Evidence-based Gastroenterology and Hepatology

Name: Evidence-based Gastroenterology and Hepatology
Brand: Wiley
Price: 262.99 EUR
Availability: OnlineOnly

John W. D. Mcdonald Brian G. Feagan Rajiv Jalan Peter J. Kahrilas(Herausgeber*in)

Wiley (Verlag)

4. Auflage

Erschienen am 13. Februar 2019

816 Seiten

E-Book

PDF mit Adobe-DRM

Systemvoraussetzungen

978-1-119-21139-6 (ISBN)

262,99 €inkl. 7% MwSt.

Systemvoraussetzungen

für PDF mit Adobe-DRM

E-Book Einzellizenz

Als Download verfügbar

Beschreibung

Weitere Details

Weitere Ausgaben

Inhalt

Intro
Evidence-Based Gastroenterology and Hepatology
Dedication
Contents
Contributors
Preface
PART I Gastrointestinal disorders
1 Gastroesophageal reflux disease
Introduction
Definition of GERD
Clinical presentation
Epidemiology
Pathophysiology
Natural history and complications
Diagnostic tests
Symptom assessment and questionnaires
PPI trial
Upper GI endoscopy
Ambulatory GERD testing: pH and pH-impedance monitoring
Esophageal high-resolution manometry
Barium swallow
Mucosal impedance
Treatment
Lifestyle modifications
Antacids and alginates
Histamine-2 receptor antagonists
Proton pump inhibitors
Potassium competitive acid blockers
Reflux inhibitors
Prokinetic drugs
Targeting hypersensitivity
Antireflux surgery
Novel surgical and endoscopic procedures
Conclusion
References
2 Barretts esophagus
Introduction
Definition
Pathogenesis
Epidemiology
Incidence and prevalence
Risk factors
Natural history
Diagnosis
Endoscopy
Diagnosis-histopathology
Advanced endoscopic imaging in BE
Screening and surveillance
Screening
Surveillance
Treatment
Acid suppression
Chemoprevention of esophageal adenocarcinoma with anti-inflammatory agents
Endoscopic therapies for Barretts esophagus
Conclusion
References
3 Esophageal motility disorders
Achalasia
Treatment of achalasia
Overview
Pharmacologic treatment
Botulinum toxin
Pneumatic dilation
Heller myotomy
Per-oral endoscopic myotomy (POEM)
Comparisons among treatment modalities
Esophagectomy
Summary
Spastic motor disorders
Treatment of spastic motility disorders
Overview
Medications
Botulinum toxin
Pneumatic dilation
Heller myotomy
POEM
Summary
References
4 Eosinophilic esophagitis
Introduction
Searching for the evidence
Definition
Etiology and pathogenesis
Genetics and genetic variants
Environmental factors
Epidemiology
Diagnosis
General approach and differential diagnosis
GERD and PPI-REE
Features in children
Features in adults
Endoscopic features
Histologic features
Prognosis and natural history
Management
Corticosteroids
Biologics
Leukotriene antagonists and mast cell stabilizers
Immunomodulators
Dietary therapy
Endoscopic management with dilation
Future advances
Evaluation and prognosis
Novel therapies
Summary of treatment data
Acknowledgments
References
5 Ulcer disease and Helicobacter pylori infection: current treatment
Introduction
What is the evidence for the role of H. pylori in peptic ulcer disease?
Association of H. pylori with ulcer disease (strength, consistency, and specificity)
Duodenal ulcer
Duodenal ulcers not related to H. pylori and NSAIDs
Gastric ulcer
Temporal relationship
Biological gradient
Biological plausibility
Effects of interventions: outcomes following H. pylori eradication
Coherence of the data with earlier epidemiological information
Treatment of duodenal ulcer
Influence of H. pylori eradication on healing of duodenal ulcer
Acid suppressive therapy need not be continued beyond the duration of eradication treatment
Duodenal ulcer complications and effects of H. pylori
Bleeding
Summary
Perforation
Obstruction
Treatment of gastric ulcer
H. pylori eradication influence on healing and recurrence of gastric ulcer
H. pylori: eradication therapy
Antibiotic regimens
Important new updates
Recommended first-line therapies
Non-bismuth quadruple therapy
Bismuth quadruple therapy
Not recommended as first line
Recommended treatments for prior treatment failure
Bismuth quadruple therapy (PBMT) for 14 days
PAL (PPI, amoxicillin and levofloxacin) for 14 days
