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oesophageal varice

F Fabbian, U Fedeli, A De Giorgi, R Cappadona, M Guarino, M Gallerani, R Manfredini R De Giorgio
OBJECTIVE: The relationship between in-hospital mortality (IHM) and acute oesophageal variceal bleeding (AOEVB) has not been fully assessed. The aim of this study was to establish the association between sex and mortality for patients hospitalized with AOEVB. PATIENTS AND METHODS: We analyzed hospitalizations from the Italian Health Ministry database by identifying all patients discharged with AOEVB from January 2001 to December 2015. A total of 144,943 hospitalizations were for oesophageal varices, but only 24,570 emergency admissions with AOEVB coded as the primary or secondary diagnosis were included for analysis...
January 2019: European Review for Medical and Pharmacological Sciences
Hannes Hagström, Jonas Höijer, Anna Andreasson, Matteo Bottai, Kari Johansson, Jonas F Ludvigsson, Olof Stephansson
BACKGROUND: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women. AIM: To study the association between BMI early in life and development of liver disease later in life in women. METHODS: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. National registers were used to ascertain incident severe liver disease, defined as cirrhosis, decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure...
February 3, 2019: Alimentary Pharmacology & Therapeutics
Filipe Nery, Sofia Correia, Carlos Macedo, Judit Gandara, Vítor Lopes, Diana Valadares, Sofia Ferreira, João Oliveira, Manuel Teixeira Gomes, Raquel Lucas, Pierre-Emmanuel Rautou, Helena Pessegueiro Miranda, Dominique Valla
BACKGROUND: Nonmalignant portal vein thrombosis is a significant event in the course of cirrhosis that can contraindicate liver transplantation and even impact survival after the surgical procedure. Risk factors are not completely known or validated and are still debated. AIM: To identify in patients with cirrhosis the risk factors for portal vein thrombosis that are assessable in clinical practice. METHODS: Between January 2014 and February 2017, 108 outpatients with cirrhosis and no portal vein thrombosis (78% Child A) were enrolled...
January 22, 2019: Alimentary Pharmacology & Therapeutics
Ivica Grgurevic, Ida Tjesic Drinkovic, Massimo Pinzani
Ultrasound (US) is usually the first and most commonly used tool in the diagnostic algorithm for liver disease. It is widely available, non-invasive and offers a real-time assessment of the liver in several anatomic planes, using different US modalities such as greyscale imaging, Doppler, elastography and contrast-enhanced US. This multiparametric ultrasound (MPUS) provides more information of the examined structures and allows for a faster and more accurate diagnosis, usually at the point of care, thus reducing the requirement for some invasive and more expensive methods...
January 21, 2019: Postgraduate Medical Journal
A Y Wendy Tan, J Y Chieng
OBJECTIVE: Approximately one-third of patients with esophageal varices will develop bleeding which is a major cause of morbidity and mortality in patients with liver cirrhosis. Currently, the two most widely used modalities to prevent variceal bleeding are pharmacologic and oendoscopic variceal band ligation (EVL). However, EVL has been associated with significant complications. Hence we aim to evaluate and to identify the epidemiology, demography, and complications of EVL at our local Malaysian tertiary hospital...
December 2018: Medical Journal of Malaysia
Chenxia Hu, Lingfei Zhao, Jinfeng Duan, Lanjuan Li
End-stage liver fibrosis frequently progresses to portal vein thrombosis, formation of oesophageal varices, hepatic encephalopathy, ascites, hepatocellular carcinoma and liver failure. Mesenchymal stem cells (MSCs), when transplanted in vivo, migrate into fibrogenic livers and then differentiate into hepatocyte-like cells or fuse with hepatocytes to protect liver function. Moreover, they can produce various growth factors and cytokines with anti-inflammatory effects to reverse the fibrotic state of the liver...
