Subjects -> MEDICAL SCIENCES (Total: 8810 journals)
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    - INTERNAL MEDICINE (180 journals)
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    - SURGERY (412 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)

INTERNAL MEDICINE (180 journals)                     

Showing 1 - 180 of 180 Journals sorted alphabetically
Abdomen     Open Access  
ACP Hospitalist     Full-text available via subscription   (Followers: 9)
ACP Internist     Full-text available via subscription   (Followers: 10)
ACP Journal Club     Full-text available via subscription   (Followers: 11)
Acta Clinica Belgica     Hybrid Journal   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 9)
Advances in Hepatology     Open Access   (Followers: 4)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
African Journal of Thoracic and Critical Care Medicine     Open Access  
American Family Physician     Full-text available via subscription   (Followers: 38)
American Journal of Hypertension     Hybrid Journal   (Followers: 31)
Anales de Medicina Interna     Open Access   (Followers: 1)
Anatomy & Physiology : Current Research     Open Access   (Followers: 9)
Angiology     Hybrid Journal   (Followers: 5)
Annals of Colorectal Research     Open Access   (Followers: 1)
Annals of Internal Medicine     Full-text available via subscription   (Followers: 392)
AORN Journal     Hybrid Journal   (Followers: 27)
Apollo Medicine     Open Access  
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archivos de Medicina Interna     Open Access   (Followers: 1)
Asia Oceania Journal of Nuclear Medicine & Biology     Open Access   (Followers: 4)
Asian Pacific Journal of Tropical Disease     Full-text available via subscription   (Followers: 3)
Australasian Physical & Engineering Sciences in Medicine     Hybrid Journal   (Followers: 1)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access   (Followers: 1)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 35)
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
Bone & Joint Journal     Hybrid Journal   (Followers: 138)
Brain Communications     Open Access   (Followers: 4)
Brain Science Advances     Open Access  
Canadian Journal of General Internal Medicine     Open Access   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Case Reports in Internal Medicine     Open Access   (Followers: 1)
Cell Death & Disease     Open Access   (Followers: 3)
Cellular and Molecular Gastroenterology and Hepatology     Open Access   (Followers: 3)
Cephalalgia     Hybrid Journal   (Followers: 8)
Cephalalgia Reports     Open Access   (Followers: 4)
Chronic Diseases and Injuries in Canada     Free   (Followers: 1)
Clinical Ethics     Hybrid Journal   (Followers: 13)
Clinical Liver Disease     Open Access   (Followers: 5)
Clinical Nutrition     Hybrid Journal   (Followers: 98)
Clinical Thyroidology     Full-text available via subscription   (Followers: 1)
CNE Pflegemanagement     Hybrid Journal  
Communication Law and Policy     Hybrid Journal   (Followers: 5)
Current Diabetes Reports     Hybrid Journal   (Followers: 30)
Current Hepatology Reports     Hybrid Journal  
Current Research: Integrative Medicine     Open Access  
CVIR Endovascular     Open Access   (Followers: 1)
Der Internist     Hybrid Journal   (Followers: 12)
Diabetes     Full-text available via subscription   (Followers: 603)
Diabetes Care     Full-text available via subscription   (Followers: 578)
Diabetes Internacional     Open Access  
Diabetes Spectrum     Full-text available via subscription   (Followers: 17)
Diagnosis     Hybrid Journal   (Followers: 1)
Egyptian Journal of Bronchology     Open Access  
Egyptian Journal of Internal Medicine     Open Access   (Followers: 1)
Egyptian Journal of Neurosurgery     Open Access  
