Hepatic fibrosis is the most important determinant of liver and non-liver outcomes in patients with nonalcoholic fatty liver disease (NAFLD). Therefore, identifying patients with clinically significant hepatic fibrosis (fibrosis stage 2 or higher) is important for targeted efforts at preventing disease progression.
Nonalcoholic steatohepatitis (NASH), a subtype of NAFLD characterized by inflammation, ballooning, and Mallory’s hyaline on liver biopsy, can lead to hepatic fibrosis, cirrhosis, and hepatocellular cancer (HCC). Both NAFLD and NASH are also associated with an increased risk of cardiovascular disease, cardiovascular and liver-related mortality, and impaired health-related quality of life.
Continue reading “Screening for Advanced Hepatic Fibrosis Related to NAFLD/NASH”
Portal hypertension is the haemodynamic abnormality associated with the most severe complications of cirrhosis, including ascites, hepatic encephalopathy and bleeding from gastroesophageal varices. Variceal bleeding is a medical emergency associated with a mortality that, in spite of recent progress, is still in the order of 10–20% at 6 weeks. The evaluation of diagnostic tools and the design and conduct of good clinical trials for the treatment of portal hypertension have always been difficult. Continue reading “Baveno VI Criteria for Compensated Advanced Chronic Liver Disease (cACLD)”
Paraneoplastic pemphigus (PNP) is a rare and life-threatening autoimmune bullous disease that classically occurs in the setting of an underlying neoplasm. PNP is also known as paraneoplastic autoimmune multiorgan syndrome (PAMS) because of its varied mucocutaneous and systemic deleterious effects. Due to the variable disease characteristics and lack of formally accepted diagnostic criteria, PNP remains a diagnostic challenge for clinicians. Continue reading “Revised Diagnostic Criteria for Paraneoplastic Pemphigus (PNP)”
The clinician must investigate and corroborate key features of the history that help to better characterize seizures while distinguishing epileptic seizures from nonepileptic events. The most common nonepileptic paroxysmal events during childhood and adolescence are syncope, psychogenic nonepileptic events (PNES), pallid and cyanotic breath holding spells, reflux/Sandifer syndrome, self-gratification disorders, and paroxysmal nonepileptic motor disorders of sleep among others. Continue reading “Clinical Aspects of the Diagnosis of Epileptic Seizures”
Osteosarcopenic obesity (OSO) syndrome describes the simultaneous deterioration of bone, muscle and excess fat, resulting in reduced functionality and systemic metabolic dysregulation. The key component contributing to this may be ectopic fat in the viscera, bone and muscle. Continue reading “Revised Physical Diagnostic Criteria for Osteosarcopenic Obesity (OSO)”
Serrated polyposis syndrome (SPS) (previously hyperplastic polyposis) is defined by number and size of serrated polyps in the colon and rectum, but the definition is purely arbitrary and there is no known genotype.
SPS is associated with a high risk of colorectal cancer, not only in the affected patient, but also family members. The carcinogenesis can be rapid, with several series describing interval cancers occurring quickly. Continue reading “WHO Criteria for Diagnosis of Serrated Polyposis Syndrome (SPS)”
The antiphospholipid syndrome (APS) is characterized by thrombotic and/or pregnancy morbidity associated with the presence of persistent antiphospholipid antibodies (aPLs). There are many other clinical manifestations associated with persistent aPL (including immune thrombocytopenia, livedo reticularis, migraine, valvular heart disease and cognitive dysfunction). Continue reading “Sydney Classification Criteria for Definite Antiphospholipid Syndrome (APS)”
Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. Continue reading “Rome IV Diagnostic Criteria for Belching Disorders”
Nausea is a subjective symptom and can be defined as an unpleasant sensation of the imminent need to vomit, typically experienced in the epigastrium or throat. Vomiting refers to the forceful oral expulsion of gastrointestinal contents associated with contraction of the abdominal and chest wall muscles. Continue reading “Rome IV Diagnostic Criteria for Nausea and Vomiting Disorders”
The Awaji recommendations for the use of electrodiagnostic studies in the diagnosis of amyotrophic lateral sclerosis (ALS) were proposed to enable earlier diagnosis of ALS to be achieved to meet an acknowledged need to obviate diagnostic delay. Continue reading “Awaji Criteria for Amyotrophic Lateral Sclerosis (ALS)”