Canadian liver journal最新文献

{"title":"Annual Meeting of the Canadian Association for the Study of the Liver (CASL), the Canadian Network on Hepatitis C (CanHepC), the Canadian Association of Hepatology Nurses (CAHN), and the Canadian NASH Network 2022 Abstracts.","authors":"","doi":"10.3138/canlivj.5.2.abst","DOIUrl":"10.3138/canlivj.5.2.abst","url":null,"abstract":"","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 2","pages":"169-317"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236590/pdf/canlivj.5.2.abst.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10310644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Checkpoint inhibition in hepatocellular carcinoma: Outsmarting the <i>Squid Game</i>.","authors":"Natasha Chandok,&nbsp;Sanjeev Sirpal,&nbsp;Eric M Yoshida","doi":"10.3138/canlivj-2022-0012","DOIUrl":"https://doi.org/10.3138/canlivj-2022-0012","url":null,"abstract":"The premise behind Squid Game, Netflix’s most viewed show to date, is a brutish contest where 456 bankrupted individuals risk their lives playing deadly children’s games for a chance to win an exorbitant money prize. The acclaimed series captures, on the silver screen, the plight of desperation and the willingness to sacrifice everything in the hopes for a cure to a bleak financial outlook. The show’s global success is perhaps attributable to its profound resonance with financial struggle, socio-economic disparities, and the quintessential tenets of human resilience. At its crux, Squid Game is a social commentary about survival, and the extreme lengths one may endure to not only live, but to prosper. Beyond a prima facie analysis, the Squid Game may indeed be an apt analogy for hepatocellular carcinoma (HCC) treatment. The first objective of any cancer treatment is, of course, to prolong survival. In the world of HCC, the ultimate Squid Game is its management. The brave player (ie, the patient diagnosed with advanced HCC beyond surgical cure) seeks to survive despite all odds—and is ready and willing to sacrifice everything to succeed. HCC therapy, therefore, is the Squid Game she must manoeuvre to survive, and her survival depends on the innovativeness of therapies to defeat HCC—its ability to grow, mutate and metastasize, and ultimately kill the host. Such survival strategies rival those employed by the players of the Squid Game, who seek innovative solutions to ensure livelihood. Analogous to the impact of direct active antivirals for hepatitis C treatment, immune checkpoint inhibitors (ICIs) have dramatically altered the landscape of oncology, and our fundamental understanding and approach to cancer treatment (1). ICIs thus allow the Squid Game player to potentially bypass the Front Man, thereby possibly Checkpoint inhibition in hepatocellular carcinoma","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236585/pdf/canlivj-2022-0012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators related to HCV treatment uptake among HIV coinfected populations in Canada: Patient and treatment provider perceptions.","authors":"David Ortiz-Paredes,&nbsp;Afia Amoako,&nbsp;David Lessard,&nbsp;Kim Engler,&nbsp;Bertrand Lebouché,&nbsp;Marina B Klein","doi":"10.3138/canlivj-2021-0020","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0020","url":null,"abstract":"<p><strong>Background: </strong>Direct-acting antiviral (DAA) uptake is challenging across HIV-hepatitis C (HCV) coinfected populations. This study sought to identify barriers and facilitators related to DAA uptake in priority populations in Canada.</p><p><strong>Methods: </strong>This qualitative descriptive study included 11 people living with HIV with a history of HCV and 15 HCV care providers. Participants were part of either nominal groups (n = 4) or individual interviews (n = 6) in which they identified and ranked barriers and facilitators to DAA uptake. Consolidated lists of barriers and facilitators were identified thematically.</p><p><strong>Results: </strong>Patient participants highly ranked the following barriers: competing priorities and needs (ie, social instability and mental health), delays in care, lack of adherence, and polypharmacy. Provider participant top barriers were the following: competing priorities and needs (ie, social chaos), delays in care (eg, systemic barriers, difficulties engaging patients, lack of trained HCV providers), and HCV-related stigma. Patient participants identified having a strong network of health care providers, family, and friends, possessing intrinsic motivation, and DAAs being a simple and tolerable oral treatment as important facilitators. Provider participant top-ranked facilitators were having resources to identify hard-to-reach populations (eg, patient navigation, outreach), holistic care and addiction management, provider HCV education, and a strong network of interprofessional collaboration.