Leading healthcare Software-As-A-Service (SaaS) and data provider taps marketing veteran to support its rapid growth AUSTIN, Texas — ESO Solutions, Inc., a leading provider of healthcare software and data interoperability solutions to emergency medical services (EMS) and hospitals, announced that Tad Druart has joined the company as Vice President of Marketing. "We're pleased to have ...
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Πέμπτη 27 Ιουλίου 2017
ESO names Tad Druart as VP of Marketing
Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection: A Meta-Analysis
Microbial Drug Resistance , Vol. 0, No. 0.
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What first responders should seek in mental health clinicians
While responder professions can be exceptionally rewarding, they also expose men and women to traumatic scenes that can challenge their ability to cope with stress
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Community Paramedic Lead - Tri County Health Care
Summary: The primary function of this role is to provide primary care and/or advanced life support including medical evaluation, treatment and stabilization of the critically ill and injured with the goal of reducing morbidity. Supports existing health services; provided integrated health services in partnership with other health professionals; extends access to health services delivery in underserved ...
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Fierce Innovation Awards: Healthcare Edition program announces finalists, Pulsara recognized
BOZEMAN, Mont. — Pulsara announced today that the company has been selected as a finalist in this year's Fierce Innovation Awards: Healthcare Edition 2017, an awards program from the publisher of FierceHealthcare. Pulsara was recognized as a finalist in the category of Digital/Mobile Health Solutions. Pulsara was selected as a finalist for its innovative, industry leading product, the Pulsara ...
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Long interspersed element-1 open reading frame 1 protein expression profiles in ovarian cancers
Abstract
Long interspersed element-1 (LINE-1) retrotransposons are autonomous mobile DNA elements with unique activity that account for about one-fifth of the human genome. Recently, it has been reported that the expression of LINE-1 is closely related to cancer prognosis, and LINE-1 hypomethylation might contribute to the acquisition of aggressive tumor behavior. Despite the importance of LINE-1 expression in cancers, research on the expression of LINE-1 open reading frame (ORF) proteins is very limited. Here, we investigated the expression profiles of LINE-1 ORF1p in ovarian cancer tissue microarrays containing 100 surgical specimens including adjacent normal ovary tissue, primary ovarian cancers, and metastatic ovarian cancers in lymph node. The tissue microarray was stained with mouse monoclonal antibody to LINE-1 ORFp1 for immunofluorescence analysis, and expression levels were evaluated by image analysis. LINE-1 ORFp was significantly overexpressed in ovarian cancers compared with normal tissues and especially upregulated in metastatic ovarian cancers. In addition, the expression of LINE-1 ORF1p was significantly higher in older ovarian cancer patients compared with young patients. These results indicate that expression of LINE-1 ORF1p is related to the progression of ovarian cancers and, in particular, to the age of the patient and the metastatic potential of the cancer.
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Automatic plume episode identification and cloud shine reconstruction method for ambient gamma dose rates during nuclear accidents
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): Xiaole Zhang, Wolfgang Raskob, Claudia Landman, Dmytro Trybushnyi, Christoph Haller, Hongyong Yuan
Ambient gamma dose rate (GDR) is the primary observation quantity for nuclear emergency management due to its high acquisition frequency and dense spatial deployment. However, ambient GDR is the sum of both cloud and ground shine, which hinders its effective utilization. In this study, an automatic method is proposed to identify the radioactive plume passage and to separate the cloud and ground shine in the total GDR. The new method is evaluated against a synthetic GDR dataset generated by JRODOS (Real Time On-line Decision Support) System and compared with another method (Hirayama, H. et al., 2014. Estimation of I-131 concentration using time history of pulse height distribution at monitoring post and detector response for radionuclide in plume. Transactions of the Atomic Energy Society of Japan 13:119–126, in Japanese (with English abstract)). The reconstructed cloud shine agrees well with the actual values for the whole synthetic dataset (1451 data points), with a very small absolute fractional bias (FB = 0.02) and normalized mean square error (NMSE = 2.04) as well as a large correlation coefficient (r = 0.95). The new method significantly outperforms the existing one (more than 95% reduction of FB and NMSE, and 61% improvement of the correlation coefficient), mainly due to the modification for high deposition events. The code of the proposed methodology and all the test data are available for academic and non-commercial use. The new approach with the detailed interpretation of the in-situ environment data will help improving the ability of off-site source term inverse estimation for nuclear accidents.
