Search results for "Liver cirrhosis"
showing 10 items of 598 documents
Non invasive tools for the diagnosis of liver cirrhosis
2014
Liver cirrhosis (LC), the end stage of many forms of chronic hepatitis of different etiologies is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules surrounded by annular fibrosis. This chronic progressive clinical condition, leads to liver cell failure and portal hypertension, which can favour the onset of hepatocellular carcinoma. Defining the phase of the natural history is crucial for therapeutic choice and prognosis. Liver biopsy is currently considered the best available standard of reference but it has some limits, so alternative tools have been developed to substitute liver biopsy when assessing liver fibros…
Spontaneous rupture of umbilical hernia in end stage liver disease patient: injection of fibrin glue as a temporary solution.
2021
Background. Umbilical hernia is a common disease, which occurs in 20% of cirrhotic patients in the presence of persistent ascites. A rare but dangerous complication of this disease in end stage liver patient is a spontaneous rupture of umbilical hernia with ascitic fluid leaking. Up to date there is no general consensus on its most appropriate treatment. Case report. A 60 years-old male patient, with Child Pugh C and Meld score of 18 end stage liver disease, came to our observation for a spontaneous minimal rupture of his long lasting 5 cm umbilical hernia with ascitic fluid leaking. A medical therapy was undertaken aiming to manage the ascites and a temporary conservative therapy, with fib…
Management of infections in cirrhotic patients: Report of a Consensus Conference
2014
a b s t r a c t The statements produced by the consensus conference on infection in end-stage liver disease promoted by the Italian Association for the Study of the Liver, are here reported. The topics of epidemiology, risk factors, diagnosis, prophylaxis, and treatment of infections in patient with compensated and decompensated liver cirrhosis were reviewed by a scientific board of experts who proposed 26 statements that were graded according to level of evidence and strength of recommen- dation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. By systematic literature search of available evidence, comparison and discussion of e…
Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid.
2015
Gadoxetic acid improves detection and characterization of focal liver lesions in cirrhotic patients and can estimate liver function in patients undergoing liver resection. The purpose of this article is to describe the optimal gadoxetic acid study protocol for the liver, the unique characteristics of gadoxetic acid, the differences between gadoxetic acid and extra-cellular gadolium chelates, and the differences in phases of enhancement between cirrhotic and normal liver using gadoxetic acid. We also discuss how to obtain and recognize an adequate hepatobiliary phase.
MR-imaging features of hepatocellular carcinoma capsule appearance in cirrhotic liver: comparison of gadoxetic acid and gadobenate dimeglumine.
2016
Purpose: The purpose of the study is to compare the MR-imaging features of hepatocellular carcinoma (HCC) capsule appearance on gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, using imaging-based presumptive diagnosis of HCC as the reference standard. Methods: Gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging of 51 patients with 71 HCCs were retrospectively reviewed. Three readers graded in consensus, using a five-point scale, the presence (score 4–5) of capsule appearance on images obtained during T1-weighted GRE portal venous phase (PVP), 3-min phase, and hepatobiliary phase (HBP). The Fisher's exact test and the t student unpaired test were performed. Results: …
Hepatic enhancement in cirrhosis in the portal venous phase: what are the differences between gadoxetate disodium and gadobenate dimeglumine?
2020
Purpose: To compare the level of parenchymal and portal venous enhancement in the portal venous phase (PVP) in cirrhotic patients undergoing gadoxetate disodium- and gadobenate dimeglumine-enhanced MRI. Methods: In this retrospective study, 84 cirrhotic patients (mean age ± SD: 66 ± 13 years) who underwent contrast-enhanced MRI with both gadoxetate disodium and gadobenate dimeglumine between 2012 and 2018 were included. Two readers measured signal intensities of hepatic parenchyma, portal vein and psoas muscle on precontrast and PVP. Relative enhancement (RE), image contrast, and portal vein-to-liver contrast difference were calculated. Intraindividual differences were compared with the Wil…
TGF-beta1 in liver fibrosis: an inducible transgenic mouse model to study liver fibrogenesis.
1999
Transforming growth factor-beta1 (TGF-beta1) is a powerful stimulus for collagen formation in vitro. To determine the in vivo effects of TGF-beta1 on liver fibrogenesis, we generated transgenic mice overexpressing a fusion gene [C-reactive protein (CRP)/TGF-beta1] consisting of the cDNA coding for an activated form of TGF-beta1 under the control of the regulatory elements of the inducible human CRP gene promoter. Two transgenic lines were generated with liver-specific overexpression of mature TGF-beta1. After induction of the acute phase response (15 h) with lipopolysaccharide (100 microgram ip), plasma TGF-beta1 levels reached600 ng/ml in transgenic animals, which is100 times above normal …
Spontaneous hepatic fibrosis in transgenic mice overexpressing PDGF-A.
2008
Platelet derived growth factor (PDGF) plays a central role in repair mechanisms after acute and chronic tissue damage. To further evaluate the role of PDGF-A in liver fibrogenesis in vivo, we generated transgenic mice with hepatocyte-specific overexpression of PDGF-A using the CRP-gene promoter. Transgenic but not wildtype mice showed expression of PDGF-A mRNA in the liver. Hepatic PDGF-A overexpression was accompanied by a significant increase in hepatic procollagen III mRNA expression as well as TGF-beta1 expression. Liver histology showed increased deposition of extracellular matrix in transgenic but not in wildtype mice. PDGF-A-transgenic mice showed positive sinusoidal staining for alp…
Sex difference in the interaction of alcohol intake, hepatitis B virus, and hepatitis C virus on the risk of cirrhosis
2017
Background The joint effect of the interaction of alcohol intake, hepatitis B virus (HBV) and hepatitis C virus (HCV) on the risk of cirrhosis is still unexplored because a large sample size is required for this investigation. Objective Evaluation of interaction of HBV, HCV and alcohol abuse on the risk of cirrhosis. Design We analysed 12,262 consecutive patients with chronic liver disease of various aetiologies referring to 95 Italian liver units in 2001 or 2014. To evaluate the interaction between alcohol abuse, HBV infection, and HCV infection, patients unexposed to either factors were used as reference category. Adjustment for BMI and age was done by multiple logistic regression analysi…
Patient outcomes in two steroid-free regimens using tacrolimus monotherapy after daclizumab induction and tacrolimus with mycophenolate mofetil in li…
2008
Introduction. Long-term steroid administration may predispose liver transplant recipients to infectious and metabolic complication. Maintaining effective immunoprophylaxis while minimizing the negative consequences of steroid therapy could be a key factor in improving clinical outcomes.Methods. Six hundred two patients were randomized to receive tacrolimus (TAC) immunosuppression with a single-steroid bolus and two doses of daclizumab (DAC) or mycophenolate mofetil (MMF).Results. The incidence of biopsy-proven acute rejection was 19.7% in the TAC/DAC group and 16.2% in the TAC/ MMF group (ns). Three-month patient and graft survival were similar. Steroid use at month-3 was low at 5.5% in the…