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https://www.readbyqxmd.com/read/28442120/american-gastroenterological-association-institute-technical-review-on-the-role-of-elastography-in-chronic-liver-diseases
#1
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
#2
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
#3
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
#4
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...
February 28, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28217253/miliary-tuberculosis-infection-during-hepatitis-c-treatment-with-sofosbuvir-and-ledipasvir-plus-ribavirin
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
November 18, 2016: 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
#12
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
#13
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
https://www.readbyqxmd.com/read/27644603/advances-in-management-of-hepatocellular-carcinoma
#14
REVIEW
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
https://www.readbyqxmd.com/read/27571469/-hepatocellular-carcinoma
#15
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
https://www.readbyqxmd.com/read/27458849/glutathione-and-glutathione-s-transferase-levels-in-patients-with-liver-metastases-of-colorectal-cancer-and-other-hepatic-disorders
#16
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
https://www.readbyqxmd.com/read/27457347/alcoholic-hepatitis-pathogenesis-diagnosis-and-treatment
#17
REVIEW
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
https://www.readbyqxmd.com/read/27383853/missed-opportunities-for-health-promotion-intervention-in-the-management-of-alcohol-withdrawal-syndrome
#18
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
https://www.readbyqxmd.com/read/27356367/-metabolic-syndrome-non-alcoholic-hepatic-steatopathy-and-hepatocellular-carcinoma-so-dangerous-liaisons
#19
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
https://www.readbyqxmd.com/read/27277335/acute-on-chronic-liver-failure-in-cirrhosis
#20
REVIEW
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...
June 9, 2016: Nature Reviews. Disease Primers
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