Clinical Signs of the Development of Acute Hepatocellular Insufficiency and Ways to Prevent it, in Patients with Liver Cirrhosis After Porto-Systemic Shunting

2010 ◽  
pp. 235-239
Author(s):  
R. A. Ibadov ◽  
N. R. Gizatulina ◽  
A. Kh. Babadzanov
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Signs

scholarly journals The course and survival of patients with liver cirrhosis and acute liver failure on the background of chronic

2020 ◽  
Vol 98 (2) ◽  
pp. 137-141
Author(s):  
S. A. Avezov ◽  
S. M. Azimova ◽  
M. H. Abdulloev
Keyword(s):  
Liver Cirrhosis ◽  
Mortality Rate ◽  
Liver Failure ◽  
Organ Failure ◽  
Predictive Factors ◽  
Clinical Signs ◽  
Multiple Organ ◽  
Kaplan Meier ◽  
Short Term Mortality ◽  
Acute Decompensation

Aims. We comparative investigated the frequency, precipitating factors, lifetimes and predictive factors of survival in patients with liver cirrhosis (LC) and acute-on-chronic liver failure (ACLF). Material and methods. We collected data from 310 hospitalized patients with LC. Patients divided into groups: 1 — patients with compensation of LC; 2 — patients with decompensation of LC, but without organ failure (OF) and 3 — patients with ACLF. Diagnostic criteria for ACLF based on consensus recommendations of EASL. Survival was assessed according to the Kaplan-Meier method. Results. 48 patients with LC reported clinical signs of ACLF. 28-day mortality was in 4,8% of patients without ACLF and in 42,0% of patients with ACLF. 90-day mortality of patients with ACLF was 50% versus 11.6% in patients without ACLF. 6-month survival rate of patients with the development of acute decompensation with organ failure was only 33,3%. The lifetimes of patients with ACLF was only 136,65 ± 18,96 days. The predictive factors of survival of patients with LC and ACLF are: the number of organ failure, indicators of CLIF-SOFA and MELD, Child-Pugh score, degree of hepatic encephalopathy, leukocytosis, hyperbilirubinemia, hypercreatininemia and increased INR. Conclusion. The prevalence of ACLF in patients with LC is 15,5% and develops against a background of stable compensated or decompensated CP. The frequent trigger of ACLF is infection, which causes acute decompensation with the development of multiple organ failure and a high incidence of short-term mortality. The 28-day mortality rate in patients with ACLF was 8.7 times greater than the mortality rate in patients with decompensated LC without ACLF.

scholarly journals Lifestyle, Nutritional Status and Seroclinical Profile of Liver Cirrhotic Patients

1970 ◽  
Vol 36 (2) ◽  
pp. 44-47
Author(s):  
Touhida Ahsan ◽  
Monira Ahsan ◽  
Md Mustafa Kamal ◽  
Kaji Jahangir Hossain ◽  
Mohammed Emdadul Haque ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Nutritional Status ◽  
Energy Intake ◽  
Clinical Signs ◽  
College Hospital ◽  
Housing Status ◽  
Medical College ◽  
Cirrhotic Patients ◽  
Almost All ◽  
Medical University

Liver cirrhotic patients were investigated for their lifestyle, energy intake, BMI, biochemical and serological indices and prevalent clinical signs. The study included 50 liver cirrhotic patients who were hospitalized in Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and BIRDEM Hospital during the period of 1999-2000. Of the fifty cirrhotic patients, hepatitis B virus infection was found responsible for 52% (n=26) of liver cirrhosis, hepatitis C was for only 6% (n=3) patients and etiology for the rest 42% (n=21) patients could not be identified. It was observed that literate, low-mid income and productive male were being suffering from the liver cirrhosis. The patients had good housing status. Low energy intake (1670.6±42.9) and low BMI (19.52±3.48) were present in almost all of the patients. Mean serum haemoglobin, total proteins, and albumin were 96.2±20.5g/L, 63.1±1.01g/L, and 31.30±0.93g/L respectively. Serum bilirubin was raised in 50% patients. Serum SGPT and SGOT levels were increased from 2 to 4 folds in 50% of the patients; alkaline phosphatase was increased only in 8% cirrhotic patients. Anaemia, PEM, ascities, oedema, muscle wasting were prevalently present in vast majority of the patients. Key words: Liver cirrhosis, nutritional status, liver function determinants   DOI: 10.3329/bmj.v36i2.3611 Bangladesh Medical Journal 36(2) 2007 44-47

Cerebral blood flow in basal ganglia is correlated with clinical signs of hepatic encephalopathy in patients with liver cirrhosis