Last ditch rescue therapy: rifabutin regimens
Probiotics in H. pylori eradication
PPI (acid suppression) as part of the eradication regimen
Acid suppression plus amoxicillin
Summary
References
6 Nonsteroidal anti-inflammatory drug-gastropathy and enteropathy
Introduction
Background
Risk factors for NSAID-related gastrointestinal toxicity
Do endoscopic ulcers predict clinical events?
The role of Helicobacter pylori in NSAID-associated ulcers
Ulcer healing
Ulcer prevention in NSAID naive patients
Secondary ulcer prevention in patients on continuous NSAID
Definition of terms
Misoprostol
Long-term efficacy of misoprostol
Endoscopic ulcers
Analysis by dose
Studies including data with less than three months' tNSAID exposure
Clinical ulcers
Adverse effects
H2-receptor antagonists
Treatment of NSAID-induced ulcer
Prevention of NSAID-induced ulcers
Symptoms
Proton pump inhibitors
Healing of ulcers with continued NSAID use
NSAID ulcer prevention
Symptoms
Head-to-head comparisons
Misoprostol vs. H2-RAs
PPI vs. H2-RA
PPI vs. misoprostol
Symptoms
Summary
Cyclo-oxygenase-2 inhibitors
Endoscopic ulcer trials
Cyclo-oxygenase-2s vs. nonselective nonsteroidal anti-inflammatory drugs
Endoscopically detected gastroduodenal ulcers
Analysis by duration
Analysis by cyclo-oxygenase-2
Celecoxib
Etoricoxib
Analysis by comparator nonsteroidal anti-inflammatory drugs
Naproxen
Ibuprofen
Diclofenac
Cyclo-oxygenase-2s vs. placebo
Clinical gastrointestinal events
Cyclo-oxygenase-2s vs. nonselective nonsteroidal anti-inflammatory drugs
Analyses stratified by cyclo-oxygenase-2s
Celecoxib
Etoricoxib
Analysis by comparator nonsteroidal anti-inflammatory drugs
Cyclo-oxygenase-2s vs. placebo
Influence of acetylsalicylic acid coadministration on clinically important ulcer complications
Addition of a proton pump inhibitor to cyclo-oxygenase-2s
Symptoms and treatment withdrawals
Treatment withdrawals as a result of gastrointestinal side effects: cyclo-oxygenase-2s vs. nonselective nonsteroidal anti-inflammatory drugs
Adverse gastrointestinal symptoms with cyclo-oxygenase-2s compared with nonselective nonsteroidal anti-inflammatory drugs
Adverse gastrointestinal symptoms with cyclo-oxygenase-2s compared with placebo
High-risk patients requiring NSAIDs
Summary
References
7 Acute non-variceal gastrointestinal hemorrhage: treatment
Introduction
Risk assessment
Resuscitation and blood transfusion
Correction of coagulaopthy
Endoscopy
Endoscopic therapy
Single or dual modality?
Adrenaline injection
Alcohol
Combination therapy with sclerosants
Thrombin and fibrin glue
Conclusion
Thermal therapies
Laser photocoagulation
Heater probe
Electrocoagulation
Argon plasma coagulation
Combination therapy with thermal modalities
Mechanical hemostasis
Hemoclips
Triclip
Combination therapy with mechanical modalities
Endoscopic therapy for ulcers with adherent blood clot
Elective repeat endoscopic therapy
Failure of endoscopic therapy
Endoscopic therapy: summary
Endoscopic therapy in current practice
Drug therapy
Prokinetic agents
Acid suppressing drugs
Tranexamic acid
Somatostatin and octreotide
Test and treatment for Helicobacter pylori
Conclusions
References
8 Functional dyspepsia
Introduction
Definition of functional dyspepsia
Overlap with GERD
ROME IV functional dyspepsia criteria
Making a functional dyspepsia diagnosis for clinical trials
Methodological considerations in functional dyspepsia treatment trials
Evidence for efficacious treatments
Drug treatment
Psycholgical therapies
Other agents
Conclusion
References
9 Celiac disease: diagnosis, screening, and prognosis
Epidemiology
Pathophysiology and clinical manifestations
Morbidity and mortality
Age
Gender
Severity of disease
Screening
Small intestinal biopsy
Therapies
Future directions
References
10 Therapy for Crohn's disease
Introduction
Therapies
5-Aminosalicylates
Corticosteroids
Conventional corticosteroids
Budesonide
Antibiotics
Nitroimadazole antibiotics
Fecal microbial transplant
Probiotics
