Elevación de enzimas hepáticas inducida por COVID-19 en embarazada / Elevated liver enzimes induced by COVID-19 in pregnancy

INTRODUCCIÓN: Las alteraciones del perfil hepático durante el embarazo ocurren en 3-5% de las gestantes. Una nueva etiología que se ha presentado en el contexto de pandemia actual es el síndrome respiratorio agudo severo relacionado con el nuevo coronavirus (SARS-CoV-2). Éste es responsable de alteraciones hepáticas en 2 a 11% de la población general infectada por este virus, y de hasta un 30% en las embarazadas que se infectan con SARS-CoV-2. Con el objetivo de mostrar una presentación poco frecuente del SARS-CoV-2 se expone un caso clínico de elevación de transaminasas en embarazada inducida por este nuevo virus. CASO CLÍNICO: Paciente de 36 años, cursando embarazo de 20+6 semanas, consulta por dolor abdominal asociado a ictericia y coluria. Se solicita estudio donde destaca elevación de transaminasas. Ecografía abdominal con vía biliar fina. Se descartan diferentes etiologías de hepatitis aguda y crónica (dada la falta de antecedentes). Finalmente se solicita PCR para COVID-19 que resulta positiva. CONCLUSIÓN: Luego de un estudio exhaustivo de diferentes etiologías de elevación de transaminasas, se atribuye esta alteración enzimática a SARS-CoV-2. Se decide seguimiento ambulatorio estricto con pruebas hepáticas cada dos semanas. La paciente evoluciona estable con exámenes normales luego de un mes desde que se indica el alta hospitalaria. Después de descartar etiologías frecuentes de elevación de transaminasas durante el embarazo, sugerimos solicitar el estudio de este virus con PCR para COVID-19, ya que podría ser una presentación poco frecuente de SARS-CoV-2.

INTRODUCTION: Approximately 3-5% of women present alterations of hepatic enzymes during pregnancy. Under the new circumstances that the world is facing with the SARS-COV2 pandemic, a new etiology for hepatic enzyme alterations has risen. The severe acute respiratory syndrome that the novel coronavirus causes is responsible for hepatic enzyme alterations in 2 to 11% of the sick population that did not have a previous underlying hepatic condition. Furthermore, hepatic enzyme alterations in pregnant women infected with SARS-COV2 presents in up to 30% of the cases. An infrequent presentation of SARS-COV2 is presented as our clinical case. CLINICAL CASE: A 36-year-old patient with a 20+6 week pregnancy presents abdominal pain, jaundice and choluria. General blood workup shows elevated transaminases. The abdominal ultrasound revealed a thin bile duct. Acute and chronic hepatitis etiologies were discarded. Finally, a PCR of COVID-19 was solicited, which turned out to be positive. CONCLUSIÓN: After an exhaustive study to determine the etiology of the elevated transaminases, the hepatic alterations were attributed to SARS-COV2 infection. A conservative management was adopted, with outpatient follow-up with liver testing every two weeks. The patient progresses with a stable steady decline in hepatic enzyme levels, and one-month post hospital discharge, her transaminases had reached normal values. Based on this clinical case, after ruling out frequent etiologies for elevated transaminases during pregnancy, it seems reasonable to request a PCR for COVID-19, since it could be a rare presentation of SARS-CoV-2.

Alteraciones bioquímicas y ecográficas a nivel hepático en pacientes que viven con VIH/Sida

