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hepatology,cirrhosis

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https://www.readbyqxmd.com/read/28405349/is-there-a-standard-for-surgical-therapy-of-hepatocellular-carcinoma-in-healthy-and-cirrhotic-liver-a-comparison-of-eight-guidelines
#1
Giulia Manzini, Doris Henne-Bruns, Franz Porzsolt, Michael Kremer
BACKGROUND AND AIMS: Liver resection (LR) and transplantation are the most reliable treatments for hepatocellular carcinoma (HCC). Aim was to compare different guidelines regarding indication for resection and transplantation because of HCC with and without underlying cirrhosis. METHODS: We compared the following guidelines published after 1 January 2010: American (American Association for the Study of Liver Diseases (AASLD)), Spanish (Sociedad Espanola de Oncologia Medica (SEOM)), European (European Association for the study of liver-European Organization for Research and Treatment of Cancer (EASL-EORTC) and European Society for Medical Oncology-European Society of Digestive Oncology (ESMO-ESDO)), Asian (Asian Pacific Association for the Study of Liver (APASL)), Japanese (Japan Society of Hepatology (JSH)), Italian (Associazione Italiana Oncologia Medica (AIOM)) and German (S3) guidelines...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28404110/ombitasvir-paritaprevir-and-ritonavir-plus-ribavirin-for-chronic-hepatitis-c-virus-genotype-4-infection-in-egyptian-patients-with-or-without-compensated-cirrhosis-agate-ii-a-multicentre-phase-3-partly-randomised-open-label-trial
#2
Imam Waked, Gamal Shiha, Roula B Qaqish, Gamal Esmat, Ayman Yosry, Mohamed Hassany, Reham Soliman, Mohammad A Mohey, Naglaa Allam, Naglaa Zayed, Tarik Asselah, Coleen Hall, Rebecca Redman, Niloufar Mobashery, Wahid Doss
BACKGROUND: In Egypt, chronic hepatitis C virus (HCV) infection occurs in around 10% of the population (about 8 million individuals), and is a leading cause of liver cirrhosis, hepatocellular carcinoma, and mortality. Although HCV genotype 4 constitutes about 20% of HCV infections worldwide, the prevalence in Egypt is more than 90%. We assessed the efficacy and safety of the two direct-acting antiviral drugs ombitasvir, an NS5A inhibitor, and paritaprevir, an NS3/4A protease inhibitor dosed with ritonavir, plus ribavirin in treatment of chronic HCV infection in Egypt...
September 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404069/patient-reported-outcomes-with-sofosbuvir-and-velpatasvir-with-or-without-ribavirin-for-hepatitis-c-virus-related-decompensated-cirrhosis-an-exploratory-analysis-from-the-randomised-open-label-astral-4-phase-3-trial
#3
Zobair M Younossi, Maria Stepanova, Michael Charlton, Michael P Curry, Jacqueline G O'Leary, Robert S Brown, Sharon Hunt
BACKGROUND: Hepatitis C virus (HCV) treatment regimens with direct-acting antivirals have not been extensively studied in patients with decompensated cirrhosis. We assessed patient-reported outcomes (PROs) in patients with decompensated cirrhosis given a fixed-dose combination of sofosbuvir and velpatasvir with and without ribavirin. METHODS: This study was an exploratory analysis of data collected in a randomised, open-label phase 3 trial (ASTRAL-4) in which patients with HCV-related decompensated cirrhosis were randomly assigned to an all-oral fixed-dose combination of sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks, sofosbuvir and velpatasvir plus oral ribavirin (weight-based 1000 mg or 1200 mg) for 12 weeks, or sofosbuvir and velpatasvir for 24 weeks...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396038/severe-reduction-of-blood-lysosomal-acid-lipase-activity-in-cryptogenic-cirrhosis-a-nationwide-multicentre-cohort-study
#4
Francesco Angelico, Stefano Ginanni Corradini, Daniele Pastori, Silvia Fargion, Anna Ludovica Fracanzani, Mario Angelico, Luigi Bolondi, Giulia Tozzi, Pietro Luigi Pujatti, Giancarlo Labbadia, Gino Roberto Corazza, Maurizio Averna, Francesco Perticone, Giuseppe Croce, Marcello Persico, Tommaso Bucci, Francesco Baratta, Licia Polimeni, Maria Del Ben, Francesco Violi
BACKGROUND AND AIMS: Blood lysosomal acid lipase (LAL) is reduced in non-alcoholic steatohepatitis, which is the major cause of cryptogenic cirrhosis (CC); few data on LAL activity in CC do exist. We investigated LAL activity in a cohort of patients with liver cirrhosis. METHODS: This is a multicentre cohort study including 274 patients with liver cirrhosis of different aetiology from 19 centres of Internal Medicine, Gastroenterology and Hepatology distributed throughout Italy...
