Abstract:
:Nonalcoholic fatty liver disease (NAFLD) is a common liver disorder that can be divided into benign steatosis or nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Elastography and scoring systems based on clinical features and routine biochemical testing can be used to assess fibrosis in patients with NAFLD. Patients with fibrosis are thought to have NASH. However, only a liver biopsy can reliably diagnose NAFLD and differentiate NAFL from NASH. Because medical therapy for NASH is not available, it is not necessary to perform a liver biopsy in all patients. Patients suspected of having NASH should undergo liver biopsy.
journal_name
Clin Liver Disjournal_title
Clinics in liver diseaseauthors
Gunn NT,Shiffman MLdoi
10.1016/j.cld.2017.08.006subject
Has Abstractpub_date
2018-02-01 00:00:00pages
109-119issue
1eissn
1089-3261issn
1557-8224pii
S1089-3261(17)30067-3journal_volume
22pub_type
杂志文章,评审abstract::Although hepatic encephalopathy (HE) is prevalent in the cirrhotic population, it has also been considered a potentially reversible condition. Liver transplantation represents the ultimate reversal of the decompensated cirrhotic state and should provide the best option for the reversibility of HE. However, the neurolo...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2011.12.004
更新日期:2012-02-01 00:00:00
abstract::Because of shared routes of transmission, hepatitis C virus (HCV) coinfection is common among HIV-infected persons. Because of the effectiveness of antiretroviral therapy, chronic HCV has now emerged as a major cause of morbidity and mortality in this population. Because chronic HCV is highly prevalent among HIV-infec...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2008.03.009
更新日期:2008-08-01 00:00:00
abstract::Patients with hepatocellular carcinoma (HCC) have many treatment options. For patients with surgical indication, consideration of future liver remnant and the surgical complexity of the procedure is essential. A new 3-level complexity classification categorizing 11 liver resection procedures predicts surgical complexi...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2020.07.004
更新日期:2020-11-01 00:00:00
abstract::The risk for potential transmission of infectious agents during gastrointestinal (GI) endoscopy is concerning for patients and physicians. However, the instance of infection transmission remains rare after GI endoscopy procedures, with an estimated frequency of 1 in 1.8 million procedures. Endoscopy-related infection ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2009.11.012
更新日期:2010-02-01 00:00:00
abstract::Since publication of the first descriptions of acute liver failure (ALF) as a distinct clinical entity in the 1950's, the understanding of the pathophysiologic mechanisms involved and the management options have increased substantially. ALF still represents a major challenge for todays hepatologists, because it can ra...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2006.05.010
更新日期:2006-05-01 00:00:00
abstract::The diagnosis of hepatic encephalopathy is predominantly clinical, and the tests available assist in the diagnosis only by excluding other causes. Covert hepatic encephalopathy, which is defined as abnormal performance on psychometric tests when standard neurologic examination is completely normal, has gained widespre...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.04.001
更新日期:2015-08-01 00:00:00
abstract::Understanding of the pathogenesis of hepatic fibrosis on a molecular level has led to the identification of several putative serum markers of hepatic fibrosis. Either individually or in combination, these serum markers appear capable of determining early and advanced hepatic fibrosis. Radiological determination of hep...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2005.08.002
更新日期:2005-11-01 00:00:00
abstract::Patients with sickle cell disease can develop liver disease as a result of intrahepatic sickling of erythrocytes, viral hepatitis and iron overload secondary to multiple blood transfusions, and gallstone disease as a result of chronic hemolysis. The spectrum of clinical liver disease is wide and often multifactorial. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.12.002
更新日期:2019-05-01 00:00:00
abstract::The study of hepatitis C virus (HCV) molecular virology is helping to shape the future of our anti-HCV strategies by identifying new antiviral targets. With the advent of agents that specifically target individual HCV proteins, HCV-specific therapy has arrived. Key to these efforts is the development of high-efficienc...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2005.05.013
更新日期:2005-08-01 00:00:00
abstract::Standard therapy with pegylated interferon and ribavirin for chronic hepatitis C is effective in 40% to 50% of individuals with genotype 1 hepatitis C virus (HCV) infection and is associated with significant treatment-related toxicities. Newly developed small molecules that target key enzymes essential for HCV replica...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2009.05.009
更新日期:2009-08-01 00:00:00
abstract::Good management of patients at risk for the development of hepatocellular carcinoma includes regular ultrasound surveillance, and aggressive management of lesions detected at ultrasound. Good radiology and good pathology are essential to the appropriate management of these small lesions. With good quality testing it i...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2007.08.011
更新日期:2007-11-01 00:00:00
abstract::The past decade has brought tremendous growth in the under-standing of the pathophysiologic mechanisms involved in cholestasis, both at the genetic and acquired levels. The discovery and characterization of an array of hepatobiliary transport proteins, the nuclear receptors that regulate them, and the potential clinic...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/S1089-3261(03)00125-9
更新日期:2004-02-01 00:00:00
abstract::The incidence of newly acquired hepatitis C infection has diminished in the United States. This decline is largely because of a decrease in cases among IDUs for reasons that are unclear and, to a lesser extent, to testing of blood donors for HCV. The virus is transmitted by blood, and such transmission now occurs prim...
