Extrahepatic cancer in liver cirrhosis: A retrospective study of prevalence, complication rate after specific oncological treatment, follow-up and prognostic predictors of outcome in 354 cirrhotic patients

2010 ◽  
Vol 48 (10) ◽  
Author(s):  
F Gundling ◽  
H Seidl ◽  
F Schmidtler ◽  
N Löffler ◽  
I Strassen ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Complication Rate ◽  
Predictors Of Outcome ◽  
Oncological Treatment ◽  
Prognostic Predictors ◽  
Cirrhotic Patients

Endoscopic Carpal Tunnel Release

1997 ◽  
Vol 22 (4) ◽  
pp. 505-507 ◽  
Author(s):  
A. P. ARMSTONG ◽  
J. R. FLYNN ◽  
D. M. DAVIES
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel ◽  
Complication Rate ◽  
Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Iatrogenic Nerve Injury ◽  
Portal Technique ◽  
Results Of Surgery

We report our experience over a 30 month period of endoscopic release of the carpal tunnel by the Chow two-portal technique. The objective of this retrospective study was to evaluate the long-term subjective results of surgery and to assess if any iatrogenic nerve injury had been caused by the endoscopic procedure. The follow-up period was from 3 to 34 months. Our permanent, iatrogenic, postoperative nerve complication rate was 0.9% (2/208). No other serious complications occurred.

scholarly journals Clinical and Epidemiological Profile of Cirrhotic Patients at a Reference Center in Belém-PA, Analysis of 10 years

10.3823/2591 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Esther Castello Branco Mello Miranda ◽  
Fernanda Araújo Santos ◽  
Ana Rachel Koury Marinho ◽  
Mayara Castello Branco de Mello Dias ◽  
Suzana Maria Klautau Ferreira ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Medical Records ◽  
Hepatic Cirrhosis ◽  
Clinical Aspects ◽  
Cross Sectional ◽  
Reference Center ◽  
Cirrhotic Patients ◽  
Male Patients ◽  
Epidemiological Profile

Background: The aim of this study was to analyze the demographic, ethyological and clinical aspects of patients with liver cirrhosis treated in the Chronic Liver Disease Center. Methods: a descriptive, cross-sectional and retrospective study based on the analysis of 580 pacients’ medical records with the diagnosis of hepatic cirrhosis treated from 2004 to 2014 in Belém, Brazil. Conclusions: the profile was predominantly of male patients, aged between 51 and 60 years, coming from the capital ​​Belem, whose main etiologies of cirrhosis were C hepatitis and alcohol. Ascites was the most frequent clinical manifestation and Child-Pugh score A was the most prevalent.

scholarly journals Decrease in Chitinase 3-Like Protein 1 Levels Reflects Improvement in Liver Fibrosis after HCV Eradication

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Qian Kang ◽  
Jianhong Chen ◽  
Hao Luo ◽  
Ning Tan ◽  
Hui Gao ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Fibrosis ◽  
Surrogate Marker ◽  
Pegylated Interferon ◽  
Serum Samples ◽  
End Of Treatment ◽  
Cirrhotic Patients ◽  
Direct Acting ◽  
Sensitive Marker

