International Journal of Hepatology最新文献

{"title":"Hepatitis C Seroconversion Remains High among Patients with Regular Hemodialysis: Study of Associated Risk Factors.","authors":"Ni Wayan Wina Dharmesti, I Dewa Nyoman Wibawa, Yenny Kandarini","doi":"10.1155/2022/8109977","DOIUrl":"10.1155/2022/8109977","url":null,"abstract":"<p><strong>Methods: </strong>An analytical cross-sectional study involving patients from 2 dialysis units (1 referral hospital and 1 private dialysis unit) in Denpasar, Bali, Indonesia, from January 2020 to December 2021. We evaluated age, gender, duration of hemodialysis, vascular access, history of transfusion, history of surgery, diabetes mellitus, hepatitis B, human immunodeficiency virus (HIV) infection, and type of dialyzer as possible risk factors of hepatitis C seroconversion among hemodialysis patients.</p><p><strong>Results: </strong>A total of 338 hemodialysis patients were enrolled in this study. We found hepatitis C seroconversion in 94 patients (27.8%), all of which occurred after regular dialysis was started. Vascular access type (OR 42.07, 95% CI 5.757-307.472) and dialyzer reuse (OR 8.324, 95% CI 4.319-16.044) were showing a statistically significant association with hepatitis C seroconversion. A separate analysis on each dialysis unit found common evidence that the duration of dialysis was significantly associated with hepatitis C infection among hemodialysis patients.</p><p><strong>Conclusion: </strong>Hepatitis C seroconversion among dialysis patients remains high. Factors related to the dialysis procedure itself played a major role in transmitting the virus.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2022 ","pages":"8109977"},"PeriodicalIF":1.5,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, Practices, and Associated Factor towards Hepatitis B Virus Infection among Health Care Professionals at Tibebe Ghion Specialized Hospital, Bahir Dar, Northwest Ethiopia, 2021: A Cross Sectional Study","authors":"Debaka Belete, Dagnaneh Wondale, Teklehaimanot Kiros, Biruk Demissie","doi":"10.1155/2022/3726423","DOIUrl":"https://doi.org/10.1155/2022/3726423","url":null,"abstract":"Background Hepatitis B virus (HBV) infection is the major infectious hazard for health care personnel. The global prevalence of HBV infection is highly heterogeneous, and the highest prevalence (6.2 and 6.1%) is among the World Health Organization Western Pacific and World Health Organization African regions, respectively. The pooled prevalence of HBV in Ethiopia among health workers was accounted for 5%. The prevalence rate of HBV in health care workers is about 2–10 times higher than the general population in the world. There for, the main aim of this study was to assess the knowledge, attitude and practice, and associated factors towards hepatitis B virus (HBV) infection among health care professionals at Tibebe Ghion Specialized Hospital, Bahir Dar, Northwest Ethiopia, 2021. Method An institutional-based cross-sectional study design was at Tibebe Ghion Specialized Hospital, Bahir Dar, in 2021, and a systematic random sampling technique was used from different professionals, and the separate sample was taken independently from each. A pretested structured questionnaire was constructed and collects data then analyzed by using SPSS version 23. Result A total of 422 health care workers having different professions have participated in this study. 243 (57.6%) of the study subjects were males. The average correctly answered knowledge, attitude, and practice questions were 65.6%, 40.3%, and 34.8, respectively. Multivariable logistic regression analysis showed that being nurse professionals (AOR = 0.17 (0.07, 0.38), P < 0.001), midwives (AOR = 0.19 (0.07, 0.5), P = 0.001), and work experience (AOR = 2.37 (1.38, 4.02), P = 0.002) were associated with knowledge levels. Being degree holders (AOR = 2.49 (1.23, 5.02), P = 0.01) and specialists (AOR = 9.78 (2.69, 35.5), P = 0.001) were associated with attitude levels. Being medical laboratories (AOR = 17.42 (5.02, 60.5), P ≤ 0.001) and pharmacy professionals (AOR = 11.2 (4.02, 31.42), P ≤ 0.001) were associated with practice levels. Conclusion and Recommendation. Based on the current study, most of the health care professionals in this study area have poor knowledge, negative attitude, and malpractice towards HBV infection. Therefore, continual professional training programs on HBV infection include increased vaccination coverage rate and postexposure prophylaxis of heath care workers especially for highly exposed professionals.