Abstract:
:In the intersection of alcohol ingestion with the law, medical ethics, and public safety, physicians are often unsure about how to proceed. Physicians' primary focus should be on patient education with an ethical and legal duty to warn the patient of the adverse effects of alcohol. Warning third parties of potential harm related to alcohol-related impairment may involve a breach of patient confidentiality; therefore it should only be undertaken after careful analysis suggests that the risk for significant harm exceeds the burden that results to the patient from warning others. The law remains vague in this area.
journal_name
Clin Liver Disjournal_title
Clinics in liver diseaseauthors
Balakrishnan M,Pappas SCdoi
10.1016/j.cld.2018.09.002subject
Has Abstractpub_date
2019-02-01 00:00:00pages
25-38issue
1eissn
1089-3261issn
1557-8224pii
S1089-3261(18)30078-3journal_volume
23pub_type
杂志文章,评审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 incidence of nonalcoholic fatty liver disease is increasing at an astonishing rate in the US population. Although only a small proportion of these patients develop steatohepatitis (NASH), those who do have a greater likelihood of developing end-stage liver disease and complications. Research on liver fibrosis and ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.05.002
更新日期:2012-08-01 00:00:00
abstract::The most consistently identified predictive factors for a response to both IFN-alpha monotherapy and IFN-alpha in combination with ribavirin are a low HCV RNA level, the absence of fibrosis, infection with HCV genotype 2 and 3, and a prolonged duration of treatment. In addition, an early response to IFN-alpha predicts...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70238-5
更新日期:1999-11-01 00:00:00
abstract::Primary biliary cirrhosis (PBC) is characterized by the presence of high-titer disease specific autoantibodies directed against mitochondrial antigens (AMA) of the inner mitochondrial membrane, that are members of the 2-oxo acid complex. Among numerous other autoantibodies found in PBC the focus of ongoing studies is ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00104-1
更新日期:2003-11-01 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::Early diagnosis of HCC is possible because certain risk factors for this tumor are known and because sensitive and relatively inexpensive diagnostic tools are available. Early diagnosis of HCC is also possible because of the long phase of asymptomatic tumor growth and the tumor's tendency to grow as a solitary mass in...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70156-2
更新日期:2001-02-01 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::Artificial liver-support devices attempt to bridge patients with fulminant hepatic failure until either a suitable liver allograft is obtained for transplantation or the patient's own liver regenerates sufficiently to resume normal function. It is thought that toxins contribute to the clinical picture of fulminant hep...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70172-0
更新日期:2001-05-01 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::The management of autoimmune and cholestatic liver disorders is a challenging area of hepatology. Autoimmune and cholestatic liver diseases represent a comparatively small proportion of hepatobiliary disorders, yet their appropriate management is of critical importance for patient survival. In this article, management...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2009.02.011
更新日期:2009-05-01 00:00:00
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 patient...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2017.08.006
更新日期:2018-02-01 00:00:00
abstract::Although there are no randomized, controlled trials evaluating the efficacy of endoscopic retrograde cholangiography (ERC) in primary sclerosing cholangitis (PSC) patients, substantial indirect evidence supports the effectiveness of ERC in symptomatic PSC patients with a dominant stricture. Currently, cumulative evide...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2014.07.013
更新日期:2014-11-01 00:00:00
abstract::Nonalcoholic fatty liver disease is emerging as the most common cause of chronic liver disease worldwide. This trend is, in part, secondary, to the growing incidence of obesity, type 2 diabetes, and metabolic syndrome. Other risk factors include age, gender, race/ethnicity, genetic predisposition, and polycystic ovari...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2017.08.008
更新日期:2018-02-01 00:00:00
abstract::Primary liver cancer is the fifth most common malignancy worldwide and the third leading cause of cancer mortality. Non-alcoholic fatty liver disease is the most common cause of chronic liver disease in the United States encompassing a spectrum of entities marked by hepatic steatosis in the absence of significant alco...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2009.07.007
更新日期:2009-11-01 00:00:00
abstract::Although recent evidence indicates that the quasispecies nature of HCV constitutes a critical strategy for the virus to survive in the host, the mechanisms of viral persistence remain unknown. Similarly, the correlates of immune protection in a limited proportion of individuals who succeed in clearing HCV are still la...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70200-2
