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Hepatologists

Hepatologists are medical professionals who specialize in the diagnosis and treatment of liver diseases.
They have expertise in a wide range of liver-related conditions, including cirrhosis, hepatitis, fatty liver disease, and liver cancer.
Hepatologists use advanced imaging techniques, laboratory tests, and liver biopsies to evaluate liver function and identify underlying causes of liver problems.
They collaborate with other healthcare providers to develop comprehensive treatment plans, which may involve medication, dietary changes, lifestyle modifications, or surgical interventions.
Hepatologists play a cruitial role in managing chronic liver conditions and ensuring optimal patient outcomes.

Most cited protocols related to «Hepatologists»

This study included patients enrolled in the Functional Assessment in Liver Transplantation (FrAILT) Study from March 2012 until February 2016. The FrAILT Study, initiated in July 2012, is an ongoing study of adults (≥18 years) with cirrhosis who are listed for liver transplantation at the University of California, San Francisco (UCSF) and are seen in the outpatient UCSF Transplant Hepatology clinic. To ensure an adequate number of events during follow-up, we prioritized consecutive recruitment of all patients with a laboratory MELD score ≥12. In September 2013, we relaxed our recruitment criteria to include all patients 60 years and older, regardless of laboratory MELD score, given the conceptual association between frailty and advancing age. Patients were excluded if they were listed with MELD exception points, as these patients have a trajectory to liver transplantation that is independent of hepatic decompensation. While national liver allocation changed in January 2016 to be based on MELDNa rather than MELD, we maintained study inclusion criteria as MELD for consistency. Also excluded were those with severe hepatic encephalopathy (n=8), as defined by the time to complete a Numbers Connection Test6 (link) of >120 seconds, as this may impair the patient’s ability to provide informed consent and complete tests of physical function. Of those who met inclusion criteria, 97% enrolled in the FrAILT Study.2 (link),5 (link) Four subjects who refused to complete all study procedures (i.e., assessments of frailty) were excluded from the analyses.
At enrollment, all patients underwent the tests of physical frailty that have been commonly utilized in the geriatric literature (Table 1). These measures included four performance-based tests (gait speed, grip strength, chair stands, and balance) and five self-reported tests (unintentional weight loss, exhaustion, physical activity, activities of daily living (ADL), and instrumental ADLs. All assessments were performed by one of two study personnel specifically trained at administering these study procedures in the same order and same manner for each study subject. On the same day as the clinic visit, the patient’s hepatologist was asked to subjectively rate his or her patient’s health using the following question:

“We are interested in your general impression about your patient’s overall health, as compared to other patients with underlying liver disease. How would you rate this patient’s overall health today? Excellent (0), very good (1), good (2), fair (3), poor (4), or very poor (5)”.

This rating was collected solely for the purposes of providing information regarding construct validity of the frailty measures. We have previously demonstrated that this subjective clinician assessment can identify liver transplant candidates at high risk for waitlist mortality.7 (link)At the time of enrollment, demographic data were extracted from the clinic visit note from the same day as the physical frailty testing. Patients were classified as having hypertension or diabetes if listed in the past medical history or taking a medication to manage hypertension or diabetes. Ascites was ascertained from the physical examination or mention of ascites in the management plan. Laboratory data within 3 months of the frailty assessment were collected from the electronic health record. Candidate prognostic indicators were recorded in blind with respect to the primary endpoint. All patients were followed prospectively until their terminal waitlist event (e.g., death/delisting, liver transplantation) or, for those who had not experienced a terminal waitlist event, until February 2016. “Delisting for being too sick for liver transplant” was decided by consensus among the liver transplant team members if there was concern that an individual would not achieve acceptable outcomes after liver transplantation due to medical co-morbidities or current medical acuity. This decision was made independently of the frailty assessments performed for the study, as the results from the study assessments were not made available to the clinical care team. Outcomes (e.g., death, delisting, transplant) were ascertained quarterly from UNet℠, the official online database for the United Network for Organ Sharing (UNOS). Per UNOS requirements, outcomes must be recorded into UNet℠ within 24 hours of the outcome and therefore, is a reliable source of information about the patients’ current waitlist status.
Publication 2017
Adult Ascites Blindness Clinic Visits Diabetes Mellitus Hepatic Encephalopathy Hepatologists High Blood Pressures Liver Liver Cirrhosis Liver Diseases Liver Transplantations Neoplasm Metastasis Outpatients Patients Pharmaceutical Preparations Physical Examination Transplantation Vision

