Una nueva etapa en la revista Hepatología / A new phase in the journal Hepatología

Este año la revista Hepatología inicia su cuarto año de publicación y continuamos esta-bleciendo cambios que serán de beneficio para mejorar la calidad y visibilidad de la revista. Entre ellos, está la implementación de la plataforma OJS (Open Journal Systems), la cual es un sistema para la edición de revistas que facilita la gestión y publicación de los artículos en línea. Se caracteriza por su capacidad de interacción con las diferentes ba-ses de datos e índices, su sistema de notificaciones y comunicación permanente entre el equipo editorial, los autores y los pares evaluadores, además de su integración con otros servicios académicos como son CrossRef y ORCID. Por lo tanto, hemos migrado todo el contenido del sitio web previo de la revista Hepatología hacia la plataforma OJS, y es-peramos comenzar a recibir los artículos por este medio (www.revistahepatologia.com)

This year the Hepatology journal begins its fourth year of publication and we continue to establish changes that will be of benefit to improve the quality and visibility of the journal. Among them is the implementation of the OJS (Open Journal Systems) platform, which is a system for publishing journals that facilitates the management and publication of articles online. It is characterized by its ability to interact with the different databases and indexes, its notification system and permanent communication between the editorial team, authors and peer reviewers, as well as its integration with other academic services such as CrossRef and ORCID. . Therefore, we have migrated all the content from the previous Hepatology journal website to the OJS platform, and we hope to start receiving articles through this means (www.revistahepatologia.com).

Trasplante ortóptico de hígado en un paciente con una prueba positiva de SARS-CoV-2 y sus complicaciones posoperatorias. Reporte de caso / Orthoptic liver transplantation in a patient with a positive SARS-CoV-2 test and its postoperative complications. Case report

Resumen Objetivo: describir un caso de trasplante hepático en un paciente con resultado positivo en la prueba del coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) con éxito en el postrasplante temprano, pero que desarrolló complicaciones asociadas a la inmunosupresión y trombosis portal sin una trombofilia identificada en un centro de alta complejidad de un país latinoamericano. Descripción del caso: paciente de 48 años con diagnóstico de cirrosis hepática secundaria a esteatohepatitis no alcohólica (NASH) complicada por varios episodios de ascitis portal hipertensiva y encefalopatía hepática, ingresada para trasplante hepático ortóptico. En los exámenes iniciales tuvo una prueba positiva para SARS-CoV-2 y era asintomático respiratorio. El trasplante se realizó con éxito luego de la autorización del comité de infección. Después del primer mes posoperatorio presentó diarrea, ascitis y daño renal agudo. Los niveles de tacrolimus en el reingreso fueron superiores a 10 ng/mL y hubo una mejoría clínica significativa con la suspensión del fármaco. Finalmente, el paciente requirió retrasplante por trombosis de la vena porta y de las venas suprahepáticas, aunque no se identificó la etiología. Conclusión: se describe uno de los primeros informes de trasplante de hígado en un paciente con recuperación reciente de COVID-19 y pruebas persistentemente positivas. En el postrasplante temprano hubo una buena respuesta; sin embargo, luego del primer mes presentó complicaciones relacionadas con la inmunosupresión. Este caso también plantea la posible asociación entre el SARS-CoV-2 y el desarrollo de trombosis en la circulación portal hepática.

Abstract Objective: To describe a case of liver transplantation in a patient with a positive result in the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) test with success in the early post-transplantation, but who developed complications associated with immunosuppression and portal vein thrombosis without thrombophilia identified at a tertiary referral center in a Latin American country. Case: A 48-year-old patient diagnosed with liver cirrhosis secondary to non-alcoholic steatohepatitis (NASH) complicated by several episodes of portal hypertension ascites and hepatic encephalopathy was admitted for orthoptic liver transplantation. On initial examinations, he had a positive test for SARS-CoV-2 and was asymptomatic in the respiratory tract. The transplant was carried out successfully after the authorization of the infection committee. After the first postoperative month, he presented with diarrhea, ascites, and acute kidney injury. Tacrolimus levels at readmission were more significant than 10 ng/mL, and there was a significant clinical improvement with drug discontinuation. Finally, the patient required re-transplantation due to thrombosis of the portal vein and suprahepatic veins, although the etiology was not identified. Conclusion: One of the first reports of liver transplantation in a patient with recent recovery from COVID-19 and persistently positive tests is described. In the early post-transplant, there was a good response; however, after the first month, he had complications related to immunosuppression. This case also posits the possible association between SARS-CoV-2 and the development of thrombosis in the hepatic portal circulation.

Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic

In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.

Effect of Treatment with Direct Acting Antiviral on Glycemic Control in Patients with Diabetes Mellitus and Chronic Hepatitis C

ABSTRACT Introduction and aim. The effect of the new direct acting antiviral drugs (DAAs) for chronic hepatitis C (HCV) on glycemic control is unknown. Materials and methods. We conducted a retrospective cohort study of patients who were treated for chronic HCV with direct-acting antiviral medications at a single academic institution between May 2013 and April 2016. Univariate analysis was performed comparing subjects pre- and post-treatment. Results. One hundred seventy-five consecutive adult patients were treated for chronic HCV and met enrollment criteria. The majority (80.8%) were genotype 1 and overall cohort sustained virologic response at week 12 (SVR12) was 97.8%. Thirty-one (18.5%) had diabetes mellitus (DM); twenty-six had pre- and post-treatment HbA1c values. Of these, 76.9% were male and 61.5% had cirrhosis. Ninety-six percent were prescribed sofosbuvir-based therapy and all but one (96.8%) achieved SVR12. Three patients were started on treatment despite meeting the definition for poorly controlled DM (HbA1c > 9 mg/dL). There was no significant difference when comparing pre-treatment (7.36 mg/dL, 95% CI 6.55-8.16) to post-treatment HbA1c (7.11 mg/dL, 95% CI 6.34-7.88, p = 0.268). Thirty-one percent of subjects required dose escalation or the initiation of insulin based therapy during treatment. Discussion. Although chronic HCV is associated with exacerbation of insulin resistance, our results showed HbA1c to be unaffected by eradication of chronic HCV with DAA in diabetic patients with and without cirrhosis. Paradoxically, almost 1/3 of patients required escalation of anti-diabetic therapy during treatment. Long-term studies are warranted to understand the relationship between HCV viral eradication and insulin metabolism.(AU)

An Uncommon Side Effect of a Commonly Used Antibiotic: Amoxicillin-Clavulanic Acid Induced Hepatitis / 가정의학회지

Amoxicillin-Clavulanic acid continues to be one of the most commonly used antibiotic combinations. Hepatic injury due to this antibiotic is rare. We report a case of amoxicillin-clavulanic acid induced hepatitis causing painless jaundice to bring to attention this rare side effect of this commonly used antibiotic. This is a case of a 62-year-old Caucasian female, who presented with acute onset severe painless jaundice, nausea, vomiting, and pruritus of less than 1-week duration. She had completed a course of amoxicillin-clavulanic acid 3 weeks prior to presentation. A careful history pointed to this simple diagnosis. It may be easily missed without an in-depth history and the patient may be subjected to unnecessary expensive tests. This case is reported to highlight cost conscious care by keeping in mind a rare side effect of the commonly used antibiotic.

Assessment for Risk of Bias in Systematic Reviews and Meta-Analyses in the Field of Hepatology

A systematic review (SR) provides the best and most objective analysis of the existing evidence in a particular field. SRs and derived conclusions are essential for evidence-based strategies in medicine and evidence-based guidelines in clinical practice. The popularity of SRs has also increased markedly in the field of hepatology. However, although SRs are considered to provide a higher level of evidence with greater confidence than original articles, there have been no reports on the quality of SRs and meta-analyses (MAs) in the field of hepatology. Therefore, we performed a quality assessment of 225 SRs and MAs that were recently published in the field of hepatology (January 2011 to September 2014) using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Using AMSTAR, we revealed both a shortage of assessments of the scientific quality of individual studies and a publication bias in many SRs and MAs. This review addresses the concern that SRs and MAs need to be conducted in a stricter and more objective manner to minimize bias and random errors. Thus, SRs and MAs should be supported by a multi-disciplinary approach that includes clinical experts, methodologists, and statisticians.