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Evolutionary processes shaping diversity across the Homo lineage
Publication date: October 2017
Source:Journal of Human Evolution, Volume 111
Author(s): Lauren Schroeder, Rebecca Rogers Ackermann
Recent fossil finds have highlighted extensive morphological diversity within our genus, Homo, and the co-existence of a number of species. However, little is known about the evolutionary processes responsible for producing this diversity. Understanding the action of these processes can provide insight into how and why our lineage evolved and diversified. Here, we examine cranial and mandibular variation and diversification from the earliest emergence of our genus at 2.8 Ma until the Late Pleistocene (0.126–0.0117 Ma), using statistical tests developed from quantitative genetics theory to evaluate whether stochastic (genetic drift) versus non-stochastic (selection) processes were responsible for the observed variation. Results show that random processes can account for species diversification for most traits, including neurocranial diversification, and across all time periods. Where selection was found to shape diversification, we show that: 1) adaptation was important in the earliest migration of Homo out of Africa; 2) selection played a role in shaping mandibular and maxillary diversity among Homo groups, possibly due to dietary differences; and 3) Homo rudolfensis is adaptively different from other early Homo taxa, including the earliest known Homo specimen. These results show that genetic drift, and, likely, small population sizes were important factors shaping the evolution of Homo and many of its novel traits, but that selection played an essential role in driving adaptation to new contexts.
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A hidden treasure of the Lower Pleistocene at Olduvai Gorge, Tanzania: The Leakey HWK EE assemblage
Publication date: Available online 26 July 2017
Source:Journal of Human Evolution
Author(s): Michael C. Pante, Ignacio de la Torre
HWK EE is a little-known archaeological site from the top of Lower Bed II and the basal part of Middle Bed II, Olduvai Gorge, Tanzania. The site was originally excavated in the early 1970s by Mary Leakey, but the excavations and resulting lithic and fossil assemblages were never described. Here we report for the first time on the lithic and fossil assemblages that were recovered by Mary Leakey from the site. The lithic assemblage is one of the largest of any Oldowan site and is characterized by a core-and-flake technology with simple flaking techniques and minimal reduction of cores. Retouched flake frequencies and battered tools are higher than those reported for Olduvai Bed I and Lower Bed II assemblages, but flaking schemes are poorly organized. The fossil assemblage is well-preserved, taxonomically-rich, but dominated by bovids, and includes abundant feeding traces of both hominins and carnivores. Hominins are inferred to have broken the majority of limb bones at the site for access to marrow, while both carnivores and hominins likely had access to at least some flesh. HWK EE may represent one of the last Homo habilis sites at Olduvai Gorge, and is important to understanding the behavioral and cultural mechanisms that led to the emergence of the Acheulean and Homo erectus in the region.
