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Patients with liver cirrhosis are readmitted less than 30 days after a hospitalization for decompensation. The results of a nurse-driven post-discharge intervention for patients with liver cirrhosis will be investigated in a randomized controlled trial, in contrast to a conventional follow-up. The intervention, based on Family Nursing's ideas, will include three home-visits within eight weeks after discharge, including therapeutic discussions focusing on improving participants' family links and social networks, disease prevention, and helping to recruit applicants to municipal offers.
Source link: https://clinicaltrials.gov/ct2/show/NCT04158986
The stool will be collected and tested for gut microbiota profiling. With transient elastography, a controlled attenuation Parameter and liver stiffness can be determined. The Ultrasound abdomen will be performed by the first degree relatives of indexed patients. Families of the First degree who will not accompany the indexed subject will be contacted telephonically and will be invited to participate in the survey. The information on first degree relative will be collected on a similar frequency as of the indexed patient. The results will be collected on a similar basis as for the indexed patient. For every case that has been enrolled, we will also have disease monitoring. As disease control, a subject with Hepatitis B virus-related liver cirrhosis will be included in Hepatitis B virus-related liver cirrhosis. In 30 percent of the sample, e. e NASH-related Cirrhosis, First Degree Relatives, Healthy Control, and HBV Disease surveillance will be conducted, according to the samples, including genetic markers and stool microbiota profiling.
Source link: https://clinicaltrials.gov/ct2/show/NCT04057287
The study will include adult patients with liver cirrhosis undergoing liver transplantation. The cardiac output monitoring laboratory uses electrocardiography, pulse oximetry, and peripheral perfusion index, with masimo pulse oximetry finger prope, end-tidal CO2, end-invasive arterial blood pressure, central venous pressure, and peripheral venous pressure. Patients in the two study groups will be given a single shot ultrasound-guided bilateral TAP block using levopubivacaine. Patients in the Opioid Sparing group will be given a loading dose of dexmedetomidine. In addition, a single induction analgesic dose of 0. 5 mg/kg ketamine will be given to all patients in the OS group. Additional top-up doses of rocuronium 0. 15 mg/kg would be maintained, and muscle relaxation can be guided by the response to ulnar nerve stimulation. The lower limb and sequential compression device will be included in the deep venous thrombosis prophylaxis from early ambulation. The intra-operative hemodynamics goal will be to keep the mean arterial blood pressure and heart rate within 20% of baseline average. In the two research groups, top-up doses of fentanyl 1u00b5g/kg would be administered, representing more than 20% rise of the baseline results but not achycardia. In the two study groups, hypotension, which is more than 20% less than the baseline mean arterial blood pressure, will be controlled by incremental doses of ephedrine 5 mg. Subsequent rocuronium-induced neuromuscular block will be antagonized by sugammadex 2 mg/kg at the end of surgery and when two reactions to train-of-four ulnar nerve stimulation are reported.
Source link: https://clinicaltrials.gov/ct2/show/NCT05674877
BACKGROUND: Mortality in patients with chronic liver disease and cirrhosis is the ninth most common cause of death in the United States. Chronic liver disease sufferers are generally limited to patients with cirrhosis, but patients with chronic liver disease have long been identified by the Child-Pugh-Turcotte score, and the mortality risk in these patients has long been known. On a yearly basis, approximately 3-5% of patients with stable Child class A cirrhosis will experience worsening in hepatic function and/or complications of cirrhosis and decompensate. Patients with cirrhosis can either be referred to or get a liver transplant before they can either be eligible for or receive a liver transplant. In comparison, approximately one-third of patients with cirrhosis experience rapid hepatic decompensation, precipitation of MELD rises and die from cirrhosis complications are delayed. This information reveals why pre-transplant mortality for patients on the UNOS waiting list is higher in patients with low MELD, not high MELD scores. Testing patients with marginal hepatic reserve and/or rapid hepatic metabolism are performed by administering either intravenously or orally a drug with a high hepatic extract ratio and/or rapid hepatic metabolism. The Food and Drug Administration has officially approved the Breath ID device, which uses a 13C-urea substrate, to test for H. Pylori infection. Patients with persistent HCV infection and renal fibrosis with increasing hepatic fibrosis, according to preliminary and post-liver transplantation studies.
Source link: https://clinicaltrials.gov/ct2/show/NCT00375011
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