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SUMMARY OBJECTIVE: Autosomal dominant polycystic kidney disease is an inherited kidney disorder with mutations in polycystin-1 or polycystin-2. Autosomal recessive polycystic kidney disease is a severe form of polycystic kidney disease that is characterized by enlarged kidneys and congenital hepatic fibrosis. Mutations at PKHD1 are responsible for all typical forms of autosomal recessive polycystic kidney disease. METHODS: We evaluated the children diagnosed with polycystic kidney disease between October 2020 and May 2022. The diagnosis was established by family history, ultrasound findings, and/or genetic analysis. The demographic, clinical, and laboratory findings were evaluated retrospectively. RESULTS: There were 28 children (male/female: 11:17) evaluated in this study. Genetic analysis was performed in all patients (polycystin-1 variants in 13, polycystin-2 variants in 7, and no variants in 8 patients). A total of 18 variants in polycystin-1 and polycystin-2 were identified and 9 (50%) of them were not reported before. A total of eight novel variants were identified as definite pathogenic or likely pathogenic mutations. There was no variant detected in the PKDH1 gene. CONCLUSION: Our results highlighted molecular features of Turkish children with polycystic kidney disease and demonstrated novel variations that can be utilized in clinical diagnosis and prognosis.
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Sophora alopecuroides, a plant of the family Leguminosae, is one of the Daodi herbs in Ningxia. The active constituents of Sophora alopecuroides are abundant and complex, including alkaloids, flavonoids, volatile oils, steroids, polysaccharides, fatty acids and so on. In recent decades, a great number of domestic and overseas studies have been carried out on Sophora alopecuroides alkaloids, which have anti-hepatitis, anti-liver fibrosis, anti-cirrhosis, anti-liver failure and anti-liver cancer and other pharmacological effects. Clinically, Matrine-related drugs are used to treat hepatitis B virus infection and other diseases. This review aims to summarize the main active ingredients of Sophora alopecuroides, mainly focusing on the research progress in their treatment activities for liver diseases.
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Introducción: La enfermedad hepática grasa no alcohólica se caracteriza por un aumento de la acumulación de lípidos (triglicéridos) de forma macrovesicular, en más de 5 % de los hepatocitos, asociado o no a inflamación y/o fibrosis hepática. Objetivo: Caracterizar a pacientes con enfermedad hepática grasa no alcohólica según variables de interés para el estudio. Método: Se realizó un estudio descriptivo y transversal de 95 pacientes atendidos en el Servicio de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde junio hasta diciembre de 2018. Entre las variables figuraron: edad, sexo, factores de riesgo, resultados de exámenes complementarios, ecografía hepática y factores de pronósticos clínicos para la fibrosis. Resultados: En la serie predominaron los grupos etarios de 35-44 y de 45-54 años (65,2 %, respectivamente), el sexo femenino, la obesidad como principal factor de riesgo (50,5 %), la transaminasa glutámico pirúvica-alanina aminotransferasa (39,0 %) entre los exámenes complementario con valores alterados y la esteatosis hepática moderada como hallazgo ecográfico (55,8 %), entre otros. Conclusiones: La enfermedad hepática grasa no alcohólica prevaleció en los pacientes entre 35-54 años, donde la obesidad constituyó el factor de riesgo más importante; asimismo, un mayor número de pacientes presentó cifras elevadas de transaminasa glutámico pirúvica-alanina aminotransferasa y los hallazgos ecográficos revelaron la primacía de la esteatosis moderada. La presencia de 4 o más factores pronósticos constituyó un riesgo para el desarrollo de fibrosis hepática.
