ENHANCEMENT OF CIRRHOSIS MORTALITY PREDICTION BY INCLUDING HEPATIC ENCEPHALOPATHY TO MELD3.0 IN A NATIONAL VETERAN COHORT.

Despite negative outcomes, hepatic encephalopathy (HE) is not included in model-for-end-stage liver disease (MELD) scores, including MELD3.0. In a national Veterans affairs (VA) database, we studied the additive mortality predictive impact of a documented inpatient overt HE diagnosis on MELD3.

A Machine Learning Algorithm Avoids Unnecessary Paracentesis for Exclusion of SBP in Cirrhosis in Resource-limited Settings.

Background & Aims: Despite the poor prognosis associated with missed or delayed spontaneous bacterial peritonitis (SBP) diagnosis, <15% get timely paracentesis, which persists despite guidelines/education in the United States. Measures to exclude SBP non-invasively where timely paracentesis cannot be performed could streamline this burden.

Methods: Using Veterans Health Administration Corporate Data Warehouse (VHA-CDW) we included patients with cirrhosis between 2009 and 2019 who underwent timely paracentesis and collected relevant clinical information (demographics, cirrhosis severity, medications, vitals, and comorbidities).

TNFalpha activates c-Jun amino terminal kinase through p47(phox).

Reactive oxygen intermediates have been implicated in the transduction of TNFalpha signals, although the source of such oxidants has not been established. We found that activation of ECV-304 cells by TNFalpha was accompanied by a transient burst of oxidants and activation of JNK, both of which were suppressed by two distinct inhibitors of the phagocyte NADPH oxidase and the thiol antioxidant N-acetyl cysteine (NAC). We cloned partial and full-length cDNA sequences from ECV-304 cells and human umbilical vein endothelial cells (HUVEC), respectively, for p47(phox), demonstrating that these nonphagocytic cells express this adapter protein known to specifically initiate assembly of the NADPH oxidase in professional phagocytes.