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1.
Infectio ; 25(4): 250-255, oct.-dic. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1286718

ABSTRACT

Resumen Introducción: Las alteraciones de la bioquímica hepática son frecuentes en los pacientes con infección por VIH, la etiología es variada, la esteatosis hepática es frecuente con una prevalencia estimada del 60% Objetivos: Caracterizar las alteraciones hepáticas en una serie de pacientes con infección por VIH en un centro de investigación de Bogotá Colombia durante el periodo 2009 - 2019. Materiales y Métodos: Estudio descriptivo, retrospectivo, observacional de pacientes con infección por VIH que asistieron a un centro de investigación durante los años 2009-2019. Resultados: 94% fueron hombres y 6% mujeres con edad promedio de 44 años, 92,5% de los pacientes presentaba uso de terapia antiretroviral. Las principales hepatopatías fueron la coinfección VIH-Hepatitis C y el hígado graso en iguales porcentajes, 31,3%. El promedio del indice HOMA fue de 2,58. Discusión: Las enfermedades hepáticas son una causa importante de morbimortalidad en pacientes con infección por VIH, las coinfecciones virales y el hígado graso pueden ser muy frecuentes en nuestro medio a diferencia de otros estudios Conclusiones: Este es el primer estudio a nivel local en describir las alteraciones hepáticas en pacientes con VIH, las comorbilidades no SIDA, juegan un papel importante dentro de la enfermedad. La hepatitis C continúa siendo una coinfección frecuente en la población VIH.


Abstract Introduction: Alterations in liver biochemistry are frequent in patients with HIV infection, the etiology is varied and includes multiple causes, liver steatosis is one of the most frequent with an estimated prevalence of 60% after the appearance of antiretroviral treatment Objectives: To characterize liver disorders in a series of patients with HIV infection at a research center in Bogotá Colombia during the period 2009-2019. Materials and Methods: Descriptive, retrospective, observational study of patients with HIV infection who attended a disease research center during the years 2009-2019. Results: 67 clinical histories were reviewed, 94% were men and 6% women with an average age of 44 years, 92.5% of the patients had use of anti-retroviral therapy and the diagnosis of HIV was known 11.7 years ago on average. The main liver diseases were HIV-Hepatitis C coinfection and fatty liver in equal percentages, 31.3%. The average HOMA index was 2.58. Discussion: Liver diseases are an important cause of morbidity and mortality in patients with HIV infection. Viral coinfections and fatty liver can be very frequent in our setting, unlike other studies. Conclusions: This is the first study locally to describe the liver disorders in patients with HIV, non-AIDS comorbidities, including fatty liver, play an important role in the disease and could behave like the general population. Hepatitis C continues to be a frequent coinfection in the HIV population.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , HIV Infections , Liver Diseases , Therapeutics , Prevalence , Acquired Immunodeficiency Syndrome , Hepatitis C , Colombia , Fatty Liver , Liver
2.
Medicina UPB ; 40(2): 75-79, 13 oct. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1342235

ABSTRACT

Los antibióticos y analgésicos han sido descritos frecuentemente como las principales causas de toxicidad hepática. Los esteroides anabólicos se han relacionado también con alteraciones en sistemas como el cardiovascular o el hepático; en este último causan colestasis, carcinoma hepatocelular, hiperplasia regenerativa nodular y sangrado de varices, secundario a hipertensión portal. Es importante entonces considerar los esteroides anabólicos como factores de riesgo para hepatotoxicidad. Se presenta el primer caso en Colombia y uno de los pocos en Latinoamérica, de colestasis asociada únicamente al uso de estanozolol. Se trata de un paciente de 21 años, en tratamiento con el medicamento para incrementar la masa muscular, que presentó compromiso hepático de tipo colestásico. Se descartaron otras posibles causas de ictericia, mediante la escala CIOMS/RUCAM se llegó a establecer causalidad entre el consumo de estanozolol y la colestasis. El objetivo de este reporte es hacer una descripción no reportada en la literatura colombiana y poco común en la literatura mundial.


Antibiotics and pain relievers have been frequently described as the main causes of liver toxicity. Anabolic steroids have also been linked to alterations in systems such as cardio-vascular or liver. In the latter, they seem to cause cholestasis, hepatocellular carcinoma, nodular regenerative hyperplasia and variceal bleeding secondary to portal hypertension. It is important to consider them as factors associated with hepatotoxicity. The first case in Colombia and one of the few in Latin America of cholestasis associated only to the use of Stanozolol is presented in a 21-year-old patient under treatment with the drug to increase muscle mass. The patient presented with cholestatic liver involvement. Other possible causes of jaundice were ruled out. From the CIOMS / RUCAM scale, causality was established between the consumption of Stanozolol and cholestasis. The objective of this case is to report a case not found in Colombian literature and little reported in world literature.


Antibióticos e analgésicos têm sido frequentemente descritos como as principais causas de toxicidade hepática. Os esteroides anabolizantes também têm sido relacionados a alterações em sistemas como cardiovasculares ou hepáticos; neste último, causam colestase, carcinoma hepatocelular, hiperplasia nodular regenerativa e sangramento varicoso, secundário à hipertensão portal. Portanto, é importante considerar os este-roides anabolizantes como fatores de risco para hepatotoxicidade. O primeiro caso é apresentado na Colômbia e um dos poucos na América Latina, de colestase associada apenas ao uso de estanozolol. Paciente de 21 anos, em tratamento com fármaco para aumento de massa muscular, apresentou acometimento hepático colestático. Outras possíveis causas de icterícia foram descartadas, a escala CIOMS / RUCAM estabeleceu causalidade entre o consumo de estanozolol e colestase. O objetivo deste relatório é fazer uma descrição não relatada na literatura colombiana e rara na literatura mundial


Subject(s)
Humans , Stanozolol , Anabolic Agents , Cholestasis , Testosterone Congeners , Jaundice , Liver
3.
Rev. cuba. cir ; 60(2): e989,
Article in Spanish | LILACS, CUMED | ID: biblio-1280220

