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Critical Care hepatology

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https://www.readbyqxmd.com/read/29681874/alexithymia-in-gastroenterology-and-hepatology-a-systematic-review
#1
Danilo Carrozzino, Piero Porcelli
Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29424123/mouse-models-of-non-alcoholic-steatohepatitis-a-reflection-on-recent-literature
#2
REVIEW
Fahrettin Haczeyni, Matthew M Yeh, George N Ioannou, Isabelle A Leclercq, Robert Goldin, Yock Young Dan, Jun Yu, Narcissus C Teoh, Geoffrey C Farrell
Non-alcoholic steatohepatitis (NASH) is strongly associated with overnutrition, insulin resistance, and predisposition to type 2 diabetes. To critically analyze the translational significance of currently used animal models of NASH, we reviewed articles published during the last 3 years that studied NASH pathogenesis using mouse models. Among 146 articles, 34 (23%) used models in which overnutrition was reported, and 36 (25%) demonstrated insulin resistance, with or without glucose intolerance. Half the articles contained no information on whether mice exhibited overnutrition or insulin resistance...
February 9, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29404491/remodeling-the-model-for-end-stage-liver-disease-for-predicting-mortality-risk-in-critically-ill-patients-with-cirrhosis-and-acute-kidney-injury
#3
Xiao-Dong Zhou, Qin-Fen Chen, Dan-Qin Sun, Chen-Fei Zheng, Dong-Jie Liang, Jian Zhou, Song-Jie Wang, Wen-Yue Liu, Sven Van Poucke, Xiao-Dong Wang, Ke-Qing Shi, Wei-Jian Huang, Ming-Hua Zheng
Serum creatinine measurement demonstrates a poor specificity and sensitivity for the early diagnosis of acute kidney injury (AKI) in patients with cirrhosis. The existing model for end-stage liver disease (MELD) score reveals multiple pitfalls in critically ill patients with cirrhosis and acute kidney injury (CAKI). The aim of this study was to re-evaluate the role of creatinine values in the existing MELD score and to develop a novel score for CAKI, named the "acute kidney injury-model for end-stage liver disease score" (AKI-MELD score)...
October 2017: Hepatology communications
https://www.readbyqxmd.com/read/29395185/variation-in-part-time-work-among-pediatric-subspecialties
#4
Gary L Freed, Debra M Boyer, Kenton D Van, Michelle L Macy, Julie McCormick, Laurel K Leslie
OBJECTIVE: To assess the part-time workforce and average hours worked per week among pediatric subspecialists in the 15 medical subspecialties certified by the American Board of Pediatrics. STUDY DESIGN: We examined data from pediatric subspecialists who enrolled in Maintenance of Certification with the American Board of Pediatrics from 2009 to 2015. Data were collected via an online survey. Providers indicated whether they worked full time or part time and estimated the average number of hours worked per week in clinical, research, education, and administrative tasks, excluding time on call...
April 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#5
REVIEW
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Mayo End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
October 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#6
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high-value health care is accelerating in the United States because of new legislation and redesign of payments from the Centers for Medicare and Medicaid Services. Because patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Because chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices...
May 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#7
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
March 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27747458/acute-on-chronic-liver-failure
#8
REVIEW
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
https://www.readbyqxmd.com/read/27061311/competency-based-medical-education-in-gastrointestinal-motility
#9
REVIEW
R Yadlapati, R N Keswani, J E Pandolfino
Traditional apprenticeship-based medical education methods focusing on subjective evaluations and case-volume requirements do not reliably produce clinicians that provide high-quality care in unsupervised practice. Consequently, training approaches are shifting towards competency based medical education, which incorporates robust assessment methods and credible standards of physician proficiency. However, current gastroenterology and hepatology training in the US continues to utilize procedural volume and global impressions without standardized criteria as markers of competence...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/26959806/intensive-care-management-of-patients-with-liver-disease-proceedings-of-a-single-topic-conference-sponsored-by-the-brazilian-society-of-hepatology
#10
Paulo Lisboa Bittencourt, Carlos Terra, Edison Roberto Parise, Alberto Queiroz Farias, Vincent Arroyo, Javier Fernandez, Gustavo Pereira, Luiz Marcelo Maubouisson, Guilherme Marques Andrade, Fernando Gomes de Barros Costa, Liana Codes, Antônio Ricardo Andrade, Angelo Alves de Mattos, André Torres, Fernanda Couto, Ivan Zyngier
Survival rates of critically ill patients with liver disease has sharply increased in recent years due to several improvements in the management of decompensated cirrhosis and acute liver failure. This is ascribed to the incorporation of evidence-based strategies from clinical trials aiming to reduce mortality. In order to discuss the cutting-edge evidence regarding critical care of patients with liver disease, a joint single topic conference was recently sponsored by the Brazilian Society of Hepatology in cooperation with the Brazilian Society of Intensive Care Medicine and the Brazilian Association for Organ Transplantation...
