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Clinics in Liver Disease

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https://read.qxmd.com/read/30454837/alcohol-and-alcoholic-liver-disease
#1
EDITORIAL
Norman L Sussman, Michael R Lucey
No abstract text is available yet for this article.
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454836/nutrition-in-alcoholic-liver-disease-an-update
#2
REVIEW
Brett Styskel, Yamini Natarajan, Fasiha Kanwal
Malnutrition is a change in body composition owing to disordered nutrition associated with a decrease in function and poor clinical outcomes. Malnutrition can result from overnutrition, undernutrition and inflammatory activity. Patients with alcoholic liver disease are at increased risk for malnutrition. In this article, we discuss the different methods used to assess malnutrition, prevalence of malnutrition, potential mechanisms underlying malnutrition, and its treatments in patients with alcoholic liver disease...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454835/acute-alcoholic-hepatitis
#3
REVIEW
Gene Y Im
Alcoholic hepatitis is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by prolonged heavy alcohol use. Treatment is mostly supportive. The short-term prognosis of acute alcoholic hepatitis depends on liver recovery, and ranges widely from rapid improvement to grim multiorgan failure despite treatment. Refinement of scoring systems have enhanced prognostication to guide clinical decision making in alcoholic hepatitis. Recent advances in the treatment of alcoholic hepatitis have solidified corticosteroids as the cornerstone of treatment to enhance short-term survival, but not intermediate or long-term survival...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454834/pathogenesis-of-alcoholic-liver-disease-an-update
#4
REVIEW
Themistoklis Kourkoumpetis, Gagan Sood
Apart from the classic knowledge that ethanol mediates its hepatotoxicity through its metabolism to acetaldehyde, a well-known hepatotoxic molecule, recent research has elucidated several key mechanisms that potentiate ethanol's damage to the liver parenchyma, such as generation of free radicals, activation of Kupffer cells, and alterations to the human bacterial and fungal microbiome. Genetic studies have suggested the role of PNPLA3 and TM6SF2 gene mutations in the progression of alcoholic liver disease.
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454833/alcohol-use-disorders-in-alcoholic-liver-disease
#5
REVIEW
Jessica L Mellinger, Gerald Scott Winder
Alcohol use disorder (AUD) is common in alcoholic liver disease (ALD) and intrinsic to its pathophysiology. Optimal treatment requires a multidisciplinary team approach and a working alliance between patients and providers. Diagnosing AUD involves a combination of thorough history taking, physical examination, screening questionnaires, and alcohol biomarkers. Alcohol biomarkers have advantages and limitations of use of which clinicians should be aware. AUD treatment is effective, multifaceted, and can be tailored to each individual...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454832/adolescent-alcoholic-liver-disease
#6
REVIEW
Sharonda Alston Taylor, Tamir Miloh
Alcohol use is common during adolescence. Adolescent alcohol use is a global problem. The risk of alcohol dependence increases based on genetic and psychosocial factors. If a provider is concerned about use of alcohol, screening is recommended. From a public health perspective, alcohol abuse should be addressed.
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454831/epidemiology-of-alcohol-consumption-and-societal-burden-of-alcoholism-and-alcoholic-liver-disease
#7
REVIEW
Page D Axley, Crit Taylor Richardson, Ashwani K Singal
Alcohol abuse is a major determinant of public health outcomes. Worldwide data from 2016 indicate that alcohol is the seventh leading risk factor in terms of disability-adjusted life years, an increase of more than 25% from 1990 to 2016. Understanding the epidemiology of alcoholic liver disease, including the regional variations in consumption and public policy, is an area of active research. In countries where the per capita consumption of alcohol decreases, there appears to be an associated decrease in disease burden...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454830/alcohol-and-the-law
#8
REVIEW
Maya Balakrishnan, Stephen Chris Pappas
In the intersection of alcohol ingestion with the law, medical ethics, and public safety, physicians are often unsure about how to proceed. Physicians' primary focus should be on patient education with an ethical and legal duty to warn the patient of the adverse effects of alcohol. Warning third parties of potential harm related to alcohol-related impairment may involve a breach of patient confidentiality; therefore it should only be undertaken after careful analysis suggests that the risk for significant harm exceeds the burden that results to the patient from warning others...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454829/will-studies-in-nonalcoholic-steatohepatitis-help-manage-alcoholic-steatohepatitis
#9
REVIEW
Vinay Sundaram, Timothy R Morgan
Hepatic steatosis and steatohepatitis have several etiologies; the most common are alcoholic steatohepatitis (ASH) and obesity/metabolic syndrome-induced steatohepatitis, also known as nonalcoholic steatohepatitis (NASH). Although the etiology of these 2 conditions is different, they share pathways to disease progression and severity. They also have differences in physiologic pathways, and shared and divergent mechanisms can be therapeutic targets. There is no approved pharmacologic therapy for NASH, but several molecules are under study...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454828/chronic-neurologic-effects-of-alcohol
#10
REVIEW
Nadia Hammoud, Joohi Jimenez-Shahed
Chronic alcohol use induces silent changes in the structure and function of the central and peripheral nervous systems that eventually result in irreversible, debilitating repercussions. Once identified, nutritional supplementation and cessation measures are critical in preventing further neurologic damage. The proposed mechanisms of neuronal injury in chronic alcohol abuse include direct toxic effects of alcohol and indirect effects, including those resulting from hepatic dysfunction, nutritional deficiencies, and neuroinflammation...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454827/liver-transplantation-for-alcoholic-liver-disease-an-update
#11
REVIEW
Elizabeth L Godfrey, Rise Stribling, Abbas Rana