Conventional immunosuppressive drugs
Thiopurines
Methotrexate (MTX)
Cyclosporine
Biologic therapies
TNF antagonists
Natalizumab
Vedolizumab
Investigational agents targeting lymphocyte trafficking
Etrolizumab
Anti-MAdCAM-1 therapy
Ustekinumab
p19 Inhibition
Sphingosine-1-phosphate receptors antagonists (S1P1-5)
Janus kinase inhibitors
Mongersen
Omega-3 fatty acids
Combination therapy with TNF-antagonist antibodies and immunosuppressives for induction and maintenance of remission
Conventional "step-up" vs. "top-down" approach to use of immunosuppressive agents for induction and maintenance of remission
Summary
Conclusions
References
11 Ulcerative colitis
Introduction
Epidemiology
Risk of cancer and surveillance
Goal of treatment
Treatment
Aminosalicylates
Corticosteroids
Azathioprine and 6-mercaptopurine
Methotrexate
Cyclosporin
Antitumor necrosis factor (TNF) monoclonal antibodies
Anti-integrin monoclonal antibodies
Novel therapies in late stage clinical development
Other anti-trafficking agents
Janus kinase inhibitors
Sphingosine-1-phosphate receptor modulators
Surgery
Algorithm for management of ulcerative colitis
References
12 Pouchitis after restorative proctocolectomy
Background and epidemiology
Pathophysiology
Risk factors
Clinical features
Diagnostic testing
Pouchoscopy
Fecal biomarkers
Stool culture for enteric pathogens
Contrast X-ray of the pouch (Pouchogram)
Pelvic MRI
Tests of pouch emptying
Therapeutic trial
Differential diagnosis of symptoms of pouch dysfunction
Recommended diagnostic strategy
Treatment options
Antibiotics
Probiotics
Other therapies
Treatment algorithm
Conclusions
References
13 Microscopic colitis: collagenous and lymphocytic colitis
Part 1: Epidemiology, histopathology, and clinical features
Epidemiology
Histopathology
Clinical features
Part 2: Pathophysiology
Etiology and pathophysiology
Part 3: Treatment
Treatment of microscopic colitis
Other treatments
Recommended treatment for microscopic colitis
References
14 Drug-induced diarrhea
Introduction
Watery diarrhea
Osmotic diarrhea
Secretory diarrhea
Drugs that inhibit absorption
Disordered or deregulation motility
Inflammatory diarrhea
Fatty diarrhea
Treatment of drug-induced steatorrhea
Conclusion
References
15 Prevention and treatment of travelers' diarrhea
Epidemiology of travelers' diarrhea
Travelers' diarrhea clinical presentation
Etiology of travelers' diarrhea
Prevention of travelers' diarrhea
Current practice and recommendations
Future research in prevention of travelers' diarrhea
Treatment of travelers' diarrhea
Current practice and recommendations
Future research for treatment of travelers' diarrhea
Conclusions
Disclaimer
References
16 Metabolic bone disease in gastrointestinal disorders
Introduction
Assessment of bone mass
Hepatic osteodystrophy
Prevalence
Pathophysiology
Treatment
Inflammatory bowel disease
Prevalence
Pathogenesis
Treatment
Glucocorticoid-induced bone loss
Pathogenesis
Prevention and treatment
PPIs and fracture risk
Celiac disease
Prevalence
Pathogenesis
Treatment
Conclusion
References
17 Colorectal cancer in ulcerative colitis: surveillance
Epidemiological investigation
Axioms
Questions
Chemoprevention
Improving cancer surveillance programs in ulcerative colitis
References
18 Colorectal cancer: population screening and surveillance
Colorectal cancer: an ideal target for prevention and early detection through screening
Epidemiology and risk factors
Organized vs. opportunistic screening
CRC screening tests
Levels of evidence and the role of modeling studies
Fecal tests for CRC screening
Radiologic tests
Endoscopic tests
Post-polypectomy surveillance
Quality
Cost effectiveness
Implementing screening
References
19 Clostridium difficile infections: epidemiology, diagnosis, and treatment
Introduction
Epidemiology
Incidence/prevalence
Source of C. difficile acquisition
Healthcare-associated outbreaks
Transmission
Risk factors
Risk factors for recurrent CDI
Costs
Clinical presentation
Diagnosis
Treatment of CDI
