scholarly journals Differences in Inflammatory Parameters of Child-Pugh B and Child-Pugh C Scores of Liver Cirrhosis with Hepatorenal Syndrome

2021 ◽  
Vol 3 (1) ◽  
pp. 12-19
Author(s):  
Lider Olmen Panggabean ◽  
Gontar Alamsyah Siregar ◽  
Masrul Lubis
Keyword(s):  
Liver Cirrhosis ◽  
Poor Prognosis ◽  
Hepatorenal Syndrome ◽  
Total Bilirubin ◽  
Cross Sectional ◽  
Sample Number ◽  
Inflammatory Parameters ◽  
The Poor ◽  
Prognosis Of Liver Cirrhosis ◽  
Ethics Commission

Background: Child-Pugh score is used to predict the poor prognosis of liver cirrhosis patients. The study objectives analyzed differences in inflammatory parameters of Child-Pugh B and Child-Pugh C of liver cirrhosis with hepatorenal syndrome. Method: Desain's study is cross-sectional in liver cirrhosis patients with hepatorenal syndrome.  This research was approved by the Health Research Ethics Commission FK USU / RSUP H. Adam Malik Medan and meets the criteria of inclusion or exclusion. Diagnosis of Liver cirrhosis Child-Pugh B and Child-Pugh C score is done by clinical examination, laboratory, and ultrasound, CT scan, MRI. The hepatorenal syndrome was diagnosed using Criteria International Ascites Club, 2007. Results: The sample number of this study was 26 liver cirrhosis with hepatorenal syndrome patients consisting of Child-Pugh B patients 9 patients and Child-Pugh C patients 17  patients. The comparison between Child-Pugh B and Child-Pugh C has significant differences in leukocyte, Na, Cl, SGOT, and CTP. There is a significant correlation between CTP and leukocytes, platelets, Cl, creatinine, GFR, albumin, total bilirubin, and glued bilirubin. Conclusion: There is no clear difference in the inflammatory parameters of the Child-Pug B and Child-Pug C scores in liver cirrhosis with hepatorenal syndrome.

scholarly journals Prevalence of Acute Kidney Injury in Patients with Liver Cirrhosis

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Pukar Thapa ◽  
Sudhamshu KC ◽  
Achyut Bikram Hamal ◽  
Dilip Sharma ◽  
Sandip Khadka ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Liver Cirrhosis ◽  
Hospital Stay ◽  
Hepatorenal Syndrome ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tubular Necrosis ◽  
Advanced Liver Cirrhosis ◽  
Life Threatening

Introduction: Acute kidney injury is a common and life-threatening event in patients with liver cirrhosis occurring in approximately 20-50% of hospitalized patients of liver cirrhosis. Pre-renal acute kidney injury, the hepatorenal syndrome type of acute kidney injury and acute tubular necrosis represent the common causes. The aim of this study was to study the profile of acute kidney injury in patients with liver cirrhosis. Methods: Consecutive patients of liver cirrhosis admitted in Liver unit of Bir Hospital were studied to see the presence of acute kidney injury in this hospital based descriptive cross-sectional study. Clinical and laboratory parameters along with various clinical outcome were compared between different groups categorized by the severity of liver disease and renal dysfunction. Results: Out of 302 liver cirrhosis patients, 56 (18.5%) had acute kidney injury among which 23 (46%) were found to have pre-renal acute kidney injury, 15 (30%) with hepatorenal syndrome– acute kidney injury and 12 (24%) with intrinsic renal disease. Patients with higher stages of acute kidney injury had longer duration of hospital stay and hepatorenal syndrome-acute kidney injury was seen in patients with higher grade of ascites and with hyponatremia. Conclusions: Acute kidney injury is a common occurrence in patients with advanced liver cirrhosis with pre-renal acute kidney injury being the commonest cause. Median hospital stay is directly affected by the severity of acute kidney injury and hepatorenal syndrome–acute kidney injury was seen in patients with higher grade of ascites and hyponatremia. Early identification of patients at high risk for acute kidney injury may help to reduce mortality and contain costs.  

