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Guidelines recommend the use of a beta-blocker or an endoscopic ligation in order to prevent the risk of the first bleeding due to the rupture of esophageal varices in liver cirrhosis, while, for the prevention of relapses, the association of ligation with beta-blocker has been more effective than beta-blocker alone. Now, the use of the drug alone has been compared with the combined therapy also in the prevention of the first bleeding episode.
MedNews (Epatologia) - Lun, 9 Gennaio 2012
http://mn.medsurfnews.com/
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This review article focuses on potentially relevant pathophysiological elements in the development of ACLF and points out some promising treatment modalities in ACLF.
Critical Care (Epatologia) - Mar, 25 Ottobre 2011
http://ccforum.com
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We have not got a specific therapy for non-alcoholic steatohepatitis (NASH), since there are many trials on various substances, but most of them are not randomized or they have been too short or with endpoints of unclear efficacy. Now, a phase-III, multicentric, double-blinded trial has been performed on 247 non-diabetic patients affected by NASH and randomized to receive pioglitazone (30 mg/die), vitamin E (800 UI/die) or placebo, for an overall of 96 weeks.
MedNews (Epatologia) - Lun, 6 Giugno 2011
http://mn.medsurfnews.com/
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From previous trials, we know that the presence of overweight can imply even severe risks for the liver, but the interaction between overweight and alcohol intake is not completely cleared up yet, so some answers to this situation are searched. In a retrospective trial performed in Scotland, 9600 males (averagely 47 years of age at the enrolment in the trial) have been examined and fol-lowed for about thirty years. After adjustments for multiple factors it was seen that deaths for liver causes are significantly associated with both an increase in alcohol intake and an increase in BMI.
MedNews (Epatologia) - Lun, 11 Aprile 2011
http://mn.medsurfnews.com/
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Some patients affected by non-alcoholic steatohepatitis (NASH) present other clinical conditions (hyperlipidemia, diabetes) for which a moderate alcohol intake implies some benefits, but we know which are the effects of a moderate intake of small amounts of alcohol on NASH, a clinical entity with an extremely varied prognosis. In order to clear the problem up, 20 rats with a highly lipid diet (71% of the energy received by fats) up to NASH onset. Rats have been then fed with a less fat diet (55% of the energy from lipids). In 10 rats, this second diet has been modified so that 16% of calories were given by alcohol.
MedNews (Epatologia) - Lun, 11 Aprile 2011
http://mn.medsurfnews.com/
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Alcoholic liver disease (ALD) remains a major cause of liver-related mortality in the US and worldwide. The correct diagnosis of ALD can usually be made on a clinical basis in conjunction with blood tests, and a liver biopsy is not usually required. Abstinence is the hallmark of therapy for ALD, and nutritional therapy is the first line of therapeutic intervention. The role of steroids in patients with moderate to severe alcoholic hepatitis is gaining increasing acceptance, with the caveat that patients be evaluated for the effectiveness of therapy at 1 week. Pentoxifylline appears to be especially effective in ALD patients with renal dysfunction/hepatorenal syndrome. Biologics such as specific anti-TNFs have been disappointing and should probably not be used outside of the clinical trial setting. Transplantation is effective in patients with end-stage ALD who have stopped drinking (usually for ≥6 months), and both long-term graft and patient survival are excellent.
Medscape (Epatologia) - Lun, 4 Aprile 2011
http://www.medscape.com
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Biliary atresia (BA) is a progressive inflammatory disorder of the extrahepatic bile ducts leading to the obliteration of bile flow. A study determines serum adiponectin in BA patients and to investigate the relationship of adiponectin with clinical parameters and liver stiffness scores. Results showed that serum adiponectin and liver stiffness values were higher in BA patients compared with normal participants. The elevated serum adiponectin levels also positively correlated with the degree of hepatic dysfunction and liver fibrosis. Accordingly, serum adiponectin and transient elastography could serve as the useful non-invasive biomarkers for monitoring the severity and progression in postoperative BA.
BioMed Central (Epatologia) - Mar, 1 Marzo 2011
http://www.biomedcentral.com
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It is normal to see very variable limits in the normality range as to the values of transaminases, according to the laboratory performing the exam, and this variability often creates some problems to the patient and to the general practitioner, since an increase in this parameter could mean a liver damage. In order to verify the reason of these differences, 67 laboratories in Indiana have been examined: the upper limit ranges from 31 U/l to 72 U/l, with mild differences between men and women.
MedNews (Epatologia) - Gio, 14 Ottobre 2010
http://mn.medsurfnews.com/
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Since the use of statins is associated with a reduction in cholesterol production, these drugs should theoretically have a role in cholesterinic biliary lithiasis, but the trials performed up to now have only given inconclusive results.
MedNews (Epatologia) - Mar, 14 Settembre 2010
http://mn.medsurfnews.com/
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In The Lancet today, Buddha Basnyat asks why are hepatitis E and the conjugate typhoid vaccines not available, despite their proven efficacy and safety.
The Lancet (Epatologia) - Mar, 14 Settembre 2010
http://www.thelancet.com