journal_title:Clinics in liver disease
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/s1089-3261(02)00078-8
更新日期:2003-02-01 00:00:00
abstract::Pharmacologic management of hepatic encephalopathy includes a broad range of therapies. This article covers the specific mainstays of therapies, such as antimicrobials and laxatives, with an established evidence base. This article also covers newer modalities of therapies, such as fecal microbiota transplant, probioti...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2020.01.005
更新日期:2020-05-01 00:00:00
abstract::Acute liver failure (ALF) is a rare but highly fatal condition. The most common causes include drug-induced and viral hepatitis, but other less common etiologies, especially autoimmune hepatitis, Budd-Chiari syndrome, and Wilson disease, need to be considered. Because diagnosis is frequently tied to potential for reve...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.01.008
更新日期:2018-05-01 00:00:00
abstract::The global risk of hepatocellular carcinoma (HCC) has been largely driven by hepatitis B virus (HBV) infection for the past century, along with hepatitis C virus (HCV), aflatoxin, excessive alcohol consumption, and obesity/diabetes. The dominant effect of HBV on global HCC risk should decline as the population vaccina...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2011.03.006
更新日期:2011-05-01 00:00:00
abstract::Hepatic encephalopathy (HE) represents a continuum of transient and reversible neurologic and psychiatric dysfunction. It is a reversible state of impaired cognitive function or altered consciousness in patients with liver disease or portosystemic shunting. Over the last several years, high-quality studies have been c...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.03.009
更新日期:2012-05-01 00:00:00
abstract::Development of ethanol-induced fatty liver, alcoholic hepatitis, and cirrhosis has been attributed in part to nutritional deficiencies for many years. Special attention must be focused on treating alcohol-induced liver disease while providing replacement of deficient amino acids, vitamins, minerals, and other nutrient...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.11.003
更新日期:2005-02-01 00:00:00
abstract::Both covert hepatic encephalopathy (CHE) and overt hepatic encephalopathy (OHE) impair the ability to operate machinery. The legal responsibilities of US physicians who diagnose and treat patients with hepatic encephalopathy vary among states. It is imperative that physicians know the laws regarding reporting in their...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.04.004
更新日期:2015-08-01 00:00:00
abstract::Abnormalities of LFTs and liver function occur not infrequently in patients with rheumatic conditions, and many diagnostic possibilities exist. Systemic inflammation that is related to uncontrolled rheumatic disease and periods of disease remission have been described as a cause for fluctuations in levels of serum ami...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(02)00052-1
更新日期:2002-11-01 00:00:00
abstract::Steatosis is a common finding in patients with chronic hepatitis C (CHC) due to a combination of the direct steatogenic effect of hepatitis C virus (HCV) and the prevalence of metabolic risk factors in the HCV population. Steatosis is now established as a risk factor for disease progression in CHC and significantly im...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.06.007
更新日期:2004-11-01 00:00:00
abstract::Despite significant advances in nonsurgical treatments of hepatocellular carcinoma, these approaches rarely result in cure. Surgery remains the mainstay of curative therapy for hepatocellular carcinoma. Liver transplantation, in particular, has emerged as one of the most beneficial therapeutic modalities. Questions re...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2011.03.005
更新日期:2011-05-01 00:00:00
abstract::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 obs...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.06.007
更新日期:2018-11-01 00:00:00
abstract::Biochemical cholestasis after liver transplantation is common and often has no clinical significance if biliary anastomosis strictures and leaks have been excluded. There is no agreed upon definition for severe cholestasis, but it is associated with a worse mortality. There has been little evaluation on risk factors, ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2007.11.001
更新日期:2008-02-01 00:00:00
abstract::Imaging and imaging guided intervention have revolutionized the management of hepatic inflammatory diseases. Pyogenic abscess is preferentially treated percutaneously. Radiologic techniques are crucial for the diagnosis of amebic liver abscess and infectious conditions of the liver in immunocompromised patients. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00073-4
更新日期:2002-02-01 00:00:00
abstract::Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are examples of complex diseases accompanied by changes in the expression of thousands of genes and a plethora of proteins encoded by these genes. Before the era of high-throughput analysis, typical translational research initiatives, a...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2007.02.003
更新日期:2007-02-01 00:00:00
abstract::The diagnosis of AIH depends on the finding of several suggestive features together with careful exclusion of liver diseases of other etiologies. Wherever possible, the diagnosis should be confirmed histologically by an experienced hepatopathologist. Seronegativity for the conventional autoantibodies at presentation d...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(02)00019-3
更新日期:2002-08-01 00:00:00
abstract::The metabolic syndrome and the hepatitis C virus (HCV) infection are 2 global health care challenges with a complex interaction. Insulin resistance, a central component of the metabolic syndrome, is epidemiologically and pathophysiologically intrinsically linked to HCV infection. Insulin resistance and diabetes affect...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2013.09.007
更新日期:2014-02-01 00:00:00
abstract::The causes of hepatic granulomas are numerous and their identification can be difficult. Sarcoidosis is a main cause of hepatic granulomas. The mechanisms that initiate the formation of sarcoid granulomas are unknown. This article discusses the pathology of hepatic sarcoidosis and hepatic granulomas. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70108-2
更新日期:2000-02-01 00:00:00
abstract::Newer noninvasive tests have begun to replace liver biopsy for staging purposes. The clinician must evaluate these tools and apply them to individual patients. None of these modalities give the exact same staging of fibrosis as a liver biopsy, but they are excellent tools for risk stratification. Still, it should be r...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2014.09.007
更新日期:2015-02-01 00:00:00