. Read More

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March 2018
3 Reads

Spontaneous bacteremia and spontaneous bacterial peritonitis in cirrhosis: two infections but similar outcomes?

Authors:
Rakhi Maiwall

Hepatol Int 2018 Mar 27;12(2):87-89. Epub 2018 Mar 27.

Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110070, India.

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March 2018
5 Reads