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Spontaneous peritonitys

Sahil Koppikar, David Yu, Mark Ropeleski, David Robertson
Connective tissue diseases can be associated with rare gastrointestinal complications such as pneumatosis intestinalis and pneumoperitoneum. In this article, we report a unique case of recurrent pneumatosis intestinalis and spontaneous pneumoperitoneum without evidence of peritonitis in a patient with long-standing mixed connective tissue disease. Computed tomography scan of the abdomen and pelvis revealed pneumatosis of the jejunum and intra-abdominal free air, without evidence of perforation. The patient was managed non-operatively...
December 2018: Archives of Rheumatology
Shweta A Singh, Kelika Prakash, Sandeep Sharma, An Anil, Viniyendra Pamecha, Guresh Kumar, Ajeet Bhadoria
Background and Aims: Blood transfusion is unpredictable in liver transplantation and is associated with increased patient morbidity, mortality and cost. This retrospective analysis was conducted to detect factors which could predict intraoperative transfusion of more than four units of packed red blood cells (PRBCs) during elective living donor liver transplantation (LDLT). Methods: This was a single-centre retrospective study. Demographic, clinical and intraoperative data of 258 adult patients who underwent LDLT from March 2009 to January 2015 were analysed...
February 2019: Indian Journal of Anaesthesia
Dennis Kumral, Rehan Qayyum, Susan Roseff, Richard K Sterling, Mohammad S Siddiqui
Hepatic encephalopathy (HE) is characterized by altered sensorium and is the most common indication for hospitalization among patients with cirrhosis. Liver societal guidelines for inpatient HE revolve around identification of potential precipitants. In this retrospective study, we aimed to determine adherence to societal guidelines for evaluation of HE in 78 inpatients. The adherence rate to societal recommended guidelines for workup of HE was low, with only 17 (22%) patients having complete diagnostic workup within 24 hours of admission...
March 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Camila Alvarez-Silva, Robert Schierwagen, Alessandra Pohlmann, Fernando Magdaleno, Frank E Uschner, Patrick Ryan, Maria J G T Vehreschild, Joan Claria, Eicke Latz, Benjamin Lelouvier, Manimozhiyan Arumugam, Jonel Trebicka
Background: Acquired dysfunctional immunity in cirrhosis predisposes patients to frequent bacterial infections, especially spontaneous bacterial peritonitis (SBP), leading to systemic inflammation that is associated with poor outcome. But systemic inflammation can also be found in the absence of a confirmed infection. Detection of bacterial DNA has been investigated as a marker of SBP and as a predictor of prognosis. Data is, however, contradictory. Here we investigated whether levels of IL-6 and IL-8 putatively produced by myeloid cells in ascites are associated with systemic inflammation and whether inflammation depends on the presence of specific bacterial DNA...
2019: Frontiers in Immunology
Yuan Wang, Qingyu Zhang
Background: We aimed to explore risk factors for patients with liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP). Methods: The clinical data of 195 patients with liver cirrhosis complicated with SBP (study group), admitted from March 2014 to March 2018 in Tianjin Medical University General Hospital, Tianjin, China and 195 patients without liver cirrhosis complicated with SBP (control group) were retrospectively analyzed. Clinical manifestations of patients and laboratory findings were analyzed...
December 2018: Iranian Journal of Public Health
Tamer R Fouad, Eman Abdelsameea, Maha Elsabaawy, M Ashraf Eljaky, Soha Zaki El-Shenawy, Nabil Omar
Cirrhotic patients with ascites are at high risk of developing spontaneous bacterial peritonitis (SBP). After exclusion of patients with acute kidney injury (AKI) or other infections, urinary neutrophil gelatinase-associated lipocalin (NGAL) levels were compared between two matched groups of Egyptian cirrhotic patients with ascites, mostly secondary to hepatitis C infection (98%). Group 1 had SBP (n = 41) and group 2 did not (n = 45). By univariate analysis, urinary-NGAL, high total bilirubin, serum creatinine, international normalised ratio and the Model of End-Stage Liver Disease (MELD) score and low platelet count were all significantly correlated with the presence of SBP, but only urinary-NGAL could independently predict development of SBP ( P = 0...
February 20, 2019: Tropical Doctor
Tomohiro Muronoi, Akihiko Kidani, Eiji Hira, Kayo Takeda, Shunsuke Kuramoto, Kazuyuki Oka, Yoshihide Shimojo, Hiroaki Watanabe
INTRODUCTION: Mediastinal and subcutaneous emphysema usually result from spontaneous rupture of the alveolar wall. We present an extremely rare case of massive mediastinal, retroperitoneal, and subcutaneous emphysema due to the penetration of the colon into the mesentery. PRESENTATION OF CASE: A 57-year-old man presented to our institution with a history of chest pain. The patient's medical history included malignant rheumatoid arthritis during the use of steroids and an immunosuppressive agent...
