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  1. Article ; Online: Review article: current management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.

    Younossi, Z M

    Alimentary pharmacology & therapeutics

    2008  Volume 28, Issue 1, Page(s) 2–12

    Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic ... alcoholic steatohepatitis (NASH) were reviewed. Articles specifically related to epidemiology, diagnosis and current ... syndrome.: Aim: To assess the epidemiological impact and the current management of patients with NAFLD ...

    Abstract Background: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome.
    Aim: To assess the epidemiological impact and the current management of patients with NAFLD.
    Methods: Published peer-reviewed literature and abstracts concerning NAFLD and non-alcoholic steatohepatitis (NASH) were reviewed. Articles specifically related to epidemiology, diagnosis and current treatment strategies for NAFLD and NASH are summarized.
    Results: NAFLD is strongly associated with the epidemic of obesity and type-2 diabetes mellitus, and is estimated to affect about 20-30% of the population in the US. From the spectrum of NAFLD, only patients with biopsy-proven NASH (estimated prevalence in the US population is about 3-5%) have been convincingly shown to progress to cirrhosis, liver failure and hepatocellular carcinoma. The clinical manifestation of NAFLD is usually absent or subtle, with abnormal aminotransferases or incidental radiographic findings of fatty liver. The pathogenesis of NAFLD is attributed to a multi-hit process involving insulin resistance, oxidative stress, apoptotic pathways, and adipocytokines. In 2008, there is no established treatment for NAFLD. Weight loss and treatment for each component of metabolic syndrome. Nevertheless, a large number of agents are being considered in clinical trials of patients with NASH.
    Conclusions: Awareness of the tremendous impact of NAFLD as an important cause of chronic liver disease is increasing along with a great deal of information about its pathogenesis. Future, well-designed clinical trials that target specific pathways involved in the pathogenesis of NASH are urgently needed.
    MeSH term(s) Antioxidants/therapeutic use ; Diabetes Mellitus, Type 2/etiology ; Fatty Liver/diagnosis ; Fatty Liver/drug therapy ; Fatty Liver/etiology ; Female ; Humans ; Hypolipidemic Agents/therapeutic use ; Insulin Resistance ; Male ; Obesity/complications ; Oxidative Stress ; Risk Factors ; Ursodeoxycholic Acid/therapeutic use ; Weight Loss/drug effects
    Chemical Substances Antioxidants ; Hypolipidemic Agents ; Ursodeoxycholic Acid (724L30Y2QR)
    Language English
    Publishing date 2008-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/j.1365-2036.2008.03710.x
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2206: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Tocotrienol in the Management of Nonalcoholic Fatty Liver Disease: A Systematic Review.

    Chin, Kok-Yong / Ekeuku, Sophia Ogechi / Chew, Deborah Chia Hsin / Trias, Anne

    Nutrients

    2023  Volume 15, Issue 4

    Abstract: The increasing burden of nonalcoholic fatty liver disease (NAFLD) requires innovative management ... were included in this review. The search located 12 articles (8 animal studies and 4 human studies ... in NAFLD management. This systematic review aimed to provide an overview of the effects of T3 ...