December 2015: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/26778768/-evaluation-and-treatment-of-the-critically-ill-cirrhotic-patient
#11
REVIEW
Javier Fernández, Carles Aracil, Elsa Solà, Germán Soriano, Maria Cinta Cardona, Susanna Coll, Joan Genescà, Manoli Hombrados, Rosa Morillas, Marta Martín-Llahí, Albert Pardo, Jordi Sánchez, Victor Vargas, Xavier Xiol, Pere Ginès
Cirrhotic patients often develop severe complications requiring ICU admission. Grade III-IV hepatic encephalopathy, septic shock, acute-on-chronic liver failure and variceal bleeding are clinical decompensations that need a specific therapeutic approach in cirrhosis. The increased effectiveness of the treatments currently used in this setting and the spread of liver transplantation programs have substantially improved the prognosis of critically ill cirrhotic patients, which has facilitated their admission to critical care units...
November 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/26776157/the-calm-before-the-storm-a-report-from-the-international-liver-cancer-association-congress-2015-part-2
#12
Giuseppe Cabibbo, Maria Reig, Gennaro Gadaleta-Caldarola, Giovanni Galati, Giuseppe Lombardi, GianCarlo Mazza, Luca Marzi, Carlo Saitta, Jean-Charles Nault, Rodolfo Sacco
International Liver Cancer Association Congress 2015, Paris, France, 4-6 September 2015 Since its creation 9 years ago, in 2007, the International Liver Cancer Association has focused on the multidisciplinary approach to liver cancer due to advances in hepatology science and care worldwide. In its 2015 annual conference, held on 4-6 September in Paris, France, the most recent progresses in the basic biology, management and treatment of liver cancer have been presented. This report, divided into two parts, introduces and critically reviews some of the most intriguing topics discussed at the meeting...
February 2016: Future Oncology
https://www.readbyqxmd.com/read/26775918/the-calm-before-the-storm-a-report-from-the-international-liver-cancer-association-congress-2015-part-1
#13
Giuseppe Cabibbo, Maria Reig, Gennaro Gadaleta-Caldarola, Giovanni Galati, Giuseppe Lombardi, GianCarlo Mazza, Luca Marzi, Carlo Saitta, Jean-Charles Nault, Rodolfo Sacco
International Liver Cancer Association Congress 2015, Paris, France, 4-6 September 2015 Since its creation 9 years ago, in 2007, the International Liver Cancer Association has focused on the multidisciplinary approach to liver cancer due to advances in hepatology science and care worldwide. In its 2015 annual conference, held on 4-6 September in Paris, France, the most recent progresses in the basic biology, management and treatment of liver cancer have been presented. This report, divided into two parts, introduces and critically reviews some of the most intriguing topics discussed at the meeting...
February 2016: Future Oncology
https://www.readbyqxmd.com/read/26762655/patterns-of-service-utilisation-within-australian-hepatology-clinics-high-prevalence-of-advanced-liver-disease
#14
N A El-Atem, K Wojcik, L Horsfall, K M Irvine, T Johnson, S M McPhail, E E Powell
BACKGROUND: Liver diseases in Australia are estimated to affect 6 million people with a societal cost of $51 billion annually. Information about utilisation of specialist hepatology care is critical in informing policy makers about the requirements for delivery of hepatology-related healthcare. AIMS: This study examined the aetiology and severity of liver disease seen in a tertiary hospital hepatology clinic, as well as the resource utilisation patterns. METHODS: A longitudinal cohort study included consecutive patients booked in hepatology outpatient clinics during a 3-month period...
