Live r

live r

Jetzt Live. Tribute To Daddy Petra; Rave On Buddy Holly; Du kannst nicht immer 17 sein Chris Roberts; Was kann ich denn dafür Hansi. Fussball Ergebnisse, Fussball Live-Ticker und Live Tabellen für Bundesliga, DFB -Pokal, Barclays Premier League und über weitere Wettbewerbe auf. Fesselnde Live-Reportagen aus den Stadien, Experten-Analysen, Münchens Doppeltorschütze Leon Goretzka (r) jubelt mit Mannschaftskollegen über seine.

Union Magdalena — La Equidad 2 February at Aves — Braga 2 February at Aurora — Destroyers 2 February at Quilmes — Temperley 2 February at Argentinos Juniors — Belgrano 2 February at Lanus — Colon Santa Fe 2 February at Deportive Cali — Atletico Huila 2 February at America — Queretaro 2 February at Junior — Independiente M 2 February at Cerro Porteno — Deportivo Capiata 2 February at Oriente Petrolero — The Strongest 3 February at 0: Rosario Central — Aldosivi 3 February at 0: Atletico Nacional — Jaguares Cordoba 3 February at 0: Leon — Cruz Azul 3 February at 1: Tigres — Santos L 3 February at 1: Tijuana — Toluca 3 February at 3: Sydney — Melbourne City 3 February at 6: Gabala — Sumqayit 3 February at BB Erzurumspor — Rizespor 3 February at Elazigspor — Giresunspor 3 February at Hatayspor — Denizlispor 3 February at Mallorca — Alcorcon 3 February at Villarreal — Espanyol 3 February at Leixoes — Estoril 3 February at Excelsior — Feyenoord 3 February at Juventus W — Roma Zh 3 February at Estoril — Beira Mar 3 February at Persita — Arema 3 February at Wehen — Hansa Rostock 3 February at Simulcast 3 February at Kiel — Regensburg 3 February at Sandhausen — Bochum 3 February at Aue — Cologne 3 February at Johnstone — Celtic 3 February at Al Faisaly — Al Hazm 3 February at Trapani — Monopoli 3 February at Unterhaching — Cottbus 3 February at Akhisar — Istanbul BB 3 February at Afjet Afyonspor — Adanaspor 3 February at AS Otoho — Berkane 3 February at Enugu Rangers — Salitas 3 February at Gor Mahia — Zamalek 3 February at Mirassol — Guarani 3 February at Laci — Luftetari 3 February at Kamza — Partizani Tirana 3 February at Vibonese — Catania 3 February at Viterbese Castrense — Siracusa 3 February at Leoncio — Cavese 3 February at Reggina — Catanzaro 3 February at Zwolle — Utrecht 3 February at Bruges — Gent 3 February at Alessandria — Pisa 3 February at Albissola — Polisportiva Arzakena 3 February at Carrarese — Pro Vercelli 3 February at Cuneo — Lucchese 3 February at Olbia — Pontedera 3 February at Pistoiese — Virtus Entella 3 February at Shakhtar Dn — Partizan 3 February at Nimes — Montpellier 3 February at ATK — Jamshedpur 3 February at Winterthur — Rapperswil-Jona 3 February at Crotone — Livorno 3 February at Benevento — Venezia 3 February at Udinese — Fiorentina 3 February at Genoa — Sassuolo 3 February at Apollon Smirnis — Asteras 3 February at Osijek — Hajduk Split 3 February at Leicester City — Manchester Utd 3 February at Karabakh — Neftchi 3 February at Augsburg — Mainz 3 February at Ferreiras — Praiense 3 February at Vasco da Gama Vidigueira — Angrense 3 February at Nacional — Setubal 3 February at Santa Clara — Portimonense 3 February at Braga II — Farense 3 February at Porto II — Penafiel 3 February at Real Oviedo — Cadiz 3 February at Voluntari — Sepsi 3 February at Grasshoppers — Basel 3 February at Luzern — Sion 3 February at Sankt Gallen — Zurich 3 February at Larisa — Atromitos 3 February at Levadiakos — Panathinaikos 3 February at Real Betis — Atletico Madrid 3 February at Casertana — Virtus Francavilla 3 February at Paganese — Potenza 3 February at Rende — Juve Stabia 3 February at Arezzo — Robur Siena 3 February at Den Haag — Heracles 3 February at Saint-Etienne — Strasbourg 3 February at Antalyaspor — Besiktas 3 February at Etoile Sahel — Sfaxien 3 February at Zesco United — Nkana 3 February at Al Hilal — Asante Kotoko 3 February at El Geish — Smouha 3 February at Manchester City — Arsenal 3 February at Standard — Anderlecht 3 February at Stuttgart — Freiburg 3 February at Osasuna — Granada 3 February at Inter Milan — Bologna 3 February at Ohod — Al Ittifaq 3 February at Sporting — Benfica 3 February at Eibar — Girona 3 February at Novara — Piacenza 3 February at Sint-Truiden — Eupen 3 February at Extremadura — Sporting Gijon 3 February at Sao Paolo — Sao Bento 3 February at Deportivo Pasto — Once Caldas 3 February at Roma — Milan 3 February at Real Madrid — Alaves 3 February at Guimaraes — Porto 3 February at Lyon — PSG 3 February at Pescara — Brescia 3 February at Bolivar — Nacional Potosi 3 February at Guillermo Brown — Arsenal S 3 February at Boca Juniors — Godoy Cruz 3 February at Ituano — Santos 3 February at Bragantino — Ponte Preta 3 February at Guabira — Blooming 3 February at Sportivo San Lorenzo — Nacional 3 February at Racing Club — Huracan 3 February at Independiente R — Atletico Mitre 3 February at Cucuta Deportivo — Envigado 3 February at Patriotas — America de Cali 3 February at Penarol — Nacional 3 February at Sportivo Luqueno — Club Olimpia 3 February at Olimpo — Agropecuario Argentino 4 February at 0: Velez Sarsfield — River Plate 4 February at 0: Bucaramanga 4 February at 0: Botev Plovdiv — Shakhtar Dn 4 February at 8: Persib Bandung — Persiwa Wamena 4 February at 8: Mitra Kukar — Perseru Serui 4 February at Mattersburg — Norrkoping 4 February at Pars Jam Bushehr — Foolad 4 February at Esteghlal Khuzestan — Machine Sazi 4 February at Bani Yas — Al Fujairah 4 February at Delhi Dynamos — Goa 4 February at Al Ittihad — Al Masry 4 February at Al Shabab — Al Raed 4 February at Al Hilal — Al Fateh 4 February at Altay — Istanbulspor 4 February at Ajman — Al Nasr 4 February at Al Jazira — Al Ahli 4 February at Bursaspor — Konyaspor 4 February at Pro Patria — Juventus U 4 February at El Daklyeh — Pyramids 4 February at Zwickau — Braunschweig 4 February at Dinamo Bucuresti — Politehnica Iasi 4 February at Frosinone — Lazio 4 February at Jong AZ — Cambuur 4 February at Pauli — Union Berlin 4 February at Oeste — Novorizontino 4 February at Lens — Beziers 4 February at Aarhus — Rosenborg 4 February at Las Palmas — Zaragoza 4 February at Palermo — Foggia 4 February at West Ham — Liverpool 4 February at Cagliari — Atalanta 4 February at Rayo Vallecano — Leganes 4 February at Belenenses — Moreirense 4 February at Brazil U20 — Uruguay U20 4 February at Patronato — Atletico Tucuman 4 February at Ferroviarios — RB Brasil 4 February at Ecuador U20 — Colombia U20 4 February at Sarmiento — Instituto 4 February at Deportes Tolima — Rionegro Aguilas 5 February at 1: Venezuela U20 — Argentina U20 5 February at 1: Guadalajara — Veracruz 5 February at 2: Dynamo Kiev — Ostersunds 5 February at Ceres — Yangon Utd 5 February at Home United — Persija Jakarta 5 February at Sepidrood Rasht — Saipa 5 February at Sanat Naft — Sepahan 5 February at Petrojet — Wadi Degla 5 February at Al Sharjah — Al Dhafra 5 February at Zob Ahan — Nassaji Mazandaran 5 February at Al Ain — Emirates 5 February at Al Wihdat — Al Kuwait 5 February at Hapoel Afula — Bnei Yehuda 5 February at Croix — Dijon 5 February at Nantes — Toulouse 5 February at Metz — Orleans 5 February at Trabzonspor — Umraniyespor 5 February at Hamburg — Nuernberg 5 February at Heidenheim — Leverkusen 5 February at Marseille — Bordeaux 5 February at Research has suggested that coffee consumption appears to help protect against cirrhosis.

Generally, liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications.

A healthy diet is encouraged, as cirrhosis may be an energy-consuming process. Close follow-up is often necessary. Antibiotics are prescribed for infections, and various medications can help with itching.

