|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Non invasive fibrosis biomarkers reduce but not substitute the need for liver biopsy显示文摘长期的肝疾病全球是很普通的,特别地,那些连接了到病毒的肝炎并且到含酒精、非酒精的脂肝。他们的自然科学是可变的,长期的进化在单个病人不同。补偿的长期的肝疾病的优化临床的管理要求肝纤维变性的阶段的精确定义,预后并且很治疗学的决定的主要决定因素。肝活体检视是为对肝的纤维变性的评价的标准答案。然而,它与可能的复杂并发症是侵略的,对抽样误差昂贵、容易。肝纤维变性的许多非侵略的标记最近作为肝活体检视的代理人在临床的背景被建议了并且估计。当间接标记使用与肝纤维变性阶段相关的简单或更复杂的参数时,直接标记基于直接连接到纤维发生的生物化学的参数。肝纤维变性的非侵略的标记在长期的肝疾病的不同形式被测试了并且很少显示出可变诊断性能,而是精确性在 75%-80% 上面。当标记被联合时,更好的结果被获得。在这根线上,我们最近建议了联合肝纤维变性的顺序间接的非侵略的标记的一套算法,到达 90%-95% 有在对肝的需要的重要减小的诊断精确性活体检视。基于可得到的证据,肝纤维变性的非侵略的标记和他们的联合使用将很快在长期的肝的许多形式的临床的管理成为一个很有用的工具,这能被期望疾病。然而,他们的实现被期望减少,然而并非完全消除,对肝的需要活体检视。 | Giada Sebastiani Alfredo Alberti | 2006 | World Journal of Gastroenterology2006，12，23： | 32 |
| 2 | Sequential algorithms combining non-invasive markers and biopsy for the assessment of liver fibrosis in chronic hepatitis B显示文摘AIM: To assess the performance of several non- invasive markers and of our recently proposed stepwise combination algorithms to diagnose significant fibrosis (F ≥ 2 by METAVIR) and cirrhosis (F4 by METAVIR) in chronic hepatitis B (CHB). METHODS: One hundred and ten consecutive patients (80 males, 30 females, mean age: 42.6 ± 11.3) with CHB undergoing diagnostic liver biopsy were included. AST- to-Platelet ratio (APRI), Forns’ index, AST-to-ALT Ratio, Goteborg University Cirrhosis Index (GUCI), Hui’s model and Fibrotest were measured on the day of liver biopsy. The performance of these methods and of sequential algorithms combining Fibrotest, APRI and biopsy was defined by positive (PPV) and negative (NPV) predictive values, accuracy and area under the curve (AUC). RESULTS: PPV for significant fibrosis was excellent (100%) with Forns and high (> 92%) with APRI, GUCI, Fibrotest and Hui. However, significant fibrosis could not be excluded by any marker (NPV < 65%). Fibro- test had the best PPV and NPV for cirrhosis (87% and 90%, respectively). Fibrotest showed the best AUC for both significant fibrosis and cirrhosis (0.85 and 0.76, respectively). Stepwise combination algorithms of APRI, Fibrotest and biopsy showed excellent performance (0.96 AUC, 100% NPV) for significant fibrosis and 0.95 AUC, 98% NPV for cirrhosis, with 50%-80% reduced need for liver biopsy. CONCLUSION: In CHB sequential combination of APRI, Fibrotest and liver biopsy greatly improves the diagnostic performance of the single non-invasive markers. Need for liver biopsy is reduced by 50%-80% but cannot be completely avoided. Non-invasive markers and biopsy should be considered as agonists and not antagonists towards the common goal of estimating liver fibrosis. | Giada Sebastiani Alessandro Vario Maria Guido Alfredo Alberti | 2007 | World Journal of Gastroenterology2007，13，4： | 26 |
| 3 | Systematic review: Preventive and therapeutic applications of metformin in liver disease显示文摘Metformin, a biguanide derivative, is the most commonly prescribed medication in the treatment of type 2 diabetes mellitus. More recently, the use of metformin has shown potential as a preventive and therapeutic agent for a broad spectrum of conditions, including liver disease and hepatic malignancies. In this systematic review,we critically analyze the literature behind the potential use of metformin across the spectrum of liver disease and malignancies. The Pub Med and Ovid MEDLINE databases were searched from 2000 to March 2015, using a combination of relevant text words and MeS H terms: metformin and mammalian target of rapamycin, hepatitis B virus(HBV), hepatitis B virus(HCV), nonalcoholic fatty liver disease(NAFLD), hepatocellular carcinoma(HCC) or cholangiocarcinoma. The search results were evaluated for pertinence to the issue of metformin in liver disease as well as for quality of study design. Metformin has a number of biochemical effects that would suggest a benefit in treating chronic liver diseases, particularly in the context of insulin resistance and inflammation. However, the literature thus far does not support any independent therapeutic role in NAFLD or HCV. Nonetheless, there is Level Ⅲ evidence for a chemopreventive role in patients with diabetes and chronic liver disease, with decreased incidence of HCC and cholangiocarcinoma. The use of metformin seems to be safe in patients with cirrhosis, and provides a survival benefit. Once hepatic malignancies are already established, metformin does not offer any therapeutic potential. In conclusion, there is insufficient evidence to recommend use of metformin in the adjunctive treatment of chronic liver diseases, including NAFLD and HCV. However, there is good evidence for a chemopreventive role against HCC among patients with diabetes and chronic liver disease, and metformin should be continued in patients even with cirrhosis to provide this benefit. | Aparna Bhat Giada Sebastiani Mamatha Bhat | 2015 | World Journal of Hepatology2015，7，12： | 20 |
