Biliary atresia(BA)is a childhood disease which manifests with abnormal narrowing,blockage or complete absence of bile ducts within the liver.Many possible etiologies have been reported for the development of BA,inclu...Biliary atresia(BA)is a childhood disease which manifests with abnormal narrowing,blockage or complete absence of bile ducts within the liver.Many possible etiologies have been reported for the development of BA,including congenital,perinatal and acquired conditions.Since the 1970's,there has been increasing evidence linking BA development to viral perinatal infections.The viral vectors most commonly implicated include members of the herpesviridae family(cytomegalovirus and Epstein-Barr virus)as well as those of the reoviridae family(reovirus and rotavirus).While extensive work has been done on a murine model of disease,the current review focuses primarily on evidence from human studies of viral vectors in children afflicted with BA.展开更多
Autoimmune hepatitis(AIH)is a cause of chronic,immunemediated liver injury which without treatment may progress to end-stage liver disease.The disease state,characterized by elevations in liver enzymes,autoantibodies,...Autoimmune hepatitis(AIH)is a cause of chronic,immunemediated liver injury which without treatment may progress to end-stage liver disease.The disease state,characterized by elevations in liver enzymes,autoantibodies,and interface hepatitis on histology,has been noted to be induced by a wide range of insults.Medications,most commonly minocycline and nitrofurantoin,have long been established as potential inducers of AIH.Recently,biologics,powerful immune-modulators,have also been reported to induce AIH.We conclude that there is an association between administration of biologics in the development of AIH,and whether the relationship is causal will require appropriate studies in the future.展开更多
Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend...Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend to be slow growing though may reach symptomatic dimensions.Misdiagnosis of biliary mucinous cystadenomas may have serious consequences secondary to their potential for malignant transformation into biliary mucinous cystadenocarcinomas.Here,we review the epidemiology,etiology,pathology,diagnostic modalities,histology,and available treatment methods for mucinous cystadenomas reported in current literature.展开更多
Since their introduction in 1987,hydroxymethyl glutaryl coenzyme A reductase(HMG-CoA)inhibitors,more commonly known as statins,have become some of the most widely prescribed medications in the world.Though generally c...Since their introduction in 1987,hydroxymethyl glutaryl coenzyme A reductase(HMG-CoA)inhibitors,more commonly known as statins,have become some of the most widely prescribed medications in the world.Though generally considered to be safe and well tolerated,statins have been associated with several side effects including mild liver dysfunction manifested by increases in aminotransferases.Rarely,statins have been noted to induce more serious hepatic injury,including liver injury with autoimmune features.Current literature supports statin induced liver injury presenting in either hepatocellular or cholestatic patterns,though with the former being the prevailing pattern of injury.Fortunately,severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation.When evaluating cases of suspected statininduced liver injury,a complete medical history,laboratory tests including a complete metabolic panel,autoimmune markers,and viral panel,as well as hepatic imaging,are crucial for a complete causality analysis with validated tools such as Roussel Uclaf Causality Assessment Method.The aim of this review is to review the current evidence for statininduced liver injury and cholestasis.展开更多
Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health conc...Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health concern.Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence.While intravenous drug use,healthcare exposure(i.e.blood transfusions and surgical care),and body modification(i.e.tattooing and piercings)are well accepted risk factors for HCV transmission,others remain controversial.Because dental practice is often asso-ciated with procedures and bleeding,the possibility of HCV transmission seemed reasonable to investigate.Here,we review the evidence for dental care as a potential risk factor for HCV transmission.We identified a total of 1,180 manu-scripts related to HCV and dental care,of which 26 manu-scripts were included in the study after exclusionary criteria were applied.As per our review of the available literature,in the developing world,the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care.In developed nations,on the other hand,general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients;although,the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission.展开更多
Peritoneal tuberculosis(PTB),although rarer than its pulmonary counterpart,is a serious health concern in regions of the world with high tuberculosis prevalence.Individuals with baseline immunocompromise condition,whe...Peritoneal tuberculosis(PTB),although rarer than its pulmonary counterpart,is a serious health concern in regions of the world with high tuberculosis prevalence.Individuals with baseline immunocompromise condition,whether acquired or medically induced,are at greatest risk for experiencing PTB.While medical treatment of the condition is similar to that of the pulmonary disease,the generally immunocompromised state of those infected with PTB,along with a lack of highly sensitive and specific testing methods make early diagnosis difficult.This review discusses the risks factors,clinical features,diagnostic methods,and treatment options for PTB.展开更多
文摘Biliary atresia(BA)is a childhood disease which manifests with abnormal narrowing,blockage or complete absence of bile ducts within the liver.Many possible etiologies have been reported for the development of BA,including congenital,perinatal and acquired conditions.Since the 1970's,there has been increasing evidence linking BA development to viral perinatal infections.The viral vectors most commonly implicated include members of the herpesviridae family(cytomegalovirus and Epstein-Barr virus)as well as those of the reoviridae family(reovirus and rotavirus).While extensive work has been done on a murine model of disease,the current review focuses primarily on evidence from human studies of viral vectors in children afflicted with BA.
