Annals of hepatology最新文献

{"title":"Palliative care and end stage liver disease: A cohort analysis of palliative care use and factors associated with referral","authors":"Hugo M Oliveira ,&nbsp;Helena Pessegueiro Miranda ,&nbsp;Francisca Rego ,&nbsp;Rui Nunes","doi":"10.1016/j.aohep.2024.101518","DOIUrl":"10.1016/j.aohep.2024.101518","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Prevalence and mortality of chronic liver disease have risen significantly. In end stage liver disease, the survival of patients is approximately two years. Despite the poor prognosis and high symptom burden of these patients, integration of palliative care is limited. We aim to assess associated factors and trends in palliative care use in recent years.</p></div><div><h3>Materials and Methods</h3><p>A Multicenter retrospective cohort of patients with end stage liver disease who suffered in-hospital mortality between 2017 and 2019. Information regarding patient demographics, hospital characteristics, comorbidities, etiology, decompensations, and interventions was collected. Two-sided tests and logistic regression analysis were used to identify factors associated with palliative care use.</p></div><div><h3>Results</h3><p>A total of 201 patients were analyzed, with a yearly increase in palliative care consultation: 26.7 % in 2017 to 38.3 % in 2019. Patients in palliative care were older (65.72 ± 11.70 vs. 62.10 ± 11.44; <em>p =</em> 0.003), had a lower Karnofsky functionality scale (χ=18.104; <em>p =</em> 0.000) and had higher rates of hepatic encephalopathy (32.1 % vs. 17.4 %, <em>p =</em> 0.007) and hepatocarcinoma (61.7 % vs. 26.2 %; <em>p =</em> 0.000). No differences were found for Model for End-stage Liver Disease (19.28 ± 6.60 vs. 19,90 ± 5.78; <em>p =</em> 0.507) or Child-Pugh scores (<em>p =</em> 0.739). None of the patients who die in the intensive care unit receive palliative care (0 % vs 31.6 %; <em>p =</em> 0.000). Half of the palliative care consultations occurred 6,5 days before death.</p></div><div><h3>Conclusions</h3><p>Palliative care use differs based on demographics, disease complications, and severity. Despite its increasing implementation, palliative care intervention occurs late. Future investigations should identify approaches to achieve an earlier and concurrent care model.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 5","pages":"Article 101518"},"PeriodicalIF":3.7,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003120/pdfft?md5=aadd9153f9c95837ae3412c1b6649263&pid=1-s2.0-S1665268124003120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The steatosis-associated fibrosis estimator (SAFE) outperformed the FIB-4 score in screening the population for liver disease","authors":"Mingkai Li ,&nbsp;Ying Lin ,&nbsp;Hongsheng Yu ,&nbsp;Weichun Lin ,&nbsp;Jianning Chen ,&nbsp;Yidong Yang ,&nbsp;Bin Wu","doi":"10.1016/j.aohep.2024.101516","DOIUrl":"10.1016/j.aohep.2024.101516","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Assessing fibrosis risk noninvasively is essential. The steatosis-associated fibrosis estimator (SAFE) score shows promise but needs validation.</p></div><div><h3>Patients and Methods</h3><p>This was a three-part study. In part 1, we compared the SAFE score with the Fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS) in the National Health and Nutrition Examination Survey (NHANES) cohort (2017–2020), using transient elastography (TE) as screening reference. In part 2, we examined patients who underwent liver biopsies at an Asian center between 2018 and 2020 to assess these models in various liver diseases. In part 3, the SAFE score was applied to adults in the NHANES cohort (1999–2016) to assess the correlation with mortality.</p></div><div><h3>Results</h3><p>In part 1, we studied 6,677 patients, comprising 595 screening positive (TE ≥8 kPa). SAFE (cutoff 100) displayed a lower proportion of false positives (10.4 %) than FIB-4 (cutoff 1.3) and NFS (cutoff -1.455) (22.1 % and 43.6 %) while retaining a low proportion of false negatives (5.5 %). In part 2, SAFE outperformed FIB-4 (<em>P</em> = 0.04) and NFS (<em>P</em> = 0.04) in staging significant fibrosis (≥S2) in NAFLD and had similar accuracies in other etiologies. In part 3, the FIB-4, NFS, and SAFE score were associated with all-cause mortality in the general population, with c-statistics of 0.738, 0.736, and 0.759, respectively.