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"98 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82228215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Patients with Hepatocellular Carcinoma: A Single-Center 3-Year Experience from Somalia","authors":"M. Hassan-Kadle, M. M. Osman, E. Keleş, H. Eker, K. N. Baydili, Hussein Mahdi Ahmed, A. Osman","doi":"10.1155/2022/3370992","DOIUrl":"https://doi.org/10.1155/2022/3370992","url":null,"abstract":"Background To evaluate the relationship between prognosticators representing tumor aggressiveness and socio-demographic, laboratory, and imaging findings in patients with hepatocellular carcinoma (HCC). Methods We retrospectively searched patients with HCC between January 2017 and December 2019 in our tertiary referral hospital. The tumor-related factors and liver damage indicators and their relationship to indicate the value of prognosis were analyzed. Results A total of 268 HCC patients, with a male-to-female ratio of 2.8 : 1. The mean age was 52.6 years. The patient with portal vein thrombosis (PVT) was older, had higher liver laboratory parameters (AST, ALT, total bilirubin, and direct bilirubin), and had larger tumor size. Patients with the larger tumor size had a higher AFP level, had more tumor multifocality. The majority of patients were in Child's A (73.6%) and B (17.2%) classes. The laboratory parameters of HCC patients were increased in Child's C compared to other groups of Child-Pugh classification. Conclusions The presence of PVT and large-sized tumor in patients with HCC indicated a poorer prognosis than non-PVT group and small tumor sizes.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"20 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78685258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases","authors":"Wenkuan Li, J. Alamoudi, N. Gautam, Devendra Kumar, Macro Olivera, Y. Gwon, Sandeep Mukgerjee, Y. Alnouti","doi":"10.1155/2022/5473752","DOIUrl":"https://doi.org/10.1155/2022/5473752","url":null,"abstract":"Hepatobiliary diseases and their complications cause the accumulation of toxic bile acids (BA) in the liver, blood, and other tissues, which may exacerbate the underlying condition and lead to unfavorable prognosis. To develop and validate prognostic biomarkers for the prediction of complications of cholestatic liver disease based on urinary BA indices, liquid chromatography-tandem mass spectrometry was used to analyze urine samples from 257 patients with cholestatic liver diseases during a 7-year follow-up period. The urinary BA profile and non-BA parameters were monitored, and logistic regression models were used to predict the prognosis of hepatobiliary disease-related complications. Urinary BA indices were applied to quantify the composition, metabolism, hydrophilicity, and toxicity of the BA profile. We have developed and validated the bile-acid liver disease complication (BALDC) model based on BA indices using logistic regression model, to predict the prognosis of cholestatic liver disease complications including ascites. The mixed BA and non-BA model was the most accurate and provided higher area under the receiver operating characteristic (ROC) and smaller akaike information criterion (AIC) values compared to both non-BA and MELD (models for end stage liver disease) models. Therefore, the mixed BA and non-BA model could be used to predict the development of ascites in patients diagnosed with liver disease at early stages of intervention. This will help physicians to make a better decision when treating hepatobiliary disease-related ascites.