2,410 results match your criteria Spontaneous Bacterial Peritonitis


[News for usage of albumin in patients with liver disease].

Dtsch Med Wochenschr 2020 Jun 3;145(11):722-726. Epub 2020 Jun 3.

Universitätsklinikum Frankfurt am Main - Medizinische Klinik I, Goethe-Universität Frankfurt am Main.

The recommended indications for short-term use of human albumin in patients with decompensated cirrhosis are the following: prevention of paracenteses induced circulatory dysfunction, treatment of hypovolemia, prevention of hepatorenal syndrome in high-risk patients with spontaneous bacterial peritonitis, as well as treatment of hepatorenal syndrome. Liver cirrhosis is associated with systemic inflammation, which is further increased in decompensated cirrhosis and acute-on-chronic liver failure. Besides its function as plasma expander, albumin is known to have pleiotropic non-oncotic properties. Read More

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http://dx.doi.org/10.1055/a-1012-6991DOI Listing

Spontaneous bacterial peritonitis caused by Campylobacter Coli in cirrhotic patient: A rare case report (CARE-compliant).

Medicine (Baltimore) 2020 May;99(21):e19887

Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Introduction: Spontaneous bacterial peritonitis (SBP) is a fatal infection in patients. It often happens in patients with cirrhosis, cancer or diabetes, and is caused mostly by Enterobacteriaceae. Here we report a rare case of SBP caused by Campylobacter Coli (C coli) infection, which was identified promptly by the matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and received adequate therapy sooner after. Read More

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http://dx.doi.org/10.1097/MD.0000000000019887DOI Listing

Spontaneous Bacterial Peritonitis: We Are Still Behind.

Cureus 2020 Apr 17;12(4):e7711. Epub 2020 Apr 17.

Gastroenterology and Hepatology, University of Missouri-Kansas City School of Medicine, Kansas City, USA.

Spontaneous bacterial peritonitis (SBP) is an infection in the ascitic fluid. Despite published guidelines, an inappropriate diagnosis of SBP is frequent. In this study, we aim to evaluate guideline adherence in diagnosing SBP. Read More

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http://dx.doi.org/10.7759/cureus.7711DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233508PMC

Differential Impact of Serum 25-Hydroxyvitamin D3 Levels on the Prognosis of Patients with Liver Cirrhosis According to MELD and Child-Pugh Scores.

J Korean Med Sci 2020 May 18;35(19):e129. Epub 2020 May 18.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Background: Prognosis of patients with diverse chronic diseases is reportedly associated with 25-hydroxyvitamin D levels. In this study, we investigated the potential role of 25-hydroxyvitamin D3 (25[OH]D3) levels in improving the predictive power of conventional prognostic models for patients with liver cirrhosis.

Methods: We investigated clinical findings, including serum 25(OH)D3 levels at admission, of 155 patients with cirrhosis who were followed up for a median of 16. Read More

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http://dx.doi.org/10.3346/jkms.2020.35.e129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234861PMC

A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management.

Ann Hepatol 2020 Apr 23. Epub 2020 Apr 23.

Gastroenterology Department, Hospital de la Samaritana, Bogotá, Colombia.

Introduction & Objectives: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes. Read More

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http://dx.doi.org/10.1016/j.aohep.2020.03.007DOI Listing

Pretreatment with zinc protects Kupffer cells following administration of microbial products.

Biomed Pharmacother 2020 Jul 14;127:110208. Epub 2020 May 14.

Department of Medicine II, University Hospital, Liver Centre Munich, LMU Munich, Germany. Electronic address:

Background: Systemic inflammation and severe fibrosis can reduce serum zinc levels, while zinc supplementation is reported to improve the prognosis of patients with chronic liver disease (CLD).

Objectives: We aimed to investigate the clinical application of serum zinc in patients with CLD and the anti-infective mechanism of zinc supplementation.

Methods: Based on the serum zinc level, 149 CLD patients were divided into 3 groups and their clinical parameters were compared. Read More

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http://dx.doi.org/10.1016/j.biopha.2020.110208DOI Listing

Acute kidney injury in critically ill cirrhotic patients with spontaneous bacterial peritonitis: a comparison of KDIGO and ICA criteria.