Treatment strategies for the initial CDI episode
Antibiotics for initial CDI
Adjunctive use of probiotics for initial CDI
Treatment strategies for recurrent CDI
Prevention of CDI recurrences
Adjunct probiotics for recurrent CDI
Fecal microbial therapy for recurrent CDI
Immunotherapy for recurrent CDI
Treatment of asymptomatic carriers
Prevention of initial CDI
Infection control practices
Environmental disinfectants
Disposal or dedicated medical equipment
Medication restrictions
Reducing host susceptibility to infection
Multidisciplinary practices
Summary
References
Contents
20 Irritable bowel syndrome
Definition of irritable bowel syndrome
Prevalence and incidence of irritable bowel syndrome
Irritable bowel syndrome and health services
Pathogenesis of irritable bowel syndrome
Evidence for genetic susceptibility
Evidence for disturbed gastrointestinal motility and visceral hypersensitivity
Evidence for abnormalities of brain-gut and gut-brain communication
Evidence for a postinfectious etiology and altered gut flora
Evidence for low-grade mucosal inflammation, immune activation, and increased mucosal permeability
Evidence for a role of bile acid metabolism
Making a diagnosis of irritable bowel syndrome
Utility of a physicians diagnosis
Utility of individual lower gastrointestinal symptoms
Utility of symptom-based diagnostic criteria
Role of investigations in excluding organic disease in patients meeting diagnostic criteria for irritable bowel syndrome
Summary
Treatment of irritable bowel syndrome
Efficacy of fiber in irritable bowel syndrome
Efficacy of antispasmodic drugs and peppermint oil in irritable bowel syndrome
Efficacy of antidepressants in irritable bowelsyndrome
Efficacy of probiotics in irritable bowel syndrome
Efficacy of antibiotics in irritable bowel syndrome
Efficacy of drugs acting on 5-HT receptors in irritable bowel syndrome
Efficacy of intestinal secretagogues in irritable bowel syndrome
Efficacy of drugs acting on opioid receptors in irritable bowel syndrome
Efficacy of psychological therapies in irritable bowel syndrome
Efficacy of dietary modifications in irritable bowel syndrome
Summary
Prognosis of irritable bowel syndrome
References
21 Intestinal pseudo-obstruction (Ogilvie's syndrome)
Introduction
Background
Epidemiology
Pathophysiology
Clinical features and diagnosis
Acute colonic pseudo-obstruction
Chronic intestinal pseudo-obstruction
Treatment
Acute colonic pseudo-obstruction
Chronic intestinal pseudo-obstruction
Conclusion
References
22 Gallstone disease
Epidemiology and pathogenesis
Symptoms and complications
Diagnosis
Treatment of gallstones
Symptomatic gallstones
Cholecystectomy: the risks and benefits
Cholecystectomy: surgical technique
Laparoscopic cholecystectomy: timing
Patients with common bile duct stones and gallstones
Asymptomatic gallstones
Summary
References
23 Acute pancreatitis
Epidemiology and pathogenesis
Types of acute pancreatitis
Symptoms and complications
Severity of acute pancreatitis
Diagnosis
Prognostic scoring systems
Treatment of acute pancreatitis
Treatment of gallstone acute pancreatitis
Treatments to avoid pancreatitis
Conclusion
References
PART II Liver disease
24 Acute-on-chronic liver failure: diagnosis, prognosis, and treatment
Background
Diagnosis
ACLF phenotype
The presence of ACLF alters the natural history of acute decompensation events
Other definitions of ACLF
Prognosis
Scoring systems to assess ACLF
CLIF-OF score
CLIF-C acute decompensation score (CLIF-AD)
Other prognostic scoring systems
ACLF biomarkers
Treatment
Mobilization of bone marrow-derived stem cells With G-CSF
Direct administration of stem cells
Plasma exchange
Extracorporeal devices
Molecular adsorbent recirculating system (MARS)
Prometheus
Other
Patient selection for liver transplant in ACLF
Conclusions
References
25 Acute liver failure: prognosis and management
Introduction
Definition
Etiology
Prognosis
Scoring systems to determine prognosis
General management
Cardiovascular support
Respiratory support