Egyptian Liver Journal     Open Access   (Followers: 2)
Egyptian Spine Journal     Open Access  
EMC - Aparato Locomotor     Hybrid Journal  
Endovascular Neuroradiology / Ендоваскулярна нейрорентгенохірургія     Open Access   (Followers: 1)
eNeuro     Open Access   (Followers: 3)
Ergonomics     Hybrid Journal   (Followers: 24)
European Journal of Inflammation     Open Access   (Followers: 2)
European Journal of Internal Medicine     Full-text available via subscription   (Followers: 10)
European Journal of Translational Myology     Open Access  
European Radiology Experimental     Open Access   (Followers: 2)
Head and Neck Tumors     Open Access   (Followers: 1)
Health Sociology Review     Hybrid Journal   (Followers: 14)
HemaSphere     Open Access   (Followers: 2)
Hepatology Communications     Open Access  
Hepatoma Research     Open Access   (Followers: 3)
Human Physiology     Hybrid Journal   (Followers: 5)
ImmunoHorizons     Open Access  
Immunological Medicine     Open Access  
Infectious Diseases: Research and Treatment     Open Access   (Followers: 5)
Inflammation and Regeneration     Open Access   (Followers: 2)
Inflammatory Intestinal Diseases     Open Access  
Innere Medizin up2date     Hybrid Journal   (Followers: 1)
Internal and Emergency Medicine     Hybrid Journal   (Followers: 5)
Internal Medicine Journal     Hybrid Journal   (Followers: 9)
International Journal of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
International Journal of Anatomy and Research     Open Access   (Followers: 2)
International Journal of Angiology     Hybrid Journal  
International Journal of Artificial Organs     Hybrid Journal   (Followers: 3)
International Journal of Hyperthermia     Open Access  
International Journal of Internal Medicine     Open Access   (Followers: 3)
International Journal of Noncommunicable Diseases     Open Access  
International Journal of Psychiatry in Clinical Practice     Hybrid Journal   (Followers: 6)
Iranian Journal of Neurosurgery     Open Access   (Followers: 1)
Italian Journal of Anatomy and Embryology     Open Access   (Followers: 1)
JAC-Antimicrobial Resistance     Open Access   (Followers: 4)
JAMA Internal Medicine     Full-text available via subscription   (Followers: 364)
JCSM Clinical Reports     Open Access   (Followers: 3)
JHEP Reports     Open Access  
JIMD Reports     Open Access  
JMV - Journal de Médecine Vasculaire     Hybrid Journal   (Followers: 1)
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
JOP. Journal of the Pancreas     Open Access   (Followers: 2)
Journal of Basic & Clinical Physiology & Pharmacology     Hybrid Journal   (Followers: 1)
Journal of Bone Oncology     Open Access   (Followers: 1)
Journal of Cancer & Allied Specialties     Open Access  
Journal of Clinical and Experimental Hepatology     Full-text available via subscription   (Followers: 3)
Journal of Clinical Movement Disorders     Open Access   (Followers: 3)
Journal of Community Hospital Internal Medicine Perspectives     Open Access  
Journal of Cutaneous Immunology and Allergy     Open Access  
Journal of Developmental Origins of Health and Disease     Hybrid Journal   (Followers: 2)
Journal of Endoluminal Endourology     Open Access  
Journal of Gastroenterology and Hepatology Research     Open Access   (Followers: 4)
Journal of General Internal Medicine     Hybrid Journal   (Followers: 23)
Journal of Hypertension     Hybrid Journal   (Followers: 14)
Journal of Infectious Diseases     Hybrid Journal   (Followers: 48)
Journal of Interdisciplinary Medicine     Open Access  
Journal of Internal Medicine     Hybrid Journal   (Followers: 11)
Journal of Liver : Disease & Transplantation     Hybrid Journal   (Followers: 7)
Journal of Medical Internet Research     Open Access   (Followers: 24)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 46)