</p></div><div><h3>Conclusions</h3><p>The SAFE score reduced futile referrals more effectively than FIB-4 without raising the missed TE ≥ 8 kPa rate. It correlated with all-cause mortality in the general population and excelled in staging significant fibrosis in NAFLD.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 5","pages":"Article 101516"},"PeriodicalIF":3.8,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003107/pdfft?md5=173d10da0767e549ff95b95d6ca9e7dc&pid=1-s2.0-S1665268124003107-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of low hepatic fat content in advanced chronic liver disease: MRI-PDFF insights","authors":"Atsushi Nakamura,&nbsp;Tsubasa Yoshimura,&nbsp;Takeshi Ichikawa,&nbsp;Keiji Okuyama","doi":"10.1016/j.aohep.2024.101507","DOIUrl":"10.1016/j.aohep.2024.101507","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>The mechanisms of hepatic fat loss in late-stage metabolic dysfunction-associated fatty liver disease (MASLD) are enigmatic and the prognostic significance of low hepatic fat content (LHF) in chronic liver disease (CLD) is unknown. Proton density fat fraction (PDFF), measured by magnetic resonance imaging (MRI), is considered the most accurate noninvasive method for quantifying hepatic fat content. This study aimed to address these issues by evaluating PDFF.</p></div><div><h3>Patients and Methods</h3><p>This is a single-center, retrospective study involving 762 patients with CLD, measuring liver stiffness (LS) using MR elastography and PDFF using MRI. LHF was defined as a PDFF ≤ 2.7 % and hepatic reserve function was assessed using the albumin-bilirubin (ALBI) score. Multivariate analysis explored associations between variables.</p></div><div><h3>Results</h3><p>LHF was 27 % in the entire cohort, and PDFF was significantly decreased with LS ≥ 5.5 kPa (<em>p</em> &lt; 0.05). On the multivariate analysis, low body mass index and ALBI score were independently associated with LHF (<em>p</em> &lt; 0.05). In advanced CLD (<em>n</em> = 288), ALBI score and PDFF showed a significant negative correlation regardless of etiology (MASLD/non-MASLD: <em>r</em>= -0.613/-0.233), and the prevalence of LHF increased with progression of ALBI grade (<em>p</em> &lt; 0.01 each). In addition, lower PDFF was associated with increased liver-related and all-cause mortality (<em>p</em> &lt; 0.01), and Cox proportional hazards models extracted LHF as an independent prognostic factor, along with ALBI score and hepatocellular carcinoma (<em>p</em> &lt; 0.05 each).</p></div><div><h3>Conclusions</h3><p>In ACLD, hepatic reserve dysfunction contributed to hepatic fat loss independent of nutritional status, suggesting that LHF may be a poor prognostic factor in all etiologies.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101507"},"PeriodicalIF":3.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003016/pdfft?md5=5de8a56f03f73fecaabfdd25f91bea64&pid=1-s2.0-S1665268124003016-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery disease as a risk factor for metabolic dysfunction-associated steatotic liver disease and liver fibrosis","authors":"Luis Vega ,&nbsp;Daniela Simian ,&nbsp;Abraham I. Gajardo ,&nbsp;Marcelo Salinas ,&nbsp;Andrea Urra ,&nbsp;Máximo Cattaneo ,&nbsp;Rosario Pino ,&nbsp;Juan P. Roblero ,&nbsp;Álvaro Urzúa ,&nbsp;Katherine Rojas ,&nbsp;Jaime Poniachik","doi":"10.1016/j.aohep.2024.101511","DOIUrl":"10.1016/j.aohep.2024.101511","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at an increased cardiovascular risk. On the contrary, non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with coronary heart disease (CHD). However, it is not known whether patients with significant CHD show a higher frequency of liver fibrosis. This study aimed to determine the frequency of MASLD and liver fibrosis in patients with CHD and to assess whether coronary stenosis is significantly associated with MASLD and fibrosis.</p></div><div><h3>Patients and Methods</h3><p>This observational and analytical study included adult patients without any known liver disease who underwent coronary angiography for suspected coronary artery disease (Jul 2021–Jul 2022). The presence of significant CHD (&gt; 50% stenosis of at least one coronary artery) was determined. Liver elastography (FibroScan®) was performed up to 6 months after the coronary angiographic study to determine liver fibrosis, a measurement of liver stiffness (&gt; 6.5 Kpa). Fisher's test, Mann–Whitney U test, and logistic regression models were used (<em>p</em> &lt; 0.05).