1,720,989 research outputs found
Liver enzymes, nonalcoholic fatty liver disease and incident cardiovascular disease. [Letter]
No full textLiver Enzymes, Nonalcoholic Fatty Liver Disease, and Incident Cardiovascular Diseas
Risk of all-cause and cardiovascular mortality in patients with chronic liver disease. [Letter]
No full textWe read with interest the article by Stepanova et al in a recent issue of Gut. These authors used death certificate data from the third National Health and Nutrition Examination survey (NHANES-III 1988e1994) in order to assess the impact of metabolic syndrome components on all-cause and cause-specific mortality in patients with chronic liver disease (CLD).To gain a better understanding of these unexpected findings, we believe that the authors should provide the number of deathsand the age-, and sex-standardised rates for all-cause and CVD mortality for the suspected NAFLD group and the control group
Disorders of coagulation and hemostasis in abdominal obesity – Emerging role of fatty liver. [Review]
No full textAbdominal obesity represents a public health concern because its prevalence is reaching epidemic proportions worldwide, and it is associated with an increased risk of cardiovascular morbidity and mortality and other pathological conditions. A large body of evidence suggests that abdominal obesity is associated with a prothrombotic tendency, which may, at least in part, contribute to the increased risk of atherothrombosis in these individuals. This review briefly summarizes the evidence of direct and indirect effects of the accumulation of excess lipid in visceral adipose tissue on coagulation and fibrinolysis. In addition, this article critically appraises the rapidly expanding body of experimental and clinical data that support a potential direct contribution for the accumulation of excess lipid in the liver (i.e., nonalcoholic fatty liver disease, a very frequent pathological condition in subjects with abdominal obesity) in the pathogenesis of the obesity-induced disorders of coagulation and fibrinolysis
Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. [Review]
No full textAbstract | NAFLD is a spectrum of progressive liver disease that encompasses simple steatosis, NASH, fibrosis and, ultimately, cirrhosis. NAFLD is recognized as the hepatic component of the metabolic syndrome, as these conditions have insulin resistance as a common pathophysiological mechanism. Therefore, NAFLD is strongly associated with type 2 diabetes mellitus and abdominal obesity. As lifestyles have become increasingly sedentary and dietary patterns have changed, the worldwide prevalence of NAFLD has increased dramatically and is projected to be the principal aetiology for liver transplantation within the next decade. Importantly, a growing body of clinical and epidemiological evidence suggests that NAFLD is associated not only with liver-related morbidity and mortality, but also with an increased risk of developing both cardiovascular disease and type 2 diabetes mellitus. This article reviews the evidence that suggests NAFLD is a multisystem disease and the factors that might determine interindividual variation in the development and progression of its major hepatic and extrahepatic manifestations (principally type 2 diabetes mellitus and cardiovascular disease)
Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. [Review]
No full textNonalcoholic fatty liver disease encompasses a spectrum ofpathologic conditions, ranging from simple steatosis to nonalcoholic steatohepatitis and cirrhosis. The disease has reached epidemic proportions and is the most common cause of chronic liver disease in Western countries. Approximately20 to 30% of adults in the general population in Western countries have nonalcoholic fatty liver disease, and its prevalence increases to 70 to 90% among persons who are obese or have diabetes; such patients are also at increasedrisk for the development of advanced fibrosis and cirrhosis.Recognition of the importance of nonalcoholic fatty liver disease and its strong association with the metabolic syndrome has stimulated interest in its putative role in the development and progression of cardiovascular disease.Accumulating evidence suggests that cardiovascular disease dictates the outcome (or outcomes) in patients with nonalcoholic fatty liver disease more frequently and to a greater extent than does the progression of liver disease.This review focuses on the rapidly expanding body of clinical evidence that supports a strong association between nonalcoholic fatty liver disease and the risk of cardiovascular disease. Because of the link between the two disorders, morecareful surveillance of these patients will be needed
Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD.
No full textBACKGROUND: Differentiating steatosis from NASH is key in deciding treatment and follow-up schedules. We hypothesized that sonographic grading of steatosis willcorrelate with metabolic and pathologic changes of NASH.METHODS: Fifty-three non-consecutive patients had a semi-quantitative evaluation of hepatic steatosis through ultrasonographic Fatty Liver Indicator (US-FLI) justprior to liver biopsy. All biopsies demonstrated NAFLD. US-FLI is a new scoring system ranging 2-8 based on the intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focalsparing. NAFLD is diagnosed by the minimum score ≥2. Ultrasonographic findings were correlated with metabolic and histological data. Inter-observer US-FLI scoreagreement, evaluated by three different operators in 31 consecutive patients with steatosis, showed "almost perfect/substantial" agreement (P < 0.001).RESULTS: US-FLI showed a positive correlation with HOMA, insulin, uric acid, ferritin, ALT and bilirubin and was associated with steatosis extent assessed histologically and histological features of NASH, except for fibrosis. US-FLI was an independent predictor of NASH (OR 2.236; P = 0.007) and a US-FLI < 4 had ahigh negative predictive value (94%) in ruling out the diagnosis of severe NASH according to Kleiner's criteria.CONCLUSION: Data confirm the hypothesis that US-FLI significantly correlates with metabolic derangements and individual pathologic criteria for NASH and may betterselect patients for liver biopsy
Steatosis and hepatitis C virus: mechanisms and significance for hepatic and extrahepatic disease
Get PDFNonalcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV)-related liver disease are common in the general population, but their concurrence is 2- to 3-fold higher than would be expected by chance alone. In patients with chronic HCV infection, steatosis is attributable to a variable combination of the mechanisms considered to play a role in the pathogenesis of NAFLD-insulin resistance in the obese and in the lean subject-along with a direct effect of HCV on hepatic lipid metabolism that leads to triglyceride accumulation through inhibition of export proteins that are required for very low density lipoprotein (VLDL) assembly and secretion. Accumulating evidence suggests that steatosis contributes to the progression of fibrosis in HCV-related disease in a pattern similar to that observed in NAFLD. Potential mechanisms of this effect include the increased sensitivity of steatotic livers to oxidative stress and cytokine-mediated injury. Steatosis-related hepatic insulin resistance may also play a role through the profibrogenic effects of the compensatory hyperinsulinemia and provides a potential explanation for the association between HCV and type 2 diabetes mellitus. Indeed, an appreciation of the importance of fat in HCV has recently led to trials of adjuvant therapy for HCV directed at steatosis-associated disease mechanisms, with encouraging results reported for various modalities, including weight loss and antioxidants. Future therapy should be aimed at exploiting the interactions of HCV with host insulin and lipid metabolism, particularly in nonresponders to standard antiviral schedules
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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