Introduction: The non alcoholic fatty hepatic disease is characterized by an increase of the lipids accumulation (triglycerides) in a macrovesicular way, in more than 5 % of the hepatic cells, associated or not with inflammation and/or hepatic fibrosis. Objective: To characterize patients with non alcoholic fatty hepatic disease according to variables of interest for the study. Method: A descriptive and cross-sectional study of 95 patients assisted in the Gastroenterology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from June to December, 2018. Among the variables figured: age, sex, risk factors, results of complementary exams, hepatic echography and clinical prognosis factors for the fibrosis. Results: In the series there was a prevalence of the 35-44 and 45-54 age groups (65.2 %, respectively), female sex, obesity as main risk factor (50.5 %), transaminase glutamic piruvic-alanineaminotransferase (39.0 %) among the complementary exams with altered values and the moderate fatty liver as echographic finding (55.8 %), among others. Conclusions: The non alcoholic fatty hepatic disease prevailed in patients between 35-54 years, where obesity constituted the most important risk factor; also, a greater number of patients presented high figures of transaminase glutamic piruvic-alanineaminotransferase and the echographic findings revealed the primacy of the moderate steatosis. The presence of 4 or more prognosis factors constituted a risk for the development of hepatic fibrosis.
Subject(s)
Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Secondary Care , Alanine TransaminaseABSTRACT
Purpose: To assess the Correlation of obesity and other factors with presence of extrahepatic disease among the patients presenting with fatty liver at CMH Rawalakot, Azad Kashmir. Study design: Correlational Study. Setting: Gastroenterology department CMH//Sheikh Khalifa Bin Zayad Al Nahyan Hospital Rawalakot. Duration of study: Six months, from 01-09-2018 to 01-03-2019. Patients and methods: A prospective study was conducted on 51 patients of fatty liver diagnosed on ultrasound by consultant radiologist of own hospital. The demographic profile included age, gender, presence of obesity, triglyceride levels and total cholesterol levels. Common extra-hepatic conditions which were looked for in this study included Diabetes mellitus (DM), Hypertension (HTN), Ischemic heart disease (IHD) and Osteoarthritis (OA) which were diagnosed with the help of detailed history taking, relevant physical examination and laboratory investigations. Results: Out of 51 patients included in the final analysis 31 were male and 20 were female. Twenty-seven participants had one or more co-morbid illnesses while 24 had no such diseases at the time of study. DM was the commonest comorbid illness while OA was least reported. Twenty four patients were obese while 27 had BMI less than 30. The presence of obesity and raised total cholesterol levels had a significant relationship with presence of extra-hepatic illness among the patients presenting with fatty liver. Conclusion: Patients presenting with fatty liver have high prevalence of extrahepatic diseases. Routine screening of common illnesses should be done on all the patients who have been diagnosed as having a fatty liver. Special attention should be given to the patients who had BMI more than 30 or raised total cholesterol levels.
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Objective To understand the awareness of hepatic disease related knowledge among hepatic physicians in poverty-stricken counties in China,assess the effectiveness of training and provide a reference for the training in the future.Methods The training was conducted in 90 clinical hepatic physicians selected from county hospitals in poverty-stricken counties (or cities) in Shanxi and Shaanxi provinces.An examination was conducted before the training,immediately after the training and at 5th month after the training,respectively.One-way analysis of variance and x2 test were conducted to evaluate the score and the correct rate.Results The knowledge score was (42.96± 14.02) before the training,(62.86 ± 13.28) immediately after the training and (59.03 ± 17.92) at 5thmonth after the training,and the differences were significant.After the training,the awareness of all aspects of related knowledge was improved,the difference was significant compared to knowledge score before training,and at 5th month after the training,the difference was still significant.Conclusion After the training,the awareness of liver disease related knowledge of clinical hepatic physicians in poverty-stricken counties (cities) in Shanxi and Shaanxi provinces was improved,and the improvement could be maintained for nearly halfa year.
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Objective To understand the awareness of hepatic disease related knowledge among hepatic physicians in poverty-stricken counties in China,assess the effectiveness of training and provide a reference for the training in the future.Methods The training was conducted in 90 clinical hepatic physicians selected from county hospitals in poverty-stricken counties (or cities) in Shanxi and Shaanxi provinces.An examination was conducted before the training,immediately after the training and at 5th month after the training,respectively.One-way analysis of variance and x2 test were conducted to evaluate the score and the correct rate.Results The knowledge score was (42.96± 14.02) before the training,(62.86 ± 13.28) immediately after the training and (59.03 ± 17.92) at 5thmonth after the training,and the differences were significant.After the training,the awareness of all aspects of related knowledge was improved,the difference was significant compared to knowledge score before training,and at 5th month after the training,the difference was still significant.Conclusion After the training,the awareness of liver disease related knowledge of clinical hepatic physicians in poverty-stricken counties (cities) in Shanxi and Shaanxi provinces was improved,and the improvement could be maintained for nearly halfa year.