</p><p><strong>Conclusion: </strong>The barriers to DAA initiation addressed by patients and providers overlapped, with some nuances. Multidisciplinary care fostering a strong supportive network and intrinsically motivated patients along with HCV education emerged as key facilitators. This study provides insights for developing potential strategies to improve DAA uptake among HIV-HCV coinfected people in Canada.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"124-143"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236584/pdf/canlivj-2021-0020.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tribute to Dr Saya Victor Feinman.","authors":"Jordan Feld","doi":"10.3138/canlivj-2022-0004","DOIUrl":"https://doi.org/10.3138/canlivj-2022-0004","url":null,"abstract":"","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236594/pdf/canlivj-2022-0004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of gastric varices and splenic artery aneurysm secondary to splenic arteriovenous fistula.","authors":"Felix Zhou,&nbsp;Christopher B Lightfoot,&nbsp;Geoff Williams,&nbsp;Julie H Zhu","doi":"10.3138/canlivj-2021-0024","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0024","url":null,"abstract":"<p><p>A 33-year-old male with no relevant medical history presented with a few months of fatigue and reduced exercise tolerance and was found to have iron-deficiency anemia. An esophagogastroduodenoscopy revealed a cluster of isolated gastric fundal varices with high-risk stigmata. Serologic workup for cirrhosis was negative, and a FibroScan measured liver stiffness at 4.2 kilopascals. Computed tomography (CT) of his abdomen and pelvis showed non-cirrhotic portal hypertension, as well as the presence of a splenic arteriovenous (AV) fistula and splenic artery aneurysm (SAA). Resection of the fistula, SAA, and spleen completely resolved the gastric varices and anemia.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"160-164"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236588/pdf/canlivj-2021-0024.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential interventions to support HCV treatment uptake among HIV co-infected people in Canada: Perceptions of patients and health care providers.","authors":"David Ortiz-Paredes,&nbsp;Afia Amoako,&nbsp;David Lessard,&nbsp;Kim Engler,&nbsp;Bertrand Lebouché,&nbsp;Marina B Klein","doi":"10.3138/canlivj-2021-0021","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0021","url":null,"abstract":"<p><strong>Background: </strong>Increasing direct-acting antiviral (DAA) treatment uptake is key to eliminating HCV infection as a public health threat in Canada. People living with human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection face barriers to HCV treatment initiation. We sought to identify interventions that could support HCV treatment initiation based on patient and HCV care provider perspectives.</p><p><strong>Methods: </strong>Eleven people living with HIV with a history of HCV infection and 12 HCV care providers were recruited for this qualitative descriptive study. Participants created ranked-ordered lists of potential interventions during nominal groups (<i>n</i> = 4) and individual interviews (<i>n</i> = 6). Following the nominal group technique, transcripts and intervention lists underwent thematic analysis and ranking scores were merged to create consolidated and prioritized lists from patient and provider perspectives.</p><p><strong>Results: </strong>Patient participants identified a total of eight interventions. The highest-ranked interventions were multidisciplinary clinics, HCV awareness campaigns and patient education, nurse- or pharmacist-led care, peer involvement, and more and better-prepared health professionals. Provider participants identified 11 interventions. The highest-ranked were mobile outreach, DAA initiation at pharmacies, a simplified process of DAA prescription, integration of primary and specialist care, and patient-centred approaches.</p><p><strong>Conclusion: </strong>Participants proposed alternatives to hospital-based specialist HCV care, which require increasing capacity for nurses, pharmacists, primary care providers, and peers to have more direct roles in HCV treatment provision. They also identified the need for structural changes and educational initiatives. In addition to optimizing HCV care, these interventions might result in broader benefits for the health of HIV-HCV co-infected people.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 1","pages":"14-30"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231425/pdf/canlivj-2021-0021.