Alcohol-related liver cirrhosis patients have higher-disease severity, one-year morbidity and mortality after index hospitalisation-followup of a cohort of 5,138 patients

Here, we report on a rare case of gastric hyperplastic polyps which disappeared after the discontinuation of proton pump inhibitor (PPI). The patient was an 83-year-old woman with liver cirrhosis and portal hypertension, along with gastroesophageal reflux disease treated by PPI. An initial upper gastrointestinal endoscopy showed unique polypoid lesions in the greater curvature of the stomach. Biopsy specimens of the lesions were diagnosed as hyperplastic polyps and she was followed. One year later, a second endoscopy showed that the lesions had increased in number and size, and an endoscopic mucosal resection (EMR) was performed for the main polyps. The resected specimens indicated a proliferation of foveolar epithelium cells with an increase of capillary ectasia and parietal cell hyperplasia, which was thought to be induced by hypergastrinemia from the PPI. Three months after the EMR, she was admitted because of bleeding from the remaining polyps along with an increase in new polyps. After conservative treatment, PPI was stopped and rebamipide was used. One year and 6 months later, an endoscopy showed the complete disappearance of all gastric polyps.

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Decreased Plasma Pituitary Adenylate Cyclase Activating Polypeptide (PACAP) Levels are Linked with Disease Severity in Patients with Liver Cirrhosis

International Journal of Peptide Research and Therapeutics ◽

10.1007/s10989-021-10163-6 ◽

2021 ◽

Author(s):

Lian-Ying Yang ◽

Ji-Ping Hou ◽

En-Kun Han ◽

Gang Qiao ◽

Li-Bin Liu ◽

...

Keyword(s):

Liver Cirrhosis ◽

Adenylate Cyclase ◽

Disease Severity ◽

Pituitary Adenylate Cyclase

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Patterns of dendritic cell and monocyte subsets are associated with disease severity and mortality in liver cirrhosis patients

Scientific Reports ◽

10.1038/s41598-021-85148-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chandra Chiappin Cardoso ◽

Camila Matiollo ◽

Carolina Hilgert Jacobsen Pereira ◽

Janaina Santana Fonseca ◽

Helder Emmanuel Leite Alves ◽

...

Keyword(s):

Dendritic Cells ◽

Liver Cirrhosis ◽

Liver Disease ◽

Dendritic Cell ◽

Disease Severity ◽

Advanced Liver Disease ◽

Hla Dr ◽

Acute Decompensation ◽

Cirrhotic Patients ◽

Classical Monocytes

AbstractLiver cirrhosis is often complicated by an immunological imbalance known as cirrhosis-associated immune dysfunction. This study aimed to investigate disturbances in circulating monocytes and dendritic cells in patients with acute decompensation (AD) of cirrhosis. The sample included 39 adult cirrhotic patients hospitalized for AD, 29 patients with stable cirrhosis (SC), and 30 healthy controls (CTR). Flow cytometry was used to analyze monocyte and dendritic cell subsets in whole blood and quantify cytokines in plasma samples. Cirrhotic groups showed higher frequencies of intermediate monocytes (iMo) than CTR. AD patients had lower percentages of nonclassical monocytes than CTR and SC. Cirrhotic patients had a profound reduction in absolute and relative dendritic cell numbers compared with CTR and showed higher plasmacytoid/classical dendritic cell ratios. Increased plasma levels of IL-6, IL-10, and IL-17A, elevated percentages of CD62L+ monocytes, and reduced HLA-DR expression on classical monocytes (cMo) were also observed in cirrhotic patients. Patients with more advanced liver disease showed increased cMo and reduced tissue macrophages (TiMas) frequencies. It was found that cMo percentages greater than 90.0% within the monocyte compartment and iMo and TiMas percentages lower than 5.7% and 8.6%, respectively, were associated with increased 90-day mortality. Monocytes and dendritic cells are deeply altered in cirrhotic patients, and subset profiles differ between stable and advanced liver disease. High cMo and low TiMas frequencies may be useful biomarkers of disease severity and mortality in liver cirrhosis.

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EPIDEMIOLOGY OF LIVER CIRRHOSIS MORBIDITY AND MORTALITY IN WESTERN AUSTRALIA, 1971-82: SOME PRELIMINARY FINDINGS

Australian Alcohol/Drug Review ◽

10.1080/09595238580000101 ◽

1985 ◽

Vol 4 (1) ◽

pp. 80-90

Author(s):

D.I. SMITH ◽

P.W. BURVILL

Keyword(s):

Liver Cirrhosis ◽

Western Australia ◽

Morbidity And Mortality

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Liver lobe-based magnetic resonance diffusion-weighted imaging using multiple b values in patients with hepatitis B-related liver cirrhosis: association with the liver disease severity according to the Child-Pugh class

Clinics ◽

10.6061/clinics/2015(07)05 ◽

2015 ◽

Vol 70 (7) ◽

pp. 486-492

Author(s):

HJ Tang ◽

L Zhou ◽

XM Zhang ◽

J Liu ◽

TW Chen ◽

...

