Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The therapy of viral hepatitis has great medical and socioeconomic impact. Today chronic viral hepatitis is the most important cause for chronic liver disease, liver cirrhosis, and hepatocellular carcinoma. Hepatitis A and E cause acute courses exclusively whereas infection with the hepatitis B, C, and D virus might result in chronic hepatitis as well. The goal of therapy of chronic viral hepatitis has to be a reduction/normalisation of elevated transaminases, decrease of the serologic parameters of active viral replication, improvement of histology and prevention of complications of chronic hepatitis. The only drug with proven benefit in the treatment of chronic viral hepatitis is interferon alpha. This therapy results in a sustained response in 25 to 40% for hepatitis B and 10 to 25% for hepatitis C infection. New developments under clinical evaluation are Lamivudine and Famciclovir in the treatment of HBV-infection and Ribavirin in combination with INFa for chronic HCV-infection.
 ...
PMID:[Therapy of viral hepatitis]. 954 47

Subacute hepatic failure has been a controversial diagnosis ever since it was first identified more than 15 years ago. The Working Committee on Subacute Hepatic Failure has attempted to redefine this entity in which exclusion of preexisting cirrhosis on liver biopsy has been emphasized. Acute viral hepatitis in a patient with asymptomatic chronic liver disease (e.g., hepatitis B or C, Wilson's disease) can be misdiagnosed as subacute hepatic failure in the absence of a liver biopsy. This situation is common in developing countries where the prevalence of feco-orally transmitted (hepatitis A [<20 years] and hepatitis E [>20 years]) and parenterally transmitted (hepatitis B) viruses is high. To obtain and interpret liver biopsy specimens in such a situation is difficult and hazardous, and hence rarely performed. Acute viral hepatitis in a patient with asymptomatic chronic liver disease should be carefully looked for and excluded, especially in developing countries, before a diagnosis of subacute hepatic failure is confirmed.
 ...
PMID:Subacute hepatic failure: diagnosis of exclusion? 956 18

The study of viral hepatitis was expanded over the past decade with the emergence of new viruses, therapies, and vaccination guidelines as well as new data on the risks of perinatal transmission. There are now at least six hepatitis viruses. Hepatitis A and E are causes of epidemic, enteric infection and do not carry a significant risk of chronic infection. Hepatitis B, C, D, and G are hematogenously spread and are significant causes of chronic hepatitis, hepatocellular carcinoma, and cirrhosis. The following report reviews the types of hepatitis as well as the consequences of infection to the mother and fetus.
 ...
PMID:Hepatitis in pregnancy. 963 5

This article describes the preliminary experimental steps and clinical implementation of a purely pediatric liver transplantation (LT) program in a large public children's hospital in Buenos Aires, Argentina, a city with well over 10 million inhabitants and a referral population of over 30 million. Between 1993 and 1997, 84 LTs were performed in 81 patients, of which one-fourth weighed below 10 kg. The main indications were biliary atresia (n = 25, 30%) and fulminant liver failure (n = 23, 27%), followed by autoimmune cirrhosis (n = 14, 16%) and other liver diseases. Shortage of organs due to local conditions led to the use of liver-reduction techniques in 48 cases (57%), split liver in 2, and living-related donor (LRD) in 2. Retransplantation was necessary in 3 instances. Seventy-eight percent of the recipients survived for more than 1 year and 71% were alive after 4 years. The authors comment on the need for adaptation to local conditioning factors when developing a pediatric LT program in any country in which demographics and economic, medical, and sociological environments have a decisive influence on organ procurement, the actual performance of the operation, and the lifelong postoperative medication. In Buenos Aires, where the hospital setting is well-developed, the indications are in part determined by the high incidence of hepatitis A. Organ shortages in our area led to liberal use of liver reduction, split-liver, and LRD techniques. The overall results of the first years of such a program were largely satisfactory.
 ...
PMID:Development of a pediatric liver transplantation program in Argentina. 963 7