Los pacientes con Virus de inmunodeficiencia humana (VIH) pueden presentar alteraciones del funcionalismo y estructura hepática como consecuencia de la terapia antirretroviral (TARV), de otras coinfecciones o de patologías metabólicas o neoplásicas que pueden presentarse en cualquier estadio de la enfermedad. La realización de las pruebas de laboratorio y el ultrasonido abdominal son herramientas fundamentales para la detección y seguimiento de estos casos. Objetivo: Describir las alteraciones bioquímicas y ecográficas a nivel hepático en pacientes que viven con condición de VIH/Sida que reciben TARV. Metodología: Investigación clínica, descriptiva, de campo, de corte transversal, donde se incluyeron pacientes con VIH mayores de 18 años que acudieron a la consulta de Infectología del Hospital Central de Maracay en el período marzo-junio de 2017. Se excluyeron pacientes con coinfecciones y patologías metabólicas. Se registraron datos epidemiológicos, clínicos y paraclínicos. Resultados: Se incluyeron 23 pacientes que recibían TARV, predominando el sexo masculino y el rango etario de 20-29 años. 60,87 % tenían entre 1 y 3 años en TARV regular. 21,73 % de los pacientes mostraron elevación de las transaminasas tanto glutámico-pirúvica (TGP) como glutámico-oxalacética (TGO), destacándose que todos los pacientes de este grupo recibían terapia con inhibidores de la transcriptasa reversa análogo de nucleósido más inhibidores de la transcriptasa reversa no análogo de nucleósido (ITRN/ ITRNN); en cuanto a los valores de bilirrubina se evidenció que quienes recibían la combinación ITRN/Inhibidores de la proteasa (IP) presentaron elevación de los niveles de bilirrubina a predominio de la indirecta (21,7 %). Para la GGT solo un paciente presentó alteración. El hallazgo ecográfico más frecuente fue la esteatosis hepática (69,56 %), predominando la esteatosis hepática grado II. Conclusión: Es necesario en los pacientes con condición VIH la evaluación regular e integral de parámetros hepáticos, en búsqueda de efectos adversos de la terapéutica, u otras condiciones médicas y nutricionales que puedan incrementar el riesgo de patología hepática

Patients with Human Immunodeficiency Virus (HIV) may have alterations in liver function and structure because of antiretroviral therapy (ART), other coinfections or metabolic or neoplastic diseases that can occur at any stage of the disease. The performance of laboratory tests and abdominal ultrasound are essential tools for the detection and monitoring of these cases. Objective: Describe the biochemical and ultrasound alterations at a hepatic level in patients living with HIV/ AIDS who receive ART. Methodology: Clinical research, descriptive, field, cross-sectional, which included patients with HIV over 18 years who attended the consultation of Infectious Diseases at the Central Hospital of Maracay in the period March-June 2017. Patients with coinfections and metabolic pathologies were excluded. Epidemiological, clinical and paraclinical data were recorded. Results: Twenty-three patients receiving ART were included, predominantly male and with an age range of 20-29 years. 60.87 % were between 1 and 3 years on regular ART. 21.73 % of the patients showed elevation of both glutamic-pyruvic transaminase (GPT) and glutamic-oxalacetic transaminase (GOT), highlighting that all patients in this group received therapy with nucleoside analogue reverse transcriptase inhibitors plus non-nucleoside analogue reverse transcriptase inhibitors (NRTIs/NNRTIs). In terms of bilirubin values, it was shown that those receiving the combination of NRTIs/Protease Inhibitors (PI) showed an increase in bilirubin levels with a predominance of hint (21.7 %). About GGT only one patient presented alteration. The most frequent ultrasound finding was Hepatic Steatosis (69.56 %), with predominance of hepatic steatosis grade II. Conclusion: It is necessary in patients with HIV condition regular and comprehensive assessment of liver parameters, in search of adverse effects of therapy, or other medical and nutritional conditions that may increase the risk of liver disease.

Possible protective effect of olive leaves extract on paracetamol induced hepatotoxicity in male albino rats / Possível efeito protetor do extrato de folhas de oliveira na hepatotoxicidade induzida por paracetamol em ratos albinos machos

Paracetamol (PCM) overdose can cause hepatotoxicity with oxidative stress; the present study was carried out to establish the possible protective effect of olive leaves extract (OLE) on toxicity induced by paracetamol in adult male rats. Twenty four adult male rats were divided into four equal groups; control, olive leaves extract group, paracetamol group and olive leaves extract plus paracetamol group. Some biochemical parameters and liver histopathology were evaluated. PCM treatment significantly increased serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), urea, creatinine and alpha-fetoprotein. Paracetamol was found to significantly increase malonaldehyde (MDA) and decrease glutathione reductase (GR) activity in tissue and significantly decrease total antioxidant capacity (TAC) and superoxide dismutase (SOD) in serum. Administration of OLE caused a significant decrease serum AST, ALT enzyme, total bilirubin, GGT, LDH, creatinine, urea, alpha-fetoprotein. Also, amelioration of oxidant ­ antioxidant status with olive leaves extract was observed in addition to a significant decrease in MDA and a significant increase in TAC in liver tissue with a significant increase in glutathione reductase (GR) and SOD in serum compared to paracetamol treated group The chemical pathological changes were in step with histopathological observation suggesting marked hepatoprotective result of olive leaves extract. It could be concluded that olive leaves extract (OLE) treatment may be effective in decreasing hepatic injury and oxidative stress induced by paracetamol overdose in male albino rats

