The New Cutoff Value of the Hepatic Venous Pressure Gradient on Predicting Long-Term Survival in Cirrhotic Patients.
This study aimed to determine the prognostic role of the categorized hemodynamic stage (HS) based on the hepatic venous pressure gradient (HVPG) in patients with portal hypertension. METHODS: Of 1,025 cirrhotic patients who underwent HVPG measurement, data on 572 non-critically-ill patients were collected retrospectively between 2008 and 2013. The following two HS categorizations were used: HS-1 (6-9, 10-12, 13-16, 17-20, and> 20 mmHg; designated as groups 1-5, respectively) and HS-2 (6-12, 13-20, and> 20 mmHg). Clinical characteristics, mortality rates, and prognostic predictors were analyzed according to the categorized HS. RESULTS: During the mean follow-up period of 25 months, 86 (15.0%) patients died. The numbers of deaths in HS-1 groups were 7 (6.3%), 7 (6.9%), 30 (18.0%), 20 (15.6%), and 22 (34.4%), respectively (P 20 mmHg; HR, 8.77; P
AbstractPortal hypertension increases pressure in lymphatic ducts, which may lead to gastrointestinal (GI) protein loss. Reports have shown that adults with portal hypertension had resolution of protein-losing enteropathy after transplantation; but studies in children are very limited. We therefore aimed to evaluate GI protein loss in children with portal hypertension and defined changes after liv er transplantation. Children aged 3 months to 18 years with portal hypertension and the age-matched healthy controls were enrolled during August 2018 to September 2019. Random fecal alpha-1 antitrypsin measurement...
The objective of the study was to determine risk factors associated with cholangitis in a large retrospective cohort after HPE. Methods: The Pediatric Health Information System (PHIS) was queried for BA (ICD-9 975.61) and HPE (ICD-9-CM 51.37) admissions from 2004 to 2013. We performed univariate analysis and linear regression with dependent variables of ≥ 2 or ≥ 5 episodes of cholangitis, and independent variables of age at time of HPE, race, ethnicity, gender, insurance, ursodeoxycholic acid (UDCA) use, steroid use, presence of esophageal varices (EV), and portal hypertension (PH). Results: We identified 1112 ...
CONCLUSION: Type 4 collagen could predict the presence of significant and advanced fibrosis in NAFLD patients and it would be a useful tool in routine clinical practice. PMID: 32949785 [PubMed - as supplied by publisher]
We read with interest the correspondence from Kolhe and colleagues addressing some relevant questions about the management of patients with portopulmonary hypertension (PoPH).1
Authors: Shao M, Ye Z, Qin Y, Wu T Abstract Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases and can lead to liver cirrhosis or liver cancer in severe cases. In recent years, the incidence of NAFLD has increased substantially. The trend has continued to increase and has become a key point of concern for health systems. NAFLD is often associated with metabolic abnormalities caused by increased visceral obesity, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, atherosclerosis and systemic microinflammation. Therefore, the pathophysiological mechani...
CONCLUSION: Overall, the epidemiologic evidence remains limited. For a few outcomes there has been some replication of our earlier findings. More longitudinal research is needed in large populations with large exposure contrasts. Additional cross-sectional studies of low exposed populations may be less informative. PMID: 32950793 [PubMed - as supplied by publisher]
Portopulmonary hypertension (PoPH) is defined as the presence of pulmonary arterial hypertension (PAH) in the setting of portal hypertension (with or without cirrhosis) and is associated with significant mortality.1 PoPH management remains a formidable task for the clinicians as there are few studies supporting the use of PAH-specific therapy in PoPH prior to liver transplantation (LT), while the decision of whether to perform LT in these patients remains difficult.2
ConclusionPancreatic ascites is a rare entity. Diagnosis is suspected with raised ascitic fluid amylase in the presence of pancreatic disease. Such cases can be managed by conservative approach or interventional approach. We managed this case through a conservative approach.
A 23 year old female with a history of hypertension presented with left lower quadrant abdominal pain. She was afebrile, physical examination showed abdominal tenderness and blood studies showed leukocytosis. Computed tomography scan of the abdomen with contrast showed extensive and homogenous jejunal wall thickening (Figs. 1 and 2, arrows) with mesenteric edema. The patient was empirically treated with antibiotics but failed to improve and underwent esophagogastroduodenoscopy and push enteroscopy which showed a grossly normal jejunum.
CONCLUSIONS: Multimorbid patients with ACS are at a greater risk for worse outcomes than their nonmultimorbid counterparts. Lack of consistent measurement makes interpretation of the impact of multimorbidity challenging and emphasizes the need for more research on multimorbidity's effects on postdischarge healthcare utilization. PMID: 32925234 [PubMed - as supplied by publisher]