ABSTRACT

Introducción: El cáncer de colon constituye un grave problema sanitario debido a su alta incidencia y mortalidad. Objetivo: Describir algunos aspectos epidemiológicos, etiopatogénicos, diagnósticos, terapéuticos y evolutivos del cáncer de colon con metástasis hepáticas. Métodos: Revisión documental en bases de datos bibliográficos biomédicas sobre el tema durante el período 2015-2020. Se seleccionaron 31 artículos relacionados con el objetivo propuesto. Desarrollo: Los pacientes con cáncer de colon con metástasis hepáticas sincrónicas son tratados mediante tres estrategias: la tradicional o clásica consiste en la resección quirúrgica del tumor primario y posteriormente, quimioterapia, radioterapia o ambas, para proceder a la resección de las lesiones hepáticas tres a seis meses después; la simultánea, consistente en la resección de la lesión tumoral primaria y de las metástasis hepáticas en un mismo acto quirúrgico, seguida de quimioterapia, radioterapia o ambas y la inversa, que administra de tres a seis ciclos de quimioterapia sistémica, seguidos por la resección de las metástasis hepáticas y en un segundo tiempo resecar el tumor primario, todo esto con quimioterapia durante el intervalo entre ambas cirugías. Conclusiones: El único tratamiento con potencial curativo en los pacientes con metástasis hepáticas debe ser la resección de todo el volumen tumoral hepático con márgenes adecuados y la suficiente preservación del parénquima sano (25 - 30 por ciento), según criterios oncológicos y anatómicos establecidos, lo que incide en la calidad de vida y la supervivencia de estos enfermos(AU)


Introduction: Colon cancer is a serious health concern due to its high incidence and mortality. Objective: To describe some epidemiological, etiopathogenic, diagnostic, therapeutic and evolutionary aspects of colon cancer with hepatic metastases. Methods: Documentary review about the subject carried out in biomedical bibliographic databases, during the period 2015-2020. Thirty-one articles related to the proposed objective were selected. Development: Colon cancer patients with synchronous hepatic metastases are treated using three strategies: the traditional, or classic, strategy consists in surgical resection of primary tumor and, subsequently, chemotherapy, radiotherapy or both, before proceeding then to resection of liver lesions three to three six months later; the simultaneous strategy consists in resection of primary tumor lesion and hepatic metastases in the same surgical procedure, followed by chemotherapy, radiotherapy or both; and the reverse strategy, in which three to six cycles of systemic chemotherapy are administered, followed by resection of hepatic metastases and, in a second stage, resection of primary tumor, all this with chemotherapy during the interval between both surgeries. Conclusions: The only treatment with curative potential in patients with hepatic metastases should be the resection of the entire hepatic tumor volume with adequate margins and sufficient preservation of the healthy parenchyma (25-30 percent), according to established oncological and anatomical criteria, which has an incidence on the quality of life and survival of these patients(AU)


Subject(s)
Humans , Quality of Life , Databases, Bibliographic , Colonic Neoplasms/surgery , Colonic Neoplasms/epidemiology , Neoplasm Metastasis/therapy , Survivorship , Liver/injuries
4.
Rev. bras. med. esporte ; 27(2): 138-141, Apr.-June 2021. tab
Article in English | LILACS | ID: biblio-1280072

ABSTRACT

ABSTRACT Introduction: High intensity interval training (HIIT) is a method that is widely used today. Objective: The present study aimed to evaluate the effects of HIIT on markers of oxidative stress and muscle damage in rats. Methods: The sample consisted of 60-day-old Wistar rats, divided into two groups: a control group (n=8) and an HIIT group (n=8). The training consisted of fourteen 20-second swimming sessions (loaded with weights equivalent to 14% of their body weight) with 10-second intervals between each session, performed for 12 consecutive days. Results: HIIT induced a reduction (−17.75%) in thiobarbituric acid reactive substances (an oxidative stress marker) in hepatic tissue (p=0.0482). There was also a reduction (−31.80%) in the HIIT group in the level of superoxide dismutase enzyme activity in the liver (p=0.0375). However, there were no differences between the groups in catalase, glutathione peroxidase, glutathione reductase, the total content of SH sulfhydryls, hydroperoxides, or carbonylated proteins in the hepatic tissue. No significant differences were found in any of these markers in the gastrocnemius muscle. The muscle damage markers creatinine kinase and lactate dehydrogenase were also similar between the groups in the gastrocnemius. Conclusion: The conclusion was that that short-term HIIT does not cause oxidative stress or muscle damage. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.


RESUMEN Introducción: El entrenamiento en intervalos de alta intensidad (HIIT) es un método muy utilizado actualmente. Objetivo: El presente estudio tuvo como objetivo evaluar los efectos del HIIT en corto plazo sobre marcadores de estrés oxidativo y daño muscular en ratones. Métodos: La muestra consistió en ratones Wistar con 60 días de edad, divididos en dos grupos: grupo control (n = 8) y grupo HIIT (n = 8). El entrenamiento consistió en catorce sesiones de natación de 20 segundos (con cargas equivalentes a 14% del peso corporal) con intervalos de 10 segundos entre cada sesión, realizadas durante 12 días consecutivos. Resultados: El HIIT indujo una reducción (-17,75%) de las sustancias reactivas al ácido tiobarbitúrico (un marcador de estrés oxidativo) en el tejido hepático (p = 0,0482). También hubo reducción (~31,80%) en el grupo HIIT en el nivel de enzima superóxido dismutasa en el hígado (p=0,0375). Sin embargo, no hubo diferencias entre los grupos con relación a catalasa, glutatión peroxidasa, glutatión reductasa, tenor total de sulfhidrilos SH, hidroperóxidos o proteínas carboniladas en el tejido hepático. No fue encontrada ninguna diferencia significativa en ninguno de esos marcadores en el músculo gastrocnemio. Los marcadores de lesión muscular, creatinina quinasa y lactato deshidrogenasa también fueron similares entre los grupos en el gastrocnemio. Conclusión: Fue posible concluir que el HIIT de corta duración no causa estrés oxidativo o daño muscular. Nivel de evidencia I; Estudio clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de información estrechos.


