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alcoholic hepatitis guidelines

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https://www.readbyqxmd.com/read/28692443/a-single-test-combining-blood-markers-and-elastography-is-more-accurate-than-other-fibrosis-tests-in-the-main-causes-of-chronic-liver-diseases
#1
Alexandra Ducancelle, Vincent Leroy, Julien Vergniol, Nathalie Sturm, Brigitte Le Bail, Jean Pierre Zarski, Eric Nguyen Khac, Dominique Salmon, Victor de Ledinghen, Paul Calès
BACKGROUND AND GOAL: International guidelines suggest combining a blood test and liver stiffness measurement (LSM) to stage liver fibrosis in chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). Therefore, we compared the accuracies of these tests between the main etiologies of chronic liver diseases. STUDY: Overall, 1968 patients were included in 5 etiologies: CHC: 698, chronic hepatitis B: 152, human immunodeficiency virus/CHC: 628, NAFLD: 225, and alcoholic liver disease (ALD): 265...
August 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28688543/liver-steatosis-the-new-epidemic-of-the-third-millennium-benign-liver-state-or-silent-killer
#2
REVIEW
Claudio Puoti, Maria Giuseppa Elmo, Daniela Ceccarelli, Michela Ditrinco
Until the end of the 90's of the last century, rather little attention was paid to the issue of the non-alcoholic fatty liver disease (NAFLD), perhaps due to the fact that the newly discovered hepatitis C virus did attract a paramount interest of hepatologists and researchers. On the other side, fatty liver was considered a relatively uncommon cause of liver damage, occurring almost exclusively in obese females, often associated with non-insulin dependent diabetes mellitus (NIDDM), and with a relatively benign prognosis...
July 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28676020/current-and-potential-future-pharmacological-approaches-for-non-alcoholic-fatty-liver-disease
#3
Konstantinos Imprialos, Konstantinos Stavropoulos, Sofia Bouloukou, Georgios Kerpiniotis, Asterios Karagiannis, Michael Doumas
BACKGOUND: Non-alcoholic fatty liver disease (NAFLD) affects a large proportion of the general population. The disease ranges from simple steatosis, to non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma. Several drugs are used in daily clinical practice to manage the disease. However, data on their efficacy in liver histology are not consistent. AIM: We discuss current treatment options for NAFLD and NASH and preliminary results from novel drugs under investigation...
June 20, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28637103/-the-development-of-hepatocellular-carcinoma-in-non-alcoholic-fatty-liver-disease
#4
REVIEW
Oh Sang Kwon, Joon Hwan Kim, Ju Hyun Kim
Non-alcoholic fatty liver disease (NAFLD) may be one of the important causes of cryptogenic hepatocellular carcinoma (HCC). NAFLD-related HCCs (NAFLD-HCCs) have the following clinical features: high body mass index, deranged lipid profiles, diabetes mellitus, hypertension, and metabolic syndrome. Among them, obesity, diabetes mellitus, and high Fe contents in the liver are risk factors of developing HCC in patients with NAFLD. Inflammatory cytokines, adipokines, insulin like growth factor-I, and lipotoxicity are intermingled and may cross react with each other to develop HCC...
June 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28598048/hepatotoxicity-in-hiv-patients-an-observational-study-in-patients-from-tertiary-care-centre-of-western-india
#5
Smrati Bajpai, Kavita Joshi
OBJECTIVE: HIV AIDS has currently become a chronic manageable condition with HAART, but with its chronicity and lifelong therapy currently the adverse drug reactions to these drugs are the main concern for any treating physician. Hepatotoxicity is one of the prime concerns of any physician managing HIV patients. We observe a number of patients reporting hepatotoxicity in our cohort and this had great impact on the efficacy and intake of the HAART drugs, this led us to explore this area and to find out the prevalence and etiologies in our cohort...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28517024/treatment-of-severe-alcoholic-hepatitis-past-present-and-future
#6
REVIEW
Nicolas Lanthier, Peter Stärkel
Alcoholic hepatitis (AH) manifests as a clinical syndrome characterized by recent jaundice and liver function deterioration in an actively drinking patient. The principal cause of AH is alcoholic steatohepatitis (ASH) defined histologically by the coexistence of steatosis, hepatocyte ballooning and satellitosis. While nonsevere AH usually responds to alcohol abstinence, severe AH, identified by Maddrey scoring ≥ 32, has a bad prognosis and is traditionally treated by a 28-day course of prednisone therapy...
