Talk:Cirrhosis

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This was the original source citation:

I removed it after I had began editing. RJFJR 22:52, Dec 25, 2004 (UTC)

The text Original text from was added back in. I removed and replaced it with an attribution. I don't feel that referring to it as an original source of material is appropriate once we begin editing it. During our editing we will add material from other sources, delete, or reword; all of these could introduce inaccuracies in spite of our best efforts and intentions. It is inappropriate to state the source is material for our own mistakes. RJFJR 03:51, Dec 31, 2004 (UTC)

Contents

[edit] Images requested

It is requested that this article be expanded with images. The more disgusting and frightening, the better wikipedia will be able to deter people from drinking their livers into oblivion!

I have images of my ERCP, or Endoscopic Retrograde Cholangiopancreatography confirming the diagnosis of Primary Sclerosing Cholangitis, that show what is left of my biliary tree, normally seen on angiography of this type as clearly defined, sharp edged "spagetti noodles" all over the place. In my case, there are nothing left but mere wisps of biliary tracts, upon a very black background. Now if someone can help me with getting these images a)into my computer, and b)onto this site, I would be more than happy to oblige!! AirMed95 05:31, 3 December 2006 (UTC)"Ken" somethings are good though so i will try to keep my head up

[edit] Empty talk

>Signs and symptoms of cirrhosis >Liver size. Can be enlarged, normal, or shrunken.

The information content of this sentence in the article is exactly ZERO...

—Preceding unsigned comment added by 195.70.32.136 (talk • contribs)
No, there is direct information - a small or large liver may be associated with cirrhosis, but not always; similarly enlarged neck lymph nodes may or may not occur with sore throats, but that does not equal an absence of information nor that doctors should not examine for enlarged lymph nodes. If cirrhosis is the scaring up of the liver and eventual loss of liver function, then one might reasonable wonder if the liver enlarges with the initial assault upon it or shrivels up as it scars. The fact that the liver size may or may not be altered in size therefore is of note. Also examining a patient to identify possible enlargement (liver edge extends below the rib cage), or the size of the liver reported on ultrasound scans will not in itself therefore indicate the severity of cirrhosis that has occured. David Ruben Talk 16:33, 6 June 2006 (UTC)

[edit] Coffee

Coffee postitively modifies the risk profile[1]. JFW | T@lk 22:26, 12 June 2006 (UTC)

More links: http://www.forbes.com/forbeslife/health/feeds/hscout/2006/06/13/hscout533237.html

[edit] Number One on Google

http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/ ranks #1 on Google for "Cirrhosis"NumberOneGoogle 18:29, 25 November 2006 (UTC)

Well, there's a link to it here. NIDDK is a good resource. JFW | T@lk 14:13, 1 March 2007 (UTC)

[edit] Copyedit

I've done some copyediting. It involved removing all the boldface (WP:MOS), adding the hepato-pulmonary vascular disorders (glaringly absent) and removing the speculative hype about sulfasalazine. I'm much more interested in endothelin antagonism, especially if one considers that sulfasalazine itself can be hepatotoxic.

I suspect we should we mention something about decompensation of cirrhosis - what is done urgently in terms of examinations and treatments. We should talk about fluid management, sodium retention, maintaining nutrition (already briefly covered) and perhaps even acetylcysteine and pentoxifylline.

We need to refer to guidelines more. For example, the BSG have a very good ascites guideline authored mainly by Kevin Moore. JFW | T@lk 14:13, 1 March 2007 (UTC)

[edit] Useful review articles for expansion

Link for my own personal use while working on this article:

Some papers I don't have fulltext access to:

I'm planning some work on this article. Stop me if I get too engrossed. JFW | T@lk 16:53, 1 March 2007 (UTC)

[edit] Sleep

Cirrhotics sleep poorly, especially when minimally encephalopathic. doi:10.1111/j.1572-0241.2006.01028.x suggests Hydroxyzine should be tried. JFW | T@lk 14:37, 1 April 2007 (UTC)

[edit] Additions

Kaesernm (talk · contribs) made a very large addition (22 KB) to the article, replacing the preexisting "general care" paragraph. Unfortunately, there are several problems with the material added:

  • It is highly technical (basic pathophysiological research being cited instead of clinical papers).
  • It gives the suggestion that it was copied verbatim from a recent review paper (but I cannot confirm a copyvio from simple Google checks).
  • The footnotes do not follow the cite.php-based system previously in place.

I have asked the contributor to comment here. Obviously, I would not want to turn off an editor with an obvious interest in chronic liver disease. JFW | T@lk 14:12, 14 May 2007 (UTC)

[edit] Bye bye, Dr Quick

PT/INR is quite rubbish to stratify risk in cirrhosis, doi:10.1111/j.1365-2036.2007.03369.x JFW | T@lk 22:54, 23 June 2007 (UTC)

[edit] Circular Reference

The page has a link to "Cardiac cirrhosis" (in the Causes section). This link Takes the user to the page that the user is already on. This may need fixing/changing. Cs1kh 14:33, 31 July 2007 (UTC)

Perhaps you want to turn the redirect into a stub? JFW | T@lk 21:45, 24 September 2007 (UTC)

[edit] Thrombosis

I have long suspected that cirrhotics are actually a tad prothrombotic due to various mechanisms, and many cirrhotics I have looked after have had a history of VTE. doi:10.1111/j.1538-7836.2007.02772.x addresses this issue, as well as pointing out how poorly we can measure coagulation in liver disease. I reckon it's all about decreased fibrinolytic activity. JFW | T@lk 21:45, 24 September 2007 (UTC)

[edit] Sources

I am concerned that some of the content in this article appears not to be original. For instance, a quick Google search for "cirrhosis and is associated with a poor quality of life", copied directly from the introduction, shows that this segment of text, as well as text around it appears in several other places on the Internet. I am not sure how much of this article directly duplicates material from its sources, but I feel that it may be a large proportion. I don't believe it is appropriate for me to make any major content changes, but I do think that it is important that this be addressed. Thank you, Helikophis 23:49, 23 October 2007 (UTC)

Wikipedia content is extensively forked all over the internet, sometimes without mention of Wikipedia or its license. Could you identify the site from which this content would have been copied? Even if that is the case, it has undergone substantial editing by several editors, and I suspect the present version is not in breech of copyright. JFW | T@lk 07:32, 30 December 2007 (UTC)

[edit] Platelets

doi:10.1002/hep.21941 - a myth shattered. Platelet count is moderately predictive of the portal venous gradient, but not of oesophageal varicosis. JFW | T@lk 07:32, 30 December 2007 (UTC)

doi:10.1111/j.1572-0241.2008.01826.x - ALT, INR and albumin can be used to predict clinically significant portal hypertension (CSPH). A low CSPH score would mean that screening for varices is a waste of time - in this series this applied to 40% of the cohort. JFW | T@lk 09:11, 11 May 2008 (UTC)

[edit] Patek

PMID 16694854 - was the Patek regimen as popular in the past as some old publications seem to indicate? JFW | T@lk 15:15, 15 May 2008 (UTC)

Full text at PMC: 1305772 - probably the most concise summary of cirrhosis I've ever seen. A great example of how this article could work. JFW | T@lk 09:28, 30 May 2008 (UTC)