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alcoholic hepatitis guidelines

Pongphob Intaraprasong, Sith Siramolpiwat, Ratha-Korn Vilaichone
Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor and a high impact health problem worldwide. The prevalence of HCC is particularly high in many Asian and African countries. Some HCC patients have no symptoms prior to diagnosis and many of them therefore present at late stage and have a grave prognosis. The well-established causes of HCC are chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection or alcoholic cirrhosis and nonalcoholic steatohepatitis. The Barcelona Clinic Liver Cancer (BCLC) Staging System remains the most widely used for HCC management guidelines...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Massimo Colombo, Angelo Sangiovanni
Hepatocellular carcinoma (HCC) is the third leading cause of cancer death and the first in patients with compensated cirrhosis. Chronic infection with hepatitis B and C, alcohol, smoking, exposure to aflatoxin and metabolic syndrome, associated with diabetes and obesity are the main etiological factors. Regardless of etiology, patients with cirrhosis stand as the category at higher risk of developing HCC, and indeed are the target of surveillance programs aimed to the early diagnosis of HCC, the only chance to reduce HCC-related mortality...
July 2016: Recenti Progressi in Medicina
Edita Baltruskeviciene, Birutė Kazbariene, Robertas Badaras, Loreta Bagdonaitė, Aurelija Krikštaponienė, Linas Zdanavičius, Eduardas Aleknavicius, Janina Didziapetrienė
BACKGROUND/AIMS: Glutathione and glutathione S-transferases (GST) are involved in cell defence against reactive oxygen species, which induces oxidative stress and are associated with different chronic diseases. The aim of the present study was to determine the differences in reduced glutathione (GSH) and GST levels in patients with different liver diseases. MATERIALS AND METHODS: Overall, 114 patients were enrolled in this study: 58 patients with colorectal cancer (18 without and 40 with liver metastases), 27 with liver steatosis, 29 with alcoholic cirrhosis and a group of 40 healthy volunteers...
July 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Ludovico Abenavoli, Mario Masarone, Alessandro Federico, Valerio Rosato, Marcello Dallio, Carmela Loguercio, Marcello Persico
Alcohol represents the oldest substance of abuse known and Alcoholic Liver Disease (ALD) is the most common cause of chronic liver disease worldwide. The ALD includes a wide spectrum of injury and may lead progressively from simple steatosis to frank cirrhosis. The ALD diagnosis may be hard and it is mainly defined by the history of chronic alcohol intake, physical and laboratory abnormalities suggestive of liver disease. Abstinence is the cornerstone of ALD therapy. Although the burden on health of ALD is not negligible, in the last decades few therapeutic advances have been made...
2016: Reviews on Recent Clinical Trials
Jessica Johnson, David E Wilson, Bennett P deBoisblanc
OBJECTIVE: We aimed to characterize utilization of evidence-based health promotion practices not included in Alcohol Withdrawal Syndrome (AWS) guidelines, such as vaccinations and counseling services, hypothesizing that missed opportunities for health promotion intervention would abound. METHODS: Retrospective medical record review of 99 patients presenting to a safety-net academic medical center with AWS between August 1, 2012 and March 31, 2013. RESULTS: Thiamine replacement (70%), tobacco cessation counseling (28%), influenza or pneumonia vaccination (25% and 28% respectively), psychiatric counseling (70%), referral to alcohol support group or treatment center(40%), and screening for viral hepatitis and HIV (39% and 44%, respectively) were documented by healthcare providers at lower than optimal frequency...
March 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Olivier Rosmorduc, Laetitia Fartoux
Obesity and the metabolic syndrome are fast-growing epidemics associated with an increased risk for many types of cancer. In the liver, inflammatory and angiogenic changes due to insulin resistance and fatty liver disease are associated with an increased incidence of liver cancer. Regardless of underlying liver disease, cirrhosis remains the most important risk factor for hepatocellular carcinoma (HCC) although cases of HCC arising without cirrhosis do not exclude the possibility of a direct carcinogenesis secondary to non-alcoholic fatty liver disease...
December 2014: Bulletin de L'Académie Nationale de Médecine
Vicente Arroyo, Richard Moreau, Patrick S Kamath, Rajiv Jalan, Pere Ginès, Frederik Nevens, Javier Fernández, Uyen To, Guadalupe García-Tsao, Bernd Schnabl
The definition of acute-on-chronic liver failure (ACLF) remains contested. In Europe and North America, the term is generally applied according to the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) Consortium guidelines, which defines this condition as a syndrome that develops in patients with cirrhosis and is characterized by acute decompensation, organ failure and high short-term mortality. One-third of patients who are hospitalized for acute decompensation present with ACLF at admission or develop the syndrome during hospitalization...
