Aa
Hepatology needs to enter the 21st Century ?
http://ihlpress.com/pdf%20files/hepdart09_presentations/liver/5_afdal_HepDart%202009%20Afdhal.pdf
Thought this is a very interesting presentation not to miss that is why posted it again on its own.
Bali05
Thought this is a very interesting presentation not to miss that is why posted it again on its own.
Bali05
I appreciate the absence of defensiveness and the consideration. And I'm really not trying to create a distracting metadiscussion on humor other than to say some of the humor some of the time feels indulgent and irrelevant and kind of "insiderish". While I would feel this way philosophically under any life circumstances, having cirrhosis myself makes it personal. Living with a question mark *****. Counting down your life in years or months rather than decades *****. Having your liver be a picnic for the Hep C virus *****: No joke. d
I've made a joke myself on the topic of biopsy/autopsy.
I've said that autopsy is the "gold standard", meaning the best that there is.
We often hear that a biopsy is the gold standard, but in reality, in addition to being invasive and in the rare occasion, even being fatal, they at times do not accurately reflect the actual condition of the liver. This can be for a variety of reasons; ranging condition of the liver where sample are taken (all livers are not homogeneous, staging wise throughout), the varying of sizes of sample, the number of samples used, and the actual range of interpretation by the people evaluating the actual sample.
Bill was making a similar joke, the point being that a biopsy lacks the amount of information needed to completely make a correct assessment. A tiny plug of liver pulled from a biopsy needle just doesn't compare. (However) A biopsy still remains the best *single* tool for assessment that we have available to us to plot our course.
My own belief is that the combination of tests gives the best sense of where we sit; our labs, an annual fibrosure test and a liver biopsy every so often depending on our staging and other risks and of course any other tests recommended by our medical team and circumstances.
Anyway, Bill's comment was taken by me for humor and in no way to be hurtful.
My 2 cents.
Willy
I've said that autopsy is the "gold standard", meaning the best that there is.
We often hear that a biopsy is the gold standard, but in reality, in addition to being invasive and in the rare occasion, even being fatal, they at times do not accurately reflect the actual condition of the liver. This can be for a variety of reasons; ranging condition of the liver where sample are taken (all livers are not homogeneous, staging wise throughout), the varying of sizes of sample, the number of samples used, and the actual range of interpretation by the people evaluating the actual sample.
Bill was making a similar joke, the point being that a biopsy lacks the amount of information needed to completely make a correct assessment. A tiny plug of liver pulled from a biopsy needle just doesn't compare. (However) A biopsy still remains the best *single* tool for assessment that we have available to us to plot our course.
My own belief is that the combination of tests gives the best sense of where we sit; our labs, an annual fibrosure test and a liver biopsy every so often depending on our staging and other risks and of course any other tests recommended by our medical team and circumstances.
Anyway, Bill's comment was taken by me for humor and in no way to be hurtful.
My 2 cents.
Willy
It was necessary to see if the liver was experiencing iron overload which will cause more damage.
Let me phrase this differently because of course there was iron overload in my blood and liver. What I should have said was the biopsy determined if iron had accumulated in my liver thus causing more problems with additional damage and increasing the percentages for cirrhosis and liver cancer.
Let me phrase this differently because of course there was iron overload in my blood and liver. What I should have said was the biopsy determined if iron had accumulated in my liver thus causing more problems with additional damage and increasing the percentages for cirrhosis and liver cancer.
Biopsy was the most effective tool I could have used to determine the health of my liver. Having PCT, in was necessary to see if the liver was experiencing iron overload which will cause more damage. Ferritin tests cannot tell you whether the liver has been affected or not. In my case, no iron overload yet and biopsy which was sent to the Mayo Clinic determined stage 3/4. Two samples were sent and I got the most accurate diagnosis available so I did not have to fret about whether treatment was necessary or pit it against any other test. No other test could have given me as detailed a diagnosis of my liver stage as my biopsy did and I did not incur additional costs trying to make an intelligent decision about treatment.
I maintain liver biopsy is still the gold standard and especially when there are any other factors involved.
Trinity
I maintain liver biopsy is still the gold standard and especially when there are any other factors involved.
Trinity
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