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Rev. Assoc. Med. Bras. (1992) ; 66(1): 55-60, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091898


SUMMARY OBJECTIVE It has been observed that celiac disease (CD) is not restricted to a single type characterized by diarrhea but also has atypical, asymptomatic (silent), and latent forms. The prevalence of this autoimmune disease, which affects approximately 1% of the world, is estimated to be around 3%, including atypical and asymptomatic cases. In our study, we aimed to evaluate adult celiac patients. METHODS Between December 2008-2015, patients diagnosed with CD over the age of 18 years old were included in the study. Patients' symptoms at admission, frequency and type of anemia, transaminase levels, and celiac antibody positivity, and autoimmune diseases diagnosed at follow up were evaluated retrospectively. RESULTS Of 195 patients, 151 (77.4%) were female. The mean age of the patients was 35.73 ± 12.19 years (range, 18-71 years). A hundred patients (51.3%) had gastrointestinal symptoms. At the time of admission, 118 patients (60.5%) had anemia, and 52 (26.7%) had hypertransaminasemia. During the mean follow-up period of 58 months (36-120 months), 84 (43.1%) of the patients presented at least one autoimmune disease, and this rate was 96.6% in individuals diagnosed above the age of 50 years. CONCLUSION In adult CD, resistant anemia, dyspepsia, and hypertransaminasemia are very common findings at the time of diagnosis, and the association with other autoimmune diseases, especially Hashimoto's thyroiditis, is high.

RESUMO OBJETIVOS Observou-se que a doença celíaca (DC) não se restringe a um único tipo caracterizado por diarreia, mas também tem formas atípicas, assintomáticas (silenciosas) e latentes. Estima-se que a prevalência desta doença autoimune, que afeta aproximadamente 1% da população do mundo, seja em torno de 3%, incluindo casos atípicos e assintomáticos. Em nosso estudo, objetivou-se avaliar pacientes celíacos adultos. MÉTODOS Entre dezembro de 2008 e 2015, pacientes diagnosticados como DC com idade acima de 18 anos foram incluídos no estudo. Os sintomas dos pacientes na admissão, frequência e tipo de anemia, níveis de transaminases e positividade de anticorpos celíacos e doenças autoimunes diagnosticadas no seguimento foram avaliados retrospectivamente. RESULTADOS Dos 195 pacientes, 151 (77,4%) eram do sexo feminino. A média de idade dos pacientes foi de 35,73±12,19 anos (variação de 18 a 71 anos). Cem pacientes (51,3%) foram encaminhados com sintomas gastrointestinais. No momento da internação, 118 pacientes (60,5%) apresentavam anemia e 52 (26,7%) apresentavam hipertransaminemia. Durante o período médio de acompanhamento de 58 meses (36-120 meses), 84 (43,1%) pacientes estavam acompanhados por pelo menos uma doença autoimune, e essa taxa foi de 96,6% em indivíduos diagnosticados acima dos 50 anos de idade. CONCLUSÃO No adulto DC, anemia resistente, dispepsia e hipertransaminasemia são achados muito comuns no momento do diagnóstico e a associação com outras doenças autoimunes, especialmente tireoidite de Hashimoto, é alta.

Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Autoimmune Diseases/epidemiology , Celiac Disease/epidemiology , Anemia/epidemiology , Autoimmune Diseases/complications , Thyroid Diseases/complications , Thyroid Diseases/epidemiology , Turkey/epidemiology , Celiac Disease/complications , Prevalence , Retrospective Studies , Age Distribution , Statistics, Nonparametric , Tertiary Care Centers/statistics & numerical data , Transaminases/blood , Anemia/complications , Middle Aged
Arch. endocrinol. metab. (Online) ; 63(2): 128-136, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001219


ABSTRACT Objective: Nonalcoholic fatty liver disease is the commonest diffuse liver disease, of which women with polycystic ovary syndrome are at an increased risk. The aim of the present study was to assess the diagnostic value of the semiquantitative strain parameters of real-time ultrasound elastography for nonalcoholic fatty liver disease in patients with polycystic ovary syndrome. Subjects and methods: Thirty-five polycystic ovary syndrome patients with nonalcoholic fatty liver disease, 70 polycystic ovary syndrome patients without nonalcoholic fatty liver disease, and 70 healthy female controls of reproductive age were included. All participants underwent ultrasonic examination and semiquantitative analysis of real-time ultrasound elastography of the liver. Results: Main semi quantitative strain parameters, such as average strain value, differed significantly among groups polycystic ovary syndrome with nonalcoholic fatty liver disease, polycystic ovary syndrome without nonalcoholic fatty liver disease, and control (87.02 ± 10.16 vs. 96.31 ± 11.44 vs. 104.49 ± 7.28, p < 0.001). Clinical and laboratory parameters differed significantly between the two subgroups with low or high average strain value. For diagnostic value of average strain value for elevated aminotransferase, the area under the curve was 0.808 (range 0.721-0.895). In multiple linear regression analysis, polycystic ovary syndrome, waist circumference, and metabolic syndrome were stand-alone independent factors associated with average strain value among subjects without nonalcoholic fatty liver disease. Conclusion: Semiquantitative real-time ultrasound elastography analysis could distinguish liver parenchyma alterations in patients with polycystic ovary syndrome more sensitively. The diagnostic value of the proposed method for nonalcoholic fatty liver disease need further research.