Metabolic and nutritional support
Renal support
Sepsis
Coagulation support
Neurological support
Liver-specific management
N-Acetyl cysteine
Artificial liver systems
Plasma exchange
Liver transplantation
Conclusions
References
26 Infection in cirrhosis
Introduction
Outcomes and consequences of infection
The early diagnostic approach
Bacterial infections
The burden of multidrug resistant (MR) bacteria
Treatment of bacterial infections
Antibiotic prophylaxis for bacterial infections
Nonantibiotic strategies for prevention of bacterial infections
Invasive fungal infections (IFIs)
Invasive candidiasis (IC)
Invasive aspergillosis (IA)
Conclusions
References
27 Liver biopsy
Introduction
Indications
Contraindications
An optimal biopsy
Preparing patient for the biopsy
Methods for liver biopsy
Percutaneous liver biopsies
Transvenous biopsy
Laparoscopic biopsy
Endoscopic ultrasound-guided liver biopsy
Complications
Death
Hemorrhage
Pain
Perforation and other miscellaneous complications
Histopathological features
Sampling
Scoring systems, reproducibility, and clinical usefulness
References
28 Pregnancy and liver disease
Introduction
Normal physiology in pregnancy
The pregnancy-related liver diseases
Hyperemesis gravidarum
Intrahepatic cholestasis of pregnancy
Preeclampsia/HELLP syndrome
Acute fatty liver of pregnancy
Preexisting liver diseases and pregnancy
(Chronic) Hepatitis B virus infection and pregnancy
Chronic hepatitis C infection and pregnancy
Autoimmune hepatitis and pregnancy
Cholestatic liver disease and pregnancy
Budd-Chiari syndrome and pregnancy
Liver transplantation and pregnancy
Liver disease coincidentally arising with pregnancy
Acute viral infections and pregnancy
Drug-induced hepatotoxicity and pregnancy
References
29 Cholangiocarcinoma
Introduction
Epidemiology
Histology
Clinical features
Investigations
Blood tests
Tumor markers
Immunoglobulin G4 (IgG4)
Noninvasive imaging
Invasive imaging
Pathological diagnosis
Staging
Treatment
Surgery
Chemotherapy
Radiotherapy
Proton beam therapy (PBT)
Combined chemoradiotherapy
Biological therapies
Endoscopic treatments
Interventional radiology
Follow-up
Prognosis
Conclusion
References
30 Noninvasive tests of liver fibrosis
Currently available noninvasive methods
Biological approach: serum biomarkers of liver fibrosis
Physical approach: measuring liver stiffness
Diagnostic performances of noninvasive methods for staging liver fibrosis
Endpoints
Serum biomarkers of fibrosis
Transient elastography
Other imaging methods
Use in clinical practice
Monitoring disease progression and prognosis
References
31 Hepatitis C: treatment
Treatment of chronic hepatitis C
Direct acting antivirals
NS3/4A protease inhibitors (Paritaprevir, Grazoprevir, Glecaprevir, Voxilaprevir)
NS5A inhibitors (Ledipasvir, Ombitasvir, Elbasvir, Daclatasvir, Velpatasvir, Pibrentasvir)
NS5B nucleoside (Sofosbuvir) and non-nucleoside polymerase inhibitors (Dasabuvir)
Ribavirin
Genotype 1
Sofosbuvir-ledipasvir
Elbasvir-grazoprevir
Paritaprevir-ritonavir-Ombitasvir with Dasabuvir (PrOD) and weight-based ribavirin
Sofosbuvir and daclatasvir
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Genotype 2
Sofosbuvir and daclatasvir
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Genotype 3
Sofosbuvir and daclatasvir
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Genotype 4
Sofosbuvir-ledipasvir
Elbasvir-grazoprevir
Paritaprevir-ritonavir-Ombitasvir (PrO) with weight-based ribavirin (note: Dasabuvir is not included in this regimen for G4 patients)
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Genotype 5
Sofosbuvir-ledipasvir
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Genotype 6
Sofosbuvir-ledipasvir
Sofosbuvir-velpatasvir
Glecaprevir-pibrentasvir
Mixed genotypes
HIV-HCV coinfection
Clinical trials of DAA therapy in patients with HIV-HCV coinfection
Sofosbuvir-ledipasvir
Elbasvir-grazoprevir
Paritaprevir-ritonavir-Ombitasvir with Dasabuvir (PrOD) and weight-based ribavirin
Sofosbuvir and daclatasvir
