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)”
Chronic neutrophilic leukemia (CNL) is a rare, often aggressive myeloproliferative neoplasm (MPN) defined by persistent mature neutrophilic leukocytosis, bone marrow granulocyte hyperplasia, and frequent hepatosplenomegaly. The seminal discovery of oncogenic driver mutations in colony-stimulating factor 3 receptor (CSF3R) in the majority of patients with CNL in 2013 anchored a new scientific framework, deepening our understanding of its molecular pathogenesis, providing a diagnostic biomarker, and rationalizing the use of pharmacological targeting. Continue reading “Diagnostic Criteria for Chronic Neutrophilic Leukemia (CNL)”
The chronic myeloid leukemia (CML) is classically staged into chronic phase (CP, most patients at presentation), accelerated phase (AP) and blast phase (BP). Many definitions have been used for these stages, but all the data generated from the tyrosine kinase inhibitor (TKI) studies has used the historically standard definition where AP is defined by the presence of one or more of the following: ≥15% blasts in PB/BM, ≥20% basophils in PB, platelets <100,000/µL unrelated to treatment or the development of cytogenetic evolution. Blast phase is defined by the presence of ≥30% blasts in the peripheral blood or bone marrow, the presence of clusters of blasts in marrow or the presence of extramedullary disease with immature cells (i.e., a myeloid sarcoma). Continue reading “Accelerated Phase Criteria for Chronic Myeloid Leukemia (CML)”
International practice guidelines for the care of patients with valvular heart disease were most recently updated in 2017, before the publication of the results of the COAPT and MITRA-FR trials in 2018, and these guidelines were conservative in their recommendations regarding surgery for secondary mitral regurgitation. Continue reading “Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation”
The ICHD-3 provides diagnostic criteria for the three main categories of migraine: migraine without aura, migraine with aura, and chronic migraine. Continue reading “Diagnostic Criteria for Migraine (ICHD-3)”
Chronic rhinosinusitis is defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 consecutive weeks, in addition to objective evidence. Objective evidence of chronic rhinosinusitis may be obtained on physical examination (anterior rhinoscopy, endoscopy) or radiography, preferably from sinus computed tomography. Continue reading “Diagnostic Criteria for Chronic Rhinosinusitis (CRS)”
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease characterized by chronic, profound, disabling, and unexplained fatigue. Continue reading “Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)”
Nasal polyps are benign inflammatory masses, arising from the mucosa of the nose and paranasal sinuses. They are considered to be a subgroup of chronic rhinosinusitis, and clinical diagnosis is made on the basis of the presence of sinonasal symptoms for more than 3 months and the visualization of polyps in the nasal cavity. Continue reading “Diagnostic Criteria for Chronic Rhinosinusitis with Nasal Polyps”
Long-term responses that develop over a period of time (usually a minimum of 6 weeks) when training is repeated regularly are referred to as chronic adaptations to training. The combined effect of all chronic adaptations is known as the training effect.
Chronic adaptations to training may occur in the cardiovascular, respiratory and muscular systems. The result of these physiological adaptations is an improvement in performance. Continue reading “Chronic Adaptations to Physical Training (PT)”
Grading and staging refers to a semiquantitative assessment of the necroinflammatory activity (grade) and degree of fibrosis (stage) in relation to chronic hepatitis.
Continue reading “Histologic Scoring Systems for Chronic Liver Disease”