Conception of hepatology as a medical specialty

EASL clinical practice guidelines

“…At the end of quite a difficult voyage, important milestones have been passed and landmarks reached. Among those one may mention the state's official recognition of hepatology as a self-standing medical specialty (Slovak Ministry of Health, 1998) [3], paralleled with its comprehensive integration into the health care system and the system of postgraduate medical education and training in Slovakia [4,5]. Among the strategies that have proven to be helpful in fostering these developments we can affirm that the production of clinical practice guidelines (CPG) played a crucial role.…”

“…It has also enabled Slovak hepatologists to foster -firstly as an 'awareness building', later on as a strong 'advocacy', and finally as an established recognition of the ''obvious" requirement: ''the patients with serious diseases of the liver should be cared for (first of all) by hepatologists", and -albeit within the widest interdisciplinary collaboration: ''the liver 'belongs' (in the first place) to hepatology" [7].…”

“…Within 3 weeks the animals purportedly developed panlobular steatosis with inflammatory foci, in association with insulin resistance and increased hepatic TNF-a levels and lipid peroxidation products, i.e., clinical features of NASH. In a recent study published in this Journal, Lieber et al [3] used medium chain triglycerides to prevent LDC diet-induced NASH. In this letter we would like to address several irreproducibility issues regarding the LDC diet and its solid highfat equivalent.…”

“…Of the 38 experimental studies, 6 articles (Fig. 1C) reported the use of the LDC diet, of which 2 actually followed its original experimental 3-week diet protocol; both by Lieber et al [3,6]. In another study by Lieber et al [7] the diet was employed during 3 and 6 weeks.…”