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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Saturday, May 5, 2012

Enfermedad hepática alcohólica

Treatment of Alcoholic Liver Disease
Christofer Paul Day. Liver Transpl 2007; 13: S69-S75
"Severe alcoholic steatohepatitis (ASH) is the major complication of advanced alcoholic liver disease (ALD) and has a high mortality even when treated with corticosteroids. Despite the importance of reactive oxygen species in the pathophysiology of ALD and ASH, antioxidants provide no benefit in the treatment of patients with ASH. Proinflammatory cytokines are important in the pathophysiology of ALD and might mediate most of the inflammatory aspects of these disorders. New treatment modalities in ASH might involve antagonism of proinflammatory cytokines such as tumor necrosis factor (TNF) by specific antibodies or other TNFinterfering treatment strategies. Propylthiouracil and S-adenosyl methionine may be beneficial to patients with alcoholic cirrhosis, but both require further randomized, controlled trials before their use can be recommended. Liver transplantation is an effective therapy for patients with advanced alcoholic cirrhosis who have not recovered after a period of abstinence."
Maddrey’s Discriminant Function for Alcoholic Hepatitis
Suggests which patients with alcoholic hepatitis may have a poor prognosis
and benefit from steroid administration.
Glasgow Alcoholic Hepatitis Score
Predicts mortality in patients with alcoholic hepatitis by lab results and age.