    Abstract The increasing burden of nonalcoholic fatty liver disease (NAFLD) requires innovative management strategies, but an effective pharmacological agent has yet to be found. Apart from weight loss and lifestyle adjustments, one isomer of the vitamin E family-alpha-tocopherol-is currently recommended for nondiabetic steatohepatitis patients. Another member of the vitamin E family, tocotrienol (T3), has anti-inflammatory and antioxidant properties that reach beyond those of alpha-tocopherol, making it a potential agent for use in NAFLD management. This systematic review aimed to provide an overview of the effects of T3 supplementation on NAFLD from both clinical and preclinical perspectives. A literature search was performed in October 2022 using PubMed, Scopus and Web of Science. Original research articles reporting NAFLD outcomes were included in this review. The search located 12 articles (8 animal studies and 4 human studies). The literature reports state that T3 isomers or natural mixtures (derived from palm or annatto) improved NAFLD outcomes (liver histology, ultrasound or liver profile). However, the improvement depended on the severity of NAFLD, study period and type of intervention (isomers/mixture of different compositions). Mechanistically, T3 improved lipid metabolism and prevented liver steatosis, and reduced mitochondrial and endoplasmic reticulum stress, inflammation and ultimately liver fibrosis. In summary, T3 could be a potential agent for use in managing NAFLD, pending more comprehensive preclinical and human studies.
    MeSH term(s) Animals ; Humans ; Non-alcoholic Fatty Liver Disease/metabolism ; Tocotrienols/metabolism ; alpha-Tocopherol ; Liver/metabolism ; Vitamin E/metabolism
    Chemical Substances Tocotrienols ; alpha-Tocopherol (H4N855PNZ1) ; Vitamin E (1406-18-4)
    Language English
    Publishing date 2023-02-06
    Publishing country Switzerland
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu15040834
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  3. Article ; Online: Review article: non-alcoholic fatty liver disease and cardiovascular diseases: associations and treatment considerations.

    Polyzos, Stergios A / Kechagias, Stergios / Tsochatzis, Emmanuel A

    Alimentary pharmacology & therapeutics

    2021  Volume 54, Issue 8, Page(s) 1013–1025

    Abstract: Background: There are increasing data on the association between non-alcoholic fatty liver disease ... licenced medication currently exists. Pioglitazone, proposed for non-alcoholic steatohepatitis (NASH ... Advanced liver fibrosis is a crucial prognostic factor for end-stage liver disease and for cardiovascular ...

    Abstract Background: There are increasing data on the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD).
    Aim: To summarise evidence on the association between NAFLD and CVD in the clinical setting and provide potential therapeutic implications.
    Methods: We searched PubMed. Evidence was primarily derived from meta-analyses. and then, if data were insufficient, from clinical trials, and then from observational studies.
    Results: NAFLD has been linked to arterial hypertension, arterial stiffness, atherosclerosis, coronary artery disease, atrial fibrillation and aortic valvular sclerosis. Advanced liver fibrosis is a crucial prognostic factor for end-stage liver disease and for cardiovascular and overall mortality. Weight loss through lifestyle modifications (diet and exercise) remains the cornerstone of the management of both NAFLD and CVD, but is difficult to achieve and possibly more difficult to sustain long term. Therefore, pharmacological management of NAFLD seems to be important, although no licenced medication currently exists. Pioglitazone, proposed for non-alcoholic steatohepatitis (NASH) by most guidelines, increases weight and should be avoided in congestive heart failure. Statins should not be avoided in NAFLD patients at risk for CVD. Glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, two classes of anti-diabetic drugs, have shown promising results in NAFLD and CVD, but more studies with hard end points are needed. Obeticholic acid, a promising medication for NASH under investigation, should be carefully considered, owing to its adverse effect on lipid profile.
    Conclusions: NAFLD is associated with CVD, which may have certain clinical and therapeutic implications.
    MeSH term(s) Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Diabetes Mellitus, Type 2 ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/therapy ; Sodium-Glucose Transporter 2 Inhibitors
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Sodium-Glucose Transporter 2 Inhibitors
    Language English
    Publishing date 2021-08-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.16575
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2206: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Bioactive Components and Possible Activities of Medicinal Mushrooms in Alleviating the Pathogenesis of Nonalcoholic Fatty Liver Disease (Review).

    Lo, Hui-Chen

    International journal of medicinal mushrooms

    2021  Volume 23, Issue 3, Page(s) 29–41

    Abstract: Nonalcoholic fatty liver disease (NAFLD) is a global disease that is closely associated ... to nonalcoholic steatohepatitis and further to liver fibrosis, cirrhosis, and hepatocellular carcinoma. The underlying mechanism ... fatty degeneration, and chronic inflammation of the liver activate the progression of NAFLD from simple steatosis ...