March 31, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28392702/hepatic-encephalopathy-what-the-multidisciplinary-team-can-do
#5
REVIEW
Andy Liu, Eric R Yoo, Osama Siddique, Ryan B Perumpail, George Cholankeril, Aijaz Ahmed
Hepatic encephalopathy (HE) is a complex disease requiring a multidisciplinary approach among specialists, primary care team, family, and caregivers. HE is currently a diagnosis of exclusion, requiring an extensive workup to exclude other possible etiologies, including mental status changes, metabolic, infectious, traumatic, and iatrogenic causes. The categorization of HE encompasses a continuum, varying from the clinically silent minimal HE (MHE), which is only detectable using psychometric tests, to overt HE, which is further divided into four grades of severity...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28297785/-minutes-of-the-fifth-chinese-national-symposium-on-liver-fibrosis-and-cirrhosis-held-by-chinese-society-of-hepatology-chinese-medical-association
#6
H Ma, X Y Xu
No abstract text is available yet for this article.
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28275579/factors-influencing-surveillance-for-hepatocellular-carcinoma-in-patients-with-liver-cirrhosis
#7
Hager A Ahmed Mohammed, Ju Dong Yang, Nasra H Giama, Jonggi Choi, Hawa M Ali, Kristin C Mara, William S Harmsen, Russell H Wiesner, Michael D Leise, Terry M Therneau, Lewis R Roberts
OBJECTIVE: Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality worldwide, and a rising cause of cancer mortality in the U.S. Liver cirrhosis is the major risk factor for HCC. Surveillance of persons with cirrhosis facilitates early detection and improves outcomes. We assessed the surveillance rate for HCC within a major academic health system and identified factors influencing surveillance. PATIENTS AND METHODS: We examined the surveillance rate for HCC using liver ultrasound, CT, or MRI, and factors influencing surveillance in a cohort of 369 Minnesota residents with cirrhosis seen at the Mayo Clinic between 2007 and 2009...
February 2017: Liver Cancer
https://www.readbyqxmd.com/read/28267072/an-attempt-to-determine-the-prevalence-of-two-inborn-errors-of-primary-bile-acid-synthesis-results-of-a-european-survey
#8
Jörg Jahnel, Evelyn Zöhrer, Björn Fischler, Lorenzo D'Antiga, Dominique Debray, Antal Dezsofi, Dorothea Haas, Nedim Hadzic, Emmanuel Jacquemin, Thierry Lamireau, Giuseppe Maggiore, Pat J McKiernan, Pier Luigi Calvo, Henkjan J Verkade, Loreto Hierro, Valerie McLin, Ulrich Baumann, Emmanuel Gonzales
OBJECTIVE: Inborn errors of primary bile acid (BA) synthesis are genetic cholestatic disorders leading to accumulation of atypical BA with deficiency of normal BA. Unless treated with primary BA, chronic liver disease usually progresses to cirrhosis and liver failure before adulthood. We sought to determine the prevalence of two common disorders, 3β-hydroxy-Δ-C27-steroid dehydrogenase (3β-HSD) and Δ-3-oxosteroid-5β-reductase (Δ-3-oxoR) deficiencies and to describe current diagnostic and treatment strategies among different European paediatric hepatology centres...
March 6, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28199774/sarcopenia-predicts-minimal-hepatic-encephalopathy-in-patients-with-liver-cirrhosis
#9
Tatsunori Hanai, Makoto Shiraki, Satoshi Watanabe, Takahiro Kochi, Kenji Imai, Atsushi Suetsugu, Koji Takai, Hisataka Moriwaki, Masahito Shimizu
AIM: Minimal hepatic encephalopathy (MHE) and sarcopenia impair the health-related quality of life and prognosis in patients with liver cirrhosis; however, the relationship between MHE and sarcopenia remains unclear. The aim of this study was to investigate their relationship and to identify the predictors of MHE in cirrhotic patients. METHODS: This retrospective study evaluated 120 cirrhotic patients who were tested for MHE and sarcopenia. MHE was diagnosed by using the computer-aided neuropsychiatric test...