Sofosbuvir-velpatasvir
Resistance-associated substitutions (RAS)
Retreatment of treatment failures
People who inject drugs
Future directions
References
32 Hepatitis C virus (HCV) infection: in special situations
Chronic kidney disease
Severe renal impairment and end-stage renal disease (ESRD)
HCV infection in setting of kidney transplantation
DAA treatment after kidney transplantation
Decompensated liver cirrhosis
Pharmacokinetics of DAA in decompensated liver cirrhosis
Efficacy of DAA treatment in decompensated cirrhosis
Safety of DAA in patients with decompensated cirrhosis
Improvement of liver function tests after achievement of SVR - the point of no return
Delisting patients from the LT waiting list
DAA in patients with hepatocellular carcinoma
Risk for hepatocellular carcinoma after interferon-induced SVR
Risk for hepatocellular carcinoma after DAA treatment
Acute hepatitis C virus infection
Interferon-based treatment
Treatment with DAAs
Extrahepatic manifestations
Impact of HCV eradication on EHMs
B-cell lymphoma
Patients with associated rheumatic/autoimmune systemic diseases
DAA treatment in patients with EHM: efficacy and tolerance
Non-antiviral therapeutic approaches
References
Disclaimer
DAA treatment in patients with end-stage renal disease
DAA in patients with hepatocellular carcinoma
Treatment with DAA in acute hepatitis C virus infection
References
33 Hepatitis B: prognosis and treatment
Introduction
Epidemiology
Immunopathogenesis and virology
Immunopathogenesis of HBV
Virology-role of viral mutants
Diagnosis and HBV serology
Natural history and course of hepatitis B virus (figure with HBsAg)
Novel insights into disease phase
Acute HBV infection
Management of hepatitis B virus
General
Indications for treatment and assessment
The treatment sequence of CHB
Pegylated interferon
Nucleos(t)ide analogues
The cirrhotic patient
Monitoring the untreated patient
Novel treatment strategies in CHB
Patient selection for new treatment strategies
Immune aspects of conventional HBV therapies
Monotherapy regimes
Combination and sequential therapy regimes
Prognosis in CHB
References
34 Alcoholic liver disease
Introduction
Burden of alcoholic liver disease
Natural history and modifying factors
Pathogenesis
Diagnosis
Alcohol abuse as a cofactor of other liver diseases
Alcoholic cirrhosis AHD hepatocellular carcinoma
Alcoholic hepatitis
Liver transplantation for alcoholic liver disease
Acknowledgments
References
35 Nonalcoholic fatty liver disease
Introduction
Epidemiology
The natural course of nonalcoholic fatty liver disease
Risk factors that influence the natural history of NAFLD/NASH
Host factors
Environmental factors
Hepatocellular carcinoma (HCC) and NAFLD
Extrahepatic complications of NAFLD
NAFLD and type 2 diabetes
NAFLD and cardiovascular disease
NAFLD and chronic kidney disease (CKD)
NAFLD and colorectal cancer (CRC)
Disease associations
Polycystic ovarian syndrome (PCOS) and NAFLD
Obstructive sleep apnea (OSA) and NAFLD
Clinical presentation of NAFLD
Laboratory investigations
Noninvasive evaluation of liver disease
Diagnosis and quantification of steatosis
Diagnosis of NASH vs. hepatic steatosis
Diagnosis and staging of hepatic fibrosis
Role of liver biopsy
Overall management strategy for NAFLD
Weight loss
Lifestyle intervention
Bariatric surgery
Pharmacotherapy
CVD risk modifiers
Agents that affect natural disease history
Chemoprevention of HCC
Liver transplantation
References
36 Hemochromatosis
Introduction
Pathogenesis of hemochromatosis
Diagnosis of hemochromatosis
Diagnostic tests for hemochromatosis
Serum iron
Transferrin saturation
Serum ferritin
Iron removed by venesection
Liver biopsy
Hepatic iron concentration
Imaging studies of the liver
Genetic testing for hemochromatosis
Population screening
Treatment of hemochromatosis
References
37 Wilson's disease
Introduction
Diagnosis
Ophthalmologic assessment
Neuropsychiatric evaluation
Radiological assessment
Neuropsychiatric features
Ceruloplasmin
Hemolysis
Liver biopsy