Journal of Pancreatic Cancer     Open Access  
Journal of Renal and Hepatic Disorders     Open Access  
Journal of Solid Tumors     Open Access   (Followers: 1)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of the American Board of Family Medicine     Open Access   (Followers: 11)
Journal of the European Mosquito Control Association     Open Access  
Journal of Translational Internal Medicine     Open Access  
Jurnal Vektor Penyakit     Open Access  
La Revue de Medecine Interne     Full-text available via subscription   (Followers: 3)
Lege artis - Das Magazin zur ärztlichen Weiterbildung     Hybrid Journal   (Followers: 1)
Liver Cancer International     Open Access  
Liver Research     Open Access  
Molecular Diagnosis & Therapy     Hybrid Journal   (Followers: 3)
Molecular Therapy - Oncolytics     Open Access  
Multiple Sclerosis and Demyelinating Disorders     Open Access   (Followers: 7)
MYOPAIN. A journal of myofascial pain and fibromyalgia     Hybrid Journal   (Followers: 18)
Neuro-Oncology Advances     Open Access   (Followers: 1)
Neurobiology of Pain     Open Access   (Followers: 2)
Neurointervention     Open Access   (Followers: 6)
Neuromuscular Diseases     Open Access  
Nigerian Journal of Gastroenterology and Hepatology     Full-text available via subscription  
OA Alcohol     Open Access   (Followers: 5)
Oncological Coloproctology     Open Access  
Open Journal of Internal Medicine     Open Access  
Pleura and Peritoneum     Open Access  
Pneumo News     Full-text available via subscription  
Polish Archives of Internal Medicine     Full-text available via subscription   (Followers: 2)
Preventing Chronic Disease     Free   (Followers: 2)
Progress in Transplantation     Hybrid Journal   (Followers: 1)
Prostate International     Open Access   (Followers: 2)
Psychiatry and Clinical Psychopharmacology     Open Access   (Followers: 1)
Pulmonary Therapy     Open Access   (Followers: 2)
Quality of Life Research     Hybrid Journal   (Followers: 20)
Research and Practice in Thrombosis and Haemostasis     Open Access  
Revista Chilena de Fonoaudiología     Open Access   (Followers: 1)
Revista de la Sociedad Peruana de Medicina Interna     Open Access   (Followers: 4)
Revista del Instituto de Medicina Tropical     Open Access  
Revista Hispanoamericana de Hernia     Open Access   (Followers: 1)
Revista Médica Internacional sobre el Síndrome de Down     Full-text available via subscription   (Followers: 1)
Revista Virtual de la Sociedad Paraguaya de Medicina Interna     Open Access   (Followers: 1)
Romanian Journal of Diabetes Nutrition and Metabolic Diseases     Open Access   (Followers: 1)
Romanian Journal of Internal Medicine     Open Access  
Russian Journal of Child Neurology     Open Access   (Followers: 1)
Scandinavian Journal of Primary Health Care     Open Access   (Followers: 8)
Schlaf     Hybrid Journal  
Schmerzmedizin     Hybrid Journal  
Scientific Journal of the Foot & Ankle     Open Access   (Followers: 1)
SciMedicine Journal     Open Access   (Followers: 3)
SEMERGEN - Medicina de Familia     Full-text available via subscription   (Followers: 1)
The Journal of Critical Care Medicine     Open Access   (Followers: 9)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 8)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 6)
Thieme Case Report     Hybrid Journal   (Followers: 1)
Tijdschrift voor Urologie     Hybrid Journal  
Tissue Barriers     Hybrid Journal   (Followers: 1)
Transactions of the Royal Society of Tropical Medicine and Hygiene     Hybrid Journal   (Followers: 3)
Transgender Health     Open Access   (Followers: 3)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)
US Cardiology Review     Open Access  
Vascular and Endovascular Review     Open Access   (Followers: 1)
Ожирение и метаболизм     Open Access  

