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Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral, and/or pharmacologic treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In […]

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Kaplan-Meier curves across the longitudinal categories of insomnia. Insomnia was defined by International Classification of Sleep Disorders criteria and participants categorized into 3 groups: never insomnia (green), intermittent insomnia (blue), or persistent insomnia (red).

Researchers Find Link between Persistent Insomnia and Increased Mortality Risk

A connection between persistent insomnia and increased inflammation and mortality has been identified by a group of researchers from the University of Arizona. Their study, published in The American Journal of Medicine, found that people who suffer from persistent insomnia are at greater risk than those who experience intermittent insomnia. Although about 20% of U.S. […]

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Macrophage activation syndrome leading to massive hepatomegaly due to steatohepatitis and extreme hyperferritinemia in adult-onset Still's disease. (A), Marrow hemophagocytosis, showing macrophage ingestion of red blood cells (arrow). (B), Macrophage ingestion of leukocytes (arrow). (C), Massive hepatomegaly down to the pelvic brim. (D), Massive hepatosplenomegaly, with the liver showing minimal fluorodeoxyglucose uptake. (E), Liver biopsy showing mixed microvesicular and macrovesicular steatosis. (F), Immunohistochemical staining for CD3, showing that the scanty small lymphoid cells were mainly T cells, most likely to be reactive.

Pyrexia, Massive Hepatomegaly, and Extreme Hyperferritinemia

A 39-year-old woman presented with pyrexia. Extensive investigations showed negative results. On referral, she was febrile (41°C) and jaundiced, with a massive hepatomegaly to the pelvis. Clinical Summary Investigations showed a hemoglobin level of 9.3 g/dL, leukocyte level of 2.3×109/L, platelet level of 162×109/L, bilirubin level of 76 (4-23) μmol/L, alanine aminotransferase level of 94 […]

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Pyogenic Liver Abscess as the Initial Manifestation of Underlying Hepatocellular Carcinoma

The prognosis of patients who present with pyogenic liver abscess as the initial manifestation of underlying hepatocellular carcinoma is poor. In regions with a high prevalence of both pyogenic liver abscess and hepatocellular carcinoma, physicians should not ignore the possibility of underlying hepatocellular carcinoma in patients with risk factors. Abstract Background Pyogenic liver abscess and […]

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Alcoholic Cirrhosis

Massive Aquaresis After Tolvaptan Administration and Albumin Infusion in a Patient with Alcoholic Cirrhosis The management of hyponatremia in patients with end-stage liver disease is always a challenge for caring physicians because of limited options, poor responses, and risk of central pontine myelinolysis due to rapid correction of hyponatremia.1 Tolvaptan, an oral competitive arginine vasopressin […]

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American Journal of Medicine Editor Joseph Alpert

Should Physicians Measure High-sensitivity C-reactive Protein Levels to Assess Coronary Heart Disease Risk?

When I was a medical student, atherosclerosis was seen as a process resembling the deposition of calcium deposits in pipes in an old house with gradual accumulation of precipitated minerals on the inner walls of these pipes. Basic science and clinical research over the last 40 years have made it clear that the process that […]

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