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Intraoperative subdural low-noise EEG recording of the high frequency oscillation in the somatosensory evoked potential
Source:Clinical Neurophysiology
Author(s): Tommaso Fedele, Claudio Schönenberger, Gabriel Curio, Carlo Serra, Niklaus Krayenbühl, Johannes Sarnthein
ObjectiveThe detectability of high frequency oscillations (HFO, >200 Hz) in the intraoperative ECoG is restricted by their low signal-to-noise ratio (SNR). Using the somatosensory evoked HFO, we quantify how HFO detectability can benefit from a custom-made low-noise amplifier (LNA).MethodsIn 9 patients undergoing tumor surgery in the central region, subdural strip electrodes were placed for intraoperative neurophysiological monitoring. We recorded the somatosensory evoked potential (SEP) simultaneously by custom-made LNA and by a commercial device (CD). We varied the stimulation rate between 1.3 and 12.7 Hz to tune the SNR of the N20 component and the evoked HFO and quantified HFO detectability at the single trial level. In three patients we compared Propofol® and Sevoflurane® anesthesia.ResultsIn the average, amplitude decreased in both in N20 and evoked HFO amplitude with increasing stimulation rate (p < 0.05). We detected a higher percentage of single trial evoked HFO with the LNA (p < 0.001) for recordings with low impedance (<5 kΩ). Average amplitudes were indistinguishable between anesthesia compounds.ConclusionLow-noise amplification improves the detection of the evoked HFO in recordings with subdural electrodes with low impedance.SignificanceLow-noise EEG might critically improve the detectability of interictal spontaneous HFO in subdural and possibly in scalp recordings.
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Co-occurring Down syndrome and SUCLA2-related mitochondrial depletion syndrome
Mitochondrial DNA depletion syndrome 5 (MIM 612073) is a rare autosomal recessive disorder caused by homozygous or compound heterozygous pathogenic variants in the beta subunit of the succinate-CoA ligase gene located within the 13q14 band. We describe two siblings of Hispanic descent with SUCLA2-related mitochondrial depletion syndrome (encephalomyopathic form with methylmalonic aciduria); the older sibling is additionally affected with trisomy 21. SUCLA2 sequencing identified homozygous p.Arg284Cys pathogenic variants in both patients. This mutation has previously been identified in four individuals of Italian and Caucasian descent. The older sibling with concomitant disease has a more severe phenotype than what is typically described in patients with either SUCLA2-related mitochondrial depletion syndrome or Down syndrome alone. The younger sibling, who has a normal female chromosome complement, is significantly less affected compared to her brother. While the clinical and molecular findings have been reported in about 50 patients affected with a deficiency of succinate-CoA ligase caused by pathogenic variants in SUCLA2, this report describes the first known individual affected with both a mitochondrial depletion syndrome and trisomy 21.
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Physiological versus pharmacological signalling to myosin phosphorylation in airway smooth muscle
Abstract
Ca2+/calmodulin activation of myosin light chain kinase (MLCK) initiates myosin regulatory light chain (RLC) phosphorylation for smooth muscle contraction with subsequent dephosphorylation for relaxation by myosin light chain phosphatase (MLCP) containing regulatory (MYPT1) and catalytic (PP1cδ) subunits. RLC phosphorylation-dependent force development is regulated by distinct signalling modules involving protein phosphorylations. We investigated responses to cholinergic agonist treatment versus neurostimulation by electric field stimulation (EFS) in bovine tracheal smooth muscle. Concentration/temporal responses to carbachol demonstrated tight coupling between force development and RLC phosphorylation, but sensitivity differences in MLCK, MYPT1 T853, MYPT1 T696, MBS85, paxillin, and CPI-17 phosphorylations. EFS increased force and phosphorylation of RLC, CPI-17, and MLCK. In the presence of the cholinesterase inhibitor neostigmine, EFS led to an additional increase in phosphorylation of MYPT1 T853 and MYPT1 T696, MBS85, and paxillin. Thus, there were distinct pharmacological versus physiological responses in signalling modules acting on RLC phosphorylation and force responses, probably related to degenerate G protein signalling networks.
Studies with genetically modified mice were performed. Expression of another MYPT1 family member, MBS85, was enriched in mouse, as well as bovine tracheal smooth muscle. Carbachol concentration/temporal-force responses were similar in trachea from MYPT1SM+/+, MYPT1SM-/− and the knockin mutant mice containing nonphosphorylatable MYPT1 T853A with no differences in RLC phosphorylation. Thus, MYPT1 T853 phosphorylation was not necessary for regulation of RLC phosphorylation in tonic airway smooth muscle. Furthermore, MLCP activity may arise from functionally shared roles between MYPT1 and MBS85, resulting in minimal effects of MYPT1 knockout on contraction.
