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https://www.readbyqxmd.com/read/29325274/-an-interpretation-of-2017-easl-clinical-practice-guidelines-the-diagnosis-and-management-of-patients-with-primary-biliary-cholangitis
#1
Y Han, Y Chen
Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease and may progress to liver fibrosis, liver cirrhosis, decompensated cirrhosis, and even end-stage liver disease without effective treatment. The diagnosis of PBC is mainly based on the biochemical parameters indicating cholestatic hepatitis and the presence of specific autoantibody in circulation. The goals of the treatment and management of PBC are to prevent the development of end-stage liver disease, to improve related clinical symptoms, and to improve patients' quality of life...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29312973/critical-appraisal-of-chinese-2017-guideline-on-the-management-of-hepatocellular-carcinoma
#2
REVIEW
Di-Yang Xie, Zheng-Gang Ren, Jian Zhou, Jia Fan, Qiang Gao
Hepatocellular carcinoma (HCC) is the fourth most common and the third most lethal cancer in China. An updated version of consensus-based recommendations on the management of HCC has been recently published by a multidisciplinary group of Chinese experts including liver surgeons, hepatic oncologists, radiologists and pathologists. Major changes have been made to the diagnostic criteria. In addition to dynamic multi-detector computed tomography (CT) and magnetic resonance imaging (MRI), gadoxetic acid-enhanced MRI and contrast-enhanced ultrasound (CEUS) are added to the diagnostic imaging tests...
December 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29311411/clinical-findings-of-hcv-chronic-infection-in-undocumented-immigrants-and-low-income-refugees-in-three-areas-of-southern-italy
#3
Evangelista Sagnelli, Loredana Alessio, Caterina Sagnelli, Luciano Gualdieri, Mariantonietta Pisaturo, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Lorenzo Onorato, Gaetano Scotto, Margherita Macera, Nicola Coppola
INTRODUCTION AND AIM: In recent decades, Italy has become a land of immigration from countries suffering a socio-economic crisis. The aim of this study was to perform an organized screening to identify and offer care to immigrants with HCV infection. MATERIAL AND METHODS: The screening, performed from 2012 to 2015, involved 1,727 immigrants in the Campania and Apulia regions in southern Italy. RESULTS: Screening was accepted by 1,727 (85%) out of 2,032 immigrants interviewed; 70 (4...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29311398/acute-variceal-bleeding-does-octreotide-improve-outcomes-in-patients-with-different-functional-hepatic-reserve
#4
Roberto Monreal-Robles, Carlos A Cortez-Hernández, José A González-González, Juan G Abraldes, Francisco J Bosques-Padilla, Héctor N Silva-Ramos, Jorge A García-Flores, Héctor J Maldonado-Garza
BACKGROUND: Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. MATERIAL AND METHODS: In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus endoscopic therapy (ET) and 216 patients with ET alone were compared in terms of failure to control bleeding, in-hospital mortality, and transfusion requirements stratifying the results according to liver disease severity by Child-Pugh (CP) score and MELD...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29310928/sofosbuvir-and-velpatasvir-for-hepatitis-c-virus-infection-in-people-with-recent-injection-drug-use-simplify-an-open-label-single-arm-phase-4-multicentre-trial
#5
Jason Grebely, Olav Dalgard, Brian Conway, Evan B Cunningham, Philip Bruggmann, Behzad Hajarizadeh, Janaki Amin, Julie Bruneau, Margaret Hellard, Alain H Litwin, Philippa Marks, Sophie Quiene, Sharmila Siriragavan, Tanya L Applegate, Tracy Swan, Jude Byrne, Melanie Lacalamita, Adrian Dunlop, Gail V Matthews, Jeff Powis, David Shaw, Maria Christine Thurnheer, Martin Weltman, Ian Kronborg, Curtis Cooper, Jordan J Feld, Chris Fraser, John F Dillon, Phillip Read, Ed Gane, Gregory J Dore
BACKGROUND: Despite revised guidelines that no longer exclude people who inject drugs (PWID) from treatment for hepatitis C virus (HCV) infection, many clinicians are reluctant to treat recent PWID. This study aimed to evaluate the efficacy of sofosbuvir and velpatasvir therapy in people with chronic HCV infection and recent injection drug use. METHODS: In this open-label, single-arm phase 4 trial (SIMPLIFY), we recruited participants with recent injection drug use (past 6 months) and chronic HCV genotype 1-6 infection from seven countries (19 sites)...
January 5, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29301497/evaluating-screening-approaches-for-hepatocellular-carcinoma-in-a-cohort-of-hcv-related-cirrhosis-patients-from-the-veteran-s-affairs-health-care-system
#6
Nabihah Tayob, Peter Richardson, Donna L White, Xiaoying Yu, Jessica A Davila, Fasiha Kanwal, Ziding Feng, Hashem B El-Serag
BACKGROUND: Hepatocellular carcinoma (HCC) has limited treatment options in patients with advanced stage disease and early detection of HCC through surveillance programs is a key component towards reducing mortality. The current practice guidelines recommend that high-risk cirrhosis patients are screened every six months with ultrasonography but these are done in local hospitals with variable quality leading to disagreement about the benefit of HCC surveillance. The well-established diagnostic biomarker α-Fetoprotein (AFP) is used widely in screening but the reported performance varies widely across studies...