2016: Nature Reviews. Disease Primers
Helma P Cotrim, Claudia P Oliveira, Henrique Sérgio M Coelho, Mario R Alvares-da-Silva, Leticia Nabuco, Edison Roberto Parise, Claúdia Ivantes, Ana Lc Martinelli, João Galizzi-Filho, Flair J Carrilho
OBJECTIVE: The majority of cases of hepatocellular carcinoma have been reported in individuals with cirrhosis due to chronic viral hepatitis and alcoholism, but recently, the prevalence has become increasingly related to nonalcoholic steatohepatitis around the world. The study aimed to evaluate the clinical and histophatological characteristics of hepatocellular carcinoma in Brazilians' patients with nonalcoholic steatohepatitis at the present time. METHODS: Members of the Brazilian Society of Hepatology were invited to complete a survey regarding patients with hepatocellular carcinoma related to nonalcoholic steatohepatitis...
May 2016: Clinics
Ashwani K Singal, Sudha Kodali, Lee A Vucovich, Victor Darley-Usmar, Thomas D Schiano
Alcoholic hepatitis (AH) occurs in about one-third of individuals reporting long-term heavy alcohol use. It is associated with high short-term mortality, economic burden, and hospital resources utilization. We performed this systematic review to (i) describe clinical characteristics and genomics associated with the risk of AH; (ii) discuss role and limitations of liver biopsy and prognostic scoring systems; (iii) summarize evidence regarding the currently available therapies including liver transplantation; and (iv) outline emerging therapies with areas of unmet need...
July 2016: Alcoholism, Clinical and Experimental Research
Sonia Pascual, Iván Herrera, Javier Irurzun
Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified...
March 28, 2016: World Journal of Hepatology
Matthew L Cowan, James D Maxwell
BACKGROUND: Hepatitis C virus (HCV) infection is common among intravenous drug users, and because of the long latent period, HCV liver disease is set to increase. OBJECTIVES: We sought to examine practice guidelines regarding treatment of HCV in drug users and to review the evidence for current practices. METHODS: A structured search of the Pubmed database, websites of the National Institute for Clinical Excellence and national and international expert groups and opinion of independent experts in the field...
October 2006: Acta Neuropsychiatrica
Liang Xu, Ping Li, Wei Lu, Qiyu Shi, Ruifang Shi, Xiaoying Zhang, Yonggang Liu, Qiujing Wang, Jangao Fan, Yuqiang Mi
OBJECTIVE: To investigate the value of controlled attenuation parameter (CAP) in the diagnosis of fatty liver using FibroScan in patients with chronic liver disease (CLD). METHODS: A prospective cohort study was performed for the patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and non-alcoholic fatty liver disease (NAFLD) who underwent liver pathological examination followed by CAP measurement within 1 week in The Second People's Hospital of Tianjin from February 2013 to May 2014...
February 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Diego García-Compeán, José Alberto González-González, Fernando Javier Lavalle-González, Emmanuel Irineo González-Moreno, Jesús Zacarías Villarreal-Pérez, Héctor Jesús Maldonado-Garza
Diabetes mellitus (DM) that occurs because of chronic liver disease (CLD) is known as hepatogenous diabetes (HD). Although the association of diabetes and liver cirrhosis was described forty years ago, it was scarcely studied for long time. Patients suffering from this condition have low frequency of risk factors of type 2 DM. Its incidence is higher in CLD of viral, alcoholic and cryptogenic etiology. Its pathophysiology relates to liver damage, pancreatic dysfunction, interactions between hepatitis C virus (HCV) and glucose metabolism mechanisms and genetic susceptibility...
March 14, 2016: World Journal of Gastroenterology: WJG
Henry Namme Luma, Servais Albert Fiacre Bagnaka Eloumou, Agnes Malongue, Elvis Temfack, Dominique Noah Noah, Olivier Donfack-Sontsa, Ivo Che Ditah
INTRODUCTION: Hepatitis C virus (HCV) infection is a major public health problem, especially in resource-limited settings where many patients are diagnosed at the stage of complications. In Cameroon, where HCV is endemic, little is known about the clinical, biological, and virological profile of HCV-infected patients. METHODS: A clinical case note review of all patients positive for antibodies against HCV diagnosed at the gastroenterology outpatient clinic of the Douala General Hospital, Cameroon, from January 2008 to December 2014, was performed...
