Canadian liver journal最新文献

Population-level cascade of care for hepatitis C in Newfoundland and Labrador 纽芬兰省和拉布拉多半岛的丙型肝炎人口级护理体系

Canadian liver journal Pub Date : 2024-05-10 DOI: 10.3138/canlivj-2024-0003

Cindy Whitten, Alison Turner, Kobe Roberts, Brittany Howell, Brooklyn Sparkes, Peter Daley

{"title":"Population-level cascade of care for hepatitis C in Newfoundland and Labrador","authors":"Cindy Whitten, Alison Turner, Kobe Roberts, Brittany Howell, Brooklyn Sparkes, Peter Daley","doi":"10.3138/canlivj-2024-0003","DOIUrl":"https://doi.org/10.3138/canlivj-2024-0003","url":null,"abstract":"Global elimination of hepatitis C virus (HCV) is feasible using existent tools. Reporting the provincial HCV care cascade will contribute to national and global HCV elimination efforts. This observational study was a secondary use of population-level medical record data, including laboratory results for HCV testing and prescription data for HCV treatment in the province of Newfoundland and Labrador (NL). All patients with HCV antibody testing performed between Jan 1, 2017 and Jan 1, 2022 were included. All prescriptions dispensed from a community pharmacy in NL for any HCV treatment during the same period were included. There were 84,252 antibody tests included. Of these, 3,626 (4.3%) tests were positive for HCV antibodies. Seventy eight percent (1,377/1,766) of the individuals with positive antibody tests were tested for HCV RNA. Only 377/1,061 (35.5%) individuals with a positive RNA test were treated, and 257/395 (65.1%) achieved sustained virological response at 12 weeks. NL has successfully identified and treated HCV, but treatment access is low. Targets for improvement include increased screening, reflex testing of positive antibody with RNA, increased linkage to care, change in treatment funding policy, and quicker treatment funding decision.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" 74","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isolated hepatic sarcoidosis: A case series 孤立性肝肉样瘤病：病例系列

Canadian liver journal Pub Date : 2024-02-29 DOI: 10.3138/canlivj-2023-0030

Xin Mu, Ziran Meng, Ashley Stueck, Magnus McLeod

引用次数: 0

Exploring autoantibodies as predictors of severe fibrosis or cirrhosis in metabolic dysfunction associated steatotic liver disease 将自身抗体作为代谢功能障碍相关性脂肪性肝病中严重纤维化或肝硬化的预测因子的探索

Canadian liver journal Pub Date : 2024-02-26 DOI: 10.3138/canlivj-2023-0026

Mariam Ragheb, M. Grubert Van Iderstine, Gerald Minuk, Nabiha Faisal

{"title":"Exploring autoantibodies as predictors of severe fibrosis or cirrhosis in metabolic dysfunction associated steatotic liver disease","authors":"Mariam Ragheb, M. Grubert Van Iderstine, Gerald Minuk, Nabiha Faisal","doi":"10.3138/canlivj-2023-0026","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0026","url":null,"abstract":"Metabolic dysfunction associated steatotic liver disease (MASLD) and metabolic dysfunction associated steatohepatitis (MASH) are rapidly growing public health concerns. Identifying predictive markers for advanced liver disease in MASLD patients is crucial for early intervention. This study investigates the association between autoantibody positivity and risk for severe fibrosis or cirrhosis across various subgroups. We conducted a retrospective study of adult patients diagnosed with MASLD between 1994 and 2019. Autoantibody status (anti-nuclear and anti-smooth muscle antibodies) was assessed using laboratory studies. Hepatic fibrosis or cirrhosis was determined histologically or through accepted non-invasive measures. Logistic regression analyses were employed to evaluate the association between autoantibody positivity and severe fibrosis or cirrhosis. Patients with co-morbid viral and alcohol liver disease were assessed separately. Among 2,749 MASLD patients, 1,425 (51.8%) were males and 1,324 (48.2%) were females, with a mean age of 58.7 years. A total of 541 (19.7%) patients tested positive for autoantibodies. Autoantibody positivity was associated with a higher risk of severe fibrosis or cirrhosis in MASLD patients (odds ratio 1.28, 95% CI [1.0–1.6]). This association persisted across various subgroups, including those with concurrent hepatitis B and C virus infections. In contrast, in alcohol liver disease, autoantibody-positive patients exhibited a lower risk. Autoantibody positivity emerges as a potential predictive marker for advanced liver disease in MASLD patients, facilitating risk stratification and tailored interventions. This study highlights the clinical relevance of autoantibodies in MASLD and underscores the need for prospective validation and mechanistic investigations to refine risk assessment and management strategies.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"109 S129","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of curcumin in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis 姜黄素对非酒精性脂肪肝患者的影响：系统回顾和荟萃分析

