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Gastroenterology Clinics of North America

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https://www.readbyqxmd.com/read/28506375/erratum
#1
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506374/liver-pathology
#2
EDITORIAL
Jay H Lefkowitch
No abstract text is available yet for this article.
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506373/heart-disease-and-the-liver-pathologic-evaluation
#3
REVIEW
Anne Knoll Koehne de Gonzalez, Jay H Lefkowitch
Liver injury due to acute and chronic heart failure has long been recognized. This article discusses the concepts of acute cardiogenic liver injury (ACLI) and cardiac or congestive hepatopathy (CH) along with their clinical manifestations and sequelae. Histologically, ACLI manifests as centrilobular hepatocellular necrosis, whereas CH is associated with centrilobular hepatocyte atrophy, dilated sinusoids, and perisinusoidal fibrosis, progressing to bridging fibrosis and ultimately cirrhosis. ACLI is associated with marked increases in aminotransferase levels, whereas CH is associated with a cholestatic pattern of laboratory tests...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506372/hepatic-progenitor-cells-an-update
#4
REVIEW
Matthias Van Haele, Tania Roskams
Liver regeneration is a fascinating and complex process with many medical implications. An important component of this regenerative process is the hepatic progenitor cell (HPC). These appealing cells are able to participate in the renewal of hepatocytes and cholangiocytes when the normal homeostatic regeneration is exhausted. Moreover, the HPC niche is of vital importance toward the activation, differentiation, and proliferation of the HPC. This niche provides a rich microenvironment for the regulation of the HPC, thanks to the intercellular secretion of molecules...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506371/hepatitis-e-virus-and-the-liver-clinical-settings-and-liver-pathology
#5
REVIEW
Daniela Lenggenhager, Achim Weber
Infection with hepatitis E virus (HEV) is a leading cause of acute hepatitis worldwide, now increasingly recognized also in nonendemic regions. Clinical manifestation of hepatitis E includes mostly asymptomatic/subclinical presentations or acute, self-limiting hepatitis, but also potentially fatal liver failure or chronic hepatitis in immunocompromised individuals. Accordingly, hepatitis E histolpathologic patterns range from an unremarkable histology over acute (cholestatic) hepatitis with variable degree of necrosis to chronic hepatitis with fibrosis...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506370/morphologic-subtypes-of-hepatocellular-carcinoma
#6
REVIEW
Michael S Torbenson
Hepatocellular carcinomas can be further divided into distinct subtypes that provide important clinical information and biological insights. These subtypes are distinct from growth patterns and are on based on morphologic and molecular findings. There are 12 reasonably well-defined subtypes as well as 6 provisional subtypes, together making up 35% of all hepatocellular carcinomas. These subtypes are discussed, with an emphasis on their definitions and the key morphologic findings.
