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Cirrhosis - Europe PMC

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Last Updated: 15 January 2023

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Utilization of Hepatocellular Carcinoma Surveillance Programs in Patients With Cirrhosis: A Systematic Review and Meta-Analysis.

Patients with cirrhosis are recommended to do hepatocellular carcinoma testing every six months. Following the introduction of interventional services, we sought to quantify the uptake of HCC surveillance in cirrhotic patients. Patients in surveillance services were 6 times more likely to perform abdominal sonography than in standard of care. Clinical reminders were associated with a four times higher rate of HCC surveillance on subgroup analysis than with standard of care. The rate of HCC surveillance has greatly increased thanks to interventional services, which has significantly increased the prevalence of HCC surveillance.

Source link: https://europepmc.org/article/MED/34999648


Outcome of untreated low-level viremia vs. antiviral therapy-induced or spontaneous undetectable HBV-DNA in compensated cirrhosis.

Background The present virological results of hepatitis B virus infection compensated cirrhosis with low-level viremia is uncertain versus maintained virological response. We conducted a large, multi-ethnic, multi-center study to investigate how LLV's natural history has been examined in cases of compensated cirrhosis compensated. Methods We recruited patients with HBV-infected compensated cirrhosis from 19 hospitals in South Korea, Singapore, and Japan. Patients with AVT-induced MVR were categorized as untreated patients with detectable serum HBV-DNA, Spontaneous-MVR group as untreated patients with spontaneously achieved MVR, and antiviral therapy – MVR group as patients with AVT-induced MVR. The HCC and decompensation risks in the LLV group were comparable to those in Spontaneous-MVR and AVT-MVR companies, according to multivariable studies. Similar findings for HCC and decompensation risks were also reproduced by Pro-matching, which also produced similar findings for HCC and decompensation risks. Conclusions Untreated LLV in HBV-infected compensated cirrhosis is not at risk of disease progression compared to Spontaneous-MVR and AVT-MVR.

Source link: https://europepmc.org/article/MED/36633913


Diabetes and cirrhosis: Current concepts on diagnosis and management.

Both conditions are closely related to NAFLD, the most common cause of chronic liver disease, and given the increasing burden on the international economy, managing T2DM in cirrhosis is a new challenge. Patients with T2DM should be systematically tested for NAFLD-related fibrosis/cirrhosis using non-invasive methods, beginning with FIB-4 index and transient elastography, if available, if available, in the absence of effective therapies for cirrhosis. For the correct diagnosis of diabetes and the right management technique, in cirrhosis, evaluation of liver function is vital. Diagnosis of diabetes in patients with cirrhosis and impaired liver function can be missed if based on A1C results, since anemia can render the test unreliable. Clinicians should become familiar with the safety and effectiveness of diabetes drugs for patients with advanced fibrosis and compensated cirrhosis.

Source link: https://europepmc.org/article/MED/36631005


Portal venous blood flows determine liver function in patients with decompensated cirrhosis due to HCV infection receiving successful sofosbuvir/velpatasvir therapy

Aim: To determine the significance of the portal venous blood flow and portosystemic shunts in patients with decompensated cirrhosis due to HCV infection following SVR confirmation. Portal venous blood flow, liver volume, serum albumin, and bilirubin levels at baseline were correlated with serum albumin levels at 12 weeks after EOT, according to a multi-line regression study. Conclusion: The initial portal venous blood flow and liver function were predictive of liver disease in patients with decompensated cirrhosis caused by HCV, according to the HCV, while the number of portosystemic shunts predicted the event of portal hypertension was predicted.

Source link: https://europepmc.org/article/PPR/PPR595605


Erectile dysfunction in patients with liver cirrhosis; upper Egypt experience

This research was done to determine the prevalence and risk factors of erectile dysfunction in patients with liver cirrhosis. Method: A cross-sectional study was done on 200 patients with liver cirrhosis and segregated into three groups based on child score and erectile dysfunction. 80% of erectile dysfunction in the cirrhotic patient was 80%. While the liver disease progressed, the erectile dysfunction worsened, cirrhotic patients' penile venous leakage increased to 28 percent in advance liver cirrhosis.

Source link: https://europepmc.org/article/PPR/PPR595081


Impact of fentanyl analgesia on the accuracy of HVPG measurements in patients with cirrhosis: a prospective, multicenter study.