February 15, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28195067/the-effect-of-short-term-treatment-with-probiotic-vsl-3-on-various-clinical-and-biochemical-parameters-in-patients-with-liver-cirrhosis
#10
W Marlicz, E Wunsch, M Mydlowska, M Milkiewicz, K Serwin, M Mularczyk, P Milkiewicz, J Raszeja-Wyszomirska
The evidence is mounting that alterations of innate immunity and gut microbiota contribute to chronic liver disease and its complications. Modulation of intestinal microbiota is an emerging therapeutic strategy in hepatology. Probiotics through modulation of intestinal milieu have the potential to affect the course of liver disease. The data concerning the influence of probiotics on various plasma molecules and compounds involved in the pathogenesis of hyperdynamic circulatory state in liver cirrhosis is still not confluent and require further evaluation...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28192622/the-safety-and-efficacy-of-baclofen-to-reduce-alcohol-use-in-veterans-with-chronic-hepatitis-c-a-randomized-controlled-trial
#11
Peter Hauser, Bret Fuller, Samuel B Ho, Paul Thuras, Shira Kern, Eric Dieperink
BACKGROUND AND AIMS: Alcohol use disorders (AUDs) are common among people with chronic hepatitis C (HCV) and accelerate the development of fibrosis and cirrhosis caused by HCV. Baclofen, a gamma-aminobutyric acid (GABA) beta-receptor agonist, differs from medications for AUDs currently approved by the United States Food and Drug Administration (FDA), as it is metabolized primarily through the kidneys. The primary outcome of this study was to compare baclofen with a placebo in the percentage of days abstinent from alcohol...
February 13, 2017: Addiction
https://www.readbyqxmd.com/read/28176349/early-detection-and-curative-treatment-of-hepatocellular-carcinoma-a-cost-effectiveness-analysis-in-france-and-in-the-united-states
#12
Benjamin Cadier, Julie Bulsei, Pierre Nahon, Olivier Seror, Alexis Laurent, Isabelle Rosa, Richard Layese, Charlotte Costentin, Carole Cagnot, Isabelle Durand-Zaleski, Karine Chevreul
Hepatocellular carcinoma (HCC) is the leading cause of death in patients with cirrhosis. Patients outside clinical trials seldom benefit from evidence-based monitoring. The objective of this study was to estimate the cost-effectiveness of complying with HCC screening guidelines. The economic evaluation compared surveillance of patients with cirrhosis as recommended by the guidelines ("gold-standard monitoring") to "real-life monitoring" from the health care system perspective. A Markov model described the history of the disease and treatment course including current first-line curative treatment: liver resection, radiofrequency ablation (RFA), and liver transplantation...
April 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28176238/vitamin-d-status-in-patients-with-cirrhosis-of-the-liver-and-their-relatives-a-case-control-study-from-north-india
#13
Ravikant Kumar, Pavan Kumar, Kandarp Nath Saxena, Manjul Mishra, Vivek Kumar Mishra, Anju Kumari, Manisha Dwivedi, Sri Prakash Misra
BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed...
January 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#14
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28092846/status-epilepticus-in-patients-with-cirrhosis-how-to-avoid-misdiagnosis-in-patients-with-hepatic-encephalopathy
#15
Marika Rudler, Clémence Marois, Nicolas Weiss, Dominique Thabut, Vincent Navarro
PURPOSE: Status epilepticus (SE) in patients with cirrhosis is a rare but serious situation. Diagnosis may be difficult in emergency presentation, especially when patients present with hepatic encephalopathy (HE). Misdiagnosis must be avoided since some anti-epileptic drugs aggravate HE. In this retrospective study, we therefore assessed the frequency of SE in patients with cirrhosis, evaluated the accuracy of diagnosis and determined rates of mortality. METHOD: We reviewed data from all patients hospitalized from 2005 to 2013 in the Hepatology ICU for complications of cirrhosis with an initial diagnosis of SE...