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"3 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79119405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Clinical Characteristics and Outcomes of Liver Diseases Unique to Pregnancy at a Tertiary Hospital in Ethiopia: A Retrospective Cohort Study.","authors":"Sintayehu Mekonnen,&nbsp;Henok Fisseha,&nbsp;Tewodros Getinet","doi":"10.1155/2022/9894407","DOIUrl":"https://doi.org/10.1155/2022/9894407","url":null,"abstract":"Background Liver disease is a rare complication of pregnancy that can lead to several consequences and require specific intervention with implications for both the mother and fetus. This study is aimed at assessing the clinical profile and associated complications of liver diseases unique to pregnancy at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methodology. This study is a retrospective cohort study of all identified cases admitted to the obstetrics ward and intensive care unit (ICU) from January 2018 to December 2020 at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Medical records were reviewed for clinical features, biochemical profiles, and fetomaternal complications. Data were analyzed using SPSS version 26. A chi-square test was done to look for an association with a p value less than 0.05 considered statistically significant, and an odds ratio was determined to assess the effect size. Results From 95 cases identified, preeclampsia/eclampsia with liver dysfunction accounted for 43 (45%), followed by hemolysis elevated liver enzyme and low platelet (HELLP syndrome) 35 (36.8%), hyperemesis gravidarum with liver dysfunction 9 (9.5%), acute fatty liver of pregnancy (AFLP) 7 (7.4%), and intrahepatic cholestasis of pregnancy 1 (1.1%). When compared to HELLP syndrome, AFLP showed significantly higher median (IQR) values (p < 0.05) for total bilirubin 13.3 (7.3-16.3), direct bilirubin 9.73 (6.87-11.9) mg/dL, prothrombin time 23 (20.4-25.7) seconds, international normalization ratio 2.2 (1.9-2.4), white blood count 23.8 (17.8-26.6)∗103/μL, creatinine 3.5 (2.44-5.6) mg/dL, and lower hemoglobin level of 7.9 (6.2-10) g/dL. There were 4 (4.2%) maternal hospital deaths, with a case fatality rate of HELLP syndrome being 8.6% and 14.3% in AFLP. The overall hospital fetal mortality was 33 (34.7%). In this study, 42 patients with HELLP syndrome and AFLP had an increased risk of maternal ICU admission (OR = 25.5, 95% CI: 5.48-118.6, p value = 0.001), acute kidney injury requiring dialysis (OR = 12.2, 95% CI: 1.46-102.2, p value = 0.009), placental abruption (OR = 14.2, 95% CI: 1.72-117.1, p value = 0.004), and stillbirth (OR = 7.2, 95% CI: 2.38-21.7, p value = 0.001). Conclusion Preeclampsia with liver dysfunction and HELLP syndrome accounted for the majority of cases. It also demonstrated key biochemical characteristics that can be used to distinguish between HELLP syndrome and AFLP. Emphasis has to be given to the risk of requiring maternal ICU admission, dialysis, abruption of the placenta, and stillbirths while managing patients diagnosed with HELLP syndrome and AFLP.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2022 ","pages":"9894407"},"PeriodicalIF":1.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9792252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD).","authors":"Harshavardhan Rao B,&nbsp;Priya Nair,&nbsp;Anoop K Koshy,&nbsp;S Krishnapriya,&nbsp;C R Greeshma,&nbsp;Rama P Venu","doi":"10.1155/2021/1795851","DOIUrl":"https://doi.org/10.1155/2021/1795851","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation.</p><p><strong>Methods: </strong>This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up.</p><p><strong>Results: </strong>A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation (27.5 ± 15 mg/dL vs. 43.5 ± 13.9 mg/dL; <i>p</i> value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C (OR = 6.072; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation.</p><p><strong>Conclusions: </strong>HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"1795851"},"PeriodicalIF":1.8,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39781583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic Dysfunction Is a Predictor of Poor Survival in Patients with Decompensated Cirrhosis.","authors":"Manas Kumar Behera,&nbsp;Surendra Nath Swain,&nbsp;Manoj Kumar Sahu,&nbsp;Gaurav Kumar Behera,&nbsp;Debakanta Mishra,&nbsp;Jimmy Narayan,&nbsp;Ayaskant Singh,&nbsp;Shobhit Agarwal,&nbsp;Pradeep Kumar Mallick","doi":"10.1155/2021/5592376","DOIUrl":"https://doi.org/10.1155/2021/5592376","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular diastolic dysfunction (LVDD) appears to be the earliest cardiac disturbance in cirrhosis patients. There are many previous reports reporting the significance of severity of LVDD on the outcome of liver transplantation or TIPS insertion, a few Indian studies have addressed the role of LVDD on survival in decompensated cirrhosis. The objective of this study is to assess the effect of LVDD on the survival of decompensated cirrhotic patients.