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Puneeta Tandon, K Rajender Reddy, Jacqueline G O'Leary, Guadalupe Garcia-Tsao, Juan G Abraldes, Florence Wong, Scott W Biggins, Benedict Maliakkal, Michael B Fallon, Ram M Subramanian, Paul Thuluvath, Patrick S Kamath, Leroy R Thacker, Jasmohan S Bajaj
BACKGROUND AND AIMS: Identification of patients with cirrhosis at risk for death within 3 months of discharge from the hospital is essential to individualize post-discharge plans. The objective of the study was to identify an easy-to-use prognostic model based on the Karnofsky Performance Status (KPS). METHODS: NACSELD consists of 16 tertiary-care hepatology centers that prospectively enroll non-electively admitted cirrhotic patients. Patients enrolled had KPS assessed one week post-discharge...
October 24, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Omair Atiq, Jasmin Tiro, Adam C Yopp, Adam Muffler, Jorge A Marrero, Neehar D Parikh, Caitlin Murphy, Katharine McCallister, Amit G Singal
: Although surveillance ultrasound and alpha fetoprotein (AFP) have minimal direct harm, downstream harms from follow-up tests must be weighed against surveillance benefits when determining the value of hepatocellular carcinoma (HCC) screening programs. Our study's aims were to characterize prevalence and correlates of surveillance benefits and harms in cirrhosis patients undergoing HCC surveillance. We conducted a retrospective cohort study among patients with cirrhosis followed at a safety-net health system between July 2010 and July 2013...
October 24, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
H L Cole, S Pennycook, P C Hayes
BACKGROUND: Proton pump inhibitor (PPI) therapy has been reported to be an independent mortality risk factor in patients with cirrhosis. AIMS: To identify the prevalence of PPI prescription, the appropriateness of this therapy and to investigate the relationship between PPI therapy and overall survival in patients with liver disease. METHODS: This retrospective cohort study used patient data for 2012 to 2014 collected from the Scottish Liver Transplant Unit and the Hepatology Ward at the New Royal Infirmary of Edinburgh...
October 23, 2016: Alimentary Pharmacology & Therapeutics
Gavin Low, Harini Dharmana, Samantha Saravana-Bawan, Safwat Girgis
History An asymptomatic 33-year-old woman was referred to the Hepatology Department in 2013 for work-up of indeterminate multifocal liver masses. These lesions were discovered incidentally at multiphase contrast material-enhanced multidetector computed tomography (CT) performed in 2004 to investigate right lower quadrant pain. Imaging surveillance at sporadic intervals revealed slow progressive growth of the lesions over time; however, the number of lesions remained constant. There was no history of cancer, nor were there predisposing factors for chronic liver disease or cirrhosis...
November 2016: Radiology
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
Atsushi Takahashi, Teruko Arinaga-Hino, Hiromasa Ohira, Takuji Torimura, Mikio Zeniya, Masanori Abe, Kaname Yoshizawa, Akinobu Takaki, Yoshiyuki Suzuki, Jong-Hon Kang, Nobuhiro Nakamoto, Tomoo Fujisawa, Koji Yonemoto, Atsushi Tanaka, Hajime Takikawa
BACKGROUND: A nationwide survey of autoimmune hepatitis (AIH) patients was performed in Japan in 2015. The aims of this study were to elucidate the trends and characteristics of AIH in Japan, in addition to identifying differences in AIH between acute hepatitis and chronic hepatitis. METHODS: Questionnaires about patients with AIH diagnosed from 2009 to 2013 were sent to 437 hospitals or clinics with hepatology specialists. RESULTS: A total of 1682 patients were enrolled...