Aim. The success of direct-acting antivirals (DAAs) against hepatitis C virus is a major breakthrough in hepatology. Previous studies have shown that chitinase 3-like protein 1 (CHI3L1) was a marker for staging of liver fibrosis caused by HCV. In this investigation, we used CHI3L1 as a surrogate marker to compare dynamic hepatic fibrosis variations following the elimination of HCV among cases receiving sofosbuvir (SOF)-based regimens and pegylated interferon/ribavirin (PR) treatments. Methods. The study enrolled 105 patients, including 46 SOF-based regimens treated patients, 34 PR-experienced patients, and 25 untreated patients. Serum samples and clinical data were obtained at the baseline, the end of treatment, and at weeks 24 and 48 after treatments. Results. First, we found that serum level of CHI3L1 correlated moderately but significantly with LSM (r=0.615, P<0.001) at the baseline, and diagnosed liver cirrhosis at baseline with high accuracy (AUC=0.939) by ROC analysis. So we explored CHI3L1 as a sensitive biomarker to monitor the regression of liver fibrosis after HCV eradication. We found that the serum CHI3L1 level of CHC cases receiving SOF-based regimen treatments was markedly reduced immediately after treatment compared with that at the baseline (123.79 (118.55) vs. 118.20 (103.68), P=0.001). For cases undergoing PR treatment, the serum CHI3L1 decreased significantly at week 24 posttreatment compared with that at the baseline (69.98 (51.44) vs 89.15 (110.59), P=0.016). For the untreated cirrhotic patients, CHI3L1 levels increased at week 96 follow-up compared with that at the baseline (194.73 (172.46) vs. 89.50 (242.97), P=0.048), reflecting continued worsening of liver fibrosis. Conclusion. CHI3L1 is suggested to be the sensitive marker to monitor fibrosis variations in weeks during treatments and after achieving SVR. It has the potential to allow the identification of early treatment failure for a timely switch to alternative treatment and to allow monitoring progression of fibrosis as a risk factor for liver cirrhosis.

scholarly journals PHILOS Plate Plus Oblique Insertion of Autologous Fibula for 2-Part Proximal Humerus Fractures With Medial Column Disruption: A Retrospective Study

2021 ◽  
Vol 12 ◽  
pp. 215145932199266
Author(s):  
Ying Shu ◽  
Meiji Chen ◽  
Weiguang Yu ◽  
Zhe Ge ◽  
Hao Hu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Aseptic Loosening ◽  
Complication Rate ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Loss Of Reduction ◽  
Primary Procedure ◽  
Philos Plate ◽  
Humerus Fractures

Introduction: The aim of this retrospective study was to evaluate the outcomes of older patients with 2-part proximal humerus fractures (PHFs) with medial column disruption stabilized using a proximal humeral internal locking system (PHILOS) plate plus oblique insertion of autologous fibula as a primary procedure. Materials and Methods: Data involving 112 patients (112 shoulders) sustaining 2-part PHFs with medial column disruption treated with PHILOS plate plus oblique insertion of autologous fibula as a primary procedure during 2012-2019 were identified. The median follow-up was 36 months (range: 11.2-43.5 months). The primary endpoint was the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores. The secondary endpoint was the main orthopedic complication rate. Results: The median Constant and ASES scores were 78 (range, 52-95) and 77 (range, 62-96) at the final follow-up, respectively. The main orthopedic complication rate was 10.7% (12/112). Twelve orthopedic complications in 8 patients were detected, and they involved loss of reduction, varus collapse, aseptic loosening, mal-union, revision, and intolerable shoulder pain. Of these complications, 3 (2.6%) involved loss of reduction, 2 (1.7%) involved varus collapse, 3 (2.6%) involved aseptic loosening, 1 (0.8%) involved mal-union, 2 (1.7%) required revision surgery, and 1 (0.8%) presented intolerable shoulder pain. Conclusion: PHILOS plate plus oblique insertion of autologous fibula as a primary procedure may yield good functional outcomes and a low rate of the main orthopedic complications.

scholarly journals AN AUDIT OF HYSTERECTOMIES IN HMC PESHAWAR

1969 ◽  
Vol 4 (1) ◽  
pp. 438-441
Author(s):  
FARZANA NAWAZ
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Complication Rate ◽  
Postoperative Hospital Stay ◽  
Vaginal Route

BACKGROUND: An audit of gynecological hysterectomieswas carried out in Gyne C department ofObstetrics & Gynecology Hayatabad Medical Complex Peshawar. Among the patients admitted formajor Gynecological operations, those undergoing hysterectomy were entered in to study programme.This study was carried out to assess the reasons and other related features of patients who underwenthysterectomies in Gyne-C Unit of Hayatabad Medical complex, Peshawar.METHODS: It was retrospective study of hysterectomies at Gyne C unit of Hayatabad MedicalComplex Peshawar, from January 2013 to December 2013. The indications for hysterectomy wereevaluated. Patients were studied and observed preoperatively, during surgery and postoperatively tilltheir stay in hospital. The follow up visit was also recorded with histopathology report after 6 weeksRESULTS: The incidence of hysterectomy among major operations was almost 22%. Ratio ofabdominal to vaginal route was almost 6:1. The complication rate and postoperative hospital stay wasseen more in the former group. Most of the operations were done electively. Majority of indicationswere benign in which surgery could have been avoided reflecting non availability of other effectivemedical treatments.CONCLUSION: There is a need to increase the number of vaginal hysterectomies for better outcomes.But still with all these limitations in our setup hysterectomy proved curative and acceptable form oftherapy to most of the patients.Key Words: Complications, Histopathology, Hysterectomy.

