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Liver Disease

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24 papers 1000+ followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/28052623/prevention-and-treatment-of-variceal-haemorrhage-in-2017
#1
REVIEW
Felix Brunner, Annalisa Berzigotti, Jaime Bosch
Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28427875/easl-2017-clinical-practice-guidelines-on-the-management-of-hepatitis-b-virus-infection
#2
(no author information available yet)
Hepatitis B virus (HBV) infection remains a global public health problem with changing epidemiology due to several factors including vaccination policies and migration. This Clinical Practice Guideline presents updated recommendations for the optimal management of HBV infection. Chronic HBV infection can be classified into five phases: (I) HBeAg-positive chronic infection, (II) HBeAg-positive chronic hepatitis, (III) HBeAg-negative chronic infection, (IV) HBeAg-negative chronic hepatitis and (V) HBsAg-negative phase...
April 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28176894/autoimmune-hepatitis-current-challenges-and-future-prospects
#3
REVIEW
Yoshio Aizawa, Atsushi Hokari
Autoimmune hepatitis (AIH) is a chronic progressive liver disease characterized by high levels of aminotransferases and autoantibodies, hypergammaglobulinemia, and interface hepatitis. AIH affects all races and all ages worldwide, regardless of sex, although a preponderance of females is a constant finding. The etiology of AIH has not been completely elucidated, but immunogenetic background and environmental parameters may contribute to its development. The most important genetic factor is human leukocyte antigens (HLAs), especially HLA-DR, whereas the role of environmental factors is not completely understood...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27379904/effects-of-moderate-and-vigorous-exercise-on-nonalcoholic-fatty-liver-disease-a-randomized-clinical-trial
#4
RANDOMIZED CONTROLLED TRIAL
Hui-Jie Zhang, Jiang He, Ling-Ling Pan, Zhi-Min Ma, Cheng-Kun Han, Chung-Shiuan Chen, Zheng Chen, Hai-Wei Han, Shi Chen, Qian Sun, Jun-Feng Zhang, Zhi-Bin Li, Shu-Yu Yang, Xue-Jun Li, Xiao-Ying Li
IMPORTANCE: Nonalcoholic fatty liver disease (NAFLD) is a prevalent risk factor for chronic liver disease and cardiovascular disease. OBJECTIVE: To compare the effects of moderate and vigorous exercise on intrahepatic triglyceride content and metabolic risk factors among patients with NAFLD. DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial, participants with central obesity and NAFLD were recruited from community-based screening in Xiamen, China, from December 1, 2011, through December 25, 2013...
August 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/24372568/review-article-controversies-in-the-management-of-primary-biliary-cirrhosis-and-primary-sclerosing-cholangitis
#5
REVIEW
T H Karlsen, M Vesterhus, K M Boberg
BACKGROUND: Despite considerable advances over the last two decades in the molecular understanding of cholestasis and cholestatic liver disease, little improvement has been made in diagnostic tools and therapeutic strategies. AIMS: To critically review controversial aspects of the scientific basis for common clinical practice in primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) and to discuss key ongoing challenges to improve patient management...
February 2014: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/26870928/new-therapeutic-strategies-for-primary-sclerosing-cholangitis
#6
REVIEW
Kate D Williamson, Roger W Chapman
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease, which in the majority of patients progresses to liver transplantation or death. To date, no medical treatment has been proven to be of benefit, although ursodeoxycholic acid is widely used. The etiopathogenesis of PSC is unclear, although it is associated with inflammatory bowel disease. Various hypotheses have been suggested, which have led to different therapeutic strategies. Recent studies have suggested that the microbiome may play a role in PSC, raising the possibility of efficacy of antibiotics and fecal microbiota transplantation...
February 2016: Seminars in Liver Disease
https://www.readbyqxmd.com/read/27207975/primary-sclerosing-cholangitis-is-characterised-by-intestinal-dysbiosis-independent-from-ibd
#7
João Sabino, Sara Vieira-Silva, Kathleen Machiels, Marie Joossens, Gwen Falony, Vera Ballet, Marc Ferrante, Gert Van Assche, Schalk Van der Merwe, Severine Vermeire, Jeroen Raes
OBJECTIVE: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease often leading to end-stage liver disease. Its pathogenesis remains largely unknown, although frequent concomitant IBD hints towards common factors underlying gut and bile duct inflammation. Considering the mounting evidence on the involvement of the intestinal microbiota in initiating and determining IBD phenotype, we investigated intestinal microbiota composition in patients with PSC. DESIGN: Stool samples were collected from 147 individuals (52 patients with PSC, 52 age, gender and body mass index-matched healthy volunteers, 13 UC and 30 patients with Crohn's disease)...