Copper tests
Urinary copper
Genetic testing
General investigations
Special situations
Acute liver failure
Penicillamine challenge
Family screening
Treatment of Wilson disease
General principles for treatment
Chelation therapy
D-Penicillamine
Trientine dihydrochloride
Zinc
Tetrathiomolybdate
Other medical therapies
Diet
Liver transplantation
Monitoring of treatment
Asymptomatic patients
Decompensated cirrhosis
Acute liver failure
Surgery
Pregnancy and contraception
References
38 Primary biliary cholangitis (formerly primary biliary cirrhosis)
Introduction
Clinical course
Risk stratification in PBC
Licensed therapies: ursodeoxycholic acid
Impact on liver biochemistry
Impact on liver histology
Clinical disease progression
Linking biochemical surrogates to therapeutic efficacy and clinical outcomes
Licensed therapies: obeticholic acid
Nonlicensed therapy: fibric acid derivatives
Bezafibrate
Fenofibrate
Nonlicensed therapy: budesonide
Nonlicensed therapy: colchicine
Nonlicensed therapy: methotrexate
Nonlicensed therapy: antiproliferative agents
Nonlicensed therapy: Ustekinumab
Treatment of pruritus
Cholestyramine
Rifampicin
Opioid antagonists
Serotonin reuptake inhibitors
External biliary drainage
Albumin dialysis and plasmapheresis
Inhibitors of intestinal bile acid transport
Complications of chronic cholestasis
Hepatic osteodystrophy
Hyperlipidemia
Liver transplantation
Summary
Disclosures
References
39 Autoimmune hepatitis
Introduction
Features of autoimmune hepatitis
Clinical features
Serological features
Histological features
Genetic features
Diagnosis
Treatment
Conventional corticosteroids and azathioprine
Budesonide
Second-line therapies
Liver transplantation
Prognosis
References
40 Primary sclerosing cholangitis
Introduction
Epidemiology
Etiology and pathogenesis
Diagnosis and follow-up
Diagnosis of PSC
Imaging
Endoscopy in PSC
Liver biopsy
Symptoms and signs
Biochemistry and immunological tests
Variant phenotypes
Small-duct PSC
AIH in PSC
Elevated IgG4
Pediatric PSC
IBD in PSC
Malignancy in PSC
Prognosis
Natural history risk models
Histology
Imaging
Serum-based biomarkers of prognosis
Treatment
What is the evidence for bile acid therapy in PSC?
What is the evidence for immune-targeting treatment in PSC?
What is the evidence for treatment targeting the microbiota in PSC?
What is the evidence for endoscopic treatment in PSC?
Liver transplantation
Treatment of IBD in PSC
Treatment of cholangiocarcinoma in PSC
General treatment
Summary
References
41 Variceal bleeding
Introduction
Pathophysiology
Risk factors for the development of gastroesophageal varices
Portal hypertension and hepato venous portal gradient
Acute variceal bleeding
Risk factors for variceal bleeding
Initial resuscitation
Blood product and clotting factor replacement
Antibiotic prophylaxis
Vasoactive drugs
Proton pump inhibitors in treatment of acute variceal bleeding
Prevention of hepatic encephalopathy
Endoscopic therapy in acute variceal bleeding
Gastric varices
Failure to control gastroesophageal bleeding
TIPS for the treatment of acute variceal bleeding
Prevention of rebleeding of gastroesophageal varices
Nonselective -adrenergic blockers (NSBB) in the prevention of recurrent variceal hemorrhage
Carvedilol in the prevention of recurrent variceal hemorrhage
NSBB plus isosorbide mononitrate in preventing recurrent variceal hemorrhage
Endoscopic therapy in the prevention of recurrent gastroesophageal variceal bleeding
VBL compared to NSBB in the prevention of recurrent variceal hemorrhage
NSBB plus VBL in the prevention of recurrent variceal hemorrhage
Prevention of rebleeding of varices in patients whose primary bleed occurs while taking NSBB
Simvastatin in the prevention of recurrent variceal hemorrhage
TIPS for the prevention of rebleeding variceal hemorrhage
TIPS plus embolization therapy in the prevention of rebleeding of gastroesophageal varices
Prevention of rebleeding of gastric varices
Endoscopic therapy