           

Similar Journals
Journal Cover
Current Hepatology Reports
Number of Followers: 0  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Online) 2195-9595
Published by Springer-Verlag Homepage  [2657 journals]
  • Harms of Hepatocellular Carcinoma Surveillance
    • Abstract: Purpose of Review Hepatocellular carcinoma (HCC) surveillance in patients with cirrhosis is associated with decreased mortality by enabling early tumor detection. However, the benefits of any cancer screening program must be considered in light of potential physical, financial, and psychological harms, as well as the risk of overdiagnosis. Herein, we summarize the potential harms of HCC surveillance. Recent Findings To date, two retrospective studies have addressed physical harms of HCC surveillance. Based on these data, 15% to 28% of patients undergoing HCC surveillance experience physical harm including additional cross-sectional imaging or liver biopsy. Although psychological and financial harms have been reported for other cancers, there are currently limited data specific to HCC. An ongoing multi-center prospective study assessing all four types of harms should provide data in the near future. Summary HCC screening may improve survival by diagnosing tumors at an early stage, but limited sensitivity and specificity of screening tests can result in unintended harms. There is a need for further quality data evaluating both the benefits and harms of HCC surveillance.
      PubDate: 2019-10-15
      DOI: 10.1007/s11901-019-00488-8
       
  • Correction to: Stereotactic Ablative Radiotherapy (SABR/SBRT) for
           Hepatocellular Carcinoma
    • Abstract: The article Stereotactic Ablative Radiotherapy (SABR/SBRT) for Hepatocellular Carcinoma, written by Byung-Han Rhieu, Amol K. Narang and Jeffrey Meyer, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 16 October 2018 without open access.
      PubDate: 2019-09-16
      DOI: 10.1007/s11901-019-00487-9
       
  • Economic Analyses to Inform and Support Health Policy for Chronic
           Hepatitis B Treatment
    • Abstract: Purpose of Review Summarize insights into the economic impact of global hepatitis B treatment policies. Recent Findings With the highly effective antiviral treatment, entecavir and recently tenofovir, coming off patent, hepatitis B treatment is now very inexpensive and may save costs in the long run. In the USA alone, dramatic increases in screening and treatment would prevent between 80 and 100 thousand cases of cirrhosis, 50 and 60 thousand cases of liver cancer, and 80 to 100 thousand HBV-related deaths over the next 50 years. Summary Cost-effectiveness analyses can provide information in the form of what a proper course of action will cost, and what the benefits will be in terms of health impact. Since the sharp reduction in antiviral drug pricing, the focus should be on treating patients with generic antivirals to ensure that the chronic hepatitis B care and treatment efforts are highly cost-effective and even cost-saving.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00482-0
       
  • Global Epidemiology of Drug-Induced Liver Injury (DILI)
    • Abstract: Purpose of Review Drug-induced liver injury (DILI) is not an uncommon liver disease in many parts of the world. DILI is one of the most common causes of acute liver failure in most countries. The current review summarizes the global epidemiology of DILI. Recent Findings The number need to harm in terms of DILI due to amoxicillin-clavulanate was approximately 1 out 2300, but was higher for azathioprine (1 out of 133) and infliximab (1 out of 148). A retrospective Chinese study showed the highest rate of DILI in hospitalized patients with an incidence of approximately 24 patients per 100,000 annually with a more favorable prognosis in the DILI cohort than previously reported from Europe, the USA, and Asia. Summary Although large DILI registries from Europe and the USA have collected much data, more prospective studies with continual enrollment are needed particularly as new therapies such as immune modulatory and oncological medications with longer half-lives and latencies come to market.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00475-z
       
  • Strategies for Global Elimination of Chronic HBV Infection: 2019 Update
    • Abstract: Purpose of Review With just over a decade to go before the WHO 2030 hepatitis elimination targets, this review takes a global perspective at the major challenges standing in the way of hepatitis B virus (HBV) elimination and discusses potential innovative solutions on the horizon for use in high burden settings. Recent Findings Universal HBV infant vaccination has been an incredible success. However, in order to reach the elimination targets, efforts now need to urgently focus on scaling up HBV prevention of mother-to-child (PMTCT) interventions, particularly in sub-Saharan Africa and increasing population level testing and treatment. Summary Innovative outreach strategies, simplified diagnostics and novel biomarkers and integration of systems are promising solutions to allow HBV elimination to be reached in an effective and affordable way. This should go alongside careful financing, policy planning and establishment of strong surveillance systems.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00478-w
       
