Brad Fortune

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This research paper focuses on the condition known as ascites, which is the buildup of fluid in the abdomen that can happen for various reasons. The authors reviewed how to diagnose and manage ascites effectively, emphasizing the importance of a specific test called the serum-ascites albumin gradient to help pinpoint the cause. They also outlined different treatment options, from draining the fluid to specialized procedures, and noted that while there are established guidelines for ascites related to liver disease, guidance for other causes is less clear. Who this helps: This helps patients with ascites, particularly those with less common causes of the condition.

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This study looked at how alcohol-related liver issues, specifically in patients suffering from acute-on-chronic liver failure, affect survival and health care needs after liver transplants. Researchers tracked 640 patients and found that one year after their transplants, survival rates were similar for those with and without alcohol-related complications (about 84%), but patients with alcohol-related issues needed more medical care, staying in the hospital longer (about 29 days versus 19 days) and requiring rehabilitation more often (71% vs. 42%). This is important because it highlights the greater health care needs of patients with alcohol-related liver problems after they receive a transplant, suggesting that hospitals need to prepare for these extra requirements. Who this helps: This information helps doctors and medical facilities better support liver transplant patients, especially those with alcohol-related liver issues.

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This study looked at how well primary care providers in major U.S. cities understand and manage metabolic dysfunction-associated steatotic liver disease (MASLD), a common liver condition. Researchers found that only 54.7% of these providers recognized the term MASLD, although 86.6% were aware of fatty liver disease. This gap in awareness can lead to delays in proper diagnosis and treatment, making it crucial to improve education and guidelines around MASLD. Who this helps: Patients with liver disease.

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Researchers examined whether worsening liver disease is linked to a specific type of heart dysfunction called cirrhotic cardiomyopathy in patients awaiting liver transplant. Among 208 patients, 23% had this condition, and those with more severe liver disease—measured by higher MELD-Na scores and worse ascites—were significantly more likely to have it. This matters because recognizing this cardiac problem early could improve how transplant candidates are selected and monitored.

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In a primate model of glaucoma, researchers found that the tiny blood vessels supplying nerve fibers in the eye deteriorate faster and earlier than the nerve fibers themselves. This capillary loss in the retinal nerve fiber layer was detectable even before significant structural damage occurred, suggesting that vascular decline is an early feature of glaucoma. The finding supports exploring treatments aimed at protecting blood vessel function to slow disease progression.

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This research paper looks at the increasing costs associated with liver transplants in the U.S., which are essential for treating severe liver disease. The costs have surged due to factors like broader criteria for who can get a transplant and the use of less ideal organs, with some new technologies also driving up expenses. In particular, despite these rising costs, the funding that transplant programs receive has not changed much, making it harder for these programs to keep running effectively. Who this helps: This impacts patients needing liver transplants and doctors involved in transplant care.

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This study looked at 8,852 patients in Sweden who had just been diagnosed with cirrhosis, a liver condition, and examined how timely follow-up care after their hospital stay affected their health outcomes. It found that 42% of these patients received follow-up care within 90 days of leaving the hospital, and those who did had a lower chance of dying within a year (about 14% less likely) compared to those who did not have follow-up care, but it did not help reduce the number of patients who ended up back in the hospital. This matters because regular follow-up care seems to improve survival for patients with cirrhosis. Who this helps: Patients with cirrhosis and their healthcare providers.

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This study looked at how people with liver cirrhosis who have bleeding from varices (swollen veins in the esophagus) are affected differently based on whether their cirrhosis is due to alcohol or other causes. It found that patients with non-alcohol-related cirrhosis had a significantly higher 6-week mortality rate (about 29% more likely to die compared to those with alcohol-related cirrhosis) after such bleeding. This is important because understanding these differences can help doctors better predict outcomes and tailor treatments for patients based on the cause of their cirrhosis. Who this helps: This helps doctors manage the care of patients with liver cirrhosis.

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This study looked at how increasing pressure inside the eye (especially over 30 mmHg) affects blood flow in the optic nerve and retina using 31 non-human primates. They found that as the pressure rose, blood flow resistance increased, but in more advanced stages of damage, this resistance actually decreased back to normal levels. Understanding these changes is important because it can help researchers identify how glaucoma progresses and develop better treatments. Who this helps: This research helps patients with glaucoma and their doctors by improving understanding of disease progression and treatment options.

