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| 1 | Dual-sugar tests of small intestinal permeability are poor predictors of bacterial infections and mortality in cirrhosis: a prospective study显示文摘AIM: To prospectively analyze the impact of increased intestinal permeability(IP) on mortality and the occurrence of infections in patients with cirrhosis.METHODS: IP was quantified using the lactulose/mannitol(L/M) test in 46 hospitalized patients with cirrhosis(25 Child-Pugh A/B, 21 Child-Pugh C) and in 16 healthy controls. Markers of inflammation [LPSbinding protein, Interleukin-6(IL-6)] and enterocyte death [intestinal fatty-acid binding protein(I-FABP)] were determined in serum using enzyme-linked immunosorbent assays. Patients were followed for one year and assessed for survival, liver transplantation, the necessity of hospitalization and the occurrence of bacterial infections. The primary endpoint of the study was defined as differences in survival between patients with pathological and without pathological lactulose/mannitol test.RESULTS: Thirty-nine(85%) patients with cirrhosis had a pathologically increased IP index(L/M ratio > 0.07) compared to 4(25%) healthy controls(P < 0.0001). The IP index correlated with the ChildPugh score(r = 0.484, P = 0.001) and with serum IL-6(r = 0.342, P = 0.02). Within one year, nineteen(41%) patients developed a total of 33 episodes of hospitalization with bacterial or fungal infections. Although patients who developed spontaneous bacterial peritonitis(SBP)(n = 7) had a higher IP index than patients who did not(0.27 vs 0.14, P = 0.018), the baseline IP index did not predict time to infection, infection-free survival or overall survival, neither when assessed as linear variable, as tertiles, nor dichotomized using an established cut-off. In contrast, model for end-stage liver disease score, Child-Pugh score, the presence of ascites, serum IL-6 and I-FABP were univariate predictors of infection-free survival.CONCLUSION: Although increased IP is a frequent phenomenon in advanced cirrhosis and may predispose to SBP, it failed to predict infection-free and overall survival in this prospective cohort study. | Anika Vogt Philipp A Reuken Sven Stengel Andreas Stallmach Tony Bruns | 2016 | World Journal of Gastroenterology2016，22，11： | 8 |
| 2 | Soluble urokinase plas- minogen activator receptor (suPAR) is compartmentally regulated in decompensated cirrhosis and indicates immune activation and short-term mortality显示文摘 | Zimmermann HW Reuken PA Koch A | 2013 | J Intern Med2013，1，274： | 1 |
| 3 | Imbalance of vonWillebrand factor and its cleaving protease ADAMTS13 during sys-temic inflammation superimposed on advanced cirrhosis 显示文摘 | Reuken PA Kussmann A Kiehntopf M | 2015 | LiverInt2015，35，1： | 1 |
| 4 | Soluble urokinase plasminogen activator receptor is compartmentally regulated in decompensated cirrhosis and indicates immune activation and short‐term mortality显示文摘 | H. W. Zimmermann P. A. Reuken A. Koch M. Bartneck D. H. Adams C. Trautwein A. Stallmach F. Tacke T. Bruns | 2013 | J Intern Med2013，，1： | 1 |
| 5 | Reactions of orthoesters with active methylene compounds 显示文摘 | Reuken G Jones | 1952 | J Am Chem Soc1952，74，5： | 1 |
| 6 | Soluble urokinase plasminogen activator receptor is compart- mentally regulated in decompensated cirrhosis and in- dicates immune activation and short-term mortality 显示文摘 | Zimmermann HW Reuken PA Koeh A | 2013 | Journal of Internal Medicine2013，274，1： | 1 |
| 7 | Knife or catheter? Treatment of intra-abdominal abscesses in patients with Crohns disease显示文摘 | Reuken P Stallmach A | 2013 | Z Gastroenterol2013，51，7： | 1 |
| 8 | Reactions of orthoesters with active methylene compounds 显示文摘 | Reuken G Jones | 1952 | J Am Chem Soc1952，74，5： | 1 |
| 9 | Reactions of orthoesters with active methylene compounds显示文摘 | Reuken G Jones | 1952 | J Am Chem Soc1952，74，5： | 1 |
| 10 | Evaluation of Ultrasound-based Surveillance for Hepatocellular Carcinoma in Patients at Risk:Results From a German Multicenter Retrospective Cohort Study显示文摘Background and Aims:Hepatocellular carcinoma(HCC)surveillance in patients at risk is strongly recommended and usually performed by ultrasound(US)semiannually with or without alfa-fetoprotein(AFP)measurements.Quality pa-rameters except for surveillance intervals have not been strictly defined.We aimed to evaluate surveillance success and risk factors for surveillance failure.Methods:Patients with≥1 US prior to HCC diagnosis performed at four tertiary referral hospitals in Germany between 2008 and 2019 were retrospectively analyzed.Surveillance success was defined as HCC detection within Milan criteria.Results:Only 47%of 156 patients,median age 63(interquartile range:57-70)years,56%male,and 96%with cirrhosis,received recom-mended surveillance modality and interval.Surveillance fail-ure occurred in 29%and was significantly associated with lower median model for end-stage liver disease(MELD)score odds ratio(OR)1.154,95%confidence interval(CI):1.027-1.297,p=0.025)and HCC localization within right liver lobe(OR:6.083,95%CI:1.303-28.407,p=0.022),but not with AFP≥200μg/L.Patients with surveillance failure had sig-nificantly more intermediate/advanced tumor stages(93%vs.6%,p<0.001),fewer curative treatment options(15%vs.75%,p<0.001)and lower survival at 1 year(54%vs.75%,p=0.041),2 years(32%vs.57%,p=0.019)and 5 years(0%vs.16%,p=0.009).Alcoholic and non-alcoholic fatty liver disease(OR:6.1,95%CI:1.7-21.3,p=0.005)and ascites(OR:3.9,95%CI:1.2-12.6,p=0.021)were in-dependently associated with severe visual limitations on US.Conclusions:US-based HCC surveillance in patients at risk frequently fails and its failure is associated with unfavorable patient-related outcomes.Lower MELD score and HCC lo-calization within right liver lobe were significantly associated with surveillance failure. | Johannes Gillessen Philipp Reuken Peter-Marton Hunyady Matthias Christian Reichert Lucian Lothschütz Fabian Finkelmeier Matthias Nowka Gabriel Allo Fabian Kütting Martin Bürger Dirk Nierhoff Hans-Michael Steffen Christoph Schramm | 2023 | Journal of Clinical and Translational Hepatology2023，11，3： | 0 |
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