April 2016: International Journal of Infectious Diseases: IJID
C Loinaz Segurola, J L LIedó Navarro, R de la Cruz Burgos, D Martín Ríos, F Ochando Cerdán, S Alonso López, J Martel Villagrán, M L Gutiérrez Garcia, J M Fernandez Cebrián, C Fernández Rodríguez
BACKGROUND/AIMS: Mean survival in hepatocellular carcinoma remains low. Many efforts have been done during the last years through screening, diagnosis and treatment to improve the results. The aim of this work is to present the experience of our hospital multidisciplinary group during the first decade of this century. METHODOLOGY: The patients with hepatocellullar carcinoma presented at the multidisciplinary meeting from 1999 to 2009 were prospectively studied. According to the tumor and functional status they were treated through the current available guidelines by transplant, partial hepatectomy, local/regional procedures, systemic or symptomatic treatment...
June 2015: Hepato-gastroenterology
Elena S Papamiltiadous, Stuart K Roberts, Amanda J Nicoll, Marno C Ryan, Catherine Itsiopoulos, Agus Salim, Audrey C Tierney
BACKGROUND: Non-alcoholic fatty liver disease, the most prevalent liver disease in developed countries, remains difficult to manage with no proven safe and effective pharmacotherapy available. While weight reduction is the most commonly practiced treatment strategy, this is difficult to both achieve and/or maintain in the majority. Furthermore evidence-based dietary recommendations to guide the nutritional management of these patients are lacking. Using a randomised controlled trial design, this study compares the effectiveness of the Mediterranean diet to a standard low fat diet in terms of differences in insulin sensitivity, hepatic steatosis and metabolic outcomes in participants with non-alcoholic fatty liver disease...
2016: BMC Gastroenterology
Mingyun Chen, Tingting Li, Rong Zhang, Lianxi Li, Junxi Lu, Yuqian Bao, Weiping Jia
OBJECTIVE: To investigate the clinical features of non-alcoholic fatty liver disease (NAFLD) and its relationship with serum C-peptide levels in patients with latent autoimmune diabetes in adults (LADA). METHODS: A total of 155 patients with LADA who had no drinking history and were hospitalized in department of endocrinology and metabolism from January 2007 to June 2009 were divided into two groups, including patients with LADA but without NAFLD and patients with both LADA and NAFLD, according to Chinese medical association's guidelines of NAFLD and hepatic ultrasound result...
November 24, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Maria Forţofoiu, Mircea Cătălin Forţofoiu, Violeta Comănescu, Aurelian Constantin Dobrinescu, Vlad Pădureanu, Cristin Constantin Vere, Costin Teodor Streba, Paulina-Lucia Ciurea
Hepatocellular carcinoma (HCC) represents a major health burden, as curative methods only apply to a select small portion of the affected population. Screening programs are ineffective in the absence of established underlying conditions such as viral hepatitis or alcohol abuse resulting in liver cirrhosis. Thus, overweight or obese, diabetic patients as well as non-alcoholic fatty liver disease (NAFLD) cases are often overlooked as potential candidates for HCC development. Current diagnostic methods for HCC are restricted to non-invasive imaging tests; however, the need for accurate predictive or therapeutic markers make histological studies a necessity; the latest guidelines and recommendations demand an increased effort in obtaining pertinent data from immunohistochemical investigations...
2015: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Aezam Katoonizadeh, Shima Ghoroghi, Maryam Sharafkhah, Masoud Khoshnia, Samaneh Mirzaei, Amaneh Shayanrad, Hossein Poustchi, Reza Malekzadeh
This study aimed to assess the association of chronic hepatitis B (CHB) with vascular mortality and metabolic syndrome (MS) using data from a large population-based cohort study in Iran. A total of 12,781 participants (2249 treatment-naïve CHB and 10,532 without CHB) were studied. Logistic regression model was used to assess the association between MS and CHB with adjustment for age, ALT, PLT, alcohol intake, smoking, exercise, and socioeconomic status. MS was defined according to the ATPIII guidelines. Cox proportional hazards model was used to assess the hazard ratios for overall and vascular related mortality...
July 2016: Journal of Medical Virology
Mark Thursz, Ewan Forrest, Paul Roderick, Christopher Day, Andrew Austin, John O'Grady, Stephen Ryder, Michael Allison, Dermot Gleeson, Anne McCune, David Patch, Mark Wright, Steven Masson, Paul Richardson, Luke Vale, Jane Mellor, Louise Stanton, Megan Bowers, Ian Ratcliffe, Nichola Downs, Scott Kirkman, Tara Homer, Laura Ternent
BACKGROUND: Alcoholic hepatitis (AH) is a distinct presentation of alcoholic liver disease arising in patients who have been drinking to excess for prolonged periods, which is characterised by jaundice and liver failure. Severe disease is associated with high short-term mortality. Prednisolone and pentoxifylline (PTX) are recommended in guidelines for treatment of severe AH, but trials supporting their use have given heterogeneous results and controversy persists about their benefit. OBJECTIVES: The aim of the clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis trial was to resolve the clinical dilemma on the use of prednisolone or PTX...
December 2015: Health Technology Assessment: HTA
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