Humans , Female , Adult , Young Adult , Polycystic Ovary Syndrome/diagnostic imaging , Elasticity Imaging Techniques/methods , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Polycystic Ovary Syndrome/physiopathology , Blood Pressure , Image Processing, Computer-Assisted , Body Mass Index , Sensitivity and Specificity , Diagnosis, Differential , Waist Circumference , Non-alcoholic Fatty Liver Disease/physiopathology , Parenchymal Tissue/physiopathology , Parenchymal Tissue/diagnostic imaging , Transaminases/blood , Menstruation/physiology
Rev. Soc. Bras. Med. Trop ; 52: e20180526, 2019. tab, graf
Article in English | LILACS | ID: biblio-1020439


Abstract INTRODUCTION: Crotalus envenomations cause serious complications and can be fatal without appropriate treatment. Venom isoforms present and inter/intraspecific variations in the venom composition can result in different symptoms presented by bites by snakes from the same species but from different geographical regions. We comparatively evaluated the local and systemic effects caused by Crotalus durissus terrificus (Cdt), C.d. collilineatus (Cdcolli), and C.d. cascavella (Cdcasc) envenomation. METHODS: Venom chromatography was performed. Proteolytic, phospholipase, and LAAO activities were analyzed. Edema, myotoxicity, hepatotoxicity, nephrotoxicity, and coagulation alterations were evaluated. RESULTS: The venom SDS-PAGE analyses found the presence of convulxin, gyroxin, crotoxin, and crotamine in Cdt and Cdcolli venoms. Crotamine was not present in the Cdcasc venom. Cdt, Cdcollli, and Cdcasc venoms had no proteolytic activity. Only Cdcasc and Cdt venoms had phospholipase activity. LAAO activity was observed in Cdcolli and Cdcasc venoms. Cdcolli and Cdcasc venoms caused 36.7% and 13.3% edema increases, respectively. Cdt venom caused a 10% edema induction compared to those by other venoms. All venoms increased TOTAL-CK, MB-CK, and LDH levels (indicating muscle injury) and ALT, AST, GGT, and ALP levels (markers of liver damage) and were able to induce a neuromuscular blockade. Urea and creatinine levels were also altered in both plasma and urine, indicating kidney damage. Only Cdcolli and Cdcasc venoms increased TAPP and TAP. CONCLUSIONS: Together, these results allow us to draw a distinction between local and systemic effects caused by Crotalus subspecies, highlighting the clinical and biochemical effects produced by their respective venoms.

Animals , Crotalus/classification , Crotalid Venoms/toxicity , Edema/chemically induced , Kidney/drug effects , Liver/drug effects , Urea/blood , Creatine Kinase/drug effects , Creatine Kinase/blood , Creatinine/blood , Models, Animal , Edema/pathology , Electrophoresis, Polyacrylamide Gel , Alkaline Phosphatase/drug effects , Alkaline Phosphatase/blood , Transaminases/drug effects , Transaminases/blood , Kidney/pathology , L-Lactate Dehydrogenase/drug effects , L-Lactate Dehydrogenase/blood , Liver/pathology , Mice
Arq. gastroenterol ; 54(1): 51-56, Jan.-Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-838823


ABSTRACT BACKGROUND Periportal fibrosis is the major pathological consequence of the Schistosoma mansoni infection. OBJECTIVE To evaluate the accuracy of serum markers and to construct an index to assess fibrosis. METHODS Patients (n=116) with schistosomiasis were evaluated by ultrasound scan and measurements of serum levels of aminotransferases, γ-glutamyl transferase, alkaline phosphatase, hyaluronic acid, cytokines and platelets. Ultrasound images were used to evaluate the fibrosis using Niamey's classification and identified 19 patients without periportal fibrosis (patterns A and B), 48 with mild to moderate fibrosis (C and D) and 49 with advanced fibrosis (E and F). RESULTS Using multivariate analysis, a model was created, which involved alkaline phosphatase and platelets and could separate patients with different patterns of fibrosis. This index showed a better performance in separating patients without fibrosis from with advanced periportal fibrosis. The biological index showed an area under the ROC curve of 1.000. Using values below the lowest or above the highest cut-off point, the presence or absence of advanced fibrosis could be predicted in all patients. CONCLUSION The index constructed can be used to separate patients with different patterns of periportal fibrosis, specially to predict advanced fibrosis in schistosomiasis patients.

RESUMO CONTEXTO A fibrose periportal é a maior consequência patológica da infecção pelo Schistosoma mansoni. OBJETIVO Avaliar a acurácia de marcadores séricos e construir um índice para avaliar a fibrose. MÉTODOS Pacientes (n=116) com esquistossomose foram avaliados pela ultrassonografia e dosados os níveis de aminotransferases, γ-glutamil transferase, fosfatase alcalina, ácido hialurônico, citocinas e plaquetas. Imagens de ultrasom foram utilizadas para avaliar a fibrose através de classificação de Niamey e identificados 19 pacientes sem fibrose periportal (padrão A e B), 48 com fibrose média a moderada (C e D) e 49 com fibrose avançada (E e F). RESULTADOS Através de análise multivariada, um modelo foi criado, que envolveu a fosfatase alcalina e plaquetas e conseguiu separar pacientes com diferentes padrões de fibrose periportal. Este índice mostrou um melhor desempenho em separar pacientes sem fibrose dos pacientes com fibrose avançada. O índice biológico mostrou uma área sob a curva ROC de 1,000. Usando valores infereiores e acima do ponto de corte, a presença ou ausência de fibrose avançada pode ser prevista em todos os pacientes. CONCLUSÃO O índice construído pode ser usado para separar os pacientes com diferentes padrões de fibrose periportal, especialmente para prever fibrose avançada em pacientes com esquistossomose.

Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Schistosomiasis mansoni/blood , Schistosomiasis mansoni/diagnostic imaging , Biomarkers/blood , Liver Cirrhosis/blood , Liver Cirrhosis/diagnostic imaging , Severity of Illness Index , Blood Platelets , Schistosomiasis mansoni/complications , Predictive Value of Tests , Cytokines/blood , Sensitivity and Specificity , Alkaline Phosphatase/blood , gamma-Glutamyltransferase/blood , Transaminases/blood , Hyaluronic Acid/blood , Liver Cirrhosis/parasitology , Middle Aged
J. pediatr. (Rio J.) ; 92(5): 512-520, Sept.-Oct. 2016. tab
Article in English | LILACS | ID: lil-796116


