The etiology, diagnosis and prevention of liver cirrhosis: part 1 of a series on liver cirrhosis.


BACKGROUND:Cirrhosis of the liver is the end stage of chronic liver disease. Among the many liver disorders that can lead to cirrhosis, some progress rapidly (years) and others more slowly (decades). In Germany, cirrhosis is often a consequence of fatty liver disease due to alcoholism or other causes, but can also be caused by hepatitis B and hepatitis C. Cirrhosis is more common in overweight persons and smokers. The underlying causes of cirrhosis determine its rate of progression and are the focus of preventive efforts and treatment. The prevalence of cirrhosis in Germany is rising; it now ranks among the top 20 causes of death in the country. METHODS:This article is based on a selective review of pertinent literature, including reviews and current guidelines. RESULTS:Strictly speaking, cirrhosis is a pathological diagnosis; it is, nevertheless, usually diagnosed clinically, by history, physical examination (e.g., cutaneous signs of liver disease), ancillary testing (e.g., ultrasonography, transient elastography) and laboratory analyses (e,g., APRI, which is the quotient of the GOT concentration and the platelet count). There are no laboratory cutoff values for the diagnosis of cirrhosis. Early detection of chronic liver disease, followed by individually tailored, risk-adapted treatment, is the best way to prevent it. Esophagogastroduodenoscopy can be performed early on to assess the risk of variceal bleeding. In most patients, the progression of fibrosis can be averted by early detection and appropriate treatment. CONCLUSION:Screening for chronic liver disease should include history and physical examination, serum transaminase measurement, upper abdominal ultrasonography, and, in some cases, transient elastography.


Dtsch Arztebl Int


Wiegand J,Berg T




Has Abstract


2013-02-01 00:00:00










  • Skin tumors in childhood.

    abstract:BACKGROUND:Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. METHODS:Selective literature review. RESULTS:Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of maligna...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Hamm H,Höger PH

    更新日期:2011-05-01 00:00:00

  • Internet- Based Interventions in Chronic Somatic Disease.

    abstract:BACKGROUND:Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-ba...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Bendig E,Bauereiß N,Ebert DD,Snoek F,Andersson G,Baumeister H

    更新日期:2018-11-05 00:00:00

  • Quality of life and occupational disability in endocrine orbitopathy.

    abstract:BACKGROUND:In endocrine orbitopathy (EO), disfiguring proptosis and diplopia impair patients' quality of life both at home and at work. METHODS:From late 2006 to the beginning of 2008, 250 outpatients in an interdisciplinary thyroid and eye clinic filled out a questionnaire about their quality of life, occupational di...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Ponto KA,Pitz S,Pfeiffer N,Hommel G,Weber MM,Kahaly GJ

    更新日期:2009-04-01 00:00:00

  • Spontaneous Pneumothorax.

    abstract:BACKGROUND:Few reliable data are available on the epidemiology and treatment of spontaneous pneumothorax. We studied the sex and age distribution, frequency of hospitalization, mortality, and conservative versus surgical care of this condition in Germany in order to draw well-founded conclusions about its in-hospital d...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Schnell J,Koryllos A,Lopez-Pastorini A,Lefering R,Stoelben E

    更新日期:2017-11-03 00:00:00

  • Atrial fibrillation: established and innovative methods of evaluation and treatment.

    abstract:BACKGROUND:5% to 8% of 70-year-olds and some 10% of persons over age 80 have atrial fibrillation (AF). METHODS:Selective literature review. RESULTS:New scoring schemes (CHA(2)DS(2)-VASc score, HAS-BLED score) have been introduced to enable more accurate estimation of the risk of stroke and hemorrhage in patients with...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Trappe HJ

    更新日期:2012-01-01 00:00:00

  • The Treatment of Incisional Hernia.