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40714612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current considerations for clinical management and care of non-alcoholic fatty liver disease: Insights from the 1st International Workshop of the Canadian NASH Network (CanNASH).","authors":"Giada Sebastiani,&nbsp;Keyur Patel,&nbsp;Vlad Ratziu,&nbsp;Jordan J Feld,&nbsp;Brent A Neuschwander-Tetri,&nbsp;Massimo Pinzani,&nbsp;Salvatore Petta,&nbsp;Annalisa Berzigotti,&nbsp;Peter Metrakos,&nbsp;Naglaa Shoukry,&nbsp;Elizabeth M Brunt,&nbsp;An Tang,&nbsp;Jeremy F Cobbold,&nbsp;Jean-Marie Ekoe,&nbsp;Karen Seto,&nbsp;Peter Ghali,&nbsp;Stéphanie Chevalier,&nbsp;Quentin M Anstee,&nbsp;Heather Watson,&nbsp;Harpreet Bajaj,&nbsp;James Stone,&nbsp;Mark G Swain,&nbsp;Alnoor Ramji","doi":"10.3138/canlivj-2021-0030","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0030","url":null,"abstract":"<p><p>Non-alcoholic fatty liver disease (NAFLD) affects approximately 8 million Canadians. NAFLD refers to a disease spectrum ranging from bland steatosis to non-alcoholic steatohepatitis (NASH). Nearly 25% of patients with NAFLD develop NASH, which can progress to liver cirrhosis and related end-stage complications. Type 2 diabetes and obesity represent the main risk factors for the disease. The Canadian NASH Network is a national collaborative organization of health care professionals and researchers with a primary interest in enhancing understanding, care, education, and research around NAFLD, with a vision of best practices for this disease state. At the 1st International Workshop of the CanNASH network in April 2021, a joint event with the single topic conference of the Canadian Association for the Study of the Liver (CASL), clinicians, epidemiologists, basic scientists, and community members came together to share their work under the theme of NASH. This symposium also marked the initiation of collaborations between Canadian and other key opinion leaders in the field representative of international liver associations. The main objective is to develop a policy framework that outlines specific targets, suggested activities, and evidence-based best practices to guide provincial, territorial, and federal organizations in developing multidisciplinary models of care and strategies to address this epidemic.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 1","pages":"61-90"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231423/pdf/canlivj-2021-0030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40714616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late presentation of posterior reversible encephalopathy syndrome following liver transplantation in the setting of tacrolimus and cannabis use.","authors":"Felix Zhou,&nbsp;Andreu F Costa,&nbsp;Magnus McLeod","doi":"10.3138/canlivj-2021-0017","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0017","url":null,"abstract":"<p><p>A 45-year-old female presented to hospital with confusion and visual disturbances. She had undergone a liver transplant 3 years prior for cirrhosis secondary to primary biliary cholangitis. Computed tomography and magnetic resonance imaging of the brain showed features consistent with posterior reversible encephalopathy syndrome. Her medications included tacrolimus, sirolimus, and prednisone. She reported smoking 4 grams of cannabis per day. Following cessation of tacrolimus, the patient's encephalopathy and visual disturbances resolved. To our knowledge, this case represents the longest time elapsed from liver transplantation to the development of tacrolimus-associated posterior reversible encephalopathy syndrome in the literature. This case highlights the potential danger of cannabis use in transplant recipients who are on immunosuppressants such as tacrolimus. Clinicians should have a high index of suspicion for posterior reversible encephalopathy syndrome in post-transplant patients presenting with altered mental status, even years after liver transplantation, and be familiar with potential interactions between cannabis and immunosuppressants.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 1","pages":"91-95"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231424/pdf/canlivj-2021-0017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum IgG4 cut-off of 70 mg/dL is associated with a shorter time to cirrhosis decompensation and liver transplantation in primary sclerosing cholangitis patients.","authors":"Farhad Peerani,&nbsp;Lillian Du,&nbsp;Ellina Lytvyak,&nbsp;Vincent G Bain,&nbsp;Andrew L Mason,&nbsp;Robert J Bailey,&nbsp;Aldo J Montano-Loza","doi":"10.3138/canlivj-2021-0023","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0023","url":null,"abstract":"<p><strong>Background: </strong>Primary sclerosing cholangitis (PSC) is an immune-mediated biliary disorder of unknown etiology with no effective treatment. The purpose of this study was to better prognosticate the development of cirrhosis, decompensation, and requirement for liver transplantation (LT) in PSC patients based on serum immunoglobulin G4 (IgG4) levels.