    Abstract Nonalcoholic fatty liver disease (NAFLD) is a global disease that is closely associated with obesity, type 2 diabetes mellitus, and cardiovascular disease. Excessive fat accumulation, fatty degeneration, and chronic inflammation of the liver activate the progression of NAFLD from simple steatosis to nonalcoholic steatohepatitis and further to liver fibrosis, cirrhosis, and hepatocellular carcinoma. The underlying mechanism for the development and progression of NAFLD is complex and a multiple-hit hypothesis including dietary, environmental, genetic, and epigenetic factors has been raised. Increased de novo lipogenesis, decreased lipolysis, and insulin resistance are associated with the development of NAFLD. Currently, no effective drug therapies are approved for the treatment of NAFLD. Several medicinal mushrooms have been found to have significant weight control and gut microbe modulation activities and antihypertriglyceridemic, antihyperglycemic, antioxidant, and anti-inflammatory effects, which may be useful to prevent and attenuate the development and progression of NAFLD. These beneficial effects are associated with mushrooms' bioactive components, such as polysaccharides, dietary fibers, antioxidants, and other compounds derived from fruiting bodies, cultured mycelium, and/or broth of medicinal mushrooms. This article presents an overview of multiple aspects of NAFLD, including the epidemiology, pathogenesis, management, and treatment. The bioactive components and possible activities of medicinal mushrooms in alleviating the pathogenesis of NAFLD are also reviewed.
    MeSH term(s) Agaricales/chemistry ; Dietary Fiber/administration & dosage ; Humans ; Insulin Resistance ; Minerals/administration & dosage ; Non-alcoholic Fatty Liver Disease/drug therapy ; Non-alcoholic Fatty Liver Disease/etiology ; Non-alcoholic Fatty Liver Disease/prevention & control ; Oxidative Stress ; Polysaccharides/administration & dosage ; Vitamins/administration & dosage
    Chemical Substances Dietary Fiber ; Minerals ; Polysaccharides ; Vitamins
    Language English
    Publishing date 2021-04-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2108803-2
    ISSN 1940-4344 ; 1521-9437
    ISSN (online) 1940-4344
    ISSN 1521-9437
    DOI 10.1615/IntJMedMushrooms.2021037945
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    Z 7482: Show issues

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  5. Article ; Online: The effects of melatonin therapy on the treatment of patients with Non-alcoholic steatohepatitis: A systematic review and Meta-analysis on clinical trial studies.

    Akhavan Rezayat, Arash / Ghasemi Nour, Mohammad / Bondarsahebi, Yones / Hozhabrossadati, Seyyed Amin / Amirkhanlou, Fatemeh / Akhavan Rezayat, Shima / Kiani, Mohammadali / Imani, Bahareh

    European journal of pharmacology

    2021  Volume 905, Page(s) 174154

    Abstract: Melatonin has shown promising effects in controlling the progress of non-alcoholic fatty liver ... disease (NAFLD), introducing it as a possible candidate for NAFLD treatment. In this context, the current ... cholesterol, triglyceride, and liver aminotransferases in NAFLD patients. NAFLD and melatonin, as well ...

