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Carlo Sposito, Stefano Di Sandro, Federica Brunero, Vincenzo Buscemi, Carlo Battiston, Andrea Lauterio, Marco Bongini, Luciano De Carlis, Vincenzo Mazzaferro
AIM: To develop a prognostic scoring system for overall survival (OS) of patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC). METHODS: Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for OS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for OS...
September 28, 2016: World Journal of Gastroenterology: WJG
Sun Young Yim, Beom Jin Park, Soon Ho Um, Na Yeon Han, Deuk Jae Sung, Sung Bum Cho, Seung Hwa Lee, Min Ju Kim, Jin Yong Jung, Jin Dong Kim, Yeon Seok Seo, Dong Sik Kim, Hyonggin An, Yun Hwan Kim
To compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with that of computed tomography (CT) during hepatic arteriography and arterial portography (CT HA/AP) for detecting hepatocellular carcinoma (HCC) from small hypervascular nodules.This retrospective study included 38 patients with 131 hypervascular nodules (≤2 cm) who had underwent MRI and CT HA/AP within a 2-week interval. Two observers analyzed MRI while other 2 observers analyzed CT HA/AP. Thereafter, MRI observers reviewed the CT HA/AP and magnetic resonance (MR) images again using both modalities...
September 2016: Medicine (Baltimore)
Jens Altenbernd, Axel Wetter, Michael Forsting, Lale Umutlu
PURPOSE: The aim of this prospective study was to examine the diagnostic value of dual-energy CT (DECT) in the assessment of response of HCC after radioembolisation (RE). MATERIAL AND METHODS: 40 HCC patients with 82 measurable target lesions were included in this study. At baseline and follow-up examination target lesions were evaluated with (IU), AASLD and Choi measurement criteria. Disease control was defined as the sum of complete response (CR), partial response (PR), progression disease (PD) and stable disease (SD)...
2016: European Journal of Radiology Open
Xiaolong Qi, Xin Zhang, Zhijia Li, Jialiang Hui, Yi Xiang, Jinjun Chen, Jianbo Zhao, Jing Li, Fu-Zhen Qi, Yong Xu
Hepatic venous pressure gradient (HVPG) measurement provides independent prognostic value in patients with cirrhosis, and the prognostic and predictive role of HVPG in hepatocellular carcinoma (HCC) also has been explored. The management of HCC is limited to the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) guidelines that consider that HVPG≥10 mmHg to be a contraindication for hepatic resection (HR), otherwise other treatment modalities are recommended...
August 23, 2016: Oncotarget
Danbi Lee, Heather Lyu, Young-Hwa Chung, Jeong A Kim, Priya Mathews, Elizabeth Jaffee, Lei Zheng, Eunsil Yu, Young Joo Lee, Soo Hyung Ryu
AIM: To determine the genomic changes in hepatitis B virus (HBV) and evaluate their role in the development of hepatocellular carcinoma (HCC) in patients chronically infected with genotype C HBV. METHODS: Two hundred and forty chronic hepatitis B (CHB) patients were subjected and followed for a median of 105 mo. HCC was diagnosed in accordance with AASLD guidelines. The whole X, S, basal core promoter (BCP), and precore regions of HBV were sequenced using the direct sequencing method...
June 21, 2016: World Journal of Gastroenterology: WJG
Prabhu P Gounder, Lisa R Bulkow, Martin I Meltzer, Michael G Bruce, Thomas W Hennessy, Mary Snowball, Philip R Spradling, Bishwa B Adhikari, Brian J McMahon
BACKGROUND: The American Association for the Study of Liver Diseases (AASLD) recommends semi-annual hepatocellular carcinoma (HCC) screening using ultrasound (US) in persons with chronic hepatitis B (CHB) virus infection at high risk for HCC such as Asian males aged ≥40 years and Asian females aged ≥50 years. OBJECTIVE: To analyse the cost-effectiveness of 2 HCC screening methods in the Alaska Native (AN) health system: US-alone, or screening by alpha-fetoprotein (AFP) initially and switching to US for subsequent screenings if AFP >10 ng/mL (AFP→US)...
