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https://www.readbyqxmd.com/read/28224352/hcv-management-in-resource-constrained-countries
#1
REVIEW
Seng Gee Lim
With the arrival of all-oral directly acting antiviral (DAA) therapy with high cure rates, the promise of hepatitis C virus (HCV) eradication is within closer reach. The availability of generic DAAs has improved access to countries with constrained resources. However, therapy is only one component of the HCV care continuum, which is the framework for HCV management from identifying patients to cure. The large number of undiagnosed HCV cases is the biggest concern, and strategies to address this are needed, as risk factor screening is suboptimal, detecting <20% of known cases...
February 21, 2017: Hepatology International
https://www.readbyqxmd.com/read/28223446/management-of-nonalcoholic-fatty-liver-disease-in-patients-with-type-2-diabetes-a-call-to-action
#2
REVIEW
Fernando Bril, Kenneth Cusi
Traditionally a disease of hepatologists, nonalcoholic fatty liver disease (NAFLD) has recently become a major concern for a broad spectrum of health care providers. Endocrinologists and those caring for patients with type 2 diabetes mellitus (T2DM) are at center stage, as T2DM appears to worsen the course of NAFLD and the liver disease makes diabetes management more challenging. However, the nature of this relationship remains incompletely understood. Although the increasing prevalence of NAFLD is frequently attributed to the epidemic of obesity and is often oversimplified as the "hepatic manifestation of the metabolic syndrome," it is a much more complex disease process that may also be observed in nonobese individuals and in patients without clinical manifestations of the metabolic syndrome...
March 2017: Diabetes Care
https://www.readbyqxmd.com/read/28217887/gastric-antral-vascular-ectasia-in-systemic-sclerosis-where-do-we-stand
#3
REVIEW
Hala El-Gendy, Kyrillus S Shohdy, Gehad G Maghraby, Kerolos Abadeer, Moustafa Mahmoud
Gastric antral vascular ectasia (GAVE) continues to be a challenge in both diagnosis and treatment. GAVE has a diverse group of associations and presumed causes, including cirrhosis, chronic renal failure and autoimmune connective tissue diseases. However, in most occasions, the management plan of GAVE itself is the same whatever the underlying disease by using Argon plasma coagulation (APC). Herein, we will discuss three cases of systemic sclerosis-associated GAVE presenting with either acute or chronic gastrointestinal bleeding showing variable responses to APC...
February 20, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28215516/aisf-position-paper-on-nonalcoholic-fatty-liver-disease-nafld-updates-and-future-directions
#4
Amedeo Lonardo, Fabio Nascimbeni, Giovanni Targher, Mauro Bernardi, Ferruccio Bonino, Elisabetta Bugianesi, Alessandro Casini, Amalia Gastaldelli, Giulio Marchesini, Fabio Marra, Luca Miele, Filomena Morisco, Salvatore Petta, Fabio Piscaglia, Gianluca Svegliati-Baroni, Luca Valenti, Stefano Bellentani
This review summarizes our current understanding of nonalcoholic fatty liver disease (NAFLD), a multi-factorial systemic disease resulting from a complex interaction between a specific genetic background and multiple environmental/metabolic "hits". The role of gut microbiota, lipotoxicity, inflammation and their molecular pathways is reviewed in-depth. We also discuss the epidemiology and natural history of NAFLD by pinpointing the remarkably high prevalence of NAFLD worldwide and its inherent systemic complications: hepatic (steatohepatitis, advanced fibrosis and cirrhosis), cardio-metabolic (cardiovascular disease, cardiomyopathy, arrhythmias and type 2 diabetes) and neoplastic (primary liver cancers and extra-hepatic cancers)...
January 23, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28211229/serum-micrornas-as-predictors-for-liver-fibrosis-staging-in-hepatitis-c-virus-associated-chronic-liver-disease-patients
#5
Olfat G Shaker, Mahmoud A Senousy
Accurate staging of liver fibrosis is important for clinical decision making and personalized management. Liver fibrosis is influenced by patients' genomics, including IFNL3 genotype and microRNA expression. However, incorporating microRNAs into fibrosis prediction algorithms has not been investigated. We examined the potential of 8 selected serum microRNAs; miR-122, miR-126, miR-129, miR-199a, miR-155, miR-203a, miR-221, and miR-223 as non-invasive biomarkers to stage liver fibrosis in HCV-associated chronic liver disease (HCV-CLD)...
February 17, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28203139/spontaneous-splenic-infarcts-in-a-cirrhotic-patient-with-primary-biliary-cirrhosis
#6
Fredy Nehme, Kyle Rowe, Ahmad Haris, Imad Nassif
Spontaneous splenic infarction has been rarely reported as a complication of cirrhosis and portal hypertension. We describe the case of a 67-year-old female with past medical history of primary biliary cirrhosis presenting for a 1-day history of left upper quadrant pain. Investigations were in favor of splenic infarcts secondary to portal hypertension. The patient improved with conservative management and no recurrence was noted on further follow-up. Splenic infarction must be kept in mind when a patient with cirrhosis presents with left upper quadrant abdominal pain without a clear source...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203136/massive-hemorrhage-from-ectopic-duodenal-varices-importance-of-a-multidisciplinary-approach
#7
Tyler House, Patrick Webb, Chad Baarson
Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28197978/managing-cardiovascular-risk-in-lysosomal-acid-lipase-deficiency
#8
REVIEW
James J Maciejko
Lysosomal acid lipase deficiency (LAL-D) is a rare, life-threatening, autosomal recessive, lysosomal storage disease caused by mutations in the LIPA gene, which encodes for lysosomal acid lipase (LAL). This enzyme is necessary for the hydrolysis of cholesteryl ester and triglyceride in lysosomes. Deficient LAL activity causes accumulation of these lipids in lysosomes and a marked decrease in the cytoplasmic free cholesterol concentration, leading to dysfunctional cholesterol homeostasis. The accumulation of neutral lipid occurs predominantly in liver, spleen, and macrophages throughout the body, and the aberrant cholesterol homeostasis causes a marked dyslipidemia...
February 14, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28197805/economic-analysis-and-budget-impact-of-tenofovir-and-entecavir-in-the-first-line-treatment-of-hepatitis-b-virus-in-italy
#9
M Ruggeri, M Basile, S Coretti, C Drago, A Cicchetti
BACKGROUND: Chronic hepatitis B is a common, progressive disease, particularly when viral replication is detected. Oral antivirals can suppress viral replication and prevent or delay the development of cirrhosis and liver-related complications. The treatments of chronic hepatitis B cannot totally cure the disease but can prevent its progression to hepatocellular carcinoma, decreasing the levels of both morbidity and mortality. To date, there are several therapies indicated by the international guidelines as first-line treatments for the management of hepatitis B; two of the most effective are those based on either tenofovir or entecavir...
February 14, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28195363/liver-fibrosis-scores-predict-liver-disease-mortality-in-the-united-states-population
#10
Aynur Unalp-Arida, Constance E Ruhl
BACKGROUND AND RATIONALE: Fatty liver disease is common in the United States and worldwide due to changing lifestyles and can progress to fibrosis and cirrhosis contributing to premature death. We examined whether liver fibrosis scores were associated with increased overall and disease-specific mortality in a U.S. population-based prospective survey with up to 23 years of linked-mortality data. METHODS: Data were analyzed from 14,841 viral hepatitis negative adult participants in the third National Health and Nutrition Examination Survey, 1988-1994...
February 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28192107/gastrointestinal-complications-of-obesity
#11
Michael Camilleri, Harmeet Malhi, Andres Acosta
Obesity is usually associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause [e.g. non-alcoholic fatty liver diseases (NAFLD)] or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease (GERD), erosive esophagitis, Barrett's esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including NAFLD, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28182612/non-alcoholic-fatty-liver-disease-in-hiv-infection
#12
Juan MacĂ­as, Juan A Pineda, Luis M Real
Non-alcoholic fatty liver disease is one of the most frequent chronic hepatic conditions worldwide. The spectrum of non-alcoholic fatty liver disease goes from hepatic steatosis to steatohepatitis, cirrhosis, and hepatocellular carcinoma. Risk factors for non-alcoholic fatty liver disease are metabolic, mainly obesity and the accompanying consequences. Treatment and prevention of non-alcoholic fatty liver disease should target those metabolic abnormalities. The frequency of and the factors associated with hepatic steatosis in HIV infection seem to be similar to those reported in the general population, though direct comparisons are lacking...
January 2017: AIDS Reviews
https://www.readbyqxmd.com/read/28176238/vitamin-d-status-in-patients-with-cirrhosis-of-the-liver-and-their-relatives-a-case-control-study-from-north-india
#13
Ravikant Kumar, Pavan Kumar, Kandarp Nath Saxena, Manjul Mishra, Vivek Kumar Mishra, Anju Kumari, Manisha Dwivedi, Sri Prakash Misra
BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed...
