Portal Vein Thrombosis in Patients with Liver Cirrhosis

The myth that patients with liver cirrhosis are “auto‐anticoagulated” is outdated, and evidence shows that these patients frequently experience thrombosis. Portal vein thrombosis (PVT), although considered as rare, it gradually increases complications that are more likely to occur during late‐stage liver cirrhosis. The aim of this chapter is to perform a review of nonmalignant portal vein thrombosis in cirrhosis, in terms of prevalence, pathogenesis, diagnosis, clinical course, and management. Studies were identified by a search strategy using MEDLINE and EMBASE databases. For the MEDLINE search, we used the following terms: (“liver cirrhosis” [MeSH Terms] OR “cirrhosis” [All Fields] OR “cirrhosis” [All Fields]) AND (“portal vein” [MeSH Terms] OR “portal vein” [All Fields]) AND (“Thrombosis” [MeSH Terms]). For the EMBASE search, we used the following terms: (cirrhosis OR phrase liver cirrhosis) AND (phrase thrombosis/OR phrase vein thrombosis/OR phrase thrombosis prevention/OR phrase portal vein thrombosis/OR phrase liver vein thrombosis/OR phrase mesenteric vein thrombosis/OR thrombosis). Studies were considered eligible if they referred to any aspect of prevalence, pathophysiology, clinical presentation, diagnosis and management, or therapy of PVT in cirrhosis. We put forward possible responses to these unsettled issues starting with prevalence, pathogenesis, and treatment options

A study of the levels of glutathione peroxidase in patients with spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis (SBP) is a major complication of liver cirrhosis, which is associated with increased mortality. While recent studies have demonstrated the involvement of reactive oxygen species in the pathogenesis of liver cirrhosis, the role of oxidative stress in the development of SBP has not yet been completely established. The present study aims to evaluate the role of oxidative stress in the pathogenesis of this complication and also the relevance of the specific treatment on these aspects. We present here some of our preliminary results regarding the specific activity of glutathione peroxidase (GPX), a very important antioxidant enzyme, from both serum and ascitic fluid of patients with decompensated cirrhosis and SBP, patients diagnosed with decompensated liver cirrhosis with ascites and patients with compensated liver cirrhosis. Our results demonstrate the presence of an increased oxidative stress in patients with decompensated cirrhosis and SBP compared with those without SBS and those with compensated liver cirrhosis, as demonstrated through the significant decrease of the specific activity of GPX. The measurement of these oxidative stress parameters may have an important role in the diagnosis and follow-up of this important liver pathology and the auxiliary treatment

Microwave assisted hydro-distillation of essential oils from fresh ginger root (Zingiber officinale Roscoe)

A solvent free in situ microwave hydro-distillation method for extraction of essential oil from fresh ginger root it presented. Extraction was conducted in a TE10n single-mode microwave cavity and variable power 2 kW generator operating at 2.45GHz. The main extracted components identified by gas chromatography (GC) were Zingiberene, α-Curcumene, β-Sesquiphellandrene and α-Selinene. At energy inputs of 0.40 kWh/kg higher powers and shorter exposure times, crucially did not degrade the highly volatile components (α-Pinene and Camphene) despite providing the highest essential oil yields. Optimum processing conditions were found to be 1000W (0.40kWh/kg) for 5 min, for whole ginger root, where 0.35g oil/100g plant was obtained. This was compared to a yield of 0.2g/100g plant in 150 min in using conventional hydro-distillation and 0.3g/100g plant in 90 min using a multi-mode microwave cavity-based hydro-distillation

Gastrointestinal Manifestations of IgA Vasculitis-Henoch-Schönlein Purpura

Immunoglobulin A vasculitis, formerly called Henoch-Schönlein purpura (HSP), is the most common systemic vasculitis in childhood. It is a small-vessel vasculitis mediated by type III hypersensitivity, manifested as rash accompanied by gastrointestinal (GI) symptoms, arthritis, and nephritis. The etiology of this disease (a leukocytoclastic vasculitis) is still uncertain, but immune complexes of IgA and unidentified antigens seem to have a central pathogenic role. Most often the diagnosis is established after the clinical examination; it is easy at first glance when the clinical presentation includes the classic tetrad of rash (nonthrombocytopenic palpable purpura), arthralgia/arthritis, abdominal pain, and renal manifestations but may be difficult when the gastrointestinal manifestations precede the skin purpuric rash. Gastrointestinal involvement is frequently seen and varies from mild symptoms to severe complications; sometimes the gastrointestinal symptoms (colicky abdominal pain, nausea, vomiting, diarrhea, gastrointestinal bleeding) are the first manifestations of the disease. Immunoglobulin A vasculitis is usually a self-limited disease with a benign course, and the treatment is often symptomatic; in severe cases corticosteroids are necessary

Barriers in inflammatory bowel disease care in Central and Eastern Europe: a region-specific analysis

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are chronic immune-mediated diseases with a high incidence and prevalence in Europe. Since these are diseases with associated disability, they require complex management and the availability of high-quality healthcare resources. We focused on the analysis of IBD care in selected countries of Central and Eastern Europe (Croatia, the Czech Republic, Hungary, Moldova, Poland, Romania and Slovakia) targeting the availability and reimbursement of diagnostic and therapeutic modalities, the role of IBD centers and also education and research in IBD. As part of the analysis, we created a questionnaire of 73 statements organized in three topics: (1) diagnostics, follow-up and screening, (2) medications and (3) IBD centers. The questionnaire was filled out by co-authoring IBD experts from individual countries, and then the answers and comments on the questionnaire were analyzed. We identified that despite the financial burden, which still partially persists in the region, the availability of some of the cost-saving tools (calprotectin test, therapeutic drug monitoring) differs among countries, mainly due to variable reimbursement from country to country. In most participating countries, there also remains a lack of dedicated dietary and psychological counseling, which is often replaced by recommendations offered by gastroenterologists. However, there is adequate availability of most of the currently recommended diagnostic methods and therapies in each participating country, as well as the implementation of established IBD centers in the region. © The Author(s), 2023