Alcoholic liver disease is a serious and increasing contributor to the global liver disease burden. Extensive selection criteria, including a minimum abstinence period, has previously been used to secure good outcomes but new research questions the effectiveness of abstinence periods and has recommended changes in integrated alcohol use treatment to effectively prevent relapse. Patients have unique health concerns, including posttransplantation risks of malignancy and metabolic complications, but overall very good long-term outcomes...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454826/alcohol-associated-cirrhosis
#12
REVIEW
Michael R Lucey
Alcohol-associated cirrhosis (AC) contributes up to 50% of the overall cirrhosis burden in the United States. AC is typically a comorbid condition in association with alcohol-use disorder. AC is often coexistent with other conditions. Several noninvasive methods are available to assist in recognizing the presence of AC. The natural history of AC is governed by the patients continued drinking or abstinence. All treatment starts with abstinence. After decompensation, the progression to acute-on-chronic liver failure heralds death...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454825/histopathology-of-alcohol-related-liver-diseases
#13
REVIEW
Nitzan C Roth, Jia Qin
Excessive alcohol consumption can lead to a spectrum of liver histopathology, including steatosis, steatohepatitis, foamy degeneration, fatty liver with cholestasis, and cirrhosis. Although variability in sampling and pathologist interpretation are of some concern, liver biopsy remains the gold standard for distinguishing between steatohepatitis and noninflammatory histologic patterns of injury that can also cause the clinical syndrome of alcohol-related hepatitis. Liver biopsy is not routinely recommended to ascertain a diagnosis of alcohol-related liver disease in patients with an uncertain alcohol history, because the histologic features of alcohol-related liver diseases can be found in other diseases, including nonalcoholic steatohepatitis and drug-induced liver injury...
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30454824/introduction-alcohol-and-alcoholism
#14
REVIEW
Saira Aijaz Khaderi
This article discusses alcohol use throughout history. The discovery and cultivation of wine and beer and distillation of spirits are explored. The article spans prehistory, Egypt, Ancient Greece, Ancient Rome, Europe, and the Americas; and the religions Judaism, Christianity, and Islam. Also explored are the history and distillation of rum, gin, and champagne. Effects of alcohol use on society are discussed.
February 2019: Clinics in Liver Disease
https://read.qxmd.com/read/30266164/advances-in-pediatric-hepatology
#15
EDITORIAL
Philip Rosenthal
No abstract text is available yet for this article.
November 2018: Clinics in Liver Disease
https://read.qxmd.com/read/30266163/liver-transplantation-in-children
#16
REVIEW
Yen H Pham, Tamir Miloh
Liver transplantation (LT) for children has excellent short- and long-term patient and graft survival. LT is a lifesaving procedure in children with acute or chronic liver disease, hepatic tumors, and a few genetic metabolic diseases in which it can significantly improve quality of life. In this article, the authors discuss the unique aspects of pediatric LT, including the indications, patient selection and evaluation, allocation, transplant surgery and organ selection, posttransplant care, prognosis, adherence, and transition of care...
November 2018: Clinics in Liver Disease
https://read.qxmd.com/read/30266162/acute-liver-failure-an-update
#17
REVIEW
James E Squires, Patrick McKiernan, Robert H Squires
Pediatric acute liver failure (PALF) is a dynamic, life-threatening condition of disparate etiology. Management of PALF is dependent on intensive collaborative clinical care and support. Proper recognition and treatment of common complications of liver failure are critical to optimizing outcomes. In parallel, investigations to identify underlying cause and the implementation of timely, appropriate treatment can be life-saving. Predicting patient outcome in the era of liver transplantation has been unfulfilling and better predictive models must be developed for proper stewardship of the limited resource of organ availability...
November 2018: Clinics in Liver Disease
https://read.qxmd.com/read/30266161/pediatric-liver-tumors
#18
REVIEW
Kenneth Ng, Douglas B Mogul
Although liver tumors are rare in the pediatric population, they are common in the setting of children with specific risk factors requiring increased awareness and, in some instances, screening. The evaluation of a liver mass in children is largely driven by the age at diagnosis, the presence of any medical comorbidities, and initial testing with alpha fetoprotein and imaging. Specific guidelines for the management of different tumors have been implemented in recent years such that a multidisciplinary approach is ideal and care should be provided by centers with experience in their management...
November 2018: Clinics in Liver Disease
https://read.qxmd.com/read/30266160/cirrhosis-and-portal-hypertension-in-the-pediatric-population
#19
REVIEW
Catherine A Chapin, Lee M Bass
Cirrhosis is a complex process in which the architecture of the liver is replaced by structurally abnormal nodules due to cirrhosis. Cirrhosis frequently leads to the development of portal hypertension. In children, portal hypertension may be caused by a wide range of etiologies, including extrahepatic portal vein obstruction, biliary atresia, alpha 1 antitrypsin deficiency, and autoimmune hepatitis. Gastroesophageal varices and ascites are two of the complications of portal hypertension likely to cause morbidity and mortality...
November 2018: Clinics in Liver Disease
https://read.qxmd.com/read/30266159/nonalcoholic-liver-disease-in-children-and-adolescents
#20
REVIEW
Sara Kathryn Smith, Emily R Perito
Pediatric nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. The spectrum of NAFLD ranges from steatosis to nonalcoholic steatohepatitis (NASH) to fibrosis. Obesity rates in children continue to rise and, as a result, NAFLD in children is becoming more prevalent. The pathophysiology, natural history, and progression of disease are still being elucidated but NAFLD/NASH in children may represent a more severe phenotype that will benefit from early identification and management...
November 2018: Clinics in Liver Disease
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