July 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28489673/systematic-review-nutrition-and-physical-activity-in-the-management-of-paediatric-non-alcoholic-fatty-liver-disease
#7
Philippa S Gibson, Sarah Lang, Anil Dhawan, Emer Fitzpatrick, Michelle L Blumfield, Helen Truby, Kathryn H Hart, J Bernadette Moore
OBJECTIVES: To evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric non-alcoholic fatty liver disease (NAFLD). The prevalence of paediatric NAFLD continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus and Cochrane Libraries were systematically searched to identify randomised controlled trials (RCTs) assessing nutritional and physical activity interventions...
May 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28442120/american-gastroenterological-association-institute-technical-review-on-the-role-of-elastography-in-chronic-liver-diseases
#8
REVIEW
Siddharth Singh, Andrew J Muir, Douglas T Dieterich, Yngve T Falck-Ytter
Chronic liver diseases (CLDs), due to chronic hepatitis C; hepatitis B; nonalcoholic fatty liver diseases (NAFLD); and alcoholic liver disease, are a leading cause of morbidity and mortality globally. Early identification of patients with cirrhosis at high risk of progression to liver-related complications may facilitate timely care and improve outcomes. With risks and misclassification associated with invasive tests, such as liver biopsy, noninvasive imaging modalities for liver fibrosis assessment have gained popularity...
May 2017: Gastroenterology
https://www.readbyqxmd.com/read/28424803/use-of-a-flumazenil-infusion-to-treat-chlordiazepoxide-toxicity
#9
I R Wallace, E C Campbell, M Trimble
"Alcohol detox" is a common presentation to acute medical services and is usually managed via standardised guidelines and protocols. We present a case of chlordiazepoxide toxicity, requiring repeated bolus doses and subsequently 24 hours of an intravenous infusion of flumazenil in response to guideline directed management of an alcohol withdrawal state. The use of prolonged flumazenil infusions to treat benzodiazepine toxicity is infrequently described. Chlordiazepoxide is metabolised in the hepatic microsomal pathway and hepatic impairment can lead to accumulation of toxic metabolites, which may have been the explanation for toxicity in this case...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28276821/current-and-future-treatment-options-in-non-alcoholic-steatohepatitis-nash
#10
Nikos Lazaridis, Emmanuel Tsochatzis
Non-alcoholic steatohepatitis (NASH) is a chronic liver disease that can progress to cirrhosis and hepatocellular carcinoma. Diagnosis of NASH requires a liver biopsy and is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Although NASH is the most common cause of liver disease in the west world and among the top three indications for liver transplantation, there are no universally accepted pharmacological therapies and therapeutic advances have been slow...
April 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28258743/loco-regional-treatment-of-hcc-current-status
#11
REVIEW
L Crocetti, I Bargellini, R Cioni
Hepatocellular carcinoma (HCC) represents one of the few cancers for which locoregional treatments are recognised as being able to cure and/or prolong survival and are included in international guidelines. This is due to the unique nature of HCC, in most cases occurring in patients with underlying virus- or alcohol-related cirrhosis. The treatment choice in patients with HCC is therefore driven not only by tumour staging, as in the great majority of cancers, but also by careful evaluation of liver function and physical status...
August 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28217253/miliary-tuberculosis-infection-during-hepatitis-c-treatment-with-sofosbuvir-and-ledipasvir-plus-ribavirin
#12
Maria Pilar Ballester-Ferré, Fernando Martínez, Natalia Garcia-Gimeno, Francisco Mora, Miguel A Serra
Chronic hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. In the last 5 years, treatment for HCV infection has experienced a marked development. In 2014, the use of ledipasvir/sofosbuvir with or without concomitant weight-based ribavirin was approved with a very significant increase in the sustained virological response. However, new side effects have been associated. We report the first case of an HCV infected patient treated for 12 wk with the combination of sofosbuvir/ledipasvir plus ribavirin who developed a miliary tuberculosis (TB) infection while on therapy...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28132702/long-term-retention-in-office-based-opioid-treatment-with-buprenorphine
#13
Zoe M Weinstein, Hyunjoong W Kim, Debbie M Cheng, Emily Quinn, David Hui, Colleen T Labelle, Mari-Lynn Drainoni, Sara S Bachman, Jeffrey H Samet
BACKGROUND: Guidelines recommend long-term treatment for opioid use disorder with buprenorphine; however, little is known about patients in long-term treatment. The aim of this study is to examine the prevalence and patient characteristics of long-term treatment retention (≥1year) in an Office Based Opioid Treatment (OBOT) program with buprenorphine. METHODS: This is a retrospective cohort study of adults on buprenorphine from January 2002 to February 2014 in a large urban safety-net primary care OBOT program...