RESUMO Introdução: O treinamento intervalado de alta intensidade (HIIT) é um método muito utilizado atualmente. Objetivo: O presente estudo objetivou avaliar os efeitos do HIIT em curto prazo sobre marcadores de estresse oxidativo e dano muscular em ratos. Métodos: A amostra consistiu em ratos Wistar com 60 dias de idade, divididos em dois grupos: grupo controle (n = 8) e grupo HIIT (n = 8). O treinamento consistiu em quatorze sessões de natação de 20 segundos (com cargas equivalentes a 14% do peso corporal) com intervalos de 10 segundos entre cada sessão, realizadas por 12 dias consecutivos. Resultados: O HIIT induziu uma redução (-17,75%) das substâncias reativas ao ácido tiobarbitúrico (um marcador de estresse oxidativo) no tecido hepático (p = 0,0482). Houve também redução (-31,80%) no grupo HIIT no nível de enzima superóxido dismutase no fígado (p = 0,0375). No entanto, não houve diferenças entre os grupos com relação a catalase, glutationa peroxidase, glutationa redutase, teor total de sulfidrilas SH, hidroperóxidos ou proteínas carboniladas no tecido hepático. Nenhuma diferença significativa foi encontrada em qualquer um desses mascadores no músculo gastrocnêmio. Os marcadores de lesão muscular, creatinina quinase e lactato desidrogenase, também foram semelhantes entre os grupos no gastrocnêmio. Conclusão: Foi possível concluir que o HIIT de curta duração não causa estresse oxidativo ou dano muscular. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de informação estreitos.


Subject(s)
Humans , Animals , Male , Rats , Oxidative Stress/physiology , High-Intensity Interval Training , Swimming , Biomarkers , Rats, Wistar , Models, Animal , Liver/physiology , Muscles/physiology
5.
Arq. gastroenterol ; 58(2): 139-144, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285330

ABSTRACT

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the world, and its prevalence is increasing alongside obesity. In United States, NAFLD is already the second leading cause of liver transplantation. The spectrum of the disease ranges from simple steatosis, which has a benign course, to steatohepatitis, which may progress to cirrhosis and its complications. The rising of noninvasive methods for diagnosing and staging non-alcoholic steatohepatitis (NASH) and fibrosis decreases the need of liver biopsy, as well as the costs and the occurrence of complications related to it. OBJECTIVE: To analyze the performance of the triglyceride-glucose index to evaluate steatosis, NASH and liver fibrosis in obese patients with NAFLD. METHODS: This is a retrospective cross-sectional study. Every medical record of patients who were candidates for bariatric surgery at a leading hospital in Southern Brazil were analyzed. The triglyceride-glucose index (TyG Index), a method composed only of two simple laboratory tests (serum triglycerides and fasting glucose levels), was performed prior to surgery. The TyG Index performance regarding the anatomopathological findings was evaluated, and the AUROC curve was calculated to evaluate the best cut-off point for diagnosing steatosis, non-alcoholic steatohepatitis and liver fibrosis grade. Also, the NAFLD fibrosis Score (NFS) was evaluated. RESULTS: A total of 423 patients were evaluated. The TyG Index with a cut-off point of 8.76 excluded significant simple steatosis (grade 2-3) in obese patients, with 67.6% sensitivity, 65.1% specificity, 46.3% positive predictive value (PPV), 81.8% negative predictive value (NPV), 65.8% accuracy and 0.66 AUROC (P=0.005). In the evaluation of NASH, the TyG Index with a cut-off point of 8.82 excluded significant NASH (grade 2-3) with 57.3% sensitivity, 58.6% specificity, 33.7% PPV, 78.8% NPV, 58.2% accuracy and 0.58 AUROC (P=0.022). When evaluating liver fibrosis, the TyG Index with a cut-off point of 8.91 showed a sensitivity of 61.8%, a specificity of 62.5%, a PPV of 13.8 and a NPV of 94.4% for exclusion of advanced fibrosis (F3-4), with a 62.4% accuracy and 0.69 AUROC (P<0.001). When analyzing the performance of NFS in the diagnosis of advanced fibrosis, the cut-off point <-1.455 excluded advanced fibrosis with sensitivity of 59.4%, specificity of 51%, PPV of 11%, NPV of 92.4% and accuracy of 51.7%. However, the cut-off point of 0.676 to diagnose advanced fibrosis presented sensitivity of 21.9%, specificity of 83%, PPV of 11.7%, NPV of 91.2% and 77.3% accuracy. The AUROC was 0.54 (P=0.480). CONCLUSION: TyG Index did not perform well in the diagnosis of significant steatosis and NASH. However, it was able to exclude advanced fibrosis in obese patients who are candidates for bariatric surgery.


RESUMO CONTEXTO: A doença hepática gordurosa não-alcoólica (DHGNA) é a doença hepática mais prevalente no mundo. Nos Estados Unidos, a DHGNA já é a segunda causa de transplante hepático. O espectro da doença abrange desde a esteatose simples, que apresenta curso benigno, até esteato-hepatite não-alcoólica (EHNA), que pode progredir para cirrose e suas complicações. O desenvolvimento de métodos não invasivos para o diagnóstico e estadiamento da EHNA e da fibrose hepática visa diminuir a necessidade de biópsia hepática, um procedimento invasivo e não raro associado a complicações. OBJETIVO: Analisar o desempenho do índice triglicerídeo-glicose (TyG Index) para o diagnóstico e estadiamento da DHGNA em pacientes obesos. MÉTODOS: Este é um estudo transversal retrospectivo. Foram analisados todos os prontuários de pacientes candidatos a cirurgia bariátrica em um hospital de referência do Sul do Brasil e calculado o TyG Index, um escore composto por dois exames laboratoriais (triglicerídeos e glicose de jejum), realizados previamente à cirurgia. O desempenho do TyG Index em relação aos achados anatomopatológicos hepáticos foi avaliado, e calculada a curva ROC para avaliação de esteatose simples, EHNA e fibrose hepática. O NAFLD Fibrosis Score (NFS) também foi avaliado. RESULTADOS: Foram avaliados 423 pacientes. O melhor ponto de corte do TyG Index para a exclusão de esteatose simples significativa (grau 2-3) foi de 8,76, com sensibilidade 67,6%, especificidade 65,1%, valor preditivo positivo (VPP) 46,3%, valor preditivo negativo (VPN) 81,8%, acurácia 65,8% e AUROC 0,66 (P=0,005). Na avaliação de EHNA significativa (grau 2-3), o melhor ponto de corte foi de 8,82 com sensibilidade 57,3%, especificidade 58,6%, VPP 33,7%, VPN 78,8%, acurácia 58,8% e AUROC 0,58 (P=0,022). Em relação à fibrose avançada (grau 3-4), o melhor ponto de corte do TyG Index foi de 8,91 com sensibilidade 61,8%, especificidade 62,5%, VPP 13,8%, VPN 94,4%, acurácia 62,4% e AUROC 0,69 (P<0,001). Ao analisarmos o desempenho do NFS no diagnóstico de fibrose avançada, o ponto de corte de <-1,455 excluiu fibrose avançada com sensibilidade 59,4%, especificidade 51%, VPP 11%, VPN 92,4% e acurácia 51,7%. Entretanto, o ponto de corte de 0,676 para fibrose avançada apresentou sensibilidade de 21,9%, especificidade 83%, VPP 11,7%, VPN 91,2% e acurácia 77,3%. A AUROC foi de 0,54 (P=0,480). CONCLUSÃO: O TyG Index não apresentou bom desempenho para o diagnóstico e estadiamento da esteatose simples e da EHNA. Entretanto, foi capaz de excluir fibrose avançada em pacientes obesos candidatos a cirurgia bariátrica.