scholarly journals THE RELATIONSHIP OF APRI SCORE (ASPARTATE AMINOTRANS FERASE-TO-PLATELET RATIO INDEX) AND PUGH CHILD SCORE

2020 ◽  
Vol 7 (2) ◽  
pp. 122-129
Author(s):  
Adelia Muhlifa Saputri ◽  
Magdaleni Agustina Rahayu ◽  
Sinta Murti
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Function ◽  
Esophageal Varices ◽  
Aspartate Aminotransferase ◽  
Secondary Source ◽  
Cross Sectional ◽  
Prognosis Of Liver Cirrhosis ◽  
Apri Score ◽  
Relationship Of

Liver cirrhosis is the last stage of chronic liver disease that is in the path of the disease can cause damage of liver function and/or portal hypertension. The prognosis of liver cirrhosis can be assessed by manifestations of liver function disorders with Child Pugh score that include the presence or absence of ascites, encephalopathy, bilirubin serum, albumin serum, and prothrombin time or INR, while portal hypertension also occurs in patient of cirrhosis can lead the formation of esophageal varices. APRI score has platelet count and AST serum as its variable is suspected to be related to the Child Pugh score in assessing prognosis of cirrhosis patients. This study purposed to find the relation between APRI score (Aspartate Aminotransferase-to-Platelet Ratio Index) and Child Pugh score. Purpose of this research is to find the relation between APRI score (Aspartate Aminotransferase-to-Platelet Ratio Index) and Child Pugh score and degree of esophageal varices in patients with cirrhosis. Method used is a retrospective analytic study with cross sectional approach. The data source is secondary source. The sample in this study were patients with liver cirrhosis who were diagnosed by a doctor and had complied the inclusion criteria. The data obtained was analyzed using ANOVA. The result of this study is include 48 cirrhosis patients, male 81,3%, with a mean age 49,98 years. The most common cause of cirrhosis is hepatitis B obtained from reactive HBsAg examination in 33 patients (68,8%). The APRI score was found to have a weak correlation (r = 0.044) and not significant (p = 0.868) with the Child Pugh score. The APRI score do not able to assess the prognosis in advanced cirrhotic patients.

scholarly journals Clinical Significance of Serum Sodium Levels in Liver Cirrhosis: A Cross-sectional Observational Study

2020 ◽  
Author(s):  
Sandeep Reddy Nareddy ◽  
Akshatha Rao Aroor ◽  
Archana Bhat
Keyword(s):  
Liver Cirrhosis ◽  
Serum Sodium ◽  
Spontaneous Bacterial Peritonitis ◽  
Hepatorenal Syndrome ◽  
Primary Concern ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Bacterial Peritonitis ◽  
Low Sodium ◽  
Dominant Feature

Introduction: Hyponatremia is a dominant feature and is of primary concern in liver cirrhosis. It is an important prognostic factor for the severity and complications of liver cirrhosis associated with poor survival. The issue of hyponatremia in liver cirrhosis has been the subject of intense debate within the scientific community. Aim: To determine the association of serum sodium levels with the severity and complications of liver cirrhosis. Materials and Methods: This observational, cross-sectional study included all adult patients diagnosed with liver cirrhosis, admitted in single tertiary care centre from December 2016 to April 2018. Their serum sodium levels was estimated on admission and correlated with Child Pugh Score and complications of cirrhosis. Statistical analysis was done by Chi-Square test, Fisher’s-exact test and Odds Ratio (OR) estimation. Results: A total of 95 patients were enrolled in the study. Majority were in the age group of 41-50 years (35.8%) with a mean age of 48.38±11.8 (mean±SD). There was a male preponderance (91 patients, 96.8%). Hyponatremia (≤130 meq/L) was noted in 33 patients (34.7%). Among the patients with hyponatremia, 29 (87.9%) belonged to Child Pugh C. The association of hyponatremia with Child Pugh C was highly significant (OR 3.987; CI 1.240-12.818; p=0.029). A positive correlation was found between low sodium levels (≤130 meq/L) and complications such as spontaneous bacterial peritonitis (OR 4.667; CI 1.538-14.164; p=0.004) and hepatorenal syndrome (OR 5.357; CI 0.979-29.327; p=0.034). Conclusion: Low sodium levels in cirrhosis has a positive correlation with the disease severity, hepatorenal syndrome and spontaneous bacterial peritonitis.