Canadian liver journal Pub Date : 2024-02-26 DOI: 10.3138/canlivj-2023-0022

Adnan Malik, M. Malik

{"title":"Effects of curcumin in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis","authors":"Adnan Malik, M. Malik","doi":"10.3138/canlivj-2023-0022","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0022","url":null,"abstract":"Curcumin is an anti-inflammatory that is proposed to have a positive impact on patients with NAFLD. We aim to assess the effects of curcumin in patients with NAFLD. Clinical trials from PubMed, Scopus, the Web of Science, and Cochrane CENTRAL with variables: alanine transferase, aspartate transaminase, alkaline phosphatase, glycated hemoglobin (HBA1c), body mass index, waist circumference, total cholesterol, total glycerides, high-density lipoproteins, and low-density lipoproteins were included. Homogeneous and heterogeneous were analyzed under a fixed-effects model and the random-effects model, respectively. Fourteen clinical trials found that curcumin has no statistically significant effect on alanine transferase (MD = −2.20 [−6.03, 1.63], p = 0.26], aspartate transaminase (MD = 1.37 [−4.56, 1.81], p = 0.4), alkaline phosphatase (MD = 3.06 [−15.85, 9.73], p = 0.64), glycated hemoglobin (HBA1c), (MD = −0.06 [−0.13, 0.02], p = 0.16], and body-mass index (MD = 0.04 [−0.38, 0.46], p = 0.86). Curcumin reduced the waist circumference (MD = −4.87 [−8.50, −1.25], p = 0.008). Lipid profile parameters were not significant, except the total glycerides (MD = −13.22 [−24.19, −2.24], p = 0.02). Curcumin significantly reduces total glycerides and waist circumference in NAFLD.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"41 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breaking boundaries: Unraveling metabolic dysfunction-associated steatotic liver disease in children of India and Canada 打破界限：揭开印度和加拿大儿童代谢功能障碍相关脂肪肝的神秘面纱

Canadian liver journal Pub Date : 2024-02-26 DOI: 10.3138/canlivj-2023-0023

V. Sood, B. B. Lal, Aniket Deshmukh, R. Khanna, Esha Gahunia, Jamie Strain, Carolina Jimenez Rivera, S. Alam, M. Kehar

{"title":"Breaking boundaries: Unraveling metabolic dysfunction-associated steatotic liver disease in children of India and Canada","authors":"V. Sood, B. B. Lal, Aniket Deshmukh, R. Khanna, Esha Gahunia, Jamie Strain, Carolina Jimenez Rivera, S. Alam, M. Kehar","doi":"10.3138/canlivj-2023-0023","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0023","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease in children. Its prevalence is rising globally, yet it is uncertain if its onset and severity vary between countries. We aimed to compare pediatric NAFLD in two Canadian and Indian tertiary care centers. This study was conducted as a retrospective cohort study and patient related details were retrieved from the electronic records and reviewed. The study analyzed a total of 184 children with NAFLD/MASLD (94 from the Indian site and 89 from the Canadian site) with concordance between NAFLD and MASLD definitions. The Indian children had a higher proportion of symptomatic presentations and family history of metabolic disorders ( p = 0.0001) while the Canadian children had higher median weight, BMI, blood pressure, and waist circumference ( p < 0.05). Indian children had higher hepatic transaminases and low density lipoprotein levels, while the Canadian site had higher serum insulin, blood glucose, homeostasis model assessment of insulin resistance, high density lipoprotein cholesterol levels, liver stiffness, and controlled attenuation parameter values ( p < 0.05). Majority (78%) of the Canadian children who underwent liver biopsy had significant fibrosis (>stage 2). In the overall cohort, waist circumference could be identified as an independent risk factor, irrespective of country of origin, predicting hepatic fibrosis. The study found significant differences between cohorts. Canadian children showed higher obesity grades and greater hepatic steatosis and fibrosis severity. To comprehend the underlying causes, future studies are imperative.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"152 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140428560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of statins in the liver: A bane or a boon? 他汀类药物对肝脏的影响：是祸还是福？

