What Does Hypertension Do?

New Study Calls for Greater Awareness of Food Supply for Children With Diabetes

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

 

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Managing diabetes in a child requires a careful balance of insulin, diet, and exercise. Buying essential medical supplies, such as needles and testing strips, adds a financial burden to families. According to a new study soon to be published in The Journal of Pediatrics, the resulting food insecurity that arises from the financial burden of diabetes management increases a child's risk of being hospitalized due to complications from diabetes.

According to study author Dr. Elizabeth Cummings, "A household is food secure when all members have access to food that is safe and varied enough to meet their nutritional needs. Families who are hungry, who use food banks or food stamps, or those who worry about affording food are considered food insecure."
Dr. Cummings and colleagues interviewed 183 Canadian families with at least one child with diabetes over a 16 month period. They completed a survey that assessed their food security, demographic information (e.g., income, education levels), and strategies used to mitigate the financial burden of their child's diabetes.
The researchers found that 22% of the families they interviewed were food insecure, a significantly higher percentage than the national Canadian rate of 9.2%. Food security is not just a problem in Canada, however. A report released by the U.S. Department of Agriculture's Economic Research Service states that 17.4 million households had difficulty providing enough food due to lack of resources in 2009.1 According to Dr. "Children from food insecure families had poorer diabetes control and were 3.7 times more likely to require hospitalization for diabetes within the past year."
Almost all the families interviewed received some financial support for their diabetes supplies. However, many reported that someone in the family ate less so that the child with diabetes would have enough. "A small number of families reported that they tested their child's blood sugar less often than recommended," co-author Dr. Stacey Marjerrison reports, "or used needles more than once to help manage the cost of their child's diabetes."
Dr.believes that health professions should be more aware of this issue. "A review of financial support available to families is needed," she asserts. "Improvement of support may result in fewer hospitalizations and thus lower health care costs."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of AMF Trust or Dr.Alacc

Anti-Microbials Are a Common Cause of Drug-Induced Liver Injury and Failure?

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
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About The Charity Visit : www.amftrust.com

 

 New research shows that anti-microbial medications are a common cause of drug-induced liver injury (DILI) leading to acute liver failure (ALF), with women and minorities disproportionately affected. While ALF evolves slowly, once it does occur a spontaneous recovery is unlikely; however liver transplantation offers an excellent survival rate. 

Full findings of this ten-year prospective study are published in the December issue of Hepatology, a journal of the American Association for the Study of Liver Diseases.
Patients with liver failure resulting from DILI may experience deep jaundice, fluid retention, advanced coagulopathy and coma. More than 1100 drugs, herbal remedies, natural products, vitamins, minerals, dietary supplements, and recreational and illicit compounds are known to cause liver injury, which reportedly affect 1 in 100,000 to 1 in 10,000 patients. Prior research shows DILI is a frequent cause of hepatitis, and accounts for 5%-10% of hospitalizations for jaundice and 12% of all cases of ALF (excluding acetaminophen).
In the current study, researchers investigated liver injury and failure caused by drugs other than acetaminophen. Detailed case reports were collected from 1,198 subjects with ALF enrolled at 23 sites participating in the National Institutes of Health-funded Acute Liver Failure Study Group, led by Principal Investigator, William M. Lee, M.D., from the University of Texas Southwestern Medical Center in Dallas, TX. Researchers identified 133 patients with DILI with 71% of those cases in women.

"Our findings confirm prior medical evidence that found a high female predominance in DILI ALF, suggesting that women may be more susceptible to liver injury or use more prescription drugs than men," said Dr. Adrian Reuben, Professor of Medicine at the Medical University of South Carolina and lead study author.

Furthermore, the research team documented a disproportionately high number of minorities with DILI ALF, including African-American (16%), Hispanic (15%) and other minority groups (12%). "We observed inexplicably high numbers of minority patients with DILI ALF. This racial disparity is atypical for acetaminophen-induced ALF in the U.S. and further studies should explore this discrepancy," commented Dr. Reuben.

Researchers identified 61 different agents that, alone or in combination, could cause liver injury and failure in the study population. Anti-microbial agents were found to be the most common cause of DILI ALF cases and included anti-tuberculosis drugs (25), sulphur-containing drugs (12), nitrofurantoin (12), other antibiotics (7), antifungal agents (6), and anti-retroviral drugs (4). Patients who develop ALF after taking these drugs typically do not experience a spontaneous recovery -- the transplant-free survival rate in this study was 27%.
There were 56 eligible subjects who underwent liver transplantation of whom all but four survived, giving an overall survival for the entire cohort 66.2%. The authors highlight that the 23.3% of transplantation waitlist deaths attest to the urgent need for donor organs in this setting. "Liver transplantation offers excellent survival for ALF patients, however further investigation should include more detail on drug use duration, and the impact of alcohol use and diabetes, to provide additional understanding of idiosyncratic drug-induced liver injury and failure," Dr. Reuben concluded.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of AMF Trust or Dr.Alacc

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TMC435 Works Well in Treatment-experienced Hepatitis C

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

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Medivir last week announced interim data from the Phase 2b ASPIRE trial, demonstrating that its investigational once-daily HCV protease inhibitor TMC435 (being developed jointly with Tibotec), when combined with pegyalted interferon plus ribavirin, increased the likelihood that treatment-experienced chronic hepatitis C patients would achieve undetectable HCV viral load at 4, 12, and 24 weeks, compared with standard therapy alone. Rates of undetectable HCV RNA at week 24 ranged from 78% for prior null responders to 94% for prior relapsers.