2016: International Journal of Circumpolar Health
A Majumdar, M T Kitson, S K Roberts
BACKGROUND: The burden of HCV cirrhosis is high and projected to increase significantly over the next decade. While interferon therapy is problematic in HCV cirrhosis, the era of direct-acting anti-viral (DAA) therapy provides effective treatment for patients with cirrhosis. AIM: To systematically review the results of DAA therapy to date in patients with HCV cirrhosis, and highlight the ongoing challenges for DAA therapy in this population. METHODS: A structured Medline search was conducted to obtain phase II and III HCV trials in patients with cirrhosis...
June 2016: Alimentary Pharmacology & Therapeutics
Ying Peng, Xingshun Qi, Shanhong Tang, Han Deng, Jing Li, Zheng Ning, Junna Dai, Feifei Hou, Jiancheng Zhao, Ran Wang, Xiaozhong Guo
OBJECTIVES: Our study aimed to evaluate the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure (ACLF). METHODS: Cirrhotic patients with ACLF admitted between 2010 January and 2014 June were retrospectively reviewed. Areas under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs) were calculated...
August 2016: Expert Review of Gastroenterology & Hepatology
Julien Delicque, Mathieu Boulin, Boris Guiu, Jean-Pierre Pelage, Laure Escal, Valentina Schembri, Eric Assenat, Audrey Fohlen
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is increasing in incidence. The overall prognosis of patients with liver cancer is poor. The Barcelona Clinic Liver Cancer (BCLC) classification in 5 stages is endorsed by European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Disease (AASLD). This classification is recommended for treatment allocation. Because a small proportion of patients are suitable for curative surgical treatment, various locoregional therapies are widely used to manage patients with HCC...
April 4, 2016: Clinics and Research in Hepatology and Gastroenterology
Thomas R McCarty, Mena Bakhit, Tarun Rustagi
Isolated gastric varices are far less prevalent in Western countries where the rate of splenic thrombosis is much lower. However, in Asian countries the entity is more common and therefore a more robust treatment approach has been developed. Balloon-occlusive retrograde transvenous obliteration (BRTO) was first described in 1984 and then revived in 1996. The procedure, while uncommon in the U.S. and not recognized by the AASLD practice guidelines, allows for direct exclusion from the portosystemic system. Here we describe the case of a patient with alcoholic cirrhosis decompensated by bleeding gastric varices treated with BRTO...
March 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
R Huang, H Y Rao, H S Chen, L G Lu, L Wei
No abstract text is available yet for this article.
January 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Anne De Monte, Johan Courjon, Rodolphe Anty, Eric Cua, Alissa Naqvi, Véronique Mondain, Jacqueline Cottalorda, Laurence Ollier, Valérie Giordanengo
Use of direct-acting antiviral drugs (DAAs) greatly improves management of adults infected with hepatitis C virus (HCV) whether patients are treatment-naive or unsuccessfully pre-treated. Several inhibitors of viral nonstructural proteins (NS3/4A protease, NS5A and NS5B polymerase) allow a rapid HCV clearance and increase rates of sustained virological response. Both the EASL and AASLD guidelines have recently published up-to-date recommendations for their use, addressing each HCV genotype and particular situations...
May 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
R Rajbhandari, K Barton, A C Juncadella, A K Rubin, T Ajayi, Y Wu, A N Ananthakrishnan, R T Chung
Assiduous measures are taken to prevent perinatal transmission of hepatitis B virus (HBV) to infants; it is unclear whether the mothers receive appropriate care for their chronic HBV. We sought to assess the quality of HBV care in hepatitis B surface antigen (HBsAg)-positive mothers following pregnancy. HBsAg-positive women (n = 243) who had sought prenatal care at Massachusetts General Hospital were retrospectively identified and charts reviewed. The primary outcome was adherence to the American Association for the Study of Liver Diseases (AASLD) and American College of Obstetricians and Gynecologists guidelines...
July 2016: Journal of Viral Hepatitis
Johannes Wiegand, Florian van Bömmel, Andrés Duarte-Rojo, José Altamirano, Juan G Abraldes, Augusto Villanueva, Thomas Berg
No abstract text is available yet for this article.