Subject(s)
Humans , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/pathology , Triglycerides , Biopsy , Cross-Sectional Studies , Retrospective Studies , Glucose , Liver/pathology , Liver Cirrhosis/pathology , Obesity
6.
Arch. argent. pediatr ; 119(5): e540-e544, oct. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1292794

ABSTRACT

La infección por Bartonella henselae (BH) que causa la enfermedad por arañazo de gato puede cursar de manera asintomática, así como presentar manifestaciones locales y sistémicas. El objetivo de este caso es documentar que el compromiso hepatoesplénico es poco habitual en este tipo de infección y el tratamiento, que debe ser personalizado, aún genera controversia. Se presenta un caso de una paciente de 11 años con fiebre de origen de desconocido con hallazgos en tomografía y ecografía abdominal de abscesos hepatoesplénicos, y confirmación de infección por BH a través de métodos serológicos. Se realiza una revisión bibliográfica donde se evidencia la baja frecuencia de compromiso hepatoesplénico. De esta manera, la anamnesis y el examen físico son fundamentales para realizar un rápido diagnóstico y tratamiento


The infection by Bartonela henselae (BH), the cause of cat scratch disease, it could be asymptomatic or produce local and multisystem illness. The objective of this case report is to document that the hepato-splenic involvement is unusual in BH infection, and the treatment is discussed and individualized in each patient. This case is about an eleven-year girl who presented with findings in abdominal tomography and ultrasound of hepato-splenic abscesses, with later positive serology for BH. In this way, a bibliographic review is carried out to show the low prevalence and incidence of hepato-splenic involvement where the anamnesis and the physical examination are essential to make an early diagnosis and treatment.


Subject(s)
Humans , Female , Child , Splenic Diseases/diagnostic imaging , Cat-Scratch Disease/complications , Cat-Scratch Disease/diagnosis , Bartonella henselae , Abscess , Liver
7.
Rev. colomb. cir ; 36(3): 549-553, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1254392

ABSTRACT

Introducción. El síndrome de HELLP es una variante grave de la preeclampsia, con una baja incidencia, entre el 0,5-0,9 % de todos los embarazos. La ruptura hepática espontánea en el embarazo es infrecuente, presenta una alta mortalidad, y se ha relacionado con hemangiomas hepáticos, coriocarcinoma y síndrome de HELLP. Caso clínico. Mujer de 29 años con embarazo de 34,3 semanas, con actividad uterina progresiva, sufrimiento fetal agudo y hallazgos compatibles con síndrome de HELLP. Se practicó cesárea de urgencia encontrando hemoperitoneo y ruptura hepática del lóbulo derecho, por lo que se realizó empaquetamiento abdominal y posterior reintervención quirúrgica. Discusión. La ruptura hepática espontánea en el embarazo es una entidad infrecuente y potencialmente mortal. Es esencial un alto nivel de sospecha para realizar el diagnóstico y la rápida intervención. Requiere un manejo multidisciplinario para un resultado exitoso. Se han descrito múltiples tratamientos que dependen de las manifestaciones clínicas y extensión de la lesión, pero es claro que la laparotomía primaria y el taponamiento constituyen la mejor elección ante el hallazgo intraoperatorio.


Introduction. HELLP syndrome is a severe variant of preeclampsia with a low incidence, between 0.5-0.9% of all pregnancies. Spontaneous hepatic rupture in pregnancy is rare, has a high mortality, and has been associated with hepatic hemangiomas, choriocarcinoma, and HELLP syndrome. Clinical case. 29-year-old woman with a 34.3-week pregnancy, with progressive uterine activity and acute fetal distress and findings compatible with HELLP syndrome. An emergency cesarean section was performed, finding hemoperitoneum and hepatic rupture of the right lobe, performing abdominal packing and subsequent surgical reoperation. Discussion. Spontaneous liver rupture in pregnancy is a rare and potentially fatal entity. A high level of suspicion is essential to make the diagnosis and prompt intervention. It requires multidisciplinary management for a successful outcome. Multiple treatments have been described that depend on the clinical manifestations and extent of the lesion, but it is clear that primary laparotomy and packing constitute the best choice before the intraoperative finding.


Subject(s)
Humans , Pregnancy Complications , HELLP Syndrome , Rupture, Spontaneous , General Surgery , Liver
8.
Rev. argent. cir ; 113(1): 111-116, abr. 2021. graf
Article in Spanish | LILACS-Express | LILACS, BINACIS | ID: biblio-1288180

ABSTRACT

RESUMEN El riesgo de insuficiencia hepática posoperatoria es la limitante de mayor importancia para el trata miento de pacientes con tumores hepáticos malignos primarios o secundarios. Entre las diferentes técnicas para incrementar la resecabilidad de tumores hepáticos se desarrolló una estrategia para pa cientes con tumores previamente considerados como irresecables, técnica conocida como ALPPS (as sociating liver partition with portal vein ligation for staged hepatectomy). Informamos acerca de una cirugía ALPPS en terapia reversa en un hombre referido a nuestro centro con diagnóstico sincrónico de cáncer rectal con metástasis hepáticas múltiples consideradas irresecable al momento del diagnóstico.


ABSTRACT The risk for postoperative liver failure is the most important limitation for the treatment of patients with primary or secondary liver cancer. Among the different strategies used to increase resectability in liver tumors, a technique known as ALPPS (associating liver partition with portal vein ligation for staged hepatectomy) was developed for patients with tumors previously considered unresectable. We report the case of a male patient referred to our center with a diagnosis of synchronous multiple liver metastases of colorectal cancer considered unresectable who underwent ALPPS using liver-first reverse approach.