October 8, 2016: Journal of Gastroenterology
Zannis Almpanis, Maria Demonakou, Dina Tiniakos
Hepatic fibrogenesis may gradually result to cirrhosis due to the accumulation of extracellular matrix components as a response to liver injury. Thus, therapeutic decisions in chronic liver disease, regardless of the cause, should first and foremost be guided by an accurate quantification of hepatic fibrosis. Detection and assessment of the extent of hepatic fibrosis represent a challenge in modern Hepatology. Although traditional histological staging systems remain the "best standard", they are not able to quantify liver fibrosis as a dynamic process and may not accurately substage cirrhosis...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Giorgio Maria Saracco, Andrea Evangelista, Sharmila Fagoonee, Giovannino Ciccone, Elisabetta Bugianesi, Gian Paolo Caviglia, Maria Lorena Abate, Mario Rizzetto, Rinaldo Pellicano, Antonina Smedile
AIM: To assess the etiology of chronic liver diseases (CLD) from 1998 to 2014 at the outpatient clinic of Gastroenterology of the main hospital in Northwest of Italy among those dedicated to hepatology. METHODS: A random sample of charts of patients referred to for increased liver enzymes between January 1998 and December 2006, and between January 2012 and December 2014 were reviewed. Etiology search included testing for hepatitis B virus (HBV), hepatitis C virus (HCV), autoimmune hepatitis, primary biliary cirrhosis, Wilson's disease and hereditary hemocromatosis...
September 28, 2016: World Journal of Gastroenterology: WJG
Maya Balakrishnan, Fernanda Souza, Carolina Muñoz, Salvador Augustin, Nicole Loo, Yanhong Deng, Maria Ciarleglio, Guadalupe Garcia-Tsao
OBJECTIVES: Measurements of liver stiffness and spleen stiffness are useful noninvasive ways to assess fibrosis and portal hypertension in patients with chronic liver disease. One method for assessing stiffness is by point shear wave elastography via acoustic radiation force impulse imaging (ARFI). Its advantage is that sites where stiffness is measured are visualized sonographically. However, its reliability has not been well established, and all studies done to date evaluating the use of ARFI in chronic liver disease have been performed outside the United States...
September 23, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Kelly L Hayward, Patricia C Valery, W Neil Cottrell, Katharine M Irvine, Leigh U Horsfall, Caroline J Tallis, Veronique S Chachay, Brittany J Ruffin, Jennifer H Martin, Elizabeth E Powell
BACKGROUND: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies...
2016: BMC Gastroenterology
A Igarashi, W Tang, I Guerra, L Marié, S Cure, M Lopresti
OBJECTIVE: Hepatitis C is the result of a ribonucleic acid (RNA) virus (hepatitis C virus; HCV). The Japan Society of Hepatology (JSH) estimated that 1.5-2 million people in Japan carry HCV. Six major HCV genotypes (GT) and a large number of subtypes have been described in the literature. In Japan, around 70% to 80% of people are infected with HCV genotype 1b. The progress of the disease primarily affects the liver and may lead to liver cirrhosis, hepatocellular carcinoma (HCC) and death...
September 9, 2016: Current Medical Research and Opinion
Amal Mohamed Ahmed, Maha Abdel Ghany, Gehan Lotfy Abdel Hakeem, Aya Kamal, Rania Khattab, Asmaa Abdalla, Laila El Morsi Abou El Fotoh, Abdel Azeem El Mazary, Madiha Abdalla Sayed, Ashraf Mohamed Abdel Fadil
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is one of the health problems with great burden on the liver that may end with liver cirrhosis and hepatocellular carcinoma. The aim of this work was to assess serum vitamin D level in nonalcoholic fatty liver disease children. METHODS: This cross sectional case control study involved 47 patients with nonalcoholic fatty liver disease selected while recruiting the pediatric hepatology clinics. Their ages ranged from 5-15 years and were compared with 23 healthy age and sex matched children...
2016: Nutrition & Metabolism
Javier Fernández, Frédéric Bert, Marie-Hélène Nicolas-Chanoine
Antimicrobial resistance has become a major global public health security problem that needs coordinated approaches at regional, national and international levels. Antibiotic overuse and the failure of control measures to prevent the spread of resistant bacteria in the healthcare environment have led to an alarming increase in the number of infections caused by resistant bacteria, organisms that resist many (multi-drug and extensively drug-resistant strains), if not all (pan-drug-resistant bacteria) currently available antibiotics...
