检索结果-南通市图书馆

World Journal of Hepatology 2024年第3期16卷 331-343页

作者： Robert Lam joseph k.lim Section of Digestive Diseases Yale University School of MedicineNew HavenCT 06520United States

Chronic hepatitis B virus(HBV)infection affects over 295 million people globally and an estimated 1.6 million people in the United States.It is associated with significant morbidity and mortality due to cirrhosis,liver failure,and liver cancer.Antiviral therapy with oral nucleos(t)ide analogues is associated with high rates of virologic suppression,which in turn has been associated with a decreased risk of liver complications.However,current antiviral regimens are limited by concerns with adverse effects,adherence,resistance,long-term treatment,and ongoing risk for liver events.Novel investigational agents are currently in development and are targeted at achieving functional cure with sustained hepatitis B surface antigen(HBsAg)loss and suppression of HBV DNA.Herein we review key evidence from phases II and III trials defining the efficacy and safety profiles for key investigational agents for functional cure of chronic hepatitis B,including core/capsid inhibitors,entry inhibitors,RNA interference(siRNA/ASO),HBsAg inhibitors,Toll-like receptor agonists,checkpoint inhibitors,and therapeutic vaccines.

关键词： Hepatitis B virus Treatment Clinical trials RNA interference Entry inhibitors Core inhibitors Immunomodulators

Tailoring stepwise treatment for Budd-Chiari syndrome: insights from the Asian Pacific Association for the Study of the Liver (APASL) consensus guidance

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary Surgery and Nutrition 2023年第1期12卷 118-120页

作者： Lamia Y.Haque joseph k.lim Section of Digestive Diseases Department of Internal MedicineYale School of MedicineNew HavenCTUSA

Budd-Chiari syndrome(BCS)is a rare disease consisting of obstruction of the hepatic venous outflow tract,which can occur at any level ranging from small hepatic veins to the inferior vena cava(1-4).BCS can result from intravascular thrombosis or membranous obstruction of the hepatic venous outflow tract,or,less commonly,due to external compression from tumors,nodules,abscesses,cysts,or other intrahepatic lesions(1-3).

关键词： Budd-Chiari syndrome(BCS) hepatic venous outflow obstruction anticoagulation transjugular intrahepatic portosystemic shunts(TIPS) surgery liver transplantation guidelines

Acute Hepatitis of Unknown Origin in Children: Early Observations from the 2022 Outbreak

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2022年第3期10卷 522-530页

作者： Li-Ya Zhang Li-Su Huang Yu-Hang Yue Rima Fawaz joseph k.lim Jian-Gao Fan Department of Infectious Disease Xinhua Children’s HospitalXinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Section of Pediatric Gastroenterology and Hepatology Yale University School of MedicineNew HavenCTUSA Section of Digestive Diseases and Yale Liver Center Yale University School of MedicineNew HavenCTUSA Department of Gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Shanghai key Lab of Pediatric Gastroenterology and Nutrition ShanghaiChina

Recent reports of acute hepatitis of unknown origin in previously healthy children have been increasing worldwide.The main characteristics of the affected children were jaundice and gastrointestinal symptoms.Their serum aminotransaminase levels were above 500 IU/L,with negative tests for hepatitis viruses A–E.By 31 May 2022,the outbreak had affected over 800 children under the age of 16 years in more than 40 countries,resulting in acute liver failure in approximately 10%,including at least 21 deaths and 38 patients requiring liver transplantation.There was still no confirmed cause or causes,although there were several different working hypotheses,such as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),adenovirus serotype 41,or SARS-CoV-2 superantigen-mediated immune cell activation.Here,we review early observations of the 2022 outbreak which may inform diagnosis,treatment,and prevention in the context of an overlapping COVID-19 pandemic.

关键词： Hepatitis Acute liver failure Liver transplantation Pediatric Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Adenovirus Causality

Assessing the Effectiveness of Strategies in US Birth Cohort Screening for Hepatitis C Infection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2020年第1期8卷 25-41页

作者： Cynthia J.Tsay joseph k.lim Department of Internal Medicine Yale University School of MedicineNew HavenCTUSA Yale Liver Center Section of Digestive DiseasesYale University School of MedicineNew HavenCTUSA

Chronic hepatitis C infection in the USA is a highly morbid condition and current guidelines recommend one-time screening among the birth cohort(1945-1965).Understand-ing strategies to optimize screening can help inform future hepatitis C virus(HCV)screening guidelines.A focused literature search was performed using PubMed and manual abstract review from major hepatology conferences over the past 2 years.The search strategy involved using Medical Subject Headings terms for hepatitis C,screening,birth cohort,baby boomers,and 1945-1965.The review was limited to data from the USA.A total of 327 articles were identified and 36 abstracts were included,with studies published between 2012-2019.Strategies including clinician education,electronic medical record alerts,reflex HCV RNA testing,point-of-care testing,multisite(outpatient,inpatient,emergency department,endoscopy suite)initiatives,direct patient solicitation,and utilization of non-physician providers have increased HCV screening rates.However,broad imple-mentation remains less than optimal.Barriers include lack of patient acceptance to screening and engagement in the HCV care cascade.The Veterans Affairs Healthcare System has achieved higher birth cohort screening rates through an integrated approach requiring high-level engagement by leadership and institutional commitment.Multiple strategies for increasing birth cohort screening have been successful,but overall rates of HCV screening remain low.These strat-egies can inform public health efforts to implement emerging national recommendations for expansion of HCV screening to all U.S.adults age 18 or older.