Arch Med Sci 2020 17;16(3):569-576. Epub 2019 May 17.

Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

Introduction: Acute kidney injury (AKI) is an important independent predictor of mortality in cirrhotic patients with spontaneous bacterial peritonitis (SBP). However, the definition of AKI in cirrhosis has been debated for many years. This study aims to compare the prediction accuracy of Kidney Disease: Improving Global Outcomes (KDIGO) and International Club of Ascites (ICA) criteria for hospital mortality in cirrhotic patients with SBP admitted to the intensive care unit (ICU). Read More

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http://dx.doi.org/10.5114/aoms.2019.85148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212228PMC

Causes and Rates of 30-Day Readmissions After Transjugular Intrahepatic Portosystemic Shunts.

AJR Am J Roentgenol 2020 May 6:1-7. Epub 2020 May 6.

Department of Radiology, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Deaconess Rd, WCC 308, Boston, MA 02215.

The purpose of this study was to investigate the causes and rates of 30-day readmission after transjugular intrahepatic portosystemic shunt (TIPS) at a single liver transplant center. We reviewed 165 TIPS procedures performed between 2003 and 2013. After excluding patients who died during the index admission ( = 16), any readmission within 30 days of discharge was identified, and cause of readmission was determined. Read More

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http://dx.doi.org/10.2214/AJR.19.21732DOI Listing

Role of ascitic endocan levels in the diagnosis of spontaneous bacterial peritonitis in decompensated cirrhosis.

Biomarkers 2020 Jun 14;25(4):360-366. Epub 2020 May 14.

Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

To assess the role of ascitic endocan levels in the diagnosis of spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis. Ascites samples, as well as demographic and laboratory data, were collected at admission from patients with decompensated cirrhosis. Ascitic endocan, tumour necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured by ELISA. Read More

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http://dx.doi.org/10.1080/1354750X.2020.1764107DOI Listing

Cirrhosis, gastrointestinal bleed, and cryptococcal peritonitis.

Proc (Bayl Univ Med Cent) 2020 Apr 11;33(2):195-198. Epub 2020 Feb 11.

Division of Infectious Diseases, Department of Internal Medicine, Baylor Scott & White Medical Center - TempleTempleTexas.

Disseminated infection rarely causes peritonitis in non-HIV-infected patients but does affect cirrhotic patients. Diagnostic challenges delay treatment, and mortality is high. We performed a literature search of proven cryptococcal peritonitis cases in HIV-negative adults with underlying cirrhosis, included our own case, and collected demographic, infection risk factor, diagnostic, treatment, and outcomes data. Read More

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http://dx.doi.org/10.1080/08998280.2020.1723361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155978PMC

The impact of different infectious complications on mortality of hospitalized patients with liver cirrhosis.

Ann Hepatol 2020 Mar 6. Epub 2020 Mar 6.

Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14000, Mexico. Electronic address:

Introduction And Objectives: Bacterial infections are common complications in patients with cirrhosis and are associated with poor prognosis. There are no studies that analyze the impact of different infectious complications in the mortality of these patients, so we aimed to perform this evaluation.

Materials And Methods: We performed a case-control study in adult patients with cirrhosis with a follow-up period of one year. Read More

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http://dx.doi.org/10.1016/j.aohep.2020.02.005DOI Listing

Antibiotics for prophylaxis of spontaneous bacterial peritonitis: systematic review & Bayesian network meta-analysis.

Hepatol Int 2020 May 7;14(3):399-413. Epub 2020 Apr 7.

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

Background: Various antibiotic regimens are used for primary and secondary prevention of spontaneous bacterial peritonitis (SBP). A systematic review and network meta-analysis to compare various antibiotics regimens for primary and secondary prevention of SBP were done.

Methods: We did a comprehensive literature search using various databases (i. Read More

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http://dx.doi.org/10.1007/s12072-020-10025-1DOI Listing
May 2020
2.468 Impact Factor

as an Initiating Factor of Complications in Patients With Cirrhosis: A Single-Center Observational Study.

Front Med (Lausanne) 2020 24;7:96. Epub 2020 Mar 24.

