Journal ArticleDOI
Proton Pump Inhibitor Therapy Increases the Risk of Spontaneous Bacterial Peritonitis in Patients with HBV-Related Acute-on-Chronic Liver Failure.
Meng Zhang,Xin Xu,Wei Liu,Zhongwei Zhang,Qiuyu Cheng,Zhongyuan Yang,Tingting Liu,Yunhui Liu,Qin Ning,Tao Chen,Junying Qi +10 more
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TLDR
In this paper, the association between proton pump inhibitor (PPI) use and spontaneous bacterial peritonitis (SBP) was investigated in patients with HBV-related acute-on-chronic liver failure (ACLF).Abstract:
Spontaneous bacterial peritonitis (SBP) is a common infection in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). SBP significantly increases the mortality rate and medical costs. The association between proton pump inhibitor (PPI) use and SBP remains unclear. We conducted a retrospective study to investigate the association between PPI use and SBP in patients with HBV-related ACLF and to explore the risk factors for SBP. We compared the SBP incidence between the PPI and non-PPI groups before and after propensity score matching and explored the association between the duration and type of PPI and SBP occurrence. Risk factors for SBP occurrence were determined by univariate and multivariate logistic regression analysis. The SBP incidence was higher in the PPI group than in the non-PPI group before and after propensity score matching. The SBP incidence increased for elevated MELD scores in PPI users. There was a similar SBP incidence in both different types and durations of PPI users. MELD score, old age, male sex, and high WBC count were significant independent risk factors for SBP in PPI users with HBV-related ACLF in the hospital. PPI therapy increases the risk of SBP development in patients with HBV-related ACLF. MELD score, old age, male sex, and high WBC count could serve as predictors of SBP in PPI users. Caution should be taken regarding PPI use, especially for patients with MELD scores > 30.read more
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Journal ArticleDOI
The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic Treg Cell Homeostasis
Patrick M. Smith,Michael R. Howitt,Nicolai Panikov,Monia Michaud,Carey Ann Gallini,Mohammad Bohlooly-Y,Jonathan N. Glickman,Wendy S. Garrett +7 more
TL;DR: This study determined that short-chain fatty acids, gut microbiota–derived bacterial fermentation products, regulate the size and function of the colonic Treg pool and protect against colitis in a Ffar2-dependent manner in mice, revealing that a class of abundant microbial metabolites underlies adaptive immune microbiota coadaptation and promotes colonic homeostasis and health.
Journal ArticleDOI
Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis
Richard Moreau,Rajiv Jalan,Pere Ginès,Marco Pavesi,Paolo Angeli,Juan Córdoba,François Durand,Thierry Gustot,Faouzi Saliba,Marco Domenicali,Alexander L. Gerbes,Julia Wendon,Carlo Alessandria,Wim Laleman,Stefan Zeuzem,Jonel Trebicka,Mauro Bernardi,Vicente Arroyo +17 more
TL;DR: Diagnostic criteria for ACLF was established and showed that it is distinct from AD, based not only on the presence of organ failure(s) and high mortality rate but also on age, precipitating events, and systemic inflammation.
Journal ArticleDOI
Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.
Shiv Kumar Sarin,Manoj Kumar,George K. K. Lau,Zaigham Abbas,Henry Lik-Yuen Chan,Chien-Jen Chen,Ding-Shinn Chen,Huey-Ling Chen,Pei-Jer Chen,Rong-Nan Chien,Abdul Kadir Dokmeci,Edward Gane,J L Hou,Wasim Jafri,Jidong Jia,J. H. Kim,Ching-Lung Lai,Hon Cheung Lee,Seng Gee Lim,Chun-Jen Liu,Stephen Locarnini,M. Al Mahtab,Rosmawati Mohamed,Masao Omata,Jun Yong Park,Teerha Piratvisuth,Barjesh Chander Sharma,Jose D. Sollano,Fu-Sheng Wang,Lai Wei,Man-Fung Yuen,Shusen Zheng,Jia-Horng Kao +32 more
TL;DR: The final clinical practice guidelines and recommendations for the optimal management of chronic HBV infection are presented here, along with the relevant background information.
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EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.
TL;DR: There is a clear rationale for the management of ascites in patients with cirrhosis, as successful treatment may improve outcome and symptoms, and patients with ascites should generally be considered for referral for liver transplantation.
Journal ArticleDOI
Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)
Shiv Kumar Sarin,Ashok Kumar,John A. Almeida,Yogesh Chawla,Sheung Tat Fan,Hitendra Garg,H. Janaka de Silva,Saeed Hamid,Rajiv Jalan,Piyawat Komolmit,George K. K. Lau,Qing Liu,Kaushal Madan,Rosmawati Mohamed,Qin Ning,Salimur Rahman,Archana Rastogi,Stephen M. Riordan,Puja Sakhuja,Didier Samuel,Samir Shah,Barjesh Chander Sharma,Praveen Sharma,Yasuhiro Takikawa,Babu Ram Thapa,Chun-Tao Wai,Man-Fung Yuen +26 more
TL;DR: The original proposed definition of ACLF was found to withstand the test of time and identify a homogenous group of patients presenting with liver failure, which led to the development of the final AARC consensus.