Hepatología is a medical and scientific open access journal published semiannually. Hepatología is the dissemination tool of the Colombian Association of Hepatology for scientific and technological advances in the area of Hepatology. Through the topics addressed in Hepatología, training and ongoing education is available to those interested in this branch of medicine, whether they are students or professionals.

The journal Hepatología publishes the knowledge and experiences of the members of the Colombian Association of Hepatology, undergraduate and graduate students of the different medical faculties in the country, Hepatology residents, and groups in public and private hospitals, among other professionals related to Hepatology, both in clinical and basic sciences.

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HEPATOLOGÍA

Coagulation disorders in liver cirrhosis

The pathophysiological events of liver cirrhosis alter the processes of primary and secondary hemostasis and fibrinolysis. Previously, it was conceptualized that these alterations exclusively predisposed to hypocoagulation, due to the low hepatic production of procoagulant factors and the characteristic thrombocytopenia. Currently, there is evidence of compensation mechanisms that lead to a hemostatic rebalancing, which is unstable and easily dysregulated in the presence of comorbidities, complications and progression of the disease, leading to prohemorrhagic or prothrombotic phenomena.

Congestive liver disease

Congestive liver disease comprises the spectrum of manifestations secondary to liver injury as a consequence of hepatic venous congestion due to a disturbance in the hepatic venous outflow. The most frequent cause is right heart failure, which, due to an increase in central venous pressure, leads retrogradely to an increase in hepatic venous pressure, a decrease in liver inflow and a decrease in oxygen saturation, with sinusoidal congestion and characteristic compromise of zone 3 hepatocytes.

Systemic therapies in hepatocelular carcinoma

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related morbidity and mortality worldwide. Most cases occur in the context of cirrhosis or chronic liver inflammation. Patients with advanced HCC had no effective therapies until 2008, when sorafenib, a multi-target tyrosine kinase inhibitor, showed beneficial results when compared to placebo in terms of survival and time to progression.

Acute-on-chronic liver failure

Liver cirrhosis continues to be a common disease in our setting, with high mortality. Its decompensation can be associated with the failure of one or more organs, leading to acute-on-chronic liver failure (ACLF), giving these patients a different prognosis associated with higher mortality. The objective of this article is to report the clinical and epidemiological characteristics of patients with ACLF in a high-complexity hospital, as well as to carry out a review of the literature about the different scores for evaluating their prognosis.

Lysosomal acid lipase deficiency

Lysosomal acid lipase deficiency (LAL-D) is a rare disease of autosomal recessive inheritance, caused by mutations in the LIPA gene, located on chromosome 10 (10q23.31), which causes systemic and progressive accumulation of cholesterol esters and triglycerides. More than 40 mutations in this gene have been reported, with diverse clinical manifestations, with hepatic disease and early-onset cardiovascular disease being the predominant ones. Few cases of this condition have been described worldwide.

Hepatotoxicity by thalidomide

Thalidomide was developed and introduced to the market by Grünenthal laboratories in 1953, being used mainly as a sedative and also for the treatment of nausea during pregnancy. Reports give account of approximately 10,000 children who were born with phocomelia, which forced its withdrawal from the market in 1962. After almost 60 years, it is used again in other fields of medicine, however, multiple adverse effects have been reported in patients with leprosy and multiple myeloma, including acute or chronic hepatitis.

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