检索结果-南通市图书馆

Viscoelastic tests in liver disease: where do we stand now?

World Journal of Gastroenterology 2021年第23期27卷 3290-3302页

作者： Alina Buliarca Adelina Horhat Tudor Mocan rares craciun Bogdan Procopet Zeno Sparchez The Third Medical Department “Iuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and Hepatology“Prof.Dr.O.Fodor”Cluj-Napoca 400162Romania

Hemostasis is a complex physiological process based on the balance between procoagulant and anticoagulant systems to avoid pathological bleeding or *** changes in standard coagulation tests in liver disease were assumed to reflect an acquired bleeding disorder,and cirrhotic patients were considered naturally *** the light of the new evidence,the theory of rebalanced hemostasis replaced the old *** to this model,the hemostatic alteration leads to a unique balance between pro-coagulant,anticoagulant,and fibrinolytic *** the balance is fragile and may prone to bleeding or thrombosis depending on various risk *** standard coagulation tests[INR(international normalized ratio),platelet count and fibrinogen]only explore parts of the hemostasis,not offering an entire image of the *** thromboelastometry(ROTEM)and thromboelastography(TEG)are both point of care viscoelastic tests(VET)that provide real-time and dynamic information about the entire hemostasis process,including clot initiation(thrombin generation),clot kinetics,clot strength,and clot stability(lysis).Despite prolonged PT/INR(international normalized ratio of prothrombin time)and low platelet counts,VET is within the normal range in many patients with both acute and chronic liver ***,bleeding remains the dominant clinical issue in patients with liver diseases,especially when invasive interventions are *** has been shown to asses more appropriately the risk of bleeding than conventional laboratory tests,leading to decrial use of blood products *** clotting is common but often subtle and may be challenging to predict even with the help of *** VET has shown its benefit,more studies are needed to establish cut-off values for TEG and ROTEM in these populations and standardization of transfusion guidelines before invasive interventions in cirrhotic patients/orthotopic liver transplantation.

关键词： Liver diseases Viscoelastic tests Portal vein thrombosis Acute-on-chronic liver failure Bleeding risk Invasive procedures

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Pulmonary complications of portal hypertension:The overlooked decompensation

引用

World Journal of Clinical Cases 2022年第17期10卷 5531-5540页

作者： rares craciun Tudor Mocan Bogdan Procopet Andrada Nemes Cristian Tefas Mihaela Sparchez Lavinia-Patricia Mocan Zeno Sparchez 3^(rd)Medical Clinic Department of Internal Medicine"Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400162Romania Gastroenterology Clinic "Prof.Dr.O.Fodor"Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162Romania Intensiv Care Unit I Cluj County Emergency HosptialCluj-Napoca 400006Romania 2^(nd)Paediatric Clinic "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400126Please enter the state or provinceRomania Department of Histology "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400349Romania

The systemic nature of cirrhosis and portal hypertension has long been recognized,and the amount of data characterizing the interplay between each system is becoming ever so *** involvement was among the first described associated entities in cirrhosis,with reports dating back to the late nineteenth ***,it appears that throughout the years,interest in the pulmonary complications of portal hypertension has generally faded,especially in contrast to other decompensating events,as expertise in this field has primarily been concentrated in highly experienced tertiary care facilities and liver transplantation *** affecting up to 10%-15%of patients with advanced liver disease and having a proven prognostic impact,hepato-pulmonary syndrome,porto-pulmonary hypertension,and hepatic hydrothorax are frequently misdiagnosed,mistreated,or *** lack of precision might adversely impact patient care,referral to expert centers,and,ultimately,liver disease-related mortality and successful transplantation *** present minireview aims to increase awareness of the pulmonary complications of chronic liver disease by providing a brief overview of each of the three *** paper focuses on the essential theoretical aspects,addressing the most critical knowledge gaps on the one hand and,on the other hand,critically discussing one key issue for each complication.

关键词： Hepato-pulmonary syndrome Porto-pulmonary hypertension Hepatic hydrothorax Cirrhosis Portal hypertension Advanced liver disease

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma:When and how?

引用

World Journal of Gastrointestinal Oncology 2021年第12期13卷 2050-2063页

作者： Tudor Mocan Adelina Horhat Emil Mois Florin Graur Cristian Tefas rares craciun Iuliana Nenu Mihaela Spârchez Zeno Sparchez Third Medical Department "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400162Romania Institute for Gastroenterology and Hepatology Cluj-Napoca 400162Romania Second Pediatric Department University of Medicine and Pharmacy"Iuliu Hatieganu"Cluj-Napoca 400162Romania

Hilar cholangiocarcinoma (hCCA) is a primary liver tumor associated with a dimprognosis. The role of preoperative and palliative biliary drainage has long beendebated. The most common techniques are endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic biliary drainage (PTBD);however, recently developed endoscopic ultrasound-assisted methods are gainingmore atention. Selecting the best available method in any specific scenario iscrucial, yet sometimes challenging. Thus, this review aimed to discuss theavailable techniques, indications, perks, pitfalls, and timing-related issues in themanagement of hCCA. In a preoperative setting, PTBD appears to have someadvantages: low risk of postprocedural complications (namely cholangitis) andbetter priming for surgery. For palliative purposes, we propose ERCP/PTBDdepending on the experience of the operators, but also on other factors: the levelof bilirubin (if very high, rather PTBD), length of the stenosis and the presence ofcholangitis (PTBD), ERCP failure, or altered biliary anatomy.