2002 ◽  
Vol 97 (3) ◽  
pp. 763-764 ◽  
Author(s):  
Motoh Iwasa ◽  
Masahiko Kaito ◽  
Yukihiko Adachi ◽  
Yuri Watanabe ◽  
Kaname Matsumura ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Cerebral Blood Flow ◽  
Hepatic Encephalopathy ◽  
Basal Ganglia ◽  
Clinical Signs

PENICILLAMINE-INDUCED NORMALIZATION OF CLINICAL SIGNS, AND LIVER MORPHOLOGY AND HISTOCHEMISTRY IN A CASE OF WILSON'S DISEASE

PEDIATRICS ◽  
1970 ◽  
Vol 45 (2) ◽  
pp. 260-268
Author(s):  
Sture Falkmer ◽  
GÖsta Samuelson ◽  
Stig SjÖlin
Keyword(s):  
Liver Cirrhosis ◽  
Healthy Subjects ◽  
Wilson’S Disease ◽  
Clinical Signs ◽  
Copper Metabolism ◽  
Wilson's Disease ◽  
Portal Cirrhosis ◽  
Liver Morphology ◽  
Penicillamine Therapy

After 27 months of daily penicillamine administration (250 mg 3 or 4 times daily) a portal cirrhosis in a 10-year-old girl was found to have healed clinically and histopathologically. This case shows that even an advanced portal liver cirrhosis in Wilson's disease can be healed by adequate penicillamine therapy. Hence, it is important that all patients with liver cirrhosis who are younger than 30 years of age are examined for any signs of Wilson's disease. Copper metabolism studies with Cu64-labeled copper citrate revealed characteristic differences between the homozygote patient and her heterozygote parents and healthy subjects.

scholarly journals Hepatic encephalopathy: issues relevant to clinical practice

2021 ◽  
pp. 104-108
Author(s):  
M. V. Maevskaya
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Practice ◽  
Hepatic Encephalopathy ◽  
Clinical Signs ◽  
Ammonia Concentration ◽  
High Concentration ◽  
Expert Opinions ◽  
Diagnostic Role ◽  
Cirrhotic Patients

Hepatic encephalopathy (HE) remains one of the most serious complications of liver cirrhosis. Its clinical spectrum sometimes creates difficulties in the optimal diagnosis at the patient’s bedside and treatment. To present new data on the field of clinical management of cirrhotic patients with hepatic encephalopathy. The role of ammonia in the diagnosis of HE is still under discussion. In clinical practice, in patients with suspected overt HE, normal ammonia concentration can be used to exclude this diagnosis. In contrast, a high concentration of ammonia in the absence of clinical signs of HE should not serve as a criterion for this diagnosis and as a guide for treatment. A separate issue for discussion is the covert HE. The simplest and most affordable test for screening for covert HE and evaluating the effectiveness of therapy is the animal naming test, which can be done on bedside by physician or caregivers. Patients with covert HE need treatment that is similar in approach to overt HE. The diagnosis of overt HE and the methods of its therapy are well known. According to Russian recommendations, depending on the disease course in a certain patient, lactulose, rifaximin, L-ornithine L-aspartate can be used as first-line drugs, which is applicable to the treatment of both overt and latent PE. The main issues on the management of HE in liver cirrhosis relate to the diagnostic role of ammonia, optimal diagnosis and treatment strategy for covert HE, therapy of choice for both overt and latent HE. There are expert opinions and consensus documents on all these issues. Treatment of overt and latent PE is carried out according to the same principles. Drugs of choice: lactulose, rifaximin and L-Ornithine L-Aspartate.

Left adrenal hepatocellular carcinoma recurrence in liver transplanted patient

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Alessandro Parente
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Adrenal Gland ◽  
Blood Test ◽  
Clinical Signs ◽  
Left Adrenal Gland ◽  
Hepatocellular Carcinoma Recurrence ◽  
Hcc Recurrence ◽  
Regional Treatment

Hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been reported in less than 20% of patients fulfilling Milan Criteria. Mostly, it occurs within the liver, lungs, lymph nodes, bones and brain. A 45 years old Caucasian man affected by HCV-related liver cirrhosis with HCC, who underwent several multi-modal treatments, including hepatic resection, liver transplantation and loco regional treatment presented in our Department with an unusual mass within the left adrenal gland. No clinical signs were associated. However, considering his blood test and the high risk of HCC recurrence, a mini-invasive left surrenalectomy was performed showing HCC metastases in the left adrenal gland. This case shows that even extremely rare sites of HCC metastases have to be investigated, especially if, despite all available treatments, still persist a clinical or laboratory suspect.