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Objective: To evaluate the diagnostic value of PET/CT in single space-occupying lesion of the liver hepatic disease. Meth-ods: Data of 177 patients from Tianjin Medical University Cancer Institute and Hospital between March 2012 and September 2017 with a single hepatic space-occupying lesion who had undergone 18F-FDG PET/CT were collected. CT values and the long and short di-ameters were measured in PACS system. A post-processing workstation was employed, and PETVCAR software was used to automati-cally measure the standardized uptake value (SUV) of the focal and the normal liver tissue. Afterward, T (SUV of the focal)/N (SUV of the normal liver tissue) ratios were calculated. Then, the diagnostic value of various parameters for different pathological types was an-alyzed. The correlation between two continuous variables was calculated using Pearson analysis. Results: The long and short diame-ters of the primary hepatic carcinoma were significantly larger than those of metastatic lesions (P<0.05). The positive rates of hepato-cellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and metastases were 67.6%, 95.2%, and 98.7%, respectively. All meta-bolic parameters of HCC were significantly lower than those of the other pathological types of liver cancer or metastases (P<0.05). The AUCs for diagnosis of ICC and metastases were higher than 0.5, but there was no statistical difference between the AUCs of different SUVs. Moreover, SUVmax was related to lesion size (r=0.535, P<0.001). Conclusions: 18F-FDG PET/CT has a high positive predictive val-ue and effective diagnostic function for ICC and metastasis, and the diagnostic efficacy for both is higher than that for HCC.
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BACKGROUND/AIMS: Chronic liver disease leads to liver fibrosis, and although the liver does have a certain regenerative capacity, this disease is associated with dysfunction of the liver vessels. C-reactive protein (CRP) is produced in the liver and circulated from there for metabolism. CRP was recently shown to inhibit angiogenesis by inducing endothelial cell dysfunction. The objective of this study was to determine the effect of CRP levels on angiogenesis in a rat model of liver dysfunction induced by bile duct ligation (BDL). METHODS: The diameter of the hepatic vein was analyzed in rat liver tissues using hematoxylin and eosin (H&E) staining. The expression levels of angiogenic factors, albumin, and CRP were analyzed by real-time PCR and Western blotting. A tube formation assay was performed to confirm the effect of CRP on angiogenesis in human umbilical vein endothelial cells (HUVECs) treated with lithocholic acid (LCA) and siRNA-CRP. RESULTS: The diameter of the hepatic portal vein increased significantly with the progression of cirrhosis. The expression levels of angiogenic factors were increased in the cirrhotic liver. In contrast, the expression levels of albumin and CRP were significantly lower in the liver tissue obtained from the BDL rat model than in the normal liver. The CRP level was correlated with the expression of albumin in hepatocytes treated with LCA and siRNA-CRP. Tube formation was significantly decreased in HUVECs when they were treated with LCA or a combination of LCA and siRNA-CRP. CONCLUSION: CRP seems to be involved in the abnormal formation of vessels in hepatic disease, and so it could be a useful diagnostic marker for hepatic disease.
