Diagnosis and management of chronic liver diseases:
Gespeichert in:
Weitere Verfasser: | |
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Format: | Buch |
Sprache: | English |
Veröffentlicht: |
Philadelphia, Pa.
Elsevier
2014
|
Schriftenreihe: | Medical clinics of North America
98,1 |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | XVI, 180 S. Ill., graph. Darst., Kt. |
ISBN: | 9780323287128 |
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Datensatz im Suchindex
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adam_text | Titel: Diagnosis and management of chronic liver diseases
Autor: Larson, Anne M
Jahr: 2014
Diagnosis and Management of Chronic Liver Diseases
Contents
Foreword xiii
Douglas 5. Paauw
Preface xv
Anne M. Larson
Evaluation of Abnormal Liver Tests 1
Tinsay A. Woreta and Saleh A. Alqahtani
Serum biochemical tests play an important role in the diagnosis and
management of acute and chronic liver disease. Their routine use has
led to the increased detection of liver enzyme abnormalities in otherwise
asymptomatic patients. These tests consist of markers of hepatocellular
injury, tests of liver metabolism, and tests of liver synthetic function.
Liver injury can be characterized as primarily hepatocellular versus cho-
lestatic based on the degree of elevation of aminotransferases com-
pared with alkaline phosphatase. A comprehensive history, physical
examination, and assessment of pattern of liver injury with additional
directed laboratory testing establish the cause of hepatobiliary disease
in most cases.
Removal Notice to An Overview of Emerging Therapies for the Treatment of
Chronic Hepatitis C R1
Jawad A. Ilyas and John M. Vierling
Chronic Hepatitis B Virus Infection 39
Brian J. McMahon
Over 400,000 people worldwide are chronically infected with hepatitis B
virus (HBV), and are at increased risk of developing hepatocellular carci-
noma (HOC) and cirrhosis. HBV infected persons need regular lifelong
follow-up. Candidates for antiviral therapy include patients with moder-
ate-to-severe liver disease as determined by elevated alanine aminotrans-
ferase and/or liver biopsy and elevated HBV DNA levels above 2000
lU/mL, per evidenced-based guidelines. Pegylated interferon, tenofovir
and entecavir are the first line drugs of choice for those needing treatment.
All patients undergoing cancer chemotherapy or immunosuppressive ther-
apy should be screened for hepatitis B surface antigen (HBsAg) and given
HBV antiviral prophylaxis if positive.
Review of Treatment Options for Nonalcoholic Fatty Liver Disease 55
Richele L. Corrado, Dawn M. Torres, and Stephen A. Harrison
Nonalcoholic fatty liver disease (NAFLD) remains the most common
chronic liver disease in the western world and its prevalence is rising
x Contents
elsewhere. Among patients with NAFLD, those with nonalcoholic steato-
hepatitis (NASH) represent a large potential public health concern with
risk for development of cirrhosis and hepatocellular carcinoma. The ability
to diagnose and treat NAFLD and NASH has improved and continues to
improve as understanding of the pathogenesis of this disease develops.
This article highlights the key features of NAFLD and NASH, as well as
the available and future promising treatment options.
Cholestatic Liver Disease 73
Andrea A. Gossard and Jayant A. Talwalkar
Cholestatic liver disease may involve both extrahepatic and intrahepatic
bile ducts, or may be limited to one or the other. Cholestasis may be
due primary bile duct disease or secondary causes such as stones or
tumors. Care of the patient with cholestasis depends on identifying the
probable cause, initiating appropriate treatment or intervention, and the
recognition and management of potential complications.
Metal Storage Disorders: Wilson Disease and Hemochromatosis 87
Pushpjeet Kanwar and Kris V. Kowdley
Hereditary hemochromatosis and Wilson disease are autosomal recessive
storage disorders of iron and copper overload, respectively. These metals
are involved in multiple redox reactions, and their abnormal accumulation
can cause significant injury in the liver and other organs. Over the last few
decades clinicians have developed a much better understanding of these
metals and their mechanism of action. Moreover, sophisticated molecular
genetic testing techniques that make diagnostic testing less invasive are
now available. This article updates and discusses the pathogenesis, diag-
nosis, and management of these metal storage disorders.
Hepatocellular Carcinoma and Other Liver Lesions 103
Reena Salgia and Amit G. Singal
Patients with cirrhosis are at greatest risk for development of hepatocellu-
lar carcinoma (HCC) and should undergo semiannual surveillance using
ultrasound, with or without alpha fetoprotein. Patients with positive surveil-
lance testing should undergo contrast-enhanced MRI or 4-phase CT for
diagnostic evaluation. There are therapeutic options for most patients
with any tumor stage; however, treatment decisions must be individualized
after accounting for degree of liver dysfunction and patient performance
status. A multidisciplinary approach to care is recommended for optimal
communication and treatment delivery. The aim of this review is to provide
an up-to-date summary of the diagnosis and management of HCC.
Management of End-stage Liver Disease 119
Iris W. Liou
Major complications of cirrhosis include the development of ascites, spon-
taneous bacterial peritonitis, hepatorenal syndrome, variceal hemorrhage,
hepatic encephalopathy, and hepatocellular carcinoma. Careful evaluation
and management of ascites and varices with judicious use of prophylactic
Contents
xi
therapy can improve survival. Diagnosis of hepatic encephalopathy can
lead to appropriate intervention without protein restriction. Patients should
undergo hepatocellular carcinoma surveillance routinely every 6 months.
The development of any decompensating event should prompt referral
to a liver transplant center.
When to Consider Liver Transplant During the Management of Chronic
Liver Disease 153
Rena K. Fox
With rising rates of end-stage liver disease and hepatocellular carcinoma,
there is a growing demand for liver transplantation. The decision to allo-
cate a liver to a patient is an extensive process in a transplant center,
but the timing of initial referral for transplant evaluation will commonly be
the responsibility of the primary care physician. This article discusses
the indications and contraindications for liver transplantation. The criteria
to determine timing of transplant referral are reviewed, and integration of
these criteria into long-term management of patients with cirrhosis is
emphasized.
Index
169
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spelling | Diagnosis and management of chronic liver diseases ed. Anne M. Larson Philadelphia, Pa. Elsevier 2014 XVI, 180 S. Ill., graph. Darst., Kt. txt rdacontent n rdamedia nc rdacarrier Medical clinics of North America 98,1 Clinics review articles Larson, Anne M. (DE-588)1049227360 edt Medical clinics of North America 98,1 (DE-604)BV000003310 98,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=027202830&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
spellingShingle | Diagnosis and management of chronic liver diseases Medical clinics of North America |
title | Diagnosis and management of chronic liver diseases |
title_auth | Diagnosis and management of chronic liver diseases |
title_exact_search | Diagnosis and management of chronic liver diseases |
title_full | Diagnosis and management of chronic liver diseases ed. Anne M. Larson |
title_fullStr | Diagnosis and management of chronic liver diseases ed. Anne M. Larson |
title_full_unstemmed | Diagnosis and management of chronic liver diseases ed. Anne M. Larson |
title_short | Diagnosis and management of chronic liver diseases |
title_sort | diagnosis and management of chronic liver diseases |
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