    Abstract Melatonin has shown promising effects in controlling the progress of non-alcoholic fatty liver disease (NAFLD), introducing it as a possible candidate for NAFLD treatment. In this context, the current study is aimed to evaluate melatonin's effect on the plasma levels of Gamma-glutamyl transpeptidase, cholesterol, triglyceride, and liver aminotransferases in NAFLD patients. NAFLD and melatonin, as well as their related terms, were searched in electronic databases, until May 1st, 2020. The initial search identified 1152 studies. Considering inclusion and exclusion criteria, the final seven articles were included in the study. The methodology of the articles was assessed by the Newcastle-Ottawa Scale. Alanine transaminase levels were significantly lowered with melatonin treatment but not earlier than the 4th week (P = 0.010 and 0.519, respectively). Aspartate aminotransferase levels didn't show significant alteration before 4 weeks, although exhibiting substantial decline in total (P = 0.697 and 0.008, respectively). Alkaline phosphatase changes under 4 weeks of follow-up were not significant (P = 0.3), however, it decreased significantly in total (P = 0.006). A significant decline was detected in triglyceride levels after melatonin treatment (P = 0.015). There was a significant reduction in cholesterol levels (P = 0.005). Gamma-glutamyl transpeptidase levels were also significantly different after the administration of melatonin (P < 0.001). Melatonin could reduce the progress of NAFLD. It might also decrement hepatic function parameters. Thus, it could be used for managing NAFLD and possibly as part of the treatment plan for patients with NAFLD.
    MeSH term(s) Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Aspartate Aminotransferases/blood ; Humans ; Lipids/blood ; Liver/drug effects ; Melatonin/pharmacology ; Melatonin/therapeutic use ; Non-alcoholic Fatty Liver Disease/drug therapy ; gamma-Glutamyltransferase/blood
    Chemical Substances Lipids ; gamma-Glutamyltransferase (EC 2.3.2.2) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2) ; Alkaline Phosphatase (EC 3.1.3.1) ; Melatonin (JL5DK93RCL)
    Language English
    Publishing date 2021-05-28
    Publishing country Netherlands
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 80121-5
    ISSN 1879-0712 ; 0014-2999
    ISSN (online) 1879-0712
    ISSN 0014-2999
    DOI 10.1016/j.ejphar.2021.174154
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 522: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Nonalcoholic fatty liver disease: a systematic review.

    Rinella, Mary E

    JAMA

    2015  Volume 313, Issue 22, Page(s) 2263–2273

    Abstract: Importance: Nonalcoholic fatty liver disease and its subtype nonalcoholic steatohepatitis affect ... nonalcoholic fatty liver disease and its potential morbidity extends beyond the liver. It is important ... fatty liver disease.: Evidence review: PubMed was queried for published articles through February 28, 2015 ...

    Abstract Importance: Nonalcoholic fatty liver disease and its subtype nonalcoholic steatohepatitis affect approximately 30% and 5%, respectively, of the US population. In patients with nonalcoholic steatohepatitis, half of deaths are due to cardiovascular disease and malignancy, yet awareness of this remains low. Cirrhosis, the third leading cause of death in patients with nonalcoholic fatty liver disease, is predicted to become the most common indication for liver transplantation.
    Objectives: To illustrate how to identify patients with nonalcoholic fatty liver disease at greatest risk of nonalcoholic steatohepatitis and cirrhosis; to discuss the role and limitations of current diagnostics and liver biopsy to diagnose nonalcoholic steatohepatitis; and to provide an outline for the management of patients across the spectrum of nonalcoholic fatty liver disease.
    Evidence review: PubMed was queried for published articles through February 28, 2015, using the search terms NAFLD and cirrhosis, mortality, biomarkers, and treatment. A total of 88 references were selected, including 16 randomized clinical trials, 44 cohort or case-control studies, 6 population-based studies, and 7 meta-analyses.
    Findings: Sixty-six percent of patients older than 50 years with diabetes or obesity are thought to have nonalcoholic steatohepatitis with advanced fibrosis. Even though the ability to identify the nonalcoholic steatohepatitis subtype within those with nonalcoholic fatty liver disease still requires liver biopsy, biomarkers to detect advanced fibrosis are increasingly reliable. Lifestyle modification is the foundation of treatment for patients with nonalcoholic steatosis. Available treatments with proven benefit include vitamin E, pioglitazone, and obeticholic acid; however, the effect size is modest (<50%) and none is approved by the US Food and Drug Administration. The association between nonalcoholic steatohepatitis and cardiovascular disease is clear, though causality remains to be proven in well-controlled prospective studies. The incidence of nonalcoholic fatty liver disease-related hepatocellular carcinoma is increasing and up to 50% of cases may occur in the absence of cirrhosis.
    Conclusions and relevance: Between 75 million and 100 million individuals in the United States are estimated to have nonalcoholic fatty liver disease and its potential morbidity extends beyond the liver. It is important that primary care physicians, endocrinologists, and other specialists be aware of the scope and long-term effects of the disease. Early identification of patients with nonalcoholic steatohepatitis may help improve patient outcomes through treatment intervention, including transplantation for those with decompensated cirrhosis.
    MeSH term(s) Alanine Transaminase/blood ; Biomarkers/blood ; Biopsy ; Diabetes Complications ; Diet Therapy ; Exercise ; Fatty Liver/diagnosis ; Humans ; Liver/pathology ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/therapy ; Obesity/complications ; Risk Factors ; Thiazolidinediones/therapeutic use ; Vitamin E/therapeutic use
    Chemical Substances Biomarkers ; Thiazolidinediones ; Vitamin E (1406-18-4) ; Alanine Transaminase (EC 2.6.1.2) ; pioglitazone (X4OV71U42S)
    Language English
    Publishing date 2015-06-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2015.5370
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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.88: Show issues Location:
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  7. Article ; Online: Review article: the management of hepatocellular carcinoma.