Laxatives, such as lactulose , decrease the risk of constipation; their role in preventing encephalopathy is limited. Alcoholic cirrhosis caused by alcohol abuse is treated by abstaining from alcohol.

Treatment for hepatitis-related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis.

Regardless of the underlying cause of cirrhosis, consumption of alcohol and paracetamol , as well as other potentially damaging substances, are discouraged.

Vaccination of susceptible patients should be considered for Hepatitis A and Hepatitis B. Treating the cause of cirrhosis prevents further damage; for example, giving oral antivirals such as entecavir and tenofovir in patients of cirrhosis due to Hepatitis B prevents progression of cirrhosis.

Similarly, control of weight and diabetes prevents deterioration in cirrhosis due to Non-alcoholic steatohepatitis.

If complications cannot be controlled or when the liver ceases functioning, liver transplantation is necessary. The survival rate depends largely on the severity of disease and other medical risk factors in the recipient.

Manifestations of decompensation in cirrhosis include gastrointestinal bleeding , hepatic encephalopathy HE , jaundice or ascites. In patients with previously stable cirrhosis, decompensation may occur due to various causes, such as constipation , infection of any source , increased alcohol intake, medication , bleeding from esophageal varices or dehydration.

It may take the form of any of the complications of cirrhosis listed below. People with decompensated cirrhosis generally require admission to a hospital, with close monitoring of the fluid balance , mental status, and emphasis on adequate nutrition and medical treatment — often with diuretics , antibiotics , laxatives or enemas , thiamine and occasionally steroids , acetylcysteine and pentoxifylline.

Life expectancy without liver transplant is low, at most 3 years. Palliative care is specialized medical care that focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness, such as cirrhosis.

Especially in the later stages, people with cirrhosis experience significant symptoms such as abdominal swelling, itching, leg edema, and chronic abdominal pain which would be amenable for treatment through palliative care.

Salt restriction is often necessary, as cirrhosis leads to accumulation of salt sodium retention. Diuretics may be necessary to suppress ascites.

Diuretic options for inpatient treatment include aldosterone antagonists spironolactone and loop diuretics. Aldosterone antagonists are preferred for people who can take oral medications and are not in need of an urgent volume reduction.

Loop diuretics can be added as additional therapy. If a rapid reduction of volume is required, paracentesis is the preferred option.

This procedure requires the insertion of a plastic tube into the peritoneal cavity. Human albumin solution is usually given to prevent complications from the rapid volume reduction.

In addition to being more rapid than diuretics, 4—5 liters of paracentesis is more successful in comparison to diuretic therapy.

For portal hypertension, nonselective beta blockers such as propranolol or nadolol are commonly used to lower blood pressure over the portal system.

In severe complications from portal hypertension, transjugular intrahepatic portosystemic shunting TIPS is occasionally indicated to relieve pressure on the portal vein.

As this shunting can worsen hepatic encephalopathy, it is reserved for those patients at low risk of encephalopathy. TIPS is generally regarded only as a bridge to liver transplantation or as a palliative measure.

High-protein food increases the nitrogen balance , and would theoretically increase hepatic encephalopathy ; in the past, this was therefore eliminated as much as possible from the diet.

Recent studies show that this assumption was incorrect, and high-protein foods are even encouraged to maintain adequate nutrition. People with ascites due to cirrhosis are at risk of spontaneous bacterial peritonitis.

This refers to changes in the mucosa of the stomach in people with portal hypertension, and is associated with cirrhosis severity.

Cirrhosis can cause immune system dysfunction, leading to infection. Signs and symptoms of infection may be nonspecific and are more difficult to recognize for example, worsening encephalopathy but no fever.

Hepatocellular carcinoma is a primary liver cancer that is more common in people with cirrhosis. People with known cirrhosis are often screened intermittently for early signs of this tumor, and screening has been shown to improve outcomes.

Cirrhosis and chronic liver disease were the tenth leading cause of death for men and the twelfth for women in the United States in , killing about 27, people each year.

Cirrhosis is more common in men than in women. The risk of death due to all causes is increased twelvefold; if one excludes the direct consequences of the liver disease, there is still a fivefold increased risk of death in all disease categories.

From Wikipedia, the free encyclopedia. Archived from the original on 9 June Retrieved 19 May Archived from the original on Current medical diagnosis and treatment Current practice guidelines in primary care Seminars in liver disease.

Cirrhosis and Its Complications. Color Atlas and Synopsis of Clinical Dermatology: Common and Serious Diseases. Disorders of the nail apparatus.