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This study looked at a new way to help restore movement in the arms of individuals with severe nerve damage by using a technique called epineural stimulation. Researchers successfully implanted devices on the nerves in a monkey's brachial plexus (the network of nerves that control arm movements) through a single incision, allowing for better hand and arm control. The findings show that this method can effectively activate the muscles needed for arm movement, making it a promising option for improving mobility in people with central paralysis. Who this helps: This helps patients with paralysis and neurological impairments who need better upper limb function.

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This study focused on the importance of referring patients with severe liver problems, specifically decompensated cirrhosis, for liver transplantation (LT) in a timely manner. It found that delayed referrals can worsen patients' health and reduce their chances of receiving the life-saving transplant they need. Connecting patients early with specialists can improve their care and quality of life before undergoing a transplant. Who this helps: This helps patients with severe liver disease and their healthcare providers.

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This study looked at how blood flow and pulsatility (the rhythm of blood movement) in the optic nerve area and nearby blood vessels relate to the speed of glaucoma progression. Researchers found that lower blood flow in major vessels and tissues linked to glaucoma was connected to more severe dysfunction and damage. Specifically, they noted that increased blood pulsatility in certain arteries was tied to faster vision loss, indicating that issues with blood flow regulation play a role in the disease's advancement. Who this helps: This benefits glaucoma patients by providing insights into how blood flow affects their condition.

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This paper reviews how to manage complications like fluid buildup and low sodium levels in patients with cirrhosis, a liver disease. It found that treating these patients effectively involves dietary changes, medications, and sometimes more invasive procedures, such as removing excess fluid, to improve their symptoms and overall health. For instance, patients should limit sodium intake and closely monitor fluid intake, and those with significant fluid buildup may require hospital treatment and potential liver transplant evaluations. Who this helps: This guidance benefits patients with cirrhosis and their healthcare providers by improving treatment strategies for managing their symptoms.

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This study focused on the use of a new technique called endoscopic ultrasound-guided portosystemic pressure gradient (EUS-PPG) to measure pressures in the liver and surrounding blood vessels. Out of the 47 international experts surveyed, 79% agreed on 53 best practices for using this technique, including its safety and the recommendation to use anesthesia during the procedure. This matters because having clear guidelines improves the accuracy and effectiveness of EUS-PPG, which can help diagnose and treat liver-related conditions more effectively. Who this helps: Patients with liver issues and healthcare providers performing these procedures.

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The study looked at the structures around the optic nerve in 362 healthy eyes that do not have severe myopia (nearsightedness). It found that about 20% of the eyes had a significant exposure of the scleral flange, with this area being more pronounced in sectors where the surrounding tissue was thinnest. Understanding these details matters because they could help us learn more about eye changes related to myopia and their potential impacts on vision over time. Who this helps: This benefits eye doctors and researchers studying myopia.

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This study looked at factors affecting survival rates for patients with small liver cancers (less than 5 cm) who underwent treatment through either ablation or surgery between 2009 and 2016. It found that larger tumors (3-5 cm) were linked to a higher risk of death, with a 31% increased risk for all causes and a 59% higher risk specifically from cancer. Other factors, such as chronic kidney disease and certain liver conditions, also impacted survival rates, but social factors like race and income were less significant. Who this helps: This research benefits doctors and patients by highlighting important factors to consider when making treatment decisions for early liver cancer.

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This study looked at how different tests are used to diagnose Primary Sclerosing Cholangitis (PSC), a liver disease that causes damage to the bile ducts over time. Researchers found that while imaging tests like MRI are used to diagnose PSC, autoantibody tests are not very effective, and liver biopsies are rarely needed. They also discovered that elastography, a non-invasive test that measures liver stiffness, is useful for assessing liver damage in PSC patients. Who this helps: This information benefits patients with PSC and their doctors in making better diagnostic decisions.

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This study looked at the differences in optic nerve structure between 122 patients with severe myopia (a condition where vision is very blurry for distant objects) and 362 patients with normal eyesight. The researchers found that people with severe myopia had more exposed areas of the optic nerve and related structures, and 71% of these patients showed significant changes in these areas compared to only 20% of those without severe myopia. These findings are important because they suggest that the optic nerve in highly myopic eyes might be at greater risk of damage, which could lead to conditions like glaucoma as they age. Who this helps: This helps patients with severe myopia and their eye doctors.