Propofol sedation during HVPG measurements may alter HVPG results, according to previous studies. This study was designed to investigate fentanyl analgesia's effect on HVPG measurement accuracy in patients with cirrhosis. During HVPG testing, the 48 patients with cirrhosis, 23 were given 1. 0 bcg/kg fentanyl analgesia. After fentanyl analgesia, the HVPG measurement accuracy was not changed. The verbal Numeric Rating Score for comfort under analgesia was higher than that in preanalgesia. During HVPG testing, twenty-five patients were given 1. 5 bcg/kg fentanyl analgesia. In preanalgesia and 19. 6 mm Hg under analgesia, the HVPG was 19. 5 mm Hg in preanalgesia and 19. 6 mm Hg under analgesia. After a fentanyl analgesia, the HVPG's measurement accuracy did not change. The Verbal Numerical Rating Score for support under analgesia was higher than that in preanalgesia. Fentanyl analgesia did not change HVPG measurement accuracy, nor did it improve patient comfort in patients with cirrhosis during HVPG measurements, according to the author.

Source link: https://europepmc.org/article/MED/36633485


Clinical Evaluation of Metagenomic Next-Generation Sequencing Method for the Diagnosis of Suspected Ascitic Infection in Patients with Liver Cirrhosis in a Clinical Laboratory.

We wanted to investigate the potential of mNGS in clinical research and analyze its potential in infectious ascite diagnosis. In 211 ascitic samples and compared to culture and composite standards, the mNGS clinical detection value was determined. Lastly, eight patients with cirrhosis were prospectively recruited to determine the clinical value of mNGS in peritoneal infection diagnosis. The sensitivity and specificity of mNGS for bacterial or fungal detection using culture standards were 82% and 82 percent, respectively. In eight recent cases, the pathogen results were obtained within 24 h using mNGS, which effectively guided antibiotic therapy. Certain benefits have been found in mNGS testing in clinical laboratories associated with a hospital. ImportANCE This study was developed and evaluated assay for diagnosing suspected ascitic infection in a clinical laboratory associated with a hospital.

Source link: https://europepmc.org/article/MED/36625589


Prescribing Trends of Oral Anticoagulants in US Patients With Cirrhosis and Nonvalvular Atrial Fibrillation.

Background Information Many patients with cirrhosis have concurrent nonvalvular atrial fibrillation. Data is lacking on the most recent oral anticoagulant use patterns among U. S. patients with cirrhosis and NVAF. Methods and Results Using MarketScan's reports, we found patients with cirrhosis and NVAF eligible for OACs. Among 32 487 patients, 44. 6% used OACs within 180 days of NVAF diagnosis, including DOACs or warfarin. OAC patients were less likely to have decompensated cirrhosis, thrombocytopenia, or chronic kidney disease/end-stage renal disease than OAC nonusers. Warfarin use dropped by 21% between 2012 and 2019, while DOAC usage increased by 31. 6%, and among all DOACs between 2012 and 2019, apixaban was the most commonly prescribed drug. DOAC usage among OAC users increased by 58. 9% compared to 59%. Conclusions DOAC use among U. S. patients with cirrhosis and NVAF has soared dramatically and surpassed warfarin, especially in decompensated cirrhosis.

Source link: https://europepmc.org/article/MED/36625307


PBMCs gene expression signature of advanced cirrhosis with high risk for clinically significant portal hypertension in HIV/HCV coinfected patients: A cross-control study.

BACKGROUND Patients with advanced cirrhosis are at a high risk of experiencing clinically relevant portal hypertension. We analyzed the gene expression profile of peripheral blood mononuclear cells from HIV/HCV coinfected patients to find a genetic signature of advanced cirrhosis with a high risk of CSPH. LSM 12. 5 kPa and u2265 25 kPa were found in 60 SDE transcripts among patients with LSM 12. 5 kPa and u2265 25 kPa. According to a region under the receiver operating characteristic curve of 0. 84, those 60 SDE transcripts collectively discriminated LSM u2265 25 kPa. We verified the two SDE transcripts with the highest discrimination capacity in a different cohort, demonstrating significant differences between 25 kPa and u2265 25 kPa. Conclusions A gene expression signature of 60 transcripts has been shown to advanced cirrhosis in HIV/HCV coinfected patients, who are at a high risk for CSPH.

Source link: https://europepmc.org/article/MED/36628818


Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35.

Background The establishment of a liver cirrhosis screening scheme in a general population has been discussed for some time. Methods This research establishes the estimated diagnostic costs of SEAL in routine care and their drivers, as well as reports on current CLD etiologies in this check-up group. Patients with fibrosis/cirrhosis have varying diagnostic costs, ranging from EUR 5. 99 to 13. 74 per Check-up 35 participant and between EUR 1,577. 06 and 3,620. 52 per patient diagnosed with fibrosis/cirrhosis, depending on the estimated biopsy rates and the diagnostic procedure. Discussion The SEAL algorithm's liver screening procedure could be performed at moderate costs. Screening costs in routine care are influenced by actual biopsy results and procedures, attendance rates among liver specialists, and the prevalence of fibrosis in the Check-up 35 population. No alternative to SEAL is better than SEAL. The virus screening for viral hepatitis was recently added to Check-up 35 as a once-in-a-lifetime component of Check-up 35.

Source link: https://europepmc.org/article/MED/36623821

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions