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management cirrhosis 2016

Jonathan Cordova, Hilary Jericho, Ruba K Azzam
Cirrhosis is the end result of nearly all forms of progressive liver disease. The diffuse hepatic process can be characterized as a state of inflammation progressing to fibrosis and resulting in nodular regeneration, ultimately leading to disorganized liver architecture and function. The underlying etiology of cirrhosis in children may often differ from adults owing to specific disease processes that manifest in childhood, including biliary atresia, galactosemia, and neonatal hepatitis. Although basic management strategies in children are similar to those in adults, the care given to children with cirrhosis must keep the child's growth and development of paramount importance...
December 1, 2016: Pediatric Annals
Felix Y Yap, Matthew R Skalski, Dakshesh B Patel, Aaron J Schein, Eric A White, Anderanik Tomasian, Sulabha Masih, George R Matcuk
Hypertrophic osteoarthropathy (HOA) is a medical condition characterized by abnormal proliferation of skin and periosteal tissues involving the extremities and characterized by three clinical features: digital clubbing (also termed Hippocratic fingers), periostosis of tubular bones, and synovial effusions. HOA can be a primary entity, known as pachydermoperiostosis, or can be secondary to extraskeletal conditions, with different prognoses and management implications for each. There is a high association between secondary HOA and malignancy, especially non-small cell lung cancer...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Renáta Papp, Mária Papp, István Tornai, Zsuzsanna Vitális
INTRODUCTION: The increasing incidence and poor prognosis of hepatocellular carcinoma places huge burden on healthcare. AIM: After reviewing literature on epidemiological trends, risk factors, diagnosis and management options for hepatocellular carcinoma, the authors investigated results of treatment and survival data of patients in Northeastern Hungary. METHOD: In a retrospective study, the authors analyzed medical records of 187 patients with hepatocellular carcinoma (etiology, presence of cirrhosis, stage of the tumor, treatment and disease outcome)...
November 2016: Orvosi Hetilap
Guadalupe Garcia-Tsao, Juan G Abraldes, Annalisa Berzigotti, Jaime Bosch
No abstract text is available yet for this article.
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
James M Levin, Shabnam Dabirshahsahebi, Mindy Bauer, Eric Huckins
AIM: To determine if our health system's integrated model reflects sustained virologic response (SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions. METHODS: Subjects with chronic hepatitis C had their medical records reviewed from November 1(st), 2014 through March 1(st), 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat (ITT) analysis...
October 14, 2016: World Journal of Gastroenterology: WJG
Georgios C Sotiropoulos, Nikolaos Machairas, Paraskevas Stamopoulos, Ioannis D Kostakis, Dimitrios Dimitroulis, Dimitrios Mantas, Gregory Kouraklis
BACKGROUND: Liver resection represents the treatment of choice for a small proportion of patients with hepatocellular carcinoma (HCC), amenable to surgery. The remarkable evolution in surgical techniques during the last decades introduced laparoscopic hepatectomy in the operative management of HCC, even in the presence of liver cirrhosis. No comparative study on laparoscopic or open liver resection for HCC has been conducted in Greece yet. METHODS: Patients undergoing liver resection for HCC by one senior hepatobiliary surgeon in our Institution during the period 11/2011-02/2016 were prospectively sampled and retrospectively analyzed for the purposes of this study...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Christopher L Bowlus, James T Kenney, Gary Rice, Robert Navarro
BACKGROUND: Chronic liver disease and cirrhosis are a leading cause of morbidity and mortality in the United States. Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis and which has been designated an orphan condition, is a chronic autoimmune disease resulting in the destruction of the small bile ducts in the liver. Without effective treatment, disease progression frequently leads to liver failure and death. Until May 2016, the only FDA-approved treatment for PBC was ursodiol (UDCA), an oral hydrophilic bile acid, which can slow progression of liver damage due to PBC...