  • The Role of Traditional Chinese Medicines (TCM) and Other Complementary
           and Alternative Medicines (CAM) in the Management of Chronic Hepatitis B
    • Abstract: Purpose of Review To provide a review and update of complementary and alternative medicine (CAM) approaches to the management of chronic hepatitis B, with particular emphasis upon traditional Chinese medicines (TCM). Recent Findings The major findings are as follows: (1) TCMs were better than interferons [IFN] in lowering serum HBeAg and normalizing serum ALT, and equivalent to IFN in clearing serum HBV DNA; (2) TCMs were equivalent to lamivudine [LAM] in lowering serum HBeAg, normalizing serum ALT, and clearing serum HBV DNA; (3) TCMs along with IFN or LAM significantly lowered serum HBeAg and improved the clearance of serum HBV DNA and the normalization of serum ALT, compared with IFN or LAM alone; (4) no serious adverse reactions of TCM were reported in all cited clinical trials. Although the composition of traditional medicines in the TCMs varied among RCTs, about 60% of the used herbs were homologous. Our major overarching conclusion was that TCMs seem effective as alternative remedies for patients with CHB. Other CAM approaches also are widely used, especially in east Asian countries, and there is limited evidence of benefit for some. Summary CHB continues to be a major health problem worldwide. Although nucleosides such as tenofovir and entecavir are highly effective at suppression of HBV replication, they are expensive and often beyond reach of patients, especially in resource-limited nations and regions. Many such patients will continue to rely upon CAM and TCM for management of their chronic hepatitis B infections. Additional carefully done, placebo-controlled prospective randomized trials of CAM and TCM in chronic hepatitis B should be performed.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00480-2
       
  • Community-Based Strategies to Improve Screening, Diagnosis and Linkage to
           Care for Patients with Chronic Hepatitis B
    • Abstract: Purpose of Review Chronic hepatitis B (CHB) places 3.5% of the world population at risk of dying from liver failure or liver cancer. Effective antiviral therapies can change disease outcomes, provided that CHB screening and linkage to care can be delivered at population level, to reach the vast numbers of undiagnosed people. We therefore reviewed the experience of community-based CHB screening programs reported in the English literature since 2014. Recent Findings Twenty papers met eligibility criteria and only one originated from a low-income country. The two randomised studies found that culturally tailored hepatitis education increased hepatitis testing. Successful linkage to care was facilitated by partnerships with community-based organisations and the use of bilingual patient navigators. Point of care testing and chain referral sampling were successfully tested in two programs. Summary These studies demonstrated that community-based interventions can screen large numbers of people and could deliver the population-level outcomes required to meet the WHO targets of hepatitis B elimination.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00485-x
       
  • Regional and Racial Differences in Drug-Induced Liver Injury
    • Abstract: Purpose of Review To summarize the growing epidemiologic and genetic data that suggest racial and regional differences in drug-induced liver injury (DILI). Recent Findings Several registries and population-based studies report incidence data across continents from 2 to 24 per 100,000 with China reporting the highest incidence estimate. The agents causing DILI vary by race and region as well. Hepatotoxicity from herbal and dietary supplement is on the rise globally with China reporting the highest levels. Genome-wide association studies are beginning to shed light on racial genetic and HLA variants which may determine the risk of DILI. Summary DILI risk and outcome vary by race and region due to a combination of epidemiologic and genetic factors. The rise and maturation of DILI registries worldwide are beginning to allow important discoveries in how we should consider the diagnosis of DILI by region and race.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00476-y
       
  • Management of Virologic Failure in Patients with Chronic Hepatitis B
           Treated with Nucleos(t)ide Analogues
    • Abstract: Purpose of the Review Poorly controlled hepatitis B increases the risk for liver-related morbidity. Although there are now six approved nucleos(t)ide analogues (NA) for the treatment of chronic hepatitis B (CHB), drug resistance and thus virologic breakthrough still exist. This review outlines a systematic approach to the management of virologic failure in patients with CHB treated with NAs. Recent Findings Current NAs can be divided into older generation and newer generation agents, with newer generation agents associated with lower rates of virologic breakthrough. Both tenofovir dipovoxil fumarate (TDF) and tenofovir alafenamide (TAF) are equally as effective in addressing virologic breakthrough while on all other NAs. Entecavir is an effective treatment option for NA naïve patients only, with high rates of resistance to entecavir in those exposed to older NAs. Summary The management of virologic breakthroughs should focus on identifying risk factors for future drug resistance and escalation to appropriate newer generation drug options to avoid long-term liver-related morbidity.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00483-z
       