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Animals , Humans , Male , Rats , Angiogenic Proteins/genetics , Bile Ducts/surgery , C-Reactive Protein/analysis , Cells, Cultured , Disease Models, Animal , Hepatic Veins/abnormalities , Hepatocytes/cytology , Human Umbilical Vein Endothelial Cells , Lithocholic Acid/pharmacology , Liver/metabolism , Liver Cirrhosis/etiology , Liver Diseases/metabolism , Microscopy, Fluorescence , Mitochondria/drug effects , RNA Interference , RNA, Small Interfering/metabolism , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Serum Albumin/geneticsABSTRACT
Objetivo: brindar una guía de práctica clínica basada en la evidencia más reciente para el diagnóstico y tratamiento de la enfermedad hepática grasa no alcohólica teniendo en cuenta la efectividad y seguridad de las intervenciones dirigidas a pacientes, personal asistencial, administrativo y entes gubernamentales de cualquier servicio de atención en Colombia. Materiales y métodos: esta guía fue desarrollada por un equipo multidisciplinario con apoyo de la Asociación Colombiana de Gastroenterología, el Grupo Cochrane ITS y el Instituto de Investigaciones Clínicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clínicas relevantes y se realizó la búsqueda de guías nacionales e internacionales en bases de datos especializadas. Las guías existentes fueron evaluadas en términos de calidad y aplicabilidad; una guía cumplió los criterios de adaptación, por lo que se decidió adaptar 3 preguntas clínicas. El Grupo Cochrane realizó la búsqueda sistemática de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas con base en la metodología GRADE. Las recomendaciones de la guía fueron socializadas en una reunión de expertos con entes gubernamentales y pacientes. Resultados: se desarrolló una guía de práctica clínica basada en la evidencia para el diagnóstico y tratamiento de la enfermedad hepática grasa no alcohólica en Colombia. Conclusiones: el diagnóstico y manejo oportuno de la enfermedad hepática grasa no alcohólica contribuirá a disminuir la carga de la enfermedad en Colombia, así como de las enfermedades asociadas.
Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and treatment of nonalcoholic fatty liver disease for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated about quality and applicability. One guideline met the criteria for adaptation, so the group decided to adapt 3 clinical questions. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence-based Clinical Practice Guidelines for the diagnosis and treatment of nonalcoholic fatty liver disease was developed for the Colombian context. Conclusions: The opportune detection and appropriate management of nonalcoholic fatty liver disease would contribute to the burden of the disease in Colombia.
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Humans , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/therapyABSTRACT
PURPOSE: The association between liver enzymes and death from external causes has not been examined. We investigated the association between serum aminotransferase levels and external-cause mortality in a large prospective cohort study. MATERIALS AND METHODS: A total of 142322 subjects of 35-59 years of age who completed baseline examinations in 1990 and 1992 were enrolled. Mortalities were identified using death certificates. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were categorized into quintiles. Sub-distribution hazards ratios and 95% confidence intervals (CIs) were estimated using a competing risks regression model in which deaths from other causes were treated as competing risks. RESULTS: Of 8808 deaths, 1111 (12.6%) were due to external causes. Injury accounted for 256 deaths, and suicide accounted for 255. After adjusting for covariates, elevated ALT and AST were significantly associated with an increased risk of all external-cause mortalities, as well as suicide and injury. Sub-distribution hazards ratios (95% CIs) of the highest versus the lowest quintiles of serum ALT and AST were, respectively, 1.57 (1.26-1.95) and 1.45 (1.20-1.76) for all external causes, 2.73 (1.68-4.46) and 1.75 (1.15-2.66) for suicide, and 1.79 (1.10-2.90) and 1.85 (1.21-2.82) for injury. The risk of external-cause mortality was also significantly higher in the fourth quintile of ALT (21.6-27.5 IU/L) than in its first quintile. CONCLUSION: Elevated aminotransferase levels, even within the normal range, were significantly associated with increased risk of all external-cause mortalities, including suicide, and injury.
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Adult , Female , Humans , Male , Middle Aged , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Mortality , Population Surveillance , Proportional Hazards Models , Prospective Studies , Republic of Korea/epidemiology , RiskABSTRACT
Nrf2 signaling pathway is a major mechanism in the cellular defense against oxidative or electrophilic stress,which regulates series of detoxifying and antioxidant defense genes expression in the liver. The Nrf2 signaling pathway collectively exhibits diverse biological functions against viral hepatitis,alcoholic and nonalcoholic liver disease,fibrosis,and cancer via target gene expression. This review discusses the role of the Nrf2 pathway in liver pathophysiology and the potential application of Nrf2 as a therapeutic target of prevention and treatment of liver diseases.