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506369/autoimmune-hepatitis-overlap-syndromes-and-liver-pathology
#7
REVIEW
Albert J Czaja, Herschel A Carpenter
Autoimmune hepatitis (AIH) may have an atypical serum alkaline phosphatase elevation, antimitochondrial antibodies, histologic features of bile duct injury/loss, or cholangiographic findings of focal biliary strictures and dilations. These manifestations characterize the overlap syndromes. Patients can be classified as having AIH with features of primary biliary cholangitis, primary sclerosing cholangitis, or a cholestatic syndrome. The gold standard of diagnosis is clinical judgment. Histologic evaluation is a major diagnostic component...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506368/human-immunodeficiency-virus-infection-antiretroviral-therapy-and-liver-pathology
#8
REVIEW
Mark W Sonderup, Helen Cecilia Wainwright
The improvement in antiretroviral therapy has significantly impacted the lives of people living with human immunodeficiency virus (HIV). In high-income countries, HIV deaths are predominated by liver disease consequent to viral hepatitis coinfection, alcohol, and nonalcoholic fatty liver disease. Published liver pathology findings have shifted from being predominated by opportunistic infections to the metabolic effects of HIV and antiretroviral therapy as well as drug-induced liver injuries. Differences remain between high-income and low-income countries, where opportunistic infections and immune reconstitution syndromes, dominate findings...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506367/immunohistochemistry-in-the-diagnosis-of-hepatocellular-carcinoma
#9
REVIEW
Won-Tak Choi, Sanjay Kakar
Hepatocellular carcinoma (HCC) can be difficult to distinguish from its mimics, including metastatic tumor, benign hepatocellular lesion, and high-grade dysplastic nodule, especially when limited biopsy material is available. Hence, the judicious use of immunohistochemical stains is necessary to establish a correct diagnosis. This article describes advantages and disadvantages of immunohistochemical markers that are most commonly used to distinguish between these lesions. Diagnostic workup of malignant liver mass (HCC and its histologic variants vs metastatic tumor) as well as well-differentiated hepatocellular lesion (well-differentiated HCC vs focal nodular hyperplasia vs hepatocellular adenoma) is also discussed...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506366/antibody-mediated-rejection-after-liver-transplant
#10
REVIEW
Michael Lee
Antibody-mediated rejection (AMR) in liver transplants is a field in its infancy compared with its allograft cohorts of the kidney and lung. Acute AMR is diagnosed based on specific clinical and histopathologic criteria: serum donor specific antibodies, C4d staining, histopathologic findings on liver biopsy, and exclusion of other entities. In contrast, the histologic features of chronic AMR are not as specific and it is a more challenging diagnosis to make. Treatments of acute and chronic AMR include some combination of steroids, immune-modulating agents, intravenous immunoglobulin, plasmapheresis, and proteasome inhibitors...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506365/drug-induced-liver-injury-the-hepatic-pathologist-s-approach
#11
REVIEW
David E Kleiner
The evaluation of liver biopsies in suspected drug-induced liver injury (DILI) can be complex. The biopsy may be approached systematically, by identification of histologic lesions and then identification of the overall pattern of injury. Potential DILI must be separated from concomitant non-DILI liver disease. The findings can be analyzed with respect to the various prescription and nonprescription medications and dietary supplements under suspicion to provide a complete interpretation of the findings. The pathologic findings, the histologic differential diagnosis, and expert interpretation are part of a complete biopsy assessment and provide information that is of greatest value in patient management...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506364/hepatocellular-adenomas-morphology-and-genomics
#12
REVIEW
Paulette Bioulac-Sage, Christine Sempoux, Charles Balabaud
Hepatocellular adenomas (HCAs) are rare benign tumors. This single entity has been split into 3 subtypes corresponding to specific mutations: HNF1α-inactivated HCA; inflammatory HCA related to different mutations, all leading to activation of STAT3 pathway; and β-catenin-activated HCA related to CTNNB1 mutations. The risk of malignant transformation depends on the level of β-catenin activation, reported mainly for exon 3, including S45. It is possible using specific immunohistochemical markers to identify the 3 different HCA subtypes and the level of β-catenin activation...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506363/contemporary-evaluation-of-the-pediatric-liver-biopsy
#13
REVIEW
Deborah A Schady, Milton J Finegold
Liver disease in the neonate, infant, child, and adolescent may manifest differently depending on the type of disorder. These disorders show marked overlap clinically and on light microscopy. Histology and ultrastructural examination are used in tandem for the diagnosis of most disorders. A final diagnosis or interpretation of the pediatric liver biopsy depends on appropriate and adequate clinical history, laboratory test results, biochemical assays, and molecular analyses, as indicated by the light microscopic and ultrastructural examination...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506362/current-concepts-in-pediatric-nonalcoholic-fatty-liver-disease
#14
REVIEW
Sarah E Fleet, Jay H Lefkowitch, Joel E Lavine
Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disease. Its increasing prevalence is a direct result of historically high rates of obesity. Hepatocyte lipid accumulation is the first step in a cascade of metabolic and inflammatory events thought to precipitate NAFLD. Histologic findings provide insight into these events. Lifestyle modification remains the primary therapy in children. Current recommendations include vitamin E treatment in those with biopsy-proven NASH. Trials of novel drugs are ongoing in adults...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28506361/igg4-related-disease-and-the-liver
#15
REVIEW
Jonathan H Chen, Vikram Deshpande
Pathologists are likely to encounter IgG4-related disease in several organ systems. This article focuses on helping pathologists diagnose IgG4-related disease in the hepatobiliary system. Missing the diagnosis can result in unnecessary organ damage and/or unnecessary surgical and cancer therapy. In the liver, tumefactive lesion(s) involving the bile ducts with storiform fibrosis and an IgG4-enriched lymphoplasmacytic infiltrate are highly concerning for IgG4-related disease. The recent identification of oligoclonal populations of T cells and B cells in IgG4-related disease may lead to molecular tests, new therapeutics, and a greater mechanistic understanding of the disease...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28164857/preface
#16
EDITORIAL
Eamonn M M Quigley
No abstract text is available yet for this article.