The Clinical Significance of Chronic Fibrinaemia

1979 ◽  
Author(s):  
E.M. Haselager ◽  
J. Vreeken
Keyword(s):  
Liver Cirrhosis ◽  
Elevated Level ◽  
Malignant Disease ◽  
Clinical Signs ◽  
General Medicine ◽  
Bleeding Tendency ◽  
Highly Correlated ◽  
Short Time ◽  
Fibrin Monomers ◽  
Gelation Test

From 1970-1978 we investigated the occurrence of circulating fibrin monomers in 3293 patients in the department of general medicine by means of the aethanol gelation test. Positive tests were found in 151 patients (± 5%). In a variety of diseases (sepsis, meningitis, liver cirrhosis, bleeding with shock, malignancy) the test was only positive for a short time (1 or 2 days).Of all the patients who had a positive aethanol test for more than two days 33% turned out to have a malignant disease. When fibrin monomers could be detected for more than 5 days (chronic fibrinaemia) the percentage of malignancy rose to 75%! Fibrinaemia was highly correlated (97%) with an elevated level of FDP/fdp. In patients with malignancies and elevated levels of FDP/fdp 20% had clinical signs of thromboembolism. However when this was accompanied by circulating fibrin monomers (more than 5 days) this percentage rose to 45%. Only 12% of patients with chronic fibrinaemia had a bleeding tendency.

scholarly journals Assessment of Clinical Signs of Liver Cirrhosis Using T1 Mapping on Gd-EOB-DTPA-Enhanced 3T MRI

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e85658 ◽  
Author(s):  
Michael Haimerl ◽  
Niklas Verloh ◽  
Florian Zeman ◽  
Claudia Fellner ◽  
René Müller-Wille ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
T1 Mapping ◽  
Clinical Signs ◽  
3T Mri

FOLLOW UP OF PREKALLIKREIN AND FA3T0R VII IN PATIENTS WITH LIVER FAILURE (LF)

1987 ◽  
Author(s):  
D Ferro ◽  
F Violi ◽  
C Alessandri ◽  
C Quintarelli ◽  
M Saliola ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Clinical Signs ◽  
Coagulation Factors ◽  
Factor Vii ◽  
Short Term ◽  
Individual Assessment ◽  
The Individual

Life expectancy of patients with liver cirrhosis (LC) is dependent upon thepresence of haemodinamic and metabolic complications.Patients with ascites, hepatic encephalopathy and bleeding have lower survival than patients in compensated state. Neverthless the clinical signs of decompensated state are not useful in the individual assessment of LF. Recently we showed that some coagulation factors such as factor VII and prekallikrein (prekk) are good indexes of LF.In fact they clearly differentiate decompensated LC from compensated one and, in a short term follow up. survivors from non survivors. In order to evaluate the relation between factor VII (Mariani1s method) and prekk (Chromogenicsubstrate S-2302) activities and the survivaltime of patients with LF , we studied 23 patients with severe decompensated state and followed them up to 2 years from the hospitalization. The clinical evaluation of LC could be followed in all but 2 patients. Of 21 patients 15 (71%) died,8 for LF and 7 for bleeding, and6survived. The survival of patients was highly related to the activities of prekk and factor VII;patients with higher activities survived more than those with lower ones. There was a significant correlation between prekk (r:0,89 p<0,001), factor VII (r:0,8 p<.0,001) and survival time. The study suggests that prekk and factor VII could be useful test for the identification of patients for liver transplantation.

A rapid method for the direct identification of paramyxovirus in canine CSF by ultracentrifugation and negative staining as a rule out for distemper

1990 ◽  
Vol 48 (3) ◽  
pp. 594-595
Author(s):  
W.L. Steffens ◽  
M.B. Ard ◽  
C.E. Greene ◽  
A. Jaggy
Keyword(s):  
Subacute Sclerosing Panencephalitis ◽  
Clinical Signs ◽  
Viral Disease ◽  
Etiologic Agent ◽  
Mucosal Inflammation ◽  
Worldwide Distribution ◽  
Negative Stain ◽  
Viral Particles ◽  
Systemic Manifestations ◽  
Rule Out

Canine distemper is a multisystemic contagious viral disease having a worldwide distribution, a high mortality rate, and significant central neurologic system (CNS) complications. In its systemic manifestations, it is often presumptively diagnosed on the basis of clinical signs and history. Few definitive antemortem diagnostic tests exist, and most are limited to the detection of viral antigen by immunofluorescence techniques on tissues or cytologic specimens or high immunoglobulin levels in CSF (cerebrospinal fluid). Diagnosis of CNS distemper is often unreliable due to the relatively low cell count in CSF (<50 cells/μl) and the binding of blocking immunoglobulins in CSF to cell surfaces. A more reliable and definitive test might be possible utilizing direct morphologic detection of the etiologic agent. Distemper is the canine equivalent of human measles, in that both involve a closely related member of the Paramyxoviridae, both produce mucosal inflammation, and may produce CNS complications. In humans, diagnosis of measles-induced subacute sclerosing panencephalitis is through negative stain identification of whole or incomplete viral particles in patient CSF.

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