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Acute Severe Hepatitis of Unknown Origin in Children Across the World: A 2022 Source of Concern

Journal of Clinical and Translational Hepatology 2022年第3期10卷 386-389页

作者： lampros chrysavgis Evangelos Cholongitas First Department of Internal Medicine Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”AthensGreece

At the beginning of April 2022,the World Health Organization(WHO)identified 10 cases of acute severe hepatitis in children younger than 10 years of age,across central Scotland.1 None of the typical hepatitis viruses(A–E)that are known to cause acute viral hepatitis were isolated from any of those cases,and no common environmental exposures were *** on the latest data(up to 26 May 2022),approximately 152 cases of acute severe hepatitis were reported in the European Union and 222 cases in the UK.2 Moreover,more than 38 of the cases received a liver transplant and at least 14 deaths were reported(Table 1).2,3 The WHO,European Centre for Disease Prevention and Control,and UK Health Security Agency have posted reports trying to inform about the recent cases of acute hepatitis of unknown *** the case definition by WHO,a description of a confirmed case is not available at present,while a probable case is considered a person presenting with acute hepatitis that cannot be attributed to the hepatitis viruses A–E,with serum aminotransferase levels>500 IU/L(aspartate aminotransferase or alanine aminotransferase),who is 16 years or younger,since October 2021(Table 2).

关键词： acute younger attributed

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Non-alcoholic fatty liver disease and hepatocellular carcinoma:Clinical challenges of an intriguing link

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World Journal of Gastroenterology 2022年第3期28卷 310-331页

作者： lampros chrysavgis Ilias Giannakodimos Panagiota Diamantopoulou Evangelos Cholongitas Department of Experimental Physiology National and Kapodistrian University of AthensAthens 11527Greece First Department of Internal Medicine "Laiko"General Hospital of AthensNational and Kapodistrian University of AthensAthens 11527Greece

Non-alcoholic fatty liver disease(NAFLD)has emerged as the most common liver disorder worldwide mainly attributed to the epidemic spread of obesity and type 2 diabetes *** it is considered a benign disease,NAFLD can progress to non-alcoholic steatohepatitis,liver cirrhosis and hepatocellular carcinoma(HCC).Most data regarding the epidemiology of NAFLD-related HCC are derived from cohort and population studies and show that its incidence is increasing as well as it is likely to emerge as the leading indication for liver transplantation,especially in the Western *** cirrhosis constitutes the main risk factor for HCC development,in patients with NAFLD,HCC can arise in the absence of cirrhosis,indicating specific carcinogenic molecular *** NAFLD as an underlying liver disease for HCC is often underdiagnosed due to lack of sufficient surveillance in this population,NAFLDHCC patients are at advanced HCC stage at the time of diagnosis making the management of those patients clinically challenging and affecting their prognostic *** this current review,we summarize the latest literature on the epidemiology,other than liver cirrhosis-pathogenesis,risk factors and prognosis of NAFLD-HCC ***,we emphasize the prevention of the development of NAFLD-associated HCC and we provide some insight into the open questions and issues regarding the appropriate surveillance policies for those patients.

关键词： Non-alcoholic fatty liver disease Hepatocellular carcinoma Epidemiology Risk factors Surveillance Risk stratification

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Nonalcoholic fatty liver disease in lean subjects:Prognosis,outcomes and management

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World Journal of Gastroenterology 2020年第42期26卷 6514-6528页

作者： lampros chrysavgis Eleftheria Ztriva Adonis Protopapas Konstantinos Tziomalos Evangelos Cholongitas First Department of Internal Medicine Medical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthens 11527Greece First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA HospitalThessaloniki 54636Greece

Nonalcoholic fatty liver disease(NAFLD)accounts for most cases of chronic liver disease worldwide,with an estimated global prevalence of approximately 25%and ranges from simple steatosis to nonalcoholic steatohepatitis and *** is strongly connected to metabolic syndrome,and for many years,fatty liver was considered to be an exclusive feature of obese ***,recent studies have highlighted the presence of NAFLD in non-obese subjects,with or without increased visceral fat or even in lean subjects without increased waist circumference.“Lean NAFLD”is a relatively new concept and there is significant scientific interest in understanding the differences in pathophysiology,prognosis and management compared with NAFLD in overweight/obese *** the present editorial,we discuss the clinical and metabolic profiles and outcomes of lean NAFLD compared with both obese NAFLD and lean healthy individuals from Asian and Western ***,we shed light to the challenging topic of management of NAFLD in lean subjects since there are no specific guidelines for this ***,we discuss open questions and issues to be addressed in the future in order to categorize NAFLD patients into lean and nonlean cohorts.

关键词： Lean nonalcoholic fatty liver disease Non-obese nonalcoholic fatty liver disease Clinical outcomes Metabolic outcomes Disease management Lifestyle interventions

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Glucagon-like peptide-1 receptor agonists in non-alcoholic fatty liver disease: An update

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World Journal of Hepatology 2020年第8期12卷 493-505页

作者： Areti Sofogianni Athanasios Filippidis lampros chrysavgis Konstantinos Tziomalos Evangelos Cholongitas First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA HospitalThessaloniki 54636Greece First Department of Internal Medicine Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthens 11527Greece

Non-alcoholic fatty liver disease(NAFLD)is the predominant cause of chronic liver disease *** progresses in some cases to non-alcoholic steatohepatitis(NASH),which is characterized,in addition to liver fat deposition,by hepatocyte ballooning,inflammation and liver fibrosis,and in some cases may lead to hepatocellular *** prevalence increases along with the rising incidence of type 2 diabetes mellitus(T2DM).Currently,lifestyle interventions and weight loss are used as the major therapeutic strategy in the vast majority of patients with ***-like peptide-1 receptor agonists(GLP-1RAs)are used in the management of T2DM and do not have major side effects like *** patients with NAFLD,the GLP-1 receptor production is ***,several animal and human studies have emphasized the role of GLP-1RAs in ameliorating liver fat accumulation,alleviating the inflammatory environment and preventing NAFLD progression to *** this review,we summarize the updated literature data on the beneficial effects of GLP-1RAs in NAFLD/***,as GLP-1RAs seem to be an attractive therapeutic option for T2DM patients with concomitant NAFLD,we discuss whether GLP-1RAs should represent the first line pharmacotherapy for these patients.

关键词： Glucagon-like peptide-1 receptor agonists Non-alcoholic fatty liver disease Type 2 diabetes mellitus Clinical studies Fatty liver Animal studies

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