April 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/26660679/rates-of-treatment-eligibility-in-follow-up-of-patients-with-chronic-hepatitis-b-chb-across-various-clinical-settings-who-were-initially-ineligible-at-presentation
#15
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
https://www.readbyqxmd.com/read/25755504/hepatitis-e-and-acute-on-chronic-liver-failure
#16
REVIEW
Ashish Kumar, Vivek A Saraswat
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis (AVH) globally. It causes large scale epidemics of AVH across the low- and middle income countries in Asia and Africa, and also causes sporadic cases of AVH in the same geographical region. AVH due to HEV is usually an acute, self-limiting illness, similar in clinical presentation to AVH caused by hepatitis A virus (HAV). When HEV causes AVH in patients of chronic liver disease it may worsen rapidly to a syndrome called acute-on-chronic liver failure (ACLF) leading to very high mortality...
September 2013: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/25730177/vibration-controlled-transient-elastography-a-practical-approach-to-the-noninvasive-assessment-of-liver-fibrosis
#17
REVIEW
Elliot B Tapper, Nezam H Afdhal
PURPOSE OF REVIEW: Therapeutic advances for hepatitis C and the increasing prevalence on nonalcoholic fatty liver disease are reshaping the diagnostic approach to disease staging in clinical hepatology. Well tolerated, inexpensive and reliable alternatives to liver biopsy are a critical need for clinicians and patients alike. RECENT FINDINGS: Vibration-controlled transient elastography (VCTE, also known as 'transient elastography') is a robust, point-of-care tool for the noninvasive assessment of liver fibrosis...
May 2015: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/25419906/pharmacological-treatment-of-children-with-gastro-oesophageal-reflux
#18
REVIEW
Mark Tighe, Nadeem A Afzal, Amanda Bevan, Andrew Hayen, Alasdair Munro, R Mark Beattie
BACKGROUND: Gastro-oesophageal reflux (GOR) is a common disorder, characterised by regurgitation of gastric contents into the oesophagus. GOR is a very common presentation in infancy in both primary and secondary care settings. GOR can affect approximately 50% of infants younger than three months old (Nelson 1997). The natural history of GOR in infancy is generally that of a functional, self-limiting condition that improves with age; < 5% of children with vomiting or regurgitation continue to have symptoms after infancy (Martin 2002)...
November 24, 2014: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25392842/small-for-size-liver-remnant-following-resection-prevention-and-management
#19
REVIEW
Rony Eshkenazy, Yael Dreznik, Eylon Lahat, Barak Bar Zakai, Alex Zendel, Arie Ariche
In the latest decades an important change was registered in liver surgery, however the management of liver cirrhosis or small size hepatic remnant still remains a challenge. Currently post-hepatectomy liver failure (PLF) is the major cause of death after liver resection often associated with sepsis and ischemia-reperfusion injury (IRI). ''Small-for-size'' syndrome (SFSS) and PFL have similar mechanism presenting reduction of liver mass and portal hyper flow beyond a certain threshold. Few methods are described to prevent both syndromes, in the preoperative, perioperative and postoperative stages...
October 2014: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/25334553/assessing-mortality-in-the-medical-intensive-care-unit-of-interfacility-transferred-micu-patients
#20
Nirav Patel, Niusha Damaghi, Michael Stephen
Outcomes/Quality Control Posters IISESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: The purpose of this study was to asses outcomes in patients in an academic MICU that were transferred from an outside hospital MICU. Transferring a patient to a tertiary care MICU is costly and the risks of the transfer may outweigh the benefits. This study assessed mortality of transferred patients. Furthermore, it assesses if patients have met their primary purpose post transfer, whether it was an improvement in their condition, or if the patients received an organ transplantation (Liver/ kidney)...
October 1, 2014: Chest
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