Frontiers in Microbiology,
Journal Year:
2024,
Volume and Issue:
15
Published: March 27, 2024
Background
and
aim
The
global
burden
of
invasive
fungal
infections
(IFIs)
is
emerging
in
immunologic
deficiency
status
from
various
disease.
Patients
with
acute-on-chronic
hepatitis
B
liver
failure
(ACHBLF)
are
prone
to
IFI
their
conditions
commonly
exacerbated
by
IFI.
However,
little
known
about
the
characteristics
risk
factors
for
hospitalized
ACHBLF
patients.
Methods
A
total
243
patients
were
retrospectively
enrolled
January
2010
July
2023.
We
performed
restricted
cubic
spline
analysis
determine
non-linear
associations
between
independent
variables
identified
using
logistic
regression
extreme
gradient
boosting
(XGBoost)
algorithm.
effect
values
determined
SHapley
Additive
exPlanations
(SHAP)
method.
Results
There
24
(9.84%)
who
developed
on
average
17.5
(13.50,
23.00)
days
after
admission.
serum
creatinine
level
showed
a
association
possibility
Multiple
revealed
that
length
hospitalization
(OR
=
1.05,
95%
CI:
1.02–1.08,
P
0.002)
neutrophilic
granulocyte
percentage
1.04,
1.00–1.09,
0.042)
XGBoost
algorithm
use
antibiotics
(SHAP
value
0.446),
0.406)
log
(qHBV
DNA)
0.206)
top
three
Furthermore,
interaction
no
multiplicative
effects
glucocorticoids
(
0.990).
Conclusion
rare
complication
leads
high
mortality
patients,
occurrence
Research Square (Research Square),
Journal Year:
2024,
Volume and Issue:
unknown
Published: April 15, 2024
Abstract
Acute
liver
failure
(ALF)
and
acute-on-chronic
(ACLF)
pose
significant
threats
to
patient
prognosis,
often
leading
multiple
organ
dysfunction
syndrome
(MODS),
which
is
characterized
by
simultaneous
of
two
or
more
systems
significantly
heightens
the
risk
mortality.
Standard
strategies
for
managing
complications
in
critical
illness
may
not
always
be
suitable
patients
with
(LF).This
study
aims
investigate
outcomes
MODS
ALF
ACLF
China,
while
also
identifying
factors
influencing
mortality
prognosis.
We
conducted
a
retrospective
cohort
at
specialized
tertiary
hospital
diseases
Beijing,
spanning
from
June
1,
2009,
May
31,
2022.Risk
were
assessed
through
univariate
multivariate
analyses
using
logistic
regression.
Cumulative
90-day
rates
between
groups
compared
Cox
Analysis.
195
318
included
this
study.
The
primary
outcome
interest
was
This
enrolled
total
513
patients.
Of
these,
119
(61%)
140
(44%)
experienced
MODS.
Patients
exhibited
higher
number
failures
those
(2
vs.
P
=
0.006).
Additionally,
demonstrated
median
admission
scores.Multivariate
analysis
indicated
that
GIB
(OR
3.112,
95%
CI
1.4–6.916,
0.005),
MELD-Na
scores
1.079,
1.033–1.127,
0.001),
Age
1.056,
1.025–1.088,
<
NLR
1.073,
1.014–1.132,
0.014),
ICU
4.319,
1.347–13.851,
Clif-SOFA
1.147,
1.022–1.287,
0.02)
independent
influential
predicting
mortality,
an
AUCROC
0.881.
Multivariate
revealed
SOFA
score
1.255,
1.166–1.351,
GCS
0.674,
0.606–0.881,
1.048,
1.022–1.076,
0.258,
0.075–0.885,
0.031)
0.872.Cox
cumulative
had
(33.8%
27%,
0.026)
cirrhosis
non-cirrhosis
31%
25.9%,
0.018).Patients
incidence
consequently
poorer
BMJ Open,
Journal Year:
2024,
Volume and Issue:
14(6), P. e084237 - e084237
Published: June 1, 2024
Introduction
Acute-on-chronic
liver
failure
(ACLF)
is
a
prevalent
and
life-threatening
disease
with
high
short-term
mortality.