文摘Autoimmune hepatitis(AIH)is a cause of chronic,immunemediated liver injury which without treatment may progress to end-stage liver disease.The disease state,characterized by elevations in liver enzymes,autoantibodies,and interface hepatitis on histology,has been noted to be induced by a wide range of insults.Medications,most commonly minocycline and nitrofurantoin,have long been established as potential inducers of AIH.Recently,biologics,powerful immune-modulators,have also been reported to induce AIH.We conclude that there is an association between administration of biologics in the development of AIH,and whether the relationship is causal will require appropriate studies in the future.
文摘Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend to be slow growing though may reach symptomatic dimensions.Misdiagnosis of biliary mucinous cystadenomas may have serious consequences secondary to their potential for malignant transformation into biliary mucinous cystadenocarcinomas.Here,we review the epidemiology,etiology,pathology,diagnostic modalities,histology,and available treatment methods for mucinous cystadenomas reported in current literature.
文摘Since their introduction in 1987,hydroxymethyl glutaryl coenzyme A reductase(HMG-CoA)inhibitors,more commonly known as statins,have become some of the most widely prescribed medications in the world.Though generally considered to be safe and well tolerated,statins have been associated with several side effects including mild liver dysfunction manifested by increases in aminotransferases.Rarely,statins have been noted to induce more serious hepatic injury,including liver injury with autoimmune features.Current literature supports statin induced liver injury presenting in either hepatocellular or cholestatic patterns,though with the former being the prevailing pattern of injury.Fortunately,severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation.When evaluating cases of suspected statininduced liver injury,a complete medical history,laboratory tests including a complete metabolic panel,autoimmune markers,and viral panel,as well as hepatic imaging,are crucial for a complete causality analysis with validated tools such as Roussel Uclaf Causality Assessment Method.The aim of this review is to review the current evidence for statininduced liver injury and cholestasis.
文摘Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health concern.Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence.While intravenous drug use,healthcare exposure(i.e.blood transfusions and surgical care),and body modification(i.e.tattooing and piercings)are well accepted risk factors for HCV transmission,others remain controversial.Because dental practice is often asso-ciated with procedures and bleeding,the possibility of HCV transmission seemed reasonable to investigate.Here,we review the evidence for dental care as a potential risk factor for HCV transmission.We identified a total of 1,180 manu-scripts related to HCV and dental care,of which 26 manu-scripts were included in the study after exclusionary criteria were applied.As per our review of the available literature,in the developing world,the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care.In developed nations,on the other hand,general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients;although,the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission.
文摘Peritoneal tuberculosis(PTB),although rarer than its pulmonary counterpart,is a serious health concern in regions of the world with high tuberculosis prevalence.Individuals with baseline immunocompromise condition,whether acquired or medically induced,are at greatest risk for experiencing PTB.While medical treatment of the condition is similar to that of the pulmonary disease,the generally immunocompromised state of those infected with PTB,along with a lack of highly sensitive and specific testing methods make early diagnosis difficult.This review discusses the risks factors,clinical features,diagnostic methods,and treatment options for PTB.