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

The relationship between liver cirrhosis and () is a debatable matter. The aim of this study is to evaluate the possible association between infection and liver cirrhosis. A single-center prospective cohort pilot study of 558 patients with cirrhosis was followed up for 1 year. Read More

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http://dx.doi.org/10.3389/fmed.2020.00096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105722PMC

Clinical characteristics and 28-d outcomes of bacterial infections in patients with hepatitis B virus-related acute-on-chronic liver failure.

World J Clin Cases 2020 Mar;8(6):1042-1055

Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.

Background: Acute-on-chronic liver failure (ACLF), which includes hepatic and multiple extra-hepatic organ failure, is a severe emergency condition that has high mortality. ACLF can rapidly progress and requires an urgent assessment of condition and referral for liver transplantation. Bacterial infections (BIs) trigger ACLF and play pivotal roles in the deterioration of clinical course. Read More

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http://dx.doi.org/10.12998/wjcc.v8.i6.1042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103966PMC

In reply - Increasing Resistance to Third-Generation Cephalosporins in Spontaneous Bacterial Peritonitis.

Mayo Clin Proc 2020 Apr;95(4):829-830

Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

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http://dx.doi.org/10.1016/j.mayocp.2020.01.004DOI Listing

Increasing Resistance to Third-Generation Cephalosporins in Spontaneous Bacterial Peritonitis.

Mayo Clin Proc 2020 Apr;95(4):828-829

Division of Hospital Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington.

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http://dx.doi.org/10.1016/j.mayocp.2020.01.005DOI Listing

Risk Factors and Impact of Perioperative Prophylaxis on the Risk of Extended-spectrum β-Lactamase-producing Enterobacteriaceae-related Infection Among Carriers Following Liver Transplantation.

Transplantation 2020 Mar 20. Epub 2020 Mar 20.

Department of Anesthesiology and Critical Care, Beaujon hospital, DMU Parabol, AP-HP.Nord.

Background: ESBL-E (Extended-Spectrum β-Lactamase-producing Enterobacteriaceae) carriage is frequent among liver transplant (LT) recipients, thereby fostering a large empirical carbapenem prescription. However, ESBL-E infections occur in only 10-25% of critically ill patients with rectal colonization. Our aim was to identify risk factors for post-LT ESBL-E infection in colonized patients. Read More

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http://dx.doi.org/10.1097/TP.0000000000003231DOI Listing

Frequency, characteristics and impact of multiple consecutive nosocomial infections in patients with decompensated liver cirrhosis and ascites.

United European Gastroenterol J 2020 Jun 13;8(5):567-576. Epub 2020 Mar 13.

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

Background: Nosocomial infections are a particular threat for patients with liver cirrhosis. It is not uncommon that individuals develop even several consecutive infections during a single hospital stay. We aimed to investigate the impact and characteristics of multiple, consecutive nosocomial infections. Read More

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http://dx.doi.org/10.1177/2050640620913732DOI Listing

Albumin: Indications in chronic liver disease.

United European Gastroenterol J 2020 Jun 26;8(5):528-535. Epub 2020 Feb 26.

Department of Medical and Surgical Sciences, S Orsola-Malpighi University Hospital, Bologna, Italy.

Albumin is currently employed as a plasma expander to prevent and treat specific complications of cirrhosis with ascites, such as the prevention of paracentesis-induced circulatory dysfunction and renal dysfunction induced by spontaneous bacterial peritonitis, as well as the diagnosis and treatment of acute kidney injury and hepatorenal syndrome. Recently, evidence has shown that long-term albumin administration in patients with decompensated cirrhosis reduces mortality and incidence of complications, eases the management of ascites, is cost effective, and has a good safety profile. Read More

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http://dx.doi.org/10.1177/2050640620910339DOI Listing

Granulocyte Colony-Stimulating Factor Use in Decompensated Cirrhosis: Lack of Survival Benefit.

J Clin Exp Hepatol 2020 Mar-Apr;10(2):124-134. Epub 2019 Jun 1.

Hepatobiliary and Transplant Surgery, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi, Kerala.

