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Alcohol-Induced Liver Disease
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Alcoholic liver disease is suspected on the basis of history, labs, and other studies, complete alcohol avoidance should be recommended and supportive services such as Alcoholics Anonymous or one-on-one counseling should be offered. In most cases of liver disease, patients should be offered immunization against viral hepatitis A and hepatitis B to protect them from future superimposed liver injury. From the Washington Manual of Gastroenterology Consult.

Your search returned 60 results
from the time period: last 90 days.
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1. Circling Back for the Diagnosis.  
Date: 11/01/2017
The New England journal of medicine 
No summary available
Infectious Diseases (1), Anti-Obesity and Weight Loss (1)
Hyperbilirubinemia (1), Cholecystitis (1), Alcoholic Fatty Liver (1), more mentions
Scandinavian journal of gastroenterology
AbstractText: To evaluate the association of lifestyle with the development of alcoholic liver disease (ALD) or alcoholic pancreatitis (AlcP) AbstractText: A case-control study was conducted on 80 patients attending a tertiary university hospital, subdivided into three groups: ALD (n = 34), AlcP (n = 21) and a ... Keyword: alcoholic liver disease.
Alcoholic Pancreatitis (3), Alcoholic Liver Diseases (3), Pancreatic Diseases (1), more mentions
Hepatology (Baltimore, Md.)
Circulating bugs in blood in alcoholic liver disease!.
Alcoholic Liver Diseases (2), more mentions
Digestive diseases and sciences
INTRODUCTION: Natural language processing is a powerful technique of machine learning capable of maximizing data extraction from complex electronic medical records. METHODS: We utilized this technique to develop algorithms capable of "reading" full-text radiology reports to accurately identify the presence of fatty liver disease. Abdominal ultrasound, computerized tomography, and magnetic resonance imaging reports were retrieved from the Veterans Affairs Corporate Data Warehouse from a random national sample of 652 patients. Radiographic fatty liver disease was determined by manual review by two physicians and verified with an expert radiologist. A split validation method was utilized for algorithm development. RESULTS: For all three imaging modalities, the algorithms could identify fatty liver disease with >90% recall and precision, with F-measures >90%. DISCUSSION: These algorithms could be used to rapidly screen patient records to establish a large cohort to facilitate epidemiological and clinical studies and examine the clinic course and outcomes of patients with radiographic hepatic steatosis.
Fatty Liver (7), more mentions
The Journal of infectious diseases
Background/Aim: Antiviral treatment for patients in HBeAg-positive chronic hepatitis B virus (HBV) infection is still controversial. We assessed whether antiviral treatment reduces liver disease progression in those patients. Methods: This study included consecutive patients that tested positive for HBeAg with an HBV DNA >20,000 IU/mL, ALT <40 IU/L and without evidence of cirrhosis in eight large-volume hospitals in Korea. The primary endpoint was the development of hepatocellular carcinoma (HCC) and the secondary endpoint was the development of cirrhosis. Results: A total of 484 patients were included: 87 in the antiviral treatment group and 397 in the control group. Baseline liver function was significantly more favorable for the control group. After matching for propensity score to overcome those differences, the antiviral treatment group had significantly reduced risk for HCC (hazard ratio [HR]=0.234, log-rank P=0.046) and cirrhosis (HR=0.235, log-rank P=0.015) compared with the control group. After balancing the baseline characteristics using inverse probability weighting, antiviral therapy significantly decreased the risk of HCC (HR=0.189, log-rank P=0.004) and cirrhosis (HR=0.347, log-rank P=0.036). Conclusion: Antiviral therapy for patients in HBeAg-positive chronic HBV infection with high viral load reduces the risk of HCC, even if the ALT levels are below the upper limit of normal.
Immune System Diseases (7), Infectious Diseases (2)
Cirrhosis (4), Infections (3), Hepatocellular Carcinoma (2), more mentions
Gut 
OBJECTIVE: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients. DESIGN: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria. RESULTS: Of the patients assessed using the Chronic Liver Failure Consortium criteria with the exception of cirrhosis, 391 patients with ACLF were identified: 92 with non-cirrhotic HBV-ACLF, 271 with cirrhotic HBV-ACLF and 28 with ACLF with cirrhosis caused by non-HBV aetiologies (non-HBV-ACLF). The short-term (28/90 days) mortality of the patients with HBV-ACLF were significantly higher than those of the patients with non-HBV-ACLF. Total bilirubin (TB) ≥12 mg/dL and an international normalised ratio (INR) ≥1.5 was proposed as an additional diagnostic indicator of HBV-ACLF, and 19.3% of patients with an HBV aetiology were additionally diagnosed with ACLF. The new prognostic score (0.741×INR+0.523×HBV-SOFA+0.026×age+0.003×TB) for short-term mortality was superior to five other scores based on both discovery and external validation studies. CONCLUSIONS: Regardless of the presence of cirrhosis, patients with CHB, TB ≥12 mg/dL and INR ≥1.5 should be diagnosed with ACLF. The new criteria diagnosed nearly 20% more patients with an HBV aetiology with ACLF, thus increasing their opportunity to receive timely intensive management.