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Publication 2018
Adult Attention Bones Consultant cytidylyl-3'-5'-guanosine Debility Disease, Chronic General Practitioners Governing Board Hepatic Encephalopathy Hepatologists Liver Liver Cirrhosis Liver Diseases Liver Transplantations Malnutrition Metabolism Nutrition Assessment Nutrition Disorders Osteoporosis Patients Sarcopenia Specialists
The main outcome of this study was clinically confirmed ESLD (also referred to as decompensated liver disease). ESLD was defined by the presence of a definitive diagnosis of cirrhosis and a definitive diagnosis of a hepatic decompensation event (ascites, hepatorenal syndrome [HRS], spontaneous bacterial peritonitis [SBP], hepatic encephalopathy [HE), or gastric/esophageal variceal bleeding) in the medical record.
Cirrhosis was confirmed if a patient had a: a) liver biopsy demonstrating cirrhosis, b) radiographic imaging study (abdominal ultrasound, CT scan, or MRI) reporting cirrhosis, or c) physician’s note documenting cirrhosis based on one of the two prior criteria.(5 (link))
Definitions for hepatic decompensation events were based on guidelines published by the American Association for the Study of Liver Diseases (AASLD).(6 (link)) Confirmation of an event required physical exam (ascites, encephalopathy), imaging (ascites), or endoscopic (variceal bleeding) findings confirming a decompensation event, or documentation of an event by a treating physician within the medical record. Patients were required to have had a decompensation event within 365 days of receiving an ICD-9-CM code for that event.
Medical records were reviewed by a hepatologist (D.G.) to confirm outcomes. Chart review also determined if patients would be potential liver transplant candidates based on AASLD criteria.(7 (link))
Publication 2012
Abdomen Ascites Bacteria Biopsy Diagnosis Encephalopathies Endoscopy Hepatic Encephalopathy Hepatologists Hepatorenal Syndrome Liver Liver Cirrhosis Liver Diseases Liver Transplantations Patients Peritonitis Physical Examination Physicians Stomach Ultrasonography X-Ray Computed Tomography X-Rays, Diagnostic
A single trained abstractor reviewed the medical records of patients identified with relevant ICD-9-CM codes and laboratory abnormalities beginning one year before through six months after VACS enrollment. Data were abstracted onto structured forms that collected information from: 1) abdominal ultrasound, CT, and MRI reports (presence and quantity of ascites; presence and dimensions of liver masses); 2) laboratory results (alpha-fetoprotein; ammonia; peritoneal fluid cell count, differential, culture); 3) liver biopsy results (fibrosis stage; hepatocellular carcinoma diagnosis); 4) endoscopic reports (reason for endoscopy; presence of gastritis and/or peptic ulcers; presence of varices; signs of active variceal bleeding; banding of varices); and 5) progress notes (chronic liver disease etiology; diagnosis of variceal bleeding; reports of diagnostic and/or therapeutic paracentesis; reports of hepatic encephalopathy, asterixis). Hepatic encephalopathy was identified if there was a report of altered mentation and a definite diagnosis was recorded in a gastroenterologist's or hepatologist's note. Reports of a non-hepatic etiology of altered mentation negated a hepatic encephalopathy diagnosis. Asterixis was confirmed only if documented in the physical examination of a gastroenterologist or hepatologist.
After medical record review, data forms were independently reviewed by two arbitrators with expertise in chronic liver diseases (V.L.R. and J.K.L.). Each determined if hepatic decompensation was present and recorded the date each condition was first identified. They then decided whether the event was definite, possible, or had not occurred. Hepatic decompensation was considered to have occurred at the earliest date any diagnosis consistent with the event was documented. Disagreement on classification or date resulted in review by a third arbitrator (M.B.G.) to adjudicate the event.
Publication 2011
Abdomen alpha-Fetoproteins Ammonia Ascites Asterixis Biopsy Congenital Abnormality Diagnosis Disease, Chronic Endoscopy Fibrosis Gastritis Gastroenterologist Hepatic Encephalopathy Hepatocellular Carcinomas Hepatologists Liver Liver Diseases Paracentesis Patients Peptic Ulcer Peritoneal Fluid Physical Examination Therapeutics Ultrasonics Varices
HCC was diagnosed using histological or image-derived EASL criteria (3 (link)). All patients underwent contrast-enhanced CT or MRI prior to their first TACE treatment. Follow-up comprised clinical examination, blood sampling, and cross-sectional imaging, which was typically repeated every 6 weeks in the case of a viable tumor. In the case of a complete response, this interval was extended to 12 weeks. Prior to each treatment decision, all patients underwent an extensive discussion in an interdisciplinary tumor board consisting of hepatologists/oncologists, diagnostic and interventional radiologists, visceral surgeons, pathologists, and radiation therapists. TACE was performed in a standardized manner as described in detail elsewhere (33 (link), 34 (link)). The primary endpoint was OS, which was defined as the time interval between the initial TACE session and death or last follow-up.
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Publication 2021
ADAM17 protein, human Diagnosis Hepatologists Neoplasms Oncologists Pathologists Patients Physical Examination Radiologist Radiotherapy Surgeons