    Cabrera, R / Nelson, D R

    Alimentary pharmacology & therapeutics

    2010  Volume 31, Issue 4, Page(s) 461–476

    Abstract: ... attributed to chronic hepatitis C and non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and ... diagnosis and management strategies involved in hepatocellular carcinoma.: Methods: A literature search ... of cirrhosis in the patients complicates their management and monitoring for cirrhosis-related complications is ...

    Abstract Background: Hepatocellular carcinoma is the leading cause of death in cirrhosis. A majority of patients present at an advanced stage with poor prognosis.
    Aim: To review the current screening, diagnosis and management strategies involved in hepatocellular carcinoma.
    Methods: A literature search was performed using PubMed for publications with a predetermined search string to identify relevant studies.
    Results: Hepatocellular carcinoma is dramatically increasing in incidence that is mostly attributed to chronic hepatitis C and non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and its clinical phenotype diabetes and obesity. Cirrhosis is the major predisposing risk factor and its presence necessitates close surveillance for hepatocellular carcinoma with serial imaging studies. Hepatocellular carcinoma can be diagnosed by its unique radiological behaviour of arterial enhancement and washout on delayed images. The Barcelona Clinic Liver Cancer staging classification system is a clinically useful algorithm for the management of patients with hepatocellular carcinoma. The simultaneous presence of cirrhosis in the patients complicates their management and monitoring for cirrhosis-related complications is important.
    Conclusions: Early diagnosis and definitive treatment remains the key to long-term outcome. A multidisciplinary approach is critical to the successful management of hepatocellular carcinoma. Studies combining sorafenib with locoregional or other targeted molecular therapies are likely to improve responses and outcome.
    MeSH term(s) Ablation Techniques ; Adult ; African Continental Ancestry Group ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/economics ; Antineoplastic Agents/pharmacology ; Antineoplastic Agents/therapeutic use ; Asian Continental Ancestry Group ; Benzenesulfonates/adverse effects ; Benzenesulfonates/pharmacology ; Benzenesulfonates/therapeutic use ; Biopsy ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic ; Contrast Media ; Drug Eruptions/prevention & control ; Female ; Health Care Costs ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/epidemiology ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/epidemiology ; Humans ; Incidence ; Liver Cirrhosis/complications ; Liver Cirrhosis/mortality ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology ; Liver Neoplasms/therapy ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Staging/methods ; Neovascularization, Pathologic/drug therapy ; Niacinamide/analogs & derivatives ; Phenylurea Compounds ; Population Surveillance ; Practice Guidelines as Topic ; Pyridines/adverse effects ; Pyridines/pharmacology ; Pyridines/therapeutic use ; Quality of Life ; Randomized Controlled Trials as Topic ; Recurrence ; Risk Factors ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome ; United States/epidemiology ; Young Adult
    Chemical Substances Antineoplastic Agents ; Benzenesulfonates ; Contrast Media ; Phenylurea Compounds ; Pyridines ; Niacinamide (25X51I8RD4) ; sorafenib (9ZOQ3TZI87)
    Language English
    Publishing date 2010-02-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/j.1365-2036.2009.04200.x
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    Zs.A 2206: Show issues Location:
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  8. Article ; Online: Management of nonalcoholic fatty liver disease: an evidence-based clinical practice review.