June 2016: Journal of Hepatology
Z M Younossi, B R Bacon, D T Dieterich, S L Flamm, K Kowdley, S Milligan, N Tsai, A Nezam
Despite the clinical success in the real-world of all oral hepatitis C virus (HCV) therapy with response rates approaching that seen in the clinical trials, access has been limited by many payers with discussion of prioritization of treatment based upon AASLD guidelines. We evaluated patients in the TRIO network who were prescribed sofosbuvir (SOF)-based regimens to determine reasons for not starting treatment. Trio Health is a disease management company that works in partnership with academic medical centres, community physicians and specialty pharmacies in the United States to optimize care for HCV...
June 2016: Journal of Viral Hepatitis
Yael Gozlan, Ella Mendelson, Ziv Ben-Ari, Orna Mor
Hepatitis C virus (HCV) is a leading cause of chronic viral hepatitis affecting 130-150 million people world-wide. HCV is an RNA virus of the Flaviviridae family, containing ~9600 nucleic acids coding for structural and nonstructural proteins, divided into 7 genotypes of which the most prevalent is genotype 1. The goal of HCV therapy is to achieve sustained virological response (SVR), currently defined as undetectable serum HCV RNA 12 weeks post-treatment. Treatment with the new direct acting antivirals (DAAs) that target the HCV protease NS3/4A, NS5A and the NS5B polymerase proteins can lead to more than 90% SVR...
November 2015: Harefuah
Craig Lammert, Veronica M Loy, Kiyoko Oshima, Samer Gawrieh
Autoimmune hepatitis (AIH) is a complex autoimmune disease characterized by immune-mediated destruction of hepatic parenchyma which can result in cirrhosis, liver failure, and death. Current American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of Liver (EASL) guidelines recommend corticosteroids alone or in combination with azathioprine as first-line treatment strategies. However, a significant proportion of patients may not be able to tolerate or achieve complete biochemical response with these options...
February 2016: Current Gastroenterology Reports
Mevlut Hamamci, Fatih Karaahmet, Hakan Akinci, Serta Kilincalp, Ruchan Acıkgoz, Sahin Coban, Ilhami Yuksel
HCC is the most common type of primary liver tumor. The Practice Guideline, AASLD, for HCC recommended surveillance of HBV carriers at high risk of HCC with US every 6-12 months. Laboratory surveillance option is the measurement of serum α-fetoprotein level which has long been used for the diagnosis of HCC. But, increased serum levels of α-fetoprotein are also seen in acute hepatitis, cirrhosis, and malignancies include yolk sac carcinoma, neuroblastoma, hepatoblastoma, gastric and lung carcinoma. Because of elevation α-fetoprotein in these malignancies, liver mass with an elevated α-fetoprotein does not directly indicate HCC...
December 2015: Acta Gastro-enterologica Belgica
Lindsay A Uribe, Nghia Nguyen, Lily Kim, Huy N Trinh, Christopher Wong, Clifford Wong, Long H Nguyen, Mindie H Nguyen
BACKGROUND AND AIMS: Chronic hepatitis B (CHB) is a major cause of cirrhosis and end-stage liver disease. Not all patients with CHB require antiviral treatment but long-term monitoring is critical to identify patients who would benefit from antiviral therapy. CHB patients followed in various clinical settings may differ in disease characteristics and rates of treatment eligibility in long-term follow-up. METHODS: We conducted a retrospective cohort study of 359 consecutive treatment-naive, treatment-ineligible CHB patients (228 from community GI clinics; 73 from university hepatology clinic; 58 from primary care clinic)...
February 2016: Digestive Diseases and Sciences
Sean M McConachie, Sheila M Wilhelm, Pramodini B Kale-Pradhan
Hepatitis C is a chronic infection associated with considerable morbidity and mortality. In recent years, there has been a shift in treatment paradigm with the discovery and approval of agents that target specific proteins vital for hepatitis C replication. The NS3/4A inhibitors simeprevir and paritaprevir, the NS5A inhibitors ombitasvir, ledipasvir, and daclatasvir, and the NS5B inhibitors sofosbuvir and dasabuvir have been newly FDA approved and incorporated as first-line agents into the latest IDSA-AASLD guidelines for Hepatitis C treatment...
2016: Expert Review of Clinical Pharmacology
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