October 2016: Gut
https://www.readbyqxmd.com/read/25869391/acg-clinical-guideline-primary-sclerosing-cholangitis
#8
Keith D Lindor, Kris V Kowdley, M Edwyn Harrison
Primary sclerosing cholangitis is a chronic cholestatic liver disease that can shorten life and may require liver transplantation. The cause is unknown, although it is commonly associated with colitis. There is no approved or proven therapy, although ursodeoxycholic acid is used by many on an empiric basis. Complications including portal hypertension, fat-soluble vitamin deficiency, metabolic bone diseases, and development of cancers of the bile duct or colon can occur.
May 2015: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/23857427/radiologic-course-of-primary-sclerosing-cholangitis-assessment-by-three-dimensional-magnetic-resonance-cholangiography-and-predictive-features-of-progression
#9
Ana Ruiz, Sara Lemoinne, Fabrice Carrat, Christophe Corpechot, Olivier Chazouillères, Lionel Arrivé
UNLABELLED: Magnetic resonance imaging (MRI) with magnetic resonance cholangiography (MRC) has become the radiologic standard of reference for diagnosis of primary sclerosing cholangitis (PSC). However, natural history of radiologic features of PSC is poorly known. In the current study, we aimed at analyzing the course of PSC using three-dimensional (3D) MRC and liver MRI to find predictive radiologic features of progression. PSC patients, followed up in our center, with at least two 3D MRCs performed in at least a 1-year interval, were retrospectively reviewed...
January 2014: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/26981172/human-albumin-solution-for-patients-with-cirrhosis-and-acute-on-chronic-liver-failure-beyond-simple-volume-expansion
#10
REVIEW
Christopher Valerio, Eleni Theocharidou, Andrew Davenport, Banwari Agarwal
To provide an overview of the properties of human serum albumin (HSA), and to review the evidence for the use of human albumin solution (HAS) in critical illness, sepsis and cirrhosis. A MEDLINE search was performed using the terms "human albumin", "critical illness", "sepsis" and "cirrhosis". The references of retrieved articles were reviewed manually. Studies published between 1980 and 2014 were selected based on quality criteria. Data extraction was performed by all authors. HSA is the main plasma protein contributing greatly to its oncotic pressure...
March 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/26971824/perspectives-on-treatment-for-nonalcoholic-steatohepatitis
#11
REVIEW
Guillaume Lassailly, Robert Caiazzo, François Pattou, Philippe Mathurin
It is important to provide treatment to patients with nonalcoholic steatohepatitis (NASH) because one third of patients with the metabolic syndrome die of liver disease. Basic research studies have elucidated mechanisms of NASH pathogenesis, which could lead to therapeutic targets. Health agencies have confirmed strategies for the optimal management of NASH and approved new drugs and treatments, which urgently are needed. The US Food and Drug Administration recently endorsed end points for NASH therapy. The reversal of NASH with no evidence of progression to advanced fibrosis has been defined as the end point for phase 2b and phase 3 trials in patients with NASH and early stage fibrosis...
June 2016: Gastroenterology
https://www.readbyqxmd.com/read/26874076/elafibranor-an-agonist-of-the-peroxisome-proliferator-activated-receptor-%C3%AE-and%C3%A2-%C3%AE-induces-resolution-of-nonalcoholic-steatohepatitis-without-fibrosis-worsening
#12
RANDOMIZED CONTROLLED TRIAL
Vlad Ratziu, Stephen A Harrison, Sven Francque, Pierre Bedossa, Philippe Lehert, Lawrence Serfaty, Manuel Romero-Gomez, Jérôme Boursier, Manal Abdelmalek, Steve Caldwell, Joost Drenth, Quentin M Anstee, Dean Hum, Remy Hanf, Alice Roudot, Sophie Megnien, Bart Staels, Arun Sanyal
BACKGROUND & AIMS: Elafibranor is an agonist of the peroxisome proliferator-activated receptor-α and peroxisome proliferator-activated receptor-δ. Elafibranor improves insulin sensitivity, glucose homeostasis, and lipid metabolism and reduces inflammation. We assessed the safety and efficacy of elafibranor in an international, randomized, double-blind placebo-controlled trial of patients with nonalcoholic steatohepatitis (NASH). METHODS: Patients with NASH without cirrhosis were randomly assigned to groups given elafibranor 80 mg (n = 93), elafibranor 120 mg (n = 91), or placebo (n = 92) each day for 52 weeks at sites in Europe and the United States...
May 2016: Gastroenterology
https://www.readbyqxmd.com/read/26637729/coagulopathy-in-liver-disease-a-balancing-act
#13
Jody L Kujovich
Liver disease results in complex alterations of all 3 phases of hemostasis. It is now recognized that hemostasis is rebalanced in chronic liver disease. The fall in clotting factor levels is accompanied by a parallel fall in anticoagulant proteins. High von Willebrand factor levels counteract defects in primary hemostasis. Conventional coagulation tests do not fully reflect the derangement in hemostasis and do not accurately predict the risk of bleeding. Global coagulation assays (thrombin generation, thromboelastography) reflect the interaction between procoagulant factors, anticoagulant factors, platelets, and the fibrinolytic system and show promise for assessing bleeding risk and guiding therapy...
