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Screening for Advanced Hepatic Fibrosis Related to NAFLD/NASH

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.

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Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)

Sclerosing cholangitis (SC) is defined as a condition with progressive stenosis and destruction of the bile ducts due to diffuse inflammation and fibrosis and currently includes three categories: primary sclerosing cholangitis (PSC), secondary cholangitis, and IgG4-related sclerosing cholangitis (IgG4-SC). SC categories share similar clinical features, such as cholestasis. Patients with SC present with cholestatic symptoms, including jaundice and pruritus, and blood tests reveal elevation of cholestatic enzymes. Continue reading “Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)”

Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)

IgG4-related disease is characterized by a high level of serum IgG4 and dense infiltration of IgG4-positive plasma cells into multiple organs, with the kidney being one representative target. Although several sets of diagnostic criteria for autoimmune pancreatitis (AIP) are available and renal lesion is recognized as an extrapancreatic manifestation of AIP, it is difficult to differentiate IgG4-related tubulointerstitial nephritis (TIN) without
AIP from other types of TIN. Continue reading “Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)”

Classification Criteria for IgG4-Related Disease

Immunoglobulin G4-related disease is an immune mediated condition resulting in disease in various organs of the body such as the pancreas, kidneys, salivary glands, lung, liver, lymph nodes, biliary tract and orbits of the eyes. The disease is recognized by a characteristic pattern of pathological, serological or clinical features shared amongst the organs system that are involved. In some cases, IgG4-RD can mimic malignant, infectious or inflammatory disorders and therefore distinguishing the disease is crucial. Continue reading “Classification Criteria for IgG4-Related Disease”

Classification of Ulcer-Related Upper Gastrointestinal Bleeding

The Forrest classification is a widely used classification of ulcer-related upper gastrointestinal bleeding. It was initially developed to unify the description of ulcer bleeding for better communication amongst endoscopists. However, the Forrest Classification is now used as a tool to identify patients who are at an increased risk for bleeding, rebleeding and mortality. Continue reading “Classification of Ulcer-Related Upper Gastrointestinal Bleeding”

Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders

A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:

Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.

Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.

Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following:

Continue reading “Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders”

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