January 4, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29284151/laparoscopic-vs-open-hepatectomy-for-hepatocellular-carcinoma-in-patients-with-cirrhosis-a-meta-analysis-of-the-long-term-survival-outcomes
#7
REVIEW
En Lin Goh, Swathikan Chidambaram, Shaocheng Ma
BACKGROUND: In patients with hepatocellular carcinoma (HCC) and cirrhosis, laparoscopic hepatectomy (LH) confers short-term benefits over open hepatectomy (OH) but the long-term outcomes of this procedure are unclear. This systematic review aims to compare the long-term survival outcomes of LH and OH for patients with HCC and underlying cirrhosis. METHODS: EMBASE, MEDLINE and Scopus databases were searched from date of inception to 7th October 2016. Controlled clinical studies comparing LH to OH for HCC in cirrhotic patients, which reported long-term overall and disease-free survival were included...
December 25, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29249128/prevention-and-management-of-gastroesophageal-varices
#8
Yeon Seok Seo
Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published...
December 18, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/29238587/bacterial-infections-in-acute-variceal-hemorrhage-despite-antibiotics-a-multicenter-study-of-predictors-and-clinical-impact
#9
Stephen Lee, Lynora Saxinger, Mang Ma, Verónica Prado, Joaquin Fernández, Deepali Kumar, Juan Gonzalez-Abraldes, Adam Keough, Ravin Bastiampillai, Michelle Carbonneau, Javier Fernandez, Puneeta Tandon
Background and aims: Current guidelines recommend antibiotic prophylaxis in all patients presenting with cirrhosis and acute variceal hemorrhage (AVH). We aimed to evaluate the characteristics and clinical impact of "early" infections (developing within 14 days) of AVH in a real-world setting. Methods: We analyzed retrospective data from a cohort of 371 adult patients with cirrhosis and AVH all of whom had received antibiotic prophylaxis (74% men; mean age 56 years), admitted to tertiary care hospitals in Edmonton, Alberta, Canada, and Barcelona, Spain...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29214880/low-ascitic-fluid-total-protein-levels-is-not-associated-to-the-development-of-spontaneous-bacterial-peritonitis-in-a-cohort-of-274-patients-with-cirrhosis
#10
Silje Mo, Flemming Bendtsen, Signe Skovgaard Wiese, Nina Kimer
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a complication to decompensated cirrhosis. Fluoroquinolones may prevent SBP. However, predictive markers for SBP are wanted. Guidelines suggest that patients with ascitic fluid protein below 15 g/l receive fluoroquinolones to prevent SBP. This study aimed to assess the clinical utility of low ascitic fluid protein in predicting SBP in patients with cirrhosis and ascites. METHODS: A total of 274 patients with cirrhosis and ascites underwent paracentesis between January 2010 and June 2015...
December 7, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29185250/management-of-hepatitis-c-in-decentralised-versus-centralised-drug-substitution-programmes-and-minimally-invasive-point-of-care-tests-to-close-gaps-in-the-hcv-cascade
#11
Andrea Bregenzer, Anna Conen, Jürg Knuchel, Andrée Friedl, Franz Eigenmann, Martin Näf, Peter Ackle, Martin Roth, Christoph Andreas Fux
BACKGROUND: In Switzerland, intravenous drug use accounts for the majority of hepatitis C virus (HCV) infections. Early HCV treatment prevents further transmissions and reduces morbidity and mortality due to decompensated liver cirrhosis and hepatocellular carcinoma. Nevertheless, patients in drug substitution programmes are often insufficiently screened and treated. AIM: The aim was to compare the current state of HCV management in centralised and decentralised drug substitution programmes of the canton Aargau...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29152767/development-and-validation-of-a-primary-sclerosing-cholangitis-specific-patient-reported-outcomes-instrument-the-psc-pro
#12
Zobair M Younossi, Arian Afendy, Maria Stepanova, Andrei Racila, Fatema Nader, Rachel Gomel, Ricky Safer, William R Lenderking, Anne Skalicky, Leah Kleinman, Robert P Myers, G Mani Subramanian, John G McHutchison, Cynthia Levy, Christopher L Bowlus, Kris Kowdley, Andrew J Muir
BACKGROUND: PSC is a chronic liver disease associated with inflammation and biliary fibrosis that leads to cholangitis, cirrhosis, and impaired quality of life. Our objective was to develop and validate a PSC-specific PRO instrument. METHODS: We developed a 42-item PSC PRO instrument that contains 2 modules (Symptoms and Impact of Symptoms), and conducted external validation. Reliability and validity were evaluated using clinical data and a battery of other validated instruments...