Abstract Objective This study aims to investigate the role of metabolic syndrome (MetS) and the hypertriglyceridemic-waist (HW) phenotype in determining cardiometabolic risk factors and elevated liver enzymes in a national sample of Iranian pediatric population. Method This nationwide study was conducted in the framework of the third survey of a surveillance program. Students, aged 10-18 years, were recruited from 27 provinces in Iran. The prevalence of cardiometabolic risk factors was compared in students with and without HW and MetS. The association of HW with different cardiometabolic risk factors was determined. Results The mean age of studied population was 14.73 ± 2.41 years. Prevalence of HW and MetS was 3.3% and 4%, respectively. Sixty-nine (71.1%) participants with HW had MetS. The prevalence of obesity, elevated systolic blood pressure, hypercholesterolemia, and elevated alanine aminotransaminase (ALT) was significantly higher in subjects with HW phenotype and MetS than in their peers (p < 0.05). A significant association was observed between HW and elevated levels of cholesterol and ALT, as well as between obesity and low HDL-C (p < 0.05). Conclusions The current findings serve as complementary evidence to previous studies, which have been mainly conducted among adults, suggesting that the HW phenotype is associated with cardiometabolic risk factors, especially with elevated cholesterol and ALT. The authors propose that, in primary care settings and in large epidemiological studies, the measurement of all MetS components can be replaced by studying HW as a screening tool for identifying children at high risk for cardiometabolic disorders.

Resumo Objetivo Investigar o desempenho da síndrome metabólica (SM) e do fenótipo de cintura hipertrigliceridêmica (CH) na determinação de fatores de risco cardiometabólico e enzimas hepáticas elevadas em uma amostra nacional da população pediátrica iraniana. Método Estudo nacional feito na estrutura da terceira pesquisa de um programa de vigilância. Foram recrutados alunos de 10-18 anos de 27 províncias do Irã. A prevalência de fatores de risco cardiometabólico foi comparada em alunos com e sem CH e SM. Foi determinada a associação da CH com diferentes fatores de risco cardiometabólico. Resultados A média de idade da população estudada foi de 14,73 ± 2,41 anos. A prevalência de CH e SM foi de 3,3% e 4%, respectivamente; 69 (71,1%) dos participantes com CH apresentaram SM. A prevalência de obesidade, pressão arterial sistólica elevada, hipercolesterolemia e alanina aminotransferase (ALT) elevada foi significativamente maior em meninos e meninas com fenótipo CH e SM do que em seus outros pares (p < 0,05). A associação de CH foi significativa com elevados níveis de colesterol e ALT, bem como obesidade e HDL-C baixo (p < 0,05). Conclusões Os achados atuais servem de evidência complementar de estudos anteriores, conduzidos principalmente com adultos, e sugerem que o fenótipo CH está associado a fatores de risco cardiometabólico, principalmente com colesterol e ALT altos. Propomos que, em ambientes de cuidados básicos e em grandes estudos epidemiológicas, a medição de todos os componentes de SM possa ser substituída pelo estudo da CH como ferramenta de triagem para identificar crianças com alto risco de apresentarem distúrbios cardiometabólicos.

Humans , Male , Female , Child , Adolescent , Metabolic Syndrome/epidemiology , Dyslipidemias/blood , Hypertriglyceridemic Waist/epidemiology , Transaminases/blood , Phenotype , Cardiovascular Diseases/complications , Cardiovascular Diseases/blood , Prevalence , Cross-Sectional Studies , Risk Factors , Metabolic Syndrome/complications , Dyslipidemias/complications , Hypertriglyceridemic Waist/complications , Pediatric Obesity/complications , Iran/epidemiology
J. pediatr. (Rio J.) ; 91(5): 442-447, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-766168


ABSTRACT OBJECTIVE: Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. METHOD: A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), transaminases (AST and ALT), blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. RESULTS: Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys) were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%), rhinorrhea (23%), and fever (63%), with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%), limited ambulation (57%), gait abnormality (40%), and muscle weakness in the lower limbs (71%), with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507 ± 9180 U/L), LDH (827 ± 598 U/L), and AST (199 ± 245 U/L), with a tendency to leukopenia (4590 ± 1420) leukocytes/mm3. The complete recovery of laboratory parameters was observed in 30 days (median), and laboratory and clinical recurrence was documented in one case after 10 months. CONCLUSION: Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.

RESUMO OBJETIVO: Descrever o perfil clínico-laboratorial, o acompanhamento e o desfecho de uma série de casos de miosite aguda viral. MÉTODO: Foi conduzida uma análise retrospectiva de casos suspeitos, em observação em unidade de emergência, e seguimento ambulatorial com o registro de sintomas de infecção respiratória, sintomas músculo-esqueléticos, determinação de enzimas musculares, creatina-fosfoquinase (CPK), desidrogenase lática (DHL), transaminases (AST e ALT), hemograma, proteína C reativa e velocidade de hemossedimentação, na fase aguda e no acompanhamento, até a normalização. RESULTADOS: Entre 2000 e 2009, 42 casos suspeitos foram identificados e 35 (27 meninos) foram incluídos. A mediana de idade foi de sete anos e o diagnóstico relatado em 89%, na primeira visita de emergência. Os sintomas respiratórios observados foram: tosse (31%), coriza (23%) e febre (63%), com duração média de 4,3 dias. Os sintomas músculo-esqueléticos foram: dor localizada nas panturrilhas (80%), deambulação limitada (57%), marcha anormal (40%) e fraqueza muscular nos membros inferiores (71%), com duração média de 3,6 dias. Observou-se elevação importante das enzimas CPK (5.507 ± 9.180) U/l, DHL (827 ± 598) U/l e AST (199 ± 245) U/l e tendência a leucopenia (4.590 ± 1.420) leucócitos/mm3. A recuperação completa dos parâmetros laboratoriais foi observada em 30 dias (mediana) e a recaída clínica e laboratorial em um caso após 10 meses. CONCLUSÃO: Os sintomas típicos com enzimas musculares elevadas após diagnóstico de influenza e o curso autolimitado foram os indícios para o diagnóstico. A elevação de enzimas musculares indica a atividade miotrópica transitória relacionada à influenza sazonal que deve ser considerada, a despeito da identificação viral, possivelmente associada com o vírus influenza ou outros vírus respiratórios.