A sobredosagem de paracetamol (PCM) pode causar hepatotoxicidade com estresse oxidativo; o presente estudo foi realizado para estabelecer o possível efeito protetor do extrato de folhas de oliveira (OLE) na toxicidade induzida pelo paracetamol em ratos machos adultos. Vinte e quatro ratos machos adultos foram divididos em quatro grupos iguais: controle, grupo extrato de folhas de oliveira, grupo paracetamol e extrato de folhas de oliveira mais grupo paracetamol. Alguns parâmetros bioquímicos e histopatologia hepática foram avaliados. O tratamento com PCM aumentou significativamente aspartato aminotransferase sérica (AST), alanina aminotransferase (ALT), bilirrubina total, gama-glutamiltransferase (GGT), lactato desidrogenase (LDH), uréia, creatinina e alfa-fetoproteína. Verificou-se que o paracetamol aumenta significativamente o malonaldeído (MDA) e diminui a atividade da glutationa redutase (GR) no tecido e diminui significativamente a capacidade antioxidante total (TAC) e a superóxido dismutase (SOD) no soro. A administração de OLE causou uma diminuição significativa de AST, enzima ALT, bilirrubina total, GGT, LDH, creatinina, uréia, alfa-fetoproteína. Também foi observada melhora do status oxidante - antioxidante com extrato de folhas de oliveira, além de uma diminuição significativa no MDA e um aumento significativo no TAC no tecido hepático, com um aumento significativo na glutationa redutase (GR) e SOD no soro em comparação ao grupo tratado com paracetamol. As alterações patológicas químicas acompanharam a observação histopatológica, sugerindo resultado hepatoprotetor acentuado do extrato de folhas de oliveira. Pode-se concluir que o tratamento com extrato de folhas de oliveira (OLE) pode ser eficaz na diminuição da lesão hepática e do estresse oxidativo induzido pela overdose de paracetamol em ratos albinos machos

Perfil metabólico de vacas Holandês e mestiças Holandês x Jersey no periparto / Metabolic profile of Holstein and crossbred Holstein x Jersey cows in the peripartum

O objetivo do presente trabalho foi determinar e comparar o perfil metabólico de vacas Holandês (H) e mestiças Holandês x Jersey (HxJ) no periparto. Avaliaram-se 24 vacas, sendo 11 vacas Holandês e 13 mestiças Holandês x Jersey. Semanalmente, coletou-se sangue para a determinação das concentrações séricas de glicose, beta-hidroxibutirato (BHB), proteína total, albumina, aspartato aminotransferase (AST), creatinoquinase (CK), cálcio total, cálcio iônico, magnésio, fósforo inorgânico e colesterol. Avaliou-se também o peso vivo e o escore de condição corporal (ECC). Os dados foram submetidos à análise de variância com medidas repetidas no tempo. As vacas Holandês apresentaram maior peso vivo. Não houve diferença entre os grupamentos genéticos para ECC. Foi observada tendência de maiores concentrações séricas de BHB, AST e maior concentração de cálcio iônico em vacas mestiças Holandês x Jersey. Vacas mestiças Holandês x Jersey e Holandês apresentaram perfil energético similar durante o período de transição pré e pós-parto na maioria dos indicadores, com exceção do cálcio, que foi maior nas vacas mestiças, e do fósforo, que foi superior nas vacas Holandês.(AU)

The aim of this study was to determine and compare the metabolic profile of Holstein (H) and crossbred Holstein x Jersey (HxJ) on peripartum. For this, 24 cows were evaluated, 11 Holstein and 13 crossbreeds Holstein x Jersey. Weekly, venous blood sample were collected to determine concentration of glucose, beta-hydroxybutyrate (BHBA), total protein, albumin, aspartate aminotransferase (AST), creatine kinase (CK), total calcium, ionic calcium, magnesium, inorganic phosphorus and cholesterol. Body weight (BW) and body condition score (BCS) were also evaluated. The data were submitted to analysis of variance with repeated measures in time. Holstein cows presented higher BW, however, there was no difference for BCS in compare to crossbreed Holstein x Jersey cows. Tendency for higher serum concentrations of BHBA, AST and higher concentration of ionic calcium was observed in crossbreed cows in comparison to the Holstein. The energetic profile during the pre and postpartum transition period is similar for both genetic groups with higher concentrations of BHBA on the first week of lactation, however, with a tendency of higher serum concentrations of BHBA for crossbreed cows. Higher concentrations of ionic calcium were observed in crossbreed cows and higher concentrations of phosphorus in Holstein cows on peripartum. Holstein and Holtein x Jersey crossbreed cows have a similar energy profile during the pre and postpartum transition period in most of the indicators, except for calcium that was higher in crossbred cows and higher phosphorus in Holstein cows.(AU)

Transaminases elevadas em um paciente assintomático: o que fazer? / Elevated transaminases in an asymptomatic patient: what to do?

