European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Dec 2014
Multicenter StudyAssociation of markers of bacterial translocation with immune activation in decompensated cirrhosis.
Bacterial translocation (BT) may cause infections, in particular, spontaneous bacterial peritonitis (SBP). In the absence of overt infection, BT may further stimulate the immune system and contribute to haemodynamic alterations and complications. Bacterial DNA (bDNA) is claimed to be a promising surrogate marker for BT, although its clinical relevance has been questioned. ⋯ bDNA as assessed by this PCR method was largely unrelated to markers of inflammation and does not seem to be of clinical value in the diagnosis of SBP. According to our results, bDNA is not a reliable marker of BT.
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Eur J Gastroenterol Hepatol · Dec 2014
Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients.
Hepatitis B virus infection is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. Liver biopsy is the gold-standard method to assess the severity of liver fibrosis, but the invasive nature of this method limits its usage. Currently, noninvasive parameters are utilized to estimate liver histology. In the present study, we aimed to investigate the relationship between the severity of fibrosis and red blood cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), and MPV and red blood cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis B (CHB). ⋯ MPV and RDW values are significantly higher in hepatitis B virus-infected patients, associated with severity, and can be defined as independent predicting factors in hepatic fibrosis. Further studies are required to determine the associations between MPV and the severity of fibrosis in hepatitis B patients.
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Eur J Gastroenterol Hepatol · Nov 2014
Frequency, pattern and short-term outcome of chronic renal dysfunction in patients with cirrhosis: a prospective study using HRS and ADQI-IAC criteria.
Diagnostic criteria of hepatorenal syndrome type 2 (HRS2) fail to detect milder degrees of chronic renal dysfunction (CRD) in cirrhosis and exclude patients with pre-existing kidney disease. Definitions addressing this have been proposed by Working Party of the Acute Dialysis Quality Initiative and International Ascites Club (ADQI-IAC). ⋯ Compared with HRS2 criteria, eGFR less than 60 ml/min/1.73 m detected almost twice the number of cirrhotics with CRD. Patients with eGFR less than 60 ml/min/1.73 m who did not fulfil criteria for HRS2 also had significant short-term mortality. ADQI-IAC criteria thus appear to be a more useful definition of CRD in cirrhotics.
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Eur J Gastroenterol Hepatol · Oct 2014
Multicenter Study Observational StudyHigher free serum cortisol is associated with worse survival in acute variceal bleeding because of cirrhosis: a prospective study.
Critical illness-related corticosteroid insufficiency has been reported in acute variceal bleeding (AVB). In cirrhosis, free serum cortisol (FC) is considered optimal to assess adrenal function. Salivary cortisol (SC) is considered a surrogate for FC. We evaluated FC and its prognostic role in AVB. ⋯ Higher FC is present in cirrhosis with AVB compared with CC and is associated independently with bleeding-related mortality. However, whether high FC solely indicates the severity of illness or whether there is significant adrenal insufficiency cannot be discerned.
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Eur J Gastroenterol Hepatol · Oct 2014
High prevalence of hepatitis markers in immigrant populations: a prospective screening approach in a real-world setting.
Immigrant populations are believed to be more frequently infected with hepatitis viruses. However, limited unbiased data are available on immigrants outside of academic centres. Therefore, the aim of this study was to perform large-scale screening for hepatitis markers in primary care centres treating mainly individuals with a migrational background in Germany. ⋯ Hepatitis virus infections are indeed significantly more prevalent in immigrant populations as compared with the general German population. These data underline the importance of introducing screening programs in this particular risk group.