Kenneth D. Flora

TIPS for Budd-Chiari Syndrome

Budd-Chiari syndrome (BCS) is a rare disorder that results in portal hypertension due to obstruction of hepatic-vein outflow; most patients present

Does HCV Ever Really Go Away

Long-term follow-up of patients who have cleared hepatitis C virus (HCV), either spontaneously or after successful therapy with interferon and

Liver Biopsy for Which Patients with Subclinical Elevated Transaminases

About 2.8% of the U.S. population has elevated serum alanine aminotransferase (ALT) levels. Although 90% of these cases are discovered from routine testing in the absence of symptoms, many such patients have underlying chronic liver disease. An increasing percentage of patients whose routine exams detect unsuspected elevated ALT levels have nonalcoholic steatohepatitis (NASH), which currently can be diagnosed only by liver biopsy. Given the expense and morbidity associated with …

Prophylactic Antibiotics Prevent Rebleeding from Varices

Without endoscopic therapy, one third of patients with cirrhosis and gastroesophageal variceal bleeding (GEVB) die at presentation, and more than 80%

Peginterferon-α2a and Ribavirin Therapy for Chronic HCV Infection

Two pegylated interferon products now are FDA-approved for hepatitis C therapy. They are more efficacious than standard interferon monotherapy regimens or combinations of standard interferon with ribavirin, but these pegylated drugs are associated with substantial side effects and costs. To determine the optimal duration of therapy with pegylated interferon-α2a and ribavirin for chronic hepatitis C infection, patients from 99 international centers were screened in this industry-sponsored study; 1014 patients were assigned randomly to receive 24- or 48-week combination therapy. In addition, interferon dosing was randomized: Patients received standard regimens, weight-based regimens (1000 mg or 1200 mg daily), …

Nadolol Prophylaxis Delays Growth of Small Varices

The rate of bleeding from small varices is low; most esophageal variceal hemorrhage springs from large varices. Beta-blockers, particularly

Live- vs. Deceased-Donor Liver Transplantation: Patient and Graft Survival Differences

The cadaver liver shortage and long waiting lists for liver transplantation in the U.S. have led to the development of alternative procurement

Ursodiol for NASH Doesn't Work

So far, there is no proven treatment for nonalcoholic steatohepatitis (NASH). Standard recommendations include weight loss and control of diabetes and

Hepatic Impairment in Patients with SARS Hepatitis

Severe acute respiratory syndrome-associated coronavirus (SARS-CoV), an enveloped coronavirus discovered in March 2003, causes atypical pneumonia and

Colchicine or Methotrexate Plus UDCA for Primary Biliary Cirrhosis: 10-Year Results

Primary biliary cirrhosis (PBC) is a chronic cholestatic disease presumed to be of autoimmune origin. Ursodeoxycholic acid (UDCA), the only approved therapy, improves results of biochemical tests of liver function, but its long-term effect on survival is unclear. Initially, the authors of this 10-year, randomized trial intended to compare methotrexate with colchicine monotherapy for PBC, but when data about UDCAs efficacy became available after 2 years, UDCA (12-15 mg/kg per day) was administered to …