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28164856/the-gut-microbiome-in-irritable-bowel-syndrome-and-other-functional-bowel-disorders
#17
REVIEW
Yehuda Ringel
Emerging data from epidemiologic, microbiome, and physiology research in patients with functional bowel disorders (FBDs) provide evidence for a linkage between alterations in the intestinal microbiota and FBDs. However, currently most of the data is based on association studies, and the causality role of the microbiota in these disorders is not established. Growing evidence for compositional changes and the increasing recognition of the association between the intestinal microbiota and gut-brain functions that are relevant to the pathophysiology and/or clinical symptoms of FBDs have led to increased interest in manipulating the intestinal microbiota for the treatment of these disorders...
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28164855/from-culture-to-high-throughput-sequencing-and-beyond-a-layperson-s-guide-to-the-omics-and-diagnostic-potential-of-the-microbiome
#18
REVIEW
Paul W O'Toole, Burkhardt Flemer
Detailed knowledge of the community of organisms in the gut has become possible in recent years because of the development of culture-independent methods. Largely based on latest DNA sequencing platforms, it is now possible to establish the composition of the microbiota and the repertoire of biochemical functions it encodes. Variations in either or both of these parameters have been linked to intestinal and extraintestinal disease. This article summarizes how these methods are applied, with special reference to gastroenterology, and describes the achievements and future potential of microbiota analysis as a diagnostic tool...
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28164854/the-microbiome-gut-brain-axis-in-health-and-disease
#19
REVIEW
Timothy G Dinan, John F Cryan
Gut microbes are capable of producing most neurotransmitters found in the human brain. Evidence is accumulating to support the view that gut microbes influence central neurochemistry and behavior. Irritable bowel syndrome is regarded as the prototypic disorder of the brain-gut-microbiota axis that can be responsive to probiotic therapy. Translational studies indicate that certain bacteria may have an impact on stress responses and cognitive functioning. Manipulating the gut microbiota with psychobiotics, prebiotics, or even antibiotics offers a novel approach to altering brain function and treating gut-brain axis disorders, such as depression and autism...
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28164853/impact-of-antibiotics-on-necrotizing-enterocolitis-and-antibiotic-associated-diarrhea
#20
REVIEW
Michael A Silverman, Liza Konnikova, Jeffrey S Gerber
Antibiotic treatment alters the composition and metabolic function of the intestinal microbiota. These alterations may contribute to the pathogenesis of necrotizing enterocolitis (NEC) and antibiotic-associated diarrhea (AAD). Recent studies are beginning to unravel the contribution of specific groups of microbes and their metabolic pathways to these diseases. Probiotics or other microbiota-targeted therapies may provide effect strategies to prevent and treat NEC and AAD.
March 2017: Gastroenterology Clinics of North America
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