Child , Child, Preschool , Female , Humans , Male , Myositis/virology , Virus Diseases/complications , Acute Disease , C-Reactive Protein/analysis , Clinical Enzyme Tests/methods , Creatine Kinase, MB Form/blood , Creatine Kinase/blood , Influenza, Human/complications , Muscle Weakness/etiology , Myositis/diagnosis , Retrospective Studies , Sex Distribution , Time Factors , Transaminases/blood , Virus Diseases/diagnosis
Int. j. morphol ; 33(2): 483-490, jun. 2015. ilus
Article in English | LILACS | ID: lil-755499


The aim of the present study was to determine biochemical profile of youth national soccer teams and to compare the values of nine biochemical parameters between three Serbian youth national teams (under 14, 15 and 16 years old), as well as between soccer players and non-athletes. Eighty young soccer players and thirty non-athletes participated in the study. Nine biochemical parameters (glucose, cholesterol, triglycerides, urea, creatinine, total bilirubin, AST (SGOT), ALT (SGPT), iron) were measured. In order to determine the significance of differences between the groups on a multivariate level a multivariate analysis of variance (MANOVA) was administered, and to test the differences between the groups on an univariate level a univariate analysis of variance (ANOVA) was applied. Statistically significant differences were found between groups (soccer players up to 14, 15 and 16 years of age) on a multivariate level of the applied biochemical variables (MANOVA, p= 0.00). ANOVA also revealed significant differences in Creatinine (p= 0.00), Total bilirubin (p= 0.00) and ALT (SGPT) (p= 0.02). Statistically significant differences in the applied variables were found between soccer players and non-athletes on a multivariate level (MANOVA p= 0.00). ANOVA also revealed significant differences in Glucose, Cholesterol, Triglycerides, Creatinine, Total bilirubin, ALT (SGPT) and Iron (p= 0.00) between soccer players and non-athletes, but there were no statistically significant differences in other variables (AST (SGOT) and Urea). It was concluded that there is significant difference in almost all variables (glucose, cholesterol, triglycerides, etc.), except AST (SGOT) and Urea between soccer players and non-athletes. From a practical point of view, the clinician has to take into account not only age, but also training status of individuals when evaluating their blood tests.

El objetivo fue determinar el perfil bioquímico de los equipos juveniles de fútbol nacional y comparar los valores de nueve parámetros bioquímicos entre tres equipos nacionales serbios (menores de 14, 15 y 16 años de edad), así como entre los jugadores de fútbol y no atletas. Ochenta jóvenes jugadores de fútbol y treinta no atletas participaron en el estudio. Se midieron nueve parámetros bioquímicos (glucosa, colesterol, triglicéridos, urea, creatinina, bilirrubina total, AST (SGOT), ALT (SGPT), hierro). Con el fin de determinar la significación de las diferencias entre los grupos en un nivel multivariado se administró un análisis multivariado de varianza (MANOVA), y para poner a prueba las diferencias entre los grupos en un nivel univariado se aplicó un análisis univariado de la varianza (ANOVA). Se encontraron diferencias estadísticamente significativas entre los grupos (jugadores de fútbol hasta 14, 15 y 16 años de edad) en un nivel multivariado de las variables bioquímicas (MANOVA, p= 0,00). ANOVA también reveló diferencias significativas en creatina (p= 0,00), la bilirrubina total (p= 0,00) y ALT (SGPT) (p= 0,02). Se encontraron diferencias estadísticamente significativas en las variables aplicadas entre los jugadores de fútbol y no atletas a nivel multivariado (MANOVA p= 0,00). ANOVA también reveló diferencias significativas en glucosa, colesterol, triglicéridos, creatinina, bilirrubina total, ALT (SGPT) y hierro (p= 0,00) entre los jugadores de fútbol y no atletas. Sin embargo no hubo diferencias estadísticamente significativas en otras variables (AST (SGOT) y urea). Se concluyó que a excepción de la AST (SGOT) y urea no existe diferencia significativa en casi todas las variables (glucosa, colesterol, triglicéridos, etc.) entre los jugadores de fútbol y no atletas. Desde un punto de vista práctico, el médico debe tener en cuenta no solamente la edad, sino también la formación de estado de los individuos en la evaluación de sus análisis de sangre.

Humans , Male , Adolescent , Blood Chemical Analysis , Soccer , Bilirubin/blood , Blood Glucose , Cholesterol/blood , Creatinine/blood , Iron/blood , Multivariate Analysis , Transaminases/blood , Triglycerides/blood , Urea/blood
Arab Journal of Gastroenterology. 2015; 16 (3-4): 99-104
in English | IMEMR | ID: emr-174961


Background and study aims: Treatment of nonalcoholic fatty liver [NAFLD] is important because NAFLD patients have a 1.7-fold increase in standardised age and gender matched mortality. Currently treatment is based on life style modification and managing comorbid associating disease. Other medications remain experimental. Essential phospholipid [EPL] is a nutrient for the liver, helping to maintain vitality of cell membranes where the vast majority of liver activities are regulated. We performed a randomised open label study to evaluate EPL as an adjuvant nutrient to the treatment of primary NAFLD or NAFLD with comorbid disease

Patients and method: Three groups of NAFLD patients were recruited: lone [n = 113], diabetes mellitus type 2 [n = 107] and mixed hyperlipidaemia [n = 104]. Diagnosis was established by excluding other chronic liver diseases. A standard diet and physical activity plan were advised to all patients. 1800 mg of EPL a day was given for 24 weeks, followed by 900 mg for 48 weeks

Results: Essential phospholipid EPL led to a significant improvement of symptoms and a mean reduction of ALT of 50.8 IU and AST of 46.1 IU per patient [p < 0.01]. Abdominal ultrasonography indicated normalisation in 4.6% and a shift from grade II to grade I in 24% of patients. Liver stiffness measurement indicated an improvement in 21.1%, with a mean reduction in the LSM of 3.1 K Pascal/patient. Reducing the dosage after six months led to a limited relapse in 43.8-63.2% of patients, for lone and NAFLD with co-morbid conditions

