Liver Patients (liver + patient)

Distribution by Scientific Domains


Selected Abstracts


Dietary lactulose decreases apparent nitrogen absorption and increases apparent calcium and magnesium absorption in healthy dogs

JOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 3-4 2001
A. C. Beynen
To study the effect of lactulose on the route of nitrogen excretion, we fed six healthy, adult dogs on diets containing either 0, 1 or 3 g lactulose/MJ metabolizable energy according to a 3 × 3 Latin square design. The results were analysed to identify statistically significant linear trend effects of lactulose. Faecal pH was significantly lowered by lactulose. Faecal ammonium and nitrogen excretion tended to be raised by lactulose feeding whereas urinary urea excretion was significantly reduced. Lactulose feeding significantly lowered apparent nitrogen digestibility. It is concluded that lactulose feeding shifts nitrogen excretion from urine to faeces in dogs which may be beneficial for liver patients. The data are in line with the concept that lactulose stimulates bacterial growth in the colon which in turn enhances faecal nitrogen excretion and lowers the entry of colonic ammonia into the bloodstream, leading to a lesser workload for the liver and less urinary nitrogen excretion. Lactulose consumption was also found to produce a dose-dependent increase in the apparent absorption of calcium and magnesium, but not phosphorus. [source]


Determinants of quality of life in chronic liver patients

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2006
J. J. GUTTELING
Summary Background and aim Health-related quality of life of patients with chronic liver disease has been shown to be impaired in numerous studies. However, the factors which influence health-related quality of life in treated chronic liver patients are not quite known. This is the first study to assess the impact of physical and psychosocial determinants on a weighted score of health-related quality of life in patients with chronic liver disease. Methods The data of 1175 chronic liver patients were used to assess the relationship between items of the disease-specific Liver Disease Symptom Index 2.0 and the Short Form (SF)-6D weighted utility score by means of linear regression analyses. Results Health-related quality of life was most strongly related to disease severity (B = ,0.029) and joint pain (B = ,0.023). Depression (B = ,0.014), pain in the right upper abdomen (B = ,0.014), decreased appetite (B = 0.014) and fatigue (B = ,0.013) were also strongly related to health-related quality of life. In hepatitis C virus patients, disease severity (B = ,0.037) and depression (B = ,0.030) were strong determinants of health-related quality of life. Conclusions This study shows that health-related quality of life in chronic liver patients is clearly determined by disease severity, joint pain, depression, decreased appetite and fatigue. These patients may benefit most from interventions aimed at improving adaptation to the symptoms described. [source]


Interpreting the significance of drinking by alcohol-dependent liver transplant patients: Fostering candor is the key to recovery

LIVER TRANSPLANTATION, Issue 6 2000
Robert M. Weinrieb
Few studies have examined the value of treating alcohol addiction either before or after liver transplantation. Nevertheless, most liver transplant programs and many insurance companies require 6 months to 1 year of abstinence from alcohol as a condition of eligibility for liver transplantation (the 6-month rule). We believe there are potentially harsh clinical consequences to the implementation of this rule. For example, the natural history of alcohol use disorders often involves brief fallbacks to drinking ("slips"), but when alcoholic liver transplant candidates slip, most are removed from consideration for transplantation or are required to accrue another 6 months of sobriety. Because there is no alternative treatment to liver transplantation for most patients with end-stage liver disease, the 6-month rule could be lethal in some circumstances. In this review, we survey the literature concerning the ability of the 6-month rule to predict drinking by alcoholic patients who undergo liver transplantation and examine its impact on the health consequences of drinking before and after liver transplantation. We believe that fostering candor between the alcoholic patient and the transplant team is the key to recovery from alcoholism. We conclude that it is unethical to force alcoholic liver patients who have resumed alcohol use while waiting for or after transplantation to choose between hiding their drinking to remain suitable candidates for transplantation or risk death by asking for treatment of alcoholism. Consequently, we advocate a flexible approach to clinical decision making for the transplant professional caring for an alcoholic patient who has resumed drinking and provide specific guidelines for patient management. [source]


Plasma transforming growth factor-,1 level and efficacy of ,-tocopherol in patients with non-alcoholic steatohepatitis: a pilot study

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2001
T. Hasegawa
Background: Non-alcoholic steatohepatitis is a distinct entity, characterized by fatty change, lobular inflammation and fibrosis of the liver. Some cases of non-alcoholic steatohepatitis progress to cirrhosis, but it is not easy to distinguish this disease from non-alcoholic fatty liver by non-invasive examinations. No proven therapy for non-alcoholic steatohepatitis exists. Transforming growth factor-,1 is implicated in the development of liver fibrosis, and is inhibited by ,-tocopherol (vitamin E) in the liver. Therefore, in this study, the significance of the measurement of the level of plasma transforming growth factor-,1 and the effect of ,-tocopherol on the clinical course of non-alcoholic steatohepatitis were investigated. Methods: Twelve patients with non-alcoholic steatohepatitis and 10 patients with non-alcoholic fatty liver, with a diagnosis confirmed by liver biopsy, were studied. None of the patients had a history of alcohol abuse, habitual medicine or malignant or inflammatory diseases. All patients were negative for hepatitis B, C and G virus. Patients were given dietary instruction for 6 months, and then ,-tocopherol (300 mg/day) was given for 1 year. Blood chemistries, measurement of plasma transforming growth factor-,1 level and liver biopsies were undertaken before and after the 1-year ,-tocopherol treatment. Results: The serum alanine transaminase level decreased in non-alcoholic fatty liver patients, but not in non-alcoholic steatohepatitis patients, after 6 months of dietary therapy. Although the serum alanine transaminase level in non-alcoholic steatohepatitis patients was reduced during the 1-year ,-tocopherol treatment, ,-tocopherol had no effect on the serum alanine transaminase level in non-alcoholic fatty liver patients. The histological findings, such as steatosis, inflammation and fibrosis, of the non-alcoholic steatohepatitis patients were improved after ,-tocopherol treatment. The plasma transforming growth factor-,1 level in non-alcoholic steatohepatitis patients was significantly elevated compared with that in non-alcoholic fatty liver patients and healthy controls, and decreased, accompanied by an improvement in serum alanine transaminase level, with ,-tocopherol treatment. Conclusions: lOur data suggest that the measurement of the level of plasma transforming growth factor-,1 represents a possible method of distinguishing between non-alcoholic steatohepatitis and non-alcoholic fatty liver. Long-term ,-tocopherol treatment may be safe and effective for non-alcoholic steatohepatitis. A randomized, controlled, double-blind trial is needed to confirm the full potential of ,-tocopherol in the management of non-alcoholic steatohepatitis. [source]