</p><p><strong>Methods: </strong>We prospectively evaluated 92 decompensated cirrhotic patients from April 2015 to March 2017 at IMS and SUM Hospital, Bhubaneswar, India. 2D echocardiography with tissue Doppler imaging was used to evaluate cardiac function, as per the American society of echocardiography guidelines. The primary endpoint was to evaluate the effect of LVDD on overall mortality.</p><p><strong>Results: </strong>Ninety-two decompensated cirrhotic patients were evaluated in this prospective cohort study. Twenty-eight out of 92 patients (30%) died due to liver-related complications after a follow-up of 24 months. The decompensated cirrhotic patients with MELD score ≥ 15 had a significantly higher <i>E</i>/<i>e</i>' ratio (11.94 ± 4.24 vs. 8.74 ± 3.32, <i>p</i> < 0.001) suggesting severe LV dysfunction in advanced cirrhosis. Patients with <i>E</i>/<i>e</i>' ratio > 10 had significantly higher MELD score and Child-Pugh score (19.88 ± 7.72 vs. 14.31 ± 5.83; 10.25 ± 1.74 vs. 9.02 ± 1.74, <i>p</i> < 0.01, respectively) as compared to the<i>E</i>/<i>e</i>' ratio < 10 group. In Cox proportional hazard multivariate analysis, <i>E</i>/<i>e</i>' ≥ 10 (HR 2.72, 95% CI 1.07-6.9, <i>p</i> = 0.03) and serum albumin (HR 0.32, 95% CI 0.14-0.7, <i>p</i> < 0.01) were found to be independent predictors of mortality in decompensated cirrhotic patients.</p><p><strong>Conclusion: </strong>: The presence of LVDD and low serum albumin were independent predictors of mortality in decompensated cirrhotic patients. Hence, LVDD is an indicator of advanced cirrhosis and mortality.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"5592376"},"PeriodicalIF":1.8,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39719711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplementation with Branched-Chain Amino Acids Induces Unexpected Deleterious Effects on Astrocyte Survival and Intracellular Metabolism with or without Hyperammonemia: A Preliminary In Vitro Study.","authors":"Ting Wang, Kazuyuki Suzuki, Toshimi Chiba, Keisuke Kakisaka, Yasuhiro Takikawa","doi":"10.1155/2021/7615126","DOIUrl":"10.1155/2021/7615126","url":null,"abstract":"<p><strong>Introduction: </strong>Ammonia is a key component in the pathogenesis of hepatic encephalopathy. Branched-chain amino acids (BCAA) have been reported to improve the symptoms of HE induced by hyperammonemia; however, we recently reported that ammonia increases intracellular levels of BCAA and exerts toxic effects on astrocytes.</p><p><strong>Objectives: </strong>This follow-up study was designed to confirm the direct effects of BCAA on human astrocytes and clarify their underlying mechanisms using metabolome analysis and evaluation of associated signaling.</p><p><strong>Methods: </strong>We performed cytotoxicity and cell proliferation tests on astrocytes following BCAA treatment with and without ammonium chloride (NH₄Cl) and then compared the results with the effects of BCAA on hepatocytes and neurons. Subsequently, we used metabolomic analysis to investigate intracellular metabolite levels in astrocytes with and without BCAA treatment.</p><p><strong>Results: </strong>The astrocytes showed increased leakage of intracellular lactate dehydrogenase and reduced proliferation rate upon BCAA treatment. Interestingly, our analysis showed a BCAA-induced impairment of intracellular glycolysis/glyconeogenesis as well as amino acid and butyric acid metabolism. Furthermore, BCAA treatment was found to cause decreased levels of Glut-1 and phosphorylated GSK-3<i>β</i> and mTOR in astrocytes.</p><p><strong>Conclusions: </strong>Although further investigations of the effect of BCAA on human astrocytes with hyperammonemia are needed, our work demonstrates that BCAA supplementation has direct negative effects on astrocyte survival and intracellular metabolism.