    Arab, Juan P / Candia, Roberto / Zapata, Rodrigo / Muñoz, Cristián / Arancibia, Juan P / Poniachik, Jaime / Soza, Alejandro / Fuster, Francisco / Brahm, Javier / Sanhueza, Edgar / Contreras, Jorge / Cuellar, M Carolina / Arrese, Marco / Riquelme, Arnoldo

    World journal of gastroenterology

    2014  Volume 20, Issue 34, Page(s) 12182–12201

    Abstract: ... with nonalcoholic fatty liver disease (NAFLD) in clinical practice.: Methods: NAFLD has now reached epidemic ... efficacy of these therapies have not yet been established.: Conclusion: Current NAFLD management is ... of liver disease, diabetes and cardiovascular events. ...

    Abstract Aim: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.
    Methods: NAFLD has now reached epidemic proportions worldwide. The optimal treatment for NAFLD has not been established due to a lack of evidence-based recommendations. An expert panel of members of the Chilean Gastroenterological Society and the Chilean Hepatology Association conducted a structured analysis of the current literature on NAFLD therapy. The quality of the evidence and the level of recommendations supporting each statement were assessed according to the recommendations of the United States Preventive Services Task Force. A modified three-round Delphi technique was used to reach a consensus among the experts.
    Results: A group of thirteen experts was established. The survey included 17 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 93.8% in the first round and 100% in the second and third rounds. The final recommendations support the indication of lifestyle changes, including diet and exercise, for all patients with NAFLD. Proven pharmacological therapies include only vitamin E and pioglitazone, which can be used in nondiabetic patients with biopsy-proven nonalcoholic steatohepatitis (the progressive form of NAFLD), although the long-term safety and efficacy of these therapies have not yet been established.
    Conclusion: Current NAFLD management is rapidly evolving, and new pathophysiology-based therapies are expected to be introduced in the near future. All NAFLD patients should be evaluated using a three-focused approach that considers the risks of liver disease, diabetes and cardiovascular events.
    MeSH term(s) Biopsy ; Chile/epidemiology ; Consensus ; Delphi Technique ; Evidence-Based Medicine ; Health Care Surveys ; Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/therapy ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires ; Treatment Outcome
    Language English
    Publishing date 2014-08-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v20.i34.12182
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    Zs.A 6039: Show issues Location:
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  9. Article ; Online: Review article: the management of paediatric nonalcoholic fatty liver disease.

    Mitchel, E B / Lavine, J E

    Alimentary pharmacology & therapeutics

    2014  Volume 40, Issue 10, Page(s) 1155–1170

    Abstract: ... restrict their use.: Aim: To review the current management of paediatric NAFLD, including lifestyle and ... Background: Paediatric nonalcoholic fatty liver disease (NAFLD) is a major public health concern ... given the recent increase in its prevalence and link to obesity and other metabolic comorbidities. Current ...

    Abstract Background: Paediatric nonalcoholic fatty liver disease (NAFLD) is a major public health concern given the recent increase in its prevalence and link to obesity and other metabolic comorbidities. Current treatment strategies involve lifestyle changes. Other surgical and pharmacologic interventions have been proposed; however, limited randomised controlled trials (RCTs) in the paediatric population restrict their use.
    Aim: To review the current management of paediatric NAFLD, including lifestyle and pharmacologic interventions, and to formulate recommendations for study design for future studies.
    Methods: A MEDLINE, Pubmed and Cochrane Review database search used a combination of keywords, including NAFLD, nonalcoholic steatohepatitis (NASH), paediatric, treatments, lifestyle changes, bariatric surgery, orlistat, metformin, thiazolidinediones, vitamin E, cysteamine bitartrate, ursodeoxycholic acid (UDCA), probiotics, omega-3 fatty acids, pentoxyfylline, farnesoid X receptor agonist and toll-like receptor modifiers. The articles were selected based on their relevance to the review.
    Results: Lifestyle interventions involving diet and exercise remain first-line treatment for paediatric NAFLD. Bariatric surgery, orlistat, insulin sensitisers and UDCA have been evaluated but are not recommended as first or second-line therapy. Medications such as cysteamine bitartrate, probiotics, polyunsaturated fats and pentoxyfilline share beneficial effects in trials, however, there is a paucity of adequately powered RCTs in which liver histology is evaluated. Vitamin E has been shown to be effective and safe in improving NASH histology in children.
    Conclusions: Lifestyle intervention should be first-line treatment for paediatric NAFLD. Vitamin E should be considered for those with biopsy-proven NASH or borderline NASH failing first-line therapy. Other therapeutics show promising results but require larger RCTs with convincing endpoints. Improved screening techniques, objective validated inclusion criteria and outcome measures as well as rigour in study design are necessary for propelling therapeutic discovery.
    MeSH term(s) Child ; Diet ; Humans ; Life Style ; Motor Activity ; Non-alcoholic Fatty Liver Disease/therapy ; Vitamin E/therapeutic use ; Weight Loss
    Chemical Substances Vitamin E (1406-18-4)
    Language English
    Publishing date 2014-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.12972
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Systematic review with meta-analysis: non-alcoholic steatohepatitis - a case for personalised treatment based on pathogenic targets.

