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Emilie Blond, Emmanuel Disse, Charlotte Cuerq, Jocelyne Drai, Pierre-Jean Valette, Martine Laville, Charles Thivolet, Chantal Simon, Cyrielle Caussy
AIMS/HYPOTHESIS: We aimed to assess the application of the recent European Association for the Study of the Liver (EASL)-European Association for the Study of Diabetes (EASD)-European Association for the Study of Obesity (EASO) clinical practice guidelines for the management of non-alcoholic fatty liver disease (NAFLD) in severely obese individuals in routine clinical practice. METHODS: We performed a single-centre retrospective observational study of 385 patients referred for severe obesity (BMI ≥ 35 kg/m(2)) to our Endocrinology, Diabetes and Nutrition department, between 1 November 2014 and 31 December 2015...
March 28, 2017: Diabetologia
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
Justin Triemstra, Kelsey Reno, Rebecca Chohlas-Wood, Colleen Nash
Brief resolved unexplained event (BRUE) is a common pediatric problem that presents to ambulatory and emergency settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines. Most low-risk infants who present with a BRUE can be discharged home with anticipatory guidance and education provided to the caregivers; however, high-risk infants should undergo further testing and observation to determine the cause of their event. Congenital neurosyphilis can be a rare cause of a BRUE...
February 1, 2017: Pediatric Annals
Natalie E Leland, Michael Lepore, Carin Wong, Sun Hwa Chang, Lynn Freeman, Karen Crum, Heather Gillies, Paul Nash
AIM: The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. METHODS: Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California...
January 23, 2017: Disability and Rehabilitation
Adebola Adedimeji, Andrew Edmonds, Donald Hoover, Qiuhu Shi, Jean d'Amour Sinayobye, Martin Nduwimana, Patricia Lelo, Denis Nash, Kathryn Anastos, Marcel Yotebieng
BACKGROUND: Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described. MATERIALS AND METHODS: Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0-15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda...
2017: PloS One
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
Kathryn Effendi, Kenichi Harada, Etsuko Hashimoto, Masayoshi Kage, Kazuhiko Koike, Fukuo Kondo, Masayuki Nakano, Hidenori Ojima, Takeshi Okanoue, Michiie Sakamoto, Yoshio Sumida, Hanako Tsujikawa, Gotaro Yamada, Yoh Zen
Nonalcoholic fatty liver disease (NAFLD) is an increasingly common chronic liver disease worldwide. NAFLD comprises a variety of clinical and histopathological changes that can be broadly divided into nonalcoholic fatty liver (NAFL, simple steatosis) and nonalcoholic steatohepatitis (NASH). The differential diagnosis between NAFL and NASH is important because NASH is a more advanced form. This diagnosis therefore determines the prognosis and therapeutic management. At present the interpretation of NASH is made based on the histopathological features of steatohepatitis, i...
November 27, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Ali Canbay, Jan-Peter Sowa, Wing-Kin Syn, Jürgen Treckmann
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a continuously increasing cause of chronic liver disease and a health burden in all populations affected by the obesity and metabolic syndrome pandemic. Cirrhotic alterations or hepatocellular carcinoma developing from NAFLD may require liver transplantation (LTx). METHODS: Current literature was screened for data on LTx in the setting of NAFLD. RESULTS: NAFLD-associated LTx is expected to increase in number and relevance during the next decade...
August 2016: Visceral Medicine
S A Townsend, Philip N Newsome
INTRODUCTION: Non-alcoholic fatty liver disease is the commonest cause of liver disease worldwide, and is rapidly becoming the leading indication for liver transplantation. SOURCES OF DATA: Original articles, reviews and meta-analyses, guidelines. AREAS OF AGREEMENT: NAFLD strongly correlates with obesity and insulin resistance; currently, the best management strategy is weight loss and treatment of the metabolic syndrome. AREAS OF CONTROVERSY: Recent data suggest that the presence of fibrosis and not non-alcoholic steatohepatitis (NASH) is the predictor of clinical outcome...
September 2016: British Medical Bulletin
Mark S Nash, Rochelle E Tractenberg, Armando J Mendez, Maya David, Inger H Ljungberg, Emily A Tinsley, Patricia A Burns-Drecq, Luisa F Betancourt, Suzanne L Groah
OBJECTIVE: To assess cardiometabolic syndrome (CMS) risk definitions in spinal cord injury/disease (SCI/D). DESIGN: Cross-sectional analysis of a pooled sample. SETTING: Two SCI/D academic medical and rehabilitation centers. PARTICIPANTS: Baseline data from subjects in 7 clinical studies were pooled; not all variables were collected in all studies; therefore, participant numbers varied from 119 to 389. The pooled sample included men (79%) and women (21%) with SCI/D >1 year at spinal cord levels spanning C3-T2 (American Spinal Injury Association Impairment Scale [AIS] grades A-D)...
October 2016: Archives of Physical Medicine and Rehabilitation
Robert Nash, Anooj Majithia, Arvind Singh
OBJECTIVE: There are a number of published criteria for the investigation of asymmetrical audiovestibular symptoms. Our aim was to determine the agreement between these protocols when determining whether to investigate a group of patients treated at our institution. MATERIALS AND METHODS: Retrospective audit of the indications for arranging 854 consecutive magnetic resonance imaging scans of the internal auditory meatus. These indications were compared to the Oxford, Northern, Charing Cross, and Nashville guidelines on the investigation of asymmetrical audiovestibular symptoms...