Most recents protocols related to «Hepatologists»

The NEQ-LD was developed including 23 items from the NEQ19 (link),20 and 4 items (i.e., “I need help in transfer from home to hospital,” “I need more dialogue between hepatologists and general practitioner,” “I need more help to maintain my normal daily activities as much as possible,” and “I need help in facing problems with my sex life”) adapted from the “Supplementary outpatient module” proposed by Bonacchi et al.22 (link) A focus group discussion including 3 hepatologists and a clinical psychologist with experience in Hepatology was conducted to remove items from the NEQ deemed inappropriate for patients with liver diseases, and to develop items specific to the hepatologic context. None of the 27 items developed in oncology were deemed inappropriate or unusable in Hepatology by the experts, and 2 items were added (“I need to have more information on the transmission of my disease” and “I need to have more information on norms and behaviors that can improve my health [healthy balanced diet, appropriate exercise, etc.]”). These additional items are largely aligned with the literature towards health attitudes and behaviors specific to patients with liver diseases.23 (link) Thus, we obtained a self-administered instrument with 29 dichotomous items (i.e., yes/no answer) about informative, assistance/care, relational, psychoemotional and spiritual support, and material needs. Higher scores indicate that there are more unmet needs (range: 0–29). Since the NEQ-LD is a newly developed instrument for patients with liver diseases, we added an open-ended question at the end to ask patients to list any further unmet needs that were not included in the questionnaire. With this additional question, we aimed to ascertain the requirement to add new items to better describe patients’ unmet needs.
The participants filled out a paper-and-pencil self-report battery that included the NEQ-LD and the following scales (for a detailed description, see Supplementary File 1, http://links.lww.com/HC9/A23).
Publication 2023
Hepatologists Hospital to Home Transition Liver Diseases Neoplasms Outpatients Patients Psychologist Transmission, Communicable Disease
All study participants provided written informed consent. Studies complied with the Declaration of Helsinki, Good Clinical Practice (Directive 2001/20/EC) and general data protection regulations (EU) 2016/679. Suspected DILI cases were consecutively recruited at centers across Europe between April 2016 and July 2021: UK, Spain, Germany, Iceland, Portugal; approved by: Yorkshire and the Humber - Leeds East Research Ethics Committee (Ref15./YH/0294); Biomedical Investigation Ethics Committee of Andalucia (Ref: AND-HEP-2015-01); Ethical Commission of Ludwig Maximilian University of Munich (Project 85-16); Bioethics Committee Iceland (Ref: 15–104-V1); Ethics Comission of Centro Académico Médico de Lisboa (Ref: 126/15) and National Data Protection Comission Portugal (Authorization 479/2016), respectively. Standard clinical investigations including imaging were performed and cases were followed until liver profile normalization where possible.
Causality assessment was performed48 (link) and the cases were reviewed by an expert panel of at least three experienced clinical hepatologists or clinical pharmacologists from three different European academic centres47 . The panel adjudicated episodes as DILI or alternative diseases termed ‘acute non-DILI. They excluded patients where the investigations were inconclusive or when disagreement of probable diagnosis occurred within the panel. Both DILI and non-DILI groups met the same biochemical criteria as defined previously48 (link), having serum ALT ≥ 5x ULN or ALT ≥ 3x ULN plus TBL ≥ 2x ULN or ALP ≥ 2x ULN with accompanying elevations of gamma-glutamyl transferase. DILI was diagnosed based on the presence of a compatible temporal sequence between drug intake and detection of liver injury as well as test results to exclude alternative conditions, which included, but were not limited to, viral serology, viral load, imaging tests, presence of autoantibodies, immunoglobulin G values and biopsy findings (when available). Table 1 and Supplementary Table 1 show clinical and demographic data, the primary causative drug implicated in DILI and etiology of acute non-DILI controls. Cases of acetaminophen overdose were not excluded and were eligible as an acute control, although none were recruited during the period of this study. The ‘onset’ samples for both DILI cases (DO) and acute non-DILI controls (NDO) were collected at the time of enrollment into the study. A second sample termed ‘follow-up’ was collected from both DILI (DF) and acute non-DILI control (NDF) group patients (median follow-up of 35 days after the enrollment). This was to explore the trajectory of biomarkers in relation to the course of the liver injury. Patients who had liver enzymes below ULN at the follow-up visit were considered to have ‘complete recovery’. Those patients where liver enzymes decreased at follow-up but remained above ULN were termed ‘partial recovery’ (Supplementary Table 6). Where there was no follow-up visit, levels recorded in clinical notes were used to define recovery type.