The 2014 Hepatology Society of the Philippines consensus statements on the diagnosis and treatment of hepatitis C

Hepatitis C virus (HCV) infection is a devastating disease that is increasingly being diagnosed among Filipinos, especially in at-risk populations. There are disease-specific nuances in the evaluation and management of this infection. Furthermore, advances in the field brought about by clinical research are rapidly moulding the way we evaluate and manage HCV patients. Evidently, consensus statements formulated by experts in the field are needed in order to serve as a guide to physicians who see HCV patients in the clinic. With this in mind, the Hepatology Society of the Philippines spearheaded the formation of these statements which aimed to address issues in the diagnosis, evaluation, treatment, and follow-up care of patients with HCV infection.Recommendations on the specific tests to perform in the evaluation of HCV patients before, during and after treatment, and first-line treatment of patients with acute and chronic HCV infection were provided. Treatment algorithms for chronic HCV infection, divided according to viral genotype, were also devised. We acknowledge the limitations brought about by the local inavailability of some drugs/treatment regimens in the local setting at the time of the formulation of these statements. As such, these statements will be revised as soon as new data become locally applicable.  

Overview and recent trends of systematic reviews and meta-analyses in hepatology

A systematic review (SR) is a research methodology that involves a comprehensive search for and analysis of relevant studies on a specific topic. A strict and objective research process is conducted that comprises a systematic and comprehensive literature search in accordance with predetermined inclusion/exclusion criteria, and an assessment of the risk of bias of the selected literature. SRs require a multidisciplinary approach that necessitates cooperation with clinical experts, methodologists, other experts, and statisticians. A meta-analysis (MA) is a statistical method of quantitatively synthesizing data, where possible, from the primary literature selected for the SR. Review articles differ from SRs in that they lack a systematic methodology such as a literature search, selection of studies according to strict criteria, assessment of risk bias, and synthesis of the study results. The importance of evidence-based medicine (EBM) in the decision-making for public policy has recently been increasing thanks to the realization that it should be based on scientific research data. SRs and MAs are essential for EBM strategy and evidence-based clinical practice guidelines. This review addresses the current trends in SRs and MAs in the field of hepatology via a search of recently published articles in the Cochrane Library and Ovid-MEDLINE.

European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the diagnosis of coeliac disease in 2012 / 中华实用儿科临床杂志

Diagnostic criteria for coeliac disease(CD) from the European Society for Paediatric Gastroenterology,Hepatology,and Nutrition were published in 1990.Since then,the autoantigen in CD,tissue transglutaminase had been identified;CD-specific antibody tests had improved.The perception of CD had changed greatly.A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process in 2012.The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CDspecific antibody testing.In group of children with symptoms suggestive of CD,the diagnosis of CD is based on symptoms,positive serology,and histology that is consistent with CD.If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (＞ 10 times the upper limit of normal),then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests.In group of asymptomatic children at increased risk for CD,the diagnosis of CD is based on positive serology and histology.Human leukocyte antigen-DQ2 and human leukocyte antigen-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative.The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families.

Hepatopatología para gastroenterólogos y hepatólogos: segunda parte: terminología útil en la interpretación de los hallazgos histopatológicos / Hepatopathology for gastroenterologists and hepatologists: part two useful terminology in the interpretation of the histopathological findings

Hepatic diseases, histology, hepatology, diagnostic histology, hepatic cells

Hepatic diseases, histology, hepatology, diagnostic histology, hepatic cells

Requirement of diagnosis and tereatment for liver diseases and improvement of laboratory technology / 中华检验医学杂志

There are so many patients with different liver diseases in our country that the diagnosis and treatment of liver diseases directly relate to the people's healthy level.The requirement of diagnosis and treatment to clinical laboratories can be summarized as: ( 1 ) sensitivity,which means shortening window period;(2) specificity,which means various subtypes and variant can be detected;( 3 )speed,which means finding out the pathogen as soon as possible;(4)accuracy,which means providing physicians with accurate test reports.Detecting techniques,for instances,chemiluminescence,polymerase chain reaction and gene mutational site detecting method,were applied to the diagnosis and treatment of liver disease,thus improving the degree of precision,accuracy,sensitivity,specificity and detection speed and satisfying the requirement of diagnosis and treatment maximatily.

