A Systematic Review of the Evidence Behind Use of Reduced Doses of Acetaminophen in Chronic Liver Disease.

A Systematic Review of the Evidence Behind Use of Reduced Doses of Acetaminophen in Chronic Liver Disease. J Pain Palliat Care Pharmacother. 2019 Jun 17;:1-14 Authors: Schweighardt AE, Juba KM Abstract Acetaminophen is among the most commonly used nonopioid analgesics, but significant variation exists in its prescribing practices for cirrhosis patients. Our primary objective was to describe the quality of evidence supporting or refuting the use of acetaminophen in patients with hepatic dysfunction. A comprehensive literature review of PubMed, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts using the search terms "acetaminophen," "paracetamol," "chronic liver disease," "cirrhosis," and "hepatic disease" for studies describing changes in acetaminophen metabolism in patients with hepatic dysfunction was conducted. Twelve studies and four abstracts were included. Ten studies and three abstracts were pharmacokinetic studies. Two studies and one abstract evaluated the association of acetaminophen use and decompensation in the cirrhotic patient. The level of certainty for dosing recommendations obtainable from reviewing the evidence is low due to a small number of studies meeting search criteria, small samples sizes, inadequate information regarding cirrhosis etiology and compensated versus uncompensated liver disease, and lack of information on patient centered health outcomes. High-...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

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Authors: Mavilia MG, Sharma A, Forouhar F Abstract Cholangiocarcinoma (CC) is the second most common primary hepatic malignancy. Although the frequency of malignancy is generally increased in chronic liver disease, CC rarely presents in Wilson disease (WD). The incidence of hepatic malignancy in WD is only 1.2%, with CC accounting for 0.5%. A 66 year old male with history of hypertension, diabetes, and compensated cryptogenic cirrhosis presented with acute onset dyspnea and pleuritic chest pain. He was incidentally found to have a sizeable mass in the right hepatic lobe. Ultimately, a liver biopsy revealed dense de...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
In this study, we aimed to clarify the prevalence and characteristics of muscle cramps in individual CLD. Patients and methods A total of 432 patients with CLD who visited our hospital were enrolled. The existence of muscle cramps, frequency, time zone, duration, and the degree of pain were investigated using a medical interview questionnaire. Results The median age of the patients was 65 years and 48.6% of the patients were women. The prevalence of muscle cramps was 25.9%. Age, female sex, lower BMI, existence of comorbid diseases, and liver fibrosis were associated significantly with muscle cramps. In LC, muscle cr...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
Conclusion: TFF administration in adult SCD patients presenting with VOE appears to be safe, but was unexpectedly associated with significantly higher 24-hour MEQ use, which may reflect more severe VOE episodes at the TFF visits, as patients had higher LDH values, and increased complications (ACS and return to ED). However, there were no significant differences in other outcomes including change in pain scores, time spent in ED, admission duration or oxygen requirements. Overall, utilization of TFF in the TGH ED for SCD VOEs was low.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology Source Type: research
Aspirin is best known as an over-the-counter painkiller. But acetylsalicylic acid, as it’s called chemically, has many other health benefits, as well as side effects, in the body that have only become clear in recent years. Here’s what the latest science says about the health benefits and side effects of aspirin, as well as which conditions it may treat and those it doesn’t appear to improve. (If you are taking aspirin for any reason other than for periodic pain relief, it’s best to consult with your doctor to confirm whether the benefits outweigh the risks in your particular case.) How aspirin affe...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Drugs healthytime Source Type: news
CONCLUSION: Multiple management challenges usu- ally arise in pregnancies com- plicated by end-stage - liver disease. However, with com- prehensive multidisciplin- ary care a successful perina- tal outcome can be accom- - plished. PMID: 30383957 [PubMed]
Source: Journal of Reproductive Medicine - Category: Reproduction Medicine Tags: J Reprod Med Source Type: research
Abstract BACKGROUND: End-stage liver disease is a common cause of morbidity and mortality worldwide, yet little is known about its symptomatology and impact on health-related quality of life. AIM: To describe symptom prevalence and health-related quality of life of patients with end-stage liver disease to improve care. DESIGN: Systematic review. DATA SOURCES: We searched eight electronic databases from January 1980 to June 2018 for studies investigating symptom prevalence or health-related quality of life of adult patients with end-stage liver disease. No language restrictions were applied. Meta-ana...
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
Authors: Golfeyz S, Lewis S, Weisberg IS Abstract INTRODUCTION: Hereditary hemochromatosis (HH) is an autosomal recessive disorder that occurs in approximately 1 in 200-250 individuals. Mutations in the HFE gene leads to excess iron absorption. Excess iron in the form of non-transferrin bound iron (NTBI) causes injury and is readily up-taken by cardiomyocytes, pancreatic islet cells and hepatocytes. Symptoms greatly vary among patients and include fatigue, abdominal pain, arthralgias, impotence, decreased libido, diabetes and heart failure. Untreated hemochromatosis can lead to chronic liver disease, fibrosis, cirr...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
Conclusions: Interferon-free regimens could result in higher SVR rates in HCV patients with autoimmune liver diseases. As interferon-free treatment for HCV may have an effect on hepatic immunity and activity of the autoimmune liver diseases, careful attention should be paid to unexpected adverse events in their treatments. Methods: Total 12 patients with HCV and autoimmune liver diseases [7 AIH and PBC], who were treated with interferon-free regimens, were retrospectively analyzed. PMID: 29545925 [PubMed]
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
Follow me on Twitter @RobShmerling Ever wonder what other people are wondering about? I know I do. So, here are the top 10 health searches in Google for 2017. And just so you don’t have to look each one up, I’ve provided a brief answer. You’re welcome. 1.  What causes hiccups? I was surprised this one made it to the top 10 list of health searches. Maybe this search is common because hiccups are as mysterious as they are universal. I’ve written about hiccups before, but let’s just say the cause in any individual person is rarely known or knowable. Then again, the reason hiccups stop is als...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Source Type: blogs
Discussion Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane receptor (CFTR). It is found in the epithelium of the bronchi, intestine, pancreatic duct and biliary tree. It regulates chloride, bicarbonate and water secretion. The heterozygous state helps prevent against secretory diarrhea, but the homozygous state causes thickened secretions in the hollow tubes of the lungs and digestive tract. There are multiple mutations (> 2000) which have been currently classified into classes depending on their protein production and activity. CF patients generally are l...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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