January 11, 2019: Journal of Cellular and Molecular Medicine
Kostantinos Gkouvatsos, Fabrizia D'Angelo, Stefano Guglielmi, Jean-Louis Frossard
The purpose of this article is to detail the major gastroenterology novelties for 2018. In the field of hepatology we address the monitoring of hepatocellular carcinoma, the Baveno VI extended criteria for the detection of oesophageal varices and the management of cramps in cirrhotic patients. Concerning intestinal inflammatory diseases, two novel treatments have recently been approved by the European Commission, including injection of stem cells for the treatment of complex perianal fistulas and the JAK inhibitor tofacitinib for the RCH (ulcerative colitis)...
January 9, 2019: Revue Médicale Suisse
Warren Chapman, Keith Siau, Fiona Thomas, Selvajothi Ernest, Shriya Begum, Tariq Iqbal, Neeraj Bhala
This article outlines latest evidence-based care for patients with acute upper gastrointestinal (GI) bleeding. It aims to help gastroenterology and general medical ward nurses plan nursing interventions and understand the diagnostic treatment options available. Acute upper GI bleeding can present as variceal or non-variceal bleeding and has a high death rate. Endoscopy is used for diagnosis and to provide therapy, prior to which the patient should be adequately resuscitated and assessed. Various therapies can be initiated at endoscopy, depending on the source of bleeding...
January 10, 2019: British Journal of Nursing: BJN
Graeme Greenfield, Mary Frances McMullin
Background: Splanchnic Vein Thrombosis (SVT) is strongly associated with underlying JAK2 V617F positive myeloproliferative neoplasms (MPN). Methods: Patients attending the tertiary haematology service in Northern Ireland with SVT and underlying JAK2 V617F MPN were identified by consultant staff. A retrospective audit was undertaken to examine therapeutic interventions and relevant outcomes. Descriptive statistics were used for qualitative data whilst students t-test allowed comparison of quantitative data...
2018: Thrombosis Journal
Jennifer A Flemming, Yvonne Dewit, Jeffrey M Mah, James Saperia, Patti A Groome, Christopher M Booth
BACKGROUND: Recent data show that the prevalence of chronic liver disease and cirrhosis is increasing in adolescents and young adults in the USA. We aimed to describe the epidemiology of cirrhosis using an age-period-cohort approach to define birth-cohort effects on the incidence of cirrhosis in Ontario, Canada. METHODS: We did a retrospective population-based cohort study in Ontario, Canada, using linked administrative health data from the databases of ICES, formerly the Institute for Clinical Evaluative Sciences...
December 17, 2018: Lancet. Gastroenterology & Hepatology
Antony P Zacharias, Rebecca Jeyaraj, Lise Hobolth, Flemming Bendtsen, Lise Lotte Gluud, Marsha Y Morgan
BACKGROUND: Non-selective beta-blockers are recommended for the prevention of bleeding in people with cirrhosis, portal hypertension and gastroesophageal varices. Carvedilol is a non-selective beta-blocker with additional intrinsic alpha1 -blocking effects, which may be superior to traditional, non-selective beta-blockers in reducing portal pressure and, therefore, in reducing the risk of upper gastrointestinal bleeding. OBJECTIVES: To assess the beneficial and harmful effects of carvedilol compared with traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices...
October 29, 2018: Cochrane Database of Systematic Reviews
Marcus Overhaus, Lydia Garcia Park, Rolf Fimmers, Tim R Glowka, Cornelius van Beekum, Steffen Manekeller, Jörg C Kalff, Nico Schaefer, Tim Vilz
BACKGROUND: The most dangerous complication of portal hypertension is the formation of oesophageal varices, as the risk of bleeding is up to 80%. In order to reduce pressure reduction in the portosystemic circulation and as secondary prophylaxis, the TIPSS procedure has proven successful. In patients with portal vein thrombosis, portosystemic shunt surgery is possible to reduce the risk of variceal bleeding. However, if thrombosis of the mesentericoportal axis or hepatic encephalopathy is imminent, interventional or surgical creation of a portosystemic shunt is contraindicated...
October 2018: Zentralblatt Für Chirurgie
S Nagasaki, S Nishiguchi, J Branch
No abstract text is available yet for this article.