Conclusion: Essential phospholipid [EPL] as a nutritional supplement resulted in a significant improvement in clinical parameters and transaminases for all NAFLD patients. Ultrasound and LSM revealed modest improvement. There is a need for uninterrupted maintenance to avoid relapse

Adult , Aged , Female , Humans , Male , Middle Aged , Phospholipids , Prospective Studies , Transaminases/blood , Phosphatidylcholines , Disease Management
Arch. argent. pediatr ; 112(4): 369-374, ago. 2014. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1159620


El aumento de las cifras de transaminasas séricas puede observarse en diferentes escenarios de la consulta médica cada vez con mayor frecuencia. Esto supone un desafío complejo para el pediatra dada la escasa información bibliográfica que existe sobre este tema. Desde el paciente completamente asintomático hasta el niño con signos de cronicidad, el espectro es muy variado y obliga a orientar rápida y eficientemente la investigación a fin de evitar costos y sufrimientos innecesarios para el paciente y su familia. El trabajo coordinado con el hepatólogo es recomendable en la mayoría de los casos.

The raising of serum transaminases is seen with increasing frequency in different scenarios from daily practice. This poses a complex challenge to the pediatrician owing to the scarcity of bibliographic information available on this topic. From the completely asymptomatic patient to the child with signs of chronic liver disease, the full spectrum is highly varied, compelling to guide the investigation efficiently, in order to avoid unnecessary costs and suffering to the patient and their family. Coordinated work with the hepatologist is advisable in most instances.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Transaminases/blood , Metabolic Diseases/diagnosis , Metabolic Diseases/enzymology , Metabolic Diseases/blood
Braz. j. infect. dis ; 18(2): 170-176, Mar-Apr/2014. tab
Article in English | LILACS | ID: lil-709427


The potential role of coffee as a hepatoprotective substance for chronic liver diseases has been widely discussed. Our main aim was to evaluate the effect of coffee intake regarding clinical, biochemical tests and liver biopsy data in treatment naïve patients with chronic hepatitis C. One hundred and thirty-six patients with chronic hepatitis C, diagnosed through liver biopsy, or by means of clinical, ultrasound or endoscopic signs of cirrhosis, were assessed by determination of biochemical tests, metabolic and morphological alterations. Food frequency was scrutinized by using a structured questionnaire. Coffee intake represented more than 90% of the total daily caffeine, and the 75th percentile was 4-Brazilian coffee-cup/day (>255mL/day or >123mg caffeine/day). According to caffeine intake, patients were divided into two groups (< or >123mg caffeine/day). Patients with higher ingestion of caffeine had lower serum levels of aspartate aminotransferase (× upper limit of normal) (1.8±1.5 vs 2.3±1.5, p=0.04), lower frequencies of advanced (F3, F4) fibrosis (23.5% vs 54.5%, p<0.001) and of histological activity grade (A3, A4) observed in liver biopsies (13.8% vs 36.9%, p<0.001). By multivariate logistic regression, fibrosis was independently associated with caffeine intake (OR- 0.16; 95%CI - 0.03-0.80; p=0.026), γ-glutamil transferase serum levels and morphological activity. But only fibrosis was associated with histological activity. In conclusion caffeine consumption greater than 123mg/day was associated with reduced hepatic fibrosis. In addition, this study supports the assumption that coffee intake has hepatoprotective benefits for Brazilian patients with chronic hepatitis C, even in lower doses than that of American and European population intake.

Female , Humans , Male , Middle Aged , Coffee , Caffeine/administration & dosage , Hepatitis C, Chronic , Liver , Liver Cirrhosis/prevention & control , Transaminases/blood , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Brazil , Coffee/chemistry , Europe , Hepatitis C, Chronic/enzymology , Hepatitis C, Chronic/pathology , Liver Cirrhosis/pathology , Liver/enzymology , Liver/pathology , United States
Biol. Res ; 47: 1-7, 2014. ilus, graf
Article in English | LILACS | ID: biblio-950745


BACKGROUND: The liver is an important organ for its ability to transform xenobiotics, making the liver tissue a prime target for toxic substances. The carotenoid bixin present in annatto is an antioxidant that can protect cells and tissues against the deleterious effects of free radicals. In this study, we evaluated the protective effect of bixin on liver damage induced by carbon tetrachloride (CCl4) in rats. RESULTS: The animals were divided into four groups with six rats in each group. CCl4 (0.125 mL kg-1 body wt.) was injected intraperitoneally, and bixin (5.0 mg kg-1 body wt.) was given by gavage 7 days before the CCl4 injection. Bixin prevented the liver damage caused by CCl4, as noted by the significant decrease in serum aminotransferases release. Bixin protected the liver against the oxidizing effects of CCl4 by preventing a decrease in glutathione reductase activity and the levels of reduced glutathione and NADPH. The peroxidation of membrane lipids and histopathological damage of the liver was significantly prevented by bixin treatment. CONCLUSION: Therefore, we can conclude that the protective effect of bixin against hepatotoxicity induced by CCl4 is related to the antioxidant activity of the compound.

Animals , Male , Rats , Carbon Tetrachloride/antagonists & inhibitors , Carotenoids/pharmacology , Reactive Oxygen Species/analysis , Oxidative Stress/drug effects , Chemical and Drug Induced Liver Injury/prevention & control , Antioxidants/pharmacology , Plant Extracts/chemistry , Lipid Peroxidation/drug effects , Carotenoids/chemistry , Rats, Wistar , Bixaceae/chemistry , Chemical and Drug Induced Liver Injury/metabolism , Chemical and Drug Induced Liver Injury/pathology , Glutathione/analysis , Glutathione Reductase/drug effects , Transaminases/blood , Liver/enzymology , Malondialdehyde/analysis , NADP/analysis
Arq. gastroenterol ; 50(3): 208-213, July-Sept/2013. tab, graf
Article in English | LILACS | ID: lil-687258


Context To evaluate lung and liver changes in two experimental models using intraperitoneal carbon tetrachloride (CCl4) and bile duct ligation (BDL). Methods Twenty-four male Wistar rats were divided into a control group (CO) and an experimental group (EX). We evaluated the liver transaminases (AST, ALT, AP), arterial blood gases (PaO2, PCO2 and SpO2) and lipid peroxidation by TBARS (substances that react to thiobarbituric acid) and chemiluminescence. We also evaluated the antioxidant enzyme superoxide dismutase (SOD) and histology of lung tissue and liver. Results There were significant differences in AST, ALT, ALP and PaO2 between CO group and EX group (P<0.05). The levels of TBARS, chemiluminescence and activity of enzyme superoxide dismutase were increased to different degrees in the CCl4 groups: CO and in the BDL -EX (P<0.05, respectively). In the lung histology, an increase in the wall thickness of the pulmonary artery and a diameter reduction in the CCl4 animal model were observed: comparing CO group with EX group, we observed a reduction in thickness and an increase in the diameter of the artery wall lung. Conclusion Both experimental models have caused liver damage and alterations in the artery wall that are associated with major changes in pulmonary gas exchange. .