关键词： Hepatitis C Epidemiology HCV antibody Screening Birth cohort Baby boomers Care cascade Electronic medical records

Treatment of Hepatitis C in Patients Undergoing Immunosuppressive Drug Therapy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2016年第3期4卷 206-227页

作者： kohtaro Ooka joseph k.lim Department of Internal Medicine Yale University School of Medicine New Haven CT USA Yale Liver Center Section of Digestive Diseases Yale University School of Medicine New Haven CT USA

With 185 million people chronically infected globally,hepatitis C is a leading bloodborne infection.All-oral regimens of direct acting agents have superior efficacy compared to the historical interferon-based regimens and are significantly more tolerable.However,trials of both types of regimens have often excluded patients on immunosuppressive medications for reasons other than organ transplantation.Yet,these patients-most often suffering from malignancy or autoimmune diseases-could stand to benefit from these treatments.In this study,we systematically review the literature on the treatment of hepatitis C in these neglected populations.Research on patients with organ transplants is more robust and this literature is reviewed here non-systematically.Our systematic review produced 2273 unique works,of which 56 met our inclusion criteria and were used in our review.The quality of data was low;only 3 of the 56 studies were randomized controlled trials.Sustained virologic response was reported sporadically.Interferon-containing regimens achieved this end-point at rates comparable to that in immunocompetent individuals.Severe adverse effects and death were rare.Data on all-oral regimens were sparse,but in the most robust study,rates of sustained virologic response were again comparable to immunocompetent individuals (40/41).Efficacy and safety of interferoncontaining regimens and all-oral regimens were similar to rates in immunocompetent individuals;however,there were few interventional trials.The large number of case reports and case series makes conclusions vulnerable to publication bias.While firm conclusions are challenging,given the dearth of high-quality studies,our results demonstrate that antiviral therapy can be safe and effective.The advent of all-oral regimens offers patients and clinicians greatly increased chances of cure and fewer side effects.Preliminary data reveal that these regimens may confer such benefits in immunosuppressed individuals as well.More prospective interventional trials would greatly be

关键词： MeSH termsHepatitis C/dt[drug therapy] Interferons Direct acting antivirals Immunosuppressive agents Chemotherapy

Future Pharmacotherapy for Non-alcoholic Steatohepatitis (NASH): Review of Phase 2 and 3 Trials

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2018年第3期6卷 264-275页

作者： James J.Connolly kohtaro Ooka joseph k.lim Department of Internal Medicine Yale University School of MedicineNew HavenCTUSA Division of Gastroenterology Hepatology and NutritionUniversity of Pittsburgh Medical CenterPittsburghPAUSA Yale Liver Center Section of Digestive DiseasesYale University School of MedicineNew HavenCTUSA

Non-alcoholic steatohepatitis(NASH)results from inflammation and hepatocyte injury in the setting of hepatic steatosis.Non-alcoholic steatohepatitis increases the risk of progression to liver fibrosis and cirrhosis,and is the most rapidly growing etiology for liver failure and indication for liver transplantation in the USA.Weight loss and lifestyle modification remain the standard first-line treatment,as no USA Food and Drug Administration-approved pharmacotherapy currently exists.The past decade has seen an explosion of interest in drug development targeting pathologic pathways in non-alcoholic steatohepatitis,with numerous phase 2 and 3 trials currently in progress.Here,we concisely review the major targets and mechanisms of action by class,summarize results from com-pleted pivotal phase 2 studies,and provide a detailed outline of key active studies with trial data for drugs in development,including obeticholic acid,elafibranor,cenicriviroc and selonsertib.

关键词： Fatty liver Non-alcoholic steatohepatitis Clinical trials Pharmacotherapy Obeticholic acid

Treatment of Nonalcoholic Fatty Liver Disease: The Role of Medical, Surgical, and Endoscopic Weight Loss

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2015年第3期3卷 230-238页

作者： Violeta B.Popov joseph k.lim Division of Gastroenterology New York University School of Medicine New York NY USA Yale Liver Center Section of Digestive Diseases Yale University School of Medicine New Haven CT USA

Nonalcoholic fatty liver disease (NAFLD) represents a rapidly growing cause of chronic liver disease in the United States and is associated with significant morbidity and mortality,including progression to liver cirrhosis and hepatocellular carcinoma.NAFLD comprises a spectrum of liver conditions,ranging from simple steatosis to steatosis with inflammation (steatohepatitis) and progressive fibrosis.Weight loss represents a first line therapeutic modality for the management of NAFLD.Herein,we review the evidence base for medical,surgical,and endoscopic approaches to weight loss and their potential impact on the natural history of NAFLD.