November 2016: Journal of Hepatology
Adam E Mikolajczyk, Jeanne M Farnan, John F McConville, Donald M Jensen, K Gautham Reddy, Helen S Te, Nancy Reau, Andrew I Aronsohn
: There is an increasing burden of chronic liver disease (CLD) in the United States but a significant shortage of hepatologists. Thus, it is necessary to develop new recruitment strategies to the field of hepatology as well as ensure that non-gastroenterology-trained physicians are able to capably assist in the care of CLD. We established a novel, nonelective, inpatient hepatology rotation that uses required modules in the American Association for the Study of Liver Diseases Curriculum and Training-First Hepatitis B and C curriculums as well as in LiverLearning...
August 10, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Jörg Trojan, Stephan Zangos, Andreas A Schnitzbauer
BACKGROUND: Hepatocellular carcinoma (HCC) is a frequent complication of liver cirrhosis. Worldwide, HCC is one of the most common cancers, with a rising incidence. METHODS: A selective literature search was conducted, taking into account current studies, reviews, meta-analyses, and guidelines. RESULTS: The diagnosis is established either non-invasively by dynamic imaging, showing a typical contrast enhancement and wash-out, or histopathologically...
April 2016: Visc Med
Hai-Peng Zhu, Yu-Rong Gu, Geng-Lin Zhang, Yu-Jie Su, K E Wang, Yu-Bao Zheng, Zhi-Liang Gao
Depression in patients with chronic hepatitis B (CHB) can affect the quality of life, disease diagnosis and case fatality rate. The aim of this study was to explore depression in patients with CHB and cirrhosis, and the effect of the severity of liver cirrhosis on the depressive emotional state. The depressive emotional state was investigated using the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in 114 patients with CHB and cirrhosis, comprising 42 cases classified as Child-Pugh grade (CPG)-A, 38 cases classified as CPG-B and 34 cases classified as CPG-C at a single hepatology center...
July 2016: Experimental and Therapeutic Medicine
J Gregory Fitz
The ∼90% probability of curing individual patients with hepatitis C virus (HCV)using direct-acting antivirals represents one of the most dramatic medical success stories of the modern era, and the journey from viral discovery to treatment occurred over just ∼25 years. The realities of the global burden of disease (2-3% of the world's population is infected), limited access to care and cost of treatment mean that HCV will continue to be a major problem for the next 25 years. But what if HCV (and hepatitis B) could be eradicated? Since liver transplantation and HCV management have been the mainstays of academic hepatology practice, where do we go from here? Unfortunately, we are in an era where the incidence and prevalence of liver diseases around the globe is increasing, and death from complications of cirrhosis is now among the top 10 causes in most countries; so hepatologists are expected to play a major role in the future...
2016: Digestive Diseases
Helma P Cotrim, Edison R Parise, Cláudio Figueiredo-Mendes, João Galizzi-Filho, Gilda Porta, Claudia P Oliveira
The prevalence of obesity-related metabolic syndrome has rapidly increased in Brazil, resulting in a high frequency of nonalcoholic fatty liver disease, that didn't receive much attention in the past. However, it has received increased attention since this disease was identified to progress to end-stage liver diseases, such as cirrhosis and hepatocellular carcinoma. Clinical practice guidelines for the diagnosis and treatment of nonalcoholic fatty liver disease have not been established in Brazil. The Brazilian Society of Hepatology held an event with specialists' members from all over Brazil with the purpose of producing guideline for Nonalcoholic Fatty Liver Disease based on a systematic approach that reflects evidence-based medicine and expert opinions...
April 2016: Arquivos de Gastroenterologia
Seth N Sclair, Olveen Carrasquillo, Frank Czul, Juan P Trivella, Hua Li, Lennox Jeffers, Paul Martin
BACKGROUND: Evidence-based guidelines and quality indicators for cirrhosis care have been established. Whether there are variations in adherence to these cirrhosis standards at different specialty settings has not been investigated. AIMS: To evaluate the quality of cirrhosis care delivered at diverse hepatology care sites. METHODS: We conducted a retrospective study comparing the quality of care at three hepatology specialty clinics: a Faculty Practice, safety-net hospital, and Veterans Affairs (VA) Medical Center...
October 2016: Digestive Diseases and Sciences
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
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