Infectious Diseases (4)
Cirrhosis (5), Chronic Liver Failure (3), Hepatitis B (3), more mentions
Journal of general internal medicine 
BACKGROUND: Hepatorenal syndrome (HRS) is a common complication among patients with cirrhosis, primarily attributable to vasodilation of renal vessels. Vasoactive agents are commonly used to treat HRS. The present network meta-analysis compares the vasoactive agents used in HRS. METHODS: We searched electronic databases for appropriate randomized controlled clinical trials in patients with HRS, comparing active interventions with either placebo or standard of care. The primary outcome was complete HRS reversal; secondary outcomes included partial HRS reversal, mortality, adverse events, and cardiovascular adverse events. The data were pooled using a random effects model. We also carried out direct comparisons for the primary outcome with trial sequential analysis. RESULTS: A total of 16 studies were included in the systematic review. Rates of complete HRS reversal were significantly higher with terlipressin and noradrenaline combined with albumin than with placebo (OR 6.65, 95% CI: 2.08-21.31 and 6.81, 95% CI: 1.87-24.83, respectively). No significant differences were observed in terms of mortality, partial HRS reversal, or adverse events for any of the interventions. However, cardiovascular adverse events were significantly higher with continuous-infusion terlipressin/albumin (OR 7.07, 95% CI: 1.23-40.62), bolus terlipressin/albumin (OR 7.39, 95% CI: 1.89, 28.94), octreotide/midodrine/albumin (OR 9.85, 95% CI: 1.1, 88.1), and noradrenaline/albumin (OR 15.24, 95% CI: 2.1, 112.6) than with albumin alone. Trial sequential analyses revealed adequate evidence to conclude that terlipressin combined with albumin was effective in achieving complete HRS reversal. DISCUSSION: Terlipressin combined with albumin shows strong evidence of improving short-term survival in patients with type 1 but not type 2 HRS. Through indirect comparison, noradrenaline with albumin was also associated with significant benefits in terms of HRS reversal.
Cirrhosis (2), Hepatorenal Syndrome (2), more mentions
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
No Abstract Available
Hepatocellular Carcinoma (2), more mentions
Journal of hepatology
No Abstract Available
Endocrine Disorders (2)
Liver Fibrosis (2), Diabetes Mellitus, Type 2 (2), more mentions
Abdominal radiology (New York)
Thrombosis of the portal venous system, although rare in the general population, is commonly diagnosed in patients with specific underlying conditions including prothrombotic diseases, cirrhosis, hepatobiliary malignancy, and intraabdominal inflammation. Recent improvements in imaging have played a fundamental role in increased detection of portal vein thrombosis (PVT), frequently reported in asymptomatic patients as an incidental finding. Minimally invasive, endovascular therapy is a medically rational option to achieve recanalization of the portal vein as an adjunct to conservative medical management. This review focuses on the advances in imaging modalities to diagnose, stage and follow-up PVT, and gives a short overview of the available endovascular techniques in this field.
Thrombosis (3), Cirrhosis (1), more mentions
Hepatology (Baltimore, Md.)
Hepatocellular carcinoma (HCC) is the third most lethal cancer worldwide. The lack of effective biomarkers for the early detection of HCC results in unsatisfactory curative treatments. Here, metabolite biomarkers were identified and validated for HCC diagnosis. A total of 1448 subjects, mainly including normal controls and patients with chronic hepatitis B virus infection, liver cirrhosis, and HCC were recruited from multi-center in China. Liquid chromatography-mass spectrometry (LC-MS)-based metabolomics methods were used to characterize the subjects' serum metabolic profiles and to screen and validate the HCC biomarkers. A serum metabolite biomarker panel including phenylalanyl-tryptophan and glycocholate, was defined. This panel had a higher diagnostic performance than did α-fetoprotein (AFP) in differentiating HCC from a high-risk population of cirrhosis, such as area under the receiver-operating characteristic curve (AUC) of 0.930, 0.892, 0.807 for panel versus 0.657, 0.725, 0.650 for AFP in the discovery, test and cohort 1 of the validation set, respectively. In the nested case-control study, this panel had high sensitivity (rang 80.0-70.3%) to detect preclinical HCC, and its combination with AFP provided better risk prediction of preclinical HCC before clinical diagnosis. Besides, this panel showed a larger AUC than did AFP (0.866 versus 0.682) to distinguish small-HCC, and 80.6% of the AFP false-negative patients with HCC were correctly diagnosed using this panel in the test set, which was corroborated by the validation set. The specificity and biological relevance of the identified biomarkers were further evaluated using sera from other two cancers and HCC tissue specimens, respectively. CONCLUSIONS: The discovered and validated serum metabolite biomarker panel exhibits good diagnostic performance for the early detection of HCC from at-risk populations. This article is protected by copyright. All rights reserved.