关键词： Fatty liver Nonalcoholic steatohepatitis Weight loss Exercise Pharmacotherapy Endoscopic therapy Bariatric surgery

Combination strategies for pharmacologic treatment of nonalcoholic steatohepatitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2022年第35期28卷 5129-5140页

作者： Jaspreet Suri Sebastian Borja joseph k.lim Department of Gastroenterology Norwalk HospitalNorwalkCT 06856United States Department of Internal Medicine Norwalk HospitalNorwalkCT 06850United States Section of Digestive Diseases Yale University School of MedicineNew HavenCT 06520United States

Non-alcoholic steatohepatitis (NASH) is defined as hepatic steatosis, inflammation,and hepatocyte injury with or without fibrosis. It has emerged as thesecond leading indication for liver transplantation with a rising death rate in thenon-transplantable population. While there are many drugs in evaluation,currently no approved therapies are on the market for this condition. Given thisimportance, the Food and Drug Administration has provided formal guidanceregarding drug development for stopping or reversing NASH or NASH associatedfibrosis. The complex pathogenesis of NASH and its bidirectional relationshipwith metabolic syndrome has highlighted multiple drugs of interest thataddress metabolic, inflammatory, and fibrotic factors. A few promising liverspecific targets include farnesoid X receptor agonists and peroxisome proliferatoractivatedreceptor agonists. Previously studied drug classes such as glucagon-likepeptide-1 analogs or sodium/glucose transport protein 2 inhibitors have alsodemonstrated ability to improve hepatic steatosis. Here we discuss currentrationale, scientific work, and preliminary data in combining multiple drugs forthe purposes of a multimodal attack on the pathogenesis of NASH. We highlightmultiple Phase 2 and Phase 3 studies that demonstrate the potential to achieve aresponse rate higher than previously assessed monotherapies for this condition.Ultimately, one of these combination strategies may rise above in its safety andefficacy to become a part of a standardized approach to NASH.

关键词： Non-alcoholic steatohepatitis Fatty liver Combination treatment Drug therapy Pharmacologic treatment Clinical trials

Increasing contribution of non-alcoholic fatty liver disease to hepatocellular carcinoma incidence and mortality in U.S. Medicare

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary Surgery and Nutrition 2019年第5期8卷 506-508页

作者： Carrie R.Wong joseph k.lim Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at the University of CaliforniaLos AngelesCAUSA Department of Health Policy and Management Jonathan and Karin Fielding School of Public Health at the University of CaliforniaLos AngelesCAUSA Yale Liver Center and Section of Digestive Diseases Yale University School of MedicineNew HavenCTUSA

Hepatocellular carcinoma(HCC)has one of the fastestgrowing rates of cancer-related incidence and mortalityin the United States(U.S.)(1-3).From 2009 to 2013,theaverage annual percent change(AAPC)for liver cancerincidence became the highest among other reported cancersfor both males(+2.9%)and females(+3.8%)(1).In addition,cancer-related mortality rates for liver cancer are the highestamong solid malignancies from 2010 to 2014 for males(+2.6%)and females(+3.0%)(1).

关键词： mortality liver cancer

Hepatocellular carcinoma in patients with non-alcoholic fatty liver disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第37期22卷 8294-8303页

作者： Carrie R Wong Mindie H Nguyen joseph k.lim Department of Internal Medicine Yale University School of Medicine Division of Gastroenterology and Hepatology Stanford University School of Medicine Yale Liver Center Section of Digestive Diseases Yale University School of Medicine

Nonalcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in the United States and represents an increasingly important etiology of hepatocellular carcinoma(HCC) with annual cumulative incidence rates ranging from 2% to 12% in cohorts of NAFLD cirrhosis. While the risk of progression of NAFLD to HCC remains higher among patients with fibrosis or cirrhosis, an increasing amount of literature describes NAFLD-HCC as a disease that can occur in the absence of cirrhosis. Efforts to characterize the pathogenesis of NAFLD-HCC have suggested mechanisms that strongly associate with states of hyperinsulinemia and chronic inflammation, cellular mechanisms including adaptive immune responses and hepatic progenitor cell populations, and genetic polymorphisms including mutations of PNPLA3. Current literature describes NAFLD-HCC mostly as a disease of late presentation with lower rates of receipt of curative therapy and worse prognosis. However, a growing body of evidence has reported comparable and potentially more favorable disease-free and overall survival rates among patients with NAFLD-HCC after receipt of curative treatment. This review summarizes current evidence of epidemiology, pathophysiology, disease presentation, demand and receipt of curative therapy, post-treatment outcomes, and overall survival of NAFLD-associated HCC.

关键词： Fatty liver Nonalcoholic steatohepatitis Hepatocellular carcinoma Liver cirrhosis Liver cancer