  • Bile Duct Injury Due to Drug-Induced Liver Injury
    • Abstract: Purpose of Review Drug-induced liver injury (DILI) can present with a variable clinical and pathological phenotype and can be classified using liver enzymes as hepatocellular, cholestatic, or a mixed pattern. The cholestatic pattern has been considered amongst the spectrum of direct liver damage at the microscopic level, but recently, bile duct injury, as a manifestation of DILI, has emerged as a distinct entity, and this review examines several examples of biliary tract abnormalities due to DILI from a clinical, radiologic, and pathologic perspective. Recent Findings Case series and reports have emerged over the last few years of drugs causing cholangiographic changes or direct injury to the intra- and extra-hepatic biliary tree, such as ketamine and several chemotherapy agents. The DILI Network (DILIN) in the USA has published their experience of cases with vanishing bile duct syndrome on histology and sclerosing cholangitis-like changes seen on cholangiography. The pathogenesis of these changes is unclear but it appears that this type of injury is more severe and more likely to lead to a chronic injury with increased mortality than other cases of DILI. Summary Bile duct injury due to DILI is an increasingly recognized entity and imaging of the biliary tree in conjunction with liver biopsy should be considered in patients with severe cholestatic DILI.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00474-0
       
  • Epidemiology, Diagnosis, and Management of Bone Disease in Patients with
           Chronic HBV Infection
    • Abstract: Purpose of Review Chronic hepatitis B (CHB) and treatment may be associated with increased risk of osteopenia/osteoporosis. Here, we review the prevalence of osteopenia/osteoporosis among patients with CHB and the effect of antiviral therapy on bone density. We also highlight screening and management strategies for bone disease among patients with CHB. Recent Findings While there are concerns with first-line antiviral therapy such as tenofovir disoproxil fumarate in the development of osteopenia/osteoporosis, the available data remain rather unclear. However, with the development of tenofovir alafenamide, these concerns may be mitigated. At present, EASL recommends dual-energy X-ray absorption (DEXA) scans for patients with osteoporotic risk factors, with a repeat DEXA scan based upon baseline findings. Summary Patients with CHB have higher incidence and prevalence of osteopenia/osteoporosis compared with patients without CHB. Further studies are needed to understand the impact of antiviral therapy on bone therapy, and more CHB specific recommendations are needed for bone health management.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00481-1
       
  • The Role of Liver Biopsy in Drug-Induced Liver Injury
    • Abstract: Purpose of Review This review presents the current understanding of the role played by liver biopsy in the diagnosis and management of drug-induced liver injury (DILI). Recent Findings While liver biopsy remains an optional procedure in the evaluation of DILI, it has the potential to provide detailed information about the state of the liver. Recent histological surveys of DILI provide a framework for categorizing the patterns of injury that may be seen. Pattern information can be used to distinguish DILI from other potential causes of injury, both other acute injuries as well as pre-existing injury. The pattern of injury is related to differential diagnosis and in some cases can suggest a mechanism of injury. The character and severity of the injury could potentially be used in clinical decision-making. Examples of the use of liver biopsy in the context of DILI encountered in clinical trials are provided which highlight these points. Summary Liver biopsy may be a useful tool in DILI evaluation, particularly in complex clinical situations and clinical trials with experimental therapies.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00486-w
       
  • Chronic Hepatitis B in US Veterans
    • Abstract: Purpose of Review This review summarizes recent data on chronic hepatitis B virus (HBV) epidemiology, issues in special populations undergoing immunosuppressive and hepatitis C virus (HCV) direct-acting antiviral (DAA) therapy, and describes care delivery, adherence to guideline-recommended care, and barriers to access to care and high-quality care for chronic HBV. Recent Findings Chronic HBV is present in up to 1% of veterans and is more than in the general US population. HBV is associated with more advanced liver disease in HCV, HIV, and delta hepatitis co-infection. Recent data on HBV reactivation show a substantial risk of reactivation with anti-CD20 antibodies, no documented cases of reactivation with anti-tumor necrosis factor (anti-TNF) therapy, and a low risk of reactivation with HCV DAA therapy. Adherence to guideline-recommended care for HBV is suboptimal for many quality indicators. Summary Important studies in HBV epidemiology, long-term outcomes, and care delivery practices have been conducted in the VA. Future studies should prospectively investigate how to improve guideline-recommended care for HBV.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00479-9
       
