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liver disease physician

Y-M Chiu, C-H Tang, S-T Hung, Y-W Yang, C-H Fang, H-Y Lin
OBJECTIVES: Few studies on tumour necrosis factor (TNF) inhibitor-associated tuberculosis (TB) and hepatic events have been performed in regions where these risks are elevated. This study aimed to provide a direct comparison between adalimumab and etanercept in a high-risk population and to address the implications for physicians working with patients in such an environment. METHOD: Data collected from the National Health Insurance Research Database (NHIRD) in Taiwan between 2007 and 2011 were analysed retrospectively for incidences of eight adverse events associated with TNF-α inhibitors...
October 21, 2016: Scandinavian Journal of Rheumatology
Seung Man Cho, Byung-Ho Choe
This review article was requested by editor-in-chief of this journal as 'pediatric CHB treatment' for the upcoming special issue. The main objective of chronic hepatitis B (CHB) treatment is diminishing the risk of complications related to chronic liver disease. In Asia, there are already some reports about hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) infected children. The key points of treatment in children with CHB infections are selection of which patients to treat and conformation of the optimal therapy time that would reduce viral resistance...
September 2016: Annals of Translational Medicine
Olivier Mir, Thomas Brodowicz, Antoine Italiano, Jennifer Wallet, Jean-Yves Blay, François Bertucci, Christine Chevreau, Sophie Piperno-Neumann, Emmanuelle Bompas, Sébastien Salas, Christophe Perrin, Corinne Delcambre, Bernadette Liegl-Atzwanger, Maud Toulmonde, Sarah Dumont, Isabelle Ray-Coquard, Stéphanie Clisant, Sophie Taieb, Cécile Guillemet, Maria Rios, Olivier Collard, Laurence Bozec, Didier Cupissol, Esma Saada-Bouzid, Christine Lemaignan, Wolfgang Eisterer, Nicolas Isambert, Loïc Chaigneau, Axel Le Cesne, Nicolas Penel
BACKGROUND: Regorafenib is a multikinase inhibitor with proven activity in refractory gastrointestinal stromal tumours and chemotherapy-refractory advanced colorectal cancers. We assessed this agent's efficacy and safety in patients with metastatic soft tissue sarcomas previously treated with anthracycline. METHODS: In this randomised, double-blind, phase 2 trial undertaken in France and Austria, we enrolled patients aged 18 years and older with advanced soft tissue sarcomas who had received previous doxorubicin or other anthracycline treatment...
October 14, 2016: Lancet Oncology
Radha K Dhiman, Sandeep Satsangi, Gagandeep S Grover, Pankaj Puri
Hepatitis C virus (HCV) is a globally prevalent pathogen and is a major cause of healthcare burden in India. HCV poses a significant problem in the state of Punjab, India owing to the higher prevalence of risk factors like unsafe medical practices (including unsafe injections and dental procedures) and intravenous drug use. The reported prevalence of HCV in this part of the country was 5.2% in 2012, while a recent study has shown the prevalence to be 3.2% in 2016. Similar to the other geographic belts in India, genotype 3 predominates in the state of Punjab...
September 2016: Journal of Clinical and Experimental Hepatology
Serena Stigliano, Livia Archibugi, Giulia Zerboni, Gianfranco Delle Fave, Gabriele Capurso
BACKGROUND: Herbal remedies and other complementary and alternative medicine (CAM) are used by 30% of the patients with liver and inflammatory bowel diseases. However, there are no data regarding CAM use in patients with pancreatic disorders, including potential pancreatotoxicity. AIM OF THE STUDY: The aim of the study was to assess the prevalence of CAM use in patients with pancreatic disorders and screen for pancreatotoxicity. MATERIALS AND METHODS: This was a cross-sectional survey of consecutive outpatients seen at a Pancreas Center...
November 2016: Journal of Clinical Gastroenterology
Riad Lutfi, Kamal Abulebda, Mara E Nitu, Jean P Molleston, Molly A Bozic, Girish Subbarao
Pediatric acute liver failure is rare but life-threatening illness that occurs in children without preexisting liver disease. The rarity of the disease, along with its severity and heterogeneity, presents unique clinical challenges to the physicians providing care for pediatric patients with acute liver failure. In this review, practical clinical approaches to the care of critically ill children with acute liver failure are discussed with an organ system specific approach. The underlying pathophysiological processes, major areas of uncertainty, and approaches to the critical care management of pediatric acute liver failure are also reviewed...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
A Poujois, J-M Trocello, N Djebrani-Oussedik, J Poupon, C Collet, N Girardot-Tinant, R Sobesky, D Habès, D Debray, C Vanlemmens, F Fluchère, F Ory-Magne, J Labreuche, C Preda, F Woimant
BACKGROUND AND PURPOSE: The severity of Wilson's disease (WD) is linked to free copper accumulating in the liver and brain. Exchangeable copper (CuEXC) is a new technique to determine plasmatic copper and is useful in the diagnosis of WD. It is hypothesized that it may also enable a good evaluation of extra-hepatic involvement and its severity. METHODS: Forty-eight newly diagnosed WD patients were prospectively evaluated using hepatic, neurological, ophthalmological and brain magnetic resonance imaging (MRI) scores...
