Henry Hefler

All articles by Henry Hefler

Hepatopulmonary syndrome

I. What every physician needs to know. Mild hypoxemia occurs in approximately one third of all patients with chronic liver disease and is usually multifactorial. It may result from common cardiopulmonary diseases such as pneumonia, congestive heart failure, chronic obstructive pulmonary disease. Cirrhosis may also be complicated by pulmonary vascular complications. This interaction between the…

Elevated Alkaline Phosphatase

I. Problem/Condition. Routine laboratory testing is performed quite frequently in the hospital for both diagnostic purposes in symptomatic patients as well as for screening purposes in asymptomatic patients. Many of these screening tests now include serum alkaline phosphatase; although this enzyme is present in tissues throughout the body, it is most often elevated in patients…

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