Infectious Diseases (1), Oncology (1)
Hepatocellular Carcinoma (2), Cirrhosis (1), Chronic Hepatitis B (1), more mentions
Journal of gastrointestinal cancer
PURPOSE: This study is aimed to determine the performance of alpha-fetoprotein (AFP) as part of hepatocellular carcinoma (HCC) screening in a non-viral cirrhosis population. METHODS: A retrospective audit was conducted of patients with non-viral cirrhosis over a 13 year period managed at a single centre. All patients were investigated routinely for evidence of viral hepatitis; patients with positive results were excluded from analysis. Cirrhosis was defined on basis of clinical, biochemical, and radiological investigations and examinations. All patients underwent HCC screening with 6-monthly AFP measurement and 6-12-monthly upper abdominal ultrasound (US). Diagnosis of HCC was confirmed by biopsy, definitive imaging, or natural disease progression. RESULTS: Sixty-seven patients were included (49 males, average age 58.7 years). Of 14 patients who developed HCC during the study period, 12 patients had HCC detected via screening. Of the screening diagnosed HCC cases, four (33%) patients had a normal AFP with abnormal surveillance US, three (25%) had raised AFP with normal surveillance US, and five (42%) had concurrent AFP elevation and US abnormality. Patients with raised AFP and normal surveillance US had HCC diagnosed after a progressive rise in AFP precipitated imaging with alternative modalities. Within the 53 patients who remained free of HCC, a raised AFP precipitated additional imaging on 10 occasions. HCC was diagnosed in 12 out of 64 patients over a total of 4292 screening months giving an annual incidence of 3.35%. CONCLUSIONS: Twenty-five percent of HCC occurring in non-viral cirrhosis will be detected earlier using a surveillance program incorporating both AFP and US compared to imaging alone programs.
Infectious Diseases (1)
Cirrhosis (5), Hepatocellular Carcinoma (2), Hepatitis (1), more mentions
Hepatology (Baltimore, Md.)
Hereditary hemochromatosis (HH) is a genetic disorder of iron metabolism which may lead to iron overload. Clinical penetrance is low, however those afflicted may develop cirrhosis, hepatocellular carcinoma, diabetes mellitus and cardiomyopathy. Treatment involves regular phlebotomy to reduce the systemic iron burden. In many countries-including the United States-numerous blood centers do not accept donated blood obtained from HH patients during therapeutic phlebotomy and there are inconsistent positions regarding this globally. This refusal is borne out of a few concerns. First, there is a theoretical increase in the infectious risk of these blood products, particularly by siderophilic organisms such as Yersinia enterocolitica. Second, given the increased incidence of hepatitis C infection from non-voluntary donors in the 1970s, there is a concern that blood from HH donors may harbor additional risk given the non-voluntary nature of their presentation. In this review, we examine the existing biologic and clinical data concerning infectious risk and summarize clinical experience from centers allowing HH donors, and demonstrate that blood from HH patients is safe and should be allowed into the donor pool. We conclude that there is no convincing evidence to exclude this population from serving as blood donors. This article is protected by copyright. All rights reserved.
Endocrine Disorders (1), Infectious Diseases (1)
Hemochromatosis (2), Cirrhosis (1), Hepatocellular Carcinoma (1), more mentions
Hepatology (Baltimore, Md.)
Cirrhotic cardiomyopathy is associated with poor outcomes in patients with cirrhosis. We investigated if subclinical cardiac morphologic and functional modifications can influence survival in cirrhotic patients during follow-up. A series of cirrhotic patients without cardiovascular or pulmonary disease underwent standard and tissue Doppler echocardiography to assess left ventricular (LV) geometry, systo/diastolic function and the main haemodynamic parameters. After baseline evaluation 115 cirrhotic patients were followed up for at least 6 years. During follow up 54 patients died (47%). On univariate analysis age, BSA, MELD, mean arterial pressure, heart rate, cardiac index, systemic vascular resistance index, the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e') were associated with increased risk of death. In a Cox hazard regression analysis including these factors and other hypothesized important factors (but not MELD) increased age (p=0.04) and left atrial dimension (p=0.005), and lower BSA (p=0.03) were the strongest predictors of death. When MELD was included in the analysis the main predictors were MELD, age and BSA. When multivariate analysis was performed incorporating only cardiovascular parametres, increased E/e' (p=0.003) and heart rate (p= 0.03) and reduced mean blood pressure (p= 0.01) resulted significantly associated with poor prognosis. CONCLUSION: in a large cohort of cirrhotic patients and after a long follow-up MELD, age and BSA were the main predictors of death. Among cardiovascular parameters, left atrium enlargement, increased heart rate and E/e' and reduced mean blood pressure resulted independent predictors of death. This article is protected by copyright. All rights reserved.