Subject(s)
Patients , Rectal Neoplasms , Therapeutics , Colorectal Neoplasms , Risk , Health Strategies , Liver Failure , Hepatic Insufficiency , Diagnosis , Research Report , Hepatectomy , Ligation , Liver , Methods , Neoplasm Metastasis
9.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 101-108, 20210000.
Article in Spanish | LILACS | ID: biblio-1178954

ABSTRACT

La litiasis vesicular sintomática puede presentarse asociada a litiasis de la vía biliar principal, siendo necesaria la utilización de medios diagnósticos adecuados para su posterior tratamiento. En este trabajo, se sugiere la evaluación mediante las guías de la Sociedad Americana para Endoscopia Gastrointestinal (American Society for Gastrointestinal Endoscopy ASGE), usando factores como la edad, pruebas hepáticas y hallazgos ecográficos, categorizando a los pacientes en baja, intermedia y alta probabilidad de coledocolitiasis. Estudio de diseño retrospectivo, observacional, descriptivo, de corte transversal, con un muestreo no probabilístico de casos consecutivos, sobre pacientes con diagnóstico de litiasis vesicular sintomática y sospecha de litiasis de la via biliar principal internados en la II Cátedra de Clínica Quirúrgica, del Hospital de Clínicas de San Lorenzo, entre los años 2017 a 2019. Con los siguientes resultados, de un total de 339 pacientes con diagnóstico de litiasis vesicular sintomática, el 6,64% tuvo el diagnóstico de coledocolitiasis asociada. En cuanto a los predictores muy fuertes de coledocolitiasis el más frecuentemente (68,6%,) encontrado fue el nivel de la bilirrubina total ≥ 4mg/dl; de los predictores fuertes el 70,6% presentaba la vía biliar principal dilatada; de los predictores moderados, el 84,3% presentó las enzimas hepáticas alteradas. En conclusión, se pudo identificar que la mayoría de los pacientes presentó alta probabilidad de coledocolitiasis y la conducta tomada fue realizar en primer lugar una colangiografía retrógrada endoscópica, con fines terapéuticos y luego colecistectomía, correspondiente al manejo correcto establecido por las guías actuales internacionales.


Symptomatic gallstones can occur associated with lithiasis of the main bile duct, requiring the use of adequate diagnostic tools for subsequent treatment. In this paper, we suggest using the guidelines of the American Society for Gastrointestinal Endoscopy (ASGE), that uses factors such as age, liver tests, and ultrasound findings, categorizing patients as those with low, intermediate, and high probability. of choledocholithiasis. A Retrospective, observational, descriptive, cross-sectional design study, with a non-probabilistic sampling of consecutive cases, on patients with a diagnosis of symptomatic gallstones and suspected stones of the main bile duct admitted to the the 2nd Surgical Department and Service of Clinica´s Hospital of San Lorenzo, between the years 2017 to 2019. With the following results; of a total of 339 patients with the diagnosis of symptomatic gallstones, 6.64% had associated choledocholithiasis. Regarding the very strong predictors of choledocholithiasis, the most frequent (68.6%) was the total bilirubin level ≥ 4mg / dl; 70.6% had a dilated main bile duct as a strong predictor; as a moderate predictor, 84.3% had altered liver enzymes. In conclusion, it was possible to identify that most of the patients presented a high probability of choledocholithiasis and the action taken was to first perform an endoscopic retrograde cholangiography, for therapeutic purposes, and then cholecystectomy, corresponding to the correct management established by current international guidelines.


Subject(s)
Bile Ducts , Bilirubin , Cholangiography , Cholecystectomy , Gallstones , Lithiasis , Liver , Sampling Studies , Endoscopy, Gastrointestinal , Endoscopy
10.
Rev. colomb. gastroenterol ; 36(1): 51-57, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251521

ABSTRACT

Resumen Introducción: la enfermedad de Wilson es una enfermedad heterogénea causada por mutaciones en el gen ATP7B. La presentación clínica es variable, en fenotipos hepáticos y neuropsiquiátricos. El objetivo de este estudio es describir una cohorte retrospectiva de pacientes. Materiales y métodos: estudio retrospectivo descriptivo de pacientes atendidos en el Hospital Pablo Tobón Uribe desde enero de 2004 a septiembre de 2017. Resultados: se reportaron 27 pacientes, 17 hombres y 10 mujeres. El tiempo de seguimiento medio fue de 2,18 años, el 40% presentó síntomas neurológicos; el 29%, psiquiátricos; y el 85%, alteración hepática. En el laboratorio, el 85% presentó ceruloplasmina baja; 55%, cobre urinario alto; en casos con biopsia hepática, 7 tenían depósito de cobre en coloraciones especiales. En neuroimágenes, el 84% presentó hallazgos sugestivos de enfermedad de Wilson y en 3 casos se documentó una mutación genética patogénica. Durante el seguimiento, el 51% mejoró clínica o bioquímicamente, el 11% se mantuvo estable y el 18% se deterioró. El 88% de los casos sobrevivió al final del seguimiento. Conclusiones: este estudio es la cohorte retrospectiva más grande de Colombia. Los resultados son base para nuevos estudios poblacionales buscando de manera activa la enfermedad para documentarla en su fase preclínica y, de este modo, impactar en el pronóstico.


Abstract Introduction: Wilson's disease is a heterogeneous disorder caused by mutations in the ATP7B gene. Its clinical presentation is variable in hepatic and neuropsychiatric phenotypes. The aim of this study is to describe a retrospective cohort of patients. Materials and methods: A descriptive retrospective study was carried out in patients treated at the Hospital Pablo Tobón Uribe from January 2004 to September 2017. Results: 27 patients were reported, 17 men and 10 women. The mean follow-up time was 2.18 years. 40% of the patients had neurological symptoms, 29% psychiatric symptoms, and 85% hepatic impairment. Lab tests showed that 85% had low ceruloplasmin and 55% had increased urinary copper. In cases that underwent liver biopsy, 7 had special copper colorations. Neuroimaging revealed that 84% had findings suggestive of Wilson's disease and a pathogenic genetic mutation was documented in 3 cases. During follow-up, 51% improved clinically or biochemically, 11% remained stable, and 18% deteriorated. 88% of cases survived at the end of follow-up. Conclusions: This study is the largest retrospective cohort carried out in Colombia. The results are the basis for new population-based studies actively seeking this disease to describe its preclinical development and thus impact prognosis.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Copper , Hepatolenticular Degeneration , Signs and Symptoms , Disease , Retrospective Studies , Genetics , Liver
11.
Rev. colomb. gastroenterol ; 36(1): 58-64, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251522