April 2016: Journal of International Advanced Otology
Philippe Kolly, Jean-François Dufour
European and American guidelines recommend surveillance for hepatocellular carcinoma (HCC) by performing ultrasonography on a six-month basis on an at risk population, defined by presence of cirrhosis. HCC, due to non-alcoholic steatohepatitis (NASH), is rising. Patients with NASH have a high risk of developing HCC and, therefore, have to be enrolled in a screening program. One of the challenges with NASH-induced HCC is that half of the cases arise in non-cirrhotic patients. There is a need to identify those patients in order to screen them for HCC...
June 7, 2016: Diagnostics
Speranta Iacob, Carmen Ester, Mihaela Lita, Vlad Ratziu, Liana Gheorghe
INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) has an increasing incidence worldwide, reflecting the epidemics of obesity and metabolic syndrome. Data on knowledge, attitude and management by the Romanian gastroenterologists with regard to NAFLD are lacking. METHODS: We assessed current diagnostic and treatment patterns of the management of NAFLD among 102 Romanian board certified gastroenterologists using a survey developed to collect information regarding participants' clinical practice, diagnostic tools and usage of medication in patients with NAFLD...
June 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
William N Hannah, Stephen A Harrison
NAFLD is the leading cause of chronic liver disease in the Western world with an estimated prevalence of 20-30 %. Lifestyle interventions targeted at weight loss through dietary interventions and exercise are the most effective treatment, but only a minority of patients are able to achieve and sustain the necessary intervention targets. Weight loss of 3-5 % has been associated with a reduction of hepatic steatosis while weight loss of ≥5-7 % has correlated with resolution of NASH in some studies. Greater reductions in weight loss (≥10 %) may improve hepatic fibrosis...
May 2016: Digestive Diseases and Sciences
Jun He, Guangyu Li, Jun Chen, Juan Lin, Cheng Zeng, Jing Chen, Junliang Deng, Ping Xie
Microcystin-LR (MCLR), a cyanotoxin widely present in freshwater, has been shown to have potent acute hepatotoxicity. However, the chronic toxicity of low-dose MCLR remains confusing by traditional measurements of toxicity. This has impeded understanding of the chronic liver damage of low-dose MCLR and corresponding safety risks of the human exposure guideline value. Here, iTRAQ-based proteomics and NMR-based metabonomics were used to decipher the molecular toxicological signatures of low doses of MCLR in mice exposed to this agent for 90 days...
January 2017: Archives of Toxicology
Ryan M Gill, Sanjay Kakar
This article reviews diagnostic criteria for nonalcoholic steatohepatitis (NASH), current grading and staging methodology, and diagnostic challenges and pitfalls in routine practice. Current practice guidelines and prognostic and treatment considerations are discussed. The clinical diagnosis of nonalcoholic fatty liver disease may represent stable disease without progressive liver damage, in the form of nonalcoholic fatty liver (NAFL), or aggressive disease that will progress to advanced fibrosis, in the form of NASH...
June 2013: Surgical Pathology Clinics
Kathleen E Corey, Matthew J Klebanoff, Angela C Tramontano, Raymond T Chung, Chin Hur
BACKGROUND AND AIM: Individuals with type 2 diabetes are at heightened risk for nonalcoholic fatty liver disease, which gives rise to nonalcoholic steatohepatitis (NASH) and cirrhosis. Yet, current guidelines do not recommend screening for NASH among these high-risk patients. Using a simulation model, we assessed the effectiveness and cost-effectiveness of screening diabetic patients for NASH. METHODS: A Markov model was constructed to compare two management strategies for 50-year-olds with diabetes...
July 2016: Digestive Diseases and Sciences
Mary E Rinella, Zurabi Lominadze, Rohit Loomba, Michael Charlton, Brent A Neuschwander-Tetri, Stephen H Caldwell, Kris Kowdley, Stephen A Harrison
BACKGROUND: Management guidelines from the American Association for the Study of Liver Diseases/American College of Gastroenterology/American Gastroenterology Association published in 2012 for nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) recommend weight loss, vitamin E and pioglitazone as effective therapies for the treatment of biopsy-confirmed NASH. However, little is known about how physicians in the US diagnose NASH or whether published guidelines are being followed...
January 2016: Therapeutic Advances in Gastroenterology
J Joshua Smith, Oliver S Chow, Marc J Gollub, Garrett M Nash, Larissa K Temple, Martin R Weiser, José G Guillem, Philip B Paty, Karin Avila, Julio Garcia-Aguilar
BACKGROUND: Treatment of patients with non-metastatic, locally advanced rectal cancer (LARC) includes pre-operative chemoradiation, total mesorectal excision (TME) and post-operative adjuvant chemotherapy. This trimodality treatment provides local tumor control in most patients; but almost one-third ultimately die from distant metastasis. Most survivors experience significant impairment in quality of life (QoL), due primarily to removal of the rectum. A current challenge lies in identifying patients who could safely undergo rectal preservation without sacrificing survival benefit and QoL...
October 23, 2015: BMC Cancer
Barbara L Gracious, Ramona Bhatt, Carol Potter
OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has become a worldwide epidemic because of the greater prevalence of obesity. Despite implications for youth with severe mental disorders, little has been published in the psychiatric literature about this increasingly common medical comorbidity. The goals of this article are to: 1) provide an overview of the epidemiology and pathophysiology of NAFLD, including progression to nonalcoholic steatohepatitis (NASH); 2) describe two clinical cases illustrating difficulties faced in management; and 3) review screening recommendations, differential diagnosis, and monitoring and intervention approaches...
October 2015: Journal of Child and Adolescent Psychopharmacology
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