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Clinical Hepatology (clinical + hepatology)

Distribution by Scientific Domains
Medical Sciences80%

Selected Abstracts

Review article: drug-induced liver injury in clinical practice

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010
E. Björnsson
Aliment Pharmacol Ther 2010; 32: 3,13 Summary Background, Drug-induced liver injury (DILI) is an important differential diagnosis in many patients in clinical hepatology. DILI is the leading cause of acute liver failure and is an important safety issue when new drugs are developed. Aims, To provide a review of the recent data on DILI with particular focus on the most common and relevant issues seen in clinical practice. Methods, A Medline search was undertaken to identify relevant literature using search terms including ,drug-induced liver injury' and ,hepatotoxicity'. Results, The true incidence of DILI remains unknown but incidence up to 14 cases per 100 000 inhabitants and year has been reported. Antibiotics, analgesics and NSAIDs are the most common drugs causing liver injury. Idiosyncratic DILI has been shown to have a dose-dependent component and drugs without significant hepatic metabolism rarely cause DILI. Chronic elevation in liver enzymes can develop after DILI but this is rarely associated with clinical morbidity or mortality. Conclusions, Drug-induced liver injury remains a diagnostic challenge. Multicentre studies and international collaborative work with well-characterized patients will increase our understanding of liver injury associated with drugs. New therapies for acute liver failure resulting from drugs are needed. [source]

Can mathematical models be useful in clinical hepatology?

LIVER INTERNATIONAL, Issue 5 2010
Eirini I. Rigopoulou
No abstract is available for this article. [source]

Percutaneous liver biopsy in clinical practice

LIVER INTERNATIONAL, Issue 9 2007
Bandar Al Knawy
Abstract Percutaneous liver biopsy (PLB) is the standard procedure for obtaining hepatic tissue for histopathological examination, and remains an essential tool in the diagnosis and management of parenchymal liver diseases. The use of liver biopsy (LB) is increasing with the advent of liver transplantation and the progress being made in antiviral therapeutic agents. While blind percutaneous needle biopsy is the traditional technique, the use of ultrasound (US) guidance has increased considerably. Literatures were reviewed to assess the existing clinical practice of PLB with an emphasis on the technique, the operator, types of biopsy needles, quality of LB specimens and the risk of complications. The best available evidence indicates that the use of ultrasound-guided biopsy (UGB) is superior to blind needle biopsy (BNB). The odds ratios of the controlled studies showed that BNB carried a higher risk for major complications, postbiopsy pain and biopsy failure. Therefore, percutaneous LB under US control is superior to BNB and it is recommended that UGB be considered the standard of care for this important and widely used invasive procedure in the field of clinical hepatology. [source]

Review article: albumin in the treatment of liver diseases,new features of a classical treatment

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2002
V Arroyo
Summary Albumin was introduced initially in the treatment of patients with cirrhosis and ascites to increase serum albumin concentration due to its oncotic effect. Although its administration declined some years later, at present it constitutes an essential treatment in clinical hepatology. Several studies have clearly demonstrated its efficacy in the prevention and treatment of circulatory dysfunction and hepatorenal syndrome in patients with cirrhosis. These effects can be due not only to its properties as a plasma expander but also to its capacity to bind numerous substances such as bile acids, nitric oxide and cytokines. Based on this capacity an albumin dialysis system (MARS) has recently been developed. The usefulness of this system in the management of patients with acute and chronic liver failure is, at present, under evaluation. [source]

Oxidation of specific methionine and tryptophan residues of apolipoprotein A-I in hepatocarcinogenesis

PROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 18 2005
Jokin Fernández-Irigoyen
Abstract Hepatocellular carcinoma (HCC) is the fifth most common neoplasm with more than 500,000 new cases diagnosed yearly. Although major risk factors of HCC are currently known, the identification of biological targets leading to an early diagnosis of the disease is considered one of the priorities of clinical hepatology. In this work we have used a proteomic approach to identify markers of hepatocarcinogenesis in the serum of a knockout mice deficient in hepatic AdoMet synthesis (MAT1A,/,), as well as in patients with HCC. Three isoforms of apolipoprotein A-I (Apo A-I) with different pI were identified in murine serum. Isoform 1 is up-regulated in the serum of MAT1A,/, mice much earlier than any histological manifestation of liver disease. Further characterization of the differential isoform by electrospray MS/MS revealed specific oxidation of methionine 85 and 216 to methionine sulfoxide while the sequence of the analogous peptides on isoforms 2 and 3 showed the nonoxidized methionine residues. Enrichment of an acidic isoform of Apo A-I was also assessed in the serum of hepatitis B virus patients who developed HCC. Specific oxidation of methionine 112 to methionine sulfoxide and tryptophans 50 and 108 to formylkinurenine were identified selectively in the up-regulated isoform. Although it is not clear at present whether the occurrence of these modifications has a causal role or simply reflects secondary epiphenomena, this selectively oxidized Apo A-I isoform may be considered as a pathological hallmark that may help to the understanding of the molecular pathogenesis of HCC. [source]