Although
recent
clinical
trials
on
the
use
of
mesenchymal
stem
cells
(MSCs)
for
ACLF
treatment
have
shown
promising
results,
multicentre
randomised
controlled
phase
II
remain
uncommon.
The
primary
aim
this
trial
to
assess
safety
efficacy
different
MSCs
courses
ACLF.
Methods
analysis
This
multicentre,
double-blind,
two-stage,
placebo-controlled
trial.
In
first
stage,
150
patients
will
be
enrolled
randomly
assigned
either
control
group
(50
cases)
or
an
(100
cases).
They
receive
placebo
umbilical
cord-derived
(UC-MSCs)
three
times
(at
weeks
0,
1
2).
second
28
days
after
UC-MSCs
infusion,
surviving
in
further
divided
into
MSCs-short
MSCs-prolonged
groups
at
1:1
ratio.
two
additional
rounds
4
5.
endpoints
are
transplant-free
survival
rate
incidence
treatment-related
adverse
events.
Secondary
include
international
normalised
ratio,
total
bilirubin,
serum
albumin,
blood
urea
nitrogen,
model
end-stage
score
Child-Turcotte-Pugh
score.
Ethics
dissemination
Ethical
approval
study
has
been
obtained
from
Fifth
Medical
Center
Chinese
PLA
General
Hospital
(KY-2023-3-19-1).
All
results
submitted
journals
conferences
publication
completion
study.
Trial
registration
number
NCT05985863
.
Monaldi Archives for Chest Disease,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Sept. 10, 2024
Acute-on-chronic
liver
failure
(ACLF)
is
a
severe
clinical
condition
for
which
transplantation
(LT)
the
only
curative
option.
Due
to
recipients'
generally
poor
pre-operative
conditions
and
extensive
surgery,
post-LT
respiratory
disorders
are
very
common
significantly
contribute
related
morbidity
mortality.
We
report
case
of
49-year-old
patient
with
ACLF
grade
3
who
has
been
taken
care
by
Respiratory
Physiotherapy
Team
since
hospital
admission.
After
extubation,
was
supported
non-invasive
ventilation
mechanical
in-exsufflation;
meanwhile,
early
resistance
functional
training
were
started.
No
adverse
events
occurred
during
physiotherapy
sessions,
returned
home
without
support.
physical
therapy
in
intensive
unit
after
LT
safe
feasible
interventions
this
patient.
Given
high
incidence
postoperative
pulmonary
complications
rehabilitation
needs,
we
suggest
that
should
be
provided
recipients.
Artificial Organs,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Nov. 22, 2024
The
utilization
of
extracorporeal
liver
support
systems
is
increasingly
prevalent
for
the
management
acute-on-chronic
failure
in
clinical
settings.
Yet,
efficacy
these
interventions
terms
tangible
benefits
patients
remains
a
matter
debate,
underscoring
need
meta-analysis.
An
updated
meta-analysis
was
performed
to
elucidate
relationship
between
application
versus
standard
pharmacological
treatment
and
prognostic
endpoints
patient
survival,
specifically
assessing
1-month
3-month
mortality
rates,
as
well
incidence
complications
such
hepatic
encephalopathy,
spontaneous
bacterial
peritonitis,
hepatorenal
syndrome.
Literature
were
searched
via
PubMed,
EMBASE,
Web
Science.
revealed
following:
odds
ratio
0.63
(95%
confidence
interval
[CIs]:
0.51-0.76),
0.70
CI:
0.61-0.81),
encephalopathy
0.81
0.67-0.97),
peritonitis
0.66
0.44-0.99),
syndrome
0.68
0.51-0.92).
These
results
suggest
that
with
undergoing
system
therapy
have
significantly
better
survival
rates
lower
complication
incidences
compared
those
receiving
conventional
drug
therapy.
Further
subgroup
analysis
indicated
model
end-stage
disease
(MELD)
scores
reduced
total
bilirubin
(Tbil)
levels
demonstrated
greater
from
support.
This
study
establishes
failure,
confer
advantage
reduce
relative
pharmacotherapy.