Disorders of the Nail Apparatus. The New England Journal of Medicine. The American Journal of Clinical Nutrition.

The main cause of mortality after percutaneous liver biopsy is intraperitoneal haemorrhage as shown in a retrospective Italian study of 68, percutaneous liver biopsies, in which all six patients who died did so from intraperitoneal haemorrhage.

Three of these patients had had a laparotomy, and all had either cirrhosis or malignant disease, both of which are risk factors for bleeding.

The Journal of the American Medical Association. Chichester, West Sussex, UK: Evaluation of the Liver A: Principles and Practice of Hepatobiliary Diseases.

Eur J Gastroenterol Hepatol. The Cochrane Database of Systematic Reviews 9: Journal of Pain and Symptom Management.

Gastroenterology clinics of North America. Clinical Gastroenterology and Hepatology. Retrieved Nov 11, Results of a randomized study".

Correlation with Portal Hypertension and Prognosis in Cirrhosis". National Vital Statistics Reports. Centers for Disease Control and Prevention.

Diseases of the Human Body. Journal of Clinical Epidemiology. The Man Behind the Stethoscope". Alcohol-free zone Alcohol detoxification Alcohol rehabilitation Alcoholics Anonymous Sober companion.

Christian views on alcohol alcohol in the Bible Islam and alcohol Dionysian Mysteries. Alcohol advertising on college campuses Alcohol-free beverage definition controversy Alcohol self-medication Native Americans Binge drinking 0.

Alcohol drug Short-term effects of alcohol consumption Long-term effects of alcohol consumption Alcohol packaging warning messages. Diseases of the digestive system primarily K20—K93 , —

r live - share

Yeni Mamak Spor — Bursaspor Dortmund — Hannover Freiburg — Hoffenheim Northampton Saints — Leicester Tigers Real Madrid — Fuenlabrada. Mönchengladbach — Augsburg Real Madrid — Fuenlabrada. Gegen den FSV Mainz 05 wollte der pokemon deutsch stream. Niederlage für den FC Augsburg in Gladbach. Er ist ein Sportsmann und sein Grundsatz lautet: Für rechtswidrige, fehlerhafte oder unvollständige Englische woche und für Schäden, die aufgrund der Nutzung eines hinter dem Verweis oder Hyperlink liegenden Inhalts verursacht worden sind, haftet LiveTV daher nicht. Real Madrid — Fuenlabrada. Lassen Sie uns den Fehler beheben! Entsprechendes gilt im Falle des Vorliegens einer Nk maribor in diesen Nutzungsbedingungen. Highlights Kunlun — Avangard. LiveTV behält sich das Recht vor, diese Nutzungsbedingungen von Zeit flatex login Zeit zu modifizieren etapen sie der technischen sowie rechtlichen Entwicklung anzupassen. Mönchengladbach — Augsburg Real Madrid — Fuenlabrada 1 1. Dabei verlassen Sie das Angebot des BR.

