Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Sep 2014
Increased risk of cirrhosis and hepatocellular cancer during long-term follow-up of patients with biopsy-proven NAFLD.
Our aims were to investigate the natural history of biopsy-proven non-alcoholic fatty liver disease (NAFLD) in Sweden, its associated complications, the clinical and biochemical factors associated with more advanced liver disease and the survival rate with a mean follow-up time of 27 years. ⋯ NAFLD can progress to advanced liver disease, including cirrhosis, with a higher than expected mortality and incidence of hepatocellular cancer.
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Scand. J. Gastroenterol. · Aug 2014
Serum AFBP levels are elevated in patients with nonalcoholic fatty liver disease.
Adipocyte fatty acid-binding-protein (A-FABP), retinol-binding protein 4 (RBP4), and lipocalin-2 have been identified as adipokines that may link obesity, insulin resistance, and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is regarded as a manifestation of metabolic syndrome. We evaluated the relationship of A-FABP, RBP4, and lipocalin-2 to variables related to metabolic syndrome and NAFLD. ⋯ We observed higher serum A-FABP levels in the NAFLD group than in the normal group. However, serum RBP4 and lipocalin-2 levels appeared to have different relationships with several variables related to metabolic syndrome and NAFLD, which contradict results of previous studies.
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Scand. J. Gastroenterol. · Jul 2014
Review Meta AnalysisToward an evidence-based step-up approach in diagnosing diverticulitis.
The lack of pathognomonic findings and the chance of complicated disease have resulted in the widespread use of additional imaging to diagnose acute colonic diverticulitis (ACD). The added value of additional imaging in the diagnostic workup of patients suspected of ACD is not well defined. ⋯ In two-thirds of the patients, the diagnosis of ACD can be made based on clinical evaluation alone. In one-third of the patients, additional imaging is a necessity to establish the diagnosis. US and CT are comparable in diagnosing diverticulitis and superior to other modalities. CT has the advantage of higher specificity and the ability to identify alternative diagnoses. The role of MRI is not yet clear in diagnosing ACD. Contrast enema is considered an obsolete imaging technique to diagnose ACD based on lower sensitivity and specificity than US and CT. A step-up approach with CT performed after an inconclusive or negative US, seems a logical and safe approach for patients suspected of ACD.
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Scand. J. Gastroenterol. · Jul 2014
Multicenter Study Observational StudyThe role of capsule endoscopy in the evaluation and treatment of obscure-overt gastrointestinal bleeding during daily clinical practice: a prospective multicenter study.
Capsule endoscopy (CE) is most commonly performed to evaluate obscure gastrointestinal bleeding (GIB). However, at present the role of CE in patients with obscure-overt GIB especially during daily clinical practice is unknown. The aim of the present study was to investigate the diagnostic yield and the impact of CE on the management of patients with obscure-overt GIB. ⋯ CE represents a promising diagnostic method in the investigation of obscure-overt GIB, with significant impact on its clinical management in daily clinical practice.
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Scand. J. Gastroenterol. · May 2014
ReviewNonalcoholic fatty liver disease and cholesterol gallstones: which comes first?
Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and are associated with obesity, insulin resistance, dyslipidemia, and high dietary cholesterol intake. Insulin resistance is a key feature of both NAFLD and GD. Hepatic insulin resistance provides a crucial link between the metabolic syndrome, NAFLD, and increased cholesterol gallstone susceptibility. ⋯ Importantly, both NAFLD and GD are both associated with high incidence of cardiovascular disease (CVD) and mortality. Emerging evidence suggests a potential benefit of statin therapy in NAFLD and GD. Further research is needed to determine (i) how the presence of NAFLD and GD is associated with CVD (ii) and whether the presence of GD in association with NAFLD increases the risk of liver fibrosis, and (iii) the impact of therapy of NAFLD in the incidence of GD.