| 4 | Chronic hepatitis C and liver fibrosis显示文摘Chronic infection with hepatitis C virus(HCV) is a leading cause of liver-related morbidity and mortality worldwide and predisposes to liver fibrosis and endstage liver complications. Liver fibrosis is the excessive accumulation of extracellular matrix proteins, including collagen, and is considered as a wound healing response to chronic liver injury. Its staging is critical for the management and prognosis of chronic hepatitis C(CHC) patients, whose number is expected to rise over the next decades, posing a major health care challenge. This review provides a brief update on HCV epidemiology, summarizes basic mechanistic concepts of HCV-dependent liver fibrogenesis, and discusses meth-ods for assessment of liver fibrosis that are routinely used in clinical practice. Liver biopsy was until recently considered as the gold standard to diagnose and stage liver fibrosis. However, its invasiveness and drawbacks led to the development of non-invasive methods, which include serum biomarkers, transient elastography and combination algorithms. Clinical studies with CHC patients demonstrated that non-invasive methods are in most cases accurate for diagnosis and for monitoring liver disease complications. Moreover, they have a high prognostic value and are cost-effective. Non-invasive methods for assessment of liver fibrosis are gradually being incorporated into new guidelines and are becoming standard of care, which significantly reduces the need for liver biopsy. | Giada Sebastiani Konstantinos Gkouvatsos Kostas Pantopoulos | 2014 | World Journal of Gastroenterology2014，20，32： | 19 |
| 5 | Non-invasive assessment of liver fibrosis in chronic liver diseases:Implementation in clinical practice and decisional algorithms显示文摘Chronic hepatitis B and C together with alcoholic and non-alcoholic fatty liver diseases represent the major causes of progressive liver disease that can eventually evolve into cirrhosis and its end-stage complications,including decompensation,bleeding and liver cancer.Formation and accumulation of fibrosis in the liver is the common pathway that leads to an evolutive liver disease.Precise definition of liver fibrosis stage is essential for management of the patient in clinical practice since the presence of bridging fibrosis represents a strong indication for antiviral therapy for chronic viral hepatitis,while cirrhosis requires a specif ic follow-up including screening for esophageal varices and hepatocellular carcinoma.Liver biopsy has always represented the standard of reference for assessment of hepatic fibrosis but it has some limitations being invasive,costly and prone to sampling errors.Recently,blood markers and instrumental methods have been proposed for the non-invasive assessment of liver fibrosis.However,there are still some doubts as to their implementation in clinical practice and a real consensus on how and when to use them is not still available.This is due to an unsatisfactory accuracy for some of them,and to an incomplete validation for others.Some studies suggest that performance of non-invasive methods for liver fibrosis assessment may increase when they are combined.Combination algorithms of non-invasive methods for assessing liver fibrosis may represent a rational and reliable approach to implement non-invasive assessment of liver fibrosis in clinical practice and to reduce rather than abolish liver biopsies. | Giada Sebastiani | 2009 | World Journal of Gastroenterology2009，15，18： | 12 |
