Abstract Background Behçet’s syndrome (BS) is a well-recognized cause of Budd–Chiari syndrome (BCS); however, information about its clinical characteristics and outcome is limited. Methods We ...reviewed the records of about 9000 patients with BS registered at the multidisciplinary Behçet’s syndrome outpatient clinic at Cerrahpasa Medical Faculty between July 1977 and October 2013. We identified 43 (40 M/3 F) patients who were diagnosed as having BCS. Their outcome was evaluated between September 2012 and October 2013. Results In total, 33 patients (77%) had presented with liver-related symptoms (Group I), while 10 (23%) were asymptomatic for liver disease (Group II). This latter group had presented with symptoms related to the presence of major vessel disease such as fever, leg swelling, or dyspnea. The site of venous obstruction determined in 41 patients was inferior vena cava (IVC) and hepatic veins combined in 25 (61%), IVC alone in 12 (29%), and only hepatic veins in 4 patients (10%). The number of patients with concurrent obstruction in the hepatic veins and the IVC was less in Group II than in Group I (3/10 vs 22/31, p = 0.06). A total of 20 (19 M/1 F) patients (47%) had died at a median of 10 months after diagnosis. Mortality was significantly lower in Group II (10%) than in Group I (58%), ( p = 0.011). By the end of the survey, 23 patients were alive, of whom 21 could be re-evaluated at the clinic. Conclusions BCS associated with BS is usually due to IVC thrombosis with or without hepatic vein thrombosis. Silent cases exist and have a better prognosis. The mortality rate among the patients symptomatic for liver disease remains high.
Minimal hepatic encephalopathy can only be detected by specific psychometric or neuropsychological tests. We aimed to determine the prevalence of minimal hepatic encephalopathy in a hepatology ...outpatient clinic of a tertiary center.
A total of 82 patients with chronic liver disease were involved prospectively in this study. Control groups consisted of healthy volunteers (n = 123) and chronic renal failure patients (n = 28). We used 2 different methods to detect minimal hepatic encephalopathy. First method was a battery of 5 psychometric tests (number connection tests A and B, digit symbol test, serial dot test, line tracing test) which was filled by all patients. The second method was critical flicker frequency test. Both methods were used in the whole group (n = 233). We applied linear regression analysis to the results of psychometric tests of healthy volunteers to establish equations to calculate the expected values of each test. Test results of the patients were evaluated according to the expected results obtained from these equations.
The prevalence of minimal hepatic encephalopathy detected by psychometric tests and critical flicker frequency test was 13% and 14%, respectively. When the positivity of both tests was deemed necessary to diagnose minimal hepatic encephalopathy, the rate of minimal hepatic encephalopathy was 3.6% (n = 3) in a chronic liver disease patient group.
Minimal hepatic encephalopathy is a difficult clinical condition to diagnose, and it is more appropriate to use psychometric tests and critical flicker frequency test together.
A central issue in the understanding of the pathogenesis of nonalcoholic fatty liver disease is the problem of the underlying mechanisms which are not fully understood.In the setting of excessive ...central adiposity,insulin resistance is the major underlying cause of fat accumulation in hepatocytes.Because of the difficulties with human trials,several animal models have been developed for this purpose mainly characterized as follows:genetically disturbed or murine fatty liver,methionine-choline deficient diet...
Mallory-Denk Bodies in chronic hepatitis Basaranoglu, Metin; Turhan, Nesrin; Sonsuz, Abdullah ...
World journal of gastroenterology,
05/2011, Letnik:
17, Številka:
17
Journal Article
Odprti dostop
Mallory-Denk Bodies（MDB） are important as investigators,suggesting MDB as an indicator of the histologic severity of chronic hepatitis,causes of which include hepatitis C,primary biliary ...cirrhosis（PBC）,and nonalcoholic fatty liver disease（NAFLD）.Matteoni et al scored MDB in patients with NAFLD as none,rare and many,and reported that MDB plays a prominent role in this classification scheme in an earlier classification system.In this study,we evaluated 258 patients with chronic hepatitis due to metabolic,autoimmune and viral etiologies.Liver biopsy samples were evaluated with hematoxylin and eosin,periodic acid-Schiff-diastase,Gordon and Sweet＇s reticulin,Masson＇s trichrome,and iron stains.Both staging and grading were performed.Additionally,MDB were evaluated and discussed for each disease.We examined patients with nonalcoholic steatohepatitis（NASH;50 patients）,alcoholic hepatitis（10 patients）,PBC（50 patients）,Wilson disease（WD;20 patients）,hepatitis B（50 patients）,hepatitis C（50 pati-ents） and hepatocellular carcinoma（HCC;30 patients）.Frequency of MDB was as follows;NASH：10 patients with mild in 60% and moderate in 40% and observed in every stage of the disease and frequently seen in zone 3.PBC：11 patients with mild in 10%,moderate in 70%,and cirrhosis in 20%,and frequently seen in zone 1.WD：16 patients with moderate and severe in 60% and cirrhosis in 40% and frequently seen in zone 1.Hep B：3 patients with mild in 66% and severe in 34%.Hep C：7 patients with mild in 40% and moderate in 60% and observed in every stage.HCC：3 patients with hep B in 2 patients.We found that there is no relationship between MDB and any form of chronic hepatitis regarding histologic severity such as alcoholic steatohepatitis and NAFLD and variable zone distribution by etiology.
