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Non-viral causes of hepatocellular carcinoma

World Journal of Gastroenterology 2010年第29期16卷 3603-3615页

作者： Wojciech Blonski David S Kotlyar kimberly a forde Division of Gastroenterology University of Pennsylvania Department of Gastroenterology Medical University Wroclaw Department of Internal Medicine Montefi ore Medical CenterAlbert Einstein College of Medicine

Hepatocellular carcinoma(HCC) is the most common primary liver malignancy and represents an international public health concern as one of the most deadly cancers *** main etiology of HCC is chronic infection with hepatitis B and hepatitis C ***,there are other important factors that contribute to the international burden of *** these are obesity,diabetes,non-alcoholic steatohepatitis and dietary *** evidence suggests that the etiology of many cases of HCC is in fact multifactorial,encompassing infectious etiologies,comorbid conditions and environmental *** of relevant non-viral causes of HCC will aid in preventative efforts to curb the rising incidence of this disease.

关键词： Hepatocellular carcinoma Etiology Nonalcoholic steatohepatitis Obesity Diabetes Alcohol Tobacco Oral contraceptive

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Do statins reduce hepatitis C RNA titers during routine clinical use?

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World Journal of Gastroenterology 2009年第40期15卷 5020-5027页

作者： kimberly a forde Connie Law Rose O’Flynn David E Kaplan Philadelphia Veterans Administration Medical Center Department of Medicine Division of GastroenterologyUniversity of Pennsylvania Department of Pharmacy Philadelphia Veterans Administration Medical Center

AIM: To compare hepatitis C virus (HCV) titers in patients with chronic hepatitis C with and without exposure to 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins).METHODS: Medical records were reviewed for 6463 patients with documented HCV infection at a single center between March 2004 and September 2006. Patients with confi rmed viremia and meeting inclusion criteria were assigned to one of three groups: Group A (n = 50), dyslipidemic patients with statin usage during HCV RNA polymerase chain reaction (PCR) determination; Group B (n = 49), dyslipidemic patients with prior or future statin usage but not at the time of HCV RNA PCR determination; and Group C (n = 102), patients without statin usage during the study period. The primary analysis explored the effect of statin therapy on HCV viremia. Secondary analyses assessed class effect, dose response, and effect of other lipid-lowering therapies on HCV viral ***: Median HCV RNA titers did not signif icantly differ among the three groups (Group A: 4 550 000 IU/mL, Group B: 2 850 000 IU/mL, Group C: 3 055 000 IU/mL).For those subjects with longitudinal assessment of HCV viremia prior to and while on statins, there were no signif icant differences between pre- and post-HCV viral titers. Additionally, no differences in HCV titers were observed at any dose level of the most prescribed statin, simvastatin. However, hypertriglyceridemia independently correlated with HCV titers, and niacin exposure was associated with signif icantly lower viral titers (P < 0.05).CONCLUSION: There was no apparent effect of statins on HCV viral replication in this analysis. Further investigation is warranted to explore the possible antiviral properties of triglyceride-lowering agents and their potential role as adjuncts to standard HCV therapy.

关键词：他汀类药物临床应用 RNA 滴度肝炎 C型

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Budd-Chiari syndrome:A single-center experience

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World Journal of Gastroenterology 2014年第43期20卷 16236-16244页

作者： Tanya M Pavri Alan Herbst Rajender Reddy kimberly a forde Division of Gastroenterology and Hepatology Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA 19104United States Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA 19104United States

AIM:To investigate challenges,risk factors,prognostic indicators,and treatment outcomes associated with Budd-Chiari syndrome(BCS)at a tertiary care ***:A retrospective cohort study was conducted at the University of Pennsylvania in patients with a diagnosis of BCS or hepatic vein *** patients receiving care at the University of Pennsylvania,and who had at least 2 clinical encounters in the University of Pennsylvania Health system from January1,2008 to September 10,2013 were eligible for study *** were extracted from the electronic medical record of each patient,and recorded in a secure Research Electronic Data Capture *** regression analyses were applied to identify predictors of outcome of liver transplant(LT)or ***:Between January 1,2008 and September10,2013,forty-seven patients were *** age was 42.4 ***-one(66.0%)were women.A majority were Caucasian(68.1%).At diagnosis,43(91.5%)patients had ascites,27(57.4%)patients had a hematologic disorder associated with a hypercoagulable state and 26(55.3%)had ***(85.1%)patients were on anticoagulation(AC),30(63.8%)of whom were maintained on *** patients(4.3%)underwent thrombolytic therapy.A transjugular intrahepatic portosystemic shunt(TIPS)was placed in21(44.7%)patients,19(90.5%)of whom were also on ***-one(44.7%)received AC *** a median of 974 d,8(17.0%)patients received LT,and10(21.3%)*** median time from listing to death was 26 mo[interquartile range(IQR)=16,65)].TIPS with AC was utilized more frequently in younger patients(P=0.02).Age,cirrhosis and chronic kidney disease(CKD)were significant predictors of LT or ***:AC alone was employed as frequently as TIPS with AC,though the latter was used more frequently in younger patients with polycythemia *** were no significant differences in treatment outcome regardless of the therapeutic intervention *** predictors of poor

关键词： Budd-Chiari syndrome Transjugular intrahepatic por

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