Alcoholic Hepatitis: Risk Factors, Pathogenesis, and Approach to Treatment.

Background: Alcoholic hepatitis (AH) is an inflammatory disorder of the liver characterized clinically by jaundice, hepatomegaly, and abdominal pain, and histologically by macrovesicular steatosis and necroinflammation.

Methods: This clinical review will cover what is known about the pathogenesis, clinical presentation, current treatments, and novel therapies for AH.

Results: The pathogenesis and treatment of AH remain areas of active research.

Lactulose vs polyethylene glycol 3350--electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial.

Importance: Hepatic encephalopathy (HE) is a common cause of hospitalization in patients with cirrhosis. Pharmacologic treatment for acute (overt) HE has remained the same for decades.

Objective: To compare polyethylene glycol 3350-electrolyte solution (PEG) and lactulose treatments in patients with cirrhosis admitted to the hospital for HE.

Elevated ammonia concentrations: potential for pre-analytical and analytical contributing factors.

Background: No study has explored the separate contributions of pre-analytical and analytical factors to hyperammonemia.

Methods: Laboratory information systems were queried for tests of ammonia concentrations over a 12 month period. Pre-analytic (collection to laboratory receipt) and analytic (laboratory receipt to result) elapsed times were determined.

Establishing, harmonizing and analyzing critical values in a large academic health center.

Background: No report on establishing critical values (CVs) lists has described a process for harmonizing different lists in a large academic health center or validation on follow-up after 5 years.

Methods: A definition of a critical value was adopted. CVs in use and reporting times for chemistry, hematology and coagulation (CH&C) tests during a 1-week period at one hospital were analyzed prior to the revision and again 5 years later.

Predicting short-term mortality and long-term survival for hospitalized US patients with alcoholic hepatitis.

Background: No study has evaluated current scoring systems for their accuracy in predicting short and long-term outcome of alcoholic hepatitis in a US population.

Methods: We reviewed electronic records for patients with alcoholic liver disease (ALD) admitted to Parkland Memorial Hospital between January 2002 and August 2005. Data and outcomes for 148 of 1,761 admissions meeting pre-defined criteria were collected.

Long-term benefit of hepatitis C therapy in a safety net hospital system: a cross-sectional study with median 5-year follow-up.

Objectives: To demonstrate the survival benefit from sustained virological response (SVR) in a safety net hospital population with limited resources for hepatitis C virus (HCV) therapy.

Design And Setting: We conducted a retrospective study at an urban safety net hospital in the USA.

Participants And Intervention: 242 patients receiving standard HCV therapy between 2001 and 2006.

An automated model using electronic medical record data identifies patients with cirrhosis at high risk for readmission.

Background & Aims: Patients with cirrhosis have 1-month rates of readmission as high as 35%. Early identification of high-risk patients could permit interventions to reduce readmission. The aim of our study was to construct an automated 30-day readmission risk model for cirrhotic patients using electronic medical record (EMR) data available early during hospitalization.

Hemorrhagic ascites. Clinical presentation and outcomes in patients with cirrhosis.

Background & Aims: Hemorrhagic ascites can pose diagnostic and therapeutic dilemmas in patients with cirrhosis. We aimed at exploring the characteristics and outcomes of patients with cirrhosis and hemorrhagic ascites.

Methods: The records of all patients with cirrhosis and ascites, who underwent paracentesis between 2003 and 2010 at Parkland Memorial Hospital, were retrospectively reviewed.

Continuous furosemide infusion in the management of ascites.

Background: The current therapy for patients hospitalized with ascites requires titration of oral diuretics and often needs several days. A faster method for predicting the response to a given dose of diuretic may allow this process to be completed more rapidly.

Aim: The objective of this study was to describe the short-term safety and efficacy of a diuretic infusion to predict net sodium excretion in patients with cirrhosis, ascites, and edema using a fractional excretion of sodium (FENa) of 1% or greater as the target.

Predictors of liver transplant eligibility for patients with hepatocellular carcinoma in a safety net hospital.

Background: Liver transplantation for patients with hepatocellular carcinoma (HCC) affords excellent long-term survival but is limited to patients with early stage tumors. Predictors for orthotopic liver transplantation eligibility are not well defined for patients in a safety-net hospital system.

Aims: To clarify the clinical presentation of HCC and define predictors for early stage disease in a racially diverse safety-net hospital system.

Acute kidney injury and chronic kidney disease in hospitalized patients with cirrhosis.

Background: Renal dysfunction is a common and potentially life-threatening complication in hospitalized patients with cirrhosis.

Aims: To determine the prevalence, cause, and outcome of patients with cirrhosis and acute kidney injury (AKI) and/or chronic kidney disease (CKD).

Methods: This retrospective analysis examined hospital records of 152 consecutive patients with cirrhosis and creatinine levels of 1.