February 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28070199/performance-and-utility-of-transient-elastography-and-non-invasive-markers-of-liver-fiibrosis-in-patients-with-autoimmune-hepatitis-a-single-centre-experience
#16
Olympia E Anastasiou, Matthias Büchter, Hideo A Baba, Johannes Korth, Ali Canbay, Guido Gerken, Alisan Kahraman
OBJECTIVES: Autoimmune hepatitis (AIH) is a relatively rare cause of hepatic dysfunction, which can lead to acute liver failure (ALV) and cirrhosis if not treated. The performance of transient elastography (TE) compared to liver biopsy has been evaluated in many liver diseases. The aim of the present study was to evaluate the performance of TE and other non-invasive markers for liver fiibrosis in patients with biopsy-proven AIH. METHODS: Fifty-three patients who were treated at the department of gastroenterology and hepatology of the University Clinic Essen from 2008 to 2013 included in this retrospective study...
November 2016: Hepatitis Monthly
https://www.readbyqxmd.com/read/28063505/alternative-treatment-methods-attenuate-the-development-of-nafld-a-review-of-resveratrol-molecular-mechanisms-and-clinical-trials
#17
REVIEW
Tomasz Charytoniuk, Krzysztof Drygalski, Karolina Konstantynowicz-Nowicka, Klaudia Berk, Adrian Chabowski
Nonalcoholic fatty liver disease (NAFLD) is considered to be one of the most common liver pathologies that occur widely among societies with a predominance of the Western dietary pattern. NAFLD may progress from hepatic steatosis to nonalcoholic steatohepatitis (NASH), subsequently leading to cirrhosis and becoming a major cause of hepatocellular carcinoma. Thus its prevention and therapy play an important role in hepatology. To our knowledge, there is no effective treatment for patients with NAFLD. The aim of this review was to summarize the results of recent alternative treatment studies conducted both on cell cultures and in vivo that concern molecular effects of resveratrol (3,5,4'-trihydroxystilbene) in the treatment of NAFLD...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28039913/the-unfolded-protein-response-mediates-fibrogenesis-and-collagen-i-secretion-through-regulating-tango1-in-mice
#18
Jessica L Maiers, Enis Kostallari, Malek Mushref, Thiago M deAssuncao, Haiyang Li, Nidhi Jalan-Sakrikar, Robert C Huebert, Sheng Cao, Harmeet Malhi, Vijay H Shah
Fibrogenesis encompasses the deposition of matrix proteins, such as collagen I, by hepatic stellate cells (HSCs) that culminates in cirrhosis. Fibrogenic signals drive transcription of procollagen I, which enters the endoplasmic reticulum (ER), is trafficked through the secretory pathway, and released to generate extracellular matrix. Alternatively, disruption of procollagen I ER export could activate the unfolded protein response (UPR) and drive HSC apoptosis. Using a small interfering RNA screen, we identified Transport and Golgi organization 1 (TANGO1) as a potential participant in collagen I secretion...
March 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28025746/gender-specific-differences-in-baseline-peak-and-delta-serum-creatinine-the-nacseld-experience
#19
Jacqueline G O'Leary, Florence Wong, K Rajender Reddy, Guadalupe Garcia-Tsao, Patrick S Kamath, Scott W Biggins, Michael B Fallon, Ram M Subramanian, B Maliakkal, Leroy Thacker, Jasmohan S Bajaj
BACKGROUND: Women have lower serum creatinine values than men for similar renal function. AIMS: We aimed to determine the differential effect of baseline, peak, and delta creatinine between genders on outcomes in infected hospitalized cirrhotic patients. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a 15-center consortium of tertiary care hepatology centers prospectively enrolling infected cirrhotic inpatients...
March 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28012259/reduction-in-liver-transplant-wait-listing-in-the-era-of-direct-acting-antiviral-therapy
#20
Jennifer A Flemming, W Ray Kim, Carol L Brosgart, Norah A Terrault
Direct-acting antiviral (DAA) therapy, recently approved for patients with decompensated cirrhosis (DC) secondary to hepatitis C virus (HCV), is associated with improved hepatic function. We analyzed trends in liver transplant (LT) wait-listing (WL) to explore potential impact of effective medical therapy on WL registration. This is a cohort study using the Scientific Registry of Transplant Recipients database from 2003 to 2015. A total of 47,591 adults wait-listed for LT from HCV, hepatitis B virus (HBV), and nonalcoholic steatohepatitis (NASH) were identified...
March 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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