Objetivos: Enzimas hepáticas elevadas são um cenário comum encontrado pelos médicos na prática clínica. O objetivo desse estudo é auxiliar os profissionais de saúde na condução desses casos, revisando possíveis causas tanto hepáticas, quanto extra-hepáticas para este achado e como prosseguir com a avaliação diagnóstica frente ao mesmo. Métodos: As buscas foram realizadas nas bases de dados MEDLINE e LILACS. A estratégia de busca foi desenvolvida utilizando-se os seguintes termos de pesquisa: "transaminases" OR "alanina transaminase" OR "aspartato transaminase". Os critérios de elegibilidade foram: estudos realizados em humanos, adultos, maiores de 19 anos, estudos com texto disponível, publicados em português, espanhol ou inglês a partir de 2012. Resultados: De um total de 1219 artigos que foram encontrados nas bases de dados, 20 foram incluídos nessa revisão. Foram selecionados 11 artigos com base na relevância clínica e fator de impacto das revistas. Conclusões: A alteração dos níveis das enzimas hepáticas em um paciente assintomático é um problema comum encontrado no cenário médico. A anamnese, exame físico e avaliação laboratorial são fundamentais para o diagnóstico. Dessa forma, uma abordagem sistemática pode auxiliar na condução ao correto diagnóstico, sendo necessário, por vezes, o auxílio de um especialista.

Aims: Elevated liver enzymes are a common scenario found by doctors in clinical practice. The aim of this study is to assist health care professionals in the conduct of these cases, reviewing possible causes so much liver as liver extra for this found and how to proceed with the diagnostic evaluation it. Methods: The searches were performed in the MEDLINE and LILACS databases. The search strategy was developed using the following search terms: "transaminases" OR "alanine transaminase" OR "aspartate transaminase". The eligibility criteria were: studies in humans, adults over 19 years, studies with available text, published in Portuguese, Spanish or English from 2012 up. Results: Of a total of 1219 articles that were found in the databases, 20 were included in this review. Based on 11 articles based on the clinical relevance and impact factor of the journals. Conclusions: Changing liver enzyme levels in an asymptomatic patient is a common problem found in the medical setting. Anamnesis, physical examination and laboratory evaluation are fundamental for diagnosis. In this way, a systematic approach can help in conducting the correct diagnosis, sometimes requiring the assistance of a specialist.

Avaliação hepática em ratos Wistar expostos ao chá de Ayahuasca / Hepatic evaluation in Wistar rats exposed to Ayahuasca tea

O chá de Ayahuasca é empregado no xamanismo, na terapia antidrogas e indevidamente em recreações alucinógenas. O estudo teve como objetivo avaliar o fígado, tanto histológica como bioquimicamente, por se tratar do órgão responsável pela metabolização desse chá. Foram utilizados ratos Wistar (n=24), machos, adultos, divididos em dois grupos (controle e tratado). Foi administrada uma dose diária quatro vezes superior à utilizada no contexto religioso, por quatro dias consecutivos. Não houve alteração morfológica pela análise qualitativa, porém, na análise quantitativa do grupo tratado ocorreu redução do volume do hepatócito e de seu núcleo. Na análise bioquímica observou-se uma redução da Gama-Glutamil-Transferase e da Fosfatase Alcalina. De acordo com a dose e o tempo de exposição não foram encontradas alterações morfológicas nesse estudo. O estudo morfométrico mostrou alterações significativas no volume do hepatócito e de seu núcleo, onde ocorreu diminuição do volume do grupo tratado em relação ao grupo controle. Observou-se uma redução estatisticamente significativa nos parâmetros da Gama-Glutamil-Transferase e Fosfatase Alcalina. Nesse experimento foi observada uma redução do volume dos hepatócitos, sem ocorrer, entretanto, alterações na função e na estrutura hepática.