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"7615126"},"PeriodicalIF":1.5,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39572259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma.","authors":"Natwutpong Leeratanakachorn,&nbsp;Vor Luvira,&nbsp;Theerawee Tipwaratorn,&nbsp;Suapa Theeragul,&nbsp;Apiwat Jarearnrat,&nbsp;Attapol Titapun,&nbsp;Tharatip Srisuk,&nbsp;Supot Kamsa-Ard,&nbsp;Ake Pugkhem,&nbsp;Narong Khuntikeo,&nbsp;Chawalit Pairojkul,&nbsp;Vajarabhongsa Bhudhisawasdi","doi":"10.1155/2021/1625717","DOIUrl":"https://doi.org/10.1155/2021/1625717","url":null,"abstract":"<p><strong>Background: </strong>Major hepatectomy is the mainstay of the treatment for cholangiocarcinoma. Infrahepatic inferior vena cava (IVC) clamping is an effective maneuver for reducing blood loss during liver transection. The impact of this procedure on major hepatectomy for cholangiocarcinoma is unknown. This study evaluated the effect of infrahepatic IVC clamping on blood loss during liver transection.</p><p><strong>Methods: </strong>Clinical and pathological data were collected retrospectively for 116 cholangiocarcinoma patients who underwent major hepatectomy between January 2015 and December 2016, to investigate the benefit of infrahepatic IVC clamping. Two of five surgeons adapted the policy performing infrahepatic IVC clamping during liver transection in all cases. Patients, therefore, were divided into those (<i>n</i> = 39; 33.6%) who received infrahepatic IVC clamping during liver transection (C1) and those (<i>n</i> = 77; 66.4%) who did not (C0).</p><p><strong>Results: </strong>The patients' backgrounds, operative parameters, and extent of hepatectomy did not differ significantly between the 2 groups, except for gender. A significantly lower blood loss (<i>p</i> = 0.028), blood transfusion (<i>p</i> = 0.011), and rate of vascular inflow occlusion requirement (<i>p</i> < 0.001) were observed in the C1 group. The respective blood losses in the C1 group and the C0 group were 498.9 (95% CI: 375.8-622.1) and 685.6 (95% CI: 571-800.2) millilitres.</p><p><strong>Conclusions: </strong>The current study found infrahepatic IVC clamping during liver transection for cholangiocarcinoma reduces blood loss, blood transfusion, and rate of vascular inflow occlusion requirement.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"1625717"},"PeriodicalIF":1.8,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39386444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States.","authors":"Aniruddha Potnis,&nbsp;Susan VanMeter,&nbsp;Jan Stange","doi":"10.1155/2021/8542179","DOIUrl":"https://doi.org/10.1155/2021/8542179","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatic encephalopathy (HE), a complication of cirrhosis, is associated with increased healthcare resource utilization and mortality, and impaired quality of life. Information on the prevalence of HE in the US general population is limited.</p><p><strong>Methods: </strong>Prevalence of HE was estimated by sequential stepwise data analysis of the Symphony Health anonymized patient-level data (APLD) claims database. First, patients ≥ 18 years with International Classification of Diseases ninth/tenth edition, clinical modification (ICD-9/10-CM), and codes for cirrhosis from 2018 medical and hospital claims were used to estimate prevalence of cirrhosis within the data set and number of patients with cirrhosis in the US general population. Second, patients diagnosed with cirrhosis in the APLD data set from 2015-2016 with an HE ICD-9/10-CM code within 1 year of cirrhosis diagnosis were used to deduce the prevalence of HE within the data set and estimate the number of patients with HE in the US general population. Last, US DiagnosticSource data on serum ammonia level laboratory results measured within ±2 days of a confirmed HE event were merged with the APLD HE data set, then applied to the US general population.</p><p><strong>Results: </strong>Medical and hospital claims data were available for 272,256 patients with cirrhosis in 2018. An estimated 536,856 US adults had a diagnosis of cirrhosis (prevalence of 0.21%) in 2018. This proportion applied to the estimated number of patients with cirrhosis in the United States resulted in a prevalence estimate of 201,858 cirrhosis patients with HE in 2018. When factoring in serum ammonia data, prevalence was conservatively estimated as approximately 196,000 cirrhosis patients with HE and serum ammonia levels > 21 <i>μ</i>mol/L.</p><p><strong>Conclusions: </strong>In this longitudinal cohort-based study, it was estimated that ≈202,000 patients had HE in the United States in 2018, representing a considerable burden to society and payers.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"8542179"},"PeriodicalIF":1.8,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}