关键词： Hilar cholangiocarcinoma Endoscopic biliary drainage Percutaneous biliary drainage Endoscopic ultrasound biliary drainage Surgical oncology

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Combined treatments in hepatocellular carcinoma:Time to put them in the guidelines?

引用

World Journal of Gastrointestinal Oncology 2021年第12期13卷 1896-1918页

作者： Zeno Sparchez Pompilia Radu Adrian Bartos Iuliana Nenu rares craciun Tudor Mocan Adelina Horhat Mihaela Spârchez Jean-François Dufour 3^(rd)Medical Department “Ïuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and HepatologyCluj-Napoca 400162Romania Department of Visceral Surgery and Medicine HepatologyInselspitalBern University HospitalUniversity of BernBern 3010Switzerland Department of Surgery “Ïuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and HepatologyCluj-Napoca 400162Romania Department of Mother and Child 2nd Paediatric Clinic“Ïuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400177Romania Department for BioMedical Research HepatologyUniversity of BernBern 3008Switzerland

The time for battling cancer has never been more suitable than nowadays and fortunately against hepatocellular carcinoma(HCC)we do have a far-reaching ***,because liver cancer comprises a plethora of stages-from very early to advanced disease and with many treatment options–from surgery to immunotherapy trials–it leaves the clinician a wide range of *** scope of our review is to throw light on combination treatments that seem to be beyond guidelines and to highlight these using evidence-based analysis of the most frequently used combination therapies,discussing their advantages and flaws in comparison to the current standard of *** particular combination therapy seems to be in the forefront:Transarterial chemoembolization plus ablation for medium-size non-resectable HCC(3-5 cm),which is currently at the frontier between Barcelona Clinic Liver Cancer classification A and *** only does it improve the outcome in contrast to each individual therapy,but it also seems to have similar results to ***,the abundance of immune checkpoint inhibitors that have appeared lately in clinical trials are bringing promising results against *** the path of combination therapies in HCC is still filled with uncertainty and caveats,in the following years the hepatology and oncology fields could witness an HCC guideline revolution.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Radiofrequency ablation Microwave ablation Systemic therapy Immunotherapy combined treatments

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Malnutrition and non-compliance to nutritional recommendations in patients with cirrhosis are associated with a lower survival

引用

World Journal of Hepatology 2020年第10期12卷 829-840页

作者： Dana Crisan Bogdan Procopet Alexandra Epure Horia Stefanescu Alina Suciu Andreea Fodor Emil Mois rares craciun Nicolae Crisan Internal Medicine Department “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400126Romania 3rd Medical Clinic “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400126Romania Hepatology Unit “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162Romania Surgery Department “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400126Romania Hepatology Unit “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400126Romania

BACKGROUND Malnutrition is frequently encountered in patients with cirrhosis and appears to significantly impact their *** evaluating the burden of malnutrition in cirrhosis is gathering momentum,as suggested by multiple recently published reports,there is still a persistent scarcity of solid data in the field,especially with regards to the role of nutritional *** To assess the prevalence of malnutrition in patients with advanced cirrhosis and to evaluate its impact on *** One hundred and one consecutive patients with advanced cirrhosis were screened for malnutrition using the Subjective Global Assessment(SGA)criteria and the mid-arm circumference(MAC).Malnutrition was defined as SGA class B and C and MAC<10th *** patients were interviewed regarding their food intake using an adapted ***,total energy intake was calculated and further subdivided in main *** data were then compared to the available recommendations at the time of analysis to assess *** 54/79 patients(68.4%)in the decompensated group had malnutrition,while only 3/22 patients(13.6%)were malnourished in the compensated *** a median follow-up time of 27 mo(0-53),the overall mortality was 70%.Survival was significantly lower among patients with *** mortality rates were 50%at 1 year and 63%at 2 years for the patients with malnutrition,compared to 21%at 1 year and 30%at 2 years for patients without malnutrition(P=0.01).On multivariate analysis,the factors independently associated with mortality were age,creatinine level and adherence to the protein intake *** mortality was lower in patients with the appropriate protein intake:8%at 1 year and 28%at 2 years in the adherent group,compared to 47%at 1 year and 56%at 2 years in the non-adherent *** The prevalence of malnutrition is high among patients with advanced cirrhosis and might be related in part to a low adherenc

关键词： Malnutrition Decompensated cirrhosis Survival Subjective global assessment Protein intake

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：