Nov 262013
 
Related Articles

Metal storage disorders: Wilson disease and hemochromatosis.

Med Clin North Am. 2014 Jan;98(1):87-102

Authors: Kanwar P, Kowdley KV

Abstract
Hereditary hemochromatosis and Wilson disease are autosomal recessive storage disorders of iron and copper overload, respectively. These metals are involved in multiple redox reactions, and their abnormal accumulation can cause significant injury in the liver and other organs. Over the last few decades clinicians have developed a much better understanding of these metals and their mechanism of action. Moreover, sophisticated molecular genetic testing techniques that make diagnostic testing less invasive are now available. This article updates and discusses the pathogenesis, diagnosis, and management of these metal storage disorders.

PMID: 24266916 [PubMed - in process]

Link to Article at PubMed

Share


Nov 262013
 
Related Articles

Management of End-stage Liver Disease.

Med Clin North Am. 2014 Jan;98(1):119-52

Authors: Liou IW

Abstract
Major complications of cirrhosis include the development of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, variceal hemorrhage, hepatic encephalopathy, and hepatocellular carcinoma. Careful evaluation and management of ascites and varices with judicious use of prophylactic therapy can improve survival. Diagnosis of hepatic encephalopathy can lead to appropriate intervention without protein restriction. Patients should undergo hepatocellular carcinoma surveillance routinely every 6 months. The development of any decompensating event should prompt referral to a liver transplant center.

PMID: 24266918 [PubMed - in process]

Link to Article at PubMed

Share


Nov 262013
 
Related Articles

Management of End-stage Liver Disease.

Med Clin North Am. 2014 Jan;98(1):119-52

Authors: Liou IW

Abstract
Major complications of cirrhosis include the development of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, variceal hemorrhage, hepatic encephalopathy, and hepatocellular carcinoma. Careful evaluation and management of ascites and varices with judicious use of prophylactic therapy can improve survival. Diagnosis of hepatic encephalopathy can lead to appropriate intervention without protein restriction. Patients should undergo hepatocellular carcinoma surveillance routinely every 6 months. The development of any decompensating event should prompt referral to a liver transplant center.

PMID: 24266918 [PubMed - in process]

Link to Article at PubMed

Share


Nov 262013
 
Related Articles

Cholestatic liver disease.

Med Clin North Am. 2014 Jan;98(1):73-85

Authors: Gossard AA, Talwalkar JA

Abstract
Cholestatic liver disease may involve both extrahepatic and intrahepatic bile ducts, or may be limited to one or the other. Cholestasis may be due primary bile duct disease or secondary causes such as stones or tumors. Care of the patient with cholestasis depends on identifying the probable cause, initiating appropriate treatment or intervention, and the recognition and management of potential complications.

PMID: 24266915 [PubMed - in process]

Link to Article at PubMed

Share


Nov 052013
 
Related Articles

Patients with immunodeficiency.

Med Clin North Am. 2013 Nov;97(6):1139-59

Authors: Hannaman MJ, Ertl MJ

Abstract
Patients presenting in an immunocompromised state merit special consideration when being evaluated for fitness to undergo surgery. A variety of immunodeficient conditions and their respective therapies, including human immunodeficiency virus, cancer, and transplantation, exert numerous systemic effects that may lead to multiorgan dysfunction. Understanding the potential impact of these disease manifestations, and their proper evaluation, is essential in achieving optimal perioperative outcomes for these patients.

PMID: 24182724 [PubMed - in process]

Link to Article at PubMed

Share


Nov 052013
 
Related Articles

Patients with chronic endocrine disease.

Med Clin North Am. 2013 Nov;97(6):1123-37

Authors: Njoku MJ

Abstract
This article summarizes the key features and clinical considerations related to preoperative management and planning for the care of patients of common endocrine disorders (diabetes mellitus, adrenal insufficiency, thyroid disease), a less common disorder but one that has significant perioperative implications (acromegaly), and 2 disorders for which preoperative management is essential to good postoperative outcomes (pheochromocytoma and carcinoid syndrome). There are few evidence-based guidelines for preoperative management of chronic endocrine disease; hence, this review is based on recent subspecialty society consensus guidelines and professional society clinical practice recommendations.

PMID: 24182723 [PubMed - in process]

Link to Article at PubMed

Share