Publications by authors named "David S Kotlyar"
While the etiological underpinnings of inflammatory bowel disease (IBD) are highly complex, it has been noted that both clinical and pathophysiological similarities exist between IBD and both asthma and non-pulmonary allergic phenomena. In this review, several key points on common biomarkers, pathophysiology, clinical manifestations and nutritional and probiotic interventions for both IBD and non-pulmonary allergic diseases are discussed. Histamine and mast cell activity show common behaviors in both IBD and in certain allergic disorders.
View Article and Find Full Text PDFBackground & Aims: Thiopurine therapy for inflammatory bowel disease (IBD) has been associated with increased risk for lymphoma. We estimated the relative risk of lymphoma in patients with IBD exposed to thiopurines and compared relative risk values derived from population-based studies with those from referral center-based studies. We investigated whether active use increased risk compared with past use, and whether sex, age, or duration of use affects risk of lymphoma.
View Article and Find Full Text PDFBackground & Aims: Hepatosplenic T-cell lymphoma (HSTCL) is a rare and usually fatal lymphoma that primarily affects men younger than 35 years old. Treatment of patients with inflammatory bowel disease (IBD) using antibodies to tumor necrosis factor (anti-TNFs) and thiopurines has been associated with HSTCL. We investigated the medications, duration of therapy, and ages of patients associated with HSTCL.
View Article and Find Full Text PDFHepatocellular carcinoma (HCC) is the most common primary liver malignancy and represents an international public health concern as one of the most deadly cancers worldwide. The main etiology of HCC is chronic infection with hepatitis B and hepatitis C viruses. However, there are other important factors that contribute to the international burden of HCC.
View Article and Find Full Text PDFNoninvasive approaches in the diagnosis and monitoring of fibrosis are still evolving. Transient elastography is an inexpensive, rapid, and relatively accurate form of noninvasive monitoring, especially in severe fibrosis It is a nascent technology, however, and there is no clear indication that elastography is better than biopsy for less severe fibrosis. With improved resolution and longer term data, it may become a vital supplement.
View Article and Find Full Text PDFArticle Synopsis
- Many candidates with end-stage alcoholic liver disease (ESALD) in the U.S. are not being referred for liver transplantation due to unclear guidelines on alcohol abstinence and psychosocial criteria.
- There is a perception among the public and non-transplant physicians that patients with a history of alcohol abuse are poor candidates, while transplant specialists see selected ESALD patients as viable.
- A 3-month period of alcohol abstinence may be more beneficial for listing patients for transplantation compared to the commonly recommended 6 months, with social support and mental health factors playing a key role in consideration.
Article Synopsis
- Long-term survival rates for liver transplants are improving, but disease recurrence, especially hepatitis C, remains a significant challenge.
- Hepatitis C leads to higher rates of graft failure and mortality compared to other reasons for transplantation, while hepatitis B recurrence has decreased due to better preventative measures.
- Other conditions like autoimmune liver disease and alcoholic liver disease have varied post-transplant outcomes, emphasizing the need for careful management to address complications from disease recurrence.
Article Synopsis
- In patients with renal insufficiency, deciding between combined kidney/liver transplantation (CKLT) and liver transplantation alone (OLTa) can be challenging.
- Duration of pre-transplant renal dysfunction is linked to post-transplant creatinine levels, with a cutoff of 3.6 weeks predicting increased renal insufficiency at 12 months after OLT.
- CKLT patients experience longer periods of renal dysfunction and higher pre-transplant creatinine levels compared to OLTa, but overall, CKLT patients have comparable or better renal outcomes by 6 and 12 months post-transplant when adjusted for baseline characteristics.