Background: Granulocyte colony-stimulating factor (GCSF) has been utilized in decompensated cirrhosis (DC) for improving transplant-free survival (TFS). Data from multiple centers are conflicting with regard to patient outcomes. In this retrospective study, we present our 'real-world experience' of GCSF use in a large group of DC. Read More

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http://dx.doi.org/10.1016/j.jceh.2019.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067994PMC

Ascitic calprotectin for the diagnosis of spontaneous bacterial peritonitis: a systematic review and meta-analysis.

Eur J Gastroenterol Hepatol 2020 Mar 13. Epub 2020 Mar 13.

College of Medicine, Sulaiman Al Rajhi University, Saudi Arabia.

Calprotectin is a promising diagnostic biomarker for spontaneous bacterial peritonitis (SBP) among cirrhotic patients, but published studies report a wide variation of its diagnostic accuracy. We systematically searched six databases for eligible studies (i.e. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001709DOI Listing

Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis.

Int J Environ Res Public Health 2020 03 6;17(5). Epub 2020 Mar 6.

Department of Infectious Diseases, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.

: The aim of this study was to assess the diagnostic performance of new morphology-related indices and Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores during hospitalization in predicting the onset of bacterial infection in patients with liver cirrhosis. : A total of 171 patients (56.9% males; median age 59 years; total number of hospitalizations 209) with liver cirrhosis were included in this observational study. Read More

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http://dx.doi.org/10.3390/ijerph17051727DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084714PMC

Complications Associated with Anesthesia Services in Endoscopic Procedures Among Patients with Cirrhosis.

Hepatology 2020 Mar 10. Epub 2020 Mar 10.

Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina (UNC) Health Care, Chapel Hill, NC, United States.

Background & Aims: Anesthesia services for endoscopic procedures have proliferated with the promise of increased comfort and safety. Cirrhosis patients are higher risk for sedation, yet limited data are available describing anesthesia complications in this population.

Approach & Results: This cross-sectional study utilized the National Anesthesia Clinical Outcomes Registry, a multi-center quality improvement database from 2010 to 2015. Read More

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http://dx.doi.org/10.1002/hep.31224DOI Listing

Can Macrophages in Cirrhotic Ascites Fluid Predict Clinical Outcome in Spontaneous Bacterial Peritonitis?

Authors:
Annie J Kruger

Gastroenterology 2020 May 2;158(6):1540-1543. Epub 2020 Mar 2.

Department of Gastroenterology, MedStar Georgetown University Hospital. Electronic address:

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http://dx.doi.org/10.1053/j.gastro.2020.02.040DOI Listing

Clinical features and outcomes of bacterascites in cirrhotic patients: A retrospective, multicentre study.

Liver Int 2020 Jun 17;40(6):1447-1456. Epub 2020 Mar 17.

Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Background & Aims: Current guidelines on the management of bacterascites are limited. This multicentre, retrospective study investigated the clinical features and outcomes of cirrhosis patients with bacterascites.

Methods: Two series of cirrhosis patients were evaluated. Read More

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http://dx.doi.org/10.1111/liv.14418DOI Listing

The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients.

Antiinflamm Antiallergy Agents Med Chem 2020 Mar 2. Epub 2020 Mar 2.

Department of Tropical Medicine, Tanta University, Egypt.

Background & Aims: The early diagnosis of spontaneous bacterial peritonitis (SBP) has been considered important in overall patient's survival. Ascitic fluid culture examination performance, in the emergency setting, is time consuming and not always available, so there is a need for easy to apply, rapid and reliable markers to predict diagnosis in patients with ascites. This present prospective study aimed to determine the early diagnostic value of serum procalcitonin (PCT) levels in decompensated cirrhotic patients (DCPs) with SBP. Read More

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http://dx.doi.org/10.2174/1871523019666200303104932DOI Listing

Effects of poor hepatic reserve in cirrhotic patients with bacterial infections: A population-based study.

Ci Ji Yi Xue Za Zhi 2020 Jan-Mar;32(1):47-52. Epub 2019 Feb 18.

Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

Objective: Ascites, hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and esophageal variceal bleeding are major complications associated with cirrhosis. The presence of these complications indicates poor hepatic reserve. This study aimed to identify the effects of poor hepatic reserve on mortality in cirrhotic patients with bacterial infections. Read More

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http://dx.doi.org/10.4103/tcmj.tcmj_142_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015002PMC
February 2019

The value of ascitic neutrophil gelatinase-associated lipocalin in decompensated liver cirrhosis with spontaneous bacterial peritonitis.