</p></div><div><h3>Results</h3><p>The study included 113 patients (76% men, average age: 63 years [standard deviation: 9.9]), of which 72% presented with significant CHD. The prevalence rate of MASLD was 52%. Liver fibrosis was present in 12% of the patients and all patients in the significant CHD group (<em>p</em> = 0.007). An increase in the number of vessels with significant CHD increased the probability of liver fibrosis (odds ratio, 1.79; 95% confidence interval, 1.06–3.04; <em>p</em> = 0.029).</p></div><div><h3>Conclusions</h3><p>MASLD is highly prevalent in patients with significant CHD but without known liver damage. These data suggest that MASLD and liver fibrosis should be investigated in patients with CHD. The presence of confounding variables, especially the presence of type 2 diabetes mellitus, should be evaluated in further studies.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101511"},"PeriodicalIF":3.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003053/pdfft?md5=c271d26aa405e8ebd80dc477a0ce94e7&pid=1-s2.0-S1665268124003053-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-wide DNA methylation and transcriptomic analysis of liver tissues subjected to early ischemia/reperfusion injury upon human liver transplantation","authors":"Pablo J. Giraudi ,&nbsp;Allen A. Laraño ,&nbsp;Simeone Dal Monego ,&nbsp;Riccardo Pravisani ,&nbsp;Deborah Bonazza ,&nbsp;Gabriel Gondolesi ,&nbsp;Claudio Tiribelli ,&nbsp;Francisco Baralle ,&nbsp;Umberto Baccarani ,&nbsp;Danilo Licastro","doi":"10.1016/j.aohep.2024.101506","DOIUrl":"10.1016/j.aohep.2024.101506","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Epigenetic changes represent a mechanism connecting external stresses with long-term modifications of gene expression programs. In solid organ transplantation, ischemia-reperfusion injury (IRI) appears to induce epigenomic changes in the graft, although the currently available data are extremely limited. The present study aimed to characterize variations in DNA methylation and their effects on the transcriptome in liver transplantation from brain-dead donors.</p></div><div><h3>Patients and Methods</h3><p>12 liver grafts were evaluated through serial biopsies at different timings in the procurement-transplantation process: T0 (warm procurement, in donor), T1 (bench surgery), and T2 (after reperfusion, in recipient). DNA methylation (DNAm) and transcriptome profiles of biopsies were analyzed using microarrays and RNAseq.</p></div><div><h3>Results</h3><p>Significant variations in DNAm were identified, particularly between T2 and T0. Functional enrichment of the best 1000 ranked differentially methylated promoters demonstrated that 387 hypermethylated and 613 hypomethylated promoters were involved in spliceosomal assembly and response to biotic stimuli, and inflammatory immune responses, respectively. At the transcriptome level, T2 vs. T0 showed an upregulation of 337 and downregulation of 61 genes, collectively involved in TNF-α, NFKB, and interleukin signaling. Cell enrichment analysis individuates macrophages, monocytes, and neutrophils as the most significant tissue-cell type in the response.</p></div><div><h3>Conclusions</h3><p>In the process of liver graft procurement-transplantation, IRI induces significant epigenetic changes that primarily act on the signaling pathways of inflammatory responses dependent on TNF-α, NFKB, and interleukins. Our DNAm datasets are the early IRI methylome literature and will serve as a launch point for studying the impact of epigenetic modification in IRI.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101506"},"PeriodicalIF":3.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003004/pdfft?md5=06f4462790d874b8def1ec8c6ecc14ac&pid=1-s2.0-S1665268124003004-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing a novel MRI technique to identify adverse muscle composition in end-stage liver disease: A pilot study","authors":"Avesh J. Thuluvath ,&nbsp;Mikael F. Forsgren ,&nbsp;Daniela P. Ladner ,&nbsp;Amit D. Tevar ,&nbsp;Andres Duarte-Rojo","doi":"10.1016/j.aohep.2024.101508","DOIUrl":"10.1016/j.aohep.2024.101508","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Sarcopenia is a common complication of end-stage liver disease (ESLD), but its exact relationship to myosteatosis and frailty remains unclear. In this pilot study, we tested the feasibility of a specialized MRI protocol and automated image analysis in patients with ESLD.