Centro Medico Lachesi

Mese: Ottobre 2019

  • Hepatobiliary tumours

    Hepatobiliary tumours

    Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two major types of primary liver tumour. Both are increasing in incidence in the UK, in the case of HCC because of the increasing prevalence of chronic liver disease, particularly caused by alcohol and non-alcoholic fatty liver disease. They have a poor overall prognosis because of late presentation and the presence of underlying liver cirrhosis in patients with HCC.

    Patients usually present with a liver mass or jaundice. Assessment is primarily radiological by means of computed tomography and/or magnetic resonance imaging. Surgery remains the major curative option for both tumour types; liver transplantation and, rarely, resection are performed for HCC, and surgical resection for cholangiocarcinoma. However, only approximately 20% of these cancers present at a stage when surgery is possible.

    For non-surgical candidates with HCC, there are three potential treatment options: ablation, trans-arterial chemo-embolization and sorafenib or lenvatinib. Chemotherapy for cholangiocarcinoma is limited to gemcitabine-based systemic chemotherapy. Screening for HCC is a strategy that could potentially enhance early diagnosis.

    Keywords

    BCLC stagingcholangiocarcinomagallbladder carcinomagemcitabinehepatocellular carcinomaMRCPsorafenib

  • Cleaner Teeth, Healthier Heart?

    Cleaner Teeth, Healthier Heart?

    MONDAY, Dec. 2, 2019 (HealthDay News) — Brushing your teeth may be good for your heart, a new study suggests.It included more than 161,000 South Korean adults, ages 40 to 79, with no history of heart failure or the heart rhythm disorder atrial fibrillation.

    Between 2003 and 2004, participants had a routine medical exam and were asked about a wide range of lifestyle habits, including how often they brushed their teeth. During a median follow-up of 10.5 years, 3% developed a-fib and 4.9%, developed heart failure. (Median means half were followed for less time, half for more.)

    Those who brushed their teeth three or more times a day had a 10% lower risk of afib and a 12% lower risk of heart failure during the follow-up. The reduced risk was independent of age, sex, wealth, exercise, alcohol use, body fat and conditions such as high blood pressure, according to the study published Dec. 2 in the European Journal of Preventive Cardiology.

    Researchers didn’t investigate how regular brushing might reduce heart disease risk. But previous studies have suggested that poor oral hygiene results in bacteria in the blood, causing inflammation that increases odds of heart disease.

    The study was conducted in one country and was observational, so it does not prove a direct link between regular brushing and reduced heart risk, said senior author Dr. Tae-Jin Song, of the Department of Neurology at Ewha Womans University in Seoul.

  • Tropical liver disease

    Tropical liver disease

    The liver is frequently involved in infections that are prevalent in different regions of the tropics, and chronic liver disease, sometimes with multiple aetiological explanations, is an important cause of early morbidity and mortality. This article describes some hepatic and biliary problems that are seen in the tropics or can be imported from resource-poor settings.

    The epidemiology of hepatitis A is changing in some areas, and hepatitis E is now recognized in an increasing range of tropical and non-tropical settings. Vaccines have been developed against hepatitis E. Hepatitis B and C continue to cause chronic liver disease, cirrhosis and hepatocellular carcinoma, but these can be eclipsed in epidemiological importance by the sequelae of the emerging epidemic of non-alcoholic fatty liver disease in many parts of the tropics.

    The pathophysiology of acute and chronic liver disease caused by aflatoxins is better understood, as is the relationship of veno-occlusive disease of the liver to pyrrolizidine alkaloids. Self-poisoning with hepatotoxins is common in many countries. The diagnosis and management of cystic hydatid disease of the liver has been rationalized, based on a systematic approach to the classification of imaging findings.

    Keywords

    Aflatoxinsbiliary parasiteshepatitishepatobiliary tumoursjaundiceMRCPtropical liver disease

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