J Clin Lab Anal 2020 Feb 26:e23247. Epub 2020 Feb 26.

Department of Hepatology, The Third Central Clinical College of Tianjin Medical University, Tianjin, China.

Background: Spontaneous bacterial peritonitis (SBP) is one of the most critical complications of decompensated liver cirrhosis. This study aimed to assess whether ascitic neutrophil gelatinase-associated lipocalin (NGAL), a reliable inflammation biomarker, can be used to detect SBP in decompensated cirrhosis patients and to predict mortality from decompensated cirrhosis-related SBP.

Methods: This study included 204 hospitalized patients with ascites of decompensated liver cirrhosis and follow-up of 28 days. Read More

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http://dx.doi.org/10.1002/jcla.23247DOI Listing
February 2020

[Usefulness of test strips for early diagnosis of spontaneous bacterial peritonitis in cirrhotic patients with ascites].

Rev Gastroenterol Peru 2019 Oct-Dec;39(4):348-354

Departamento de Gastroenterología-Hepatología, Fundación Cardioinfantil, Instituto de Cardiología. Bogotá, Colombia.

Introduction: Spontaneous bacterial peritonitis requires an early diagnosis to start antibiotic therapy. The ideal diagnostic study is the cytochemical of ascites fluid, which can be expensive, delayed and of limited availability in primary health care centers.

Objective: Evaluate the usefulness and diagnostic accuracy of Multistix 10SG test strips for the diagnosis of spontaneous bacterial peritonitis in cirrhotic patients with ascites. Read More

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February 2020

Microbiological profile of pathogens in spontaneous bacterial peritonitis secondary to liver cirrhosis: a retrospective study.

Trop Doct 2020 Apr 18;50(2):138-141. Epub 2020 Feb 18.

Professor and Head, Department of Microbiology, JIPMER, Pondicherry, India.

Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection of ascitic fluid without an obvious source. The prevalence of SBP in patients with cirrhosis is in the range of 10%-30%. With increasing use of antibiotics, there is a gradual shift in the causative flora of SBP from Gram-negative bacteria to Gram-positive and, more importantly, to drug-resistant bacteria. Read More

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http://dx.doi.org/10.1177/0049475520905745DOI Listing

Intractable hepatic encephalopathy in cirrhotic patients: mid-term efficacy of balloon-occluded retrograde portosystemic shunt obliteration.

Eur Radiol 2020 Jun 11;30(6):3462-3472. Epub 2020 Feb 11.

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

Purpose: To evaluate the efficacy and intermediate-term outcome of balloon-occluded retrograde transvenous obliteration (BRTO) for the treatment of hepatic encephalopathy (HE) secondary to portosystemic shunt (PSS) in cirrhotic patients.

Materials And Methods: Institutional review board (IRB) approval was obtained for this study and hospital records of patients who underwent BRTO, from August 2011 to August 2015, were analyzed. Based on the inclusion and exclusion criteria, 39 patients (age, 54. Read More

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http://dx.doi.org/10.1007/s00330-019-06644-4DOI Listing
June 2020
4.014 Impact Factor

First Documented Case of Percutaneous Endoscopic Gastrostomy (PEG) Tube-Associated Bacterial Peritonitis due to Species with Literature Review.

Case Rep Gastrointest Med 2020 16;2020:4397930. Epub 2020 Jan 16.

Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.

species (spp.) peritonitis has seldom been identified in medical literature. Scarce cases of peritonitis described previously have been correlated with peritoneal dialysis and more sparingly with spontaneous bacterial peritonitis. Read More

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http://dx.doi.org/10.1155/2020/4397930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007964PMC
January 2020

Beta-blockers in cirrhosis: Evidence-based indications and limitations.

JHEP Rep 2020 Feb 20;2(1):100063. Epub 2019 Dec 20.

Swiss Liver Center, UVCM, Inselspital, Bern University Hospital, Department of Biomedical Research, University of Bern, Bern, Switzerland.