October 14, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Sylva Skalova, Stepan Kutilek
Transient hyperphosphatasemia of infancy and early childhood (THI) is characterized by transiently increased activity of serum alkaline phosphatase (S-ALP), predominantly its bone or liver isoform, in children under five years of age. There are no signs of metabolic bone disease or hepatopathy corresponding with the increased S-ALP. THI is benign disorder, rather laboratory than clinical disorder, which is usually accidentally detected in both healthy and sick children. When encountered in a child with either chronic bone, liver or kidney disease, it might concern the physician...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visc Med
Gamal Shiha, Alaa Ibrahim, Ahmed Helmy, Shiv Kumar Sarin, Masao Omata, Ashish Kumar, David Bernstien, Hitushi Maruyama, Vivek Saraswat, Yogesh Chawla, Saeed Hamid, Zaigham Abbas, Pierre Bedossa, Puja Sakhuja, Mamun Elmahatab, Seng Gee Lim, Laurentius Lesmana, Jose Sollano, Ji-Dong Jia, Bahaa Abbas, Ashraf Omar, Barjesh Sharma, Diana Payawal, Ahmed Abdallah, Abdelhamid Serwah, Abdelkhalek Hamed, Aly Elsayed, Amany AbdelMaqsod, Tarek Hassanein, Ahmed Ihab, Hamsik GHaziuan, Nizar Zein, Manoj Kumar
Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated...
October 6, 2016: Hepatology International
Pamela A Kushner, Michael E Cobble
This review aims to explain risk factors, consequences, and management strategies recommended for patients with hypertriglyceridemia. A search of PubMed was performed: "Hypertriglyceridemia"[Majr], limited to English-language and published in the 5 years up to April 2016. Abstracts of the 680 results were screened for inclusion. Reference lists of publications included were also screened for inclusion. Approximately 25% of the United States population has elevated (≥150 mg/dL) triglycerides (TG) putting them at an increased risk of cardiovascular disease, non-alcoholic fatty liver disease, and pancreatitis...
October 6, 2016: Postgraduate Medicine
Mirinae Jang, Min Su Oh, Se Cheol Oh, Ki Soo Kang
Although liver function test abnormality is frequently noted in children, there is no report about the distribution of the etiology and natural recovery time of the abnormal liver function. From March 2005 to February 2014, clinical information was retrospectively collected from 559 children who had abnormal liver function and were hospitalized or visited the outpatient clinic at the Jeju National University Hospital. The etiology of abnormal liver function was classified into groups and the natural recovery time of abnormal liver function was analyzed...
November 2016: Journal of Korean Medical Science
Cornelius Kürten, Mladen Tzvetkov, Volker Ellenrieder, Harald Schwörer
History and clinical findings | We report about a 79 year old non-diabetic patient who was admitted to the emergency room with severe hypoglycemia (blood glucose level: 36 mg / dl and Glasgow Coma Scale Score: 3). After the infusion of G40 % her blood glucose level stabilised. The patient reported to have taken 50 mg of Tramadol during the night to treat her headache. Investigations and diagnosis | No other differential diagnosis for hypoglycemia (i.e. diabetes, insulinoma, severe liver or kidney disease) could be established...
