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Liver Disease—Alcoholic Hepatitis/Cirrhosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Complications of cirrhosis include portal hypertension (due to increased resistance to blood flow with rupture of esophageal varices), encephalopathy, hepatorenal syndrome, and hepatopulmonary syndrome. Tobacco smoking and certain drugs may also contribute to cirrhosis.4
Gastroenterology
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
It can occur acutely (acute liver failure) or following progress to cirrhosis. A number of terms are used to define the timing of liver failure: fulminant hepatic failure (FHF) describes failure that occurs within 8 weeks of onset of the underlying illness. Subacute FHF occurs within 8–26 weeks and chronic decompensated hepatic failure occurs over a period ≥6 months. Cirrhosis occurs when the liver is replaced by fibrotic tissue and represents the final histological pathway for a number of liver diseases.
Medical Problems in Alcoholics
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Cirrhosis is suspected from the clinical history and the physical examination. Marked jaundice, a typical complication of cirrhosis, firm hepatomegaly, splenomegaly, or abdominal collaterals of the portal vein often make this diagnosis highly likely. It is confirmed by biopsy, confirmation of portal hypertension on endoscopy or sonography, or by the course of the disease. Cirrhosis progresses because it is present, but may progress even faster if new liver disease occurs from further drinking. Thus abstinence is an essential form of therapy for alcoholic cirrhosis.
Serum troponin is elevated in acute decompensation and acute-on-chronic liver failure and is associated with severity of liver disease and short-term mortality
Published in Scandinavian Journal of Gastroenterology, 2023
Iliana Mani, Theodoros Alexopoulos, Larisa Vasilieva, Alexandra Alexopoulou
A total of 296 consecutive patients with decompensated cirrhosis [69.3% male, median age 57 (IQR 51-68) years, MELD score 19 (13-25)] were included. Cause of cirrhosis was alcoholic liver disease in 54.4%, chronic viral hepatitis in 20.6% and miscellaneous in 25.0%. ACLF, AD and DC were diagnosed in 29.4%, 48.3% and 22.3%, respectively. Hs-cTnI ≥ 4 ng/L was detected on admission in 66.2% of total patients. Hs-cTnI ≥ 4 ng/L was more prevalent in ACLF vs AD or DC groups without the difference reaching statistical significance. Moreover, patients with hs-cTnI ≥ 4 ng/L were older and had more severe liver disease (higher MELD score, INR and more prevalent hepatic encephalopathy) and higher creatinine compared to those with < 4 ng/L (Table 1). In addition, higher CLIF-C AD grades were illustrated in those with hs-cTnI ≥ 4 ng/L within AD group. There was no difference in gender, etiology and inflammation markers (CRP and neutrophil-to-lymphocyte ratio) between patients with hs-cTnI ≥ 4 and those with hs-cTnI < 4 ng/L.
Bone disease in patients with cirrhosis of different etiology and severity; are Klotho protein and osteoprotegerin potential biomarkers?
Published in Scandinavian Journal of Gastroenterology, 2023
Panagiotis V. Katsaounis, Emilia S. Hadjiyannis, Teressa Skaltsi, Vassiliki A. Anargyrou, Alexandra A. Alexopoulou, Spyridon P. Dourakis, John S. Koskinas
Seventy-four consecutive patients diagnosed with liver cirrhosis, attended the outpatient Liver Clinic of the Academic Department of Medicine in Hippocration General Hospital of Athens, were enrolled in this study. In all patients, the diagnosis of cirrhosis has been confirmed either by liver biopsy examination or compatible clinical and/or imaging characteristics on ultrasonography or CT scan. Patients who have been treated with glucocorticoids for more than 3 months or had been on treatment with calcium supplements, vitamin D, bisphosphonates or other drugs for osteoporosis were excluded from the study. A complete medical history and demographics of the patients were recorded. Data from 25 healthy volunteers was collected as controls, after matching for age, gender and body mass index.
EncephalApp stroop test versus electronic number connection test-A for screening minimal hepatic encephalopathy in patients with liver cirrhosis: a comparative study
Published in Scandinavian Journal of Gastroenterology, 2022
Ming Luo, Fang-Rui Hu, Peng-Da Wang, Li Yao, Sheng-Juan Hu, Fei-Hu Bai
According to the inclusion and exclusion criteria, 25 cirrhotic patients were excluded and 95 cirrhotic patients were eventually included in this study (Supplementary Figure 3). As shown in Supplementary Table 1, 61 (64%) of included patients were male, with a median age of 52 years (range 25–68 years) and a median education time of 9 years (range 6–20 years). The aetiology of liver cirrhosis in all included patients was hepatitis B virus infection. The median duration since the diagnosis of liver cirrhosis was 3 years (range 1–6 years), and 75 (79%) included patients who had a history of previous hospitalization. Seventy-eight (82%), 14 (15%) and 3 (3%) included patients were classified as CTP grade A, B and C, respectively. Eighty (84%) included patients had been treated with nucleoside analogues including tenofovir and entecavir, and the serum HBV-DNA of 64 (67%) patients was positive. Eighty-eight (93%) included patients had experience in using smartphone, computer or tablet computer. Laboratory values of plasma ammonia, serum sodium, haemoglobin, creatinine and C reactive protein were shown in Supplementary Table 1.