Schiff’s Diseases of the Liver 12th Edition PDF
|Author||Eugene R. Schiff and Willis C. Maddrey|
|File size||298 MB|
The twelfth edition of Schiff’s Diseases of the Liver continues to chronicle the major scientific advances in pathogenesis diagnosis management treatment and in some instances cure of hepatobiliary disorders. The rapid rollout of innovation has led to the decision that this edition will be accompanied by a subsequently expanded electronic program in order to bridge the gap of evolving knowledge until the next edition. The spectrum of liver disease is changing. The gratifying spectacular cure rates now available for hepatitis C have had major impacts on the practice of hepatology. Widespread instruction of treatment with the newer agents should markedly reduce the number of patients who progress to advanced cirrhosis and likely will lead to a reduction in hepatocellular carcinoma as well the need for liver transplantation. Unfortunately hepatitis C virus vaccines are not anticipated to be available in the near future and development of effective vaccines is a major goal. It is apparent to all hepatologists that nonalcoholic steatohepatitis worldwide has come to the fore as a prominent liver disease that leads to cirrhosis and hepatocellular carcinoma. The challenges are to develop safe and effective therapies to curtail the progression of nonalcoholic steatohepatitis and hopefully reverse necroinflammation and fibrosis. Recognition of the earlier stages of steatohepatitis should provide a better therapeutic opportunity to prevent cirrhosis. Many of the cases of acute liver failure have been found to be a result of acute-on-chronic liver disease which highlights the importance of preventing superimposed hepatic injury in patients with advanced liver disease of any etiology. Specific biomarkers are emerging which provide more accurate diagnostic and prognostic serologic parameters. Implementation of universal vaccination for hepatitis B virus (HBV) continues throughout the world; however a definitive cure for HBV infection remains elusive. An ongoing research focus in chronic hepatitis B is to develop ways to eliminate covalently closed circular DNA and thereby block HBV integration. Prevention of reactivation of HBV in a patient receiving immunosuppressants and chemotherapy and the development of more effective HBV treatments have become areas of great interest. Liver transplantation has become a major life-saving procedure for patients who have progressive liver disease and for a minority who have acute liver failure. Surgical techniques are well advanced and live donor liver transplantation presents a life-saving option albeit for a minority of patients. Organ allocation has been modified and is well served with the model for end-stage liver disease (MELD) score while we continue to work on optimizing immunosuppression regimens and develop new approaches to improve upon them.
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