scholarly journals Glutathione and Related Antioxidant Capacities But Not Vitamin B-6 Had Significant Association with Severity of Liver Dysfunction in Liver Cirrhotic Patients

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1128-1128
Author(s):  
Yi-Chia Huang ◽  
Chia-Yu Lai ◽  
Shao-Bin Cheng ◽  
Hsiao-Tien Liu ◽  
Shih-Chien Huang
Keyword(s):  
Oxidative Stress ◽  
Liver Cirrhosis ◽  
Liver Dysfunction ◽  
Trolox Equivalent Antioxidant Capacity ◽  
Vitamin B ◽  
Double Blind ◽  
Antioxidant Capacities ◽  
Trolox Equivalent ◽  
Cirrhotic Patients

Abstract Objectives Liver cirrhosis is often associated with increased oxidative stress and decreased antioxidant capacities. Vitamin B-6 and glutathione (GSH) are antioxidant nutrients. Inadequate vitamin B-6 status may indirectly limit GSH synthesis and further affect the antioxidant capacities. The purpose of this study was to assess whether individual or the combination of vitamin B-6 and GSH supplementation had effects on antioxidant capacities and clinical outcomes in patients with liver cirrhosis. Methods This was a double-blind randomized clinical trial and a follow-up study. 61 liver cirrhotic patients were randomly assigned to placebo, vitamin B-6 (50 mg pyridoxine/d), GSH (500 mg/d) or B-6 + GSH groups for 12 weeks. After the end of supplementation, 61 patients were followed until the end of the study. Baseline and 12 weeks of fasting blood samples were drawn to measure levels of plasma GSH, oxidized GSH (GSSG), trolox equivalent antioxidant capacity (TEAC), activities of glutathione S-transferase (GSH-St), glutathione peroxidase (GSH-Px), glutathione reductase (GSH-Rd), superoxide dismutase (SOD) and catalase. The severity of liver dysfunction (Child-Turcotte-Pugh score) was evaluated at baseline, 12 weeks after baseline, and the end of the follow-up time. Results The median follow-up time was 984 d, 21 patients were lost of follow-up during follow-up period. After 12 weeks of supplementation, neither vitamin B-6 nor GSH supplementation had effects on indicators of oxidative stress and antioxidant capacities. However, high levels of GSH, GSH/GSSG ratio, and GSH-St activity at baseline (week 0) but not at week 12 had significant effect on low Child-Turcotte-Pugh scores at week 0, week12 and the end of follow-up in all patients after adjusting for potential confounders. Conclusions Although GSH supplementation had no significant effect on reducing oxidative stress and increase antioxidant capacities, the decreased glutathione and its related enzyme activity should be considered by clinicians in the treatment of liver cirrhotic patients. Funding Sources This study was funded by a grant from the Ministry of Science and Technology, Taiwan (MOST 104–2320-B-040–009-MY3) and Taichung Veterans General Hospital, Taiwan (TCVGH-1084601C).