</p></div><div><h3>Materials and Methods</h3><p>In a single-center prospective study, adult liver transplant candidates with ESLD underwent assessment of muscle composition between 3/2022 and 6/2022 using the AMRA® MAsS Scan. The primary outcome of interest was feasibility of the novel MRI technique in patients with ESLD. We also tested if thigh muscle composition correlated with validated measures of frailty and sarcopenia.</p></div><div><h3>Results</h3><p>Eighteen subjects (71 % male, mean age 59 years) were enrolled. The most common etiologies of cirrhosis were alcohol-related liver disease (44 %) and non-alcohol-associated fatty liver disease (33 %), with a mean MELD-Na of 13 (± 4). The mean time needed to complete the MRI protocol was 14.9 min and only one patient could not complete it due to metal hardware in both knees. Forty-one percent of patients had adverse muscle composition (high thigh fat infiltration and low-fat free muscle volume) and these patients were more likely to have undergone a recent large volume paracentesis (43 % vs<em>.</em> 0 %, <em>p</em> &lt; 0.02). The adverse muscle composition group performed significantly worse on the 6-minute walk test compared to the remainder of the cohort (379 vs 470 m, <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>The AMRA® MAsS Scan is feasible to perform in patients with ESLD and can be used to quantify myosteatosis, a marker of muscle quality and potentially muscle functionality in ESLD.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101508"},"PeriodicalIF":3.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003028/pdfft?md5=0da0cf02e200d9117535a41f0303322b&pid=1-s2.0-S1665268124003028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spending on nucleos(t)ide analogues for hepatitis B in medicaid beneficiaries: 2012-2021","authors":"Stephen E. Congly ,&nbsp;Mayur Brahmania ,&nbsp;Carla S. Coffin","doi":"10.1016/j.aohep.2024.101509","DOIUrl":"10.1016/j.aohep.2024.101509","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Treatment of chronic hepatitis B (CHB) with nucelos(t)ide analogues (NA) can improve outcomes, but NA treatment is expensive for insurance plans.</p></div><div><h3>Materials and Methods</h3><p>The Centers for Medicare &amp; Medicaid Services database was assessed from 2012 to 2021 to assess the use of NA for CHB in patients on Medicaid. Data extracted included the number of claims, units, and costs of each agent stratified by originator and generic.</p></div><div><h3>Results</h3><p>Over the study period, 1.9 billion USD was spent on NA, with spending peaking in 2016 at $289 million US, which has subsequently decreased. Lower expenditures since 2016 have been associated with increased use of generics. The use of generic tenofovir or entecavir led to savings of $669 million US over the study period.</p></div><div><h3>Conclusions</h3><p>Increased generic use has significantly reduced expenditures for NA drugs; policy shifts towards generic drug use may help with sustainability.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101509"},"PeriodicalIF":3.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S166526812400303X/pdfft?md5=80b949017c82b0852edaae9546714f2f&pid=1-s2.0-S166526812400303X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MAFLD criteria are better than MASLD criteria at predicting the risk of chronic kidney disease","authors":"Ziyan Pan ,&nbsp;Moutaz Derbala ,&nbsp;Khalid AlNaamani ,&nbsp;Hasmik Ghazinian ,&nbsp;Jian-Gao Fan ,&nbsp;Mohammed Eslam","doi":"10.1016/j.aohep.2024.101512","DOIUrl":"10.1016/j.aohep.2024.101512","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Fatty liver disease is a multisystem disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a more accurate indicator of chronic kidney disease (CKD) than nonalcoholic fatty liver disease (NAFLD). However, the relationship between recently defined metabolic dysfunction-associated steatotic liver disease (MASLD) and CKD is currently unclear. The objective of this cross-sectional study was to investigate the prevalence of CKD and albuminuria among individuals diagnosed with either MAFLD or MASLD.