| Intestinal decontamination improves liver haemodynamics in patients with alcohol-related decompensated cirrhosis. | |
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MedLine Citation:
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PMID: 19210289 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endotoxaemia is commonly seen in cirrhotic patients with ascites and this may be associated with increased portal pressure. AIM: To investigate the effect of intestinal decontamination on liver haemodynamics in alcohol-related cirrhotic patients with ascites. METHODS: We included 30 patients. At day 0, systemic and splanchnic circulation endotoxin levels were determined and HVPG measurement performed. Patients received rifaximin (1200 mg/day) for 28 days. At day 29, systemic and splanchnic circulation endotoxin levels were determined and HVPG measurement performed again. RESULTS: Median (range) plasma endotoxin levels decreased significantly after rifaximin administration both in systemic [1.45(0-3.1) vs. 0.7(0-2.7), P < 0.0001] and splanchnic circulation [1.8(0-3.4) vs. 0.8(0-2.1), P < 0.0001]. Meanwhile, the difference seen in endotoxin levels between the splanchnic and systemic circulation at day 0 (P = 0.001) was not noted at day 29 (P = 0.137). HVPG measurement was possible in 28 patients. Median (range) HVPG values were 18 mmHg (12.7-26.3) on day 0 vs. 14.7 mmHg (7-20) on day 29 (P < 0.0001). HVPG decreased after rifaximin in 23, remained stable in two and increased in three patients. CONCLUSION: Hepatic venous pressure gradient values decreased significantly after intestinal decontamination with rifaximin in patients with alcohol-related decompensated cirrhosis and this might have been achieved through significant reduction of plasma endotoxin levels. |
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Authors:
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J Vlachogiannakos; A S Saveriadis; N Viazis; I Theodoropoulos; K Foudoulis; S Manolakopoulos; S Raptis; D G Karamanolis |
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Publication Detail:
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Type: Journal Article Date: 2009-02-07 |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 29 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-21 Completed Date: 2009-10-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 992-9 Citation Subset: IM |
Affiliation:
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2nd Department of Gastroenterology, Evangelismos Hospital, Athens, Greece. jvlachog@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Alcohol-Related Disorders Anti-Infective Agents / therapeutic use* Ascites / drug therapy Endotoxins / metabolism* Female Humans Liver Circulation / drug effects* Liver Cirrhosis / blood* Male Middle Aged Rifamycins / administration & dosage* Treatment Outcome Venous Pressure / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Infective Agents; 0/Endotoxins; 0/Rifamycins; 88747-56-2/rifaximin |
| Comments/Corrections | |
Comment In:
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Aliment Pharmacol Ther. 2009 Aug;30(3):309-11; author reply 311-2
[PMID:
19624465
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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