更新日期:2001-11-01 00:00:00
abstract::Decision analysis helps evaluate competing strategies under conditions of uncertainty in a wide variety of clinical settings. Despite some limitations, decision trees and Markov models remain essential tools for medical decision analysts. These techniques allow comparison of competing management strategies in a quanti...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.12.004
更新日期:2005-05-01 00:00:00
abstract::This article discusses direct-acting antiviral agents that target hepatitis C virus replication, their mechanism of action, strengths, and weaknesses. In addition, varying strategies using combinations of these agents are discussed. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.06.002
更新日期:2015-11-01 00:00:00
abstract::Bile acid synthetic defects are uncommon disorders that cause progressive cholestatic liver disease that is often lethal in infancy or early childhood. Five specific primary defects have been described. Diagnosis is based on mass spectrometry of urine and serum. Pathogenesis of liver injury is related to persistent re...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70144-6
更新日期:2000-11-01 00:00:00
abstract::Hepatobiliary dysfunction associated with the use of total parenteral nutrition is a commonly recognized phenomenon occurring in up to 90% of patients on long-term therapy. Reasons for these abnormalities, both supported by research as well as theoretical possibilities are explored. Practical guidelines considered use...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70368-8
更新日期:1998-02-01 00:00:00
abstract::In conclusion, the natural history of chronic HCV infection has not yet been fully defined. Current data suggest that the process runs an indolent course during the first two decades after initial infection, accounting for modest morbidity and mortality. Serious sequelae are more likely to emerge as the disease proces...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70323-8
更新日期:1997-11-01 00:00:00
abstract::Pruritus is a common symptom with primary biliary cholangitis. Research has focused on refining understanding of the neurohumoral pathways involved in transduction of pruritus from peripheral cutaneous receptors to the central nervous system, and identifying modulating drugs. Current treatments have variable efficacy ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.03.005
更新日期:2018-08-01 00:00:00
abstract::Since the introduction of small bowel capsule endoscopy, and more recently of esophageal capsule endoscopy, these diagnostic tools have become available for the evaluation of the consequences of portal hypertension in the esophagus, stomach, and small intestine. The main advantage of the esophageal and the small bowel...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2010.03.004
更新日期:2010-05-01 00:00:00
abstract::Hepatotoxicity associated with any antibiotic is rare. With the wide-spread use of antimicrobial agents, however, hepatic injury is not an infrequent occurrence. Penicillins remain a widely used class of antimicrobials with a well defined record of low hepatotoxicity. The combination of clavulanate with amoxicillin ma...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00021-7
更新日期:2003-05-01 00:00:00
abstract::For patients who present with variceal bleeding refractory to endoscopic and pharmacologic methods, TIPS is a new and effective therapy. Stents are used in selected patients with decompensated liver disease and those who anticipate liver transplantation within 6 to 12 months. Surveillance of TIPS with ultrasound, with...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70257-9
更新日期:1997-05-01 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::Liver biopsy is used to determine the pathogenesis of liver dysfunction after liver transplantation. One or more causative factors may be identified on biopsy. The pathologist must be familiar with the histopathology of acute rejection to differentiate it from other potential complications, including biliary obstructi...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(02)00003-x
更新日期:2002-05-01 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::Serologic assays for HBV are the mainstay diagnostic tools for HBV infection. However, the advent of molecular biology-based techniques has added a new dimension to the diagnosis and treatment of patients with chronic HBV infection. Over the past decade, improvements in molecular technology, permitting detection of as...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.02.001
更新日期:2004-05-01 00:00:00
abstract::Mathematical modeling of hepatitis C viral kinetics has been an important tool in understanding hepatitis C virus (HCV) infection dynamics and in estimating crucial in vivo parameters characterizing the effectiveness of HCV therapy. Because of the introduction of direct-acting antiviral agents, there is a need to exte...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.09.003
更新日期:2013-02-01 00:00:00
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