    abstract:BACKGROUND:A meta-analysis of studies from multiple countries has shown that the incidence of incisional hernia varies from 4% to 10% depending on the type of operation. No epidemiological surveys have been conducted so far. The worst possible complication of an incisional hernia if it is not treated surgically is inca...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析


    authors: Dietz UA,Menzel S,Lock J,Wiegering A

    更新日期:2018-01-19 00:00:00

  • Vocal cord dysfunction: an important differential diagnosis of bronchial asthma.

    abstract:INTRODUCTION:Intermittent paradoxical closure of the vocal cords can induce major attacks of dyspnea. Such attacks, called "vocal cord dysfunction" (VCD), are an important element in the differential diagnosis of intractable bronchial asthma. METHODS:Selective review of the literature. RESULTS:The etiology of VCD is ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Kenn K,Hess MM

    更新日期:2008-10-01 00:00:00

  • Antibiotics: MRSA prevention measures in German hospitals: results of a survey among hospitals, performed as part of the MRSA-KISS module.

    abstract:BACKGROUND:In this study, we investigated the measures currently being taken in German hospitals to prevent infection with methicillin-resistant strains of Staphylococcus aureus (MRSA). To this end, we circulated a questionnaire among hospitals participating in the MRSA-KISS module. "KISS" in the name of this project s...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Chaberny IF,Wriggers A,Behnke M,Gastmeier P

    更新日期:2010-09-01 00:00:00

  • The treatment of anterior dental trauma.

    abstract:BACKGROUND:Avulsed frontal teeth often cannot be saved because of improper or lack of initial treatment. The result is a need for multiple interventions over the patient's lifetime, which also carry a high financial cost. METHODS:We explored the subject of lost anterior teeth in young patients with a PubMed search bas...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Brüllmann D,Schulze RK,d'Hoedt B

    更新日期:2010-08-01 00:00:00

  • Fenestrated and Branched Aortic Grafts.

    abstract:BACKGROUND:Abdominal and thoracic aortic aneurysms are diagnosed in 40 and 10 to 15 out of 100 000 persons per year, respectively. Fenestrated (fEVAR) and branched (bEVAR) stent grafts have been developed for abdominal juxtarenal and thoracoabdominal aneurysms. We discuss the patency and complication rates of fEVAR and...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审


    authors: Rylski B,Czerny M,Südkamp M,Russe M,Siep M,Beyersdorf F

    更新日期:2015-11-27 00:00:00

  • Case Numbers and Process Quality in Breast Surgery in Germany: A Retrospective Analysis of Over 150,000 Patients From 2013 to 2014.

    abstract:BACKGROUND:Numerous studies from around the world have shown a positive association between case numbers and the quality of medical care. The evidence to date suggests that conformity to guidelines for the treatment of patients with breast cancer is better in German hospitals that have higher case numbers. METHODS:We ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,多中心研究


    authors: Köster C,Heller G,Wrede S,König T,Handstein S,Szecsenyi J

    更新日期:2015-08-31 00:00:00

  • Epilepsy in the elderly.

    abstract:BACKGROUND:Epilepsy is the third most common disease affecting the brain in the elderly. Current demographic trends will lead to an increased prevalence of epilepsy in the general population. METHOD:A selective literature search revealed 102 relevant publications as of September 2008, 50 of which were original article...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Werhahn KJ

    更新日期:2009-02-01 00:00:00

  • Non-specific, functional, and somatoform bodily complaints.

    abstract:BACKGROUND:4-10% of the general population and 20% of primary care patients have what are called "non-specific, functional, and somatoform bodily complaints." These often take a chronic course, markedly impair the sufferers' quality of life, and give rise to high costs. They can be made worse by inappropriate behavior ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Schaefert R,Hausteiner-Wiehle C,Häuser W,Ronel J,Herrmann M,Henningsen P

    更新日期:2012-11-01 00:00:00

  • Surgical intervention for pulmonary metastases.