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This study looked at how obesity and metabolic health affect patients who need liver transplants, particularly those with liver disease linked to metabolic issues. It found that these patients face higher risks for heart problems, kidney issues, obesity-related muscle loss, and cancer. It highlighted the importance of careful health assessments and management of metabolic risks before and after surgery to ensure better outcomes for these patients. Who this helps: This helps liver transplant patients, especially those with obesity and metabolic health problems.

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This study looked at how blood circulation patterns differ in people with glaucoma, those suspected of having it, and healthy individuals. Researchers found that people with glaucoma and those suspected of having it had higher vascular resistance and different blood pressure waveforms compared to healthy individuals. Specifically, the average blood pressure was significantly lower in healthy individuals (91.7 mm Hg) compared to those with glaucoma (102.8 mm Hg) and glaucoma suspects (102.4 mm Hg), indicating possible issues with blood flow in patients with glaucoma that could affect their eye health. Who this helps: This benefits patients with glaucoma and their doctors by providing insights into the disease's effects on blood circulation.

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This study explored how daily eye drops containing human insulin can help repair nerve cells in the eyes of glaucoma patients. The researchers found that insulin promotes the growth of important connections between these nerve cells, improving their function and potentially restoring vision. Specifically, they noted improved calcium signaling in these cells and better eye-brain communication, which could lead to improved visual responses. Who this helps: This research benefits patients with glaucoma by offering a new treatment avenue.

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This study looked at blood flow resistance in different parts of the eye, specifically comparing the upper and lower regions of the optic nerve head and retina in people with and without glaucoma. Researchers found that, on average, blood flow resistance in the upper part of the optic nerve was 9% higher in glaucoma patients and 10% higher in healthy individuals compared to the lower part, indicating a pattern that is consistent regardless of disease status. Understanding these differences is important because they might help explain why glaucoma often affects the upper visual field first, highlighting potential areas for future research. Who this helps: Patients with glaucoma and eye doctors.

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This research paper examined various drug treatments aimed at preventing the worsening of liver disease, known as hepatic decompensation, in people with cirrhosis. The study found that while nonselective beta-blockers are currently the only approved medication for this prevention, many new drugs are being tested, though more work is needed to find effective treatments. This research is important because cirrhosis affects over 100 million people worldwide, and better treatments could significantly improve their health and quality of life. Who this helps: This helps patients with cirrhosis and their healthcare providers.

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This study examined how well different layers of the retina can indicate damage from glaucoma by measuring their thickness in 188 eyes with glaucoma, 148 eyes suspected of having glaucoma, and 362 healthy eyes. The research found that the nerve fiber layer (NFL) and ganglion cell layer (GCL) were the most accurate at identifying glaucoma, with the GCL achieving an accuracy of 93.4% and the NFL at 92.3%. This is important because it helps improve early detection of glaucoma, which is crucial for preventing vision loss. Who this helps: Patients at risk of glaucoma and healthcare providers diagnosing eye conditions.

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This study looked at how increased pressure in the eye affects the tiny nerve fibers (axons) connected to the eye, particularly in relation to glaucoma. Researchers found that different parts of these axons experienced unique kinds of damage; for example, axons in some regions underwent more stretching while others faced more compression. This matters because understanding how pressure affects axons could lead to better ways to prevent and treat glaucoma. Who this helps: Patients at risk of glaucoma and their doctors.

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Researchers tested how well liver severity scores predict six-week mortality in cirrhosis patients hospitalized with upper gastrointestinal bleeding, regardless of whether the bleeding was caused by portal hypertension. Both the Child-Turcotte-Pugh and MELD scores showed strong predictive accuracy, but only the Child-Turcotte-Pugh score performed well across all types of bleeding. This means clinicians can use this score before performing an endoscopy to quickly classify patients as low, moderate, or high risk.

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This review outlines the racial, ethnic, and socioeconomic gaps that affect patients with chronic liver disease at every stage of care, from initial screening through liver transplantation. It uses a health equity framework to identify specific barriers and offers practical, evidence-based strategies for providers and health systems to deliver more equitable care. The goal is to give clinicians concrete tools rather than simply documenting that disparities exist.

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This study looked at what predicts whether kidney injury will resolve in hospitalized cirrhosis patients, and what happens to those whose kidney function doesn't improve by discharge. Higher albumin levels on admission and having a non-fatty-liver cause of cirrhosis were linked to better chances of kidney recovery, while more severe kidney injury at admission predicted worse odds. Patients whose kidney injury didn't resolve had much higher short- and long-term mortality, underscoring the urgency of aggressive treatment.