scholarly journals Predictors of the development of hepatorenal syndrome

2021 ◽  
Vol 18 (4) ◽  
pp. 69-73
Author(s):  
E. A. Kozich ◽  
E. L. Krasavtsev
Keyword(s):  
Liver Cirrhosis ◽  
Medical Records ◽  
Blood Test ◽  
Hepatorenal Syndrome ◽  
Total Bilirubin ◽  
Leukocyte Count ◽  
Albumin Level ◽  
Laboratory Research ◽  
Indirect Bilirubin ◽  
Leukocyte Counts

Objective. To identify the predictors of the development of hepatorenal syndrome in patients with liver cirrhosis.Materials and methods. We analyzed the medical records of 79 patients diagnosed with liver cirrhosis. The laboratory research included general and biochemical blood tests. The general blood test measured erythrocyte and leukocyte counts. The biochemical blood test measured the content of ALT (U/L), AST (E/L), total bilirubin (μmol/L), direct bilirubin (μmol/L), indirect bilirubin (μmol/L), alkaline phosphatase (U/L), albumin (g/L), urea (mmol/L), creatinine (mmol/L), cholesterol (mmol/L).Viral hepatitis markers were determined for all the patients.Results. The predictors of the development of hepatorenal syndrome were identified: increased leukocyte count, increased total and indirect bilirubin levels, urea level and decreased erythrocyte count and albumin level. The most specific predictors were the amount of indirect bilirubin (98 %) and the content of albumin in the serum (89.8 %), and the most sensitive predictors were AST (96.7 %) and the content of red blood cells and creatinine (73.3 %).Conclusion. The most significant predictors of the development obtained will contribute to the diagnosis of the development of hepatorenal syndrome in patients with liver cirrhosis.  

scholarly journals The Effect of Heterogenous Subregions in Glioblastomas on Survival Stratification: A Radiomics Analysis Using the Multimodality MRI

2021 ◽  
Vol 20 ◽  
pp. 153303382110330
Author(s):  
Lulu Yin ◽  
Yan Liu ◽  
Xi Zhang ◽  
Hongbing Lu ◽  
Yang Liu
Keyword(s):  
Poor Prognosis ◽  
Intratumor Heterogeneity ◽  
Short Term ◽  
Prognostic Information ◽  
Manual Delineation ◽  
Flair Sequence ◽  
The Poor ◽  
Contrast Enhanced ◽  
Mri Sequences

Intratumor heterogeneity is partly responsible for the poor prognosis of glioblastoma (GBM) patients. In this study, we aimed to assess the effect of different heterogeneous subregions of GBM on overall survival (OS) stratification. A total of 105 GBM patients were retrospectively enrolled and divided into long-term and short-term OS groups. Four MRI sequences, including contrast-enhanced T1-weighted imaging (T1C), T1, T2, and FLAIR, were collected for each patient. Then, 4 heterogeneous subregions, i.e. the region of entire abnormality (rEA), the regions of contrast-enhanced tumor (rCET), necrosis (rNec) and edema/non-contrast-enhanced tumor (rE/nCET), were manually drawn from the 4 MRI sequences. For each subregion, 50 radiomics features were extracted. The stratification performance of 4 heterogeneous subregions, as well as the performances of 4 MRI sequences, was evaluated both alone and in combination. Our results showed that rEA was superior in stratifying long-and short-term OS. For the 4 MRI sequences used in this study, the FLAIR sequence demonstrated the best performance of survival stratification based on the manual delineation of heterogeneous subregions. Our results suggest that heterogeneous subregions of GBMs contain different prognostic information, which should be considered when investigating survival stratification in patients with GBM.