This article is protected by copyright. All rights reserved
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Homing in a tropical social wasp: role of spatial familiarity, motivation and age
Abstract
We captured foragers of the tropical social wasp Ropalidia marginata from their nests and displaced them at different distances and directions. Wasps displaced within their probable foraging grounds returned to their nests on the day of release although they oriented randomly upon release; however, wasps fed before release returned sooner, displaying nest-ward orientation. When displaced to places far from their nests, thus expected to be unfamiliar, only a third returned on the day of release showing nest-ward orientation; others oriented randomly and either returned on subsequent days or never. When confined within mosquito-net tents since eclosion and later released to places close to their nests (but unfamiliar), even fed wasps oriented randomly, and only older wasps returned, taking longer time. Thus, contrary to insects inhabiting less-featured landscapes, R. marginata foragers appear to have thorough familiarity with their foraging grounds that enables them to orient and home efficiently after passive displacement. Their initial orientation is, however, determined by an interaction of the information acquired from surrounding landscape and their physiological motivation. With age, they develop skills to home from unfamiliar places. Homing behaviour in insects appears to be influenced by evolutionarily conserved mechanisms and the landscape in which they have evolved.
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Short- and medium-term outcomes following primary ileocaecal resection for Crohn's disease in two specialist centres
British Journal of Surgery
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Doctors view technology as largely problematic
Reuters Health News
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Describing peripancreatic collections according to the revised Atlanta classification of acute pancreatitis: An international interobserver agreement study
Pancreas
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99% of pro football players in US autopsy study had brain damage
Reuters Health News
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Comparative efficacy of various endoscopic techniques for the treatment of common bile duct stones: A network meta-analysis
Gastrointestinal Endoscopy
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Prevalence and effectiveness of psychiatric treatments for patients with IBD: A systematic literature review
Journal of Psychosomatic Research
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Superiority of peginterferon ?-2a and ribavirin combination over peginterferon ?-2a monotherapy in the management of hemodialysis patients with chronic Hepatitis C virus infection
Saudi Journal of Kidney Diseases and Transplantation
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Reproductive aging and hepatic fibrosis progression in HIV/hepatitis C virus co-infected women
Clinical Infectious Diseases
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Does neutrophil-to-lymphocyte ratio predict 1-year mortality in patients with primary biliary cholangitis?: Results from a retrospective study with validation cohort
BMJ Open
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The correlation between liver fat content and ulcerative colitis disease severity
Acta Medica Iranica
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FABP1 and Hepar expression levels in Barrett's oesophagus and associated neoplasia in an Asian population
Digestive and Liver Diseases
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Impact of venous invasion on the efficacy of adjuvant chemotherapy in elderly patients with stage III colorectal cancer
Medical Oncology
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Anthem may exit more individual markets over Obamacare funding
Reuters Health News
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Serum HBV DNA, RNA and HBsAg: Which correlated better to intrahepatic covalently closed circular DNA before and after nucleos(t)ide analogue treatment?
