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Gustavo In Fatty Liver Disease Normal ALT Levels May Mask Advanced Fibrosis

Patients with nonalcoholic fatty liver disease (NAFLD) may have normal alanine aminotransferase (ALT) levels in spite of having advanced fibrosis, according to a new study in the September issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article is available online at Wiley Interscience NAFLD is the hepatic expression of the metabolic syndrome and it can progress to cirrhosis, portal hypertension… Continue

Added by Gustavo on September 24, 2008 at 5:51pm — No Comments

Gustavo Killer at Large

Local documentary filmmaker Steven Greenstreet explored the local manifestation of a national phenomenon in his Michael Moore-vs.-Sean Hannity study This Divided State. His follow-up project paints a bigger picture of an even more serious subject: the national epidemic of obesity. And the most fascinating aspect of his approach is how complex he makes the issue—a tangle of biology, sociology, psychology and even politics that makes it hard to toss off the old “eat less and exercise” rejoinder. T… Continue

Added by Gustavo on September 13, 2008 at 8:44am — No Comments

Gustavo Is The Clinical Impact Of Nonalcoholic Fatty Liver Disease (NAFLD) The Y2K Of Hepatology ?

Is the clinical impact of nonalcoholic fatty liver disease (NAFLD) the Y2K of our specialty? Have we fashioned a mountain from a molehill of end-stage liver disease? The answer merits some consideration. Ian Wanless’s landmark cross-sectional study reported convincingly that the overall prevalence of NASH in adults in North America is 18.5% in obese and 2.7% in nonobese individuals.1 Of obese individuals found to have NASH at autopsy, about one in seven had bridging fibrosis or cirrhosis.… Continue

Added by Gustavo on May 16, 2008 at 4:00pm — No Comments

Gustavo Nonsurgical Treatment of Obesity

Most patients with a BMI of 30 or greater, and many with a BMI between 25 and 30, have at least… Continue

Added by Gustavo on May 1, 2008 at 2:49pm — No Comments

Gustavo Our Own Domain !

Now "Nashion" has own domain: www.nashion.com You don´t have to do nothing .You can go to Nashion with the old url : www.nashion.ning.com or with the new own domain: www.nashion.com Gustavo administrator Continue

Added by Gustavo on May 1, 2008 at 10:56am — No Comments

Gustavo TREATMENT OF NASH

TREATMENT OF NASH IN THE PEDIATRIC POPULATION No drug therapies have been developed specifically for the treatment of fatty liver disease in either children or adults. The strategies that have been used in the treatment of NASH thus far are based on the current best understanding of the pathophysiology of this disease, the so-called "2-hit theory" (66). Thus, weight loss/decreased visceral fat, improved insulin sensitivity and antioxidant therapy have been the approaches explored in ther… Continue

Added by Gustavo on April 19, 2008 at 4:03pm — No Comments

Gustavo NATURAL HISTORY OF NASH IN THE PEDIATRIC POPULATION

Clinical series have reported fibrosis in 53% to 100% of liver biopsies from children with NAFLD, including several reports of children with cirrhosis (4,9-11). In fact, cirrhosis secondary to NASH has been reported in children as young as 10 years (10). A recent case report described a young man dying of complications of liver failure secondary to NASH cirrhosis at the age of 34 years (110). The incidence rate of cirrhosis secondary to pediatric NASH is unknown at this time. Predictors of advan… Continue

Added by Gustavo on April 19, 2008 at 4:01pm — No Comments

Gustavo CHILDHOOD OBSTRUCTIVE SLEEP APNEA SYNDROME AND NASH

There is a growing body of literature from human and animal studies implicating sleep apnea in the pathogenesis of impaired glucose metabolism (74). In adults, the severity of sleep apnea has been associated with insulin resistance, independent of BMI and waist circumference (75). One study in obese children likewise found that the severity of obstructive sleep apnea (OSA) correlated with fasting insulin levels, independent of BMI (76). Leptin-deficient (ob/ob) mice (an animal model of obesity a… Continue

Added by Gustavo on April 19, 2008 at 4:00pm — No Comments

Gustavo DISEASE ASSOCIATIONS: RISK FACTORS AND INDICATORS OF PATHOGENESIS

DISEASE ASSOCIATIONS: RISK FACTORS AND INDICATORS OF PATHOGENESIS A number of variables have been associated with fatty liver disease in the pediatric population, and these offer potential clues to the pathogenesis of NASH. Many of these are similar to risk factors that have been identified in the adult population, including obesity, visceral adiposity, insulin resistance, race/ethnicity and the presence of other features of the metabolic syndrome. Other variables, such as sex distributi… Continue

Added by Gustavo on April 19, 2008 at 3:59pm — No Comments

Gustavo IMAGING EVALUATION OF NAFLD/NASH

IMAGING EVALUATION OF NAFLD/NASH Although liver biopsy is considered the diagnostic criterion standard for NAFLD/NASH, it does have significant limitations, including cost and risk. Although the severity of steatosis on biopsy was shown to be reasonably reproducible, the variability in staging additional features of NASH has been shown in adult subjects (36). Thus, there is a need to develop noninvasive imaging methods for screening, diagnosis and longitudinal assessment of patients. Suc… Continue

Added by Gustavo on April 19, 2008 at 3:56pm — No Comments

Gustavo DIAGNOSIS OF NAFLD/NASH

DIAGNOSIS OF NAFLD/NASH In clinical practice, the diagnosis of NAFLD is usually suspected upon finding elevated aminotransferases and/or evidence of fatty liver on radiographic studies in the proper clinical setting. This requires exclusion of other causes of liver disease. Several studies have reported a fairly narrow mean age of presentation with NASH, ranging from 11.6 years to 13.5 years (4,9-11), although the diagnosis may be made in children as young as 2 years. Children may compla… Continue

Added by Gustavo on April 19, 2008 at 3:55pm — No Comments

Gustavo What is pediatric NASH ?

INTRODUCTION The term nonalcoholic steatohepatitis (NASH) was introduced by Ludwig et al. in 1980 to describe a pattern of liver injury in adults resembling alcoholic hepatitis that occurred in the absence of significant alcohol consumption (1). NASH was first described in children 3 years later (2). As in adults, nonalcoholic fatty liver disease (NAFLD) is probably the most common cause of liver disease in the preadolescent and adolescent age groups. There seems to have been an i… Continue

Added by Gustavo on April 19, 2008 at 3:53pm — No Comments

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