CAUSAS FRECUENTES DE CIRROSIS HEPÁTICA EN EL HOSPITAL AMBULATORIO, SEGURO SOCIAL, JIPIJAPA, MANABÍ, ECUADOR

2018 ◽  
Vol 2 (2) ◽  
pp. 61-72
Author(s):  
María Emilia Fernández Aguilar ◽  
Gustavo Toala Bozada ◽  
Bárbara Miladys Placencia López ◽  
Holanda Mariola Merchán Ponce ◽  
Angélica Aliatis Bravo
Keyword(s):  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Clinical History ◽  
Etiological Diagnosis ◽  
Frequency Table ◽  
Liver Injuries ◽  
Number Of Patients ◽  
The Social

Son numerosas las causas que provocan lesiones del hígado que finalmente llevan a una cirrosis. El presente trabajo se realizó con el objetivo de identificar las causas frecuentes de cirrosis hepática en el Hospital Ambulatorio del Seguro Social de Jipijapa, Manabí, Ecuador. Se realizó un estudio descriptivo, longitudinal, retrospectivo, considerando para el mismo pacientes atendidos en consultas de gastroenterología entre enero 2015 y enero 2017, seleccionándose aquellos con diagnóstico de cirrosis y con edades iguales o superiores a los 20 años en cuya historia clínica constaran estudios de factores etiológicos. La muestra quedó formada por 64 enfermos. Se revisaron las historias del Modelo AS 400 y se recolectaron los datos necesarios, analizándose posibles causas etiológicas. Para el análisis estadístico se utilizó la tabla de frecuencia en el software SPSS versión 22.0 para Windows. Entre los principales resultados pueden mencionarse que la cirrosis hepática  aumentó con la edad, siendo más frecuente entre los pacientes de más de 60 años sin diferencias importantes en cuanto al sexo. Según el tiempo de diagnóstico el grupo de pacientes más numeroso estuvo entre los 0 y 5 años, decreciendo el número de enfermos a mayor tiempo de seguimiento en consulta. La complicación más frecuente detectada fue la presencia de varices esofágicas. La esteatosis hepática seguida del alcoholismo asociado a la misma, fueron las causas más frecuentes de cirrosis.Palabras clave: enfermedad crónica, funcionalidad hepática, diagnóstico etiológico. ABSTRACThere are numerous causes that cause liver injuries that eventually lead to cirrhosis. The present work was carried out with the objective of identifying the frequent causes of liver cirrhosis in the Outpatient Hospital of the Social Security of Jipijapa, Manabí, Ecuador. A descriptive, longitudinal, retrospective study was carried out, considering for the study patients attended in gastroenterology consultations between January 2015 and January 2017, selecting those diagnosed with cirrhosis and with ages equal to or greater than 20 years in whose clinical history there are studies of etiological factors. The sample consisted of 64 patients. The histories of the Model AS 400 were reviewed and the necessary data were collected, analyzing possible etiological causes. For the statistical analysis, the frequency table was used in the software SPSS version 22.0 for Windows. Among the main results can be mentioned that liver cirrhosis increased with age, being more frequent among patients over 60 years without important differences in sex. According to the time of diagnosis, the largest group of patients was between 0 and 5 years of age, with the number of patients decreasing to a longer follow-up period. The most frequent complication detected was the presence of esophageal varices. Hepatic steatosis followed by alcoholism associated with it, were the most frequent causes of cirrhosis.Key words: Chronic disease, liver function, etiological diagnosis.

scholarly journals Impact of fixation method on postoperative complication rates following surgical stabilization of diaphyseal tibial fractures in cats

2015 ◽  
Vol 28 (02) ◽  
pp. 109-115 ◽  
Author(s):  
M. Bruce ◽  
K. L. Perry
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Complication Rate ◽  
Open Reduction ◽  
Tibial Fractures ◽  
Fixation Method ◽  
Complication Rates ◽  
Significant Difference ◽  
Study Population

SummaryObjectives: To compare the complication rate between open reduction and internal fixation (ORIF) and external skeletal fixation (ESF) for feline diaphyseal tibial fractures.Methods: In a retrospective study spanning a 10 year period, 57 feline tibial fractures stabilized via ESF or ORIF were included for analysis and complication rates were compared between the two methods.Results: In the overall study population, 23 (40.4%) cases suffered complications (9 major, 20 minor, 6 with both major and minor). All of the major complications occurred in the ESF group. Complications were more common in cats with ESF (50.0%) while only one (7.7%) of the ORIF cases suffered complications (OR 12.0 [CI: 2.09; 228.10], p = 0.02). Use of postoperative antibiotic medications was identified as a confounder. After adjusting for confounding, stabilization using ESF remained associated with a higher risk of complications (OR = 13.71 [CI: 2.18; 274.25], p = 0.02). Cats with ESF had a longer duration of follow-up (15.6 weeks; 95% CI: 13.0; 18.3) compared to ORIF (9.5 weeks; 95% CI: 6.4; 12.7) (p = 0.003), and a higher number of revisits (mean 3.0; 95% CI: 2.4; 3.6) than the ORIF group (mean 1.6; 95% CI: 0.9; 2.3) (p = 0.002).Clinical significance: This study demonstrates a significant difference in complication rates between the methods of stabilization, with ESF resulting in a significantly higher complication rate compared to ORIF. Based on these results, it may be prudent to select ORIF for stabilization of feline tibial fractures wherever practical.