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on PSC patients seen at the University of Alberta Hospital between 2002 and 2017. PSC patients were categorized as high IgG4 group (≥70 mg/dL) or normal IgG4 group (<70 mg/dL). Laboratory parameters, clinical characteristics, and outcomes were compared between the groups.</p><p><strong>Results: </strong>One hundred and ten patients were followed over a mean period of 7.3 (SD 5) years. Seventy-two patients (66%) were male, the mean age at diagnosis of PSC was 35 (SD 15) years, and inflammatory bowel disease (IBD) was present in 80 patients (73%). High IgG4 levels were found in 37 patients (34%). PSC patients with high IgG4 had a shorter mean cholangitis-free survival time (5.3 versus 10.4 years, <i>p</i> = 0.02), cirrhosis-free survival time (8.7 versus 13.0 years, <i>p</i> = 0.02), and LT-free survival time (9.3 years versus 18.9 years, <i>p</i> <0.001). IgG4 ≥70 mg/dL was independently associated with liver decompensation and LT-free outcomes. A cut-off IgG4 value of ≥70 mg/dL performed better than a cut-off value of ≥140 mg/dL to predict time to LT (area under the curve [AUC] 0.68, <i>p</i> = 0.03, sensitivity 72%, specificity 78%).</p><p><strong>Conclusions: </strong>Serum IgG4 ≥70 mg/dL in PSC predicts a shorter time to cirrhosis decompensation and LT.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 1","pages":"31-42"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231426/pdf/canlivj-2021-0023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40714614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-alcoholic fatty liver disease (NAFLD) in Filipino North American patients: Results from a multi-ethnic cohort.","authors":"Shirley X Jiang,&nbsp;Roberto Trasolini,&nbsp;Michael Heer,&nbsp;Benjamin Cox,&nbsp;Ciaran Galts,&nbsp;Vladimir Marquez,&nbsp;Eric M Yoshida","doi":"10.3138/canlivj-2021-0025","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0025","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is more prevalent in certain ethnicities due to a combination of genetic, environmental, and metabolic factors. North American Filipino populations may have lifestyle and metabolic risk factors for NAFLD; however, the prevalence of NAFLD in this group is unknown. We sought to determine whether Filipino patients are over-represented in a multi-ethnic NAFLD cohort and describe their clinical presentation, primarily compared to other ethnicities in the same geographical region and secondarily compared to Manila-based Filipino patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with patients with NAFLD who were followed at the Hepatology Clinic at Vancouver General Hospital, Canada, from January 2015 to August 2018. Data were extracted for clinicodemographic data, ethnicity, anthropometric measures, blood work, and transient elastography (TE). External comparison data was obtained online from the Metro Vancouver census and a NAFLD study conducted in Manila, Philippines.</p><p><strong>Results: </strong>Of 317 patients meeting inclusion criteria for the study, 224 patients had complete datasets. The mean age was 51.1 years, and 50% were female. There were 139 (62%) Caucasian and other ethnicity patients, 55 (25%) Asian patients, and 30 (13%) Filipino patients. Compared to other ethnic groups, the Filipino group had similar clinical characteristics, including NAFLD fibrosis scores and TE. Of included NAFLD patients, the proportion of Filipino patients (13.39%) was significantly greater than the proportion of Filipino residents in Metro Vancouver (5.52%, <i>p</i> <0.01). Our Filipino Canadians seemed to be younger, with fewer females and a lower proportion of diabetes mellitus, but a higher proportion of hypertension than the previously reported cohort from Manila.</p><p><strong>Conclusions: </strong>While Filipino patients have not previously been examined in multi-ethnic NAFLD studies, they may represent a high-risk population. Further research is needed to clarify the prevalence and presentation of NAFLD in Filipino Canadian patients, as this appears to be a significant health issue in this community.</p>","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"5 1","pages":"4-13"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231422/pdf/canlivj-2021-0025.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40714617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}