October 2016: Journal of Managed Care & Specialty Pharmacy
Aparna Srinivasa Babu, Michael L Wells, Oleg M Teytelboym, Justin E Mackey, Frank H Miller, Benjamin M Yeh, Richard L Ehman, Sudhakar K Venkatesh
Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver disease is tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evaluation, and follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Karn Wijarnpreecha, Charat Thongprayoon, Patompong Ungprasert
BACKGROUND/OBJECTIVES: Hepatitis C virus (HCV) infection is one of the most common causes of cirrhosis. Several studies have linked caffeine consumption to a lower degree of liver fibrosis and inflammation among patients with chronic HCV infection, but the results were inconsistent. This meta-analysis was carried out with the aim of assessing the impact of caffeine consumption among HCV-infected patients. PARTICIPANTS AND METHODS: A literature search was performed using MEDLINE and EMBASE from inception to January 2016...
January 2017: European Journal of Gastroenterology & Hepatology
Narendra Choudhary, Rinkesh Kumar Bansal, Rajesh Puri, Rajiv Ranjan Singh, Mukesh Nasa, Vinit Shah, Haimanti Sarin, Mridula Guleria, Sanjiv Saigal, Neeraj Saraf, Randhir Sud, Arvinder S Soin
BACKGROUND AND AIMS: Etiologic diagnosis of pyrexia of unknown origin is important in patients with cirrhosis for optimal management and to prevent flare up of infectious disease after liver transplantation. However, there is very limited literature available on this subject. The present study aimed to examine the safety and impact of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in patients with cirrhosis. METHODS: The study was conducted between January 2014 and January 2016 at a tertiary care center...
September 2016: Endoscopy International Open
Hui-Lian Wang, Xi Lu, Xudong Yang, Nan Xu
BACKGROUND & AIMS: Daclatasvir plus asunaprevir (DCV + ASV) has demonstrated potent antiviral activity in patients with hepatitis C virus (HCV) genotype 1b infection. A definite conclusion about efficacy and safety of DCV + ASV in patients with HCV genotype 1b is not available. A meta-analysis was conducted to evaluate outcomes of all-oral treatment with DCV + ASV in terms of sustained virological response at 12 (SVR12 ) , 24 (SVR24 ) weeks and adverse effects (AEs) after the end of treatment...
September 6, 2016: Journal of Gastroenterology and Hepatology
Kwangwoo Nam, Sung Koo Lee, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Myung-Hwan Kim
BACKGROUND: Some biliary complications after liver transplantation (LT) are difficult to manage by endoscopic or radiologic intervention alone. In these cases, percutaneous transhepatic cholangioscopy (PTCS) can be used as an adjuvant option. METHODS: Patients who underwent PTCS for post-LT biliary complications between August 1992 and January 2016 were retrospectively reviewed. RESULTS: Fifteen patients underwent PTCS for post-LT biliary complications...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Jörg Trojan, Stephan Zangos, Andreas A Schnitzbauer
BACKGROUND: Hepatocellular carcinoma (HCC) is a frequent complication of liver cirrhosis. Worldwide, HCC is one of the most common cancers, with a rising incidence. METHODS: A selective literature search was conducted, taking into account current studies, reviews, meta-analyses, and guidelines. RESULTS: The diagnosis is established either non-invasively by dynamic imaging, showing a typical contrast enhancement and wash-out, or histopathologically...
April 2016: Visceral Medicine
Vicente Soriano, Benjamin Young, Norah Terrault
The International Conference on Viral Hepatitis 2016 brought exciting news on the treatment of viral hepatitis. The conference was mainly focused on the most recent estimates of burden for HBV and HCV; the current gaps and prospects for regional and global HCV eradication; the use of HCV treatment as prevention; and the management of difficult-to-cure hepatitis C patients, including individuals who fail on direct-acting antivirals, people who inject drugs, and those with decompensated cirrhosis or renal insufficiency...