Non-selective beta-blockers (NSBBs) are the mainstay of treatment for portal hypertension in the setting of liver cirrhosis. Randomised controlled trials demonstrated their efficacy in preventing initial variceal bleeding and subsequent rebleeding. Recent evidence indicates that NSBBs could prevent liver decompensation in patients with compensated cirrhosis. Read More

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http://dx.doi.org/10.1016/j.jhepr.2019.12.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005550PMC
February 2020

MAIT cells are enriched and highly functional in ascites of patients with decompensated liver cirrhosis.

Hepatology 2020 Feb 3. Epub 2020 Feb 3.

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

Patients with advanced liver cirrhosis have an increased susceptibility to infections. As part of the cirrhosis-associated immune dysfunction, mucosal associated invariant T (MAIT) cells, that have the capacity to respond towards bacteria, are severely diminished in circulation and liver tissue. However, MAIT cell presence and function in the peritoneal cavity, a common anatomical site for infections in cirrhosis, remain elusive. Read More

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http://dx.doi.org/10.1002/hep.31153DOI Listing
February 2020

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma.

Cancer Imaging 2020 Jan 30;20(1):13. Epub 2020 Jan 30.

Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China.

Purpose: To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC).

Materials And Methods: From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS). Read More

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http://dx.doi.org/10.1186/s40644-020-0294-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993318PMC
January 2020

Propranolol plus endoscopic ligation for variceal bleeding in patients with significant ascites: Propensity score matching analysis.

Medicine (Baltimore) 2020 Jan;99(5):e18913

Department of Internal Medicine, Gangneug Asan Hospital, Republic of Korea.

The use of beta-blockers in decompensated cirrhosis accompanying ascites is still under debate. The aim of this study was to compare overall survival (OS) and incidence of cirrhotic complications between endoscopic variceal ligation (EVL) only and EVL + non-selective beta-blocker (NSBB) combination therapy in cirrhotic patients with significant ascites (≥grade 2).This retrospective study included 271 consecutive cirrhotic patients with ascites who were treated with EVL only or EVL + NSBB combination therapy as a primary prophylaxis of esophageal varices. Read More

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http://dx.doi.org/10.1097/MD.0000000000018913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004788PMC
January 2020

Genetic variants of innate immunity receptors are associated with mortality in cirrhotic patients with bacterial infection.

Liver Int 2020 Mar 16;40(3):646-653. Epub 2020 Feb 16.

Leiden University Medical Center, Leiden, The Netherlands.

Background & Aims: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis (AD), organ failure(s) and high risk of short-term mortality with bacterial infection frequently as precipitating event. Innate immune pattern recognition receptors and members of the lectin pathway of complement activation are crucial to the innate immune response to pathogens. The aim of this study was to investigate whether single nucleotide polymorphisms (SNPs) of innate immune components are associated with the occurrence of bacterial infections or mortality in patients with cirrhosis hospitalized for AD or ACLF. Read More

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http://dx.doi.org/10.1111/liv.14392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079071PMC

Rifaximin improves survival in cirrhotic patients with refractory ascites: A real-world study.

World J Gastroenterol 2020 Jan;26(2):199-218

Department of Gastroenterology and Hepatology, Beijing You An Hospital, Capital Medical University, Beijing 100069, China.

Background: Rifaximin has been shown to reduce the incidence of hepatic encephalopathy and other complications in patients with cirrhosis. However, few studies have investigated the effect of rifaximin in cirrhotic patients with refractory ascites.

Aim: To evaluate the effects of rifaximin in the treatment of refractory ascites and to preliminarily explore its possible mechanism. Read More

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http://dx.doi.org/10.3748/wjg.v26.i2.199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962437PMC
January 2020
2.369 Impact Factor

Peritoneal Level of CD206 Associates With Mortality and an Inflammatory Macrophage Phenotype in Patients With Decompensated Cirrhosis and Spontaneous Bacterial Peritonitis.

Gastroenterology 2020 May 23;158(6):1745-1761. Epub 2020 Jan 23.

Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany; The Integrated Research and Treatment Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany; Department of Internal Medicine III, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany. Electronic address:

Background & Aims: Peritoneal macrophages (PMs) regulate inflammation and control bacterial infections in patients with decompensated cirrhosis. We aimed to characterize PMs and associate their activation with outcomes of patients with spontaneous bacterial peritonitis (SBP).