scholarly journals Umbilical cord blood transplantation can overcome the poor prognosis of KMT2A-MLLT3 acute myeloid leukemia and can lead to good GVHD-free/relapse-free survival

2021 ◽  
Author(s):  
Juan Tong ◽  
Lei Zhang ◽  
Huilan Liu ◽  
Xiucai Xu ◽  
Changcheng Zheng ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Poor Prognosis ◽  
Cord Blood Transplantation ◽  
Chronic Gvhd ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Chemotherapy Group ◽  
Blood Transplantation ◽  
The Poor ◽  
First Complete Remission

AbstractThis is a retrospective study comparing the effectiveness of umbilical cord blood transplantation (UCBT) and chemotherapy for patients in the first complete remission period for acute myeloid leukemia with KMT2A-MLLT3 rearrangements. A total of 22 patients were included, all of whom achieved first complete remission (CR1) through 1–2 rounds of induction chemotherapy, excluding patients with an early relapse. Twelve patients were treated with UCBT, and 10 patients were treated with chemotherapy after 2 to 4 courses of consolidation therapy. The 3-year overall survival (OS) of the UCBT group was 71.3% (95% CI, 34.4–89.8%), and that of the chemotherapy group was 10% (95% CI, 5.89–37.3%). The OS of the UCBT group was significantly higher than that of the chemotherapy group (P = 0.003). The disease-free survival (DFS) of the UCBT group was 60.8% (95% CI, 25.0–83.6%), which was significantly higher than the 10% (95% CI, 5.72–35.8%) of the chemotherapy group (P = 0.003). The relapse rate of the UCBT group was 23.6% (95% CI, 0–46.8%), and that of the chemotherapy group was 85.4% (95% CI, 35.8–98.4%), which was significantly higher than that of the UCBT group (P < 0.001). The non-relapse mortality (NRM) rate in the UCBT group was 19.8% (95% CI, 0–41.3%), and that in the chemotherapy group was 0.0%. The NRM rate in the UCBT group was higher than that in the chemotherapy group, but there was no significant difference between the two groups (P = 0.272). Two patients in the UCBT group relapsed, two died of acute and chronic GVHD, and one patient developed chronic GVHD 140 days after UCBT and is still alive, so the GVHD-free/relapse-free survival (GRFS) was 50% (95% CI, 17.2–76.1%). AML patients with KMT2A-MLLT3 rearrangements who receive chemotherapy as their consolidation therapy after CR1 have a very poor prognosis. UCBT can overcome the poor prognosis and significantly improve survival, and the GRFS for these patients is very good. We suggest that UCBT is a better choice than chemotherapy for KMT2A-MLLT3 patients.

Usability of India’s government statistics1

2020 ◽  
pp. 1-17
Author(s):  
Vikas Kumar
Keyword(s):  
National Sample ◽  
Poor Quality ◽  
Sample Surveys ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Jammu And Kashmir ◽  
The Poor ◽  
Government Statistics

The quality of metadata is a crucial determinant of usability/interpretability of data. This paper draws attention to the poor quality of India’s government statistics and the paucity of metadata necessary to understand the problems. The paper suggests that there has been a decline in India both in terms of the availability and quality of metadata for key government sources of information including maps, decennial population censuses and National Sample Surveys amidst growing sophistication in the understanding of metadata. The poor quality of metadata impairs cross-sectional as well as inter-temporal comparisons and policymaking apart from concealing biases and lapses of government statisticians. The paper draws on the experience of three states – erstwhile Jammu and Kashmir, Manipur and Nagaland – where government statistics have been affected by serious errors that are not well-understood due to the lack of adequate metadata.

Elevated serum tyrosine concentration is associated with a poor prognosis among patients with liver cirrhosis

2021 ◽  
Author(s):  
Sho Sato ◽  
Nozomi Amano ◽  
Shunsuke Sato ◽  
Yuji Kita ◽  
Yuji Ikeda ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Poor Prognosis ◽  
Elevated Serum ◽  
Tyrosine Concentration
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