- Radioembolization-induced liver disease: a systematic review. [Journal Article]
- EJEur J Gastroenterol Hepatol 2016 Dec 06
- Radioembolization (RE) is a relatively novel treatment modality for primary and secondary hepatic malignancies. Microspheres embedded with a β-emitting radioisotope are injected into the hepatic arte...
Radioembolization (RE) is a relatively novel treatment modality for primary and secondary hepatic malignancies. Microspheres embedded with a β-emitting radioisotope are injected into the hepatic artery, resulting in microsphere deposition in the tumor arterioles and normal portal triads. Microsphere deposition in nontumorous parenchyma can result in radiation-induced liver injury, with lethal RE-induced liver disease (REILD) at the outer end of the spectrum. The primary aim of this study was to evaluate RE-related hepatotoxicity and present an overview of the currently applied definitions and clinically relevant characteristics of REILD. A systematic literature search on REILD was performed. Studies after the introduction of the term REILD (2008) were screened for definitions of REILD. Hepatotoxicity and applied definitions of REILD were compared. Liver biochemistry test abnormalities occur in up to 100% of patients after RE, mostly self-limiting. The incidence of symptomatic REILD varied between 0 and 31%, although in most reports, the incidence was 0-8%, with a lethal outcome in 0-5%. With the exception of bilirubin, the presentation of hepatotoxicity and REILD was similar for cirrhotic and noncirrhotic patients. No uniform definition of REILD was established in the current literature. Here, we propose a unifying definition and grading system for REILD. RE-related hepatotoxicity is a common phenomenon; symptomatic REILD, however, is rare. Currently, reporting of REILD is highly variable, precluding reliable comparison between studies, identification of risk factors, and treatment developments.
- Population Pharmacokinetics of Ceritinib in Adult Patients With Tumors Characterized by Genetic Abnormalities in Anaplastic Lymphoma Kinase. [Journal Article]
- JCJ Clin Pharmacol 2016 Dec 06
- Ceritinib is a second-generation selective and potent oral anaplastic lymphoma kinase (ALK) inhibitor approved for ALK-positive advanced non-small cell lung cancer previously treated with crizotinib....
Ceritinib is a second-generation selective and potent oral anaplastic lymphoma kinase (ALK) inhibitor approved for ALK-positive advanced non-small cell lung cancer previously treated with crizotinib. Population pharmacokinetic (PK) analysis was performed to describe the PK of ceritinib and was used to evaluate the covariate effects on systemic exposure at its label dose (750 mg orally once daily). Ceritinib concentration-time data from 4 clinical studies were described by a 1-compartment model with delayed first-order absorption and time-dependent elimination. The apparent clearance at steady state (CL/Fss ) was determined to increase with body weight and albumin but decrease with an increase in alanine aminotransferase. Japanese ethnicity appeared to significantly influence the apparent fractional turnover rate of the inhibited metabolic enzyme (kout ). No dose adjustment was necessary in patients with lower body weight or with preexisting mild hepatic impairment. The ceritinib steady-state exposure (AUCss ) at 750 mg increased by 8% (90% prediction interval [PI], 2-16) in non-Japanese Asians and 31% (90%PI, 17-44) in Japanese patients compared with that in white patients. Other covariates including sex, age, baseline Eastern Cooperative Oncology Group performance status, baseline total bilirubin, baseline estimated glomerular filtration rate, prior crizotinib treatment, and concomitant use of proton pump inhibitors had no statistically significant effect on ceritinib PK parameters. In conclusion, the nonlinear PK of ceritinib was described using a population-based approach in patients with ALK-positive tumors. None of the covariates assessed in this study were considered clinically relevant and therefore do not warrant dose adjustment.
- A Day-4 Lille Model Predicts Response to Corticosteroids and Mortality in Severe Alcoholic Hepatitis. [Journal Article]
- AJAm J Gastroenterol 2016 Dec 06
- CONCLUSIONS: LM4 is as accurate as LM7 in predicting response to corticosteroids, as well as 28- and 90-day mortality. Assessing the efficacy of prednisolone at an earlier time point can avoid a more prolonged futile use of this therapy.Am J Gastroenterol advance online publication, 6 December 2016; doi:10.1038/ajg.2016.539.
- Interrelationship between Mini-Mental State Examination scores and biochemical parameters in patients with mild cognitive impairment and Alzheimer's disease. [Journal Article]
- GGGeriatr Gerontol Int 2016 Dec 06
- CONCLUSIONS: Hypercholesterolemia is a risk factor for AD that might result in neurotoxicity and cognitive impairment. Dysfunction of lipoprotein and heme metabolism might also provide additional targets for AD diagnosis. Geriatr Gerontol Int 2016; ••: ••-••.
- Total serum bilirubin is an independent risk factor for coronary artery disease in men compared to women. [Journal Article]
- ACActa Cardiol 2016; 71(6):685-689
- Morbidity and mortality and predictors of outcome following hepatectomy at a Saudi tertiary care center. [Journal Article]
- ASAnn Saudi Med 2016 Nov-Dec; 36(6):414-421
- CONCLUSIONS: Factors that predicted development of complications were elevated total bilirubin level preoperatively, operative time, extent of the resection, use of epidural anesthesia and a postoperative need for blood transfusion. Liver resection is a safe and feasible option at our center.The small number of indications for resection and consequent reduction in variety of risk factors limited ability to make inferences. Additionally, only a handful of cases were performed laparoscopically.
- Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection: a matched study. [Journal Article]
- HPHepatobiliary Pancreat Dis Int 2016; 15(6):626-632
- CONCLUSIONS: R0 resection prolonged survival time in HCC patients with BDTT, although prognosis remains poor. For such patients, R0 resection is an important treatment that determines long-term survival.
- Nasobiliary Drainage for Benign Recurrent Intrahepatic Cholestasis in Patients Refractory to Standard Therapy. [Journal Article]
- CIClin Invest Med 2016 Dec 01; 39(6):27522
- CONCLUSIONS: NBD effectively eliminates BRIC in all patients and improves biomarkers of cholestasis. It can be suggested that patients with attacks of BRIC can be treated with temporary endoscopic NBD; however, the results of this study should be confirmed by prospective studies in the future.
- High Dose Oral Furosemide with Salt Ingestion in the Treatment of Refractory Ascites of Liver Cirrhosis. [Journal Article]
- CIClin Invest Med 2016 Dec 01; 39(6):27502
- We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA.
We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA.
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- Evaluation of hepatoprotective potential of Erythrina indica leaves against antitubercular drugs induced hepatotoxicity in experimental rats. [Journal Article]
- JAJ Ayurveda Integr Med 2016 Dec 01
- CONCLUSIONS: The results of this study strongly indicate the protective effect of Erythrina indica against liver injury which may be attributed to its hepatoprotective activity, and there by scientifically support its traditional use.