Methods: We isolated PMs from ascites samples of 66 patients with decompensated cirrhosis (19 with SBP) and analyzed them by flow cytometry, quantitative real-time polymerase chain reaction, functional analysis, and RNA microarrays. Read More

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http://dx.doi.org/10.1053/j.gastro.2020.01.029DOI Listing
May 2020
16.716 Impact Factor

Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis.

Cochrane Database Syst Rev 2020 01 16;1:CD013125. Epub 2020 Jan 16.

University College London, Division of Surgery and Interventional Science, London, UK, NW3 2PF.

Background: Approximately 2.5% of all hospitalisations in people with liver cirrhosis are for spontaneous bacterial peritonitis. Spontaneous bacterial peritonitis is associated with significant short-term mortality; therefore, it is important to prevent spontaneous bacterial peritonitis in people at high risk of developing it. Read More

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http://dx.doi.org/10.1002/14651858.CD013125.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984637PMC
January 2020

Mucosal-Associated Invariant T Cells Redistribute to the Peritoneal Cavity During Spontaneous Bacterial Peritonitis and Contribute to Peritoneal Inflammation.

Cell Mol Gastroenterol Hepatol 2020 15;9(4):661-677. Epub 2020 Jan 15.

Department of Internal Medicine IV, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany; Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany. Electronic address:

Background & Aims: Mucosal-associated invariant T (MAIT) cells are depleted from blood in patients with advanced liver disease and show features of immune dysfunction. Because circulating MAIT cells differ from organ-resident MAIT cells, we aimed to investigate the frequency, phenotype, and function of peritoneal MAIT cells from patients with cirrhosis and spontaneous bacterial peritonitis (SBP).

Methods: MAIT cells in blood and ascitic fluid from patients with cirrhosis were characterized using flow cytometry. Read More

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http://dx.doi.org/10.1016/j.jcmgh.2020.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160599PMC
January 2020

Adverse outcomes of proton pump inhibitors in chronic liver disease: a systematic review and meta-analysis.

Hepatol Int 2020 May 7;14(3):385-398. Epub 2020 Jan 7.

Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background And Aim: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications in the US, but their safety in cirrhosis has recently been questioned. We performed a meta-analysis of observational studies to evaluate the impact of PPIs on adverse clinical outcomes in the setting of chronic liver disease (CLD).

Methods: We searched several databases from inception to 26 May 2019 to identify comparative studies evaluating the effect of PPIs in CLD. Read More

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http://dx.doi.org/10.1007/s12072-019-10010-3DOI Listing

Non-selective beta blocker use is associated with improved short-term survival in patients with cirrhosis referred for liver transplantation.

BMC Gastroenterol 2020 Jan 6;20(1). Epub 2020 Jan 6.

Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN, 46202, USA.

Background: Recent evidence cautions against the use of non-selective beta-blockers (NSBB) in patients with refractory ascites or spontaneous bacterial peritonitis while other data suggests a survival benefit in patients with advanced liver disease. The aim of this study was to describe the use and impact of NSBB in patients with cirrhosis referred for liver transplantation.

Methods: A single-center cohort of patients with cirrhosis, who were referred and evaluated for liver transplantation between January and June 2012 were studied for baseline characteristics and clinical outcomes. Read More

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http://dx.doi.org/10.1186/s12876-019-1155-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945622PMC
January 2020

The Role of Non-Selective β-Blockers in Compensated Cirrhotic Patients without Major Complications.

Medicina (Kaunas) 2019 Dec 30;56(1). Epub 2019 Dec 30.

Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83330, Taiwan.

: Non-selective β-blockers (NSBB) could prevent decompensation and hepatocellular carcinoma (HCC) in cirrhotic patients with clinically significant portal hypertension (CSPH), but remained uncertain for compensated cirrhotic patients without major complications. We aimed to compare the clinical outcomes between propranolol users and non-users of a CC group without major complications. : We conducted this population-based cohort study by using the Taiwanese Longitudinal Health Insurance Database 2000. Read More

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http://dx.doi.org/10.3390/medicina56010014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022668PMC
December 2019

Clinical audit to determine efficacy of daily infusion of low dose of 20% albumin in combination with antibiotics in patients with spontaneous bacterial peritonitis.

