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    Changes of Intestinal Functions in Liver Cirrhosis.
    Inflamm Intest Dis 2016 Apr 8;1(1):24-40. Epub 2016 Mar 8.
    Department of Gastroenterology, University Hospital of Visceral Surgery and Medicine, Bern, Switzerland.
    Background: Understanding of the gut-liver axis is important for the up-to-date management of liver cirrhosis, and changes of intestinal functions form the core of this interesting research field.

    Summary: Most investigators noted small intestinal dysmotility in their patients with liver cirrhosis. Marked changes in the contraction pattern were observed in early manometric studies. Read More
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    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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    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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    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 May 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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    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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    Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary center in the United States.
    J Glob Antimicrob Resist 2018 May 26. Epub 2018 May 26.
    Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4849 Calhoun Rd, Houston, TX, USA.
    Objectives: The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the United States (US). The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large tertiary center in the US.

    Methods: This 1:1:4 case-case-control study included 141 adults with liver cirrhosis admitted from 11/2011 to 03/2016. 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 May 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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    [Diagnosis and treatment of bacterial infection in patients with end-stage liver disease].
    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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    Development of a novel clinical staging model for cirrhosis using the Nationwide Inpatient Sample.
    J Investig Med 2018 May 14. 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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    Grand Rounds: Alcoholic Hepatitis.
    J Hepatol 2018 Jun 13. 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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    Effects of Virologic Response to Treatment on Short- and Long-term Outcomes of Patients With Chronic HBV Infection and Decompensated Cirrhosis.
    Clin Gastroenterol Hepatol 2018 May 9. Epub 2018 May 9.
    Yonsei University College of Medicine.
    Background & Aims: Little is known about the effects of antiviral therapy on short- and long-term survival of patients with hepatitis B virus (HBV)-related decompensated cirrhosis. We aimed to determine whether a maintained virologic response (MVR, defined as persistent undetectable HBV DNA during therapy) associates with short-term (6-month) and long-term (6-120 months) survival of patients with decompensated cirrhosis.

    Methods: We performed a 10-year observation analysis using data from the Epidemiology and Natural History of Liver Cirrhosis study of patients with decompensated liver cirrhosis in Korea. Read More
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    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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    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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    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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    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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    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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    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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    Nonselective Beta-Blockers Do Not Affect Survival in Cirrhotic Patients with Ascites.
    Dig Dis Sci 2018 May 3. 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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    Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review.
    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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    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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    [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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    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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    Dose-dependent impact of proton pump inhibitors on the clinical course of spontaneous bacterial peritonitis.
    Liver Int 2018 Apr 19. Epub 2018 Apr 19.
    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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    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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    Therapy With Direct-Acting Antiviral Agents for Hepatitis C in Liver Transplant Recipients.
    Transplant Proc 2018 Mar;50(2):631-633
    Department of Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
    Background: Recurrent infection with the hepatitis C virus (HCV) after liver transplantation (LT) is associated with decreased graft and patient survival. Direct-acting antiviral (DAA) therapies have changed the landscape of HCV due to their excellent safety profile and cure rates. Our aim was to evaluate the efficacy and tolerability of antiviral therapy in recurrent HCV after LT with DAA therapy. Read More
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    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
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    IMPACT OF MICROBIOLOGICAL CHANGES ON SPONTANEOUS BACTERIAL PERITONITIS IN THREE DIFFERENT PERIODS OVER 17 YEARS.
    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
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    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
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    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(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
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    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
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    Predicting mortality in patients with spontaneous bacterial peritonitis using routine inflammatory and biochemical markers.
    Eur J Gastroenterol Hepatol 2018 07;30(7):786-791
    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
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    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
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    Homocysteine: a new diagnostic marker in spontaneous bacterial peritonitis.
    Eur J Gastroenterol Hepatol 2018 07;30(7):779-785
    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
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    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
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    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
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    Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA.
    Dig Dis Sci 2018 05 26;63(5):1327-1333. 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
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    Can combined blood neutrophil to lymphocyte ratio and C-reactive protein be used for diagnosis of spontaneous bacterial peritonitis?
    Br J Biomed Sci 2018 Apr 16;75(2):71-75. 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)/mm in 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
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    Spontaneous bacterial peritonitis due to Helicobacter pylori in a cirrhotic patient with human immunodeficiency virus and hepatitis C virus coinfection.
    Enferm Infecc Microbiol Clin 2018 Feb 8. Epub 2018 Feb 8.
    Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Burgos, Burgos, España.
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    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
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    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
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    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
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    Clarifying the role of C-reactive protein as a bacterial infection predictor in decompensated cirrhosis.
    Eur J Gastroenterol Hepatol 2018 06;30(6):645-651
    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
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    Diagnostic validity of flow cytometry vs manual counting of polymorphonuclear leukocytes in spontaneous bacterial peritonitis.
    J Clin Lab Anal 2018 Jun 31;32(5):e22395. 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/mm with 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
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    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
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    Expression of microRNAs in the ascites of patients with peritoneal carcinomatosis and peritonitis.
    Cancer Cytopathol 2018 May 23;126(5):353-363. 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
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