January 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28161471/homozygosity-for-rs738409-g-in-pnpla3-is-associated-with-increased-mortality-following-an-episode-of-severe-alcoholic-hepatitis
#14
Stephen R Atkinson, Michael J Way, Andrew McQuillin, Marsha Y Morgan, Mark R Thursz
BACKGROUND & AIMS: Carriage of rs738409:G in PNPLA3 is associated with an increased risk of developing alcohol-related cirrhosis and has a significant negative effect on survival. Short-term mortality in patients with severe alcoholic hepatitis is high; drinking behaviour is a major determinant of outcome in survivors. The aim of this study was to determine whether carriage of rs738409:G has an additional detrimental effect on survival in this patient group. METHODS: Genotyping was undertaken in 898 cases with severe alcoholic hepatitis, recruited through the UK Steroids or Pentoxifylline for Alcoholic Hepatitis (STOPAH) trial, and 1,188 white British/Irish alcohol dependent controls with no liver injury recruited via University College London...
February 1, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28160956/the-role-of-liver-function-in-the-setting-of-cirrhosis-with-chronic-infection-and-critical-illness
#15
REVIEW
Susan Lee, Latanja Divens, Leanne H Fowler
The patient with sepsis in the setting of hepatitis C virus (HCV)-related cirrhosis can have a more rapid decline in other organ dysfunction during critical illness and faces further increase in the risk for death. This article discusses the role of liver function in the patient with a systemic critical illness in contrast to the worsened pathophysiology of the patient with cirrhosis secondary to chronic HCV infection and critical illness, inpatient and posthospitalization management of the critically ill patient with chronic HCV-related cirrhosis, and the nursing implications and recommendations for future research for this population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28154944/analysis-of-gallstone-disease-after-gastric-cancer-surgery
#16
Tsung-Jung Liang, Shiuh-Inn Liu, Yu-Chia Chen, Po-Min Chang, Wei-Chun Huang, Hong-Tai Chang, I-Shu Chen
BACKGROUND: The incidence rate of newly developed gallstone disease after gastrectomy for gastric cancer is thought to be higher than that in the general population. However, the presentation and management of these gallstones remain under debate, and the role of prophylactic cholecystectomy remains questionable. METHODS: Data on adult patients who were diagnosed with gastric cancer and received gastrectomy between 2000 and 2011 were extracted from the Taiwan National Health Insurance Research Database...
February 2, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28150456/editorial-improving-in-hospital-management-of-decompensated-cirrhosis-by-a-care-bundle-hope-frustration-and-lessons-to-learn
#17
EDITORIAL
J Bosch
No abstract text is available yet for this article.
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28150450/editorial-improving-in-hospital-management-of-decompensated-cirrhosis-by-a-care-bundle-hope-frustration-and-lessons-to-learn-authors-reply
#18
EDITORIAL
S McPherson, J K Dyson, M Hudson
No abstract text is available yet for this article.
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28145084/an-exploratory-study-into-the-unmet-supportive-needs-of-people-diagnosed-with-cirrhosis-in-queensland-australia
#19
Patricia C Valery, Paul J Clark, Steven M McPhail, Tony Rahman, Kelly Hayward, Jennifer Martin, Leigh Horsfall, Michael L Volk, Richard Skoien, E Powell
BACKGROUND: Many patients with cirrhosis follow complex medication and dietary regimens and those with decompensated cirrhosis suffer debilitating complications. These factors impact on activities of daily living and quality of life. OBJECTIVE: To explore the concerns and challenges of people with cirrhosis and their use of support services. Also, to describe health professionals' (HP) perspectives of patients' concerns. METHODS: Cross-sectional study at a tertiary liver clinic involving 50 patients and 54 HPs...
February 1, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28144389/systemic-treatment-for-hepatocellular-carcinoma-still-unmet-expectations
#20
REVIEW
Dimitrios N Samonakis, Elias A Kouroumalis
Many patients with hepatocellular carcinoma (HCC) are diagnosed in an advanced stage, so they cannot be offered the option of curative treatments. The results of systemic chemotherapy are unsatisfactory and this has led to molecular targeted approaches. HCC develops in chronically damaged tissue due to cirrhosis in most patients. Several different cell types and molecules constitute a unique microenvironment in the liver, which has significant implications in tumor development and invasion. This, together with genome instability, contributes to a significant heterogeneity which is further enhanced by the molecular differences of the underlying causes...
January 18, 2017: World Journal of Hepatology
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