  • Drug-Induced Liver Injury Due to Nonsteroidal Anti-inflammatory Drugs
    • Abstract: Purpose of Review Nonsteroidal anti-inflammatory drugs (NSAIDs) are a heterogeneous group of medications intended to treat a variety of inflammatory diseases. While they are generally regarded as safe and most known for their potential gastrointestinal and renal side effects, cases of hepatotoxicity have been reported. This review summarizes the US and international literature regarding the incidence of NSAID-induced DILI and the biochemical signature of specific NSAIDs. Recent Findings Multiple studies have identified diclofenac as one of the more common culprits of NSAID-induced DILI. A genetic predisposition to DILI has been identified with diclofenac and lumiracoxib. Summary While NSAID-induced hepatotoxicity is rare, the potential for serious hepatotoxicity exists especially with certain agents such as diclofenac. An improved understanding of pharmacogenomics and post-marketing surveillance/monitoring is needed to reduce the risk of this DILI.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00477-x
       
  • Role of HBsAg Testing in the Management of Patients with Chronic HBV
    • Abstract: Purpose of Review HBsAg has been an important serological marker for the diagnosis of hepatitis B virus (HBV) infection. Recently, HBsAg quantification has been utilized to predict the disease activity and the response to antiviral treatment. This review aims to update the clinical utility of HBsAg quantification in the management of chronic hepatitis B (CHB). Recent Findings HBsAg level varies across different phases of the natural history of CHB, highest in the immune-tolerant phase and lowest in inactive carriers. HBsAg level is useful to stratify the risk of hepatocellular carcinoma in low-viremic patients. HBsAg level also helps predict the HBsAg loss in HBeAg-negative patients. Moreover, baseline level and on-treatment kinetics of HBsAg are associated with the treatment response to pegylated interferon and nucleos(t)ide analogs in both HBeAg-positive and HBeAg-negative patients. Finally, HBsAg level can serve as a therapeutic endpoint marker for evaluating novel curative agents against HBV infection. Summary HBsAg quantification can help guide the management of CHB.
      PubDate: 2019-09-01
      DOI: 10.1007/s11901-019-00484-y
       
  • Acute HCV Treatment: What Should We Do in the DAA Era'
    • Abstract: Purpose of Review Acute hepatitis C infection is a growing concern in the USA, especially in light of the opioid epidemic. Prior treatment data consisted of trials in patients receiving interferon-based regimens. There is now emerging evidence regarding the safety and efficacy of direct-acting antivirals for the treatment of acute hepatitis C. This review summarizes the current evidence on the treatment of acute HCV in the DAA era. Recent Findings Certain populations, such as people who inject drugs, or HIV-positive men who have sex with men, may benefit from early treatment of acute HCV. As compared with chronic hepatitis C, shorter durations of treatment appear highly effective in acute infection, resulting in reduced viral transmission, as well as potentially reduced overall costs of care related to this disease. Summary Further studies are needed to clarify the optimal drug combinations and treatment durations to achieve sustained virologic response in these patients.
      PubDate: 2019-06-01
      DOI: 10.1007/s11901-019-00463-3
       
  • Testing for Hepatitis C in Pregnancy: the Time Has Come for Routine Rather
           than Risk-Based
    • Abstract: Purpose of Review The purpose of this review is to discuss the reasons for HCV testing during pregnancy and to review what is known about antiviral treatment during pregnancy. Recent Findings Hepatitis C virus affects over 3 million persons in the USA and is one of the leading infectious causes of death. While HCV is most commonly transmitted via parenteral exposures, thus affecting people who inject drugs, it is also transmitted from mother-to-child. Due to an expanding opioid crisis, an increasing number of women of childbearing age are now infected, resulting in transmission to infants. Risk-based screening has never been proven effective and thus universal screening of pregnant women for HCV infection has been recommended. Summary Obstetricians may play a key role in the USA by implementing universal testing for HCV in pregnant women, thereby enhancing the health of mothers and identifying children at risk.
      PubDate: 2019-06-01
      DOI: 10.1007/s11901-019-00468-y
       