February 10, 2019: International Journal of Surgery Case Reports
Michael S Lundin, Manohar R Chintu
No abstract text is available yet for this article.
February 13, 2019: BMJ Case Reports
Eric Ardolino, Susan S Wang, Vilas R Patwardhan
OBJECTIVES: There are few studies addressing the impact of cephalosporin and quinolone resistance on hospital length of stay and mortality in spontaneous bacterial peritonitis (SBP). We aim to describe the shifting epidemiology of SBP at our institution and its impact on clinical outcomes. METHODS: We performed a single-center retrospective cohort study of all cases of SBP from 2005 to 2015 at a transplant center. Cases were identified using hospital billing data...
February 14, 2019: Digestive Diseases and Sciences
Shan Li, Pengtao Gong, Nan Zhang, Xin Li, Lixin Tai, Xu Wang, Zhengtao Yang, Ju Yang, Xingquan Zhu, Xichen Zhang, Jianhua Li
Neospora caninum is an obligate intracellular apicomplexan parasite, the etiologic agent of neosporosis, and a major cause of reproductive loss in cattle. There is still a lack of effective prevention and treatment measures. The 14-3-3 protein is a widely expressed acidic protein that spontaneously forms dimers within apicomplexan parasites. This protein has been isolated and sequenced in many parasites; however, there are few reports about the N. caninum 14-3-3 protein. Here, we successfully expressed and purified a recombinant fusion protein of Nc14-3-3 (rNc14-3-3) and prepared a polyclonal antibody...
2019: Frontiers in Microbiology
Hirotaka Miyashita, Koh Okamoto, Tatsuya Kobayashi, Yoshitaka Wakabayashi, Satoshi Kitaura, Kazuhiko Ikeuchi, Kazunaga Ishigaki, Yosuke Nakai, Shu Okugawa, Kazuhiko Koike, Kyoji Moriya
Bacterial peritonitis, an infection of the ascitic fluid, can be classified etiologically as spontaneous or secondary bacterial peritonitis. The former is mainly caused by portal hypertension and its subsequent effects, whereas the latter is caused by the direct dissemination of bacteria into the peritoneal cavity. Previous reports have described some distinguishing features of these two entities. Here, we report the first known case of bacterial peritonitis with Aeromonas hydrophilia and Escherichia coli in a patient with malignant ascites associated with pancreatic carcinoma who exhibited features of both spontaneous and secondary peritonitis...
February 6, 2019: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Kenta Yamamoto, Masatoshi Ishigami, Takashi Honda, Tomoaki Takeyama, Takanori Ito, Yoji Ishizu, Teiji Kuzuya, Kazuhiko Hayashi, Hidemi Goto, Yoshiki Hirooka
BACKGROUND: Current knowledge suggests that proton pump inhibitors (PPIs) are associated with an increased risk of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). These conditions and PPI use are related to gut microbiota. The aim of this study is to research the changes in gut microbiota caused by PPI in patients with chronic liver disease. METHODS: From 198 Japanese patients, 31 patients in the PPI and non-PPI groups were matched using propensity score matching (PSM) based on age, sex, and Child-Turcotte-Pugh class...
February 8, 2019: Hepatology International
Brian Chinnock, Robert E Woolard, Gregory W Hendey, Scott Crawford, Leann Mainis, Daniel Vo, Radosveta N Wells, René Ramirez, Deena I Bengiamin
STUDY OBJECTIVE: To determine the sensitivity of a highly sensitive bedside leukocyte esterase reagent strip (RS) for detection of spontaneous bacterial peritonitis (SBP) in emergency department (ED) ascites patients undergoing paracentesis. METHODS: We conducted a prospective, observational cohort study of ED ascites patients undergoing paracentesis at two academic facilities. Two practitioners, blinded to each other's results, did a bedside RS analysis of the peritoneal fluid in each patient and documented the RS reading at 3-min according to manufacturer-specified colorimetric strip reading as either "negative", "trace", "small", or "large"...
January 25, 2019: American Journal of Emergency Medicine
Toshiaki Komo, Toshihiko Kohashi, Yoshirou Aoki, Jun Hihara, Koichi Oishi, Noriaki Tokumoto, Mikihiro Kanou, Akira Nakashima, Manabu Shimomura, Masashi Miguchi, Hidenori Mukaida, Naoki Hirabayashi
INTRODUCTION: Perforating appendicitis and abscess-forming appendicitis may cause septic disseminated intravascular coagulation (DIC). However, non-perforating acute appendicitis with septic DIC is extremely rare. PRESENTATION OF CASE: A 67-year-old man was referred to our hospital one day after starting oral antibiotic treatment for acute appendicitis. Physical examination revealed only slight spontaneous abdominal pain without tenderness and peritoneal irritation...