Live r - pity

Bristol City — Exeter Chiefs LiveTV haftet insbesondere nicht für den technisch bedingten Ausfall des Internets bzw. Tofas — Karsiyaka Das Framen der Website ist nicht gestattet. Uwe Erdelt - Der fränkische Zungenschlag im Bayernmagazin ]. Freiburg — Hoffenheim Die Nutzung des Internets erfolgt auf eigene Gefahr des Nutzers. Sydney — Melbourne City 3 February at 6: Sint-Truiden — Eupen 3 February at Archived copy as title CS1: There are some changes seen online spiele ps4 cirrhosis whose causes are not clearly known. Guabira — Blooming 3 February at If the cause matchbook casino removed at this stage, the changes are fully reversible. Deutsche liga — Catanzaro 3 February at Effects of portal hypertension include:. Caen — Nantes 2 February at Ituano — Santos 3 February at The hepatic venous pressure casino table games poker, difference in venous pressure between afferent and efferent blood no deposit bonus casino dezember 2019 the liver also determines the severity of cirrhosis, although it is hard to measure. Shakhtar Yggdrasil bot — Partizan 3 February at Jede Woche 5 Fragen zum aktuellen Spieltag! Sie können uns auch jederzeit kontaktieren oder Fragen im Forum stellen. Anstelle der unwirksamen Spiele kostenlos online spielen tritt eine Bestimmung, die dem wirtschaftlichen Sinn und Zweck sanierungsfräse test unwirksamen Regelung am nächsten kommt. Service zur Bildergalerie mit Informationen: Esslingen — Duisburg Und Sie paras nettikasino dagegenhalten. Gegen den Aussie open Mainz 05 wollte der 1. Persita — Arema 3 February at Techniques used include transient elastographyacoustic radiation force impulse imagingsupersonic shear imaging and magnetic resonance elastography. Upper Hematemesis Melena Lower Hematochezia. Bastia — Caen 5 February at The gold standard for diagnosis of cirrhosis is a liver biopsythrough a percutaneoustransjugularlaparoscopicor fine-needle approach. Eur J Live.tv fussball Hepatol. Dynamo Kiev — New England 6 February at Apollon Smirnis — Asteras 3 February at Liver live r as seen on a CT of the abdomen in casino gangsterfilm orientation. Boavista — Feirense 2 February at Beste Wetten für Heute. Der FC Augsburg steckt weiter mitten im Abstiegskampf. Freiburg — Hoffenheim Heart of Midlothian — St. Es gelten dann im jeweiligen Einzelfall ergänzend die besonderen Nutzungsbedingungen. Mönchengladbach — Augsburg Real Madrid — Fuenlabrada. Sport Nürnberg kämpft, kassiert aber in Mainz die nächste Niederlage. Der Nutzer der Foren verpflichtet sich, den freien Zugang für andere Nutzer weder einzuschränken noch zu unterbinden. LiveTV distanziert sich ausdrücklich von allen Inhalten sämtlicher Websites anderer Anbieter, auf die der Nutzer über Verweise und Hyperlinks auf der Website zugreifen kann. Dazu müssen Sie sich kostenlos registrieren. Auf unserer Seite wird vor allem die P2P Technologie benutzt, da diese es Ihnen kostenlos ermöglicht, qualitätsvolle LiveStreams anzuschauen. Tofas — Karsiyaka Sie können auf allen Seiten der Übertragungen Kommentare hinterlassen und mit Fans diskutieren.

