Care of the cirrhotic patient:
From the Publisher: This issue of the Medical Clinics of North America brings the practicing clinician up to date on best practices of caring for the cirrhotic patient. Topics covered include diagnosis and epidemiology of cirrhosis; ascites: diagnosis and management; encephalopathy: pathophysiology...
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Saunders
2009
|
| Schriftenreihe: | Medical clinics of North America
93,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Zusammenfassung: | From the Publisher: This issue of the Medical Clinics of North America brings the practicing clinician up to date on best practices of caring for the cirrhotic patient. Topics covered include diagnosis and epidemiology of cirrhosis; ascites: diagnosis and management; encephalopathy: pathophysiology and emerging therapies; portal hypertensive bleeding; renal failure: differential diagnosis and management; pulmonary complications; hepatocellular carcinoma: current state of treatment; preventative health issues; pre-operative risk assessment; and liver transplantation: from Child's to MELD. |
| Beschreibung: | XII S., S. 787 - 962 Ill. |
| ISBN: | 9781437712407 1437712401 |
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| 245 | 1 | 0 | |a Care of the cirrhotic patient |c guest ed. David A. Sass |
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| 490 | 1 | |a Medical clinics of North America |v 93,4 | |
| 520 | 3 | |a From the Publisher: This issue of the Medical Clinics of North America brings the practicing clinician up to date on best practices of caring for the cirrhotic patient. Topics covered include diagnosis and epidemiology of cirrhosis; ascites: diagnosis and management; encephalopathy: pathophysiology and emerging therapies; portal hypertensive bleeding; renal failure: differential diagnosis and management; pulmonary complications; hepatocellular carcinoma: current state of treatment; preventative health issues; pre-operative risk assessment; and liver transplantation: from Child's to MELD. | |
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Datensatz im Suchindex
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| adam_text | Titel: Care of the cirrhotic patient
Autor: Sass, David A.
Jahr: 2009
Contents
Preface xi
David A. Sass
Diagnosis and Epidemiology of Cirrhosis 787
Harvey B. Lefton, Anthony Rosa, and Matthew Cohen
Cirrhosis is defined histologically as an advanced form of progressive he¬
patic fibrosis with distortion of the hepatic architecture and regenerative
nodule formation. It may be due to a variety of causes. It can be diagnosed
incidentally on liver biopsy or hepatic imaging studies, or patients may
present clinically with one or more features of hepatic failure. This article
gives the reader a broad overview of the epidemiology, diagnosis, and nat¬
ural history of cirrhosis; laying the foundation for subsequent articles,
which will discuss the diagnosis and management of each of the specific
cirrhosis-related complications.
Ascites: Diagnosis and Management 801
Wei Hou and Arun J. Sanyal
Ascites is the pathologic accumulation of fluid in the peritoneal cavity and
is a common manifestation of liver failure, being one of the cardinal signs of
portal hypertension. The diagnostic evaluation of ascites involves an as¬
sessment of its cause by determining the serum-ascites albumin gradient
and the exclusion of complications eg, spontaneous bacterial peritonitis.
Although sodium restriction and diuretics remain the cornerstone of asci¬
tes management, many patients require additional therapy when they
become refractory to such medical treatment. These include repeated
large volume paracentesis and transjugular intrahepatic portosystemic
shunts. This review article summarizes diagnostic tools and provides
an evidence-based approach to the management of ascites.
Hepatic Encephalopathy: Pathophysiology and Emerging Therapies 819
Vinay Sundaram and Obaid S. Shaikh
Hepatic encephalopathy is characterized by neuropsychiatric abnormali¬
ties in patients with liver failure. Severe hepatic encephalopathy is an indi¬
cation for liver transplantation as it portends poor outcome. Treatment of
hepatic encephalopathy involves correction of precipitating factors such
as sepsis, gastrointestinal bleeding, medications, and electrolyte imbal¬
ance. Effective therapies include lactulose and antibiotics such as neomy-
cin, metronidazole, and rifaximin.
Portal Hypertension and Variceal Hemorrhage 837
David A. Sass and Kapil B. Chopra
Portal hypertension is a progressively debilitating complication of cirrhosis
and a principal cause of mortality in patients who have hepatic decom¬
pensation. This article describes the classification system and
VIII V.UI I LCI I L3
pathophysiology of portal hypertension. It also discusses a practical ap¬
proach to prevention of first variceal hemorrhage, general management
of the acute bleeding episode, and secondary prophylaxis to prevent re-
bleeding, Pharmacologic, endoscopic, radiologic, and surgical modalities
are all described in detail.
Renal Failure in Patients with Cirrhosis 855
Lina Mackelaite, Zygimantas C. Alsauskas, and Karthik Ranganna
Renal failure in cirrhosis poses unique diagnostic and therapeutic chal¬
lenges. Laboratory values and predictive equations grossly overestimate
renal function in patients with cirrhosis. Development of renal failure con¬
notes a worse prognosis; mortality is especially high with hepatorenal syn¬
drome. Classification of the causes of renal failure in patients with cirrhosis
is provided with more extensive discussion of selected causes. Finally,
a suggested diagnostic approach to renal failure in cirrhosis is given.