    abstract:INTRODUCTION:Autopsy studies of persons who died of cancer have shown the lungs to be the sole site of metastasis in about 20% of cases. The resection of pulmonary metastases is indicated for palliative purposes if they contain a large volume of necrotic tumor, infiltrate the thoracic wall to produce pain, or cause hem...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Pfannschmidt J,Egerer G,Bischof M,Thomas M,Dienemann H

    更新日期:2012-10-01 00:00:00

  • The effect of introducing rebate contracts to promote generic drug substitution, on doctors' prescribing practices.

    abstract:BACKGROUND:As of 1 April 2007, pharmacists in Germany filling prescriptions covered by the statutory health insurance system (Gesetzliche Krankenversicherung, GKV) are required, whenever possible, to dispense a preparation that contains the same active substance and for which a rebate contract is in effect. The physici...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Hoffmann F,Glaeske G,Pfannkuche MS

    更新日期:2009-11-01 00:00:00

  • Interdisciplinary Risk Management in the Treatment of Multiple Sclerosis.

    abstract:BACKGROUND:Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system. There are at least 150 000 persons with MS in Germany. Recent years have seen the approval of new drugs against. METHODS:This article is based on pertinent literature retrieved by a selective search in PubMed as wel...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Havla J,Warnke C,Derfuss T,Kappos L,Hartung HP,Hohlfeld R

    更新日期:2016-12-26 00:00:00

  • The diagnosis and treatment of Crohn's disease and ulcerative colitis.

    abstract:INTRODUCTION:Crohn's disease and ulcerative colitis are chronic inflammatory diseases resulting from an inappropriate immune response, in genetically susceptible individuals, to microbial antigens of commensal microorganisms. This inappropriate response is promoted by certain environmental factors. Both diseases manife...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Baumgart DC

    更新日期:2009-02-01 00:00:00

  • Indicated prevention of schizophrenia.

    abstract:INTRODUCTION:Despite recent advances in their treatment, schizophrenic disorders are still among the diseases that most severely impair patients' quality of life. For this reason, centers for the early recognition of schizophrenic disorders have come into existence worldwide. In these centers, much effort is devoted to...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Klosterkötter J

    更新日期:2008-07-01 00:00:00

  • Radiation protection in pediatric radiology.

    abstract:BACKGROUND:The German Federal Law on Radiation Control contains no special provisions for X-ray studies in children and adolescents, even though exposure to ionizing radiation must be kept especially low in young persons, because their tissues are highly radiosensitive. Children, who have many years left to live, are m...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Alzen G,Benz-Bohm G

    更新日期:2011-06-01 00:00:00

  • The Incidence of Acute Kidney Injury and Associated Hospital Mortality.

    abstract:BACKGROUND:Studies from multiple countries have shown that acute kidney injury (AKI) in hospitalized patients is associated with mortality and morbidity. There are no reliable data at present on the incidence and mortality of AKI episodes among hospitalized patients in Germany. The utility of administrative codings of ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Khadzhynov D,Schmidt D,Hardt J,Rauch G,Gocke P,Eckardt KU,Schmidt-Ott KM

    更新日期:2019-05-31 00:00:00

  • Dextromethorphan withdrawal and dependence syndrome.

    abstract:BACKGROUND:The N-methyl-D-aspartate (NMDA) antagonist dextromethorphan has been available in pharmacies without a prescription since 1954 as an antitussive agent. There is an alarming increase in reports of its abuse. Dextromethorphan is avidly taken, mainly by young people, as a psychoactive drug. The currently availa...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Mutschler J,Koopmann A,Grosshans M,Hermann D,Mann K,Kiefer F

    更新日期:2010-07-01 00:00:00

  • Chronic myelogenous leukemia: treatment and monitoring.

    abstract:BACKGROUND:The treatment options for bcr-abl positive chronic myelogenous leukemia (CML) include chemotherapy, immune therapy, allogeneic stem cell transplantation, and molecular therapy. The tyrosine kinase inhibitor imatinib was approved for the treatment of CML in 2002. Data from clinical trials allow a comparison o...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审


    authors: von Bubnoff N,Duyster J

    更新日期:2010-02-01 00:00:00

  • Pneumococcal vaccination rates in adults in Germany: an analysis of statutory health insurance data on more than 850,000 individuals.