November 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29108205/-investigation-and-analysis-of-the-knowledge-of-nonalcoholic-fatty-liver-disease-among-residents-in-hebei-province-china
#13
Q F Liang, Y D Wang, C Y Zhao
Objective: To investigate the knowledge of nonalcoholic fatty liver disease (NAFLD) among medical staff and general population in Hebei Province, China, understand the degree of awareness of NAFLD among residents, standardize the diagnosis and treatment of NAFLD, improve the correct awareness of NAFLD among general population, promote the establishment of a reasonable lifestyle, and scientifically and effectively control the incidence and mortality rates of NAFLD. Methods: The investigation was performed in 30 hospitals and neighboring schools and communities in Hebei Province, and a questionnaire survey on the knowledge of NAFLD was performed for 1 300 medical workers and 2 000 persons from the general population...
October 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108191/-an-interpretation-of-the-aasld-practice-guideline-on-the-diagnosis-and-management-of-nonalcoholic-fatty-liver-disease-in-2017
#14
Y M Nan, N Fu, W C Li, L L Kong, X W Yuan, S Y Zhang, L D Liu, Y Lu, L Y Cui
The American Association for the Study of Liver Diseases (AASLD) updated and published the Practice Guidance for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease (NAFLD) in July 2017, which provides recommendations for the accurate diagnosis, treatment, and effective prevention of NAFLD. Related metabolic diseases should be considered during the initial evaluation of patients suspected of NAFLD. Noninvasive diagnostic techniques including transient elastography, magnetic resonance elastography, and serum biochemical models should be used to evaluate the development and progression of liver fibrosis in patients with NAFLD...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108189/-guidelines-on-the-management-of-ascites-and-complications-in-cirrhosis
#15
(no author information available yet)
No abstract text is available yet for this article.
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29101980/acr-appropriateness-criteria%C3%A2-chronic-liver%C3%A2-disease
#16
Jeanne M Horowitz, Ihab R Kamel, Hina Arif-Tiwari, Sumeet K Asrani, Nicole M Hindman, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani
Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis. Transient elastography, ultrasound elastography with acoustic radiation force impulse, and MR elastography are modalities that can assess for hepatic fibrosis. Although all international organizations recommend ultrasound for screening for hepatocellular carcinoma, ultrasound is particularly limited for identifying hepatocellular carcinoma in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29083080/underappreciation-of-non-alcoholic-fatty-liver-disease-by-primary-care-clinicians-limited-awareness-of-surrogate-markers-of-fibrosis
#17
Preya J Patel, Xuan Banh, Leigh U Horsfall, Kelly L Hayward, Fabrina Hossain, Tracey Johnson, Katherine A Stuart, Nigel N Brown, Nivene Saad, Andrew Clouston, Katharine M Irvine, Anthony W Russell, Patricia C Valery, Suzanne Williams, Elizabeth E Powell
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common cause of incidental liver test abnormalities. General practitioners have a key role in identifying people with NAFLD at risk of significant liver disease. Recent specialist guidelines emphasize the use of fibrosis algorithms or serum biomarkers rather than routine liver tests, to assess advanced fibrosis. This study evaluated primary care clinicians' current approach to diagnosis, management and referral of NAFLD. METHODS: A cross-sectional survey of primary care clinicians was undertaken through a structured questionnaire about NAFLD...
October 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29065740/budget-impact-analysis-on-the-introduction-of-a-guideline-based-hepatitis-b-and-c-screening-into-a-routine-check-up-in-the-german-primary-care-setting
#18
Cordula Barth, Silke Neusser, Janine Biermann, Jürgen Wasem, Thomas Berg, Johannes Wiegand, Ingmar Wolffram, David Petroff, Pamela Aidelsburger, Alexandra Grünbauer, Anja Neumann
OBJECTIVES: Systematic screening for chronic hepatitis B and C does not yet exist in Germany. Therefore, the implementation of a screening approach within a preventive medical examination performed by primary care physicians ('Check-Up 35+') was evaluated in a recent prospective multicenter study. The present analysis estimates the financial consequences for the statutory health insurance by budget impact analysis. MATERIALS AND METHODS: A Markov cohort model was developed consisting of 21 health states...
October 24, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29065187/prognostic-value-of-sarcopenia-in-patients-with-liver-cirrhosis-a-systematic-review-and-meta-analysis
#19
REVIEW
Gaeun Kim, Seong Hee Kang, Moon Young Kim, Soon Koo Baik
BACKGROUND: Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis. METHODS AND FINDINGS: We conducted a systematic review (SR) and meta-analysis (MA) on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/29063876/prevalence-of-hepatitis-b-and-hepatitis-c-virus-co-infection-in-india-a-systematic-review-and-meta-analysis
#20
REVIEW
Prabha Desikan, Zeba Khan
Hepatitis B virus (HBV) and hepatitis C virus (HCV) have several important similarities including worldwide distribution, hepato-tropism, similar modes of transmission and the ability to induce chronic infection that may lead to liver cirrhosis and hepatocellular carcinoma. Since both viruses are individually known to cause the pathologies mentioned above, co-infection with both HBV and HCV would be expected to be linked with higher morbidity as well as mortality and impact healthcare resource utilisation. Precise estimate of the prevalence of HBV/HCV co-infection would be needed to formulate policy decisions and plan communal health interventions...
July 2017: Indian Journal of Medical Microbiology
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