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Clinics in Liver Disease

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https://www.readbyqxmd.com/read/29128064/nonalcoholic-fatty-liver-disease-an-expanding-health-care-epidemic
#1
EDITORIAL
David E Bernstein
No abstract text is available yet for this article.
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128063/radiologic-imaging-in-nonalcoholic-fatty-liver-disease-and-nonalcoholic-steatohepatitis
#2
REVIEW
Yonah B Esterson, Gregory M Grimaldi
The article reviews the multimodality (ultrasound, computed tomography, and magnetic resonance [MR]) imaging appearance of nonalcoholic fatty liver disease (NAFLD) and discusses the radiologic diagnostic criteria as well as the sensitivity and specificity of these imaging methods. The authors review the role of both ultrasound and MR elastography for the diagnosis of fibrosis and for the longitudinal evaluation of patients following therapeutic intervention. Lastly, the authors briefly discuss the screening and diagnosis of hepatocellular carcinoma in patients with NAFLD, as there are special considerations in this population...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128062/diagnosis-and-evaluation-of-nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis-including-noninvasive-biomarkers-and-transient-elastography
#3
REVIEW
Eugenia Tsai, Tai-Ping Lee
The incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) are increasing and identification of people at risk of disease progression is extremely important. The current gold standard for diagnosing NAFLD/nonalcoholic steatohepatitis (NASH) is by liver biopsy, but it has several limitations. Noninvasive tests via biomarkers and transient elastography to assess NAFLD/NASH are being used in clinical practice. The most validated diagnostic panels include the NAFLD fibrosis score, FIB-4 (Fibrosis-4), and FibroMeter...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128061/the-genetics-of-pediatric-nonalcoholic-fatty-liver-disease
#4
REVIEW
Nidhi P Goyal, Jeffrey B Schwimmer
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. Severe fibrosis and cirrhosis are potential consequences of pediatric NAFLD and can occur within a few years of diagnosis. Observations suggest that genetics may be a strong modifying factor in the presentation, severity, and natural history of the disease. There is increasing interest in determining at-risk populations based on genetics in the hope of finding genotypes that correlate to NAFLD phenotype. Ultimately, the hope is to be able to tailor therapeutics to genetic predispositions and decrease disease morbidity in children with NAFLD...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128060/risk-factors-for-the-development-of-nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis-including-genetics
#5
REVIEW
Huei-Wen Lim, David E Bernstein
Nonalcoholic fatty liver disease is emerging as the most common cause of chronic liver disease worldwide. This trend is, in part, secondary, to the growing incidence of obesity, type 2 diabetes, and metabolic syndrome. Other risk factors include age, gender, race/ethnicity, genetic predisposition, and polycystic ovarian disease. With the introduction of genome-wide association studies, genetic mutations contributing to inherited susceptibility to steatosis have been identified, which hold keys to future improvement in diagnosis and management...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128059/pathophysiology-of-nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis
#6
REVIEW
Vignan Manne, Priya Handa, Kris V Kowdley
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH) and ultimately may lead to cirrhosis. Hepatic steatosis or fatty liver is defined as increased accumulation of lipids in hepatocytes and results from increased production or reduced clearance of hepatic triglycerides or fatty acids. Fatty liver can progress to NASH in a significant proportion of subjects. NASH is a necroinflammatory liver disease governed by multiple pathways that are not completely elucidated...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128058/nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis-in-liver-transplantation
#7
REVIEW
Danielle Carter, Douglas T Dieterich, Charissa Chang
The number of transplants caused by nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NASH) has been progressively increasing and this is expected to become the most common indication for liver transplant in the United States. Patients with NASH show many features of the metabolic syndrome and, as a result, are at higher risk for postoperative cardiovascular morbidity and mortality. Despite this, patients with NASH have long-term graft and patient survival rates comparable with other causes of chronic liver disease...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128057/nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis-and-hepatocellular-carcinoma