The incidence of delayed hepatitis B surface antigen (HBsAg) clearance in the natural history of chronic hepatitis B virus (HBV)-infected patients was low. Previous studies regarding the prognosis in such patients were controversial. Among 1,355 chronic carriers from 1985 to 1997, spontaneous HBsAg clearance was observed in 55 patients. During a mean follow-up period of 23 months, 18 (32.7%; all were male subjects) developed serious complications, including 11 with hepatocellular carcinoma (HCC) (9 of them underwent surgical resection), 6 with cirrhosis, and 1 with subfulminant liver failure. The overall cumulative probability of complications was 29.8% at 4 years, and it was higher in males (P = .044) and patients aged 45 years or more (P = .006); the latter carried an 8.6-fold increased risk (95% CI: 1.2-64.6; P = .037) of adverse events. Histories of acute or chronic infection by hepatitis A virus, C virus (HCV), or D virus (HDV) were present in 42% of patients. Patients seropositive for antibodies against HCV (anti-HCV) or HDV (anti-HDV) had higher alanine transaminase (ALT) levels (>40 U/L; P = .008) after sero-clearance. HBV DNA was detectable in 31% of 51 subjects, in 20% of 20 with antibodies against HBsAg, in 40% of 20 with anti-HCV or anti-HDV, and also in an HCC patient's serum and tumor. Staining of liver HBsAg was positive in 30% of 10 HCC patients. In conclusion, our results demonstrated that hepatitis B viremia may persist, and adverse complications were not rare in HBsAg-clearance patients. All such patients should be closely monitored, which may allow for earlier detection of HCC.
 ...
PMID:Sero-clearance of hepatitis B surface antigen in chronic carriers does not necessarily imply a good prognosis. 993 38

During recent years the outcome of acute hepatitis A in chronic liver disease has been discussed controversially. Data from large hepatitis A epidemics and surveillance data from the United States suggest a significantly higher risk of fatal outcome in patients with chronic hepatitis B. Patients with chronic active hepatitis or liver cirrhosis seem to be at highest risk, while HBsAg carriers may exhibit a benign course of the disease. Patients with chronic hepatitis C also seem to have a significantly higher risk of fulminant hepatic failure when superinfected with hepatitis A. The recently reported unsuspected coincidence of autoimmune markers with a fulminant course of hepatitis A in those patients needs to be confirmed. Vaccination against hepatitis A in patients with chronic liver disease has been shown to be safe and effective.
 ...
PMID:Risk of hepatitis A superinfection in patients with underlying liver disease. 965 10

Hepatitis A, B, C, D, E, and G are important causes of viral hepatitis. It is estimated that there are at least 32,000 new cases of hepatitis A, 300,000 new cases of hepatitis B, and 150,000 new cases of hepatitis C each year in the United States alone. Risk factors for hepatitis infection include sexual activity with multiple partners, intravenous drug use or sharing cocaine straws, tattooing or body piercing, exposure to blood and body fluids through health-care work, and having a blood transfusion or transplant. Diagnostic markers are important to determine the type of hepatitis and to differentiate acute from chronic infection. Up to 5% of adult patients infected with hepatitis B virus and up to 80% of those infected with hepatitis C virus become chronic carriers. Whereas acute hepatitis C virus infection is usually mild, chronic hepatitis C infection develops insidiously after an average of 10 years and may lead to cirrhosis and possibly hepatocellular carcinoma. Currently, interferon-alpha is the only FDA-approved agent to treat chronic hepatitis B and C and relapses are common with hepatitis C infection. There are many clinical trials using other antivirals and combination therapies to treat these chronic infections. Prevention through patient education of high-risk behaviors and immunization remain the best defense against acute and chronic viral hepatitis.
 ...
PMID:Acute and chronic viral hepatitis. 970 84