Clin Exp Hepatol 2019 Nov 16;5(4):301-307. Epub 2019 Oct 16.

SRIHER, Chennai, India.

Aim Of The Study: The recommended high dose albumin treatment for spontaneous bacterial peritonitis (SBP) is not possible in the Indian setting due to financial constraints. Aim of the study was the retrospective audit to determine the outcome of patients with SBP on combination treatment of low dose albumin and appropriate antibiotics.

Material And Methods: Patients undergoing abdominal paracentesis in the period 2016-2018 were included. Read More

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http://dx.doi.org/10.5114/ceh.2019.88774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935847PMC
November 2019

Comprehensive evaluation of effects and safety of statin on the progression of liver cirrhosis: a systematic review and meta-analysis.

BMC Gastroenterol 2019 Dec 30;19(1):231. Epub 2019 Dec 30.

Department of Pediatric Respiratory II, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, Jilin, China.

Background: Statin has been more and more widely used in chronic liver disease, however, existed studies have attained contradictory results. According to the present study, we aimed to test the efficacy and safety of statin via a meta-analysis.

Methods: Different databases were searched for full-text publication based on inclusion and exclusion criteria. Read More

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http://dx.doi.org/10.1186/s12876-019-1147-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938024PMC
December 2019

Patients with cirrhosis and SBP: Increase in multidrug-resistant organisms and complications.

Eur J Clin Invest 2020 Feb 21;50(2):e13198. Epub 2020 Jan 21.

Department of Medicine II, Liver Center Munich, University Hospital, LMU Munich, Munich, Germany.

Background: Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with liver cirrhosis. In recent years, it has been postulated that the rate of multidrug-resistant organisms (MDROs) is increasing, especially in nosocomial SBP patients. Aim of the present work was to investigate this hypothesis and its possible clinical consequences. Read More

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http://dx.doi.org/10.1111/eci.13198DOI Listing
February 2020

A Delayed Diagnosis of Hemorrhagic Shock in a Patient with Alcoholic Cirrhosis and Ascites on Bedside Ultrasound.

Case Rep Crit Care 2019 10;2019:5895801. Epub 2019 Dec 10.

Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA, USA.

Undifferentiated shock is a common and challenging problem in critical care. We present a case of hemorrhagic shock due to splenic and hepatic lacerations diagnosed by bedside paracentesis, initially misclassified as septic shock due to suspected spontaneous bacterial peritonitis (SBP). . Read More

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http://dx.doi.org/10.1155/2019/5895801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925761PMC
December 2019

Quality improvement initiative increases total paracentesis and early paracentesis rates in hospitalised cirrhotics with ascites.

Frontline Gastroenterol 2020 Jan 29;11(1):22-27. Epub 2019 Apr 29.

Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

Objective: Early paracentesis (EP) for rapid diagnosis of spontaneous bacterial peritonitis is considered best practice in the care of admitted patients with cirrhosis and ascites, but inpatient paracentesis is frequently not performed or delayed. We developed a quality improvement (QI) initiative aimed at increasing the proportion of admitted patients with cirrhosis who undergo paracentesis and EP.

Design: Pre-post study of a QI initiative. Read More

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http://dx.doi.org/10.1136/flgastro-2019-101199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914287PMC
January 2020

Initial choice of antibiotic in recurrent spontaneous bacterial peritonitis: A retrospective study.

Int J Crit Illn Inj Sci 2019 Oct-Dec;9(4):187-190. Epub 2019 Dec 11.

Department of Emergency Medicine and Critical Care, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

Context: Spontaneous bacterial peritonitis (SBP) is a commonly encountered infection seen in the setting of ascites secondary to advanced liver disease. Recurrence of SBP is common and is associated with high mortality. This study was designed to recognize a better initial choice of antibiotic in case of recurrent SBP - a third-generation cephalosporin or a carbapenem. Read More

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http://dx.doi.org/10.4103/IJCIIS.IJCIIS_49_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927126PMC
December 2019