Prognostic significance of mild ascites in patients with cirrhosis.

Background: Overt (clinically detectable) ascites is the most common decompensating event in cirrhosis and is associated with a high mortality. The impact of mild ascites (only detectable by imaging) remains unclear.

Methods: Retrospective cohort study in patients with cirrhosis using the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) cohort.

Safety of naltrexone in patients with cirrhosis.

Background & Aims: Treatment of alcohol use disorder (AUD) improves survival in patients with alcohol-related cirrhosis. However, medications for alcohol use disorder (MAUD) are underutilized in this population, partially due to concerns regarding drug-induced liver injury (DILI). Our aim was to evaluate the safety of naltrexone in patients with cirrhosis.

Medications for alcohol use disorder improve survival in patients with hazardous drinking and alcohol-associated cirrhosis.

Background: Medications for alcohol use disorder (MAUD) are highly effective in achieving and maintaining abstinence in patients with alcohol use disorder (AUD). Our aim was to evaluate the effect of MAUD on all-cause mortality in patients with alcohol-associated cirrhosis and active alcohol use.

Methods: This was a retrospective cohort study of patients with alcohol-associated cirrhosis and high-risk alcohol use disorder in the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) database.

Noninvasive predictors of clinically significant portal hypertension in NASH cirrhosis: Validation of ANTICIPATE models and development of a lab-based model.

Clinically significant portal hypertension (CSPH), defined as hepatic venous pressure gradient (HVPG) ≥ 10 mm Hg, identifies patients with compensated cirrhosis at a high risk of decompensation. However, HVPG is an invasive and nuanced method. The ANTICIPATE models, which include liver stiffness measurements by transient elastography (TE) and platelet count ± body mass index, are robust noninvasive surrogates of CSPH but required external validation in patients with nonalcoholic steatohepatitis (NASH) cirrhosis.

Nonselective Beta-Blockers in Portal Hypertension: Why, When, and How?

Content available: Author Interview and Audio Recording.

Changes in Ascitic Fluid Polymorphonuclear Cell Count After Antibiotics Are Associated With Mortality in Spontaneous Bacterial Peritonitis.

Spontaneous bacterial peritonitis (SBP) is a feared complication of ascites that affects 10%-30% of hospitalized patients with cirrhosis with an associated mortality rate of approximately 20%. Although efforts have been undertaken to encourage prompt evaluation and treatment of SBP, outcomes have generally remained dismal. There is significant interest in identifying factors that can reliably predict mortality among individuals with SBP.

Primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a rare chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic and/or extrahepatic bile ducts, leading to bile stasis, fibrosis, and ultimately to cirrhosis, and often requires liver transplantation (LT). PSC occurs more commonly in men, and is typically diagnosed between the ages of 30 and 40. Most cases occur in association with inflammatory bowel disease (IBD), which often precedes the development of PSC.

Factors associated with health-related quality of life in patients with cirrhosis: a systematic review.

Background: Patients with cirrhosis have a poor health-related quality of life (HRQoL). Recognizing factors that affect HRQoL is key in delivering patient-centred care.

Aim: To identify factors most commonly associated with a poor HRQoL in adults with cirrhosis in a systematic review of the literature.

Six-Minute Walk Distance After Critical Illness: A Systematic Review and Meta-Analysis.

Background And Objectives: Impaired physical functioning is common and long lasting after an intensive care unit (ICU) admission. The 6-minute walk test (6MWT) is a validated and widely used test of functional capacity. This systematic review synthesizes existing data in order to: (1) evaluate 6-minute walk distance (6MWD) in meters over longitudinal follow-up after critical illness, (2) compare 6MWD between acute respiratory distress syndrome (ARDS) versus non-ARDS survivors, and (3) evaluate patient- and ICU-related factors associated with 6MWD.

Evaluation of a strategy for enrolling the families of critically ill patients in research using limited human resources.

Rationale: Clinical trials of interventions aimed at the families of intensive care unit (ICU) patients have proliferated but recruitment for these trials can be challenging.

Objectives: To evaluate a strategy for recruiting families of patients currently being treated in an ICU using limited human resources and time-varying daily screening over 7 consecutive days.

Methods: We screened the Johns Hopkins Hospital medical ICU census 7 days per week to identify eligible family members.

Measuring Patient Mobility in the ICU Using a Novel Noninvasive Sensor.

Objectives: To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU.

Design: Prospective, observational study.

Setting: Surgical ICU at an academic hospital.

A systematic review finds limited data on measurement properties of instruments measuring outcomes in adult intensive care unit survivors.

Background And Objective: There is a growing number of studies evaluating the physical, cognitive, mental health, and health-related quality of life (HRQOL) outcomes of adults surviving critical illness. However, there is little consensus on the most appropriate instruments to measure these outcomes. To inform the development of such consensus, we conducted a systematic review of the performance characteristics of instruments measuring physical, cognitive, mental health, and HRQOL outcomes in adult intensive care unit (ICU) survivors.

Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis.

Objectives: To evaluate the epidemiology of and postintensive care unit (ICU) interventions for anxiety symptoms after critical illness.

Methods: We searched five databases (1970-2015) to identify studies assessing anxiety symptoms in adult ICU survivors. Data from studies using the most common assessment instrument were meta-analyzed.

Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis.

Objectives: To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivors.

Data Sources: PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and Cochrane Controlled Trials Registry (1970-2015).

Study Selection: Studies measuring depression after hospital discharge using a validated instrument in more than 20 adults from non-specialty ICUs.

Outcome Measurement in ICU Survivorship Research From 1970 to 2013: A Scoping Review of 425 Publications.

Objectives: To evaluate the study designs and measurement instruments used to assess physical, cognitive, mental health, and quality of life outcomes of survivors of critical illness over more than 40 years old as a first step toward developing a core outcome set of measures for future trials to improve outcomes in ICU survivors.

Design: Scoping review.

Setting: Published articles that included greater than or equal to one postdischarge measure of a physical, cognitive, mental health, or quality of life outcome in more than or equal to 20 survivors of critical illness published between 1970 and 2013.

Seroprevalence of Hepatitis A among Students Enrolled in Tehran University of Medical Sciences during 2011.

Background: Hepatitis A is often asymptomatic in children, however it can become a serious disease in adults. For countries that do not have a universal vaccination strategy targeted vaccination for high risk groups is recommended. Health workers could be at a higher risk of infection with hepatitis A virus (HAV) compared to the general population.

Psychiatric aspects of primary immunodeficiency diseases: the parental study.

Primary immunodeficiency diseases (PID) consist of a group of long-term illnesses which had permanent psychiatric effects on the patients and their parents. This study was designed to find out the most important origins and aspects of stressor in parents of PID patients.To assess the impact of psychiatric aspects in parents of PID patients, a valid and reliable questionnaire was compiled based on patients' complaints and consulting professionals in PID and psychology.