HV and patients with biopsy-proven chronic liver disease (NAFLD) were enrolled as additional control groups. These controls were sex and age matched to the DILI cases and were recruited in parallel in Nottingham for research approved by East Midlands Nottingham 2 research ethics committee (Ref: GM0102010). HV had no diagnosis of liver disease and for those included in the discovery cohort, absence of fatty liver was confirmed using controlled attenuation parameter of transient elastography or transabdominal ultrasound examination. Subsequent cohorts were not screened for fatty liver but had no diagnosis of liver disease. Serum samples obtained were stored at −80 °C until analysis. Both sexes were included in the study design. Sex data was collected based on self-reporting. Proportions in sub-groups are reported, but sex-based analyses could not be performed due to the small cohort size.
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Publication 2023
Acetaminophen Autoantibodies Base Sequence Biological Markers Biopsy Diagnosis Disease, Chronic Drug Overdose Elasticity Imaging Techniques Enzymes Ethics Committees Ethics Committees, Research Europeans Fatty Liver gamma-Glutamyl Transpeptidase Hepatologists Immunoglobulin G Injuries Liver Liver Diseases Non-alcoholic Fatty Liver Disease Patients Pharmaceutical Preparations Serum Transients Ultrasonics
In the primary analysis, patients were grouped according to their PSFS as F0–F2 versus F3/F4. When categorizing patients as having early versus advanced fibrosis, we referred to 80–90% thresholds for each of the eight CRFS variables as defined in Figure 1B. Proportions within each of the four groups were reported as: (i) aligned, CRFS of no/early fibrosis and PSFS both F0–F2; (ii) aligned, CRFS of advanced fibrosis and PSFS both F3/4; (iii) physician underestimated, PSFS F0–F2 but CRFS of advanced fibrosis; or (iv) physician overestimated, PSFS F3/4 but CRFS of no/early fibrosis.
The secondary objective was to identify factors associated with alignment or misalignment between PSFS and CRFS. Alignment was assessed according to treating physician specialty (gastroenterologist, hepatologist, diabetologist), liver biopsy performed (yes, no), and key patient clinical and demographic characteristics, including age (>65 years, ≤65 years), key comorbidities (hypertension, metabolic conditions [any of metabolic syndrome, T2DM, insulin resistance or hyperglycemia]), and ethnicity (White/Caucasian, Asian, Hispanic/Latino, Afro-Caribbean, other). Statistically significant differences were identified using univariate tests (t, chi-squared, Fisher’s exact and log rank tests). P-values of <0.05 were considered statistically significant; summary statistics were used to provide the size and direction of the difference.
Three sensitivity analyses were undertaken to test the assessment of alignment of fibrosis score:
Publication 2023
Asian Americans Biopsy Caribbean People Ethnicity Fibrosis Gastroenterologist Hepatologists High Blood Pressures Hispanics Hyperglycemia Hypersensitivity Insulin Resistance Latinos Liver Metabolic Diseases Metabolic Syndrome X Patients Physicians White Person
Eligible physicians were hepatologists (France, Italy and the UK), gastroenterologists (Germany, Italy, Spain and the UK), gastroenterologists with a subspecialization in hepatology (Germany and Spain), hepato-gastroenterologists (France only), endocrinologists (all countries) and diabetologists (all countries). Physicians were managing ten or more patients with NASH per month and personally responsible for NASH management decisions. Patients had to be aged 18 years or older, with a physician-confirmed diagnosis of NASH obtained via liver biopsy and/or non-invasive test. In this analysis, patients had to have both a PSFS plus a VCTE test and/or data enabling retrospective calculation of a FIB-4 score. Patients could not be participating in NASH clinical trials at the time of data collection.
The survey was performed in accordance with relevant guidelines and in line with the principles of the Declaration of Helsinki; ethics approval was obtained from Freiburg Ethics Commission International (Approval No. 017/1931). All patients provided written informed consent for use of their data, which were anonymized and aggregated. No medication was provided and no tests or investigations were performed as part of this research. No hypothesis was developed or tested.
Publication 2023
Biopsy Diagnosis Endocrinologists Gastroenterologist Hepatologists Liver Nonalcoholic Steatohepatitis Patients Pharmaceutical Preparations Physicians
The CirCare study is a multicenter longitudinal study of patients with cirrhosis recruited from 5 hospitals in Brisbane and Logan cities in the state of Queensland, Australia, from June 2017 to December 2018. Consecutive adult patients identified from appointment lists and attending Hepatology/Gastroenterology clinics or admitted with a diagnosis of cirrhosis were eligible to participate. We excluded patients if their treating clinician considered them to have a cognitive or physical impairment that could interfere with participation or if they were unable to communicate in English and an interpreter was not available to assist with the interview. A study nurse and a hepatologist assessed patients’ eligibility.
Publication 2023
Adult Cognition Diagnosis Eligibility Determination Hepatologists Liver Cirrhosis Nurses Patients Physical Examination