January 29, 2019: International Journal of Surgery Case Reports
Monkez Moteih Yousif, Ayman Magd Eldin Mohammad Sadek, Hesham Ahmad Farrag, Fayrouz Othman Selim, Emad Fawzi Hamed, Rasha Ibrahim Salama
The influence of vitamin D, 25-hydroxyvitamin D (25(OH)D), deficiency on hepatitis C virus (HCV)-related cirrhosis had been poorly elucidated especially in patients with hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). We aimed to investigate the association between vitamin D deficiency and the risk of SBP or HE, including the mortality rate. Serum 25(OH)D levels were prospectively determined in 135 patients. Of them, 45 patients had complications with HE and 45 patients had complications with SBP; 45 cirrhotic patients without complication served as the control group...
January 31, 2019: Internal and Emergency Medicine
Tomoki Sempokuya, Guangxiang Zhang, Kazuma Nakagawa
BACKGROUND: Chronic liver disease and cirrhosis is the 12th leading cause of death in the United States. Patients with decompensated-cirrhosis, especially with hepatic encephalopathy/coma (HC), have a higher rate of early readmission and contribute to higher healthcare cost. AIM: To evaluate the national inpatient trends of discharges, mortalities and financial impacts associated with four common conditions of cirrhosis. METHODS: The publicly available Healthcare Cost and Utilization Project National Inpatient Sample database was utilized to examine the temporal trends of total number of discharges, mortalities and inpatient costs related to hospitalization with a primary diagnosis of HC, transjugular intrahepatic portosystemic shunt (TIPS), esophageal varices with bleeding (EV) and spontaneous bacterial peritonitis (SBP) from 2005 to 2014...
January 27, 2019: World Journal of Hepatology
Matthias Christian Reichert, Cristina Ripoll, Markus Casper, Robin Greinert, Edith Vandieken, Frank Grünhage, Beate Appenrodt, Alexander Zipprich, Frank Lammert
OBJECTIVES: Common nucleotide-binding oligomerization domain containing 2 (NOD2) gene variants have been associated with bacterial infections (BIs) in cirrhosis, in particular, spontaneous bacterial peritonitis, and mortality. Our aim was to evaluate the independent association of NOD2 variants with BI according to the decompensation stage. METHODS: Consecutive patients with cirrhosis in 2 academic medical centers were included and genotyped for the NOD2 variants p...
January 2019: Clinical and Translational Gastroenterology
Suvi Härmälä, Constantinos Parisinos, Jennifer Ryan, Alastair O'Brien
INTRODUCTION: Use of albumin therapy is recommended for management of disease complications in cirrhosis. The effectiveness of albumin to prevent specific disease complications and death, however, is less clear. METHODS AND ANALYSIS: We will search Medline (Ovid), Embase (Ovid), Cochrane Hepato-Biliary Controlled Trials Register and Cochrane Central Register of Controlled Trials for published reports on randomised controlled trials and observational studies on the effectiveness of intravenous albumin therapy to prevent spontaneous bacterial peritonitis, renal dysfunction and death in cirrhotic patients...
January 29, 2019: BMJ Open
Ahmed Abdel-Razik, Nasser Mousa, Mahmoud Abdel-Aziz, Walid Elsherbiny, Sahar Zakaria, Walaa Shabana, Sally Abed, Rania Elhelaly, Rasha Elzehery, Waleed Eldars, Mahmoud El-Bendary
BACKGROUND AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a common bacterial infection with life-threatening sequelae in cirrhotic ascites. The purpose of this retrospective cohort study was to recognize the predictors of SBP to build up a noninvasive system to exclude or establish an episode of SBP. PATIENTS AND METHODS: Of 1194 consecutive patients with cirrhotic ascites, only 966 patients were enrolled in this study. SBP was diagnosed once polymorphonuclear count was at least 250 cells/mm and/or there was a positive ascitic fluid culture result...
January 28, 2019: European Journal of Gastroenterology & Hepatology
Jasmohan S Bajaj, Puneeta Tandon, Jacqueline G OʼLeary, Florence Wong, Scott W Biggins, Guadalupe Garcia-Tsao, Patrick S Kamath, Benedict Maliakkal, Michael B Fallon, Jennifer C Lai, Paul J Thuluvath, Hugo E Vargas, Ram M Subramanian, Leroy R Thacker, K Rajender Reddy
OBJECTIVES: Antibiotic prophylaxis is recommended for prevention of the first episode of spontaneous bacterial peritonitis (SBP; primary prophylaxis 1°) and subsequent episodes (secondary prophylaxis 2°). We aimed to compare outcomes in cirrhotic inpatients on 1° vs 2° SBP prophylaxis. METHODS: Data from North American Consortium for the Study of End-Stage Liver Disease were evaluated for cirrhosis details, reasons for admission/medications, inpatient course recorded, and outcomes over 90 days...
January 23, 2019: American Journal of Gastroenterology
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