MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinics in Liver Disease' source. Sat, 31 Dec 2011 13:26:58 +0100 http://www.medworm.com/index.php?rid=5348701&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001176%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348701 Wed, 26 Oct 2011 20:44:51 +0100 5348701 http://www.medworm.com/index.php?rid=5348698&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611100095X%2Fabstract%3Frss%3Dyes Recurrence of hepatitis C virus remains a near-universal phenomenon after liver transplantation (LT) and is responsible for the high morbidity and low survival seen in these patients. The severity of recurrent disease varies depending on multiple factors, only some of which are modifiable. Antiviral therapy is associated with improved outcomes, but viral clearance is only attainable in a small percentage of this patient population. This patient population is in need of new therapeutic options, and it remains to be seen whether direct-acting antiviral agents will be the answer to this ongoing therapeutic question. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348698 Wed, 26 Oct 2011 20:44:51 +0100 5348698 http://www.medworm.com/index.php?rid=5348697&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000997%2Fabstract%3Frss%3Dyes Long-term survival of liver transplant recipients has become the rule rather than the exception. As a result, the medical complications of long-term survival, including atherosclerotic cardiovascular disease, metabolic bone disease, and de novo malignancy, have accounted for an increasing proportion of late morbidity and mortality. Risk factors for these complications begin before transplant and are potentially modifiable but are exacerbated by the requirement for immunosuppressive medications after transplantation. Surveillance and early intervention programs administered by transplant hepatologists and other medical subspecialists may improve long-term outcomes in liver transplant recipients by ameliorating risk factors for atherosclerosis, bone fractures, and cancer. (Source: Clinics in... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348697 Wed, 26 Oct 2011 20:44:51 +0100 5348697 http://www.medworm.com/index.php?rid=5348696&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000936%2Fabstract%3Frss%3Dyes Renal dysfunction is a frequent complication in patients with endstage liver disease awaiting orthotopic liver transplantation. Although the stereotypical form of renal dysfunction is the hepatorenal syndrome, common causes of acute kidney injury include prerenal azotemia and acute tubular necrosis in this population. Management involves hemodynamic support, renal replacement therapy, and mitigation of risk factors. Renal dysfunction in a cirrhotic patient usually implies a poor prognosis in the absence of liver transplantation. An important issue is the frequent need for kidney, in addition to liver, transplantation if renal insufficiency has been persistent in a decompensated cirrhotic. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348696 Wed, 26 Oct 2011 20:44:51 +0100 5348696 http://www.medworm.com/index.php?rid=5348695&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000973%2Fabstract%3Frss%3Dyes Care of the liver transplant candidate is one of the most challenging, yet rewarding aspects of hepatology. Anticipation and intervention for the major complications of advanced liver disease increase the likelihood of survival until transplant. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348695 Wed, 26 Oct 2011 20:44:51 +0100 5348695 http://www.medworm.com/index.php?rid=5348694&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001085%2Fabstract%3Frss%3Dyes This article addresses the most common pulmonary issues that affect liver transplant candidates. Pretransplant diagnostic criteria of these pulmonary problems in liver transplant patients are reviewed. Successful pulmonary management schemes and caveats are described. Risks for liver transplant are emphasized. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348694 Wed, 26 Oct 2011 20:44:51 +0100 5348694 http://www.medworm.com/index.php?rid=5348693&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001073%2Fabstract%3Frss%3Dyes The management of hepatitis B in liver transplantation has evolved significantly over the past 2 decades. Introduction of hepatitis B immune globulin and subsequently nucleos(t)ide analogues has revolutionized transplantation for hepatitis B virus (HBV), increasing survival for patients transplanted for this indication. With the availability of new and potent antivirals for HBV, the need for liver transplant should continue to decrease in the coming years. Moreover, the newer antivirals with high resistance barriers will allow effective long-term viral prophylaxis and therefore, prevention of recurrence. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348693 Wed, 26 Oct 2011 20:44:51 +0100 5348693 http://www.medworm.com/index.php?rid=5348692&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000948%2Fabstract%3Frss%3Dyes In this article the epidemiology of substance use and substance disorders in the United States and their association with liver disease are reviewed. The relevance of tobacco use and issues of candidacy as it pertains to substance use are discussed. The use of alcohol while on the waitlist and short sobriety are also addressed. The merits of monitoring of patients are discussed, and the outcomes of these patients after liver transplantation are examined. The article concludes with a summary of recommendations for clinicians working with these patients and possible future directions for both clinical care and research. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348692 Wed, 26 Oct 2011 20:44:51 +0100 5348692 http://www.medworm.com/index.php?rid=5348691&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001061%2Fabstract%3Frss%3Dyes The past 2 decades have witnessed an exponential increase in the incidence of hepatocellular carcinoma (HCC) in the United States and, concurrently, the development of liver transplantation as an effective modality in its treatment. “Early” HCC has been defined, allowing patients with unresectable HCC to be granted priority for transplant over the past decade. This situation has produced a dramatic increase in the number of transplants for HCC. The challenge has been how to expand the indications of liver transplant for HCC with improved cancer-free survival and fewer transplant-related complications without adversely affecting non-HCC transplant candidates. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348691 Wed, 26 Oct 2011 20:44:51 +0100 5348691 http://www.medworm.com/index.php?rid=5348690&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000961%2Fabstract%3Frss%3Dyes Cholangiocarcinoma (CCA) is a primary hepatic neoplasm that arises from malignant transformation of the biliary epithelium. Chronic biliary tree inflammation as occurs in primary sclerosing cholangitis (PSC) is a risk factor for the development of CCA. Surgical resection and liver transplantation following neoadjuvant therapy in patients with early extrahepatic CCA are the only potentially curative modalities. Biliary stenting, chemotherapy, radiation therapy, and photodynamic therapy are palliative treatment options for patients who are not surgical candidates. Liver transplantation following neoadjuvant therapy is an effective therapy for patients with hilar cholangiocarcinoma that is unresectable or arising in the setting of PSC. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348690 Wed, 26 Oct 2011 20:44:51 +0100 5348690 http://www.medworm.com/index.php?rid=5348688&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001097%2Fabstract%3Frss%3Dyes Although the pioneering efforts of Dr Tom Starzl in liver transplant date back to the early 1960s, liver transplantation has become such a critical element in the management of patients with liver disease that it is sobering to reflect that its widespread use is still relatively recent after a NIH Consensus Conference in 1983 endorsed liver transplantation in patients with advanced liver disease. Similarly, the Model for Endstage Liver Disease (MELD) has become common parlance for assessing the severity of liver disease, although it was adopted by the United Network for Organ Sharing for organ allocation within the last 10 years. The role of liver transplantation for a number of controversial indications has become better defined during the same period of time including cholangiocarcinoma,... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348688 Wed, 26 Oct 2011 20:44:51 +0100 5348688 http://www.medworm.com/index.php?rid=5348687&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001164%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348687 Wed, 26 Oct 2011 20:44:51 +0100 5348687 http://www.medworm.com/index.php?rid=5348686&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001152%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348686 Wed, 26 Oct 2011 20:44:51 +0100 5348686 http://www.medworm.com/index.php?rid=5348685&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001140%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348685 Wed, 26 Oct 2011 20:44:51 +0100 5348685 http://www.medworm.com/index.php?rid=5348700&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000985%2Fabstract%3Frss%3Dyes Several criteria are used to differentiate between standard and extended allograft donors. These criteria include deceased after cardiac death, advanced donor age, steatosis, previous malignancy in the donor, hepatitis C virus-positive allografts, human T-cell lymphotropic virus-positive allografts, active infections in the donor, high-risk donors, split liver transplantations, and living donor liver transplantations. Review of the literature can lead each practitioner to incorporate extended criteria donors into their transplant program, thereby individualizing the use of these allografts, increasing the donor pool, and decreasing overall waitlist mortality. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348700 Mon, 03 Oct 2011 04:00:00 +0100 5348700 http://www.medworm.com/index.php?rid=5348699&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001000%2Fabstract%3Frss%3Dyes This article reviews diagnostic criteria, epidemiology, risk factors, and outcomes of recurrent PBC, PSC, and AIH after liver transplantation. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348699 Mon, 03 Oct 2011 04:00:00 +0100 5348699 http://www.medworm.com/index.php?rid=5348689&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111001012%2Fabstract%3Frss%3Dyes The Model for End-stage Liver Disease (MELD) score is the basis for allocation of liver allografts for transplantation in the United States. The MELD score, as an objective scale of disease severity, is also used in the management of patients with chronic liver disease in the nontransplant setting. Several models have been proposed to improve the MELD score. The authors believe that the MELD score is, by design, continually evolving and lends itself to continued refinement and improvement to serve as a metric to optimize organ allocation in the future. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5348689 Mon, 03 Oct 2011 04:00:00 +0100 5348689 http://www.medworm.com/index.php?rid=5163101&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000791%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163101 Sun, 31 Jul 2011 23:00:00 +0100 5163101 http://www.medworm.com/index.php?rid=5163099&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000390%2Fabstract%3Frss%3Dyes The introduction and ongoing development of directly acting antiviral agents (DAAs) and drugs targeting host cell structures will change the management of patients with chronic hepatitis C virus (HCV) infection. The concomitant use of the protease inhibitors telaprevir or boceprevir with the standard of care, a combination of pegylated interferon (PegIFN) and ribavirin, will represent the new standard for the treatment of HCV genotype 1 infection. Contraindications and side effects limit the applicability of interferon-based therapies and motivate the investigation of PegIFN-sparing regimens. Different DAA combinations under investigation are reviewed in this article. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163099 Sun, 31 Jul 2011 23:00:00 +0100 5163099 http://www.medworm.com/index.php?rid=5163098&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000353%2Fabstract%3Frss%3Dyes Therapies in addition to the direct-acting antiviral agents (DAA) under evaluation for chronic hepatitis C include host targets such as cyclophilin inhibitors and immunomodulators. Both passive and therapeutic vaccines hold promise for the future. Although the numbers of drug categories and individual agents are increasing, only a handful of the non-DAAs seem to be ready to move on to phase III trials. New interferon agents are in development, and ribavirin variants are still under consideration. The role of the other players in the overall armamentarium against hepatitis C virus is still evolving. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163098 Sun, 31 Jul 2011 23:00:00 +0100 5163098 http://www.medworm.com/index.php?rid=5163097&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000377%2Fabstract%3Frss%3Dyes The development and approval of direct-acting antiviral agents looks set to transform the treatment of chronic hepatitis C infection. Among the agents in development are novel compounds that inhibit the function of the NS5A protein: a pleiotropic protein with a complex and essential role in viral replication. Preclinical studies have demonstrated the potency of these agents across a broad range of viral genotypes, and in early phase trials, they rapidly suppressed viral replication when administered as monotherapy or in combination with pegylated interferon-α and ribavirin. The discovery and development of NS5A replication complex inhibitors is summarized in this review. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163097 Sun, 31 Jul 2011 23:00:00 +0100 5163097 http://www.medworm.com/index.php?rid=5163096&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000304%2Fabstract%3Frss%3Dyes This article introduces one of the most diverse classes of direct-acting antivirals for hepatitis C, the nucleoside and non-nucleoside NS5B polymerase inhibitors. Through a systematic review of the published literature, we describe their structure, mechanism of action, issues with resistance, and clinical effectiveness shown in the latest clinical trials. Direct-acting antiviral combination trials that have already shown some early promising results even in the setting of interferon-sparing antiviral regimens are discussed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163096 Sun, 31 Jul 2011 23:00:00 +0100 5163096 http://www.medworm.com/index.php?rid=5163094&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611100033X%2Fabstract%3Frss%3Dyes This article reviews the latest predictive factors of response to HCV treatment with the current standard of care in HIV-coinfected patients, and new treatment options. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163094 Sun, 31 Jul 2011 23:00:00 +0100 5163094 http://www.medworm.com/index.php?rid=5163093&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000286%2Fabstract%3Frss%3Dyes Individuals infected with hepatitis C virus (HCV) are at risk for cirrhosis and/or hepatocellular carcinoma. Treatment of HCV infection has undergone several revisions over the past 15 years and continues to evolve. The current major advance is with the protease inhibitors in addition to pegylated interferon and ribavirin. The emergence of resistance needs to be monitored carefully as newer and more potent drugs are added to the interferon and ribavirin backbone drugs. In addition, adverse events will be more frequent and some novel ones will require special attention. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163093 Sun, 31 Jul 2011 23:00:00 +0100 5163093 http://www.medworm.com/index.php?rid=5163092&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000407%2Fabstract%3Frss%3Dyes This article discusses phase I, II, and III trials examining telaprevir's role in treating patients with HCV. We have now entered an era of combination therapy utilizing direct acting anti-virals, the start of which was marked by the FDA approval of HCV protease inhibitors. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163092 Sun, 31 Jul 2011 23:00:00 +0100 5163092 http://www.medworm.com/index.php?rid=5163091&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000328%2Fabstract%3Frss%3Dyes Given its essential role in the process of hepatitis C virus (HCV) replication, the viral NS3/4A serine protease is arguably the most thoroughly characterized HCV enzyme and the most intensively pursued anti-HCV target for drug development thus far. Recent data have demonstrated promise for the NS3 protease inhibitor boceprevir, which, when added to the standard of care peginterferon and ribavirin, improves sustained virological response while shortening duration of therapy in genotype-1–infected individuals. This review discusses the mechanism of action of boceprevir, its effects on HCV, and its viral resistance. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163091 Sun, 31 Jul 2011 23:00:00 +0100 5163091 http://www.medworm.com/index.php?rid=5163090&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000298%2Fabstract%3Frss%3Dyes Chronic hepatitis C (CHC) is a leading cause of chronic hepatitis, cirrhosis, liver failure, and hepatocellular carcinoma (HCC) worldwide. Currently, pegylated interferon (Peg-IFN) and ribavirin therapy achieve curative responses in 40% to 80% of patients, depending on genotype. Recognition of new therapeutic targets for HCV therapy has led to development of novel therapies. The purpose of this review is to summarize the status of novel therapeutics for CHC that promise to increase the safety and efficacy of therapy. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163090 Sun, 31 Jul 2011 23:00:00 +0100 5163090 http://www.medworm.com/index.php?rid=5163089&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000365%2Fabstract%3Frss%3Dyes The current standard of care for hepatitis C virus (HCV) infection is pegylated interferon and ribavirin. Unfortunately, treatment cures at best only 40% to 50% of patients infected with genotype 1 HCV, the most common HCV genotype in Western countries. Treatment is also expensive and is often poorly tolerated. Therefore, the identification of patients most likely to benefit from treatment is clinically important. Genome-wide association studies have recently identified genetic variants, most notably IL28B and ITPA, which will enhance the ability of clinicians to personalize antiviral therapy for HCV infection. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163089 Sun, 31 Jul 2011 23:00:00 +0100 5163089 http://www.medworm.com/index.php?rid=5163088&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000389%2Fabstract%3Frss%3Dyes Hepatitis C has a high prevalence in the United States, and the disease burden of HCV will increase over the next 20 to 30 years by many estimates. Trials to evaluate new therapies and optimize the use of triple drug therapies are needed if HCV is to be successfully controlled and its incumbent morbidity and mortality drastically lowered for all groups of patients. With improvements in ability to achieve SVR with agents such as telaprevir and boceprevir, efforts to improve treatment uptake rates and to re-examine the utility of universal or more inclusive screening for chronic hepatitis C are warranted. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163088 Sun, 31 Jul 2011 23:00:00 +0100 5163088 http://www.medworm.com/index.php?rid=5163086&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000481%2Fabstract%3Frss%3Dyes The field of hepatitis C saw a historic year in 2011 with the approval of the first two direct-acting antiviral agents targeting a nonstructural protein of the virus. This advance has been heralded as revolutionary in its potential impact on the care of the hepatitis C patient and the direction of future research. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163086 Sun, 31 Jul 2011 23:00:00 +0100 5163086 http://www.medworm.com/index.php?rid=5163085&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611100078X%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163085 Sun, 31 Jul 2011 23:00:00 +0100 5163085 http://www.medworm.com/index.php?rid=5163084&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000778%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163084 Sun, 31 Jul 2011 23:00:00 +0100 5163084 http://www.medworm.com/index.php?rid=5163083&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000766%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163083 Sun, 31 Jul 2011 23:00:00 +0100 5163083 http://www.medworm.com/index.php?rid=5163100&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000316%2Fabstract%3Frss%3Dyes This article reviews the mechanisms through which interferon is believed to suppress HCV and lead to SVR. These observations are used to speculate as to whether an all-oral antiviral cocktail could “cure” HCV in the near future. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163100 Sun, 26 Jun 2011 23:00:00 +0100 5163100 http://www.medworm.com/index.php?rid=5163095&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000419%2Fabstract%3Frss%3Dyes This article gives an overview of the compounds that will soon be available. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163095 Sun, 26 Jun 2011 23:00:00 +0100 5163095 http://www.medworm.com/index.php?rid=5163087&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000341%2Fabstract%3Frss%3Dyes Twenty-five years have passed since interferon-α was first used in the treatment of chronic hepatitis C infection, and even now it remains an essential part of the standard of care for this condition. At present, the recommended treatment is a combination of pegylated interferon and ribavirin A. There have been enormous advances in our understanding of the mechanisms through which interferon works and in identifying factors related to the response to this treatment. Even with the development of new protease inhibitors, it is likely that interferon will remain an essential component of hepatitis C treatment. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=5163087 Tue, 14 Jun 2011 23:00:00 +0100 5163087 http://www.medworm.com/index.php?rid=4946932&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000249%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946932 Sat, 30 Apr 2011 23:00:00 +0100 4946932 http://www.medworm.com/index.php?rid=4946931&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000122%2Fabstract%3Frss%3Dyes Management of pediatric liver tumors has significantly improved over the last 2 decades. The management options for hepatocelluar carcinoma (HCC) are not well defined. In the pediatric context, the main clinical aims are to reduce chemotherapy toxicity (predominantly ototoxicity and nephrotoxicity) in children treated for hepatoblastoma and to investigate additional modes of treatment for HCC. An increasing number of children develop HCC in the background of chronic liver disease, and screening methods need to be better observed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946931 Sat, 30 Apr 2011 23:00:00 +0100 4946931 http://www.medworm.com/index.php?rid=4946930&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000031%2Fabstract%3Frss%3Dyes Many potential systemic therapies are being investigated for the treatment of hepatocellular carcinoma (HCC). The incidence of this malignancy is rising sharply and the vast majority of patients present at advanced stages. Although the earlier dismal results with cytotoxic chemotherapies made way for the development of locoregional therapies that provided improved overall survival, truly personalized therapy will require the selection of phenotypically similar stages of disease and populations, an understanding of the complex molecular and genetic pathways leading to HCC, and a keen understanding of the pathobiology of cirrhosis. Only then will we understand how to offer a particular patient at a specific stage of disease the appropriate therapy to truly prolong survival. (Source: Clinics ... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946930 Sat, 30 Apr 2011 23:00:00 +0100 4946930 http://www.medworm.com/index.php?rid=4946929&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000146%2Fabstract%3Frss%3Dyes Locoregional therapies for hepatocellular carcinoma have progressed greatly in the last 30 years, beginning with the introduction of chemoembolization. Embolization techniques have evolved with the use of drug-eluting beads and radioembolization with yttrium-90. In the last 10 years, several new ablation techniques were developed including radiofrequency ablation, microwave ablation, cryoablation, laser ablation, and irreversible electroporation. Isolated or in combination, these techniques have already shown that they can improve patient survival and/or provide acceptable palliation. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946929 Sat, 30 Apr 2011 23:00:00 +0100 4946929 http://www.medworm.com/index.php?rid=4946928&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000067%2Fabstract%3Frss%3Dyes Despite significant advances in nonsurgical treatments of hepatocellular carcinoma, these approaches rarely result in cure. Surgery remains the mainstay of curative therapy for hepatocellular carcinoma. Liver transplantation, in particular, has emerged as one of the most beneficial therapeutic modalities. Questions remain, however, regarding hepatocellular carcinoma surveillance, the choice of surgical resection versus transplantation, the role of chemotherapy, optimal selection criteria for transplantation, and the role of ablative therapies to halt tumor progression and downsize tumors exceeding transplant criteria. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946928 Sat, 30 Apr 2011 23:00:00 +0100 4946928 http://www.medworm.com/index.php?rid=4946927&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000109%2Fabstract%3Frss%3Dyes Laparoscopic liver resection is an emerging technique in liver surgery. Although laparoscopy is well established for several abdominal procedures and is considered by some the preferred approach, laparoscopic hepatic resection has been introduced into clinical practice more widely since 2000. These procedures are performed only in experienced centers and only in a select group of patients. While initially performed only for benign hepatic lesions, the indications for laparoscopic resection have gradually broadened to encompass all kinds of malignant hepatic lesions, including hepatocellular carcinoma in patients with cirrhosis, for whom the advantages of the minimally invasive approach may be most evident. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946927 Sat, 30 Apr 2011 23:00:00 +0100 4946927 http://www.medworm.com/index.php?rid=4946926&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000092%2Fabstract%3Frss%3Dyes Liver resection remains the standard therapy for solitary hepatocellular carcinoma in patients with preserved hepatic function. In well-selected patients, 5-year survival rates are good and can approach that of liver transplantation for early-stage disease. Patient selection is critical to optimizing therapeutic benefit, and the health of the native liver must be considered in addition to tumor characteristics. Hepatic recurrence after resection is common. The difficulty lies in deciding which patients with chronic liver disease and small solitary tumors are best served by resection and which should proceed with transplant evaluation; this is the focus of this article. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946926 Sat, 30 Apr 2011 23:00:00 +0100 4946926 http://www.medworm.com/index.php?rid=4946925&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000158%2Fabstract%3Frss%3Dyes Hepatocellular carcinoma (HCC) is most commonly seen in patients with cirrhosis. Criteria for diagnosis include arterial-phase enhancement, venous-phase washout, and a capsule on delayed sequences. Tiny HCC are best detected with magnetic resonance imaging using the new hepatocyte-specific gadolinium agents; otherwise, short-term follow up versus biopsy is considered. Diffuse HCC can be difficult to diagnose because of the inherent heterogeneous hepatic parenchyma in cirrhosis, however, portal vein expansion due to thrombosis is a helpful sign. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946925 Sat, 30 Apr 2011 23:00:00 +0100 4946925 http://www.medworm.com/index.php?rid=4946924&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000043%2Fabstract%3Frss%3Dyes Active screening of patients at risk for HCC has led to the identification of early HCCs that are amenable to treatment with a high rate of cure. This requires high-quality ultrasound examinations at 6-month intervals. If widely applied, screening has the potential to substantially reduce the mortality from this disease. The application of the Barcelona Cancer of the Liver Clinic (BCLC) staging system should standardize assessment of prognosis and determination of the most effective treatments for each stage. With new molecular targeted agents coming, it is critical that studies are performed in patients stratified by stage into homogeneous groups. Because it is linked with therapy, the BCLC is ideally suited to this purpose. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946924 Sat, 30 Apr 2011 23:00:00 +0100 4946924 http://www.medworm.com/index.php?rid=4946923&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000110%2Fabstract%3Frss%3Dyes This article discusses the molecular and genomic changes that are important in hepatocellular carcinoma in order for clinicians to understand the current and forthcoming treatment options for patients with liver cancer. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946923 Sat, 30 Apr 2011 23:00:00 +0100 4946923 http://www.medworm.com/index.php?rid=4946922&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000134%2Fabstract%3Frss%3Dyes Early diagnosis of hepatocellular carcinoma (HCC) has a significant impact on survival by implementation of effective treatment strategies, including hepatic resection, locoregional ablative therapy, and liver transplantation. The use of serum tumor markers and biopsy are particularly important for diagnosis of small hepatic lesions with atypical features on imaging studies. α-Fetoprotein remains the most frequently used tumor marker for the diagnosis of HCC. The development of novel serum biomarkers for HCC, identification of molecular markers for tissue immunohistochemistry, and emergence of new diagnostic techniques such as proteomic profiling may improve the early detection rate of HCC in the future. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946922 Sat, 30 Apr 2011 23:00:00 +0100 4946922 http://www.medworm.com/index.php?rid=4946921&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000080%2Fabstract%3Frss%3Dyes Coinciding with the increased incidence of hepatocellular carcinoma (HCC), there has been a significant increase in the global incidence of obesity and diabetes mellitus (DM), the two major risk factors for nonalcoholic steatohepatitis (NASH). There are many causes of HCC, and nonalcoholic fatty liver disease/NASH is now emerging as a leading risk factor owing to the epidemic of obesity and type 2 DM. The mechanisms leading to HCC in obesity and type 2 DM likely involve interactions between several signaling pathways, including oxidative stress, inflammation, oncogenes, adiponectins, and insulin resistance associated with visceral adiposity and diabetes. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946921 Sat, 30 Apr 2011 23:00:00 +0100 4946921 http://www.medworm.com/index.php?rid=4946920&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611100002X%2Fabstract%3Frss%3Dyes HBV and HCV have major roles in hepatocarcinogenesis. More than 500 million people are infected with hepatitis viruses and, therefore, HCC is highly prevalent, especially in those countries endemic for HBV and HCV. Viral and host factors contribute to the development of HCC. The main viral factors include the circulating load of HBV DNA or HCV RNA and specific genotypes. Various mechanisms are involved in the host-viral interactions that lead to HCC development, among which are genetic instability, self-sufficiency in growth signals, insensitivity to antigrowth signals, evasion of apoptosis, limitless replicative potential, sustained angiogenesis, and tissue invasiveness. Prevention of HBV by vaccination, as well as antiviral therapy against HBV and for HCV seem able to inhibit the develop... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946920 Sat, 30 Apr 2011 23:00:00 +0100 4946920 http://www.medworm.com/index.php?rid=4946919&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000055%2Fabstract%3Frss%3Dyes A better understanding of signaling pathways in HCC pathogenesis has led to targeted therapies against HCC. Identification of liver cancer stem cell markers and their related pathways is one of the most important goals of liver cancer research. New therapies should ideally target cancer stem cells and not normal stem/progenitor cells, because the latter are very important in regeneration and repair. Individualized HCC therapy will require better definition of patient subgroups that benefit most or should be protected from therapy failure and unwanted side effects. Tumor tissue acquisition should be mandatory, reversing the practice that was established years ago when targeted HCC therapy was but a pope dream. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946919 Sat, 30 Apr 2011 23:00:00 +0100 4946919 http://www.medworm.com/index.php?rid=4946918&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000079%2Fabstract%3Frss%3Dyes The global risk of hepatocellular carcinoma (HCC) has been largely driven by hepatitis B virus (HBV) infection for the past century, along with hepatitis C virus (HCV), aflatoxin, excessive alcohol consumption, and obesity/diabetes. The dominant effect of HBV on global HCC risk should decline as the population vaccinated against HBV grows older. Infection with HCV is also expected to decline. Projections of HCV-related HCC rates remaining high for another 30 years may be overly pessimistic. Alcohol may be less of a factor in HCC in coming years. However, obesity and diabetes may become even more important risk factors for HCC. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946918 Sat, 30 Apr 2011 23:00:00 +0100 4946918 http://www.medworm.com/index.php?rid=4946917&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611100016X%2Fabstract%3Frss%3Dyes Hepatocellular carcinoma, commonly acronymized as HCC, is a scourge and a tragedy. Who would argue against the sentiment that HCC, for which the incidence and mortality virtually par and the global death toll is over half a million annually, is a blight on humanity. The tragedy is that HCC is largely preventable, theoretically at least. The major risk factors for HCC, namely chronic hepatitis B and C infection, are avoidable and treatable. Aflatoxin, which synergizes with hepatitis B in hepatocarcinogenesis, could be eradicated if cereals, nuts, and legumes were stored below 50°F at less than 17% humidity. Whether or not the pandemic of obesity and diabetes is due to a “Thrifty Gene” that evolved to conserve bodily energy in lean times, but is detrimental in our “obesogenic” envir... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946917 Sat, 30 Apr 2011 23:00:00 +0100 4946917 http://www.medworm.com/index.php?rid=4946916&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000237%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946916 Sat, 30 Apr 2011 23:00:00 +0100 4946916 http://www.medworm.com/index.php?rid=4946915&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000225%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946915 Sat, 30 Apr 2011 23:00:00 +0100 4946915 http://www.medworm.com/index.php?rid=4946914&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326111000213%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4946914 Sat, 30 Apr 2011 23:00:00 +0100 4946914 http://www.medworm.com/index.php?rid=4204119&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001650%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204119 Sat, 27 Nov 2010 05:09:37 +0100 4204119 http://www.medworm.com/index.php?rid=4204118&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000084X%2Fabstract%3Frss%3Dyes Liver diseases related to pregnancy may be associated with preeclampsia (liver dysfunction related to preeclampsia; hemolysis, elevated liver enzymes, and low platelets with or without preeclampsia [HELLP syndrome]; and acute fatty liver of pregnancy) or may not involve preeclampsia (hyperemesis gravidarum and intrahepatic cholestasis of pregnancy). Liver diseases associated with pregnancy have unique presentations, but it can be difficult differentiating these from liver diseases that occur coincidentally with pregnancy. Recently, advances have been made in the disease mechanism and intervention of pregnancy-related liver diseases. Early diagnosis and delivery remains the key element in managing the liver diseases associated with preeclampsia, but emerging data suggest that incorporating ... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204118 Sat, 27 Nov 2010 05:09:37 +0100 4204118 http://www.medworm.com/index.php?rid=4204117&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000814%2Fabstract%3Frss%3Dyes Liver dysfunction is common in both the critically ill and postoperative patient. Metabolic derangements secondary to sepsis, poor hepatic perfusion, total parenteral nutrition, in addition to hemodynamic and anesthetic-induced changes that occur during surgery, can cause liver damage ranging from small self-limited abnormalities in liver chemistries to acute liver failure. Early recognition, supportive care, and effective treatment of the underlying disease process are crucial steps in managing liver disease in a critically ill patient. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204117 Sat, 27 Nov 2010 05:09:37 +0100 4204117 http://www.medworm.com/index.php?rid=4204116&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000784%2Fabstract%3Frss%3Dyes This article reviews the medical literature and discusses the spectrum of dermatologic manifestations of liver disorders and their pathogenesis, significance, and treatment. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204116 Sat, 27 Nov 2010 05:09:37 +0100 4204116 http://www.medworm.com/index.php?rid=4204115&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000838%2Fabstract%3Frss%3Dyes This article reviews the spectrum of liver-related abnormalities associated with several rheumatologic diseases. Hepatotoxicity related to medications commonly prescribed in such conditions is also discussed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204115 Sat, 27 Nov 2010 05:09:36 +0100 4204115 http://www.medworm.com/index.php?rid=4204114&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000899%2Fabstract%3Frss%3Dyes Hepatitis C virus-Human immunodeficiency virus (HCV-HIV) coinfections are identified in up to 30% of patients infected with HIV and in 8% of patients infected with HCV. Now that progression of HIV and deaths due to AIDS can be prevented by highly active antiretroviral therapy (HAART), it is clear that HCV coinfection is associated with accelerated progression to cirrhosis and increased liver-related morbidity and mortality. Antiviral therapy with pegylated interferon and ribavirin for HCV in HCV-HIV coinfected patients is less successful than in patients with HCV monoinfection, and HAART can cause drug-induced liver injury. Multiple barriers limit the number of HCV-HIV coinfected patients who receive antiviral therapy for HCV, and the role of orthotopic liver transplantation (OLT) in HIV m... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204114 Sat, 27 Nov 2010 05:09:36 +0100 4204114 http://www.medworm.com/index.php?rid=4204113&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000796%2Fabstract%3Frss%3Dyes This article reviews the involvement of the liver during systemic infections with organisms that are not considered to be primarily hepatotropic. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204113 Sat, 27 Nov 2010 05:09:36 +0100 4204113 http://www.medworm.com/index.php?rid=4204112&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000802%2Fabstract%3Frss%3Dyes This article reviews aspects of pathogenesis, diagnosis, and management of hepatobiliary manifestations associated with a selection of gastrointestinal and nutritional disorders including inflammatory bowel disease, celiac disease, Whipple's disease, and parenteral nutrition associated disorders. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204112 Sat, 27 Nov 2010 05:09:36 +0100 4204112 http://www.medworm.com/index.php?rid=4204111&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000905%2Fabstract%3Frss%3Dyes This article discusses the most common hematologic and oncologic disorders and their effect on the liver. The section on nonmalignant hematologic disorders includes the anemias, paroxysmal nocturnal hemoglobinuria, disseminated intravascular coagulation, malaria, Banti syndrome, the porphyrias, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. Malignant hematologic conditions include leukemias, lymphomas, and myeloproliferative disorders. Other conditions causing portal hypertension and hepatic metastases are also discussed. The most commonly encountered hepatic manifestations of hematologic and oncologic disorders are reviewed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204111 Sat, 27 Nov 2010 05:09:36 +0100 4204111 http://www.medworm.com/index.php?rid=4204110&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000851%2Fabstract%3Frss%3Dyes The objective of this review is to focus on the effect of endocrine disorders on liver. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204110 Sat, 27 Nov 2010 05:09:36 +0100 4204110 http://www.medworm.com/index.php?rid=4204109&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000887%2Fabstract%3Frss%3Dyes Many liver diseases coexist with chronic renal disease, because many systemic conditions affect both the liver and the kidneys. Certain liver diseases are also common in patients with chronic renal disease, especially viral hepatitis, either because the renal disease occurs as a complication of viral hepatitis, or the viral hepatitis is acquired as a result of dialysis. Renal tubular dysfunction is also frequently observed with cholestasis. However, liver complications of renal diseases are extremely uncommon, notable examples include nephrogenic ascites and nephrogenic hepatic dysfunction. Nephrogenic ascites can mimic liver cirrhosis with ascites, and it improves with renal transplantation. Nephrogenic hepatic dysfunction is a manifestation of renal cell carcinoma, which settles with the... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204109 Sat, 27 Nov 2010 05:09:35 +0100 4204109 http://www.medworm.com/index.php?rid=4204108&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000826%2Fabstract%3Frss%3Dyes Chronic liver disease is associated with many pulmonary complications. Several, including hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax have been extensively reviewed. However, hepatobiliary manifestations of primary pulmonary diseases have received less attention. This review focuses on hepatobiliary complications of respiratory failure, cystic fibrosis, α-1 antitrypsin deficiency, sarcoidosis, and tuberculosis. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204108 Sat, 27 Nov 2010 05:09:35 +0100 4204108 http://www.medworm.com/index.php?rid=4204107&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000875%2Fabstract%3Frss%3Dyes The dual blood supply of the liver, originating from the portal vein and the hepatic artery, makes it relatively resistant to minor circulatory disturbances. However, hepatic manifestations of common cardiovascular disorders are frequently encountered in both the inpatient and outpatient setting. Beginning with the macro- and microcirculation of the liver, this article reviews the pathophysiology of hepatic blood flow and gives a detailed appraisal of ischemic hepatitis, congestive hepatopathy, and other less common hepatic conditions that arise when cardiovascular function is impaired. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204107 Sat, 27 Nov 2010 05:09:35 +0100 4204107 http://www.medworm.com/index.php?rid=4204106&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000863%2Fabstract%3Frss%3Dyes Hepatobiliary manifestations can be the clinical presentation of other systemic disorders that are commonly seen in our daily practice and usually require gastroenterology or hepatology consultation. Understanding these clinical issues would enrich our knowledge and improve outcomes of the patient care. Some of these conditions have been well reviewed in a 2002 issue of Clinics in Liver Disease edited by Dr Herbert L. Bonkovsky. This issue of Clinics in Liver Disease denotes to an updated and systematic review on hepatobiliary manifestations of other systemic disorders. It has been my privilege and pleasure to assemble a group of expert clinicians to present their views and share their vast experiences in these complicated clinical issues. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204106 Sat, 27 Nov 2010 05:09:35 +0100 4204106 http://www.medworm.com/index.php?rid=4204105&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001649%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204105 Sat, 27 Nov 2010 05:09:35 +0100 4204105 http://www.medworm.com/index.php?rid=4204104&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001637%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204104 Sat, 27 Nov 2010 05:09:35 +0100 4204104 http://www.medworm.com/index.php?rid=4204103&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001625%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4204103 Sat, 27 Nov 2010 05:09:35 +0100 4204103 http://www.medworm.com/index.php?rid=4145471&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001327%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145471 Mon, 01 Nov 2010 00:00:00 +0100 4145471 http://www.medworm.com/index.php?rid=4145470&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000711%2Fabstract%3Frss%3Dyes Recent publications on hepatology and hepatic pathology provide a wealth of new information on wideranging topics. Morphologic aspects of liver disease associated with hepatitis B and C viruses, autoimmune hepatitis, and HIV infection were addressed, as was the prevalent problem of nonalcoholic fatty liver disease. Advances in diagnosis and pathogenesis of primary biliary cirrhosis, primary sclerosing cholangitis, and the increasingly complex spectrum of IgG4 hepatobiliary diseases were also reported. The histologic and immunohistochemical features of the rare “calcifying nested stromal-epithelial tumor” of the liver were described in a 9-case series. For benign and malignant liver tumors, immunohistochemistry plays a major diagnostic role, and several recent studies demonstrate the v... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145470 Mon, 01 Nov 2010 00:00:00 +0100 4145470 http://www.medworm.com/index.php?rid=4145469&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000668%2Fabstract%3Frss%3Dyes This article reviews the most common metabolic disorders in humans that are associated with neoplasms, with a special emphasis on the molecular etiopathogenesis of this process. The cellular pathways driving carcinogenesis are poorly understood, but best known in tyrosinemia. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145469 Mon, 01 Nov 2010 00:00:00 +0100 4145469 http://www.medworm.com/index.php?rid=4145468&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000723%2Fabstract%3Frss%3Dyes This article is dedicated to hepatocellular tumors and also addresses hemangiomas as the most common benign liver tumors, and angiomyolipomas as a rare tumor often misdiagnosed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145468 Mon, 01 Nov 2010 00:00:00 +0100 4145468 http://www.medworm.com/index.php?rid=4145467&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000772%2Fabstract%3Frss%3Dyes Liver progenitor cells are activated in most human liver diseases. The dynamics, and therefore subpopulations, of progenitor cells are, however, different in acute versus chronic hepatocytic diseases and in biliary diseases. The role of Wnt and Notch signaling pathways in activation and differentiation of human hepatic progenitor cells holds great promise because they can be manipulated by drugs. Hepatocytic differentiation requires inhibition of Notch (numb switched on), whereas cholangiocytic differentiation requires Notch activation. In this way, the patients’ own regenerative response could be supported, which could eventually even avoid the need for transplantation in several patients. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145467 Mon, 01 Nov 2010 00:00:00 +0100 4145467 http://www.medworm.com/index.php?rid=4145466&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000917%2Fabstract%3Frss%3Dyes A variety of benign and malignant neoplasms can be encountered in the liver. Hematoxylin and eosin–stained tissue sections alone may not yield sufficient information to definitively diagnose liver tumors; therefore, ancillary studies with immunohistochemical markers can play a crucial role in differentiating the different hepatic neoplasms. The recent development of oncofetoprotein glypican-3 has added to the value of immunohistochemistry in diagnosing liver cancer. This review discusses the immunohistochemical markers used most often in the diagnosis of hepatic tumors. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145466 Mon, 01 Nov 2010 00:00:00 +0100 4145466 http://www.medworm.com/index.php?rid=4145465&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000681%2Fabstract%3Frss%3Dyes This article describes the progress achieved during the past 2 years in developing multiplex quantum dot (nanoparticle) staining and combining it with high-resolution whole-slide imaging using a slide scanner equipped with filters to capture 9 distinct fluorescent signals for multiple antigens. The authors first focused on precise characterization of leukocyte subsets, but soon realized that the data generated were beyond the practical limits that could be properly evaluated, analyzed, and interpreted visually by a pathologist. Therefore, the authors collaborated with the open source FARSIGHT image analysis project (http://www.farsight-toolkit.org). FARSIGHT's goal is to develop and disseminate the next-generation toolkit of automated image analysis methods to enable quantification of mole... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145465 Mon, 01 Nov 2010 00:00:00 +0100 4145465 http://www.medworm.com/index.php?rid=4145464&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000735%2Fabstract%3Frss%3Dyes Sinusoidal obstruction syndrome (SOS), formerly named venoocclusive disease, is a well-known complication of hematopoietic stem cell transplantation and ingestion of food or drinks contaminated by pyrrolizidine alkaloids. Many other drugs and toxins have been associated with SOS, including several chemotherapeutic agents and immunosuppressors. SOS contributes to significant morbidity and mortality in all these settings. This review describes the histologic lesions of SOS, details its pathogenesis as it is understood today, specifies the recent data on its causes and how it may influence clinical management of colorectal liver metastases, and discusses the current knowledge on diagnosis and preventive options. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145464 Mon, 01 Nov 2010 00:00:00 +0100 4145464 http://www.medworm.com/index.php?rid=4145463&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000760%2Fabstract%3Frss%3Dyes Hepatic vascular disorders are a set of conditions that may be acute, or may be insidious and subclinical for many years. They can be organized into 3 categories: obstruction to hepatic vascular inflow, obstruction to blood flow through the liver, and obstruction to hepatic vascular outflow. In the first category are portal vein thrombosis, hepatic artery thrombosis, and presinusoidal causes of vascular obstruction. In the second category are sickle cell disease, disseminated intravascular coagulation, intrasinusoidal malignancy, and infection. In the third category are macroscopic hepatic venous thrombosis, thrombosis of the retrohepatic inferior vena cava, and venoocclusive disease. There are 2 nodular conditions of the liver that are not neoplastic but the result of occlusion of hepatic... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145463 Mon, 01 Nov 2010 00:00:00 +0100 4145463 http://www.medworm.com/index.php?rid=4145462&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000759%2Fabstract%3Frss%3Dyes This article describes the uses of immunostaining in the diagnosis of cholestasis. To immunostain for bile salt export pump (BSEP) and multidrug resistance protein 3 in severe hepatobiliary disease manifest early in life can rapidly identify whether sequencing of ABCB11 or ABCB4 is likely to yield a genetic diagnosis. To immunostain for canalicular ectoenzymes as well as transporters, with transmission electron microscopy, can suggest whether sequencing of ATP8B1 is likely to yield a genetic diagnosis. Demonstrating BSEP expression can direct attention to bile acid synthesis disorders. Immunostaining for multidrug resistance-associated protein 2 serves principally as a control for adequacy of processing. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145462 Mon, 01 Nov 2010 00:00:00 +0100 4145462 http://www.medworm.com/index.php?rid=4145461&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000693%2Fabstract%3Frss%3Dyes Granulomatous liver disease constitutes a category of hepatic disorders and is at present diagnosed in approximately 4% of liver biopsies. Hepatic granulomas develop through the interactions of T lymphocytes and macrophages, with the integral involvement of T-helper (TH) 1 or TH2 pathways or both, depending on the specific granulomatous disease. Hepatic granulomas may be manifested clinically by elevated levels of serum alkaline phosphatase and g-glutamyltransferase enzymes, damage to specific structures (eg, intrahepatic bile ducts in primary biliary cirrhosis), or infrequently, progressive liver disease with portal hypertension and cirrhosis (eg, sarcoidosis). Systemic immunologic disorders, infectious diseases, drug hepatotoxicity, and reaction to neoplastic disease are the major causat... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145461 Mon, 01 Nov 2010 00:00:00 +0100 4145461 http://www.medworm.com/index.php?rid=4145460&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000070X%2Fabstract%3Frss%3Dyes This article describes histologic findings, and provides insights into the pathologic processes and clinical implications across the spectrum of NAFLD. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145460 Mon, 01 Nov 2010 00:00:00 +0100 4145460 http://www.medworm.com/index.php?rid=4145459&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000067X%2Fabstract%3Frss%3Dyes This article outlines the many histologic faces of autoimmune hepatitis. It discusses the fulminant and acute forms, as well as the chronic hepatitic forms. Overlap syndromes with primary biliary cirrhosis and primary sclerosing cholangitis are described. The role of the pathologist in reporting the biopsies is discussed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145459 Mon, 01 Nov 2010 00:00:00 +0100 4145459 http://www.medworm.com/index.php?rid=4145458&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000656%2Fabstract%3Frss%3Dyes This article outlines the clinical course and serologic diagnosis of HBV and HCV for the clinician and the pathologist, who together have a close working relationship in managing patients with acute and chronic liver disease. The salient histologic features are elucidated in an attempt to provide the clinician with an understanding of the basic histopathology underlying chronic HCV and HBV. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145458 Mon, 01 Nov 2010 00:00:00 +0100 4145458 http://www.medworm.com/index.php?rid=4145457&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000747%2Fabstract%3Frss%3Dyes This issue of Clinics in Liver Disease is a forum on liver pathology, with contributions by an expert panel of hepatic pathologists on many of the current diagnostic issues of hepatology, including assessment of biopsy changes in, as well as grading and staging of, chronic hepatitis B and C and autoimmune hepatitis, the spectrum of changes in nonalcoholic fatty liver disease (NAFLD), and manifestations of post-liver transplantation liver injury. Genomic and molecular diagnostics and immunohistochemistry have had a major impact on liver pathology practices, and these are also discussed in this issue. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145457 Mon, 01 Nov 2010 00:00:00 +0100 4145457 http://www.medworm.com/index.php?rid=4145456&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001315%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145456 Mon, 01 Nov 2010 00:00:00 +0100 4145456 http://www.medworm.com/index.php?rid=4145455&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001303%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145455 Mon, 01 Nov 2010 00:00:00 +0100 4145455 http://www.medworm.com/index.php?rid=4145454&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110001297%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=4145454 Mon, 01 Nov 2010 00:00:00 +0100 4145454 http://www.medworm.com/index.php?rid=3759723&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000553%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759723 Sat, 17 Jul 2010 05:42:55 +0100 3759723 http://www.medworm.com/index.php?rid=3759721&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000395%2Fabstract%3Frss%3Dyes Prevention is most cost effective toward successful control of hepatitis B virus (HBV) infection and its complications. It is particularly urgent where HBV infection and hepatocellular carcinoma (HCC) are prevalent. To achieve better results of primary HCC prevention globally, higher world coverage rates of HBV vaccine, better strategies against breakthrough infection/nonresponder, and good long-term protection are needed. With the universal hepatitis B vaccination program starting from neonates in most countries, HBV infection and its complications will be further reduced in this century. An effective decline in the incidence of HCC in adults is expected in the near future. The concept of a cancer preventive vaccine, using HBV as an example, can be applied further to other infectious agen... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759721 Sat, 17 Jul 2010 05:42:55 +0100 3759721 http://www.medworm.com/index.php?rid=3759720&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000310%2Fabstract%3Frss%3Dyes This article highlights treatment options in these special populations. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759720 Sat, 17 Jul 2010 05:42:55 +0100 3759720 http://www.medworm.com/index.php?rid=3759719&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000371%2Fabstract%3Frss%3Dyes Providing appropriate treatment and follow-up to hepatitis B virus (HBV)–infected mothers and their newborns is critical in preventing HBV mother-to-child transmission (MTCT) and eradicating HBV infection. Although highly effective in preventing MTCT, standard passive-active immunoprophylaxis with hepatitis B immunoglobulin and the hepatitis B vaccine may have a failure rate as high as 10% to 15%. Antiviral treatment has been used during pregnancy and may decrease MTCT. Several issues must be addressed in future clinical studies before universal recommendations for antiviral therapy for pregnant women can be made. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759719 Sat, 17 Jul 2010 05:42:55 +0100 3759719 http://www.medworm.com/index.php?rid=3759718&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000358%2Fabstract%3Frss%3Dyes The consequences of chronic hepatitis B virus infection include hepatocellular carcinoma and liver cirrhosis. Effective antiviral therapy in patients with hepatitis B with advanced liver disease with viral suppression and sustained HBeAg seroconversion (where applicable) may abort hepatic decompensation, diminish hepatocellular risk, and reduce the risk of viral recurrence after transplantation. Overt hepatic decompensation is an indication for referral to a transplant center. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759718 Sat, 17 Jul 2010 05:42:55 +0100 3759718 http://www.medworm.com/index.php?rid=3759717&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000383%2Fabstract%3Frss%3Dyes Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third leading cause of cancer-related deaths. More than 80% of HCC cases are from the Asian and African continents, and more than 50% of cases are from mainland China. Approximately 350 million to 400 million persons are chronically infected with hepatitis B virus (HBV), and this virus is the most common cause of HCC worldwide. It is estimated that more than 50% of liver cancers worldwide are attributable to HBV and up to 89% of HBV-related HCC are from developing countries. Recently, increasing trends in HCC incidence have been reported from several Western countries, including France, Australia, and the United States. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759717 Sat, 17 Jul 2010 05:42:54 +0100 3759717 http://www.medworm.com/index.php?rid=3759716&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000334%2Fabstract%3Frss%3Dyes The introduction of nucleos(t)ide analog therapy has seen the emergence of antiviral drug resistance, which has become the main factor limiting the long-term application of these antiviral agents for patients with chronic hepatitis B. The prevention of resistance requires the adoption of strategies that effectively control virus replication and exploit an understanding of the mechanisms and processes that drive the emergence of drug resistance, namely high replication rates, low fidelity of the hepatitis B virus rt/polymerase, selective pressure of the nucleos(t)ide analog, role of replication space (liver turnover), fitness of the mutant, and genetic barrier to the drug. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759716 Sat, 17 Jul 2010 05:42:54 +0100 3759716 http://www.medworm.com/index.php?rid=3759715&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000346%2Fabstract%3Frss%3Dyes The goal of antiviral therapy for chronic hepatitis B is to prevent the development of cirrhosis and hepatocellular carcinoma. End points, including viral suppression, alanine aminotransferase normalization, hepatitis B e antigen loss, hepatitis B surface antigen loss, and improvement in liver histology, are used to determine treatment success. Treatment is based on hepatitis B virus (HBV) replication status and stage of liver disease, modulated by the age of the patient, hepatitis B e antigen (HBeAg) status and patient preference. Seven therapies are approved, including two formulations of interferon and five orally administered nucleos(t)ide analogs. These therapies are effective in suppressing HBV replication and have also been shown to prevent disease progression. (Source: Clinics in L... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759715 Sat, 17 Jul 2010 05:42:54 +0100 3759715 http://www.medworm.com/index.php?rid=3759714&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000462%2Fabstract%3Frss%3Dyes This article introduces the innate and adaptive immune defense mechanisms in general and as related to HBV. In particular, the current concepts regarding the innate and adaptive immune components contributing to the clinical, virologic and therapeutic outcome in acute and chronic hepatitis B are examined. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759714 Sat, 17 Jul 2010 05:42:54 +0100 3759714 http://www.medworm.com/index.php?rid=3759713&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000309%2Fabstract%3Frss%3Dyes This article serves to introduce the clinically relevant aspects of the HBV life cycle as they pertain to patient management. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759713 Sat, 17 Jul 2010 05:42:54 +0100 3759713 http://www.medworm.com/index.php?rid=3759712&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000036X%2Fabstract%3Frss%3Dyes In this article, the 4 phases of chronic HBV infection are reviewed and the factors that are associated with disease progression and the development of hepatocellular carcinoma (HCC) and cirrhosis are discussed. Also discussed is what is known to date about how to identify persons at the highest risk of developing HCC and/or cirrhosis. Finally, ways in which the natural history can be altered by hepatitis B vaccination and identification, close monitoring, and appropriate treatment of chronically infected individuals are reviewed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759712 Sat, 17 Jul 2010 05:42:54 +0100 3759712 http://www.medworm.com/index.php?rid=3759711&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000401%2Fabstract%3Frss%3Dyes It has been more than 4 decades since Australian antigen was discovered by Drs Blumberg, Alter, and their colleagues in 1967. During the subsequent decades of remarkable discoveries, hepatitis B virus was identified and its molecular structures, genome and life cycle, natural history of the chronic infection, and connection with chronic hepatitis and hepatocellular carcinoma were well characterized and understood. Based on this knowledge, an effective and safe vaccine was developed, which was later declared as the first cancer-preventing vaccine by the World Health Organization. With the understanding of its life cycle, a class of safe and effective, although not perfect, antiviral therapies had become available, which showed promising results in suppressing the hepatitis viral replication... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759711 Sat, 17 Jul 2010 05:42:54 +0100 3759711 http://www.medworm.com/index.php?rid=3759710&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000541%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759710 Sat, 17 Jul 2010 05:42:54 +0100 3759710 http://www.medworm.com/index.php?rid=3759709&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000053X%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759709 Sat, 17 Jul 2010 05:42:54 +0100 3759709 http://www.medworm.com/index.php?rid=3759708&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000528%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759708 Sat, 17 Jul 2010 05:42:54 +0100 3759708 http://www.medworm.com/index.php?rid=3759722&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000322%2Fabstract%3Frss%3Dyes There have been major advances in the field of hepatitis B (HBV) over the last few decades. These advances have resulted in the understanding of the natural history of chronic HBV infection, effective vaccines against the virus, sensitive assays for screening and monitoring of treatment, and effective treatments for viral suppression, all leading to improved outcomes. Debates and controversies remain, however, over the ideal management strategies of patients with chronic hepatitis B. To eradicate HBV, the global community needs to improve current preventive, screening, and treatment strategies. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3759722 Sun, 13 Jun 2010 23:00:00 +0100 3759722 http://www.medworm.com/index.php?rid=3637810&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000267%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637810 Fri, 30 Apr 2010 23:00:00 +0100 3637810 http://www.medworm.com/index.php?rid=3637809&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000115%2Fabstract%3Frss%3Dyes This article reviews the various biliary complications after liver transplantation (both deceased donor and living-related donor) and their endoscopic management. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637809 Fri, 30 Apr 2010 23:00:00 +0100 3637809 http://www.medworm.com/index.php?rid=3637808&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000139%2Fabstract%3Frss%3Dyes Primary sclerosing cholangitis is characterized by progressive fibrosing obliteration of the biliary tract. In some cases the disease is restricted to the small bile ducts, but most patients develop fibrotic stenoses of the larger bile ducts. Despite advances in magnetic resonance cholangiography, in unclear cases endoscopic retrograde cholangiography is necessary to make the correct diagnosis. In patients with total or subtotal strictures of the large bile ducts, these so-called dominant stenoses may be treated by endoscopic balloon dilatation and/or stent placement, though in the large majority of cases a stent placement is not necessary. Several studies showed an improvement of biochemical parameters after endoscopic treatment, and actuarial survival in these patients was improved compa... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637808 Fri, 30 Apr 2010 23:00:00 +0100 3637808 http://www.medworm.com/index.php?rid=3637807&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000140%2Fabstract%3Frss%3Dyes This article summarizes the data regarding the application of ERCP in the diagnosis and management of CCA. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637807 Fri, 30 Apr 2010 23:00:00 +0100 3637807 http://www.medworm.com/index.php?rid=3637806&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000176%2Fabstract%3Frss%3Dyes This article briefly reviews the current guidelines for surveillance and diagnosis of HCC in high-risk patients and the potential role of endoscopic ultrasound and fine-needle aspiration for the diagnosis of small HCC. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637806 Fri, 30 Apr 2010 23:00:00 +0100 3637806 http://www.medworm.com/index.php?rid=3637805&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000127%2Fabstract%3Frss%3Dyes The rate of rebleeding from esophageal varices remains appreciably high after cessation of acute esophageal variceal hemorrhage. Many measures have been developed to prevent the occurrence of rebleeding. Endoscopic therapy plays a central role in the prevention of variceal bleeding. In the 1980s sclerotherapy played a pivotal role in the prevention of variceal rebleeding, but now yields to endoscopic variceal ligation. Compared with sclerotherapy, a lower incidence of complications and rebleeding is associated with banding ligation. On the other hand, β-blockers are also noted to be able to reduce portal pressure, leading to the reduction of variceal rebleeding. The reduction of variceal rebleeding with β-blockers plus nitrates is as effective as banding ligation. The combination of β-b... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637805 Fri, 30 Apr 2010 23:00:00 +0100 3637805 http://www.medworm.com/index.php?rid=3637804&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000152%2Fabstract%3Frss%3Dyes Current recommendations for the treatment of acute variceal bleeding (AVB) are to combine hemodynamic stabilization, antibiotic prophylaxis, pharmacologic agents, and endoscopic treatment. However, despite the application of the current gold-standard pharmacologic and endoscopic treatment, failure to control bleeding or early rebleed within 5 days still occurs in 15% to 20% of patients with AVB. In case of treatment failure of the acute bleeding episode, if bleeding is mild and the patient is hemodynamically stable, a second endoscopic therapy may be attempted. If this fails, or if bleeding is severe, it is usually controlled temporarily with balloon tamponade until a definitive derivative treatment is applied. Transjugular intrahepatic portosystemic shunt is highly effective in this situa... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637804 Fri, 30 Apr 2010 23:00:00 +0100 3637804 http://www.medworm.com/index.php?rid=3637803&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000164%2Fabstract%3Frss%3Dyes Portal hypertensive gastropathy and gastric antral vascular ectasia may cause gastrointestinal hemorrhage in patients with portal hypertension. Whereas the former presents exclusively in patients with portal hypertension, gastric antral vascular ectasia can also be observed in patients with other conditions. Diagnosis is established with upper gastrointestinal endoscopy, although some cases may require a biopsy to confirm the diagnosis. The most frequent manifestation is ferropenic anemia, which may become transfusion dependent. Treatment in portal hypertensive gastropathy is focused on portal pressure reducing drugs, mainly nonselective β-blockers, whereas in gastric antral vascular ectasia treatment is based on endoscopic ablation. More invasive options can be used if first-line therapi... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637803 Fri, 30 Apr 2010 23:00:00 +0100 3637803 http://www.medworm.com/index.php?rid=3637802&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000103%2Fabstract%3Frss%3Dyes This article reviews the current endoscopic treatment modalities used in gastric variceal bleeding, and the primary and secondary prophylaxis of gastric variceal bleeding. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637802 Fri, 30 Apr 2010 23:00:00 +0100 3637802 http://www.medworm.com/index.php?rid=3637801&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932611000005X%2Fabstract%3Frss%3Dyes This article will review the current management strategies for acute variceal bleeding with emphasis on endoscopic therapy for the acute episode. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637801 Fri, 30 Apr 2010 23:00:00 +0100 3637801 http://www.medworm.com/index.php?rid=3637800&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000048%2Fabstract%3Frss%3Dyes Cirrhosis is the leading cause of portal hypertension in the Western world. From a clinical standpoint, the most significant consequence of portal hypertension is the development of esophageal varices. Despite the many advances in the management of variceal bleeding, it remains a life-threatening complication of portal hypertension. Primary prophylaxis to prevent the first bleeding episode in patients with cirrhosis and esophageal varices is therefore critically important in the management of patients with cirrhosis. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637800 Fri, 30 Apr 2010 23:00:00 +0100 3637800 http://www.medworm.com/index.php?rid=3637799&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000085%2Fabstract%3Frss%3Dyes This article summarizes the current knowledge on the role of EUS for the evaluation of portal hypertension. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637799 Fri, 30 Apr 2010 23:00:00 +0100 3637799 http://www.medworm.com/index.php?rid=3637798&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000073%2Fabstract%3Frss%3Dyes Since the introduction of small bowel capsule endoscopy, and more recently of esophageal capsule endoscopy, these diagnostic tools have become available for the evaluation of the consequences of portal hypertension in the esophagus, stomach, and small intestine. The main advantage of the esophageal and the small bowel capsule is the relatively less invasiveness that could potentially increase patients' adherence to endoscopic screening/surveillance programs. When esophageal capsule endoscopy was compared with traditional gastroscopy, it showed good sensitivity and specificity in recognizing the presence and the size of esophageal varices. However, the results are not consistent among studies, and more data are needed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637798 Fri, 30 Apr 2010 23:00:00 +0100 3637798 http://www.medworm.com/index.php?rid=3637797&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000097%2Fabstract%3Frss%3Dyes Portal hypertension is defined as an increase in hepatic sinusoidal pressure to 6 mm Hg or higher. Cirrhosis is the most common cause of portal hypertension in the western world and results from increased resistance to blood flow at the hepatic sinusoidal level. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637797 Fri, 30 Apr 2010 23:00:00 +0100 3637797 http://www.medworm.com/index.php?rid=3637796&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000061%2Fabstract%3Frss%3Dyes Endoscopic procedures are often necessary in patients with chronic liver disease. The preprocedure evaluation of such patients should include an assessment of hepatic synthetic function and identification of neuropsychiatric findings suggestive of hepatic encephalopathy. It may be possible, in some cases, to perform diagnostic esophagogastroduodenoscopy without administration of sedation; this is desirable to eliminate the risks of sedation, especially encephalopathy. Nonetheless, most patients undergoing upper and lower endoscopy require sedation. Currently, the use of propofol is preferred to benzodiazepines and opioids for endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and low risk of provoking hepatic encephalopathy. In appropriately sel... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637796 Fri, 30 Apr 2010 23:00:00 +0100 3637796 http://www.medworm.com/index.php?rid=3637795&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000188%2Fabstract%3Frss%3Dyes The field of hepatology has advanced enormously in the past two decades. Novel diagnostic and therapeutic interventions in clinical hepatology and liver transplantation have grown exponentially during this period, and subspecialty interests have emerged within the liver disease arena. Endoscopy plays an important role in the management of patients of hepatobiliary diseases, yet it has remained in the periphery of this specialty. We believe that a better understanding of the indications, the diagnostic and therapeutic possibilities, the limitations, and the potential complications of endoscopic interventions are essential for those who manage patients with chronic hepatobiliary diseases and liver transplantation. In this issue, we have assembled an outstanding group of experts in the field ... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637795 Fri, 30 Apr 2010 23:00:00 +0100 3637795 http://www.medworm.com/index.php?rid=3637794&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000255%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637794 Fri, 30 Apr 2010 23:00:00 +0100 3637794 http://www.medworm.com/index.php?rid=3637793&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000243%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637793 Fri, 30 Apr 2010 23:00:00 +0100 3637793 http://www.medworm.com/index.php?rid=3637792&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326110000231%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3637792 Fri, 30 Apr 2010 23:00:00 +0100 3637792 http://www.medworm.com/index.php?rid=3206230&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109001032%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206230 Tue, 26 Jan 2010 14:22:07 +0100 3206230 http://www.medworm.com/index.php?rid=3206229&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000889%2Fabstract%3Frss%3Dyes This article examines the diagnosis of acute infection and critically appraises the various treatment regimens. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206229 Tue, 26 Jan 2010 14:22:07 +0100 3206229 http://www.medworm.com/index.php?rid=3206228&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000841%2Fabstract%3Frss%3Dyes Transmission of hepatitis B and C from health care workers to patients remains rare in developed medical care systems but may be more common in systems that are still developing. Since the 1970s, at least 69 health care workers infected with hepatitis B or C have been implicated in transmission of their infection. This likely underestimates the magnitude of the problem. In this article, risk factors associated with transmission are reviewed and infection prevention and control practices outlined. Management of infected providers is also discussed. National guidelines are compared, highlighting different countries' approaches to this complex challenge. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206228 Tue, 26 Jan 2010 14:22:07 +0100 3206228 http://www.medworm.com/index.php?rid=3206227&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000853%2Fabstract%3Frss%3Dyes This article highlights the importance of basic infection control and the need for increased awareness of safe injection practices. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206227 Tue, 26 Jan 2010 14:22:07 +0100 3206227 http://www.medworm.com/index.php?rid=3206226&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000865%2Fabstract%3Frss%3Dyes This article reviews patient-to-provider, patient-to-patient, and provider-to-patient transmission of hepatitis B and C in the health care setting. Current prevention strategies, precautions, and guidelines are discussed. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206226 Tue, 26 Jan 2010 14:22:07 +0100 3206226 http://www.medworm.com/index.php?rid=3206225&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS108932610900083X%2Fabstract%3Frss%3Dyes This article begins with an overview of the relevant sources of law and then explores legal duties and liability arising from two major categories of risk: occupational risks to health care providers and health care–associated risks to patients and other third parties. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206225 Tue, 26 Jan 2010 14:22:07 +0100 3206225 http://www.medworm.com/index.php?rid=3206224&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000919%2Fabstract%3Frss%3Dyes This article describes the epidemiology of HBV and HCV and their particular risks to DHCP. Hepatitis B vaccination is discussed, as is postexposure management recommendations for both HBV and HCV. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206224 Tue, 26 Jan 2010 14:22:07 +0100 3206224 http://www.medworm.com/index.php?rid=3206223&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000944%2Fabstract%3Frss%3Dyes Acute hepatitis B virus (HBV) is a common cause of acute icteric hepatitis in adults. The vast majority of these patients resolve this acute infection and develop long-lasting immunity. In contrast, the vast majority of patients who develop chronic HBV have minimal symptoms and do not develop jaundice after becoming infected with HBV. These patients will frequently remain undiagnosed for years or decades. Approximately 1% of persons with acute HBV develop acute liver failure. Preventing acute HBV with vaccination is the best treatment. Although universal vaccination is now administered to newborns in many countries, the majority of adults have not been vaccinated and remain at risk. Because the majority of patients with acute HBV resolve this infection spontaneously, treatment with an oral... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206223 Tue, 26 Jan 2010 14:22:07 +0100 3206223 http://www.medworm.com/index.php?rid=3206222&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000877%2Fabstract%3Frss%3Dyes The risk of acquiring hepatitis B and C in the oncology setting was historically high and predominantly related to blood product administration in the prescreening era. With the development of progressively more sophisticated testing for hepatitis B and C, breaches in infection control have played an increasingly prominent role in disease transmission. Optimizing infection control in inpatient and outpatient oncology settings is essential in preventing the health care–associated transmission of hepatitis B and C to oncology patients. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206222 Tue, 26 Jan 2010 14:22:07 +0100 3206222 http://www.medworm.com/index.php?rid=3206221&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000932%2Fabstract%3Frss%3Dyes The risk for potential transmission of infectious agents during gastrointestinal (GI) endoscopy is concerning for patients and physicians. However, the instance of infection transmission remains rare after GI endoscopy procedures, with an estimated frequency of 1 in 1.8 million procedures. Endoscopy-related infection may occur when microorganisms are spread or transmitted from patient to patient by contaminated endoscopic or accessory equipments; from the GI tract through the bloodstream during endoscopy to susceptible organs or prostheses, or spread to adjacent tissues that are breached as a result of the endoscopy procedure; or from patients to endoscopy personnel and perhaps from endoscopy personnel to patients. Proper cleaning, disinfection, and reprocessing of endoscopies and accessor... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206221 Tue, 26 Jan 2010 14:22:07 +0100 3206221 http://www.medworm.com/index.php?rid=3206220&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000920%2Fabstract%3Frss%3Dyes This article summarizes the most recent information on epidemiology, clinical significance, and management of infection by hepatitis B and C viruses in this population. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206220 Tue, 26 Jan 2010 14:22:07 +0100 3206220 http://www.medworm.com/index.php?rid=3206219&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000890%2Fabstract%3Frss%3Dyes The term “molecular epidemiology” has been ascribed to a host of different activities that involve gene-sequence analysis. Some examples of molecular epidemiology include modeling exercises of phylogenetic trees to reconstruct epidemics; studies of the evolution of hepatitis C virus (HCV); rates of nucleotide substitution in the hepatitis B virus (HBV) surface (S) gene; variations in the core promoter/pre-core/core region of HBV genotype C from different sources; analysis of HBV surface antigen mutations; molecular clock analyses of the short-term evolution of HCV; and analyses of clades and surface antigen polymorphisms of HBV. However, for most epidemiologists molecular epidemiology of viral hepatitis usually refers to studies of gene-sequence homology in HBV or HCV recovered from pe... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206219 Tue, 26 Jan 2010 14:22:07 +0100 3206219 http://www.medworm.com/index.php?rid=3206218&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000828%2Fabstract%3Frss%3Dyes This article reviews the epidemiology of occupational exposures to hepatitis B and hepatitis C in health care personnel in hospital settings. The nature and likelihood of risk to health care personnel are evaluated along with estimates of seroconversion risk. The review focuses on prevention programs and available surveillance programs to aid in monitoring and reducing occupational exposures to blood-borne pathogens. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206218 Tue, 26 Jan 2010 14:22:07 +0100 3206218 http://www.medworm.com/index.php?rid=3206217&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000907%2Fabstract%3Frss%3Dyes This article reviews the prevalence, disease burden, genotype distribution, and transmission patterns of hepatitis B virus (HBV) and hepatitis C virus in the 6 World Health Organization regions. The global epidemiology of hepatitis B and C demonstrates a predominantly declining prevalence of the diseases. Improvement in the control of hepatitis B has been largely achieved with implementation of a more universal HBV vaccine program, although a large gap still remains in the effort toward global prevention of hepatitis B. The transmission of hepatitis C has been greatly impacted by mandatory screening of blood donors in most countries in the world, although intravenous drug use continues to be a major source of infection. Public education regarding the risks of exposure to infected paraphern... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206217 Tue, 26 Jan 2010 14:22:06 +0100 3206217 http://www.medworm.com/index.php?rid=3206216&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000956%2Fabstract%3Frss%3Dyes Worldwide, a number of health care transmission outbreaks of infectious diseases, particularly hepatitis, in the past decade indicate startling evidence of an ongoing transmission of hepatitis in a health care setting. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206216 Tue, 26 Jan 2010 14:22:06 +0100 3206216 http://www.medworm.com/index.php?rid=3206215&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109001020%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206215 Tue, 26 Jan 2010 14:22:06 +0100 3206215 http://www.medworm.com/index.php?rid=3206214&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109001019%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=3206214 Tue, 26 Jan 2010 14:22:06 +0100 3206214 http://www.medworm.com/index.php?rid=2873597&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000737%2Fabstract%3Frss%3Dyes (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873597 Fri, 09 Oct 2009 09:29:11 +0100 2873597 http://www.medworm.com/index.php?rid=2873596&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000646%2Fabstract%3Frss%3Dyes As the worldwide obesity epidemic continues to increase, the prevalence of non-alcoholic fatty liver disease (NAFLD) and specifically non-alcoholic steatohepatitis (NASH) will become increasingly prominent. NASH will surpass chronic hepatitis C infection as the primary indication for orthotopic liver transplantation in the near future. With the evolution of surgical techniques, bariatric surgery is currently recognized as the most effective method for achieving sustained weight loss and reversing numerous comorbidities in severely obese individuals. This review focuses on the potential risks and benefits of bariatric surgery in subjects with NAFLD and explores its role in the management of NASH in the obese patient. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873596 Fri, 09 Oct 2009 09:29:11 +0100 2873596 http://www.medworm.com/index.php?rid=2873595&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000531%2Fabstract%3Frss%3Dyes This article discusses this therapy, with particular emphasis on pharmacologic therapy. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873595 Fri, 09 Oct 2009 09:29:11 +0100 2873595 http://www.medworm.com/index.php?rid=2873594&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000580%2Fabstract%3Frss%3Dyes This article reviews the rationale and data behind recommending lifestyle changes to prevent and reverse NASH, focusing specifically on changes that lead to increased physical activity in sedentary patients, changes in dietary habits, and decreased calorie consumption to achieve gradual and sustained weight loss in those who are overweight or obese. In a culture that values avoiding even minimal exertion these are not easy changes to make. Ultimately, the success of care providers in helping patients to recognize and overcome these barriers depends on a patient's motivation, but clinicians can be more persuasive and able to bolster this motivation when armed with a conviction based on data that establish this to be the best course of action for patients with NASH. (Source: Clinics in Liver... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873594 Fri, 09 Oct 2009 09:29:11 +0100 2873594 http://www.medworm.com/index.php?rid=2873593&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000592%2Fabstract%3Frss%3Dyes Primary liver cancer is the fifth most common malignancy worldwide and the third leading cause of cancer mortality. Non-alcoholic fatty liver disease is the most common cause of chronic liver disease in the United States encompassing a spectrum of entities marked by hepatic steatosis in the absence of significant alcohol consumption. Although simple steatosis follows a generally benign course, the more aggressive form, non-alcoholic steatohepatitis, can progress to cirrhosis and result in complications including hepatocellular carcinoma. A significant number of cases of hepatocellular carcinoma remain cryptogenic without known underlying chronic liver disease. It is increasingly recognized that non-alcoholic steatohepatitis likely accounts for a substantial portion of cryptogenic hepatocel... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873593 Fri, 09 Oct 2009 09:29:11 +0100 2873593 http://www.medworm.com/index.php?rid=2873592&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000622%2Fabstract%3Frss%3Dyes This article addresses some of these challenges. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873592 Fri, 09 Oct 2009 09:29:10 +0100 2873592 http://www.medworm.com/index.php?rid=2873591&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000543%2Fabstract%3Frss%3Dyes No imaging modality has yet been proven to reliably differentiate simple hepatic steatosis from steatohepatitis. This review focuses on the predominant non-nuclear imaging modalities available to clinicians at the present time. The key feature of the techniques outlined in this review that demonstrate the most interesting results have one thing in common: imaging is not performed in a passive manner but is undertaken as a method to investigate functional differences between simple hepatic steatosis and steatohepatitis based upon the current working model for pathogenesis and progression. The purpose of this article is to review the strengths and weakness of current clinical and experimental imaging modalities for noninvasive detection of NAFLD, with an emphasis on NASH. (Source: Clinics in... Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873591 Fri, 09 Oct 2009 09:29:10 +0100 2873591 http://www.medworm.com/index.php?rid=2873590&cid=s_33212_17_f&fid=33212&url=http%3A%2F%2Fwww.liver.theclinics.com%2Farticle%2FPIIS1089326109000634%2Fabstract%3Frss%3Dyes Non-alcoholic fatty liver disease is the most common cause of chronic liver disease in the United States. The development of non-alcoholic steatohepatitis increases the risk for cirrhosis and its complications. The gold standard for diagnosis is liver biopsy, the costs and risks of which make it impractical. Some demographic factors, blood tests, and imaging studies can be used to predict a higher risk of steatohepatitis or advanced fibrosis, but are of limited sensitivity and specificity. More accurate predictors and scoring systems would allow identifying who would benefit most from liver biopsy and monitor disease progression and response to therapy. (Source: Clinics in Liver Disease) Clinics in Liver Disease journals http://www.medworm.com/rss/comments.php?id=2873590 Fri, 09 Oct 2009 09:29:10 +0100 2873590