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Os autores comentam fundamentados em revisões sistemáticas, metanálises e em sua própria experiência, principalmente os aspectos clínicos relacionados com o tema álcool e o fígado. A Doença Hepática Alcoólica (DHA), ou seja, a hepatopatia induzida pelo etanol e/ou seus metabólitos, representa protótipo de doença em que convergem fatores biológicos, clínicos, epidemiológicos e psicológicos. A DHA representa o modelo de doença humana desencadeada pelo próprio homem e modulada por diversos fatores. O diagnóstico deve se basear na anamnese, exame físico, exames laboratoriais (por vezes incluindo alguns novos), métodos diagnósticos por imagens, exames histológicos em alguns casos e resposta terapêutica à abstenção alcoólica. Comentam sobre o uso de medicamentos e a respeito da indicação de transplante hepático na DHA. Ressaltam que para a vacinação contra a hepatite B em alcoólatras, a dose recomendada deve ser o dobro da utilizada comumente.
The authors comment based on systematic reviewa, metanalysis and in their own esperience, mainly the clinical aspects related to the subject alcohol nad the liver. The alcoholic liver disease (ALD), this is the disease induced by ethanol and/or its metabolics, represent the protolype of a disease which converges biological, clinical, epidemiological and psychological factors. The ALD represents the pattern of a human disease provoked by men themselves and influences by various factors. The diagnosis is based on anamnesis, physical and laboratorial exams (sometimes including some new exams) image diagnosis morphological data in some cases and on the improvement after the alcoholic abstention. They comment about the association alcohol and drugs, alcohol and virus B and C hepatitis, fat hepatic non-alcoholic disease and hepatocellular carcinoma. They comment about the use of drugs in ALD and liver transplant.
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Humans , Liver Diseases, Alcoholic , Hepatitis C , Alcoholism , LiverABSTRACT
Objective To evaluate the effects of different surgical treatments on polycystic hepatic disease and multiple simple hepatic cysts.Methods A total of 35 cases of polycystic hepatic disease and 54 cases of multiple simple hepatic cysts were surgically treated in our department from Jan.1998 to Jan.2006.Of the 35 cases of polycystic hepatic disease,12 were treated with the partial hepatic resection in combination with cyst fenestration,18 with laparotomic fenestration,5 with laparoscopic fenestration.Of the 54 cases of multiple simple hepatic cysts,6were treated with percutaneons aspiration and instillation of sclerosing agents (ethanol) under the guidance of ultrasonography B,36 with laparotomic fenestration,13 with laparoscopic fenestration.The surgical outcome and longterm follow-up outcome were retrospectively analyzed.Results After treatment,all polycystic hepatic disease patients experienced relief of symptoms when discharged.And the follow-up for an average of 3.0 years showed that 2 patients developed recurrence after the partial hepatic resection in combination with cyst fenestration,8 after the laparotomic fenestration,5 after the laparoscopic fenestration.The recurring rates were 16.7%,44.4% and 100.0% ,respectively.However,all patients of multiple simple liver cysts cured.Conclusions The approach of partial hepatic resection in combination with cyst fenestration is the most effective treatment for polycystic hepatic disease.Liver transplantation can cure polycystic hepatic disease,and is the only effective approach for severe cases.Percutaneous aspiration under the guidance of ultrasonography B is only effective for relief of symptoms before operation.Laparoscopic fenestration should be applied with caution.Laparoscopic fenestration is the first choice for multiple simple hepatic cysts with clinical symptoms.
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La platinosomosis es una enfermedad hepática causada por digéneos del género PlatynosomumLooss, 1907, que afecta aves y mamíferos de áreas tropicales y subtropicales. La alta incidencia de laenfermedad en gatos ha posibilitado contar con detallada información acerca del ciclo de vida del parásito,su patogenia, diagnostico y tratamiento. En el 2002, en Turbo, Antioquia, se detectó un gato (Felis catus)con mala condición corporal, alopecia, extrema delgadez, vientre inflamado y notables síntomas deenfermedad hepática. Dada la gravedad de la enfermedad, al gato se le realizó la eutanasia y durantela necropsia se hallaron quistes en el hígado que contenían digéneos de la familia Dicrocoeliidae. Esteartículo tiene como propósito establecer el estatus taxonómico específico del parásito y dar a conocerel caso mediante la descripción de los signos clínicos. El digéneo fue identificado como Platynosomumilliciens y sus signos clínicos son típicos de la enfermedad, su difícil diagnostico sugiere realizar un examencoprológico acompañado de una ecografía. Se recomienda realizar un estudio de foco en Turbo Antioquia,considerando su amplia distribución en la región del Caribe y países vecinos. El presente estudio constituyeel primer caso de platinosomosis en Colombia.