Ayahuasca tea is employed in Xamanism, in anti-drug therapy and illicitly in hallucinogenic recreations. Current study assesses the liver histologically and biochemically since it is an organ involved in the metabolism of the tea. Twenty-four male adult Wistar rats were divided into two groups (control and treated). A daily dose four times higher than that used within a religious context was given, during four consecutive days. There was no qualitative morphological change but a reduction of hepatocyte volume and its nucleus occurred when the quantitative analysis of the treated group was performed. Biochemical analysis showed a decrease in gamma-glutamyltransferasis and Alkaline Phosphatase. There were no morphological alterations for dose and exposure time in current study. Morphometric analysis showed significant alterations in hepatocyte volume and its nucleus where a decrease in volume of the treated group occurred when compared to that of control. A significant statistical decrease was detected in the gamma-glutamyl-transferasis and alkaline phosphatase parameters. Current analysis also detected a decrease in hepatocyte volume without alterations in hepatic functions and structure.

Evaluación del potencial hepatoprotector de la Mentha piperita L previo a la inducción de hepatotoxicidad con acetaminofen / Evaluation of hepatoprotective potential of Mentha piperita L before induction of hepatotoxicity with acetaminophen

A preclinical pharmacological study was conducted to evaluate the hepatoprotective effect of Mentha piperita L. against paracetamol induced toxicity. Adult male NMRI mice who were administered orally soft plant extracts in doses of 200mg/kg and 400mg/kg, three consecutive days prior to the induction of hepatotoxicity were used. Clinical signs of toxicity, hepatic biochemical parameters and morphological analysis of the liver was evaluated. The biochemical parameters analyzed showed significant differences, but none of the two groups showed a similar untreated control group behavior. No macroscopic changes in the liver were confirmed. Microscopically, the study groups with Mentha piperita L. showed mild to moderate damage with significant differences from the untreated control group. The evaluation of hepatoprotective potential on the M. piperita L. extract at doses studied did not behave as hepatoprotective agent...

Se realizó un estudio farmacológico preclínico para evaluar el efecto hepatoprotector de Mentha piperita L. frente a la toxicidad inducida por el paracetamol. Se emplearon ratones adultos machos NMRI a los que se administró por vía oral extractos blandos de la planta a dosis de 200 mg/kg y 400 mg/kg, tres días consecutivos previos a la inducción de la hepatotoxicidad. Se evaluaron los signos clínicos de toxicidad, parámetros bioquímicos hepáticos y el análisis morfológico del hígado. Los parámetros bioquímicos analizados mostraron diferencias altamente significativas, pero ninguno de los dos grupos presentaron un comportamiento similar al grupo control no tratado. No se confirmaron alteraciones macroscópicas del hígado. A nivel Microscópico, los grupos en estudio con Mentha piperita L. presentaron daños de leves a moderados con diferencias significativas respecto al grupo control no tratado. Se puede afirmar que según la evaluación del potencial hepatoprotector del extracto de M. piperita L. a las dosis estudiadas no se comportó como agente hepatoprotector...

Valoración diagnóstica de enzimas hepáticas en perfiles bioquímicos sanguíneos de vacas lecheras / Diagnostic assessment of liver enzymes in blood profiles from dairy cows

Objetivo. El objetivo del estudio fue determinar la asociación, sensibilidad (Se) y especificidad (Es) de las enzimas glutamato deshidrogenasa (GDH, EC: 1.4.1.3), aspartato aminotransferasa (AST, EC: 2.6.1.1) y g-glutamil transpeptidasa (GGT, EC: 2.3.2.2) como indicadores de daño hepático en perfiles bioquímicos sanguíneos de vacas lecheras. Materiales y métodos. Se analizaron los valores de la actividad plasmática de GDH, AST y GGT, obtenidos de 1566 vacas correspondientes a 112 perfiles bioquímicos realizados en rebaños lecheros. Se determinó la asociación entre la actividad de las enzimas y el área bajo la curva (ABC) y la Se y la Es mediante curva ROC considerando la presencia de daño hepático cuando GDH>30 U/L o GGT>39 U/L. Resultados. La AST presentó mayor asociación con la GDH (r=0.55) que la GGT (r=0.44), así como una mayor ABC (p=0.01) al utilizar GDH>30 U/L para indicar daño hepático. El grado de asociación entre AST y GGT fue de r=0.42. La sensibilidad de la AST para detectar daño hepático, utilizando el punto de corte de referencia del laboratorio (>150 U/L), fue inferior que al emplear GGT (>39 U/L). El punto crítico de máxima Se y Es de la curva ROC para daño hepático se obtuvo con AST>110 U/L, valor que incrementó la concordancia diagnóstica con la GDH (Kappa >0.300), pero no con la GGT. Conclusiones. La actividad plasmática de AST en vacas lecheras se asocia mayormente con la de GDH que con la de GGT y su límite de referencia para predecir daño hepático correspondería a >110 U/L.