2015: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/26341719/easl-clinical-practice-guidelines-autoimmune-hepatitis
#14
(no author information available yet)
No abstract text is available yet for this article.
October 2015: Journal of Hepatology
https://www.readbyqxmd.com/read/26188836/understanding-the-complexities-of-cirrhosis
#15
REVIEW
Andrew J Muir
PURPOSE: Cirrhosis and its related complications remain a prominent global health concern despite advances in understanding and treating the disorder. Early diagnosis and intervention strategies may reduce the impact of cirrhosis; however, it can be difficult for initial point-of-care health care providers to identify and refer patients with cirrhosis due to lack of knowledge and resources. This review examines current diagnostic strategies for cirrhosis and cirrhosis-related complications and the potential benefits of multidisciplinary care for patients with the disorder...
August 2015: Clinical Therapeutics
https://www.readbyqxmd.com/read/25974902/diagnosis-of-liver-fibrosis-present-and-future
#16
REVIEW
Keyur Patel, Pierre Bedossa, Laurent Castera
The diagnostic assessment of liver fibrosis, a major determinant of disease severity, is an important step in the management of patients with chronic liver diseases. Liver biopsy is still considered the gold standard for the assessment of necroinflammation and fibrosis; however, recent technical advances have resulted in the development of numerous serum biomarkers and imaging tools as noninvasive alternatives to biopsy. These tests include biological (serum biomarker algorithms), physical (imaging assessment of tissue stiffness), and physiological (breath test) methods...
May 2015: Seminars in Liver Disease
https://www.readbyqxmd.com/read/26203597/fructose-and-liver-function-is-this-behind-nonalcoholic-liver-disease
#17
REVIEW
Ran Jin, Miriam B Vos
PURPOSE OF REVIEW: The purpose was to summarize recent advances in the understanding of nonalcoholic fatty liver disease (NAFLD) pathophysiology and the role of fructose in NAFLD. RECENT FINDINGS: Epidemiological studies continue to point to a strong association between high fructose intake and NAFLD and its severity. New studies of NAFLD reveal the importance of upregulated de novo lipogenesis as a key feature in its pathophysiology along with increased visceral adiposity and alteration of gut microbiome...
September 2015: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/24890441/nonalcoholic-fatty-liver-disease-is-underrecognized-in-the-primary-care-setting
#18
Pierre Blais, Nisreen Husain, Jennifer R Kramer, Marc Kowalkowski, Hashem El-Serag, Fasiha Kanwal
OBJECTIVES: The prevalence and disease burden of nonalcoholic fatty liver disease (NAFLD) are increasing. Nonetheless, little is known about the processes related to identification, diagnosis, and referral of patients with NAFLD in routine clinical care. METHODS: Using automated data, we isolated a random sample of patients in a Veterans Administration facility who had ≥2 alanine transaminase (ALT) values >40 IU/ml >6 months apart in the absence of any positive results for hepatitis C RNA, hepatitis B surface antigen, or screens for excess alcohol use...
January 2015: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/25468718/is-there-a-rationale-for-treatment-of-chronic-liver-disease-with-antithrombotic-therapy
#19
REVIEW
Greg C G Hugenholtz, Patrick G Northup, Robert J Porte, Ton Lisman
Recent advances in the understanding of the coagulopathy in chronic liver disease have provided a strong support for anticoagulation as a new therapeutic paradigm for patients with cirrhosis. Laboratory studies indicate that the net effect of changes in hemostasis in many patients with chronic liver disease is a hypercoagulable status. In turn, clinical thrombosis is increasingly recognized as a complication of liver disease. When occurring within the liver, thrombosis may even progress the disease course. Exciting preliminary data regarding the potential of low-molecular-weight heparin to slow down the progression of liver disease indicate that this class of drugs may improve outcome without a major increase in bleeding risk...
March 2015: Blood Reviews
https://www.readbyqxmd.com/read/25274101/non-alcoholic-fatty-liver-disease-need-for-a-balanced-nutritional-source
#20
REVIEW
Jayagopalan Veena, Anjaneyulu Muragundla, Srinivas Sidgiddi, Swaminathan Subramaniam
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are an increasingly common chronic liver disease closely associated with diabetes and obesity that have reached epidemic proportions. Reports on the prevalence of NAFLD have suggested that 27-34% of the general population in the USA and 40-90% of the obese population worldwide have this disease. Increasing urbanisation rate and associated inappropriate lifestyle changes are not only the risk factors of diabetes, but also unmask genetic predisposition in various populations for the metabolic syndrome and its manifestations including NAFLD and NASH...
December 14, 2014: British Journal of Nutrition
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