Canadian liver journal最新文献_第9页

Comparing the performance of Fibrosis-4 and Non-Alcoholic Fatty Liver Disease Fibrosis Score with transient elastography scores of people with non-alcoholic fatty liver disease. 比较非酒精性脂肪性肝病患者的纤维化-4和非酒精性脂肪性肝病纤维化评分与瞬时弹性成像评分的表现

Canadian liver journal Pub Date : 2021-08-09 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2021-0004

Ben Cox, Roberto Trasolini, Ciaran Galts, Eric M Yoshida, Vladimir Marquez

{"title":"Comparing the performance of Fibrosis-4 and Non-Alcoholic Fatty Liver Disease Fibrosis Score with transient elastography scores of people with non-alcoholic fatty liver disease.","authors":"Ben Cox, Roberto Trasolini, Ciaran Galts, Eric M Yoshida, Vladimir Marquez","doi":"10.3138/canlivj-2021-0004","DOIUrl":"https://doi.org/10.3138/canlivj-2021-0004","url":null,"abstract":"Background: With the rate of non-alcoholic fatty liver disease (NAFLD) on the rise, the necessity of identifying patients at risk of cirrhosis and its complications is becoming ever more important. Liver biopsy remains the gold standard for assessing fibrosis, although costs, risks, and availability prohibit its widespread use with at-risk patients. Transient elastography has proven to be a non-invasive and accurate way of assessing fibrosis, although the availability of this modality is often limited in primary care settings. The Fibrosis-4 (FIB-4) and Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS) are scoring systems that incorporate commonly measured lab parameters and BMI to predict fibrosis.Method: In this study, we compared FIB-4 and NFS scores with transient elastography scores to assess the accuracy of these inexpensive and readily available scoring systems in detecting fibrosis.Results: Using an NFS score cut-off of -1.455 and a FibroScan score cut-off of ≥8.7 kPa, the NFS score had a negative predictive value of 94.1%. Using a FibroScan score cut-off of ≥8.7 kPa, the FIB-4 score had a negative predictive value of 91.6%.Conclusion: The NFS and FIB-4 are non-invasive, inexpensive scoring systems that have high negative predictive value for fibrosis compared with transient elastography scores. These findings suggest that the NFS and FIB-4 can provide adequate reassurance to rule out fibrosis in patients with NAFLD and can be used with select patients to circumvent the need for transient elastography or liver biopsy.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"275-282"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202768/pdf/canlivj-2021-0004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40630156","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}

引用次数: 1

Disparities in hepatitis C care across Canadian provincial prisons: Implications for hepatitis C micro-elimination. 加拿大省级监狱丙型肝炎护理的差异：对丙型肝炎微量消除的影响。

Canadian liver journal Pub Date : 2021-08-09 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2020-0035

Nadine Kronfli, Camille Dussault, Sofia Bartlett, Dennaye Fuchs, Kelly Kaita, Kate Harland, Brandi Martin, Cindy Whitten-Nagle, Joseph Cox

{"title":"Disparities in hepatitis C care across Canadian provincial prisons: Implications for hepatitis C micro-elimination.","authors":"Nadine Kronfli, Camille Dussault, Sofia Bartlett, Dennaye Fuchs, Kelly Kaita, Kate Harland, Brandi Martin, Cindy Whitten-Nagle, Joseph Cox","doi":"10.3138/canlivj-2020-0035","DOIUrl":"10.3138/canlivj-2020-0035","url":null,"abstract":"Background: Delivery of hepatitis C virus (HCV) care to people in prison is essential to HCV elimination. We aimed to describe current HCV care practices across Canada's adult provincial prisons.Methods: One representative per provincial prison health care team (except Ontario) was invited to participate in a web-based survey from January to June 2020. The outcomes of interest were HCV screening and treatment, treatment restrictions, and harm reduction services. The government ministry responsible for health care was determined. Non-nominal data were aggregated by province and ministry; descriptive statistical analyses were used to report outcomes.Results: The survey was completed by 59/65 (91%) prisons. On-demand, risk-based, opt-in, and opt-out screening are offered by 19 (32%), 10 (17%), 18 (31%), and 9 (15%) prisons, respectively; 3 prisons offer no HCV screening. Liver fibrosis assessments are rare (8 prisons access transient elastography, and 15 use aspartate aminotransferase to platelet ratio or Fibrosis-4); 20 (34%) prisons lack linkage to care programs. Only 32 (54%) prisons have ever initiated HCV treatment on site. Incarceration length and a fibrosis staging of ≥F2 are the most common eligibility restrictions for treatment. Opioid agonist therapy is available in 83% of prisons; needle and syringe programs are not available anywhere. Systematic screening and greater access to treatment and harm reduction services are more common where the Ministry of Health is responsible.Conclusions: Tremendous variability exists in HCV screening and care practices across Canada's provincial prisons. To advance HCV care, adopting opt-out screening and removing eligibility restrictions may be important initial strategies.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"292-310"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202774/pdf/canlivj-2020-0035.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40630206","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}