September 2016: Deutsche Medizinische Wochenschrift
M Teresa de la Morena, David Leonard, Troy R Torgerson, Otavio Cabral-Marques, Mary Slatter, Asghar Aghamohammadi, Sharat Chandra, Luis Murguia-Favela, Francisco Bonilla, Maria Kanariou, Rongras Damrongwatanasuk, Caroline Y Kuo, Christopher C Dvorak, Isabelle Meyts, Karin Chen, Lisa Kobrynski, Neena Kapoor, Darko Richter, Daniela DiGiovanni, Fatima Dhalla, Evangelia Farmaki, Carsten Speckmann, Teresa Espanol, Anna Shcherbina, Celine Hanson, Jiri Litzman, John Routes, Melanie Wong, Ramsay Fuleihan, Suranjith L Seneviratne, Trudy N Small, Ales Janda, Liliana Bezrodnik, Reinhard Seger, Andrea Gomez Raccio, J David M Edgar, Janet Chou, Jordan K Abbott, Joris van Montfrans, Luis Ignacio Gonzalez-Granado, Nancy Bunin, Necil Kutukculer, Paul Gray, Gisela Seminario, Srdjan Pasic, Victor Aquino, Christian Wysocki, Hassan Abolhassani, Eyal Grunebaum, Morna Dorsey, Beatriz Tavares Costa Carvalho, Antonio Condino-Neto, Charlotte Cunningham-Rundles, Alan P Knutsen, John Sleasman, Helen Chapel, Hans D Ochs, Alexandra Filipovich, Mort Cowan, Andrew Gennery, Andrew Cant, Luigi D Notarangelo, Chaim Roifman
BACKGROUND: X-linked hyper IgM syndrome (XHIGM) is a primary immunodeficiency with high morbidity and mortality compared to normal individuals. Hematopoietic cell transplant (HCT) has been considered a curative therapy, but the procedure has inherent complications, and may not be available for all patients. OBJECTIVES: We sought to collect data on the clinical presentation, treatment, and follow-up of a large sample of patients with XHIGM in order to (1) compare long-term overall survival and general well-being of patients treated with or without HCT along with clinical factors associated with mortality, and (2) summarize clinical practice and risk factors in the subgroup of patients treated with HCT...
September 30, 2016: Journal of Allergy and Clinical Immunology
Jin-Zhou Zhu, Kelseanna Hollis-Hansen, Xing-Yong Wan, Su-Juan Fei, Xun-Lei Pang, Fan-Dong Meng, Chao-Hui Yu, You-Ming Li
AIM: To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease (NAFLD). METHODS: A database search was conducted on PubMed for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation (ARGEE) Instrument II was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally...
September 28, 2016: World Journal of Gastroenterology: WJG
Sofía Verdaguer D, Juan Cristóbal Gana A
BACKGROUND: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these patients. AIM: To describe the behavior and preferences of pediatric gastroenterologists in Chile in the management of portal hypertension in children. MATERIAL AND METHODS: An online survey was sent to Chilean pediatric gastroenterologists, with questions evaluating the physicians’ approaches to screening of esophageal varices in children with portal hypertension, and their preferred methods of prophylaxis and initial management of variceal bleeding...
July 2016: Revista Médica de Chile
Nikolaos K Gatselis, Panagiotis Skendros, Konstantinos Ritis, George N Dalekos
Familial Mediterranean fever (FMF) is characterised by recurrent, self-limited fever attacks and serositis. Severe liver involvement has rarely been reported. We present two FMF cases of a 55-year-old man and a 20-year-old woman in whom the prevailing manifestations were recurrent unexplained episodes of anicteric hepatitis (man) and recurrent severe jaundice (woman). A long-term history of recurrent self-limited episodes of fever was also claimed in both. After exclusion of infectious, malignant, autoimmune, and liver and biliary diseases, a diagnosis of FMF as confirmed by molecular analysis was established...
2016: BMJ Case Reports
Brit Long, Alex Koyfman
INTRODUCTION: Organ transplantation provides improved quality of life and longevity in patients with end-organ disease. These patients have significant physiological and anatomical modifications, and with new immunosuppressive agents, many of these patients will present to the emergency department with complications. OBJECTIVE: The objective was to provide emergency physicians with a review of transplant complications, including infection, rejection, medication adverse effects, and specific complications related to the transplant...
August 27, 2016: American Journal of Emergency Medicine
Adriaan J van der Meer, Marina Berenguer
Chronic infection with the hepatitis C virus (HCV) may lead to hepatic fibrosis and eventually cirrhosis, at which stage, patients have a substantial risk of liver failure, hepatocellular carcinoma (HCC) and liver-related death. Moreover, HCV infection is associated with several extrahepatic manifestations which impact the quality of life and increase the non-liver-related mortality rate. For patients with compensated liver disease, interferon (IFN)-based antiviral therapy has been a treatment option for over two decades...
October 2016: Journal of Hepatology
A V Tkachev, G N Tarasova, V S Groshilin, D A Vasil'chenkov, T I Ushakova, D V Blinov
AIM: to analyze and summarize the data of the DIREG-2 study of the nonalcoholic fatty liver disease (NAFLD) register in Rostov-on-Don versus those in Russia. MATERIAL AND METHODS: The prospective disease registry study encompasses an epidemiologic, observational, cross-sectional, multicenter study estimating the prevalence of NAFLD in outpatients in Rostov-on-Don. A total of 3200 patients participated in this study. The investigators were 65 outpatient physicians...
2016: Terapevticheskiĭ Arkhiv
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