Results of laboratory tests ordered during a primary care encounter may reveal findings of abnormal liver function tests, including elevated liver enzymes, hyperbilirubinemia, hypoalbuminemia or abnormal coagulation tests. The object of this study was to describe the spectrum of these liver function test (LFT) abnormalities in primary care. Results of all laboratory tests ordered during 10 months in an urban primary care clinic were retrospectively reviewed and the medical charts of patients with abnormal LFTs were studied. In 217/1088 (20%) of the tests at least 1 LFT abnormality was found in 156 patients. New diagnoses were made in 104 patients. The main diagnostic groups were: non-alcoholic fatty liver changes, Gilbert's disease, acute infectious hepatitis, alcoholic liver disease and cirrhosis and hepatotoxic drug injury. In 60 patients the physician classified the abnormality as negligible and not associated with significant disease. However, an abnormal test that had been ordered for evaluation of a specific complaint, was indeed likely to represent significant disease (X2 = 29.5, p < 0.001). We conclude that finding abnormalities in liver function tests is common in the primary care clinic but does not often indicate significant liver disease.
 ...
PMID:[Abnormal liver function tests in the primary care setting]. 988 47

We have been determining the GGT IE isoenzyme in patients with hepatitis A and B with decomposed liver cirrhosis, with obstructive hepatitis caused by the gall stones. In patients with hepatitis A and B the IE is located between albumin and betaglobulin, as well as in patients with obstructive hepatitis caused by the gall stones; in the latter partly between Alpha 1 and Alpha 2 globulin. In patients with decompensated liver cirrhosis (37.7% of the patients) there was IE activity 100% in Alpha 2 globulin area; in 6.25% of patients the activity was in the prealbumin area. In patients with secondary liver tumors we got a rather high increase of the GGT IE activity in Alpha 1 globulin area, in 77.7% of the patients even 80 to 100%. In some patients with disease progression we noticed the GGT IE activity in Beta globulin area. The results in primary liver malignomas were different. In 68.5% of the patients the GGT IE activity dominated in Alpha 1 globulin area.
 ...
PMID:[Isoenzymes of gammaglutamyltransferase in patients with obstructive and hepatocellular icterus]. 1054 25

Viral hepatitis is a persisting concern. Outbreaks of hepatitis A occur in developed countries where only 10% to 20% of the population is seroprotected. The disease may cause fulminant liver failure and death. People who are targeted for vaccination include intravenous drug users, homosexuals, and chronic hepatitis patients. Secondary prophylaxis of household contacts is an efficient way to prevent secondary cases. Universal vaccination is now in progress for hepatitis B. Vaccination failure may occur in low birth weight infants, or in infants infected in utero. Chronic carriers of viral hepatitis may progress to cirrhosis and hepatocarcinoma, the latter risk being most important for men infected at birth. Alcohol intake should be avoided in carrier adolescents. Interferon is able to triple the rate of hepatitis B e antigen loss and decouple the rate of hepatitis B s antigen loss after one year, shortening disease evolution and, it is to be hoped, decreasing the risk of unfavorable outcome. Similarly, lamivudine increases by four times the rate of hepatitis B e antigen loss in adults. However, precore mutants may be selected by immune pressure after seroconversion in children, and tyrosine-methionine-aspartate-aspartate (YMDD) mutations appear in 15% of patients treated with lamivudine after 1 year. Hepatitis C is mainly acquired during childhood via true vertical transmission. The risk of acquiring Hepatitis C is related to the presence and amount of RNA for hepatitis C virus in mothers at the time of birth. The infection rate for the hepatitis C virus is higher in children from mothers who have tested positive for HIV, and higher if these children are themselves coinfected with HIV. Treatment with interferon alone has a poor rate of efficiency, although pediatric studies remain scarce. Combination treatment using ribavirin plus interferon yield a higher rate of success in eradicating viral infection in adults.
 ...
PMID:Update on prevention and treatment of viral hepatitis in children. 1055 88


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>