Canadian liver journal Pub Date : 2024-02-26 DOI: 10.3138/canlivj-2023-0028

G. Zacharia, Anu Jacob, Manivarnan Karichery, Abhishek Sasidharan

{"title":"Impact of statins in the liver: A bane or a boon?","authors":"G. Zacharia, Anu Jacob, Manivarnan Karichery, Abhishek Sasidharan","doi":"10.3138/canlivj-2023-0028","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0028","url":null,"abstract":"Treatment of hypercholesterolemia with statins is considered one of the cornerstones in the management of atherosclerotic cardiovascular diseases. Statins exert their hypolipidemic effects by inhibiting HMG-CoA reductase, the key enzyme in cholesterol biosynthesis. Beyond cholesterol reduction, statins exhibit pleiotropic effects, including anti-inflammatory, antioxidant, and antiproliferative actions, making them valuable in mitigating atherosclerotic and non-atherosclerotic diseases. Though concerns of hepatotoxicity have been associated with the use of statins, extensive evidence suggests that the risk of statin-induced liver injury (SILI) is rare, with an incidence of <1%. Hepatic adverse effects include reversible asymptomatic transaminase elevation (most frequent), hepatitis, cholestasis, and rarely acute liver failure. While hepatotoxicity concerns should not be dismissed, the evidence overwhelmingly supports the safety of statins. Contrary to the myth of statin hepatotoxicity, real-world data and extensive research emphasize the safety and benefits of statins. They are therapeutic in various liver-related conditions, mainly non-alcoholic fatty liver disease. This scientific review aims to provide a comprehensive overview of statins, shedding light on their mechanism of action, hepatotoxicity concerns, and therapeutic potential in various liver-related conditions.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"48 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of gynecological and breast cancer among female patients with cirrhosis: Scoping review of the literature 肝硬化女性患者罹患妇科和乳腺癌的情况：文献综述

Canadian liver journal Pub Date : 2024-02-22 DOI: 10.3138/canlivj-2023-0031

M. Jogendran, Jennifer A. Flemming

{"title":"Outcomes of gynecological and breast cancer among female patients with cirrhosis: Scoping review of the literature","authors":"M. Jogendran, Jennifer A. Flemming","doi":"10.3138/canlivj-2023-0031","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0031","url":null,"abstract":"The incidence of gynecological and breast cancers is on the rise in addition to a rise in the incidence of cirrhosis among women. Women with cirrhosis are generally excluded from clinical trials therefore little is known about the oncologic and/or liver-related outcomes in this population. The aim of this study was to review the current literature regarding treatment and survival outcomes in females with gynecological or breast cancer with underlying cirrhosis. An electronic search was conducted for studies reporting outcomes among females with cirrhosis and gynecological and breast cancer. References were reviewed for relevant publications. Studies were reviewed and data were extracted from publications. Three thousand one hundred ninety one articles were identified, and five studies were reviewed in full. Thirty unique patients were identified. Ten patients with breast cancer were identified, 9/10 patients did not have cancer recurrence in the follow-up period, and 1/10 did not have follow up. 1/10 patient's received chemotherapy and developed degree II abnormal liver function and bone marrow suppression. 2/9 patients experienced postoperative complications, one had worsening thrombocytopenia and one developed mild encephalopathy. Nienteen patients with ovarian cancer all received surgery and chemotherapy. 10/19 had postoperative complications and 1/19 died in follow-up period. One patient had a neuroendocrine uterine cancer stage IV who died after one cycle of chemotherapy. There is limited data on the outcomes and management of patients with both cirrhosis and gynecological or breast cancers. Therefore, further work is necessary to address these gaps in clinical practice to improve patient care.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"10 9‐10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

‘I just never wanted them to feel uncomfortable’ – Barriers to pharmacy-based identification and treatment of hepatitis C in Victoria, Canada 我只是不想让他们感到不舒服"--加拿大维多利亚州药房识别和治疗丙型肝炎的障碍