ABSTRACT

Resumen Introducción: la elastografía en tiempo real, 2D-SWE (Supersonic), es una prueba no invasiva que se utiliza para determinar la elasticidad del hígado y, de esa forma, calcular el grado de fibrosis hepática. En Colombia, la prueba se introdujo en 2016 y no existen hasta el momento estudios del comportamiento de la prueba en todos los pacientes hepáticos, solo se han publicado en pacientes sanos y cirróticos. Objetivo: analizar la experiencia de la aplicación de la elastografía en tiempo real, en sujetos atendidos en el centro de enfermedades hepáticas y digestivas de Bogotá, Colombia. Materiales y métodos: estudio descriptivo retrospectivo de una cohorte de sujetos atendidos entre marzo de 2016 y julio de 2017. Se realizó una historia clínica completa y una prueba de elastografía en tiempo real (Supersonic). Resultados: se incluyeron 654 sujetos, con una mediana de edad de 55 años (rango intercuartílico [RIC]: 45-64). La mediana de valores de fibrosis expresada en kilopascales (kPs) fue de 8,3, con un promedio de 5 mediciones. Se observó una diferencia significativa en el grado de fibrosis entre los grupos de edad y en relación con el diagnóstico final, donde se evidenció una mayor fibrosis en el grupo de enfermedades colestásicas (autoinmune, colangitis biliar primaria [CBP] y superposición autoinmune-CBP). La tasa global de fracaso fue menor al 1%. Conclusiones: es la primera descripción del comportamiento de la prueba a nivel nacional. Los valores de rigidez hepática observados en los diferentes estadios demuestran la utilidad de la prueba para la determinación de la fibrosis hepática en pacientes con diferentes patologías.


Abstract Introduction: Real-time two-dimensional shear wave elastography (2D-SWE) (Supersonic Imagine SA), is a non-invasive test used to determine liver elasticity and calculate the degree of liver fibrosis. In Colombia, this test was introduced in 2016 and, to date, no study has tested its behavior in all liver patients, only in healthy and cirrhotic patients. Objective: To analyze the experience of real-time elastography implementation in subjects treated at the Centro de Enfermedades Hepáticas y Digestivas in Bogotá, Colombia. Materials and methods: This is a retrospective descriptive study of a cohort of subjects treated between March 2016 and July 2017. A complete medical report and a real-time elastography (Supersonic) test were performed. Results: 654 subjects were included, with a median age of 55 years (interquartile range [IQR]: 45-64). The median fibrosis values expressed in kilopascals (kPs) were 8.3, with an average of 5 measurements. There was a significant difference in the degree of fibrosis between the age groups and in relation to the final diagnosis, where there was a greater fibrosis in the cholestatic disease group (autoimmune, primary biliary cholangitis [PBC], and overlap). The overall failure rate was less than 1%. Conclusions: This is the first description of this test behavior in the country. Hepatic stiffness values observed in the different stages demonstrate the usefulness of the test to establish the degree of liver fibrosis in patients with multiple diseases.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Fibrosis , Elasticity Imaging Techniques , Liver , Measurements, Methods and Theories , Medical Records , Elasticity , Research Report , Methods
12.
Med. U.P.B ; 40(1): 82-85, 03/03/2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1177504

ABSTRACT

El accidente apídico implica un bajo riesgo de morir por reacciones agudas como anafilaxia. Es frecuente que se desconozcan otros riesgos como el hepático y el neurológico. Dentro de las complicaciones menos conocidas está la polineuropatía aguda conocida como Guillain- Barré. La causa más ampliamente descrita es la reacción cruzada entre IgE y la proteína básica de mielina. A continuación, se reporta el primer caso en América Latina sobre la asociación entre Guillain-Barré y accidente por picadura de abejas. En este caso, hay criterios de causalidad como el nexo temporal, la plausibilidad biológica y la coherencia con otros artículos reportados en la literatura médica.


Bee sting accident usually implies a low risk of dying from acute reactions such as anaphylaxis. Other risks such as liver and neurological risks are often unknown. Among the lesser-known complications caused by this type of accident is the acute polyneuropathy known as Guillain-Barré. The most widely described cause is the cross reaction between IgE and myelin basic protein. The article reports the first case in Latin America on the association between Guillain-Barré and a bee sting accident. In this case, there are causality criteria such as temporal link, biological plausibility, and consistency with other articles reported in the medical literature


O acidente elapídico implica um baixo risco de morte por reações agudas, como anafilaxia. Outros riscos, como hepáticos e neurológicos, são frequentemente desconhecidos. Entre as complicações menos conhecidas está a polineuropatia aguda conhecida como Guillain-Barré. A causa mais amplamente descrita é a reação cruzada entre a IgE e a proteína básica da mielina. A seguir, é relatado o primeiro caso na América Latina sobre a associação entre Guillain-Barré e um acidente com picada de abelha. Nesse caso, há critérios de causalidade como vínculo temporal, plausibilidade biológica e consistência com outros artigos relatados na literatura médica


Subject(s)
Humans , Animals , Guillain-Barre Syndrome , Polyneuropathies , Bees , Bites and Stings , Immunoglobulin E , Accidents , Cross Reactions , Death , Anaphylaxis , Liver
13.
Alerta (San Salvador) ; 4(1): 5-11, ene, 22, 2021. ilus, tab
Article in Spanish | LILACS, BISSAL | ID: biblio-1146423

ABSTRACT

El embarazo ectópico abdominal es el más raro de los embarazos. El saco gestacional se implanta en la pelvis o en estructuras vascularizadas como el hígado, bazo o mesenterio. El riesgo de complicación es 7 a 8 veces mayor que el riesgo de un embarazo ectópico tubárico, y es 90 veces mayor que el de un embarazo intrauterino. Por esta razón, tiene una elevada mortalidad y el diagnóstico temprano, así como, su tratamiento oportuno, salva vidas. Este caso relata la historia de una mujer de 43 años multípara, de la zona rural, quien consultó por sensación de plenitud, dolor abdominal relacionado a la ingesta de comidas grasosas y ausencia de menstruación de 7 semanas. Sin precisar un diagnóstico, presentó signos de shock hipovolémico, por tal motivo, fue referida al Hospital San Juan de Dios de San Miguel, donde fue atendida en máxima urgencia, se hizo el diagnóstico de embarazo ectópico hepático roto y se realizó cirugía de emergencia en conjunto con cirugía general. Se le extirpó el lóbulo hepático derecho que contenía el embarazo y luego se le colocó un parche de epiplón. El manejo en unidad de cuidados intensivos tuvo buen término, a pesar de la inestabilidad hemodinámica que presentó.