  • Patient Selection in Transjugular Intrahepatic Portosystemic Shunt (TIPS)
           for Refractory Ascites and Associated Conditions
    • Abstract: Purpose of Review This review summarizes the key developments and latest evidence for transjugular intrahepatic portosystemic shunt (TIPS) for the indications of refractory ascites and related conditions, as well as factors that should be taken into consideration with regard to patient selection. Recent Findings Recent evidence from randomized controlled studies has suggested that the early institution of TIPS in well-selected patients with refractory ascites may confer a survival benefit. Increasing evidence is also mounting on the potential role of TIPS in improving and reversing hepatorenal syndrome. Summary TIPS has conventionally been sought as a second-line treatment for refractory ascites. Recent evidence has suggested a potential survival benefit with early TIPS in well-compensated patients for this indication; this may lead to a paradigm shift for TIPS to be considered as primary therapy in well-selected “low-risk” patients. In hepatorenal syndrome, while evidence on TIPS is limited, multiple studies have shown a serendipitous improvement to renal function in both type 1 and 2 hepatorenal syndrome following TIPS.
      PubDate: 2019-06-01
      DOI: 10.1007/s11901-019-00470-4
       
  • The Use of Grafts from HCV+ Patients in Transplantation: Are we There
           Yet'
    • Abstract: Use of organs from donors previously or currently infected with hepatitis C virus is gaining interest in the transplantation realm. Purpose of Review Here we will outline the historical perspectives for discarding such organs, review the reasons for revitalized interest in their use, and highlight available data on the use of hepatitis C virus (HCV)-viremic grafts in transplantation. We will summarize arguments supporting and against such practices and offer our recommendations. Recent Findings HCV can now be safely and effectively treated post transplantation with direct-acting antivirals (DAAs). Several reports are highlighted in which HCV-viremic organ donation was performed, followed by DAA treatment. However, opinions abound on the appropriateness of this practice. Summary Use of viremic organs requires further study and additional larger-scale data with longer-term follow-up, but overall appears safe. It is a viable method to expand the donor pool in both liver and non-liver organ transplantation, but must be carefully weighed with the risks.
      PubDate: 2019-06-01
      DOI: 10.1007/s11901-019-00466-0
       
  • Prediction of Decompensation in Patients with Compensated Cirrhosis: Does
           Etiology Matter'
    • Abstract: Purpose of Review Transition from compensated to decompensated cirrhosis, defined by overt clinical signs, represents a turning point in the clinical course of the disease. In fact, while compensated cirrhosis is a silent disease characterized by long survival, decompensated cirrhosis is associated with symptoms markedly reducing the quality of life and with a median survival of 2–4 years. Therefore, identifying predictors of decompensation and investigating potential interventions for its prevention is a major objective. Mechanisms and incidence of decompensation, together with its predictors, are summarized here, with regard to the etiology of the disease. Recent Findings In a total of 92 studies including 105 cohorts and 152,320 patients, the mean ± SD 5-year decompensation rate was 24.5 ± 13.6%. The 5-year decompensation rate was significantly different across different etiologies, ranging from 12.8% for biliary etiologies to 33.6% in alcoholic liver disease (p < 0.0001). The most frequently reported significant predictors of decompensation were liver function, portal hypertension, and inflammation/fibrosis indicators. Etiologic treatment was associated with significant risk reduction. Summary While the risk of decompensation significantly varies across different etiologies of cirrhosis, etiology per se has not been properly studied as a decompensation predictor. Although decompensation appears to be related more to inflammation/fibrosis and portal hypertension, the causing factors may determine different activation intensity of the decompensating mechanisms.
      PubDate: 2019-06-01
      DOI: 10.1007/s11901-019-00473-1
       
 
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