Objetivo Avaliar as alterações pulmonares e hepáticas em dois modelos experimentais de cirrose hepática pelo uso de tetracloreto de carbono intraperitoneal (CCl4) e ligadura de ducto biliar. Métodos Vinte e quatro ratos machos Wistar foram divididos em grupo controle (CO) e experimental (EX). Foram avaliadas as transaminases hepáticas (AST, ALT, FA), gasometria arterial (PaO2, PCO2 e SatO2) e a lipoperoxidação através de TBARS (substâncias que reagem ao ácido tiobarbitúrico) e por quimiluminescência. Também foi avaliada a atividade antioxidante da enzima superóxido dismutase e a histologia do tecido pulmonar e hepático. Resultados Nas enzimas hepáticas (AST, ALT e FA), bem como na PaO2 foram observadas diferenças significativas (P≤0,05) entre os grupos CO vs EX em ambos modelos. Os níveis de TBARS, quimiluminescência e a atividade da enzima superóxido dismutase encontram-se aumentados nos grupos CCl4 e ligadura de ducto biliar: CO vs EX (P≤0,05). Na análise histológica do pulmão observamos um aumento na espessura da parede da artéria pulmonar e uma redução no diâmetro no modelo CCl4: CO vs EX, e no modelo de ligadura de ducto biliar podemos observar uma redução da espessura e aumento no diâmetro da parede da artéria pulmonar. Conclusão Ambos os modelos experimentais provocaram dano hepático, além de causar alterações na parede da artéria pulmonar contribuindo na redução das trocas gasosas. .

Animals , Male , Rats , Liver Cirrhosis, Experimental/pathology , Liver/pathology , Lung/pathology , Blood Gas Analysis , Bile Ducts/surgery , Carbon Tetrachloride , Ligation , Lipid Peroxidation , Liver Cirrhosis, Experimental/blood , Liver/enzymology , Oxidative Stress , Rats, Wistar , Transaminases/blood
Rev. gastroenterol. Perú ; 33(3): 262-264, jul.-set. 2013. ilus, graf, tab
Article in Spanish | LILACS, LIPECS | ID: lil-692448


En este artículo hacemos una revisión de las causas más frecuentes de elevación de los niveles de las aminotransferasas, fosfatasa alcalina y gamma glutamil transpeptidasa en personas aparentemente sanas, al mismo tiempo ofrecemos una orientación sencilla que facilite al médico general una orientación escueta que permita el diagnóstico y manejo adecuado de estos casos.

In this study we make a review of the most common causes of the rise of the levels of aminotransferases, alkaline fosphatase and gamma glutamil transpeptidase en healthy people, also we offer a view of the diagnosis and management of these patients as simple as possible.

Humans , Alkaline Phosphatase/blood , Liver Diseases/blood , Liver Diseases/enzymology , Liver/enzymology , Transaminases/blood , gamma-Glutamyltransferase/blood , General Practitioners , Liver Diseases/diagnosis
IJPM-International Journal of Preventive Medicine. 2013; 4 (6): 700-704
in English | IMEMR | ID: emr-138474


Celiac disease [CD] is an immune mediated condition that leads to small bowel atrophy that resolves with a gluten free diet [GFD]. Extra-intestinal manifestations of CD include hypertransaminasemia. In this study, the effects of a GFD on hypertransaminasemia in patients with newly diagnosed CD were studied. Ninety eight new diagnosed consecutive patients with CD 40 males and 58 females] with mean age of 32 +/- 17.1 were studied. All patients with CD were treated with a GFD. Patients with hypertransaminasemia, at diagnosis, had a cirrhosis screen performed. Patients with a negative cirrhosis screen were reviewed, 6 months after the introduction of a GFD, and serum levels of liver transaminases were measured again. Nine patients had hypertransaminasemia. One patient was Hepatitis B surface antigen positive and was excluded from this study. The 8 remaining patients had no obvious cause for the hypertransaminasemia. Mean [ +/- SD] of baseline aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels were 42.6 +/- 16.5 IU/L [range: 16-66 IU/L] and 69.3 +/- 9.3 IU/L [range: 52-81 IU/L]. Six months after treatment with a GFD, mean AST and ALT levels decreased to 24.5 +/- 5.1 IU/L [range: 18-31 IU/L] [P: 0.04] and 24.6 +/- 6 IU/L [range: 17-32 IU/L] [P: 0.01], respectively. In 7 patients the hypertransaminasemia, at diagnosis had resolved. This study provides further evidence that some patients with CD have a reversible hypertransaminasemia that resolves with a GFD

Celiac Disease/diet therapy , Transaminases/blood
J. bras. med ; 100(4): 63-70, Set.-Out. 2012. tab
Article in Portuguese | LILACS | ID: lil-670542


Hepatite aguda define lesão hepática com inflamação do fígado com padrão histológico bem definido. Esses pacientes apresentam sintomas inespecíficos, como mal-estar, náuseas, vômitos e anorexia, com ou sem icterícia. Na maioria dos pacientes com elevação predominante de transaminases uma história clínica cuidadosa e um pequeno número de exames laboratoriais podem identificar a etiologia e definir tratamento específico subsequente, incluindo especialmente a investigação de hepatites virais, hepatotoxicidade induzida por drogas, hepatite autoimune e hepatite aguda alcoólica.