Ectopic abdominal pregnancy is the rarest of all kind of pregnancies. The gestational sac is implanted in the pelvis or in vascularized structures such as the liver, spleen or mesentery. The risk of complication is 7 to 8 times higher than a tubal ectopic pregnancy and 90 times higher that than an intrauterine pregnancy. For this reason, it has a high mortality rate and early diagnosis and timely treatment save lives. This clinical case it's about a 43-year-old multiparous woman from the rural area, who consulted for a sensation of fullness, diffuse abdominal pain related to the ingestion of fatty foods and absence of menstruation for 7 weeks. without specifying a diagnosis, the patient presented signs of hypovolemic shock, for which she was referred to the San Juan de Dios Hospital in San Miguel, where she was treated urgently, performing a diagnostic of ripped ectopic hepatic pregnancy requiring an emergency surgery along with a general surgery. The right lobe of the liver that contained the pregnancy was removed and then an omentum patch was placed. The intensive care management was accomplished, yet the homodynamic instability presented


Subject(s)
Pregnancy, Ectopic , Liver , Obstetrics
14.
Pesqui. vet. bras ; 41: e06713, 2021. tab, ilus
Article in English | ID: biblio-1250483

ABSTRACT

The aim of this study was the ultrasonographic evaluation of the organs in the middle third and caudal coelomic cavity of healthy snakes in the Boidae family. For such, 15 adult snakes from five species were evaluated: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi and Epicrates crassus. The animals were physically restrained for examination. After the application of acoustic gel over the scales the transducer was positioned in the frontal plane of the coelomic cavity. Microconvex and linear transducers at 10MHz were used. The ultrasound examination was conducted in the craniocaudal direction, with longitudinal and transversal sections to assess syntropy, echogenicity and echotexture of the organs. The liver was bilobulated, hyperechoic, homogeneous echotexture, hyperechoic capsule, with a hepatic lobe measuring 1.15±0.64cm wide, and the presence of a central hepatic vein, measuring 0.44±0.21cm in diameter. The gallbladder was characterized as an anechoic structure with echogenic walls and dimensions of 2.91±1.18cm x 1.38±0.84cm (length x width). The stomach showed a pleated and linear texture, echogenic, with hypoechoic walls measuring 0.3±0.07cm wide. The splenopancreas was a circular and echogenic structure, homogeneous echotexture and measuring 1.18±0.62cm in width and 1.56±0.88cm in length. The kidneys were characterized by elongated, lobulated, hypoechoic structures, an echogenic capsule and an echogenic central line, measuring 1.05±0.7cm in width. The testis were characterized by fusiform, hypoechoic structures, homogeneous echotexture, measuring 2.31±0.79cm in length and 0.6±0.23cm in width. Ovarian follicles were seen in different stages, 0.67±0.39cm wide and 0.73±0.38cm long. No differences were found between species of syntropy, echogenicity and echotexture of the organs of the coelomic cavity. The ultrasound examination proved to be a safe, non-invasive and efficient technique for characterizing the organs of the coelomic cavity of snakes.(AU)


O objetivo do estudo foi realizar a avaliação ultrassonográfica de órgãos do terço médio e caudal da cavidade celomática de serpentes hígidas da família Boidae. Para isto, foram avaliadas 15 serpentes adultas de cinco espécies: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi e Epicrates crassus. Os animais foram contidos fisicamente para a realização do exame. Após aplicação de gel acústico sobre as escamas, o transdutor foi posicionado no plano frontal da cavidade celomática. Foram utilizados transdutores microconvexo e linear em 10MHz. O exame ultrassonográfico foi conduzido no sentido craniocaudal, com cortes longitudinais e transversais para avaliar sintopia, ecogenicidade e ecotextura dos órgãos. O fígado se apresentou bilobulado, hiperecoico, ecotextura homogênea, cápsula hiperecoica, com lobo hepático medindo 1,15±0,64cm de largura, e presença de uma veia central hepática, medindo 0,44±0,21cm de diâmetro. A vesícula biliar foi caracterizada como uma estrutura anecoica de paredes ecogênicas e dimensões de 2,91±1,18cm x 1,38±0,84cm(comprimento x largura). O estômago apresentou-se com o aspecto pregueado e linear, ecogênico, com paredes hipoecoicas medindo 0,3±0,07cm de largura. O esplenopâncreasse apresentou como uma estrutura circular e ecogênica, ecotextura homogênea e medindo de 1,18±0,62cm de largura e 1,56±0,88cm de comprimento. Os rins se caracterizaram por estruturas alongadas, lobuladas, hipoecoicas, cápsula ecogênica e uma linha central ecogênica, medindo 1,05±0,7cm de largura. Os testículos foram caracterizados por estruturas fusiformes, hipoecoicas, ecotextura homogênea, medindo 2,31±0,79cm de comprimento e 0,6±0,23cm de largura. Foram visualizados folículos ovarianos em diferentes estágios, de 0,67±0,39cm de largura e 0,73±0,38cm de comprimento. Não foram encontradas diferenças entre espécies de sintopia, ecogenicidade e ecotextura dos órgãos da cavidade celomática. O exame ultrassonográfico demonstrou-se uma técnica segura, não invasiva e eficiente para caracterização dos órgãos da cavidade celomática de serpentes.(AU)


Subject(s)
Animals , Snakes , Boidae , Liver , Ultrasonography
15.
Chinese Journal of Hepatology ; (12): 385-402, 2021.
Article in Chinese | WPRIM | ID: wpr-879639

ABSTRACT

Ultrasound is a non-invasive, real-time, inexpensive, radiation-free and easily repeatable method, usually used for liver imaging. In recent years, new ultrasound examination techniques for liver diseases such as contrast-enhanced ultrasound and elastography have been rapidly developed, which can effectively identify intrahepatic space-occupying lesions, assess the degree of liver fibrosis and portal hypertension, and monitor the effects of treatment. Therefore, these technologies play an important diagnostic role in clinical liver diseases and have therapeutic interventional value. This guideline classifies the instrument set-up, patient preparation, and physician examination methods through multimodal ultrasound examinations (gray-scale ultrasound, color Doppler ultrasound, contrast-enhanced ultrasound, elastic ultrasound) for liver diseases. In addition, liver diseases multimodal ultrasound technology diagnostic criteria for diffuse hepatic lesions (inflammatory lesions, fibrosis, and sclerosis), multiple space-occupying lesions, and interventional procedures have been defined and standardized. Concurrently, we also recommend the ultrasound monitoring time interval and diagnostic report writing standard for liver diseases.