Frequency of recurrent cyanoacrylate injection in prevention of repeat GOV bleeding
TIPS in prevention of repeat GOV bleeding
Prevention of variceal formation and first variceal hemorrhage
Noninvasive (NIV) screening for clinically significant portal hypertension
Invasive screening for gastroesophageal varices
NSBB in the prevention of first gastroesophageal variceal hemorrhage
VBL in the prevention of first variceal hemorrhage
Closing remarks
References
42 Hepatic venous outflow syndromes and splanchnic venous thrombosis
Introduction
Causal factors for splanchnic vein thrombosis in the absence of underlying liver disease
Myeloproliferative neoplasms
Inherited thrombophilia
Acquired prothrombotic disorders
Hormonal factors
Local factors
Budd-Chiari syndrome
Epidemiology
Manifestations
Outcome and prognostic factors
Treatment for BCS
Portal vein thrombosis in the absence of underlying liver disease
Epidemiology
Manifestations
Imaging features
Outcome
Treatment for PVT
Portal vein thrombosis in patients with cirrhosis
Epidemiology
Etiology
Manifestations
Outcome
Management
Conclusion
References
43 Ascites, hyponatremia, spontaneous bacterial peritonitis, and hepatorenal syndrome
Ascites
Prevalence and pathophysiology
Classification and treatment
Hyponatremia
Prevalence and pathophysiology
Clinical aspects and prognostic implications
Management
Spontaneous bacterial peritonitis
Pathogenesis of spontaneous bacterial peritonitis
Clinical features and diagnosis of SBP
Treatment of SBP
Prophylaxis of SBP
Hepatorenal syndrome
Pathophysiology of HRS
Diagnosis and management of HRS
References
44 Hepatic encephalopathy: classification, diagnosis, and treatment
Introduction
Problem statement
Definition and classification
Underlying disease
Severity
Time course
Precipitating event
Pathogenesis
Ammonia
Inflammation
Neurotransmission
Manganese
Gut microbiota
Sarcopenia
Clinical presentation
Diagnosis
Overt hepatic encephalopathy
Minimal hepatic encephalopathy
Management
Treatment of acute episode of overt hepatic encephalopathy
Prevention of recurrence of hepatic encephalopathy
Treatment for covert hepatic encephalopathy
Nutrition
Liver transplantation
Summary
References
45 Hepatocellular carcinoma: diagnosis and prognosis
Introduction
Screening for early diagnosis
Population to be screened
Screening tests
Diagnosis
Staging and prognosis
References
46 Hepatocellular carcinoma: treatment
Introduction
Surgical management
Resection
Transplantation
Ablative therapy
Transarterial (chemo) embolization (TA(C)E)
Transarterial radioembolization (TARE)
Systemic therapy
Sorafenib
Chemotherapy
Targeted therapy
Molecular stratification
Immunotherapy
References
47 Drug-induced liver disease: mechanism and diagnosis
Introduction
Mechanism
Risk factors
Drug properties
Host factors
Environmental conditions
Clinical presentation
DILI diagnostic approach
References
48 Liver transplantation: prevention and treatment of rejection
Objectives of immunosuppression in liver transplantation
Immunosuppressive agents
Steroids
Calcineurin inhibitors
Antimetabolites
mTOR inhibitors
Belatacept
Agents for induction immunosuppression
Immunosuppressive regimens: a practical approach
Standard immunosuppressive regimens
Immunosuppression in specific populations
Management of acute rejection
Management of chronic rejection
Emerging immunosuppressive agents
Tolerance and withdrawal of immunosuppression
References
49 Liver transplantation: prevention and treatment of infection
Risk factors
Host factors
Surgical procedure
Immunosuppression
Donor-derived infections
Timeline after transplantation
Epidemiology and prevention
Bacterial infections
Fungal infections
Viral infections
Treatment of infection
References
50 Management of HCV infection after liver transplantation
Introduction
The course of HCV recurrence on the graft
Management of recurrent HCV infection
HCV/human immunodeficiency virus coinfected liver transplant recipients
Conclusion
References
Index
EULA

Systemvoraussetzungen

Als PDF speichern Als Link merken