scholarly journals Subjective Global Assessment and Handgrip Strength as Predictive Factors in Patients with Liver Cirrhosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Maria Ciocîrlan ◽  
Andreea Ruxandra Cazan ◽  
Mihaela Barbu ◽  
Mircea Mănuc ◽  
Mircea Diculescu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Global Assessment ◽  
Handgrip Strength ◽  
Assessment Tools ◽  
Subjective Global Assessment ◽  
Term Survival ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Short Term Survival

Background and Aims. Malnutrition is common in patients with chronic liver disease. We aimed to evaluate malnutrition assessment tools in predicting severity and survival of patients with liver cirrhosis. Material and Methods. We examined patients with liver cirrhosis. Nutritional evaluation was performed on admission, using subjective global assessment (SGA), handgrip strength (HGS), and anthropometry. Patients were followed up for 6 months. Results. We included 100 patients, 72 men, with mean age of 59.2 years. According to disease severity, patients were 23% Child-Pugh A, 46% Child-Pugh B, and 31% Child-Pugh C. SGA and HGS significantly correlated with Child-Pugh, MELD, and MELD-Na scores on admission. At 6 months follow-up, 80.4% (78 of 97) of patients survived, while 3 patients were lost from observation. Survival was predicted by SGA (1 death in 32 patients SGA A, 8 deaths in 46 patients SGA B, and 9 deaths in 19 patients SGA C, p=0.001) and HGS (25.1 ± 8.5 in deceased versus 30.6 ± 10.9 in survivors, p=0.046). The mean BMI and MAMC values did not significantly differ between patients who survived or were deceased at 6 months. Conclusion. HGS and SGA may predict severity and short-term survival in cirrhotic patients.

scholarly journals La hernia umbilical en el paciente cirrótico: ¿tratamiento conservador o cirugía?

2021 ◽  
Vol 113 (1) ◽  
pp. 83-91
Author(s):  
Carlos A. Cano ◽  
◽  
Abraham R. Arias
Keyword(s):  
Liver Cirrhosis ◽  
Public Hospital ◽  
Elective Surgery ◽  
Intraabdominal Pressure ◽  
High Morbidity ◽  
Preoperative Risk ◽  
History Of ◽  
Cirrhotic Patients ◽  
Lost To Follow Up

Background: Background: Ascites is a common complication in patients with cirrhosis, and elevated intraabdominal pressure can lead to the development of abdominal wall hernias, particularly in patients with latent umbilical defects. Objectives: The aim of this study was to report the incidence and benefits of elective surgery for the management of umbilical hernias in cirrhotic patients with ascites. Material and methods: Between January 2015 and January 2019 15 patients with symptomatic umbi- lical hernia underwent elective surgery in a public hospital; 100% were men with a history of alcoho- lism and were hospitalized due to liver cirrhosis. The defect was closed, and a polypropylene mesh was placed in the supra-aponeurotic plane in most cases. Results: The preoperative risk was estimated using the Child-Pugh score. Ascites was evacuated in all the cases. Patients were followed-up every 30 days during the first 6 months and then twice a year. There were no hernia recurrences. Two patients were lost to follow-up 12 months after surgery and 1 patient died 9 months after the procedure due to progression of cirrhosis. Conclusions: Patients with liver cirrhosis and umbilical hernia should undergo elective surgery. Watchful waiting is associated with higher risk of hernia rupture and high morbidity and mortality.

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