引用次数: 0

Screening for hepatitis C in an outpatient endoscopy unit. 筛查丙型肝炎在门诊内镜单位。

Canadian liver journal Pub Date : 2021-08-09 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2020-0038

Mandip Rai, Catherine Lowe, Jennifer A Flemming

{"title":"Screening for hepatitis C in an outpatient endoscopy unit.","authors":"Mandip Rai, Catherine Lowe, Jennifer A Flemming","doi":"10.3138/canlivj-2020-0038","DOIUrl":"https://doi.org/10.3138/canlivj-2020-0038","url":null,"abstract":"Background: The Canadian Liver Foundation recommends routine hepatitis C (HCV) screening for Canadians born between 1945 and 1975. This study aimed to determine the feasibility and outcomes of targeted birth cohort HCV screening during routine outpatient endoscopic procedures in a tertiary care hospital.Methods: We conducted a prospective cohort study of individuals born between 1945 and 1975 who attended outpatient endoscopy procedures at Kingston Health Sciences Centre from 2017 to 2019. Patients who consented received the HCV OraSure point-of-care test for the HCV antibody (HCV Ab). If positive, serum for HCV RNA was sent, and patients were linked to care with a hepatologist.Results: 2,179 patients met birth cohort criteria for HCV screening. Of those, 1,079 (49.5%) were approached for study inclusion, and 160 (15.0%) declined participation, leaving 912 patients who provided consent. The median age was 62 years (IQR 55-67). Overall, 6/912 (0.7%) of participants were HCV Ab positive and 5/912 (0.6%) were HCV RNA positive. Four were linked to care for consideration of direct-acting antiviral (DAA) therapy, 3 received DAA treatment, and all 3 achieved sustained virologic response (SVR).Conclusions: Birth cohort screening for HCV in an outpatient endoscopy unit identified an HCV prevalence similar to population estimates. In this model, however, 50% of eligible patients were not approached for screening. Linkage to care for assessment of treatment was high at 80%, and of those who received therapy, all achieved SVR. These results suggest this cohort is a suitable population for HCV screening; however, we need strategies to increase recruitment of all eligible individuals.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":" ","pages":"311-316"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202776/pdf/canlivj-2020-0038.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40630159","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}

引用次数: 0

Terlipressin and albumin: The good, the bad, and the unattractive (with apologies to Sergio Leone). 特立加压素和白蛋白:好的，坏的和不吸引人的(向塞尔吉奥·莱昂内道歉)。

Canadian liver journal Pub Date : 2021-08-09 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2021-0010

Mahmoud Omar, Trana Hussaini, Eric M Yoshida

引用次数: 1

Demanding truth, reconciliation, and justice for Canada's Indigenous Peoples: Now and forever. 为加拿大原住民要求真相、和解和正义:现在和永远。

Canadian liver journal Pub Date : 2021-06-09 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2021-0606

Natasha Chandok, Eric M Yoshida

引用次数: 0

IgG4-associated autoimmune hepatitis and cholangitis: A relatively novel entity to consider in cases of seronegative autoimmune hepatitis. igg4相关自身免疫性肝炎和胆管炎:在血清阴性自身免疫性肝炎病例中考虑的一个相对新颖的实体。

Canadian liver journal Pub Date : 2021-04-29 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2020-0023