Pulmonary Complications of Cirrhosis 871
C. Singh and J.S. Sager
Advanced liver disease and portal hypertension produce various intratho-
racic complications that involve the pleural space, the lung parenchyma,
and the pulmonary circulation. Dyspnea and arterial hypoxemia are the
most common symptoms and signs in patients with such complications.
This article focuses on the diagnosis and management of hepatopulmo-
nary syndrome, portopulmonary hypertension, and hepatic hydrothorax.
All are pulmonary processes associated with end-stage liver disease
that lead to significant morbidity and affect the quality of life of patients
who are suffering from liver cirrhosis.
Current Management of Hepatocellular Carcinoma 885
Manuel Mendizabal and K. Rajender Reddy
Hepatocellular carcinoma (HCC), one of the most common cancers world¬
wide, continues to increase in incidence in several regions around the
world and is associated with poor overall survival. Patients with cirrhosis
are at the highest risk and are candidates for surveillance. Wide implemen¬
tation of surveillance programs and improvement in noninvasive radiologic
techniques has led to tumor diagnosis at earlier stages. Surgical options
that include resection and liver transplantation offer the best chance of
successful outcomes. Locoregional therapies, such as radiofrequency ab- ;
lation and chemoembolization, provide effective local control in those with
acceptable hepatic function. A multikinase inhibitor, sorafenib, is the first
molecular targeted oral therapy that has recently been shown to provide i
a survival benefit in HCC in select patients.
i Health Maintenance Issues in Cirrhosis 901 i
I Gaurav Mehta and Kenneth D. Rothstein j
Caring for patients with cirrhosis requires special consideration. The rote of j
the hepatologist is to assist the primary care physician in caring for such
patients. This involves an active rote in immunizations, lifestyle
modifications, and providing instructions on when to go to the emergency
room (EB). There are also specific recommendations geared toward the
patient with cirrhosis relating to slowing down the disease process, main¬
taining quality of life, and improving survival.
Preoperative Risk Assessment for Patients with Liver Disease 917
Shahid M. Malik and Jawad Ahmad
Patients with underlying liver disease often present for non-liver-related
surgery and are at risk for postoperative decompensation. Several predic¬
tive models exist to determine the risk of morbidity and mortality after sur¬
gery in such patients, but the risk depends on the severity of liver disease
and also the type and urgency of the surgery. Clinicians should be cogni¬
zant of the various risk assessment tools and incorporate them into their
practice when encountering patients with liver disease undergoing
surgery.
Liver Transplantation: From Child to MELD 931
Juan F. Gallegos-Orozco and Hugo E. Vargas
The widespread availability of transplantation in most major medical cen¬
ters in the United States, together with a growing number of transplant
candidates, has made it necessary for primary care providers, especially
Internal Medicine and Family Practice physicians to be active in the clinical
care of these patients before and after transplantation. This review pro¬
vides an overview of the liver transplantation process, including indica¬
tions, contraindications, time of referral to a transplant center, the
current organ allocation system, and briefly touches on the expanding field
of living donor liver transplantation.
Index 951
|
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| discipline | Medizin |
| format | Book |
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| illustrated | Illustrated |
| indexdate | 2024-07-09T21:51:46Z |
| institution | BVB |
| isbn | 9781437712407 1437712401 |
| language | English |
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| physical | XII S., S. 787 - 962 Ill. |
| publishDate | 2009 |
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| publisher | Saunders |
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| series | Medical clinics of North America |
| series2 | Medical clinics of North America |
| spelling | Care of the cirrhotic patient guest ed. David A. Sass Philadelphia, Pa. Saunders 2009 XII S., S. 787 - 962 Ill. txt rdacontent n rdamedia nc rdacarrier Medical clinics of North America 93,4 From the Publisher: This issue of the Medical Clinics of North America brings the practicing clinician up to date on best practices of caring for the cirrhotic patient. Topics covered include diagnosis and epidemiology of cirrhosis; ascites: diagnosis and management; encephalopathy: pathophysiology and emerging therapies; portal hypertensive bleeding; renal failure: differential diagnosis and management; pulmonary complications; hepatocellular carcinoma: current state of treatment; preventative health issues; pre-operative risk assessment; and liver transplantation: from Child's to MELD. Liver Cirrhosis Liver Cirrhosis therapy Liver Cirrhosis Treatment Sass, David A. (DE-588)139010211 edt Medical clinics of North America 93,4 (DE-604)BV000003310 93,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017990566&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Care of the cirrhotic patient Medical clinics of North America Liver Cirrhosis Liver Cirrhosis therapy Liver Cirrhosis Treatment |
| title | Care of the cirrhotic patient |
| title_auth | Care of the cirrhotic patient |
| title_exact_search | Care of the cirrhotic patient |
| title_full | Care of the cirrhotic patient guest ed. David A. Sass |
| title_fullStr | Care of the cirrhotic patient guest ed. David A. Sass |
| title_full_unstemmed | Care of the cirrhotic patient guest ed. David A. Sass |
| title_short | Care of the cirrhotic patient |
| title_sort | care of the cirrhotic patient |
| topic | Liver Cirrhosis Liver Cirrhosis therapy Liver Cirrhosis Treatment |
| topic_facet | Liver Cirrhosis Liver Cirrhosis therapy Liver Cirrhosis Treatment |
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