Subject(s)
Elasticity Imaging Techniques , Humans , Hypertension, Portal , Liver/diagnostic imaging , Liver Cirrhosis , Liver Diseases/diagnostic imaging , Ultrasonography
16.
Article in Chinese | WPRIM | ID: wpr-880447

ABSTRACT

The methods of monitoring the thermal ablation of tumor are compared and analyzed in recent years. The principle method results and insufficient of ultrasound elastography and quantitative ultrasound imaging are discussed. The results show that ultrasonic tissue signature has great development space in the field of real-time monitoring of thermal ablation, but there are still some problems such as insufficient monitoring accuracy difficulty in whole-course monitoring and insufficient


Subject(s)
Catheter Ablation , Elasticity Imaging Techniques , Humans , Hyperthermia, Induced , Liver/surgery , Neoplasms/surgery , Ultrasonography
17.
Article in Chinese | WPRIM | ID: wpr-880419

ABSTRACT

This paper introduced a liver normothermic machine perfusion repair and assessment system. This system consists of a liver normothermic machine perfusion device, a fluorescence imaging system and a tissue oxygen detector. The normothermic machine perfusion device can continuously perfuse the donor liver and monitor and control the perfusion parameters in real time. The fluorescence imaging system can detect the indocyanine green metabolized by the liver to evaluate the microcirculation and the metabolism function of hepatocytes. The tissue oxygen detector can monitor the change of oxygen partial pressure of liver tissue in real time to evaluate the state of cell oxygen consumption.


Subject(s)
Humans , Liver , Liver Transplantation , Living Donors , Organ Preservation , Perfusion
18.
Article in Chinese | WPRIM | ID: wpr-879264

ABSTRACT

Unhealthy diet, habits and drug abuse cause a variety of liver diseases, including steatohepatitis, liver fibrosis, liver cirrhosis and liver cancer, which seriously affect human health. The fabrication of highly simulated cell models in vitro is important in the treatment of liver diseases and drug development. This article summarized the common strategies for the construction of liver pathology models


Subject(s)
Animals , Disease Models, Animal , Humans , Liver , Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Non-alcoholic Fatty Liver Disease/pathology
19.
Article in Chinese | WPRIM | ID: wpr-879150

ABSTRACT

To explore the effect of light intensity in cultivating environment on the hepetoprotective activity of Sedum sarmentosum, S. sarmentosum were planted under five water treatments for 60 days, namely 100% full sunlight(G1), 77% full sunlight(G2), 60% full sunlight(G3), 38% full sunlight(G4), and 16% full sunlight(G5) and CCl_4 drug-induced liver injury model in vitro was used. Cell viability, cell cycle, and cell apoptosis were individually detected by MTT, PI single staining, and Annexin-V FITC/PI double staining assays. Additionally, ALT, AST and antioxidant index in supernatant were determined by colorimetry. And the relationship among the protective effects, chemical composition and antioxidant activity were also analyzed. The results showed that S. sarmentosum aqueous extract could significantly improve the HepG2 cell viability. Among the five S. sarmentosum groups, the cell viability of G1(100% full sunlight) treatment was the highest, and the cell apoptosis was the least. Meanwhile, the level of ALT, AST, and MDA in G1 was the lowest, but it achieved the highest level of SOD and GSH. Moderate light shading(60% full light) also improved the effect of protecting liver and reducing the enzyme. It was found that cell viability was positively correlated with ferricion reducing capacity. ALT activity was positively correlated with isorhamnetin content. Taken together, different light intensity had great influence on hepatoprotective effect of S. sarmentosum, which may be related to its antioxidant capacity. From the perspective of hepetoprotective activity, S. sarmentosum should be planted under full light.


Subject(s)
Antioxidants , Chemical and Drug Induced Liver Injury , Hep G2 Cells , Humans , Liver , Plant Extracts/pharmacology , Sedum , Water
20.
Article in Chinese | WPRIM | ID: wpr-879096

ABSTRACT

Prunella vulgaris(PV) is an edible and traditional medicinal herb which has a wide range application in fighting inflammation and oxidative stress, and protecting liver. Now it has been used to treat various types of liver diseases and has significant clinical efficacy. This study aims to investigate the effects of PV on ethanol-induced oxidative stress injury in rats and its metabolic mechanism. The rats were divided into control group, model group, PV group, and VC group. The liver protection of PV was identified by measuring pharmacological indexes such as antioxidant and anti-inflammatory activity. The metabolic mechanism of long-term ethanol exposure and the metabolic regulation mechanism of PV treatment were studied by LS-MS metabonomics. The pharmacological investigation indicated that ethanol could significantly decrease the contents of SOD, GSH-Px, CAT and other antioxidant enzymes in liver and increase the content of MDA. At the same time, PV could significantly reduce the contents of inflammatory factors(TNF-α, IL-6 and IL-1β) and liver function markers(ALT, AST, ALP) in serum. What's more, long-term ethanol exposure could significantly cause liver injury, while PV could protect liver. Metabolomics based on multiple statistical analyses showed that long-term ethanol exposure could cause significant metabolic disorder, and fatty acids, phospholipids, carnitines and sterols were the main biomarkers. Meanwhile, pathway analysis and enrichment analysis showed that the β oxidation of branched fatty acids was the main influencing pathway. Also, PV could improve metabolic disorder of liver injury induced by ethanol, and amino acids, fatty acids, and phospholi-pids were the main biomarkers in PV treatment. Metabolic pathway analysis showed that PV mainly regulated metabolic disorder of ethanol-induced liver injury through phenylalanine, tyrosine and tryptophan biosynthetic pathways. This study could provide a new perspective on the hepatoprotective effect of natural medicines, such as PV.


Subject(s)
Animals , Antioxidants/metabolism , Ethanol/toxicity , Liver/metabolism , Metabolomics , Oxidative Stress , Prunella , Rats
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