We report the case of a 58-year-old male patient presenting with clinical and laboratory findings indicative of acute hepatitis. Abdominal ultrasound excluded biliary tract abnormalities. Two weeks prior, the patient had contracted COVID-19.
View Article and Find Full Text PDFBackground: this study aimed to evaluate the effects of age, time period and cohort (A-P-C) on gastric cancer (GC) mortality in Spain from 1980 to 2021.
Methods: an ecological trend study was performed (with aggregated data obtained from the Spanish National Statistics Institute (INE). Joinpoint regression software was used to estimate rates by sex and age group (< 35, 35-64, > 64 years) and mortality trends.
Gut
December 2023
Objective: We aimed to compare the response rates between two different hepatitis B virus vaccination schedules for cirrhotic subjects who were non-responders to the first three 40 µg doses (month 0-1-2), and identify factors associated with the final response.
Design: A total of 120 cirrhotic patients (72.5% decompensated) were randomised at a 1:1 ratio to receive a single 40 µg booster vaccination at month 6 (classical arm) versus an additional round of three new 40 µg doses administered at monthly intervals (experimental arm).
In common variable immunodeficiency (CVID) there is a deregulation of the immune system, which frequently leads to an increased risk of infections, but also to autoimmunity phenomena. Autoimmune hepatitis may develop at any time of CVID's evolution, but it is difficult to diagnose due to the frequent absence of autoantibodies and low levels of IgG. Early diagnosis is important because targeted treatment may allow disease improvement.
View Article and Find Full Text PDFEpstein-Barr virus, a member of the Herpesviridae family, is responsible for the infectious mononucleosis clinical syndrome, which mainly includes the pharyngitis, fever, and lymphadenopathy triad after incubation for 30-50 days. The liver is involved in 80-90% of patients in a self-limiting transient manner, with jaundice being much more uncommon (5%). From a hematological standpoint it may manifest aplastic anemia, neutropenia, and thrombocytopenia.
View Article and Find Full Text PDFDomino liver transplantation (DLT) is a strategy used to increase the number of available grafts. In this procedure, the transplant recipient is a living donor of her own liver. It is mandatory that the graft should be fully functional and the genetic defect should recur with sufficient latency period in the new recipient.
View Article and Find Full Text PDFObjective: To determine whether differences in the coping strategies used by liver patients during the pretransplantation phase were a function of their relatives' level of anxiety.
Materials And Methods: We assessed 75 pre-liver transplantation patients and 75 relatives (one per patient). To assess relatives' anxiety status, we used the Hospital Anxiety and Depression Scale (HADS), and the Questionnaire of Coping with Stress in Cancer Patients (CAEPO) to study patients' coping strategies.
Objectives: To perform a prospective analysis of changes in liver stiffness (LS) using transient elastography (TE) in a consecutive series of patients with post-liver transplant (LT) recurrent hepatitis C, either left to their natural evolution or receiving antiviral treatment.
Methods: We examined the results from 17 comparisons of TE (baseline vs follow-up) from 11 patients. We evaluated: (1) upon inclusion in the study: age, sex, genotype, time transpired since LT, and baseline fibrosis (F0-4; Scheuer), and (2) during the follow-up period: time elapsed between the two TE and either specific treatment (B) or absence of treatment (A).
In the absence of immunity, vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) is recommended for patients with chronic liver disease and those evaluated for liver transplantation (OLT) HAV and HBV infections after OLT which are frequent in this setting, are associated with a worse prognosis. The aim of this study was to estimate the need for vaccination against HBV and HAV among cirrhotic patients who were candidates for OLT and associations with gender, age, and etiologic factors. HBV and HAV serological markers HBsAg, anti-HBc, antiHBs, immunoglobulin G (IgG)-anti-HAV were investigated among 568 patients, including 75% men.
View Article and Find Full Text PDFWe performed a retrospective study to evaluate the rate of and factors associated with a response to recombinant hepatitis B virus (HBV) vaccination using 4 intramuscular doses (40 μg) administered at 0, 1, 2, and 6 months among 278 cirrhotic patients being evaluated for orthotopic liver transplantation (OLT). We re-vaccinated 57 non-responders with the same schedule. The 39.
View Article and Find Full Text PDFBackground: We performed a retrospective study to examine the prevalence of bone disease (BD) among cirrhotic patients being evaluated for liver transplantation (OLT) using bone densitometry dual-energy x-ray absorptiometry in the hip/femoral neck and lumbar spine. The associations of BD with demographic and clinical data, disease etiology and liver function were studied by univariate and multivariate logistic regression analyses. Osteopenia and osteoporosis were defined by World Health Organization criteria.
View Article and Find Full Text PDFAims: Domino liver transplantation (DLT) is a strategy to increase the donor pool. Explanted liver from patients with familial amyloidotic polyneuropathy (FAP) are often used as domino grafts, because the liver is normal apart from the production of the mutated transthyretin variant. We present the outcomes for both donors and recipients of DLT.
View Article and Find Full Text PDFObjective: Our aim was to safely and effectively reduce adverse gastrointestinal (GI) events resulting from the use of mycophenolate mofetil (MMF) in liver transplant patients by switching to enteric-coated mycophenolate sodium (EC-MPS).
Patients And Methods: We studied 19 patients on maintenance therapy presenting with GI intolerance to MMF whose therapy was switched to EC-MPS. The variables recorded were: calcineurin inhibitor (CNI) dose levels, MMF/EC-MPS dose levels, lipid profile, hematology, renal and hepatic function markers, and rejection episodes.
Surgical site infection (SSI) is an important cause of morbidity after orthotopic liver transplantation (OLT). Perioperative antibiotic prophylaxis is one of the main modifiable risk factors. We prospectively investigated the epidemiology, risk factors, and prognosis of SSI in a cohort of 167 OLT.
View Article and Find Full Text PDFObjective: Our purpose is to describe the MRI findings with pathologic correlation, in five patients with groove pancreatitis, a specific form of chronic pancreatitis affecting the groove between the pancreatic head, the common bile duct and duodenum.
Materials And Methods: Five patients with pathologically proven (four cases) and clinical and MRI findings (follow-up) consistent with the diagnosis of groove pancreatitis (one case) were reviewed. Three patients underwent cephalic pancreatoduodenectomy (Whipple procedure) due to severe duodenal stenosis; MRI findings were correlated with the histological findings.
Unlabelled: Our objective was establish a scoring system that allows a donor to be evaluated quickly and easily using a set of variables that are evaluated prior to the donation and another set that are evaluated during surgery.
Materials And Methods: Prior to the donation we analyzed age, medication requirements, natremia, hepatic biochemistry, gas levels, days in ICU, history of hypertension, and weight. A value of 40% was allocated to this group of factors.
Aims: To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection.
Methods: A retrospective analysis of 66 elective, noncombined liver transplant patients treated beginning de novo MMF and follow for a minimum of 2 years. Thirty-nine of the 66 cases received MMF, calcineurin inhibitors, and steroids.