</p></div><div><h3>Patients and Methods</h3><p>This study involved 5,492 participants who provided biochemical marker and liver ultrasound data from the U.S. National Health and Nutrition Examination Survey (2017–2020). Multiple logistic regression analyses were conducted to assess the independent associations of nonoverlapping MAFLD and MASLD with the presence of CKD or albuminuria (urinary albumin-to-creatinine ratio ≥ 3 mg/mmol).</p></div><div><h3>Results</h3><p>MAFLD and MASLD were identified in 47% and 44.5% of the participants, respectively. Individuals with MAFLD-only had a greater prevalence of CKD (24.7% vs. 8.3 %, <em>P</em> &lt; 0.006) and albuminuria (18.6% vs. 5%, <em>P</em> &lt; 0.01) than did those with MASLD-only. Importantly, after adjusting for factors such as sex, age, ethnicity, and alcohol use, it was demonstrated that individuals in the MAFLD-only group had a 4.73-fold greater likelihood of having prevalent CKD than those in the MASLD-only group (<em>P</em> &lt; 0.03).</p></div><div><h3>Conclusions</h3><p>The MAFLD criteria better identify patients with CKD than do the MASLD criteria. Therefore, it is suggested that the MASLD criteria be reconsidered, as currently, the justification for changing from MAFLD to MASLD criteria may not be appropriate.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 5","pages":"Article 101512"},"PeriodicalIF":3.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003065/pdfft?md5=eb5f3f54cbbd9e51efb710582b3a9f8f&pid=1-s2.0-S1665268124003065-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and risk factors for mortality in clostridioides difficile infection in patients with NAFLD and NASH","authors":"Ankoor H. Patel ,&nbsp;Gaurav N. Pathak ,&nbsp;Alexander Chen ,&nbsp;Patricia Greenberg ,&nbsp;Natale Mazzaferro ,&nbsp;Anish Patel ,&nbsp;Naveen Mallangada ,&nbsp;Carlos D. Minacapelli ,&nbsp;Kaitlyn Catalano ,&nbsp;Hansel Suthar ,&nbsp;Vinod K. Rustgi","doi":"10.1016/j.aohep.2024.101510","DOIUrl":"10.1016/j.aohep.2024.101510","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide and can progress to non-alcoholic steatohepatitis (NASH) and, ultimately, cirrhosis. <em>Clostridioides difficile</em> is the most common nosocomial cause of diarrhea and is associated with worse clinical outcomes in other liver diseases, including cirrhosis, but has not been extensively evaluated in concomitant NAFLD/NASH.</p></div><div><h3>Materials and Methods</h3><p>We conducted a retrospective cohort study using the National Inpatient Sample database from 2015 to 2017. Patients with a diagnosis of CDI, NAFLD, and NASH were identified using International Classification of Diseases (Tenth Revision) codes. The outcomes of our study include length of stay, hospitalization cost, mortality, and predictors of mortality.</p></div><div><h3>Results</h3><p>The CDI and NASH cohort had a higher degree of comorbidity burden and prevalence of peptic ulcer disease, congestive heart failure, diabetes mellitus, and cirrhosis. Patients with NASH and CDI had a significantly higher mortality rate compared to the CDI only cohort (mortality, 7.11 % <em>vs.</em> 6.36 %; <em>P</em> = 0.042). Patients with CDI and NASH were at increased risk for liver-related complications, acute kidney injury, and septic shock (<em>P</em> &lt; 0.001) compared to patients with CDI only. Older age, intestinal complications, pneumonia, sepsis and septic shock, and liver failure conferred an increased risk of mortality among the CDI and NASH cohort.</p></div><div><h3>Conclusions</h3><p>Patients with NASH had a higher rate of liver-related complications, progression to septic shock, and mortality rate following CDI infection compared to the CDI only cohort.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101510"},"PeriodicalIF":3.8,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124003041/pdfft?md5=11ab75aa3506d5aa1a4a48f4d1df0ce5&pid=1-s2.0-S1665268124003041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver rupture in patients with amyloidosis: Clinical features and treatment","authors":"Xiangyu Du,&nbsp;Liangzhi Wen,&nbsp;Bin Wang,&nbsp;Dongfeng Chen,&nbsp;Wei Wang","doi":"10.1016/j.aohep.2024.101500","DOIUrl":"https://doi.org/10.1016/j.aohep.2024.101500","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101500"},"PeriodicalIF":3.8,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002941/pdfft?md5=1af3cc34647e248a7c99e086ca7365cf&pid=1-s2.0-S1665268124002941-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140540498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}