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Magnetic Resonance ◽

Hepatitis B ◽

Disease Severity ◽

Diffusion Weighted Imaging ◽

Liver Lobe ◽

B Values ◽

Diffusion Weighted ◽

Pugh Class

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Clinical Presentation of Preterm Neonates with Intraventricular Hemorrhage: Experience in a Tertiary Care Hospital in Dhaka

BIRDEM Medical Journal ◽

10.3329/birdem.v7i3.33779 ◽

2017 ◽

Vol 7 (3) ◽

pp. 194-197

Author(s):

Tasnima Ahmed ◽

Abdul Baki ◽

Tahmina Begum ◽

Nazmun Nahar

Keyword(s):

Clinical Features ◽

Intraventricular Hemorrhage ◽

Tertiary Care ◽

Clinical Signs ◽

Sudden Onset ◽

Morbidity And Mortality ◽

Preterm Neonates ◽

Cranial Ultrasound ◽

Care Hospital ◽

One Year

Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them survive with the advancements in neonatal care. Severe IVH may lead to significant morbidity and mortality. The objective of our study is to find out the significant clinical signs of IVH in preterm neonate for early detection by ultrasonography.Methods: This prospective observational study was done in special care baby unit (SCABU), Bangladesh Institute of Research & rehabilitation of Diabetic, Endocrine & metabolic Disorder (BIRDEM) for a period of one year. Eighty five preterm neonates were included in this study. Clinical features of IVH like- convulsion, lethargy, irritability, bulged fontanelle, recurrent apnea, sudden onset of respiratory distress, sudden pallor and bradycardia were observed. Cranial ultrasound studies were done within 7 days of life in all cases to identify IVH.Result: Mean gestational age of these neonates was 31.31(±2.2) weeks & mean birth weight was 1413.42 (±330.55) gm. Among 85 preterm neonates 21(24.7%) developed IVH, confirmed by ultrasonography of brain. Clinical features like convulsion, bulged fontanel, repeated apnea & sudden pallor were significantly present in IVH group.Conclusion: Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. This study showed that clinical features like convulsion, bulged fontanel and sudden pallor had a significant relationship with intraventricular hemorrhage which will help for its early detection.Birdem Med J 2017; 7(3): 194-197

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Abstract 12549: Circulating Irisin is a Novel Biomarker Providing Prognostic Information in Patients With Heart Failure With Reduced Ejection Fraction

Circulation ◽

10.1161/circ.130.suppl_2.12549 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Shinsuke Hanatani ◽

Yasuhiro Izumiya ◽

Yuichi Kimura ◽

Yoshiro Onoue ◽

Satoshi Araki ◽

...

Keyword(s):

Heart Failure ◽

Skeletal Muscle ◽

Ejection Fraction ◽

Disease Severity ◽

Cardiovascular Events ◽

Roc Analysis ◽

Left Ventricular Ejection ◽

Prognostic Information ◽

Reduced Ejection Fraction ◽

One Year

Introduction: Reduced skeletal muscle function link to poor prognosis in patients with chronic heart failure (HF). Irisin is a newly identified muscle-derived protein found in human serum. The gene expression of irisin precursor fibronectin domain containing protein 5 in skeletal muscle is associated with exercise tolerance in HF patients. Hypothesis: Irisin could be a useful biomarker for disease severity and future adverse cardiovascular events in patients with HF with reduced ejection fraction (HFrEF). Methods and results: We measured serum irisin levels in 84 patients with HFrEF. HFrEF was defined as left ventricular ejection fraction≦50% and meet the Framingham criteria of HF. Serum irisin concentrations were measured by ELISA. The endpoint of this study was a composite of total mortality, cardiovascular hospitalization and coronary revascularization. Serum irisin levels were negatively correlated with serum high sensitive troponin T levels (r=-0.24, p=0.048). Right heart catheterization revealed that serum irisin levels had significant negative correlation with pulmonary capillary wedge pressure (r=-0.23, p=0.044). In receiver operating characteristic (ROC) analysis, cut-off values of irisin and BNP for prediction of one-year events were 55.548 ng/mL and 324.8 pg/mL, respectively. Kaplan Meier curve demonstrated that the event-free rate was decreased in the low irisin (≦cut-off value) group (log-rank test p=0.024). The combination of low irisin and high BNP (≧cut-off value) identified patients with a significantly higher probability of adverse events (p=0.008). Multivariate Cox hazard analysis identified low levels of irisin (≦cut-off value) (hazard ratio [HR]: 3.08; 95% confidence interval [CI]: 1.31-7.21, p=0.01) and ischemic etiology (HR: 3.32; 95% CI: 1.50-7.35, p=0.003) as independent predictors of mortality and cardiovascular events. ROC analysis revealed that irisin achieved an area under the curve (AUC) of 0.67 for one-year events (p=0.031), and that the AUC increased when irisin was added to BNP level (alone: 0.64, BNP+irisin: 0.74). Conclusions: Irisin could be a useful biomarker for evaluating disease severity and providing incremental prognostic information in patients with HFrEF.

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