| 6 | Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome显示文摘BACKGROUND Polycystic ovary disease(PCOS)may be a risk factor for nonalcoholic fatty liver disease(NAFLD)due to common pathogenetic pathways,including insulin resistance and obesity.Both PCOS and NAFLD are more severe in South Asian women.Data on NAFLD in South Asian women with PCOS are lacking.AIM To investigate prevalence and predictors of NAFLD and liver fibrosis in PCOS patients from South Asia.METHODS We conducted an observational routine screening program by means of transient elastography(TE)with associated controlled attenuation parameter(CAP).NAFLD was defined as CAP≥288 decibels per meter.Significant liver fibrosis(stage 2 and higher out of 4)was defined as TE measurement≥8.0 kilopascals.Elevated alanine aminotransferase(ALT)was defined as ALT>24 IU/L,as per upper limit of normal reported in South Asian women.Biochemical hyperandrogenism was defined as free androgen index>5.Predictors of NAFLD were determined by logistic regression analysis.RESULTS 101 PCOS patients(mean age 36.3 years)with no significant alcohol intake or viral hepatitis were included.Prevalence of NAFLD and significant liver fibrosis was 39.6% and 6.9%,respectively.Elevated ALT was observed in 40%and 11.5%of patients with and without NAFLD,respectively.After adjusting for duration of PCOS and insulin resistance measured by homeostasis model for assessment of insulin resistance,independent predictors of NAFLD were higher body mass index[adjusted odds ratio(aOR)1.30,95% confidence interval(CI):1.13-1.52],hyperandrogenism(aOR:5.32,95%CI:1.56-18.17)and elevated ALT(aOR:3.54,95%CI:1.10-11.47).Lifetime cardiovascular risk was higher in patients with NAFLD compared to those without NAFLD(0.31±0.11 vs 0.26±0.13).CONCLUSION Despite their young age,NAFLD diagnosed by TE with CAP is a frequent comorbidity in South Asian women with PCOS and is strongly associated with higher body mass index and hyperandrogenism.Non-invasive screening strategies could help early diagnosis and initiation of interventions,including counselling on weight loss,cardiovascular risk stratification and linkage to hepatology care where appropriate. | Mohamed Shengir Srinivasan Krishnamurthy Peter Ghali Marc Deschenes Philip Wong Tianyan Chen Giada Sebastiani | 2020 | World Journal of Gastroenterology2020，26，44： | 11 |
| 7 | Co-existence of non-alcoholic fatty liver disease and inflammatory bowel disease: a review article显示文摘Emerging data have highlighted the co-existence of nonalcoholic fatty liver disease(NAFLD) and inflammatory bowel disease; both of which are increasingly prevalent disorders with significant complications and impact on future health burden. Cross-section observational studies have shown widely variable prevalence rates of co-existing disease,largely due to differences in disease definition and diagnostic tools utilised in the studies. Age,obesity,insulin resistance and other metabolic conditions are common risks factors in observational studies. However,other studies have also suggested a more dominant role of inflammatory bowel disease related factors such as disease activity,duration,steroid use and prior surgical intervention,in the development of NAFLD. This suggests a potentially more complex pathogenesis and relationship between the two diseases which may be contributed by factors including altered intestinal permeability,gut dysbiosis and chronic inflammatory response. Commonly used immunomodulation agents pose potential hepatic toxicity,however no definitive evidence exist linking them to the development of hepatic steatosis,nor are there any data on the impact of therapy and prognosis in patient with co-existent diseases. Further studies are required to assess the impact and establish appropriate screening and management strategies in order to allow early identification,intervention and improve patient outcomes. | Che-yung Chao Robert Battat Alex Al Khoury Sophie Restellini Giada Sebastiani Talat Bessissow | 2016 | World Journal of Gastroenterology2016，22，34： | 7 |
| 8 | HFE gene in primary and secondary hepatic iron overload显示文摘从世袭 haemochromatosis 不同,肝的铁超载是在几长期的肝疾病的普通发现。许多研究调查了流行,分发和过量的可能的贡献角色在 non-haemochromatotic 的肝的铁长期的肝疾病。确实,一些作者在除世袭 haemochromatosis 以外的肝疾病建议了铁移动。然而,第二等的铁超载的致病仍然保持不清楚。高 Fe (HFE ) 基因被含有,但是报导数据是争论的。在这篇文章,我们在铁动态平衡关于 HFE 蛋白质的细胞的角色总结当前的概念。我们在长期的丙肝,肝炎 B,含酒精、非酒精的脂肝疾病和迟发性皮肤卟啉症关于流行,肝的分发和铁超载的可能的治疗学的含意考察文学的当前的地位。我们在这些肝疾病关于 HFE 基因变化的角色讨论证据。最后,我们在除 haemochromatosis 以外的肝疾病总结铁超载的普通、特定的特征。 | Giada Sebastiani Ann P Walker | 2007 | World Journal of Gastroenterology2007，13，35： | 2 |
| 9 | Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C显示文摘 | Giada Sebastiani Alessandro Vario Maria Guido Franco Noventa Mario Plebani Roberta Pistis Alessia Ferrari Alfredo Alberti | 2006 | Journal of Hepatology2006，，4： | 2 |
| 10 | Non-invasive assessment of liver fibrosis: it is time for laboratory medicine显示文摘 | Giada Sebastiani Konstantinos Gkouvatsos Mario Plebani | 2011 | Clinical Chemistry and Laboratory Medicine2011，，1： | 1 |
