RESUMO
Non-alcoholic fatty liver disease (NAFLD) denotes a spectrum of fatty liver disease in individuals without significant alcohol consumption. NAFLD is set to be the most common etiology of serious liver diseases in numerous nations when accompanied by obesity and type 2 diabetes. It is further histologically categorized into the non-alcoholic fatty liver (NAFL; steatosis without hepatocellular injury) and non-alcoholic steatohepatitis (NASH) which is characterized by the coexistence of hepatic steatosis and inflammation and is accompanied by hepatocyte injury (ballooning), either with or without fibrosis. NAFL is considered the benign and reversible stage arising from the excessive accumulation of triglycerides in hepatocytes. However, NASH is a more progressive stage of NAFLD, due to the increased risks of evolving more serious diseases such as cirrhosis, hepatocellular carcinoma. This concept, however, has been lately challenged by a hypothesis of multiple parallel hits of NAFLD, in which steatosis and NASH are separate entities rather than two points of the NAFLD spectrum, not only from a set of histological patterns but also from a pathophysiological perspective. The current review highlights the epidemiology and pathophysiology of NAFLD, and its progression towards steatohepatitis, with special focus on the novel imminent therapeutic approaches targeting the molecular aspects and the pathogenic pathways involved in the development, and progression of NAFLD.
RESUMO
Non-alcoholic fatty liver disease (NAFLD) denotes a spectrum of fatty liver disease in individuals without significant alcohol consumption. NAFLD is set to be the most common etiology of serious liver diseases in numerous nations when accompanied by obesity and type 2 diabetes. It is further histologically categorized into the non-alcoholic fatty liver (NAFL; steatosis without hepatocellular injury) and non-alcoholic steatohepatitis (NASH) which is characterized by the coexistence of hepatic steatosis and inflammation and is accompanied by hepatocyte injury (ballooning), either with or without fibrosis. NAFL is considered the benign and reversible stage arising from the excessive accumulation of triglycerides in hepatocytes. However, NASH is a more progressive stage of NAFLD, due to the increased risks of evolving more serious diseases such as cirrhosis, hepatocellular carcinoma. This concept, however, has been lately challenged by a hypothesis of multiple parallel hits of NAFLD, in which steatosis and NASH are separate entities rather than two points of the NAFLD spectrum, not only from a set of histological patterns but also from a pathophysiological perspective. The current review highlights the epidemiology and pathophysiology of NAFLD, and its progression towards steatohepatitis, with special focus on the novel imminent therapeutic approaches targeting the molecular aspects and the pathogenic pathways involved in the development, and progression of NAFLD.
RESUMO
Background: Group B Streptococcus [GBS] has been described as one of the commonest causes of the early onset of sepsis among the newborns, which leads to high rate of mortality and morbidity. Centers for Diseases Control [CDC] [2016] recommended GBS screening for all pregnant women between 35 and 37 weeks of pregnancy
Objectives: This work aims for evaluation of Strep B carrot broth [SCB] versus Latex agglutination technique [LA] as a screening method for early detection of Group B Streptococci colonizingthe genital tract of pregnant females
Methodology: the present study was conducted on 100 pregnant women attending the antenatal care clinic of Maternity Hospitals, Faculty of Medicine, Ain shams University. Duplicate vaginal swabs were taken, one for detection of GBS byStrep B Carrot Broth [SBC] and the second swab for detection of GBS by latex agglutination test
Results: The prevalence of GBS was 33% by SCB. SCB had excellent performance compared to LA test, with a sensitivity of 90.9%, specificity of 100%, and negative predictive value [NPV] and positive predictive value [PPV] of 95.7% and 1oo%, respectively
Conclusion:We can use SCB for rapid and reliable GBS screening in pregnancy as it has less false positive results in comparison to other conventional methods. Antepartum GBS screening is highly recommended to reduce the emerging antibiotic resistance among GBS strains