Journal of Clinical Microbiology
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The use of oral corticosteroids in inflammatory bowel diseases in ITALY: An IG-IBD survey
Digestive and Liver Diseases
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Healthcare costs related to treatment of hepatocellular carcinoma among veterans with cirrhosis in the United States
Clinical Gastroenterology and Hepatology
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A modified classification of prognostic factors based on pathological stage and tumor regression grade in patients with rectal cancer who receive preoperative chemoradiotherapy
Oncology
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Transglutaminase antibodies and celiac disease in children with type 1 diabetes and in their family members
Pediatric Diabetes
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Exploring approaches to dietetic assessment of a common task across different universities through assessment moderation
Journal of Human Nutrition and Dietetics
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The expression of hematopoietic progenitor cell antigen CD34 is regulated by DNA methylation in a site-dependent manner in gastrointestinal stromal tumours (GISTs)
International Journal of Cancer
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Noonan syndrome in diverse populations
Noonan syndrome (NS) is a common genetic syndrome associated with gain of function variants in genes in the Ras/MAPK pathway. The phenotype of NS has been well characterized in populations of European descent with less attention given to other groups. In this study, individuals from diverse populations with NS were evaluated clinically and by facial analysis technology. Clinical data and images from 125 individuals with NS were obtained from 20 countries with an average age of 8 years and female composition of 46%. Individuals were grouped into categories of African descent (African), Asian, Latin American, and additional/other. Across these different population groups, NS was phenotypically similar with only 2 of 21 clinical elements showing a statistically significant difference. The most common clinical characteristics found in all population groups included widely spaced eyes and low-set ears in 80% or greater of participants, short stature in more than 70%, and pulmonary stenosis in roughly half of study individuals. Using facial analysis technology, we compared 161 Caucasian, African, Asian, and Latin American individuals with NS with 161 gender and age matched controls and found that sensitivity was equal to or greater than 94% for all groups, and specificity was equal to or greater than 90%. In summary, we present consistent clinical findings from global populations with NS and additionally demonstrate how facial analysis technology can support clinicians in making accurate NS diagnoses. This work will assist in earlier detection and in increasing recognition of NS throughout the world.
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Autopsy findings in EPG5-related Vici syndrome with antenatal onset
Vici syndrome is one of the most extensive inherited human multisystem disorders and due to recessive mutations in EPG5 encoding a key autophagy regulator with a crucial role in autophagosome–lysosome fusion. The condition presents usually early in life, with features of severe global developmental delay, profound failure to thrive, (acquired) microcephaly, callosal agenesis, cataracts, cardiomyopathy, hypopigmentation, and combined immunodeficiency. Clinical course is variable but usually progressive and associated with high mortality. Here, we present a fetus, offspring of consanguineous parents, in whom callosal agenesis and other developmental brain abnormalities were detected on fetal ultrasound scan (US) and subsequent MRI scan in the second trimester. Postmortem examination performed after medically indicated termination of pregnancy confirmed CNS abnormalities and provided additional evidence for skin hypopigmentation, nascent cataracts, and hypertrophic cardiomyopathy. Genetic testing prompted by a suggestive combination of features revealed a homozygous EPG5 mutation (c.5870-1G>A) predicted to cause aberrant splicing of the EPG5 transcript. Our findings expand the phenotypical spectrum of EPG5-related Vici syndrome and suggest that this severe condition may already present in utero. While callosal agenesis is not an uncommon finding in fetal medicine, additional presence of hypopigmentation, cataracts and cardiomyopathy is rare and should prompt EPG5 testing.
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The Association Between Preconception Care Receipt and the Timeliness and Adequacy of Prenatal Care: An Examination of Multistate Data from Pregnancy Risk Assessment Monitoring System (PRAMS) 2009–2011
Abstract
Objectives Prenatal care (PNC) is a critical preventive health service for pregnant women and infants. While timely PNC has been associated with improved birth outcomes, improvements have slowed since the late 1990s. Therefore, focus has shifted to interventions prior to pregnancy. Preconception care is recommended for all women of reproductive age. This study aimed to examine preconception care and its association with timeliness and adequacy of PNC. Methods This retrospective cohort study used data from a large sample of United States first-time mothers (n = 13,509) who participated in the 2009–2011 Pregnancy Risk Assessment Monitoring System in ten states. Timeliness and adequacy of PNC data came from birth certificates, while preconception care receipt was self-reported. Logistic regression provided odds ratios (ORs) and 95% confidence intervals (CIs) to model the association between preconception care receipt and the two PNC outcomes. Results After adjustment, women who received preconception care had statistically significant increased odds of timely (OR 1.30, 95% CI 1.08, 1.57), but not adequate PNC (OR 1.08, 95% CI 0.94, 1.24) as compared to women who did not receive preconception care. Pregnancy intention modified these associations. Associations were strongest among women with intended pregnancies (timely PNC: OR 1.63 and adequate PNC: OR 1.22). Conclusions for Practice Given that untimely PNC is associated with adverse birth outcomes, the observed association warrants increased focus on implementing preconception care. Future studies should investigate how specific components of preconception care are associated with PNC timeliness/adequacy, health behaviors during pregnancy, and birth outcomes.
