scholarly journals The difference in prolonged continuous and intermittent Pringle maneuver during complex hepatectomy for hepatocellular carcinoma patients with chronic liver disease: A retrospective cohort study

2021 ◽  
Author(s):  
Jianwei Liu ◽  
Wei Wang ◽  
Chunchao Shi ◽  
Chenqi Li ◽  
Feng Xue ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pringle Maneuver ◽  
Chronic Liver ◽  
The Difference

Prevalence of bleeding and thrombosis in critically ill patients with chronic liver disease

2021 ◽  
Author(s):  
Tsai-Wing Ow ◽  
Evangelia Fatourou ◽  
Liane Rabinowich ◽  
Bente Pernille van den Boom ◽  
Shirjit Nair ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Blood Product ◽  
Chronic Liver ◽  
Present On Admission

Introduction: Haemorrhage and venous thromboembolism (VTE) are recognised complications of chronic liver disease (CLD), but their prevalence and risk factors in critically ill patients is uncertain. Patients and methods: We studied a retrospective cohort of patients with CLD non-electively admitted to a specialist intensive care unit determining the prevalence and timing of major bleeding and VTE (early, present on admission/diagnosed within 48h; later diagnosed >48h post ICU admission). Associations with baseline clinical and laboratory characteristics, multi-organ failure (MOF), blood product administration and mortality were explored. Odds ratios (OR) and 95% CIs were calculated using logistic regression. Results: Of 623 patients with median age 52, bleeding (>48 hours after admission) occurred in 87 (14%) patients. Bleeding was associated with greater illness severity and increased mortality. Gastrointestinal bleeding accounted for 72% of events, secondary to portal hypertension in >90%. Procedure-related bleeding was uncommon. VTE occurred in 125 (20%) patients: Early VTE in 80 (13%) and involving the portal vein (PVT) in 85%. Later VTE affected 45 (7.2%) patients. Hepatocellular Carcinoma (HCC) and non-alcoholic liver disease were independently associated with early VTE (OR 2.79, (95% CI 1.5 -5.2) and 2.32, (1.4 -3.9) respectively), and HCC, sepsis and cryoprecipitate use with late VTE (OR 2.45, (1.11-5.43), 2.26 (1.2-4.3) and 2.60 (1.3-5.1). Conclusion: VTE was prevalent on admission to critical care and less commonly developed later. Bleeding was associated with MOF and increased mortality. Severe MOF was not associated with an increased rate of VTE which was linked with HCC, and specific etiologies of CLD.

scholarly journals Separation and not residency permit restores function in resignation syndrome: a retrospective cohort study

2021 ◽  
Author(s):  
Karl Sallin ◽  
Kathinka Evers ◽  
Håkan Jarbin ◽  
Lars Joelsson ◽  
Predrag Petrovic
Keyword(s):  
Cohort Study ◽  
Social Services ◽  
Residential Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Home ◽  
Essential Components ◽  
Residential Care Home ◽  
The Difference ◽  
Oriented Approach

AbstractDespite poor treatment results, a family-oriented approach and the securing of residency have been deemed essential to recovery from resignation syndrome (RS). In a retrospective cohort study, we evaluated an alternative method involving environmental therapy, with patients separated from their parents, while actively abstaining from involving the asylum process in treatment. We examined medical records, social services acts, and residential care home acts from 13 individuals treated at Solsidan residential care home between 2005 and 2020. Severity and outcome were assessed with Clinical Global Impression, Severity and Improvement subscales. Thirteen participants were included and out of these nine (69%) recovered, i.e. they very much or much improved. Out of the eight that were separated, all recovered, also, one non-separated recovered. The difference in outcome between subjects separated and not was significant (p = 0.007). Moreover, out of the five which received a residency permit during treatment, one recovered whereas four did not. The difference in outcome between subjects granted residency and not was significant (p = 0.007). The data revealed three (23%) cases of simulation where parents were suspected to have instigated symptoms. Our evaluation suggests that separation from parents and abstaining from invoking residency permit could be essential components when treating RS. Relying on a family-oriented approach, and residency could even be detrimental to recovery. The examined intervention was successful also in cases of probable malingering by proxy.

scholarly journals Chronic Liver Disease and the Detection of Hepatocellular Carcinoma by [18F]fluorocholine PET/CT

Diagnostics ◽  
2015 ◽  
Vol 5 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Sandi Kwee ◽  
Linda Wong ◽  
Brenda Hernandez ◽  
Owen Chan ◽  
Miles Sato ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Pet Ct
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