Top products related to «Hepatologists»

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FibroScan is a non-invasive diagnostic device that uses vibration-controlled transient elastography (VCTE) technology to measure liver stiffness. The device transmits a mild vibration through the skin and measures the velocity of the resulting shear wave, which is directly related to the stiffness of the liver tissue. This information can be used to assess the degree of liver fibrosis.
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The Acuson S2000 is a diagnostic ultrasound system developed by Siemens. It is designed for general imaging applications, providing high-quality imaging capabilities.
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More about "Hepatologists"

Hepatologists are medical professionals who specialize in the diagnosis and treatment of liver-related conditions.
These highly trained doctors, also known as liver specialists or gastroenterologists with a focus on hepatology, have expertise in a wide range of liver diseases, including cirrhosis, hepatitis (e.g., viral hepatitis like hepatitis B and C), fatty liver disease (NAFLD and NASH), and liver cancer.
Hepatologists utilize advanced imaging techniques like FibroScan, Acuson S2000, and HI VISION 900 to evaluate liver function and identify underlying causes of liver problems.
They also rely on laboratory tests, including blood work and sometimes liver biopsies, to thoroughly assess the patient's condition.
Treatments recommended by hepatologists may involve medications, dietary changes, lifestyle modifications, or even surgical interventions, such as the use of Lipiodol or the CE-2 diet.
Hepatologists collaborate closely with other healthcare providers, such as primary care physicians, gastroenterologists, and surgeons, to develop comprehensive, personalized treatment plans for their patients.
This multidisciplinary approach helps ensure optimal outcomes for those dealing with chronic liver conditions.
In addition to their clinical expertise, hepatologists may also be involved in research and the development of new diagnostic tools, like the Siemens 4C1 curved array, and therapies, such as Ceftazidime or Doxorubicin.
They may utilize advanced data analysis techniques, including SAS version 9.4 and 64 raw systems, to inform their work and contribute to the advancement of hepatology.
Whether you're seeking information on liver disease management, the latest advancements in hepatology, or the qualifications and role of a hepatologist, this overview provides a comprehensive understanding of this crucial medical specialty.