October 5, 2018: QJM: Monthly Journal of the Association of Physicians
Michael Lipinski, Michael Saborowski, Benjamin Heidrich, Dina Attia, Philipp Kasten, Michael P Manns, Michael Gebel, Andrej Potthoff
OBJECTIVES: The clinical relevance of spontaneous portosystemic shunts detected by ultrasound is insufficiently investigated. The aim of this retrospective study was to assess the frequency and clinical relevance of spontaneous portosystemic shunts in patients with liver cirrhosis. METHODS: We evaluated portosystemic shunts, liver cirrhosis and spleen size by ultrasound in 982 patients with liver cirrhosis and correlated these with laboratory results, clinical data and the incidence of clinical endpoint deaths, liver transplantation and the development of HCC during the follow-up period (mean 1...
September 2018: Scandinavian Journal of Gastroenterology
Brigida E Annicchiarico, Concetta Santonocito, Massimo Siciliano, Margherita Scapaticci, Donatella Guarino, Carmine Di Stasi, Maria E Riccioni, Enrico Di Stasio, Ettore Capoluongo, Antonio Gasbarrini
BACKGROUND: In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed. AIM: The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure...
August 28, 2018: Digestive and Liver Disease
Xiaolong Qi, Annalisa Berzigotti, Andres Cardenas, Shiv Kumar Sarin
Clinically significant portal hypertension is associated with an increased risk of developing gastro-oesophageal varices and hepatic decompensation. Hepatic venous pressure gradient measurement and oesophagogastroduodenoscopy are the gold-standard methods for assessing clinically significant portal hypertension (hepatic venous pressure gradient ≥10 mm Hg) and gastro-oesophageal varices, respectively. However, invasiveness, cost, and feasibility limit their widespread use, especially if repeated and serial evaluations are required to assess the efficacy of pharmacotherapy...
October 2018: Lancet. Gastroenterology & Hepatology
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
Feiyue Zhang, Tong Liu, Pan Gao, Sujuan Fei
Objective: In recent years, the noninvasive serological scoring system has become a research hotspot in predicting hepatic fibrosis and has achieved good results. However, it has rarely been applied to the prediction of oesophageal varices. The aim of the study was to evaluate the predictive value of the four following scoring systems in cirrhosis combined with oesophageal varices: aspartate and platelet ratio index (APRI), aspartate aminotransferase-alanine aminotransferase ratio (AAR), FIB-4, and S index...
2018: Canadian Journal of Gastroenterology & Hepatology
Helmut K Seitz, Ramon Bataller, Helena Cortez-Pinto, Bin Gao, Antoni Gual, Carolin Lackner, Philippe Mathurin, Sebastian Mueller, Gyongyi Szabo, Hidekazu Tsukamoto
The originally published article contained an error in figure 8 part a, in which cut off values for F3 fibrosis, cirrhosis, and screening for oesophageal varices and HCC were incorrectly presented as <8 kPa, <12.5 kPa and <20 kPa, respectively. These cut off values have been corrected in the HTML and PDF versions of the manuscript to >8 kPa for F3 fibrosis, >12.5 kPa for cirrhosis and >20 kPa for screening for oesophageal varices and HCC.
August 28, 2018: Nature Reviews. Disease Primers
Chikwendu J Ede, Dimitrinka Nikolova, Martin Brand
BACKGROUND: Hepatosplenic schistosomiasis is an important cause of variceal bleeding in low-income countries. Randomised clinical trials have evaluated the outcomes of two categories of surgical interventions, shunts and devascularisation procedures, for the prevention of variceal rebleeding in people with hepatosplenic schistosomiasis. The comparative overall benefits and harms of these two interventions are unclear. OBJECTIVES: To assess the benefits and harms of surgical portosystemic shunts versus oesophagogastric devascularisation procedures for the prevention of variceal rebleeding in people with hepatosplenic schistosomiasis...
August 3, 2018: Cochrane Database of Systematic Reviews
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