    abstract:BACKGROUND:The German Standing Committee on Vaccination Recommendations (Ständige Impfkommission, STIKO) recommends standard vaccination against pneumococcal infections for all persons aged 60 or older, and for all persons of any age with an increased health risk. It is not known how many persons in the target group in...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Theidel U,Kuhlmann A,Braem A

    更新日期:2013-11-01 00:00:00

  • Checkpoint Inhibitors.

    abstract:BACKGROUND:Treatment with checkpoint inhibitors such as anti-programmed death-1 (anti-PD-1), anti-PD-ligand 1 (anti-PD-L1), and anti-cytotoxic T-lymphocyte antigen-4 (anti-CTLA-4) antibodies can prolong the survival of cancer patients, but it also induces autoimmune side effects in 86-96% of patients by activating the ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Heinzerling L,de Toni EN,Schett G,Hundorfean G,Zimmer L

    更新日期:2019-02-22 00:00:00

  • Sexual impairment and its effects on quality of life in patients with rectal cancer.

    abstract:BACKGROUND:The effects of rectal surgery on patients' postoperative quality of life (QOL) and sexual function has been little studied to date. The present study aims to address this issue. METHODS:519 patients who had undergone surgery for rectal cancer from January 1997 to January 2003 were included in the study. The...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Schmidt C,Daun A,Malchow B,Küchler T

    更新日期:2010-02-01 00:00:00

  • Cluster-Randomized Studies.

    abstract:BACKGROUND:Cluster-randomized trials (CRT) are needed to compare interventions that are allocated to entire groups of subjects, rather than to individuals. Publications about CRT have become steadily more common over the past decade. Readers of such publications should be able to categorize and interpret the findings o...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Lorenz E,Köpke S,Pfaff H,Blettner M

    更新日期:2018-03-09 00:00:00

  • Patient safety and error management: what causes adverse events and how can they be prevented?

    abstract:BACKGROUND:Even in industrialized countries, health care is not as safe as it should be. The term "patient safety" denotes the non-occurrence of adverse events and the presence of measures to prevent them. METHODS:The literature was selectively reviewed to obtain information on the epidemiology and causes of preventab...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Hoffmann B,Rohe J

    更新日期:2010-02-01 00:00:00

  • Intrauterine surgery--choices and limitations.

    abstract:BACKGROUND:The past decade has seen much progress in intrauterine surgery. Randomized trials have documented the benefit of some procedures of this type for the unborn child. METHOD:Selective literature review RESULTS:Randomized trials have demonstrated the benefit of fetoscopic laser coagulation of placental anastom...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Diemert A,Diehl W,Glosemeyer P,Deprest J,Hecher K

    更新日期:2012-09-01 00:00:00

  • The Diagnosis and Treatment of Nail Disorders.

    abstract:BACKGROUND:Nail disorders can arise at any age. About half of all nail disorders are of infectious origin, 15% are due to inflammatory or metabolic conditions, and 5% are due to malignancies and pigment disturbances. The differential diagnosis of nail disorders is often an area of uncertainty. METHODS:This review is b...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审


    authors: Wollina U,Nenoff P,Haroske G,Haenssle HA

    更新日期:2016-07-25 00:00:00

  • Diagnostics of cerebral gliomas with radiolabeled amino acids.

    abstract:INTRODUCTION:Magnetic resonance tomography (MRT) is the investigation of choice for diagnosing cerebral glioma, but its capacity to differentiate tumor tissue from non-specific tissue changes is limited. Positron emission tomography (PET) and single photon emission computerized tomography (SPECT) using radiolabeled ami...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章


    authors: Langen KJ,Tatsch K,Grosu AL,Jacobs AH,Weckesser M,Sabri O

    更新日期:2008-01-01 00:00:00