Objective. The aim of this study was to establish the association, sensibility (Se) and specificity (Sp) of the plasmatic activity of glutamate dehydrogenase (GDH, EC: 1.4.1.3), aspartate aminotransferase (AST, EC: 2.6.1.1) and g-glutamil transpeptidase (GGT, EC: 2.3.2.2) as liver damage markers in blood profiles of dairy cows. Materials and methods. The records of the plasma activity for GDH, AST and GGT obtained from blood profiles taken from 1566 cows from 112 dairy herds. The association between enzymatic activity, area below the curve (ABC), and Se and Sp using a ROC curve were determined, considering liver damage when GDH >30 U/L or GGT >39 U/L. Results. The AST was more likely associated to GDH (r=0.55) than to GGT (r=0.44). AST also had a higher ABC (p=0.01) when using GDH >30 U/L as an indicator of liver damage. The correlation between AST and GGT was of r=0.42. AST Se to detect liver damage with a cut-off level of >150 U/L was lower than the Se of GGT. The critical point for maximum Se and Sp of the ROC curve was obtained with AST>110 U/L and an increase in the diagnostic concordance with GDH (Kappa>0.300), was obtained using this value. Conclusions. Plasma activity of AST is more associated to GDH than to GGT in dairy cows. The cut-off level of plasma activity of AST for liver damage prediction in dairy cows would be >110 U/L.

Proteins and liver function changes in rats following cumulative total body irradiations / Proteínas y cambios de función hepática en ratas tras irradiación corporal total cumulativa

OBJECTIVE: Total body irradiation (TBI) is a choice therapy for the management of some malignancies; it is also a major cause of oxidative stress. The aim of this research is to sequentially document the effect of total body radiation on body function utilizing the sequential changes in liver function enzymes and proteins in rats. METHODS: Serum protein and liver enzymes were assessed using kits in rats exposed to total body radiations of 1.27 Gy/minute in cumulative doses to the fourth radiation at five-day intervals. RESULTS: Aspartate aminotransferase (AST), alanine transaminase (ALT) and serum protein were significantly (p < 0.05) elevated with increasing radiation. No significant differences between experimental and control groups for bilirubin concentrations were noted at any time. Serum levels of albumin were significantly (p < 0.05) increased with the first to third radiation exposures but reduced at the fourth cumulative dose exposure. CONCLUSION: Variations are associated with acute stress, inflammation which could be due to non-specific stress reaction, while fluctuations could arise as a result of tolerance and repair within the liver. These tests are significant for diagnosis of radiation-induced injury and can be important for evaluation of its severity and correct management.

OBJETIVO: La irradiación corporal total (ICT) es una terapia de elección para el tratamiento de algunos tumores malignos. También es una de las causas principales del estrés oxidativo. El objetivo de esta investigación es documentar el efecto de la radiación corporal total sobre las funciones corporales utilizando los cambios secuenciales en las enzimas de la función hepática y las proteínas en las ratas. MÉTODOS: Se evaluaron las proteínas séricas así como las enzimas hepáticas mediante el uso de kits en ratas expuestas a radiaciones corporales totales de 1.27 Gy/minuto en dosis cumulativas hasta la cuarta radiación con cinco días de intervalo. RESULTADOS: La aspartato transaminasa (AST), la alanina aminotransferasa (ALT) y la proteína sérica fueron elevadas significativamente (p < 0.05) con el aumento creciente de la radiación. No hubo diferencias significativas entre el grupo experimental y el grupo control, observándose concentraciones de bilirrubina todo el tiempo. Los niveles séricos de albúmina aumentaron significativamente (p < 0.05) con la primera de tres exposiciones a la radiación, pero experimentaron una reducción a partir de la cuarta exposición de dosis cumulativa. CONCLUSIÓN: Las variaciones están asociadas con estrés agudo e inflamación que podría deberse a una reacción a estrés no específico, mientras que las fluctuaciones podrían surgir como resultado de la tolerancia y la regeneración dentro del hígado. Estas pruebas son importantes para el diagnóstico de lesiones inducidas por radiación, así como para la evaluación de la severidad y el tratamiento correcto de las mismas.