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This study compared the actual dollar costs of three treatments for early liver cancer — ablation, surgical removal, and transplantation — using Medicare claims data from over 1,000 patients. Ablation was by far the least expensive, with median procedure costs around $6,700 versus $25,600 for resection and $66,000 for transplant, and the cost differences persisted 30 and 90 days after treatment. These figures can inform cost-effectiveness analyses and help patients and physicians weigh the financial implications of treatment choices alongside survival outcomes.

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This study looked at how well different light responses in the eyes of monkeys with glaucoma could detect early signs of vision loss. Researchers found that the brief red and blue light response (PhNR) was the most effective at spotting this loss, with a significant decrease in response observed in affected eyes, while the PhNR showed the closest link to actual eye damage. This research helps improve how glaucoma is diagnosed and monitored, potentially leading to earlier treatments and better outcomes for patients. Who this helps: This helps patients with glaucoma and their doctors by improving early diagnosis and management.

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The study looked at different scoring systems to predict the risk of death within six weeks for patients with severe liver disease who experience a sudden and serious bleeding event. Researchers found that patients with low scores on the Child-Turcotte-Pugh system had less than a 5% risk of dying, while those with high scores faced over a 20% risk. This information is important because it helps doctors better assess which patients are at higher risk and tailor their treatment accordingly. Who this helps: This helps doctors and healthcare providers make informed decisions for patients with severe liver disease.

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This study focuses on restoring vision in people suffering from optic nerve damage, particularly due to conditions like glaucoma, by repopulating retinal ganglion cells (RGCs). The researchers identified five key areas to improve efforts in regrowing these cells and connecting them properly to restore vision. Significant progress is anticipated in this field, which could greatly benefit patients who have lost their sight due to optic nerve damage. Who this helps: Patients with optic neuropathy and vision loss.

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This study looked at how blood flow problems in the eye contribute to glaucoma, a disease that damages neurons crucial for vision. Researchers found that many people with glaucoma experience reduced blood flow and issues with how blood vessels control themselves, which affects the health of the neurons. Specifically, they highlighted the role of special cells called pericytes that help regulate blood supply to the retina, emphasizing the importance of a recent discovery about tiny connections between these cells that impact blood flow distribution. Who this helps: This research benefits patients with glaucoma and their doctors by providing insights that could lead to better treatment strategies.

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This study explores the use of advanced imaging techniques called Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) for diagnosing and tracking glaucoma, a major cause of blindness. Researchers found that these tools can identify early signs of damage to the eye's retina and blood vessels, which are crucial for maintaining vision. Enhanced detection of these changes allows for better monitoring and treatment of glaucoma, ultimately improving patient outcomes and reducing healthcare costs. Who this helps: This helps patients at risk for glaucoma and their doctors.

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The RRestORe consortium was created to find ways to restore vision for people with optic nerve damage. With over 220 members, the group focuses on addressing major challenges in regenerating retinal cells and promoting teamwork among researchers. Their work could lead to new treatments that not only improve vision for these patients but also inspire advancements in other areas of brain repair. Who this helps: This helps patients with optic neuropathies and other vision-related disorders.

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This study looked at a new surgical method to help people regain hand control after nerve injuries. Researchers successfully placed electrodes on four out of five key nerves in a monkey's arm using just one incision, which could simplify future surgeries for patients with similar conditions. This is important because fewer surgeries and implants could lead to better recovery options for individuals with nerve damage. Who this helps: Patients with neurological impairments affecting hand function.

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This paper studied how to accurately measure the electrical resistance between skin and electrodes used in medical devices. The researchers found that their method worked well, achieving an average error of about 7% in the measurements. This is important because it helps improve the quality and reliability of biosignal readings, which are crucial for monitoring health. Who this helps: This benefits doctors and patients using medical devices for health monitoring.

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This study focused on improving Early Relational Health (ERH), which is the positive relationship between young children and their caregivers. Researchers and professionals came together to create a new research agenda that aims to better understand ERH and find effective ways to promote it in children's healthcare, particularly in pediatric offices. This is important because it addresses the growing mental health crisis among children and aims to ensure that nurturing relationships are a regular part of pediatric care. Who this helps: This benefits young children and their families, as well as pediatric healthcare providers.