Cirrhosis (2), Lung Diseases (1), Cardiomyopathies (1), more mentions
Journal of hepatology
No Abstract Available
Infectious Diseases (2)
Hepatitis C (2), Hepatocellular Carcinoma (2), more mentions
Journal of hepatology
No Abstract Available
Hepatocellular Carcinoma (2), more mentions
Hepatology (Baltimore, Md.)
No Abstract Available
Clinics in chest medicine
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PoPH) represent serious pulmonary complications of advanced liver diseases. Orthotopic liver transplantation (OLT) is capable of completely resolving the underlying abnormalities associated with HPS. On the other hand, post-OLT response in patients with PoPH is less predictable, although heavily influenced by pre-OLT mean pulmonary arterial pressure. It remains the case that the opportunity to reverse 2 potentially fatal organ dysfunctions in the liver and the lung make HPS and PoPH more than worthy for further clinical investigations.
Cardiovascular Diseases (2)
Hepatopulmonary Syndrome (2), Hypertension (2), Cirrhosis (1), more mentions
Journal of hepatology 
Non-alcoholic fatty liver disease (NAFLD) is now recognised as the most common liver disease worldwide. It encompasses a broad spectrum of conditions, from simple steatosis, through non-alcoholic steatohepatitis, to fibrosis and ultimately cirrhosis and hepatocellular carcinoma. A hallmark of NAFLD is the substantial inter-patient variation in disease progression. NAFLD is considered a complex disease trait such that interactions between the environment and a susceptible polygenic host background determine disease phenotype and influence progression. Recent years have witnessed multiple genome-wide association and large candidate gene studies, which have enriched our understanding of the genetic basis of NAFLD. Notably, the I148M PNPLA3 variant has been identified as the major common genetic determinant of NAFLD. Variants with moderate effect size in TM6SF2, MBOAT7 and GCKR have also been shown to have a significant contribution. The premise for this review is to discuss the status of research into important genetic and epigenetic modifiers of NAFLD progression. The potential to translate the accumulating wealth of genetic data into the design of novel therapeutics and the clinical implementation of diagnostic/prognostic biomarkers will be explored. Finally, personalised medicine and the opportunities for future research and challenges in the immediate post genetics era will be illustrated and discussed.
Infectious Diseases (2)
Alcoholic Fatty Liver (2), Cirrhosis (1), Liver Diseases (1), more mentions
Clinical journal of the American Society of Nephrology : CJASN 
BACKGROUND AND OBJECTIVES: Literature on the prognosis of patients with cirrhosis who require RRT for AKI is sparse and is confounded by liver transplant eligibility. An update on outcomes in the nonlisted subgroup is needed. Our objective was to compare outcomes in this group between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective cohort study of patients with cirrhosis acutely initiated on hemodialysis or continuous RRT at five hospitals, including one liver transplant center. Multivariable regression and survival analysis were performed. RESULTS: Four hundred seventy-two subjects were analyzed (341 not listed and 131 listed for liver transplant). Among nonlisted subjects, 15% (51 of 341) were alive at 6 months after initiating RRT. Median survival was 21 (interquartile range [IQR], 8, 70) days for those diagnosed with hepatorenal syndrome and 12 (IQR, 3, 43) days for those diagnosed with acute tubular necrosis (P=0.25). Among listed subjects, 48% (63 of 131) received a liver transplant. Median transplant-free survival was 15 (IQR, 5, 37) days for those diagnosed with hepatorenal syndrome and 14 (IQR, 4, 31) days for those diagnosed with acute tubular necrosis (P=0.60). When stratified by transplant listing, with adjusted Cox models we did not detect a difference in the risk of death between hepatorenal syndrome and acute tubular necrosis (hazard ratio [HR], 0.81; 95% confidence interval [95% CI], 0.59 to 1.11, among those not listed; HR, 0.73; 95% CI, 0.44 to 1.19, among those listed). CONCLUSIONS: Cause of AKI was not significantly associated with mortality in patients with cirrhosis who required RRT. Among those not listed for liver transplant, mortality rates were extremely high in patients both with hepatorenal syndrome and acute tubular necrosis. PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_11_09_CJASNPodcast_18_1_A.mp3.
Necrosis (7), Hepatorenal Syndrome (6), Cirrhosis (5), more mentions
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