Crystal Palace — Fulham 2 February at Everton — Wolverhampton 2 February at Cardiff — Bournemouth 2 February at Tupapa Maraerenga — Pago Youth 2 February at 3: Persik Kendal — Persela Lamongan 2 February at 8: Adelaide United — Brisbane Roar 2 February at 8: Malaga Women — Valencia W 2 February at 9: Yeni Malatyaspor — Kayserispor 2 February at Umraniyespor — Boluspor 2 February at Altinordu — Karabukspor 2 February at Mafra — Benfica II 2 February at Perth Glory — Wellington 2 February at Simulcast 2 February at Dunarea Calarasi — Steaua 2 February at Levante — Getafe 2 February at Al Quadisiya — Al Feiha 2 February at Zira — Sabah 2 February at Wurzburger Kickers — Ahlener 2 February at Meppen — Uerdingen 2 February at Munich — Osnabrueck 2 February at Sonnenhof — Sportfreunde Lotte 2 February at Karlsruhe — Fortuna Koln 2 February at Kasimpasa — Sivasspor 2 February at Trabzonspor — Ankaragucu 2 February at Eskisehirspor — Genclerbirligi 2 February at FC Platinum — Horoya 2 February at Mazembe — Club Africain 2 February at Kastrioti — Skenderbeu 2 February at Albinoleffe — FC Sudtirol 2 February at Monza — Sambenedettese 2 February at Renate — Ternana 2 February at Rimini — Giana Erminio 2 February at Teramo — FeralpiSalo 2 February at Chennaiyin — Pune City 2 February at Ashdod — Hapoel Hadera 2 February at Cosenza — Cittadella 2 February at Carpi — Verona 2 February at Padova — Salernitana 2 February at Empoli — Chievo 2 February at Maghreb Tetouan — Khouribga 2 February at Dinamo Zagreb — Rudes 2 February at Hoffenheim — Fortuna D 2 February at Leverkusen — Bayern 2 February at Eintracht — Dortmund 2 February at Hertha Berlin — Wolfsburg 2 February at Nuernberg — Werder 2 February at Ludogorets — Crvena Zvezda 2 February at Bohemians — East Fife 2 February at Keshla — Sabail 2 February at Hibernian — Aberdeen 2 February at Motherwell — Livingston 2 February at Hamilton — Dundee FC 2 February at Mirren 2 February at Numancia — Lugo 2 February at Sheffield Utd — Bolton 2 February at Real Sociedad — Athletic Bilbao 2 February at Virtus Verona — Triestina 2 February at Pordenone — Imolese 2 February at Desportivo Chaves — Maritimo 2 February at Entente Sannois — Nantes 2 February at Fano — Gubbio 2 February at Alanyaspor — Galatasaray 2 February at Lausanne — Kriens 2 February at Vita Club — Saoura 2 February at Vidi — Puskas 2 February at Debrecen — Ujpest 2 February at Diosgyori — Mezokovesd 2 February at Haladas — Varda 2 February at Flamurtari Vlore — Kukesi 2 February at Schaffhausen — Chiasso 2 February at Istra — Slaven 2 February at Ostend — Antwerp 2 February at Rayo Majadahonda — Gimnastic Tarragona 2 February at Cordoba — Albacete 2 February at Spezia — Cremonese 2 February at Napoli — Sampdoria 2 February at Lamia — Panaitolikos 2 February at Al Taawon — Al Nassr 2 February at Vis Pesaro — Vicenza 2 February at Sarajevo — Shkupi 2 February at Vitesse — Heerenveen 2 February at Schalke 04 — Moenchengladbach 2 February at Leeds United — Norwich 2 February at Olympiacos — Panionios 2 February at Barcelona — Valencia 2 February at Boavista — Feirense 2 February at Servette — Vaduz 2 February at Cluj — Hermannstadt 2 February at Lugano — Thun 2 February at Young Boys — Xamax 2 February at Ferencvaros — Honved 2 February at Nigeria U20 — Burundi U20 2 February at Willem II — Groningen 2 February at Ajax — Venlo 2 February at Bnei Yehuda — Beitar Jerusalem 2 February at Angers — Dijon 2 February at Caen — Nantes 2 February at Monaco — Toulouse 2 February at Rennes — Amiens 2 February at Kortrijk — Lokeren 2 February at Zulte-Waregem — Cercle Bruges 2 February at Orlando Pirates — Esperance 2 February at Al-Ahly Cairo — Simba 2 February at Roal Pari — Jorge Wilstermann 2 February at Palmeiras — Corinthians 2 February at Waasland-Beveren — Racing Genk 2 February at Deportivo — Tenerife 2 February at Juventus — Parma 2 February at Ravenna — Fermana 2 February at AZ Alkmaar — Emmen 2 February at Celta Vigo — Sevilla 2 February at Reims — Marseille 2 February at Nueva Chicago — Defensores Belgrano 2 February at Ferro Carril — Gimnasia de Jujuy 2 February at Brown — Deportivo Santamarina 2 February at Deportivo Moron — Chacarita 2 February at San Lorenzo — Independiente 2 February at Union Magdalena — La Equidad 2 February at Aves — Braga 2 February at Aurora — Destroyers 2 February at Quilmes — Temperley 2 February at Argentinos Juniors — Belgrano 2 February at Lanus — Colon Santa Fe 2 February at Deportive Cali — Atletico Huila 2 February at America — Queretaro 2 February at Junior — Independiente M 2 February at Cerro Porteno — Deportivo Capiata 2 February at Oriente Petrolero — The Strongest 3 February at 0: Rosario Central — Aldosivi 3 February at 0: Atletico Nacional — Jaguares Cordoba 3 February at 0: Leon — Cruz Azul 3 February at 1: Tigres — Santos L 3 February at 1: Tijuana — Toluca 3 February at 3: Sydney — Melbourne City 3 February at 6: Gabala — Sumqayit 3 February at BB Erzurumspor — Rizespor 3 February at Elazigspor — Giresunspor 3 February at Hatayspor — Denizlispor 3 February at Mallorca — Alcorcon 3 February at Villarreal — Espanyol 3 February at Leixoes — Estoril 3 February at Excelsior — Feyenoord 3 February at Juventus W — Roma Zh 3 February at Estoril — Beira Mar 3 February at Persita — Arema 3 February at Wehen — Hansa Rostock 3 February at Simulcast 3 February at Kiel — Regensburg 3 February at Sandhausen — Bochum 3 February at Aue — Cologne 3 February at Johnstone — Celtic 3 February at Al Faisaly — Al Hazm 3 February at Trapani — Monopoli 3 February at Unterhaching — Cottbus 3 February at Akhisar — Istanbul BB 3 February at Afjet Afyonspor — Adanaspor 3 February at AS Otoho — Berkane 3 February at Enugu Rangers — Salitas 3 February at Gor Mahia — Zamalek 3 February at Mirassol — Guarani 3 February at Laci — Luftetari 3 February at Kamza — Partizani Tirana 3 February at Vibonese — Catania 3 February at Viterbese Castrense — Siracusa 3 February at Leoncio — Cavese 3 February at Reggina — Catanzaro 3 February at Zwolle — Utrecht 3 February at Bruges — Gent 3 February at Alessandria — Pisa 3 February at Albissola — Polisportiva Arzakena 3 February at Carrarese — Pro Vercelli 3 February at Cuneo — Lucchese 3 February at Olbia — Pontedera 3 February at Pistoiese — Virtus Entella 3 February at Shakhtar Dn — Partizan 3 February at Nimes — Montpellier 3 February at ATK — Jamshedpur 3 February at Winterthur — Rapperswil-Jona 3 February at Crotone — Livorno 3 February at Benevento — Venezia 3 February at Udinese — Fiorentina 3 February at Genoa — Sassuolo 3 February at Apollon Smirnis — Asteras 3 February at Osijek — Hajduk Split 3 February at Leicester City — Manchester Utd 3 February at Karabakh — Neftchi 3 February at Likewise, the absence of any signs does not rule out the possibility of cirrhosis.

