From NAFLD to MAFLD: Nurse and allied health perspective.

Fatty liver disease associated with metabolic dysfunction is the most prevalent liver disease worldwide, though both patient and health professional still lack awareness of it. An international consensus panel has produced what is sure to be an influential report renaming the disease from non-alcoholic fatty liver disease (NAFLD) to metabolic (dysfunction) associated fatty liver disease (MAFLD) and suggesting how the disease should be diagnosed. This viewpoint explores the call from the perspective of nurse and allied health practitioners. This group have raised serious concerns on the existing nomenclature, which labels the disease as NAFLD, and its diagnostic criteria, including provoking nurse role confusion and representing a major barrier to various key aspects; patient-nurse communications, patient awareness, partnership working, motivation of patients to undertake lifestyle changes and multiple health behaviour change promotion and nurse-led clinics. Therefore, they are enthusiastically supportive of this call to reframe the disease that we believe will ultimately have a positive impact on nurse-patient communication, and through this, improve patient care and quality of life and reduce burden on health system.

Hepatic encephalopathy: causes and health-related burden.

Patients with cirrhosis are at risk of hepatic encephalopathy (HE). While its pathogenesis is not fully understood, the circulation of increased levels of ammonia through the bloodstream to the brain is thought to be a key causative factor. The ammonia penetrates the blood-brain barrier, ultimately leading to cerebral oedema. This can result in cognitive impairments, which can exhibit in multiple ways, adversely affecting quality of life for both patients and their families. The need for hospitalisation and longer hospital stays associated with HE has cost implications for the health service. Treatment revolves around the reduction of ammonia levels in the bloodstream.

A framework to develop nurses' liver care skills.

Following the overview of liver disease in part 1, the second part of this series looks at how a new competency framework was developed for nurses caring for people with or at risk of liver disease to address the increasing burden of the disease across public health, primary care and secondary care. Understanding of liver disease and its risk factors remains poor among many health professionals; a competency framework enables nurses and teams to identify and develop the skills, knowledge and understanding they need to provide high-quality, person-centred care.

Posttraumatic pulmonary pseudocysts as a manifestation of child abuse.

Posttraumatic pulmonary pseudocysts (PTPPCs) are air-, fluid-, or blood-filled spaces in the lung parenchyma. They are rare findings and are associated with substantial blunt force trauma to the chest. Cases in the literature have primarily reported PTPPCs as a result of motor vehicle accidents. There has not been a case of PTPPC reported in the child abuse literature. This case report describes a child with a PTPPC secondary to inflicted abusive injury.

Developments in addressing the organ donor shortage.

Non-heartbeating donation is not a new concept but it is one that has been out of vogue for many years. However, increasing shortage of organs for transplantation has led to its increased use as a viable source of organs. This article outlines the rationale for its re-emergence and the challenges it poses for health care professionals.

The invisible issue of organ laundering.

Global institutions, although suggesting measures to deter organ trafficking, reiterate the lack of official statistics about this illegal trade. In this article, we explore the reasons why organ trafficking remains unreported. We argue that the complex factors that perpetuate invisibility facilitate trafficked organs being "laundered" in the health care systems of the purchaser's country, hindering accurate estimation of the problem. The factors are as follows: (a) issues of globalization, jurisdiction, and law enforcement; (b) the power of health care professionals; (c) the reimbursement of transplantation costs abroad by insurers; (d) ambivalence of the victim status of the sellers; and (e) the buyers as vulnerable offenders.

Vaginal laceration as a result of blunt vehicular trauma.

BACKGROUND: Sexual abuse often is the primary diagnosis considered when prepubertal girls present with vaginal trauma. Although sexual abuse is very concerning and should remain high in the differential diagnosis, a variety of accidental injuries also can cause genital injury. CASE: A 5-year-old girl presented to the emergency department with genital bleeding after a vehicle rolled over her pelvis. She had isolated vaginal lacerations on exam. SUMMARY AND CONCLUSION: Extreme pelvic compression is an adequate mechanism of injury in a child presenting with vaginal laceration.