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Cancer Biomarkers
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
Using similar data to that for the diagnostic GALAD model, the BALAD model for progression of HCC for patients diagnosed with HCC was developed. Progression of HCC is mainly based on CT and MRI imaging, using the number and size of tumours and if there is portal vein invasion, together with a staging measure such as the Child-Pugh score. The Child-Pugh score is a measure of liver function, using the amounts of bilirubin and albumin in the blood, prothrombin time (how quickly the blood clots), ascites (is there is fluid in the abdomen) and encephalopathy (is the brain being affected).
Perioperative Medicine
Published in Elizabeth Combeer, The Final FRCA Short Answer Questions, 2019
This question proved the most discriminatory question of the paper. Many candidates showed poor general knowledge of liver disease. Weak candidates were unable to associate the effects of chronic liver disease with the consequences for anaesthesia, which raises concerns for safe practice. Few understood how the Child–Pugh score allowed stratification of risk.
A Regulatory View on Dose-Finding Studies and on the Value of Dose–Exposure–Response Analysis
Published in John O’Quigley, Alexia Iasonos, Björn Bornkamp, Handbook of Methods for Designing, Monitoring, and Analyzing Dose-Finding Trials, 2017
Sofia Friberg Hietala, Efthymios Manolis, Flora Musuamba Tshinanu
The assessment of impact of liver disease on PK is complicated by the range of symptoms and metrics associated with these conditions. The most commonly used clinical criteria describing liver impairment, the Child–Pugh score, are not necessarily correlated to drug elimination capacity. However, some components of the Child–Pugh score, like serum albumin, prothrombin time, and bilirubin, may be better predictors of drug clearance, and the use of such markers is encouraged.
Clinical value of hemodynamic changes in diagnosis of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
Published in Scandinavian Journal of Gastroenterology, 2022
Wanyan Li, Yayang Duan, Zhike Liu, Xiaofeng Lu, Jingwen She, Jing Qing, Chaoxue Zhang
Patients who underwent TIPS interventional treatment of cirrhotic portal hypertension in The First Affiliated Hospital of Anhui Medical University from January 2018 to January 2021 were studied. A total of 73 patients met the selection criteria. Among them, 51 patients who did not develop HE within 3 months after the operation comprised the control group (9 males and 12 females aged 29–75 with an average age of 56.06 ± 11.49); 22 patients who developed HE within 3 months after the operation comprised the observation group (16 males and 6 females aged 41–74 with an average age of 59.05 ± 11.64). All patients underwent blood routine, liver and kidney function, blood ammonia and routine color Doppler ultrasound tests before TIPS operation, as well as within 24 h and 3 months after the operation. These tests would be stopped when the 3-month follow-up ended, or patients developed HE within the follow-up. The HE was scored with the Delirium Rating Scale. The Child–Pugh score is a comprehensive scoring system based on serum bilirubin, albumin, prothrombin time, degree of ascites and HE. A Child–Pugh score of 5–6 is considered as grade A, 7–9 is grade B, and 10–15 is grade C.
A Danish population-based case series of patients with liver cirrhosis and coronavirus disease 2019
Published in Scandinavian Journal of Gastroenterology, 2021
Mohamed Attauabi, Johan Burisch, Flemming Bendtsen, Nina Kimer
Accordingly, our finding regarding a higher COVID-19 related mortality compared to the background population is in line with the current literature regarding COVID-19 and also other respiratory infections [8,9,16,17]. Although our study design precludes us from comparing mortality rates among patients with and without liver cirrhosis, two large multicenter studies reported significantly increased risk of mortality among patients with liver cirrhosis compared to patients without liver diseases [18,19]. Our study indirectly supports these alarming results as we found higherMELD and CLIF-C scores, as well as higherALAT values among patients who died of COVID-19 than in those who survived. This association has been suggested in a recent publication [9]. Although we did not find CCI to be a predictor of mortality as suggested in other publications [8], our results support that co-occurring diabetes, COPD, CKD, and bacterial infectionsincreases the risk of COVID-19 related mortality. In addition, the Child-Pugh Score has also been shown to predict mortality, but this was not confirmed in this study [7].
Improvement of human platelet aggregation post-splenectomy with paraesophagogastric devascularization in chronic hepatitis B patients with cirrhotic hypersplenism
Published in Platelets, 2020
Hui Zhang, Shaoying Zhang, Jian Zhang, Rui Zhou, Yongzhan Nie, Song Ren, Jun Li, Keping Feng, Fanpu Ji, Guangyao Kong, Zongfang Li
Cirrhotic patients can be classified according to Child-Pugh score, as grade A (5 or 6), B (7–9) or C (10–15). This scoring system was first proposed by Child and Turcotte, and later modified by Pugh et al [18]. The main parameters of the now aptly named Child–Pugh score include the features of hepatic encephalopathy, ascites, prothrombin time (seconds prolonged) or international normalized ratio, and concentrations of serum total bilirubin and albumin. It has been widely used to assess the severity of liver dysfunction in clinical work [18–20]. Splenomegaly and hypersplenism are common in cirrhotic patients. However, the severity of hypersplenism is not directly related to the size of the spleen nor the severity of the PH. Splenectomy is very effective in resolving hypersplenism and has been the standard approach for treatment [6,21]. A more obvious increase in PLT counts can be expected after the splenectomy in cases of severe thrombocytopenia, due to the larger spleen size (indicative of more PLTs stored) and higher phagocytic capacity of splenic macrophages (since peripheral PLT destruction is a major cause of thrombocytopenia) [22].