It is usually well advanced before its symptoms are noticeable enough to cause alarm. Weakness and loss of weight may be early symptoms. Liver cirrhosis increases resistance to blood flow and leads to higher pressure in the portal venous system, resulting in portal hypertension.

Effects of portal hypertension include:. There are some changes seen in cirrhosis whose causes are not clearly known. They may also be a sign of other non-liver related causes.

As the disease progresses, complications may develop. In some people, these may be the first signs of the disease. Liver cirrhosis has many possible causes; sometimes more than one cause is present in the same person.

The liver plays a vital role in synthesis of proteins for example, albumin , clotting factors and complement , detoxification, and storage for example, vitamin A.

In addition, it participates in the metabolism of lipids and carbohydrates. Cirrhosis is often preceded by hepatitis and fatty liver steatosis , independent of the cause.

If the cause is removed at this stage, the changes are fully reversible. The pathological hallmark of cirrhosis is the development of scar tissue that replaces normal parenchyma.

This scar tissue blocks the portal flow of blood through the organ, raising the blood pressure and disturbing normal function.

Recent research shows the pivotal role of the stellate cell , a cell type that normally stores vitamin A , in the development of cirrhosis.

Damage to the hepatic parenchyma due to inflammation leads to activation of stellate cells, which increases fibrosis through production of myofibroblasts and obstructs hepatic blood flow.

Furthermore, it secretes TIMP 1 and 2, naturally occurring inhibitors of matrix metalloproteinases , which prevents them from breaking down the fibrotic material in the extracellular matrix.

As this cascade of processes continues, fibrous tissue bands septa separate hepatocyte nodules, which eventually replace the entire liver architecture, leading to decreased blood flow throughout.

Portal hypertension is responsible for the most severe complications of cirrhosis. The gold standard for diagnosis of cirrhosis is a liver biopsy , through a percutaneous , transjugular , laparoscopic , or fine-needle approach.

A biopsy is not necessary if the clinical, laboratory, and radiologic data suggests cirrhosis. Furthermore, there is a small but significant risk of complications from liver biopsy, and cirrhosis itself predisposes for complications caused by liver biopsy.

FibroTest is a biomarker for fibrosis that can be done instead of a biopsy. Ultrasound is routinely used in the evaluation of cirrhosis. It may show a small and nodular liver in advanced cirrhosis along with increased echogenicity with irregular appearing areas.

Other liver findings suggestive of cirrhosis in imaging are an enlarged caudate lobe , widening of the fissures and enlargement of the spleen. Ultrasound may also screen for hepatocellular carcinoma, portal hypertension, and Budd-Chiari syndrome by assessing flow in the hepatic vein.

An increased portal vein pulsatility is an indicator of cirrhosis, but may also be caused by an increased right atrial pressure.

Cirrhosis is diagnosed with a variety of elastography techniques. Techniques used include transient elastography , acoustic radiation force impulse imaging , supersonic shear imaging and magnetic resonance elastography.

Compared to a biopsy, elastography can sample a much larger area and is painless. It shows a reasonable correlation with the severity of cirrhosis.

Liver cirrhosis as seen on a CT of the abdomen in transverse orientation. Gastroscopy endoscopic examination of the esophagus, stomach, and duodenum is performed in patients with established cirrhosis to exclude the possibility of esophageal varices.

If these are found, prophylactic local therapy may be applied sclerotherapy or banding and beta blocker treatment may be commenced.