| 11 | Genotype-specific mutations in the polymerase gene of hepatitis B virus potentially associated with resistance to oral antiviral therapy显示文摘 | Silvia Mirandola Giada Sebastiani Cristina Rossi Emanuela Velo Elke Maria Erne Alessandro Vario Diego Tempesta Chiara Romualdi Davide Campagnolo Alfredo Alberti | 2012 | Antiviral Research2012，，3： | 1 |
| 12 | Prospective comparison of two algorithms combining non-invasive methods for staging liver fibrosis in chronic hepatitis C显示文摘 | Laurent Castéra Giada Sebastiani Brigitte Le Bail Victor de Lédinghen Patrice Couzigou Alfredo Alberti | 2009 | Journal of Hepatology2009，，2： | 1 |
| 13 | Fatty liver in H63D homozygotes with hyperferritinemia显示文摘为了学习 H63D 变化的临床的相互关联,我们分析了在一个工作分派实验室通过变化分析识别的 H63D 同质接合体的显型。样品为 HFE 分析提交了的 366 血的一个总数为 C282Y 和 H63D 变化被屏蔽。四 H63D 同质接合体被识别。所有提起了浆液含铁锡但是正常转铁蛋白浸透。他们为肝炎 B 和 C 是否定的,仅仅一个病人消费了过量酒精。在所有 4 个盒子中, ultrasonography 揭示了脂肝。在二个病人,肝活体检视与不平常的分布和宏被做并且出现温和铁质沉着病小囊的脂肪变性。这些数据证实在脂肝, hyperferritinaemia 和增加的肝的铁之间的协会,但是不澄清铁质沉着病是否为 H63D 变化与脂肪变性而非纯合性有关。有脂肝的病人可以在 H63D 纯合性的表达式的人口研究复杂化数据的解释。 | Giada Sebastiani Daniel F Wallace Susan E Davies Vasu Kulhalli Ann P Walker James S Dooley | 2006 | World Journal of Gastroenterology2006，12，11： | 0 |
| 14 | Non-alcoholic steatohepatitis in liver transplant recipients diagnosed by serum cytokeratin 18 and transient elastography:A prospective study显示文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)and nonalcoholic steatohepatitis(NASH)seem common after liver transplantation.AIM To investigate incidence and predictors of NAFLD and NASH by employing noninvasive testing in liver transplant recipients,namely controlled attenuation parameter(CAP)and the serum biomarker cytokeratin 18(CK-18).We also evaluated the diagnostic accuracy of CK-18 and CAP compared to liver histology.METHODS We prospectively recruited consecutive adult patients who received liver transplant at the McGill University Health Centre between 2015-2018.Serial measurements of CK-18 and CAP were recorded.NAFLD and NASH were diagnosed by CAP≥270 dB/m,and a combination of CAP≥270 dB/m with CK-18>130.5 U/L,respectively.Incidences and predictors of NAFLD and NASH were investigated using survival analysis and Cox proportional hazards.RESULTS Overall,40 liver transplant recipients(mean age 57 years;70%males)were included.During a median follow-up of 16.8 mo(interquartile range 15.6-18.0),63.0%and 48.5%of patients developed NAFLD and NASH,respectively.On multivariable analysis,after adjusting for sex and alanine aminotransferase,body mass index was an independent predictor of development of NAFLD[adjusted hazard ratio(aHR):1.21,95%confidence interval(CI):1.04-1.41;P=0.01]and NASH(aHR:1.26,95%CI:1.06-1.49;P<0.01).Compared to liver histology,CAP had a 76%accuracy to diagnose NAFLD,while the accuracy of CAP plus CK-18 to diagnose NASH was 82%.CONCLUSION NAFLD and NASH diagnosed non-invasively are frequent in liver transplant recipients within the first 18 mo.Close follow-up and nutritional counselling should be planned in overweight patients. | Alshaima Alhinai Afsheen Qayyum-Khan Xun Zhang Patrick Samaha Peter Metrakos Marc Deschenes Philip Wong Peter Ghali Tian-Yan Chen Giada Sebastiani | 2021 | World Journal of Hepatology2021，13，12： | 0 |
| 15 | Metabolic and cardiovascular complications after virological cure in hepatitis C:What awaits beyond显示文摘The association between chronic hepatitis C(CHC)infection and extrahepatic manifestations(EHMs),particularly cardiometabolic diseases,has been extensively examined.However,there has still been insufficient evaluation for these EHMs after virological cure.Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus(HCV)developing EHMs,cardiometabolic ones,as well as the effect of antiviral therapy to resolve these EHMs.Data on these manifestations after achieving sustained virologic response(SVR)are still conflicting.However,current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile,which increases cardiovascular disease(CVD)risk.Additionally,most observations showed that metabolic alterations,such as insulin resistance and diabetes mellitus(DM),undergo some degree of reduction after viral clearance.These changes seem HCV-genotype dependent.Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM.Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results,with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones.In this review,we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR,which may have an impact on healthcare providers’clinical practice. | Mohamed Shengir Mohamed Elgara Giada Sebastiani | 2021 | World Journal of Gastroenterology2021，27，17： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员