Gabrielle Jutras, Philip Wong, José Ferreira, Jean-Frederic Leblanc

{"title":"IgG4-associated autoimmune hepatitis and cholangitis: A relatively novel entity to consider in cases of seronegative autoimmune hepatitis.","authors":"Gabrielle Jutras, Philip Wong, José Ferreira, Jean-Frederic Leblanc","doi":"10.3138/canlivj-2020-0023","DOIUrl":"https://doi.org/10.3138/canlivj-2020-0023","url":null,"abstract":"A 49-year-old woman with no inflammatory bowel disease history presented to our clinic with abnormal liver function tests and right upper quadrant abdominal pain. Blood tests revealed a mixed pattern of liver injury. Abdominal magnetic resonance imaging demonstrated hepatomegaly with periportal edema and hyper-enhancing bile ducts without any sign of biliary obstruction or stricturing. Screening for viral hepatitis and autoimmune liver diseases was negative. An elevated immunoglobulin G (IgG) level suggested the possibility of autoimmune hepatitis (AIH), and a biopsy confirmed the presence of severe interface hepatitis with necrotic areas and focal lymphoid nodular formation. IgG4 staining revealed marked IgG4-positive plasma cell infiltration. A diagnosis of IgG4-associated seronegative AIH was made, and the patient was started on prednisone and azathioprine, with rapid resolution of the enzyme abnormalities. This clinical vignette highlights the potential challenges in establishing a diagnosis of IgG4-associated AIH and cholangitis, as demonstrated by the importance of confirmatory histopathology. Clinicians should maintain a high index of suspicion when confronted with a mixed pattern of liver injury with elevated immunoglobulins but seronegative autoimmune markers.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"4 2","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204940/pdf/canlivj-2020-0023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40646063","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}

引用次数: 1

Treating hepatitis C during the COVID-19 pandemic in Alberta. 在艾伯塔省 COVID-19 大流行期间治疗丙型肝炎。

Canadian liver journal Pub Date : 2021-04-29 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2021-0007

Samuel S Lee, Sarah A Williams, Jacqueline Pinto, Heidi Israelson, Hongqun Liu

引用次数: 0

Alcohol product warning labels to deter alcohol misuse and prevent alcohol-related diseases: a call to action in Canada. 酒精产品警告标签阻止酒精滥用和预防与酒精有关的疾病:加拿大的行动呼吁。

Canadian liver journal Pub Date : 2021-04-29 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-4-2-001

Man Ting Kristina Yau, Natasha Chandok, Eric M Yoshida

引用次数: 0

A Canadian survey on knowledge of non-alcoholic fatty liver disease among physicians. 加拿大医师对非酒精性脂肪性肝病知识的调查。

Canadian liver journal Pub Date : 2021-04-29 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj-2020-0033

Giada Sebastiani, Alnoor Ramji, Mark G Swain, Keyur Patel

{"title":"A Canadian survey on knowledge of non-alcoholic fatty liver disease among physicians.","authors":"Giada Sebastiani, Alnoor Ramji, Mark G Swain, Keyur Patel","doi":"10.3138/canlivj-2020-0033","DOIUrl":"https://doi.org/10.3138/canlivj-2020-0033","url":null,"abstract":"Background: In Canada, non-alcoholic fatty liver disease (NAFLD) is the most frequently occurring liver disease, affecting one in four Canadians. NAFLD can in turn evolve into non-alcoholic steatohepatitis (NASH) and cirrhosis. No study in Canada has investigated knowledge of NAFLD among physicians.Methods: Primary care physicians (PCPs); specialists in internal medicine, gastroenterology, and hepatology; and hepatology nurses who were members of the College of Family Physicians of Canada, Canadian Association for the Study of the Liver, or Canadian Association of Hepatology Nurses were invited to participate in this web-based survey.Results: Of 650 invited physicians and nurses, 214 (33%) responded and 171 (26%) completed the whole survey. Overall, 51% of the respondents were PCPs, 38% were specialists, and 11% were nurses. Of these, 58% of PCPs, 28% of specialists, and 39% of nurses responded that they were only somewhat familiar or unfamiliar with NAFLD. Moreover, 53% of PCPs, 20% of specialists, and 35% of nurses thought the prevalence of NAFLD in Canada was 15% or less. Also, 42% of respondents thought that NASH could be diagnosed by imaging or blood tests. Finally, more than 40% of PCPs, 22% of specialists, and 33% of nurses thought that metformin and statin were treatments for NASH.Conclusions: This survey shows that a significant proportion of Canadian physicians and nurses managing patients with NAFLD are not very familiar with the disease. This study emphasizes the need for further provider education, national practice guidelines, and improved treatment options.","PeriodicalId":9527,"journal":{"name":"Canadian liver journal","volume":"4 2","pages":"82-92"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204942/pdf/canlivj-2020-0033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40646064","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}

引用次数: 6

Annual Meeting of the Canadian Association for the Study of the Liver (CASL), the Canadian Network on Hepatitis C (CANHEPC) and the Canadian Association of Hepatology Nurses (CAHN) 2021 Abstracts. 加拿大肝脏研究协会(CASL)、加拿大丙型肝炎网络(CANHEPC)和加拿大肝病学护士协会(CAHN) 2021年年会摘要。

Canadian liver journal Pub Date : 2021-04-29 eCollection Date: 2021-01-01 DOI: 10.3138/canlivj.4.2.abst

引用次数: 0