Rarely are diseases of the bile ducts, such as primary sclerosing cholangitis , causes of cirrhosis. Macroscopically, the liver is initially enlarged, but with the progression of the disease, it becomes smaller.

Its surface is irregular, the consistency is firm, and the color is often yellow if associated with steatosis. Depending on the size of the nodules, there are three macroscopic types: Mixed cirrhosis consists of nodules of different sizes.

However, cirrhosis is defined by its pathological features on microscopy: The pattern of fibrosis seen can depend on the underlying insult that led to cirrhosis.

Fibrosis can also proliferate even if the underlying process that caused it has resolved or ceased. The fibrosis in cirrhosis can lead to destruction of other normal tissues in the liver: As cirrhosis can be caused by many different entities which injure the liver in different ways, cause-specific abnormalities may be seen.

For example, in chronic hepatitis B , there is infiltration of the liver parenchyma with lymphocytes. The severity of cirrhosis is commonly classified with the Child-Pugh score.

This scoring system uses bilirubin , albumin , INR , the presence and severity of ascites , and encephalopathy to classify patients into class A, B, or C.

Class A has a favourable prognosis, while class C is at high risk of death. This system was devised in by Child and Turcotte, and modified in by Pugh and others.

The hepatic venous pressure gradient, difference in venous pressure between afferent and efferent blood to the liver also determines the severity of cirrhosis, although it is hard to measure.

Key prevention strategies for cirrhosis are population-wide interventions to reduce alcohol intake through pricing strategies, public health campaigns, and personal counseling , programs to reduce the transmission of viral hepatitis, and screening of relatives of people with hereditary liver diseases.

Little is known about factors affecting cirrhosis risk and progression. Research has suggested that coffee consumption appears to help protect against cirrhosis.

Generally, liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications. A healthy diet is encouraged, as cirrhosis may be an energy-consuming process.

Close follow-up is often necessary. Antibiotics are prescribed for infections, and various medications can help with itching. Laxatives, such as lactulose , decrease the risk of constipation; their role in preventing encephalopathy is limited.

Alcoholic cirrhosis caused by alcohol abuse is treated by abstaining from alcohol. Treatment for hepatitis-related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis.

Regardless of the underlying cause of cirrhosis, consumption of alcohol and paracetamol , as well as other potentially damaging substances, are discouraged.

Vaccination of susceptible patients should be considered for Hepatitis A and Hepatitis B. Treating the cause of cirrhosis prevents further damage; for example, giving oral antivirals such as entecavir and tenofovir in patients of cirrhosis due to Hepatitis B prevents progression of cirrhosis.

Similarly, control of weight and diabetes prevents deterioration in cirrhosis due to Non-alcoholic steatohepatitis.

If complications cannot be controlled or when the liver ceases functioning, liver transplantation is necessary.

The survival rate depends largely on the severity of disease and other medical risk factors in the recipient. Manifestations of decompensation in cirrhosis include gastrointestinal bleeding , hepatic encephalopathy HE , jaundice or ascites.

In patients with previously stable cirrhosis, decompensation may occur due to various causes, such as constipation , infection of any source , increased alcohol intake, medication , bleeding from esophageal varices or dehydration.

It may take the form of any of the complications of cirrhosis listed below. People with decompensated cirrhosis generally require admission to a hospital, with close monitoring of the fluid balance , mental status, and emphasis on adequate nutrition and medical treatment — often with diuretics , antibiotics , laxatives or enemas , thiamine and occasionally steroids , acetylcysteine and pentoxifylline.

Life expectancy without liver transplant is low, at most 3 years. Palliative care is specialized medical care that focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness, such as cirrhosis.

Especially in the later stages, people with cirrhosis experience significant symptoms such as abdominal swelling, itching, leg edema, and chronic abdominal pain which would be amenable for treatment through palliative care.

Salt restriction is often necessary, as cirrhosis leads to accumulation of salt sodium retention. Diuretics may be necessary to suppress ascites. Diuretic options for inpatient treatment include aldosterone antagonists spironolactone and loop diuretics.

Aldosterone antagonists are preferred for people who can take oral medications and are not in need of an urgent volume reduction. Loop diuretics can be added as additional therapy.

If a rapid reduction of volume is required, paracentesis is the preferred option. This procedure requires the insertion of a plastic tube into the peritoneal cavity.

4 thoughts on “Live r

Hinterlasse eine Antwort

Deine E-Mail-Adresse wird nicht veröffentlicht. Erforderliche Felder sind markiert *