Transjugular intrahepatic portosystemic shunt (TIPS) is a radiological interventional procedure useful in portal hypertension-related complications. It is able to resolve variceal bleeding and refractory ascites. However, it can lead to serious side effects such as refractory encephalopathy, cardiac failure, and end-stage liver failure. Patients with refractory ascites represent the most frequent indication for TIPS. Clinicians are challenged by the necessity to select the best candidates for TIPS, so that the procedure can be successful as far as both efficacy and survival are concerned. The correct process to select TIPS for cirrhotic patients with ascites includes different steps: first, patients with absolute contraindications, such cardiopulmonary dysfunction or too severe liver failure, should be excluded, and second, criteria to predict post-TIPS survival should be considered. The most effective predictors of survival are serum creatinine, serum bilirubin, serum sodium, age and MELD or Child-Pugh scores. According to an arbitrary choice of two thresholds of different risks for each variable, we propose a simple estimation of the whole risk after TIPS placement.

Hepatic Encephalopathy

Refractory (planetary science)

Portosystemic shunt

10.1159/000318924

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Octreotide long-term treatment in patients with portal hypertension: persistent inhibition of postprandial glucagon response without major changes in renal function

Journal of Hepatology (1997)

Alberto Malesci Milena Tacconi A Valentini M. Basilico Elettra Lorenzano

Basal (medicine)

10.1016/s0168-8278(97)80247-4

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Tecniche internazionalprivatistiche fondate sulla volontà delle parti nel Diritto dellUnione Europea

CUADERNOS DE DERECHO TRANSNACIONAL (2010)

Francesco Salerno José María Alcántara González

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Giustizia costituzionale “versus” giustizia internazionale nell'applicazione del diritto internazionale generalmente riconosciuto

Quaderni costituzionali (2015)

Francesco Salerno

In its judgment No. 238/2014, the Italian Constitutional Court reaffirmed the primacy of the fundamental principles of the Constitution over the customary international rule that grants foreign States immunity from civil jurisdiction with respect to iure imperii acts. Such principle - which is protected by Article 10, para. 1, of the Italian Constitution - also covers acts entailing a grave breach to a peremptory norm of international law, as ascertained by the International Court of Justice in a Judgment delivered on 3rd February 2012. Judgment No. 238 undeniably leads to a violation of an international obligation. This notwithstanding, by evoking the technique of the «rinvio mobile» (mobile reference) in line with the neo-dualist approach to the relationship between the international and national legal orders, the Constitutional Court acknowledged the normative autonomy of international law and even interpreted some of the fundamental principles of the Constitution in harmony with international rules. The right of access to a court enshrined in the Constitution, moreover, also applies to foreign citizens, and the Italian Government will be called to adjust its foreign policy accordingly.

Obligation

Customary international law

Constitutional court

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La Rivista e gli studi di diritto internazionale nel periodo 1906-1943

Rivista di diritto internazionale (2007)

Francesco Salerno

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