Cistos peribiliares em leão-africano (Panthera leo) / Peribiliary cysts in an African lion (Panthera leo)

São descritos os achados macroscópicos e histopatológicos de cistos peribiliares em uma fêmea adulta de leão-africano (Panthera leo). Macroscopicamente, todos os lobos hepáticos continham numerosos cistos preenchidos por líquido translúcido. Histologicamente, os cistos estavam localizados no hilo hepático e nos tratos portais. Os cistos eram revestidos internamente por epitélio simples, constituído por células colunares ou cuboidais e não mucinosas, de acordo com avaliação para ácido periódico de Schiff/azul alciano. Na imuno-histiquímica, todas as células desse epitélio foram positivas para citoceratina. O leão morreu de complicações relacionadas a um carcinoma pulmonar e não foram observadas alterações clínicas associadas à lesão hepática, comprovando que cistos peribiliares em leões também ocorrem não associados a sinais clínicos.

The gross and histopathological aspects of peribiliary cysts in an adult African lioness (Panthera leo) are described. Grossly, all hepatic lobes contained numerous cysts filled with translucent fluid. Histologically it was observed that the cysts were located in the hepatic hilum and in the portal triads. Periodic acid-Schiff and Alcian blue stains, revealed the cysts to be lined by simple, non-mucinous, cuboidal or columnar epithelium. In immunohistochemistry staining all cells comprising this epithelium were positive for cytokeratin. The lioness died due to complications stemming from a pulmonary carcinoma and no clinical signs related to the hepatic lesion were observed, demonstrating that also in lions the peribiliary cysts occur as non-clinical disease associated lesions.

An Unusual Case of Amoebic Liver Abscess Presenting with Hepatic Encephalopathy: A Case Report

Amoebic liver abscess (ALA) with jaundice and encephalopathy is a rare occurrence and has been recognised and studied more frequently in recent years. We present a case of massive ALA presenting with jaundice, hepatic encephalopathy, and septicaemia that was treated successfully with percutaneous drainage of the abscess, right-sided chest tube insertion, and anti-amoebic therapy.

Razones para revaluar la formación de especialistas en aparato digestivo / Reasons to take into account when reassessing training in digestive diseases

Boards in digestive diseases were implemented a long time ago in health organizations and until now no in-depth reassessment of those programs has been performed. Several reasons justify the need of such reassessment including the huge advance of knowledge in this field over the last 10-15 years, the important development of hepatology, and the innovative procedures introduced in endoscopy. Moreover, the latest changes in health organizations demand a reorientation of the tasks of digestive specialists in relation to the increasing role of family physicians in the field of digestive diseases. In the light of this perspective, the need for digestive specialists with different qualifications is emerging. This comprehends a basic profile that would cover the needs of general hospitals and another profile for university hospitals that use high technology where specialists need a sound training in research and in specific areas of expertise such as hepatology or advanced endoscopic techniques

Los programas de formación de residentes en Aparato Digestivo fueron implementados hace más de 25 años y desde entonces no han sufrido ningún proceso de revaluación profunda. Muchos son los cambios que justifican esta revisión y entre los más importantes cabe citar el incremento del volumen de conocimiento de la especialidad en los últimos 10 a 15 años, el enorme desarrollo de la hepatología en este período y las innovaciones endoscópicas, tanto diagnósticas como terapéuticas. Además, los cambios organizativos de la medicina hacen necesario que los especialistas de Aparato Digestivo reubiquen sus funciones en relación con las competencias crecientes de los médicos de Atención Primaria en esta especialidad y que se definan perfiles distintos de especialistas que se ajusten a la demanda laboral, que es diferente para un hospital general o para un hospital de alta tecnología, donde la razón de ser de los especialistas debe basarse en una sólida formación en investigación y una capacitación específica para áreas determinadas de la especialidad, como la hepatología y la endoscopia avanzada

Taehan Kan Hakhoe Chi (The Korean Journal of Hepatology) and Index Medicus (Medline/PubMed) / 대한간학회지

It is our great pleasure to announce that the Taehan Kan Hakhoe Chi (The Korean Journal of Hepatology) was approved for listing, from 2002, in the Index Medicus, Medline/PubMed of the National Library of Medicine, NIH of USA. Herein, I review the searching tools employing a Medical Subject Heading (MeSH) such as liver disease and liver neoplasm or an author index for this Journal in the PubMed at a website. Of course, The Korean Journal of Hepatology should be continually striving to be upgraded. Dream comes true.

Internet for Patient Education of Liver Diseases / 대한간학회지

No abstract available.

Extrahepatic Manifestation of Alcoholic Injury / 대한간학회지

No abstract available