OBJECTIVEIn this study, we aimed to investigate the effects of direct antiviral treatment on depression, anxiety, fatigue and quality of life in patients with chronic hepatitis C.
METHODSSubjects ...included in study were treatment experienced and treatment naive chronic hepatitis C patients admitted to the hepatology outpatient clinic between December 2016 and June 2017. Before and after the treatment, Beck depression, Beck anxiety, liver-specific quality of life and fatigue severity-impact scales were administered. Descriptive statistical methods, Kolmogorov-Smirnov distribution test Wilcoxon sign and kappa coefficient tests were used to evaluate the study data.
RESULTSForty-four patients were included in the study; however, it was completed with 35 patients only, as some of the patients were excluded for various reasons. There was no significant difference between depression and anxiety scores of the patients before and after the treatment, but depression and anxiety were found to be recovered in 28.5% (4/14) and 23.5% (4/17) of the subjects, respectively. At the end of the treatment, fatigue severity-impact scales and liver-specific quality of life were not significantly different from those before the treatment.
CONCLUSIONIn this study, we found that direct antivirals did not lead to depression, anxiety or fatigue and did not decrease liver-specific quality of life. In some cases, depression and anxiety decreased after the treatment.
Our objective was to determine the effect of serum iron levels and hepatic iron overload on hepatocellular damage in nonalcoholic steatohepatitis (NASH) and to compare this with chronic viral ...hepatitis. Twenty-five patients who had elevated transaminase levels on at least two occasions, without any evidence of viral and autoimmune hepatitis and diabetes, without a history of significant alcohol use, and with a liver biopsy consistent with NASH were enrolled in the study. Twenty-five patients with chronic viral hepatitis (13 patients with chronic hepatitis C and 12 with chronic hepatitis B) who were not under any antiviral treatment were taken as controls. Metabolic factors were studied in the NASH and chronic hepatitis groups. Biopsy specimens were stained with hematoxylin-eosin, and the grade of steatosis and the stage of fibrosis were evaluated as I, II, or III, I being mild and III being severe. Iron overload in the hepatic tissue was studied by Prussian blue staining. Serum ALT, AST, ALP, GGT, globulin, and ferritin levels were comparable in both steatohepatitis and chronic viral hepatitis groups. However, patients with chronic hepatitis had a lower albumin level and a higher serum iron level, with higher transferrin saturation. Among patients with NASH, mild, moderate, and severe steatosis was found in 7, 10, and 8 patients, respectively. Inflammatory infiltration was grade I in 24 patients and grade III in 1 patient. Fibrosis was mild in 12 patients and 13 patients had no fibrosis. Among patients with chronic viral hepatitis, inflammatory infiltration of grade I was seen in 11 patients, grade II in 11 patients, and grade III in 3 patients. Fibrosis was mild in 9 patients, moderate in 13 patients, and severe in 2 patients; 1 patient had no fibrosis. Compared to patients with NASH, those with chronic viral hepatitis cases had more severe inflammatory infiltration and fibrosis (P < 0.01). While five patients with chronic viral hepatitis had mild iron overload, patients with NASH had no hepatic paranchymal iron overload. Neither NASH nor chronic viral hepatitis revealed a relationship between hepatic iron overload and disease activity. This suggests that the iron overload actually may be a result of hemachromatosis gene mutation. The absence of hepatic parenchymal iron overload in the NASH group and only mild iron accumulation in the chronic hepatitis group may be explained by a lower frequency of the gene mutation in our country.
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