Platinosomosis is a liver disease caused by Digeneans of the genus Platynosomum Looss, 1907, thataffects birds and mammals in tropical and subtropical areas. The high incidence of the disease in cats hasallowed to obtain detailed information about the life cycle of the parasite, pathogenesis, diagnosis andtreatment. In 2002, in Turbo, Antioquia, we detected a cat (Felis catus) with poor body condition, hairloss, extreme thinness, swollen belly and significant symptoms of liver disease. Given the severity of thedisease, the cat was euthanized and the autopsy found digeneans from Dicrocoeliidae family in the livercysts. This paper aims to establish the taxonomic specificity of the parasite and bring forward the case bydescribing the clinical symptoms. The digenea was identified as Platynosomum illiciens and the clinicalsigns are typical of this disease, its diagnosis suggests a coprological review with an ultrasound exam. Werecommend making a focus study on Turbo Antioquia, considering its wide distribution in the Caribbeanregion and neighboring countries. This study is the first case of platinosomosis in Colombia.
Platinosomosis é uma doença hepática causada pelo gênero Digenea Platynosomum Looss de 1907, queafecta as aves e mamíferos em áreas tropicais e subtropicais. A alta incidência da doença em gatos levoua ter informações detalhadas sobre o ciclo de vida do parasita, patogenia, diagnóstico e tratamento. Em2002, na Turbo, Antioquia, era um gato (Felis catus) com má condição corporal, perda de cabelo, magrezaextrema, barriga inchada e significativos sintomas de doença hepática. Dada a gravidade da doença, osgatos foram submetidos à eutanásia e foram encontrados durante a autópsia no fígado cistos contendoDigenea Dicrocoeliidae da família. Este artigo tem por objectivo estabelecer o estatuto taxonómico doparasita específico e divulgar o evento, descrevendo os sintomas clínicos. O Digenea foi identificada comoPlatynosomum illiciens e os sinais clínicos são típicos da doença, seu diagnóstico coprológico sugereuma revisão com um ultra-som. Recomendamos que você faça um estudo incidir sobre Turbo Antioquia,considerando sua ampla distribuição na região do Caribe e de países vizinhos. Este estudo é o primeirocaso de platinosomosis na Colômbia.
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Animals , Cat Diseases/parasitology , Liver Diseases, Parasitic/veterinaryABSTRACT
El uso de la Medicina Alternativa y Complementaria (MAC) es elevado a nivel mundial, estimándose que el 3% de todos los adultos de Estados Unidos usan alguna forma de hierbas medicinales, específicamente aquellos con enfermedad hepática. Se desconoce el potencial hepatotóxico asociado con MAC, hierbas medicinales o productos de botánicoesto es debido en parte a que existe una subestimación de su uso en la población general, en parte porque hay un subreporte de casos. Con el objetivo de conocer la frecuencia del uso de MAC en los pacientes con enfermedad hepática, realizamos un estudio descriptivo tipo serie de casos en los pacientes que acudieron a la consulta de hígado del Hospital Universitario de Caracas desde febrero hasta mayo de 2005 con patología hepática de cualquier etiología. Encontramos que el 53.25% de los pacientes consumieron MAC, de éstos el 81.07% recibieron medicina alternativa a base de hierbas preparadas en forma de te o infusión y el 18.93% recibió medicina sistemática (adaptogenos). Los diagnósticos de los pacientes fueron: hepatitis C, elevación de aminotransferasas, hepatitis B, cirrosis, hígado graso, hepatopatia crónica por alcohol, HAI, LOE hepático, Hepatitis A, hepatitis por CMV.