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Secondary Sclerosing Cholangitis: a Review of Recent Literature
Abstract
Purpose of Review
Secondary sclerosing cholangitis is an emerging entity. Yet, because of the low incidence and varying etiologies of this disease, the literature is not robust. There are mainly case reports and small studies evaluating the disease. Our aim in this review is to bring the reader up to date with recent literature on secondary sclerosing cholangitis including the disease presentation, course, prognosis, and treatment options.
Recent Findings
Numerous case reports have been published the last 5 years on secondary sclerosing cholangitis. We have divided them into infectious, drug-induced, ischemic, obstructive, and autoimmune etiologies. The bulk of the literature describes secondary sclerosing cholangitis in the critically ill patient.
Summary
Secondary sclerosing cholangitis due to drugs or autoimmune causes seem to have the best prognosis. However, causes such as critical illness seem to have worse outcomes.
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Use of Statins in Patients with Chronic Liver Disease and Cirrhosis: Current Views and Prospects
Abstract
Purpose of review
The purpose of this study is to analyze the current evidence regarding the use of statins in patients with chronic liver disease and cirrhosis.
Recent findings
Chronic liver disease (CLD), cirrhosis, and its complications, including hepatocellular carcinoma (HCC), are significant public health problems. The use of statins in patients with CLD has been a matter of concern, and physicians are often reluctant to its prescription in these patients. This mainly relates to the potential occurrence of drug-induced liver injury. However, newer evidence from pre-clinical and clinical research has shown that statins are drugs with a potentially beneficial impact on the natural history of cirrhosis, on portal hypertension, and in HCC prevention.
Summary
In this review, we summarize current evidence regarding the influence of statins in endothelial dysfunction in CLD, their ability to modulate hepatic fibrogenesis, and their vasoprotective effects in portal hypertension; we also focus on existing data about the impact of statins in cirrhosis development, progression, and complications and critically assess the current concerns about its use in patients with CLD.
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Bleeding Risk with Invasive Procedures in Patients with Cirrhosis and Coagulopathy
Abstract
Purpose of Review
Previous perceptions of cirrhosis as a hypocoagulable state have resulted in empirical blood product transfusions prior to invasive procedures. We evaluate procedure-related bleeding risks in patients with cirrhosis, assess the utility of conventional and newer global coagulation tests, and explore evidence surrounding prophylactic transfusion strategies.
Recent Findings
Recent literature supports the concept of a rebalanced, albeit fragile, haemostasis equilibrium in cirrhosis, with a potential hypercoagulable tendency in stable patients. Standard coagulation tests provide a poor reflection of bleeding risks and yet are relied upon for transfusion thresholds. Consequently, a sizeable proportion of patients receive unnecessary blood products. The role of viscoelastic tests to guide transfusions requires further evaluation.
Summary
In stable cirrhotic patients, procedure-related bleeding rates appear low. Prophylactic transfusion strategies based on arbitrary thresholds lack evidence of clinical benefit. There is a pressing need for point-of-care coagulation tests that represent the complex coagulopathy of cirrhosis and well-powered randomised controlled trials to develop evidence-based pre-procedure transfusion guidelines.
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