Canadian liver journal Pub Date : 2024-01-31 DOI: 10.3138/canlivj-2023-0016

M. Selfridge, T. Barnett, K. Lundgren, K. Guarasci, A. Drost, Chris Fraser

{"title":"‘I just never wanted them to feel uncomfortable’ – Barriers to pharmacy-based identification and treatment of hepatitis C in Victoria, Canada","authors":"M. Selfridge, T. Barnett, K. Lundgren, K. Guarasci, A. Drost, Chris Fraser","doi":"10.3138/canlivj-2023-0016","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0016","url":null,"abstract":"Canada is currently on target to reach the 2030 WHO goal of HCV elimination. Continued high rates of treatment are required to meet this goal. Novel models such as Tayside, Scotland pharmacy-based HCV screening and treatment have proven successful to engage people who use drugs (PWUD) in HCV therapy with a simplified, task-shifted cascade of care. This study seeks to determine whether these successes can be replicated at community pharmacies in Victoria BC. Four pharmacies who work with PWUD and provide opioid agonist therapy were trained to provide consent and perform point of care HCV antibody screening. They were supported by study nurse to link to HCV RNA testing when antibody positive patients were identified, with HCV treatment offered to RNA positive participants. Qualitative interviews were conducted with five pharmacy staff to explore experiences and feasibility of pharmacists in HCV care cascade. Pharmacy staff completed 200 HCV OraQuick tests between October 2020 and June 2022: 65 HCV antibody positive, 29 HCV RNA negative (25 previously treated and 4 self-cleared). Of the 26 RNA positive participants, one is awaiting treatment, 25 people have started treatment, 22 achieving SVR. Although the onset of the COVID 19 pandemic was a fundamental barrier incorporating HCV testing at pharmacies, stigma related to HCV, and illicit drug use continues to impact this process. This innovative pharmacy-based approach found people with limited connection to primary health care to test and treat HCV but requires more training and support to be more widely feasible.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"95 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

An open label feasibility study of a nutrition and exercise app-based solution in cirrhosis 基于营养和运动应用程序的肝硬化解决方案的开放标签可行性研究

Canadian liver journal Pub Date : 2024-01-24 DOI: 10.3138/canlivj-2023-0011

K. Ismond, Christofer Cruz, A. Limon-Miro, Gavin Low, Carla M Prado, John C Spence, Maitreyi Raman, Margaret McNeely, Puneeta Tandon

{"title":"An open label feasibility study of a nutrition and exercise app-based solution in cirrhosis","authors":"K. Ismond, Christofer Cruz, A. Limon-Miro, Gavin Low, Carla M Prado, John C Spence, Maitreyi Raman, Margaret McNeely, Puneeta Tandon","doi":"10.3138/canlivj-2023-0011","DOIUrl":"https://doi.org/10.3138/canlivj-2023-0011","url":null,"abstract":"Nutrition and exercise are the mainstay of therapy for the prevention and treatment of frailty in cirrhosis. This pilot study assessed feasibility of the online delivery of an app-based semi-supervised nutrition and exercise intervention in this population. The 11-week pilot recruited adults with cirrhosis who owned internet-connected devices. Patients were encouraged to participate in exercise sessions 3× per week including a combination of online group exercise (weekly) and home-based follow-along exercise (biweekly). They also participated in group nutrition classes (five sessions) and one-to-one exercise and nutrition check-ins delivered through the app. Primary outcome measures pertained to program feasibility: recruitment, retention, adherence, and satisfaction. Exploratory measures included physical performance (liver frailty index [LFI], 6-minute walk test [6MWT]), health behaviour domains, and quality of life. Twenty three patients completed baseline measures. Of these, 18 (72%) completed end of study measures (mean MELD-Na, 9.2; female, 44.4%). Over 70% of participants fulfilled 75% or more of the feasibility criteria. Satisfaction with the program was high (mean, 89%). Exercise program modifications were required for 17 patients to accommodate health events or abilities. Exploratory evaluation showed improvement in the LFI and the 6MWT by −0.58-units (95% CI: −0.91 to −0.25) and 46.0 m (95% CI: 22.7–69.3) respectively without changes in quality of life or health behaviour domains. Outcomes demonstrate feasibility of the app-based delivery of programming with promising exploratory impact on efficacy for physical performance. Findings can guide the design of a large-scale app-based randomized controlled trials in cirrhosis.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139602851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The untitled editorial 无标题社论

Canadian liver journal Pub Date : 2023-12-20 DOI: 10.3138/canlivj-2023-0029

Eric M Yoshida, Natasha Chandok

引用次数: 4