    Younossi, Z M / Reyes, M J / Mishra, A / Mehta, R / Henry, L

    Alimentary pharmacology & therapeutics

    2014  Volume 39, Issue 1, Page(s) 3–14

    Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is an umbrella term, which encompasses ... a combination of keywords, which included non-alcoholic fatty liver disease, non-alcoholic hepatic steatosis ... simple steatosis and non-alcoholic steatohepatitis (NASH). The entire spectrum of NAFLD has been ...

    Abstract Background: Non-alcoholic fatty liver disease (NAFLD) is an umbrella term, which encompasses simple steatosis and non-alcoholic steatohepatitis (NASH). The entire spectrum of NAFLD has been associated with metabolic syndrome. NASH is associated with increased mortality compared with that of the general population. Many therapeutic options for NASH have been studied. However, there is very little evidence supporting the efficacy of most regimens for the treatment of NASH.
    Aim: To provide a review focusing on the current therapeutic options available for patients with NASH as well as to briefly introduce possible future interventions.
    Methods: A MEDLINE, Pubmed and Cochrane Review database search using a combination of keywords, which included non-alcoholic fatty liver disease, non-alcoholic hepatic steatosis, NAFLD, NASH, treatment, therapeutics, vitamin E, orlistat and bariatric surgery. An overall summary of the articles was developed for each section of discussion in this review.
    Results: NASH associated with metabolic syndrome can progress advanced fibrosis and cirrhosis. Weight loss and lifestyle modification have been shown to improve NASH. Other medications used for weight loss and metabolic syndrome have been evaluated, such as orlistat, metformin and thiazolidinediones. Alternative regimens using ursodeoxycholic acid, statins and probiotics as well as bariatric surgery have been evaluated, but have not been recommended as first-line treatment for NASH. Vitamin E for NASH patients without diabetes seems to be promising. The lack of effective treatment for NASH suggests the heterogeneity of patients presenting with the NASH phenotype. The best treatment strategy for these patients may be to identify their pathogenic target and develop personalised treatment protocols.
    Conclusions: Currently, there are few options available for the management of NASH. Future targeted treatment strategies based on the pathogenic pathways may be needed to develop effective treatment for patients with NASH.
    MeSH term(s) Bariatric Surgery ; Fatty Liver/therapy ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Lactones/therapeutic use ; Metabolic Syndrome/therapy ; Metformin/therapeutic use ; Non-alcoholic Fatty Liver Disease ; Precision Medicine ; Thiazolidinediones/therapeutic use ; Ursodeoxycholic Acid/therapeutic use ; Vitamin E/therapeutic use ; Weight Loss
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lactones ; Thiazolidinediones ; Vitamin E (1406-18-4) ; Ursodeoxycholic Acid (724L30Y2QR) ; Metformin (9100L32L2N) ; orlistat (95M8R751W8)
    Language English
    Publishing date 2014-01
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.12543
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2206: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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