March 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28060242/adult-liver-allocation-in-eurotransplant
#14
Ina Jochmans, Marieke van Rosmalen, Jacques Pirenne, Undine Samuel
Liver allocation in Eurotransplant is complex as allocation rules need to follow not only the guidelines of the European Commission but also the specific regulations of each of the 7 Eurotransplant countries with active liver transplant programs. Thirty-eight liver transplant centers served a population of about 135 million in 2015. Around 1600 deceased donor livers are transplanted annually. The number of deceased organ donors remains stable but donor age is increasing. Nevertheless, liver utilization rates are unchanged at around 80%...
January 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28045778/a-14-year-audit-and-analysis-of-human-skin-allograft-discards
#15
Jordan Spradbrow, Matthew Etchells, Robert Cartotto, Alison Halliday, Yulia Lin, Andrew Simor, Raj Visvalingam, Jeannie Callum
The objective of this study was to review the incidence of skin allograft discard and bacterial contamination due to donor bioburden at the Ontario Professional Firefighters Skin Bank over a 14-year period. We sought to determine whether modifications to our prerecovery donor preparation process have been effective in reducing skin bioburden and identify other potential risk factors of allograft contamination. A retrospective review of all skin donors (n = 259) processed from 2002 to 2015 was performed. Multivariate logistic regression was used to determine whether donor-related factors and procurement-related factors were significantly associated with microbial contamination predisinfection and discard secondary to contamination...
December 30, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#16
Paul Y Kwo, Stanley M Cohen, Joseph K Lim
Clinicians are required to assess abnormal liver chemistries on a daily basis. The most common liver chemistries ordered are serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase and bilirubin. These tests should be termed liver chemistries or liver tests. Hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels. Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels...
January 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27973461/bone-metabolism-in-non-alcoholic-fatty-liver-disease-vitamin-d-status-and-bone-mineral-density
#17
Ahad Eshraghian
Non alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and liver enzymes abnormalities worldwide. NAFLD is reported to be associated with other extra-hepatic diseases including cardiovascular disease, diabetes mellites and thyroid gland abnormalities. Liver is also the source of many proteins involved in bone metabolism and is the regulator of several bone metabolism pathways. Although underlying pathogenesis is not clear, the association between NAFLD and low bone mineral density (BMD) in the forms of osteoporosis and osteopenia have been recently reported...
December 14, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27870642/hepatocellular-carcinoma-surveillance-among-patients-with-cirrhosis-in-a-population-based-integrated-health-care-delivery-system
#18
Amit G Singal, Jasmin Tiro, Xilong Li, Beverley Adams-Huet, Jessica Chubak
PURPOSE: Fewer than 1 in 5 patients with cirrhosis receive hepatocellular carcinoma (HCC) surveillance; however, most studies were performed in select patient populations, which may not be informative of practice patterns in population-based community practices. Further, few reported guideline-concordant consistent surveillance rates. GOALS: Characterize guideline-concordant HCC surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis...
August 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27842443/clinical-update-on-benefit-versus-risks-of-oral-paracetamol-alone-or-with-codeine-still-a-good-option
#19
Hans Georg Kress, Gerald Untersteiner
BACKGROUND: After decades of worldwide use of paracetamol/acetaminophen as a popular and apparently safe prescription and over-the-counter medicine, the future role of this poorly understood analgesic has been seriously questioned by recent concerns about prenatal, cardiovascular (CV) and hepatic safety, and also about its analgesic efficacy. At the same time the usefulness of codeine in combination products has come under debate. METHODS: Based on a PubMed database literature search on the terms efficacy, safety, paracetamol, acetaminophen, codeine and their combinations up to and including June 2016, this clinical update reviews the current evidence of the benefit and risks of oral paracetamol alone and with codeine for mild-to-moderate pain in adults, and compares the respective efficacy and safety profiles with those of nonsteroidal anti-inflammatory drugs (NSAIDs)...
February 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27810652/alcohol-use-and-hepatitis-c-virus-treatment-outcomes-among-patients-receiving-direct-antiviral-agents
#20
Judith I Tsui, Emily C Williams, Pamela K Green, Kristin Berry, Feng Su, George N Ioannou
BACKGROUND: It is unclear whether alcohol use negatively impacts HCV treatment outcomes in the era of direct antiviral agents (DAAs). We aimed to evaluate the associations between current levels of drinking and treatment response among persons treated for HCV with DAAs in the national Veterans Affairs (VA) healthcare system. METHODS: We identified patients who initiated HCV DAAs over 18 months (1/1/14-6/30/15) and had documented alcohol screening with the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire within one year prior to initiating therapy...
December 1, 2016: Drug and Alcohol Dependence
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