The acute hepatitis defines liver injury with inflammation of the liver histological pattern well defined. Such patients present with nonspecific symptoms such as malaise, nausea, vomiting, and anorexia, with or without jaundice. In most patients with the amino-transferase-predominant picture, careful history and examination and a small number of laboratory tests can identify the etiology and define subsequent management including in particular the investigation of viral hepatitis, drug-induced hepatoxicity, autoimmune hepatitis and acute alcoholic liver disease.

Humans , Male , Female , Chemical and Drug Induced Liver Injury, Chronic/diagnosis , Hepatitis, Alcoholic/diagnosis , Hepatitis, Autoimmune/diagnosis , Hepatitis, Viral, Human/diagnosis , Chemical and Drug Induced Liver Injury, Chronic/therapy , Liver/pathology , Hepatitis, Alcoholic/therapy , Hepatitis, Autoimmune/therapy , Hepatitis, Viral, Human/therapy , Biomarkers , Histological Techniques , Clinical Laboratory Techniques , Transaminases/blood
Rev. chil. pediatr ; 83(3): 258-261, jun. 2012. tab
Article in Spanish | LILACS | ID: lil-643197


Commonly used in clinical practice, glutamic oxalacetic (GOT) and glutamic piruvic (GPT) transaminases are produced in various body tissues, including striated muscle, so their blood elevation is not due exclusively to liver disease. The objective of this study is to demonstrate the correlation between elevated creatinkinase (CK) and transaminases in patients with diagnosis of Duchenne muscular dystrophy (DMD), the most frequent neuromuscular disease in children. Patients and Method: Assessment in 61 children with diagnosis of DMD of CK, AST and ALT levels, and their correlation. Results: Aill patients had increase of CK ( = 13.363 IU/L), AST ( = 203 lU/L) and ALT ( = 194 IU/L) above normal values. The increase of transaminases related directly with the increase of CK. Conclusion: Patients with DMD have increased transaminases, so it is necessary to include this diagnostic possibility in a child with hypertransaminemia, prior to performing liver biopsy.

Las transaminasas que comúnmente se utilizan en clínica, glutámico oxalacética (GOT) y glutámico pirúvica (GPT) son producidas en varios tejidos del organismo entre los cuales se cuenta el músculo estriado, por lo que la elevación de transaminasas en sangre no es producida exclusivamente por enfermedades hepáticas. Objetivo: Demostrar la correlación entre el alza de la creatinkinasa (CK) y transaminasas en pacientes con el diagnóstico de distrofia muscular de Duchenne (DMD), la enfermedad neuromuscular más frecuente en niños. Pacientes y Método: Evaluación en 61 niños con diagnóstico de DMD de los niveles de CK, GOT y GPT y la relación entre ellos. Resultados: Todos los pacientes presentaron aumento de CK ( = 13.363 IU/L), GOT ( = 203 IU/L) y GPT ( = 194 IU/L) sobre los valores normales. El aumento de transaminasas se relacionó en forma directa con aumento de CK. Conclusiones: Los pacientes con DMD presentan transaminasas aumentadas, por lo que es necesario incluir esta posibilidad diagnóstica en niños con hipertransaminasemia, previo a realizar biopsia hepática.

Humans , Male , Child , Creatine Kinase/blood , Muscular Dystrophy, Duchenne/diagnosis , Muscular Dystrophy, Duchenne/blood , Transaminases/blood , Creatine Kinase/analysis , Muscular Dystrophy, Duchenne/enzymology , Reference Values , Transaminases/analysis
Egyptian Journal of Histology [The]. 2012; 35 (4): 749-760
in English | IMEMR | ID: emr-170227


Liver-related complications are a significant cause of death in diabetes and are often unrecognized. This study was designed to evaluate the hepatoprotective properties of Nigella sativa [NS] in streptozotocin-induced diabetes in rats. Moreover, the effect of NS on hepatic oval cells in the liver of diabetic rats was determined. Rats were divided into three groups: group I was the control group; group II included diabetic rats [single intraperitoneal injection of streptozotocin [50 mg/kg body weight]]; and group III included diabetic rats treated with NS [300 mg/kg/day, administered orally] for 4 weeks. Liver sections were subjected to H and E, masson staining, and immunohistochemical staining of proliferating cell nuclear antigen, alpha-smooth muscle actin, and insulin protein. Plasma levels of aspartate aminotransferase, alanine aminotransferase, and albumin levels were measured. Liver hepatocyte growth factor gene expression was also measured by reverse transcription PCR. Compared with the untreated diabetic group, NS preserved the hepatic architecture in diabetic rats as assessed histologically and biochemically. NS has a significant effect on liver regeneration as indicated by a significant increase in liver hepatocyte growth factor gene expression and a significant increase in proliferating cell nuclear antigen immunohistochemical staining. Hepatic fibrosis in diabetic rats was reduced by NS treatment as shown by the significant decrease in collagen deposition and alpha-smooth muscle actin immunohistochemical staining. Moreover, NS maintains functional insulin-producing hepatic oval cells as indicated by immunohistochemistry. This study showed the hepatoprotective effect of NS in experimentally induced diabetes in rats. NS also maintained functional insulin-producing hepatic oval cells in the liver of diabetic-treated rats

Male , Animals, Laboratory , Liver Diseases , Rats , Protective Agents , Nigella sativa/drug effects , Liver/pathology , Immunohistochemistry , Transaminases/blood , Treatment Outcome
Article in English | WPRIM | ID: wpr-65168


The aim of this study was to assess changes of Hsp70 and HSF-1 protein and mRNA expression in stress-sensitive organs of pigs during transportation for various periods of time. Twenty pigs were randomly divided into four groups (0 h, 1 h, 2 h, and 4 h of transportation). A significant increased activity of AST and CK was observed after 1 h and 2 h of transportation. Histopathological changes in the heart, liver, and stomach indicated that these organs sustained different degrees of injury. Hsp70 protein expression in the heart and liver of transported pigs did not change significantly while it increased significantly (p < 0.05) in the stomach. Hsp70 mRNA levels decreased significantly (p < 0.05) in the heart after 4 h of transportation. However, mRNA expression increased significantly in the liver after 1 (p < 0.05) and 4 h (p < 0.01) of transportation, and increased significantly in the stomach of the transported pigs after 1, 4 (p < 0.01), and 2 h (p < 0.05). HSF-1 levels were reduced at 1 and 4 h (p < 0.05) only in the hearts of transported pigs. These results indicate that Hsp70 mediates distinct stress-related functions in different tissues during transportation.