The use of Alternative and Complementary Medicine (MAC) is high at a world-wide level, a 3% of the adult population in the United States use some form of medical herbs, specifically those with hepatic disease. The hepatotoxic potential associated with MAC is not known, in part because the use of medical herbs or botanical products is underestimated in the general population, partly because there is a sub report of cases. With the objective to know the frequency of MAC use in patients with hepatic disease, we made a descriptive study, type "series of cases" in patients who attended the Hepatic consultation at the University Hospital of Caracas from February to May of 2005 with hepatic pathology of any etiology. We found that 53,25% of the patients consumed MAC, from these, 81,07% received alternative medicine with herbs prepared in the form of tea or infusion, and 18,93% received systemic medicine (adaptogens). The diagnoses of the patients were: hepatitis C, elevation of aminotransferases, hepatitis B, cirrhosis, fatty liver, chronic alcoholic hepatic disease, HAI, hepatic mass, hepatitis A, and hepatitis by CMV.
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Co-existent hepatic disease poses a challenge for the physicians treating tuberculosis. The hepatic disease may either be pre-existent or may develop during the course of disease or as an adverse reaction to anti-TB drugs. Treatment may need modifications, stoppage or even change of drug regimens.
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Drug pair is the basic unit of compatibility of formulas.Through selecting the prescriptions of treating diseases of the liver in "Treatise on Cold Pathogenic Diseases" and "Synopsis of Golden Chamber",we,according to therapeutic methods,classify the commonly used drug pairs in treatment of hepatic disease of ZHANG Zhong-jing into eight kinds:regulating the flow of liver-qi,promoting blood circulation by removing blood stasis,dispersing pathogenic wind and calming liver wind,removing jaundice,clearing away liver-heat,expelling liver-cold and warming the liver,nourishing the liver,and harmonizing liver-spleen.And we try to find the compatibility law.
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Objective By using multi detector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. Methods CT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrast enhanced dual phase scanning of upper abdomen. Results In hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67?0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized non dependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54?1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had high attenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); micro abscess and gas in the gallbladder wall was observed in 1 case respectively. Conclusion MDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
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El hepatocarcinoma es el tumor primario hepático más frecuente, cuyo pronóstico está ligado a la detección temprana. Su asociación con el daño hepatocelular producido por la infección crónica del virus de hepatitis B y C, obligan a establecer seguimientos estrictos en estos pacientes. Hasta el momento, el tratamiento quirúrgico mediante la resección completa del tumor ha demostrado ser la mejor alternativa con intención curativa para el hepatocarcinoma, sin embargo esta posibilidad está limitada a unos pocos pacientes, debido a la detección tardía de estos tumores, que en su inicio son indolentes y asintomáticos. De igual manera la coexistencia de enfermedad hepática crónica, contraindica en muchos casos la posibilidad de resección por el alto riesgo de falla hepática. En esta revisión se muestra la incidencia de este tumor en nuestro medio, mostrando su distribución, formas de presentación y características clínicas, con el fin de estimular su detección temprana y tratamiento.
The hepatocarcinoma is the most frequent primary hepatic tumor which prognostic is related to the early detection. The association between chronic hepatocellular damage by human hepatitis virus B and C, forces to establish strict follow up in these patients. Until now, the surgical treatment by means of the complete resection of the tumor has demonstrated to be the best alternative with healing intention for the hepatocarcinoma, however this possibility is limited to some few patients, due to the late detection of these tumors that are non-symptomatic in their beginning. In a same way the coexistence of chronic hepatic illness, contraindicates in many cases the resection possibility for the high risk of liver failure. In this revision, the incidence of this tumor is shown in our hospital, as well as its distribution, presentation forms and clinical characteristics, with the purpose of stimulating its early detection and treatment.
Subject(s)
Humans , Male , Female , Middle Aged , Carcinoma, Hepatocellular , Hepacivirus , Hepatitis B , Liver DiseasesABSTRACT
54 patients with acute viral hepatitis of which hepatic coma (8), uncompensate cirrhosis (17) and liver cancer (14) participated to a study have shown that the serum gamma glutamyl transpeptidase ((-GT) activity was slightly increased in patients with viral hepatitis coma and uncompensate cirrhosis. This was a bad sign the (-GT was highly increased in patients with liver cancer. The average serum (-GT activity was increased about 3 times in the acute viral hepatitis. But diagnostic value of (-GT was lower than this of SGPT