April 2016: AIDS Reviews
Tara Jawaro, Anna Yang, Deepali Dixit, Mary Barna Bridgeman
OBJECTIVE: To review the management of hepatic encephalopathy (HE), including lifestyle modifying strategies and pharmacological interventions. DATA SOURCES: A literature search of PubMed through March 2016 was conducted utilizing the keywords hepatic encephalopathy, ammonia, and cirrhosis All published articles evaluating treatments for HE were considered. STUDY SELECTION AND DATA EXTRACTION: Available English-language data from reviews, abstracts, presentations, and clinical trials of the treatment of HE in humans were reviewed; relevant clinical data were selected and included...
July 2016: Annals of Pharmacotherapy
Jessica Liu, Hwai-I Yang, Mei-Hsuan Lee, Chin-Lan Jen, Richard Batrla-Utermann, Sheng-Nan Lu, Li-Yu Wang, San-Lin You, Chien-Jen Chen
UNLABELLED: Serum levels of hepatitis B virus (HBV) DNA (≤2000 IU/mL) and hepatitis B surface antigen (HBsAg) (<1000 IU/mL) have been shown to distinguish inactive carriers with high accuracy. The goal of this study was to validate the predictability of one-time measurement of quantitative HBsAg and HBV DNA levels for inactive carrier status and chronic hepatitis B (CHB) progression in a community-based cohort. This study included 1529 participants chronically infected with HBV genotype B or C from the REVEAL-HBV cohort...
August 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Thomas Deleuran, Hendrik Vilstrup, Peter Jepsen
OBJECTIVES: Clinical management of certain cirrhosis complications has improved over the last two decades. In this study we aimed to examine whether mortality among Danish alcoholic cirrhosis patients has decreased during this period. METHODS: In this historical cohort study we used nationwide hospital data to identify Danish alcoholic cirrhosis patients diagnosed in 1996-1998, 1999-2001, 2002-2004, 2005-2007, 2008-2010, and 2011-2013. We used Cox regression to examine time trends in mortality after cirrhosis diagnosis, adjusting for confounding by age, gender, and prevalence of variceal bleeding, ascites, hepatorenal syndrome, alcoholic hepatitis, infection, hepatocellular carcinoma, comorbidity, and in-patient status at the time of cirrhosis diagnosis...
June 2016: American Journal of Gastroenterology
Dharmesh H Kaswala, Michelle Lai, Nezam H Afdhal
Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver pathologies characterized by hepatic steatosis with a history of little to no alcohol consumption or secondary causes of hepatic steatosis. The prevalence of NAFLD is 20-25 % of the general population in the Western countries and is associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidemia. The spectrum of disease ranges from simple steatosis to nonalcoholic steatohepatitis, fibrosis, and cirrhosis. Advanced fibrosis is the most significant predictor of mortality in NAFLD...
May 2016: Digestive Diseases and Sciences
Sílvia Vilarinho, Sinan Sari, Güldal Yilmaz, Amy L Stiegler, Titus J Boggon, Dhanpat Jain, Gulen Akyol, Buket Dalgic, Murat Günel, Richard P Lifton
UNLABELLED: Despite advances in the diagnosis and management of idiopathic noncirrhotic portal hypertension, its pathogenesis remains elusive. Insight may be gained from study of early-onset familial idiopathic noncirrhotic portal hypertension, in which Mendelian mutations may account for disease. We performed exome sequencing of eight subjects from six kindreds with onset of portal hypertension of indeterminate etiology during infancy or childhood. Three subjects from two consanguineous families shared the identical rare homozygous p...
June 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Carlos Noronha Ferreira, Susana Seijo, Aurelie Plessier, Gilberto Silva-Junior, Fanny Turon, Pierre-Emmanuel Rautou, Anna Baiges, Christophe Bureau, Jaime Bosch, Virginia Hernández-Gea, Dominique Valla, Juan-Carlos García-Pagan
UNLABELLED: In patients with chronic noncirrhotic, nontumoral portal vein thrombosis (PVT), the usually recommended strategy for endoscopic screening and management of varices is the same as in cirrhosis. However, the efficacy of this policy in patients with PVT is unknown. We assessed the course of gastroesophageal varices in a large cohort of patients with chronic PVT. Patients prospectively registered in two referral centers for vascular liver disorders were eligible for the study...
May 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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