#8
REVIEW
Omar Massoud, Michael Charlton
Although hepatocellular carcinoma (HCC) is more common in the setting of cirrhosis, there is increasing evidence that it can develop in the setting of noncirrhotic nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and that steatosis alone can promote carcinogenesis. In addition, obesity, diabetes, and metabolic syndrome are recognized risks for the development of HCC. A better understanding of the mechanisms involved in the development of NAFLD/NASH-related HCC will allow the discovery of new targets for therapeutic and preventive intervention...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128056/emerging-treatments-for-nonalcoholic-fatty-liver-disease-and-nonalcoholic-steatohepatitis
#9
REVIEW
Samer Gawrieh, Naga Chalasani
This review discusses completed phase II randomized clinical trials with high-quality published results for compounds that demonstrate effects on nonalcoholic steatohepatitis histology (obeticholic acid, elafibranor, and liraglutide). The authors also review the available preliminary data on cenicriviroc and selonsertib, with or without simtuzumab's phase II studies. Finally, the authors briefly discuss compounds that have been tested but did not achieve the primary end point of histologic improvement and appeared in high-quality published articles (cysteamine bitartrate and long-chain polyunsaturated fatty acids)...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128055/current-treatment-of-nonalcoholic-fatty-liver-disease-nonalcoholic-steatohepatitis
#10
REVIEW
Chun Kit Hung, Henry C Bodenheimer
Treatment of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is focused on patients with NASH because they are at highest risk for progressive liver disease. Current first-line treatment consists of lifestyle modifications. Patients should lose at least 7% to 10% of body weight via a combination of physical exercise and calorie restriction dieting. Surgical or endoscopic surgery for weight loss can be considered in obese patients, depending on degree of excess body weight and comorbidities...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128054/the-role-of-nonalcoholic-fatty-liver-disease-on-cardiovascular-manifestations-and-outcomes
#11
REVIEW
Alexander J Kovalic, Sanjaya K Satapathy
Cardiovascular disease has been postulated as the leading cause of mortality among patients with nonalcoholic fatty liver disease (NAFLD), rather than from sequalae of liver disease specifically. While there is ample evidence validating the association between NAFLD and increased cardiovascular comorbidities, events, and mortality, current data presents a challenge in attributing this effect solely due to NAFLD given the rampant presence of insulin resistance and type 2 diabetes mellitus (T2DM). Endpoints of increased cardiovascular risk remains tightly linked to the concomitant presence of insulin resistance and T2DM...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128053/nonalcoholic-fatty-liver-disease-and-metabolic-syndrome
#12
REVIEW
Donghee Kim, Alexis Touros, W Ray Kim
Nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are highly prevalent, affecting approximately one-third of the US population. The relationship between NAFLD and MS is complex and may be bidirectionally associated. NAFLD is strongly associated with MS, the components of which include abdominal obesity, hyperglycemia, hypertension, and dyslipidemia. NAFLD associated with certain genetic factors such as the PNPLA3 G allele variant is not accompanied by insulin resistance and MS. Lifestyle modification, including diet and physical activity targeting visceral adiposity, remains the standard of care for patients with NAFLD and MS...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128052/the-intestinal-microbiome-in-nonalcoholic-fatty-liver-disease
#13
REVIEW
Puneet Puri, Arun J Sanyal
Nonalcoholic fatty liver disease is the most common cause of chronic liver disease in North America and is growing as a cause of chronic liver disease in many other parts of the world as well. It has 2 principal clinical-pathologic phenotypes: (1) nonalcoholic fatty liver and (2) nonalcoholic steatohepatitis. The development of both phenotypes is tightly linked to excess body weight and insulin resistance. This review discusses the emerging tools for the analysis of the microbiome, their limitations, and the existing literature with respect to the intestinal microbiome and their role in nonalcoholic fatty liver...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128051/the-natural-history-of-nonalcoholic-fatty-liver-disease-an-evolving-view
#14
REVIEW
Christina C Lindenmeyer, Arthur J McCullough
Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease worldwide, and its clinical and economic burden will continue to grow with parallel increases in rates of obesity, diabetes, and the metabolic syndrome. Evolving understanding of the natural history of NAFLD suggests that these patients are at risk for disease progression to steatohepatitis, fibrosis, and cirrhosis. Recent studies also suggest that these patients are at elevated risk for cardiovascular-, malignancy-, and liver-related morbidity and mortality, although their risk for progression, decompensation, and hepatocellular carcinoma may be less than that of patients with alternative causes of chronic liver disease...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128050/the-use-of-liver-biopsy-in-nonalcoholic-fatty-liver-disease-when-to-biopsy-and-in-whom
#15
REVIEW
Nadege T Gunn, Mitchell L Shiffman
Nonalcoholic fatty liver disease (NAFLD) is a common liver disorder that can be divided into benign steatosis or nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Elastography and scoring systems based on clinical features and routine biochemical testing can be used to assess fibrosis in patients with NAFLD. Patients with fibrosis are thought to have NASH. However, only a liver biopsy can reliably diagnose NAFLD and differentiate NAFL from NASH. Because medical therapy for NASH is not available, it is not necessary to perform a liver biopsy in all patients...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29128049/clinical-and-economic-burden-of-nonalcoholic-fatty-liver-disease-and-nonalcoholic-steatohepatitis
#16
REVIEW
Zobair M Younossi, Linda Henry, Haley Bush, Alita Mishra
Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with an increasing global prevalence associated with tremendous clinical, economic, and health-related quality-of-life burden. Clinically, NAFLD is considered the liver manifestation of metabolic syndrome. However, diagnosing NAFLD presents significant challenges due to the limited noninvasive and accurate diagnostic tools available to not only accurately diagnose nonalcoholic steatohepatitis but also to stage hepatic fibrosis, the major predictor of long-term outcomes, including mortality...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987264/consultations-in-liver-disease
#17
EDITORIAL
Steven L Flamm
No abstract text is available yet for this article.
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987263/follow-up-of-the-post-liver-transplantation-patient-a-primer-for-the-practicing-gastroenterologist
#18
REVIEW
Amanda Cheung, Josh Levitsky
The focus in liver transplantation in the next 10 years will likely change from preventing viral disease recurrence to minimizing the toll of rejection and fatty liver disease, minimizing the complications from immunosuppression with withdrawal strategies, and more optimal management of long-term risks, such as malignancy, cardiovascular disease, and renal failure. In addition, now that short-term results (<1 year) have improved significantly, there will be a shift toward improving long-term patient and graft survival, as well as a focus on primary care preventive strategies...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987262/acute-liver-failure
#19
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Acute liver failure (ALF) is a life-threatening condition of heterogeneous etiology. Outcomes are better with early recognition and prompt initiation of etiology-specific therapy, intensive care protocols, and liver transplantation (LT). Prognostic scoring systems include the King's College Criteria and Model for End-stage Liver Disease score. Cerebral edema and intracranial hypertension are reasons for high morbidity and mortality; hypertonic saline is suggested for patients with a high risk for developing intracranial hypertension, and when it does, mannitol is recommended as first-line therapy...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987261/wilson-disease-diagnosis-treatment-and-follow-up
#20
REVIEW
Michael L Schilsky
Consideration of a diagnosis of Wilson disease is still the critical factor in testing for and establishing disease diagnosis. In association with other clinical and biochemical tests, liver biopsy results and molecular genetic testing can also be used to generate a score for diagnosing Wilson disease. Medical therapy is effective for most patients; liver transplant can rescue those with acute liver failure or those with advanced liver disease who fail to respond to or discontinue medical therapy. Treatment monitoring must be done at regular intervals and includes clinical evaluation, liver tests and blood counts, and copper metabolic parameters...
November 2017: Clinics in Liver Disease
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