Validation of gender-equity model for liver allocation (GEMA) and its sodium variant (GEMA-Na) in candidates for liver transplantation.

Background: The current allocation system for liver transplantation (LT) is based on the sickest-first policy, using objective variables to ensure equal priority. However, under-prioritization of female patients for LT, compared to males, is well demonstrated and new scores have been proposed to overcome this systematic bias. This study evaluated the ability of these new scores to predict the long-term outcomes of patients with cirrhosis.

The evolution in the prioritization for liver transplantation.

Policies for organ allocation can be based on medical urgency, utility or transplant benefit. With an urgency policy, patients with worse outcomes on the waiting list are given higher priority for transplantation [based on the Child-Turcotte-Pugh score or the Model for End-stage Liver Disease (MELD) score, or United Kingdom model for End-stage Liver Disease (UKELD) score]. The MELD and UKELD scores have statistical validation and use objective and widely available laboratory tests.

Prioritization for liver transplantation.

There are three possible policies for prioritization for liver transplantation: medical urgency, utility and transplant benefit. The first is based on the severity of cirrhosis, using Child-Turcotte-Pugh score and, more recently, the Model for End-stage Liver Disease (MELD) score, or variants of MELD, for allocation. Although prospectively developed and validated, the MELD score has several limitations, including interlaboratory variations for measurement of serum creatinine and international normalized ratio of prothrombin time, and a systematic adverse female gender bias.

Pneumobilia, chronic diarrhea, vitamin K malabsorption: a pathognomonic triad for cholecystocolonic fistulas.

Cholecystocolonic fistula (CF) is an uncommon type of internal biliary-enteric fistulas, which comprise rare complications of cholelithiasis and acute cholecystitis, with a prevalence of about 2% of all biliary tree diseases. We report a case of a spontaneous CF in a 75-year-old diabetic male admitted to hospital for the investigation of chronic watery diarrhea and weight loss. Massive pneumobilia demonstrated on abdominal ultrasound and computerized tomography, along with chronic, bile acid-induced diarrhea and a prolonged prothrombin time due to vitamin K malabsorption, led to the clinical suspicion of the fistula.

Low serum adiponectin levels are predictive of advanced hepatic fibrosis in patients with NAFLD.

Background: Adiponectin, an adipocytokine-mediating insulin action, has recently been found to be involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to assess possible associations between serum adiponectin levels and factors of the metabolic syndrome or histologic parameters in biopsy-proven NAFLD.

Methods: Patients with persistently abnormal liver function tests satisfying inclusion criteria were subjected to liver biopsy.

Herb-induced hepatitis by Teucrium polium L.: report of two cases and review of the literature.

Herbal medicinal products are being increasingly used throughout the world. Herbal 'remedies' are, however, not risk free and many cases of hepatotoxicity have been reported. Teucrium polium grows mostly in the Mediterranean basin and is popular, because of hypoglycemic and hypolipidemic properties.

Can maturation arrest occur at the stage of spermiogenesis?

This article attempts to clarify the pathological condition during which the maturation of the germinal epithelium is unable to evolve beyond a certain stage and is characterized as maturation arrest. Emphasis is given to the histological entity named spermiogenic arrest.

Ilio-psoas abscess in a neonate.

A full-term, small-for-gestational-age, neonate was born 4 days after rupture of the membranes. On the 5th day of life, she developed sepsis due to Klebsiella pneumoniae. On the 18th day of life, the right hip was noted swollen with limited range of motion, but it was painless on passive movements.

Fetal varicella syndrome with manifestations limited to the eye.

The manifestations of fetal varicella syndrome usually involve several organ systems, including skin, ocular, neurologic, gastrointestinal, and genitourinary. Although ocular anomalies have been reported to be as high as 68%, manifestations limited to the eyes is extremely rare. Herein we report the case of fetal varicella syndrome with no clinical signs other than esotropia and a chorioretinal scar.