Animals , Creatine Kinase/blood , DNA-Binding Proteins/metabolism , Enzyme-Linked Immunosorbent Assay/veterinary , HSP70 Heat-Shock Proteins/metabolism , Liver/metabolism , Myocardium/metabolism , RNA, Messenger/metabolism , Random Allocation , Real-Time Polymerase Chain Reaction/veterinary , Stomach/metabolism , Stress, Physiological , Swine/blood , Time Factors , Transaminases/blood , Transcription Factors/metabolism , Transportation
Article in English | IMSEAR | ID: sea-136330


Background & objectives: Curcuma longa (turmeric) has a long history of use in Ayurvedic medicine as a treatment for inflammatory conditions. The purpose of the present study was to investigate the preventive effects of curcumin against acute pancreatitis (AP) induced by caerulein in mouse and to elucidate possible mechanism of curcumin action. Methods: Curcumin (50 mg/kg/day) was intraperitoneally injected to Kun Ming male mice for 6 days, followed by injection of caerulein to induce AP. GW9662 (0.3 mg/kg), a specific peroxisome proliferator-activated receptor gamma (PPARγ) antagonist, was intravenously injected along with curcumin. Murine macrophage RAW264.7 cells were treated with 100 μmol/l curcumin for 2 h, and then stimulated with 0.1 μ g/ml lipopolysaccharide (LPS). Serum amylase and transaminase levels were measured at 10 h after AP. TNF-α level in mouse serum and cell culture medium were detected by ELISA. Expression of PPARγ and NF-κB were analyzed by RT-PCR and Western blot. Results: Curcumin significantly decreased the pancreas injury and reversed the elevation of serum amylase, ALT and AST activities and TNF-α level in mice with AP. Curcumin treatment inhibited the elevation of NF-κB-p65 in the nucleus of mouse pancreas AP group and RAW264.7 cells, but significantly increased the expression of PPARγ. GW9662 could abolish the effects of curcumin on serum levels of amylase, ALT, AST, TNF-α, and NF-κB level. Interpretation & conclusions: Our results suggest that curcumin could attenuate pancreas tissue and other organ injury by inhibiting the release of inflammatory cytokine TNF-α. These effects may involve upregulation of PPARγ and subsequent downregulation of NF-κB.

Alanine Transaminase/genetics , Alanine Transaminase/immunology , Amylases/blood , Anilides/pharmacology , Animals , Ceruletide/chemistry , Ceruletide/pharmacology , Cell Nucleus , Curcuma/immunology , Curcumin/administration & dosage , Curcumin/pharmacology , Disease Models, Animal , Gene Expression Regulation/drug effects , Inflammation/genetics , Inflammation/metabolism , Lipopolysaccharides/pharmacology , Macrophages , Male , Mice , NF-kappa B/genetics , NF-kappa B/metabolism , PPAR gamma/antagonists & inhibitors , PPAR gamma/genetics , PPAR gamma/metabolism , Pancreatitis/chemically induced , Pancreatitis/drug therapy , Plant Extracts/pharmacology , Transaminases/blood , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/metabolism
Indian J Biochem Biophys ; 2011 June; 48(3): 184-190
Article in English | IMSEAR | ID: sea-135318


Lindane (-hexachlorocyclohexane, -HCH), a highly persistent organochlorine insecticide is neurotoxic at acute doses and has been reported to induce oxidative stress in cells and tissues. In this study, we investigated the antioxidant property of Nigella sativa seed oil (N.O) and omega-3 polyunsaturated fatty acids (3) against -HCH-induced oxidative hepatic and renal damage in male rats serum. Rats were orally given sublethal dose of -HCH (12 mg/kg, 24 h prior to decapitation), while N.O (0.3 ml/kg) and 3 (20 mg/kg) were given every 48 h for 20 days single or together, or also combined with -HCH. -HCH caused a significant increase in the levels of serum total lipids, cholesterol, and triglycerides by 49, 61 and 30% respectively, while HDL-cholesterol decreased by 45% compared to control group. Pretreatment with 3 and N.O prior -HCH administration re-established the altered biochemical features and alleviated the harmful effects of g-HCH on lipid profile. The concentration of serum total protein and albumin was significantly decreased by 35 and 45% respectively in rats treated with -HCH compared to control. -HCH also caused hepatic and renal damage, as observed from the elevated serum levels of urea, creatinine, total bilirubin and uric acid contents and aminotransferases (AST and ALT), phosphatases (ACP and ALP) and lactate dehydrogenase (LDH) activities. Co-administration of 3 and N.O reversed the hazardous effects induced by -HCH on the liver and kidney and also protected acetylcholinesterase from the inhibitory action of -HCH as well as suppressed the lipid peroxidation. Thus, the results show that 3 and N.O might prevent oxidative stress and attenuate the changes in the biochemical parameters induced by -HCH in male rats.

Animals , Antioxidants/administration & dosage , Antioxidants/metabolism , Cholesterol/blood , Creatinine/blood , Fatty Acids, Omega-3/administration & dosage , Hyperlipidemias/chemically induced , Hyperlipidemias/drug therapy , Hyperlipidemias/metabolism , Kidney/drug effects , Kidney/metabolism , L-Lactate Dehydrogenase/blood , Hexachlorocyclohexane , Lipid Peroxidation/drug effects , Liver/drug effects , Liver/metabolism , Oxidative Stress/drug effects , Plant Oils/administration & dosage , Rats , Transaminases/blood , Transaminases/drug effects , Triglycerides/blood , Urea/blood , Uric Acid/blood