Laparoscopic Pancreas Surgery - Roger Williams Medical Center

Daily Checkup: Alcohol still risk, But ......main causes of cirrhosis ?

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment support

and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease.

      About The Charity Visit : www.amftrust.com

Who’s at risk
“Fibrosis” is a term doctors use to describe the scarring of the liver that builds up over time as the result of liver damage. “Over many years, that scarring progresses and culminates in cirrhosis, which refers to an end-stage fibrosis,”. “By then, the blood flow through the liver is impaired, and liver function may be compromised.”

A healthy liver has many vital functions, like detoxifying the blood, synthesizing critical proteins and hormones, fighting off infection and metabolizing sugars, fats and proteins.
Advanced fibrosis and cirrhosis are major public-health concerns that dramatically increase your chance of developing liver cancer.

“Liver cancer is the fastest-rising cancer in the U.S. and the third-leading cause of cancer mortality worldwide,”. “The bulk of patients with cirrhosis in this country have it from hepatitis B or C − about 5.3 million Americans are living with chronic viral hepatitis.”

The second-leading cause of fibrosis is called “fatty liver disease,” in which fat accumulates in the liver and eventually leads to scarring. “Obese patients often overlook the risk of liver damage,” . “Obesity often goes hand in hand with metabolic syndrome, which is associated with elevated blood lipids and blood pressure, insulin resistance and pro-thrombotic and an inflammatory state.” Fatty liver disease often improves after weight-loss regimens like bariatric surgery.

The underlying cause for fibrosis can also be alcohol abuse or rarer conditions like autoimmune diseases of the liver. “Alcohol abuse is definitely a risk factor, but the vast majority of patients with fibrosis and cirrhosis don’t abuse alcohol. The old association linking cirrhosis solely with alcohol abuse no longer holds true now that viral hepatitis and fatty liver disease are the two primary causes of fibrosis and cirrhosis.

Signs and symptoms
One of the challenges of diagnosing and treating liver disease is that it most often develops stealthily.

“The liver is so resilient that it can compensate for years of disease, and the patient may have no symptoms until the disease is very progressed,”. “In reality, many patients have advanced fibrosis but have no symptoms.”

The very late manifestation of symptoms means that it is even more important to identify if people are at risk and screen them to catch the disease early.

“People at high risk of liver disease include Asian immigrants, who are more prone to hepatitis B, and patients with evidence of metabolic syndrome, who are at high risk of fatty liver disease,”. Other risk factors for hepatitis include people who got blood transfusions before 1990 and people who engage in high-risk behavior like needle-sharing. Alcohol abuse is still a risk factor, even if it is no longer the most common underlying cause.

New evidence shows that simple blood tests can do an excellent job of identifying a patient’s risk of liver disease. “We screen for ALT − alanine aminotransferase − an enzyme that enters the bloodstream if the liver is damaged,” . “An elevated ALT level without explanation merits followup.”

Traditional treatment
“We have no treatments approved to attack the scarring in the liver yet,” . “But we have some excellent treatments for the underlying diseases.”

There are effective medical therapies for hepatitis B and C. “For hepatitis B, the main drugs are molecules that block the multiplication of the virus,” “The hepatitis C treatments are a combination of the drugs interferon and an immunomodulatory drug called ribavarin, which together boost the immune system to fight the virus.”

New drugs that attack the hepatitis C virus directly are expected to be available next year. For patients with fatty liver disease, weight-loss regimens also reduce liver damage. “Anything from diet and exercise and medications to bariatric surgery can have great results,” .

If alcohol abuse is the underlying cause, patients are usually required to enroll in a 12-step rehab program.

Once the liver disease progresses to the point of impairing liver function, doctors treat the resulting symptoms. “We try to treat all the liver problems and screen for liver cancer,” “For select patients, liver transplantation may be necessary.”

But doctors hope they can help more patients control their liver damage before it gets to that point. “There is now evidence that if we treat the underlying liver disease, even cirrhosis is reversible,”.

Doctors are making liver disease an increasingly
manageable illness through prevention, early detection and the treatment of fibrosis before it progresses too far.

Research breakthroughs
Some of the most exciting liver disease research is being done at the molecular level.

In 1985, Friedman identified the cell type that’s responsible for the formation of scarring tissue.

“Basically, we’ve gone from uncovering [what] causes scar formation to soon being able to treat and prevent fibrosis with medication,”  “Our hope is that if we develop new treatments for fibrosis, we’ll be able to prevent the development of cirrhosis.”

Questions for your doctor
Hepatitis is a major public health risk, so be proactive about asking your doctor, “Am I at risk of hepatitis?”

Follow up with, “Should I be vaccinated for hepatitis A and B?” Another good question is, “Do I have any risk factors for liver disease?” and “Is my ALT elevated?”

What you can do

Know your risk level.
That means knowing the risk factors of liver disease — especially hepatitis and fatty liver disease — and knowing your ALT level. “If your ALT level is abnormal on even one reading, you should have it followed up,” 

See a specialist.
“If there’s evidence of chronic liver disease based on virus or blood tests, see a liver specialist,” 

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