Efeito da pimenta rosa associada a diversas dosagens de antibióticos em frangos de corte / Effect of Brazilian red pepper meal associated with different levels of antibiotics on broilers chickens

Este trabalho objetivou avaliar o efeito da adição de níveis crescentes de antibióticos associado ao farelo de pimenta rosa (FPR) sobre a função hepática e desempenho de frangos de corte. Utilizou-se 528 pintos, machos, da linhagem Cobb de um dia de idade distribuídos num delineamento inteiramente casualizado com seis tratamentos, quatro repetições com 22 aves cada: T1: Controle Negativo (CN): Dieta Basal; T2: Controle Positivo (CP): Dieta Basal com 1,2% FPR; T3: CP+11ppm bacitracina Zn e 17ppm salinomicina; T4: CP+22ppm bacitracina Zn e 34ppm salinomicina; T5: CP+33ppm bacitracina Zn e 51ppm salinomicina; T6: CP + 45ppm bacitracina Zn e 67ppm salinomicina. Por conter taninos, o uso de pimenta rosa na alimentação animal requer avaliação da função hepática, sendo a dosagem das enzimas ALT (alanina aminotransferase), AST (aspartato aminotransferase) e GGT (gama glutamiltransferase) ferramenta auxiliar no diagnóstico de lesões hepáticas. Portanto, aos 21 e 41 dias de idade, 10 animais por tratamento foram escolhidos aleatoriamente e coletadas amostras de sangue. Aos 21 dias de idade, verificou-se efeito significativo (P<0,05) dos tratamentos sobre os valores da AST e ALT, sendo que as aves alimentadas com FPR associado com maiores doses de antibióticos tiveram valores elevados de AST e reduzidos de ALT, comparada aos demais tratamentos. Entretanto, as concentrações séricas das enzimas AST, ALT e GGT nos frangos alimentados com 1,2% de FPR não diferiram (P>0,05) do CN aos 21 e 41 dias de idade. Não houve efeito (P>0,05) dos tratamentos sobre o peso das aves e do peso relativo do fígado aos 43 dias. A adição do farelo de pimenta rosa com ou sem promotor de produção melhorou a conversão alimentar aos 43 dias de idade. Concluiu-se que a adição de 1,2% FPR não comprometeu a função hepática e que a inclusão de doses mais altas de antibióticos, associado ao FPR na dieta, resultou em alteração das enzimas hepáticas.

The aim of this research was to evaluate the effects of the increase levels of antibiotics associated with the Brazilian red pepper meal (BRPM) on liver function and performance of broilers. A total of 528 day-old male chicks, Cobb, distributed in a randomized design of six treatments and four replicates of 22 birds each: T1: Negative Control (NC): basal diet; T2: Positive Control (PC): basal diet with 1,2% BRPM; T3: PC+11ppm zinc bacitracin and 17ppm salinomycin, T4: PC + 22ppm zinc bacitracin and 34ppm salinomycin; T5: PC+33ppm zinc bacitracin and 51ppm salinomycin; T6: PC+45ppm zinc bacitracin and 67ppm salinomycin. BRPM contains tannins thus its use in animal feed needs to evaluate by liver function and animal performance. The dosage of the enzymes ALT (alanine aminotransferase), AST (aspartate aminotransferase) and GGT (gamma glutamyltransferase) is a tool in the diagnosis of liver damage. For this, were randomly collected blood samples from 10 animals per treatment between 21 and 41 days age. At 21 days of age it was observed elevated values of AST and decreased of ALT in broilers fed diet BRPM associated with higher levels of antibiotics compared to the others (P<0.05). However, it was observed that the serum concentrations of AST, ALT and GGT in broiler chickens fed diet with 1.2% of BRPM did not differ from NC at 21 and 41 days (P>0.05). There was no effect (P>0.05) of treatments on broilers weight and relative liver weight at 43 days of age. The supplementation of Brazilian red pepper with or without antibiotics improved feed conversion at 43 days of age. It was concluded that the inclusion of 1.2% BRPM did not affect liver function but the addition of high levels of antibiotics associated with the BRPM resulted in alteration of hepatic enzymes.

Parâmetros sanguíneos de vacas leiteiras suplementadas com diferentes fontes de gordura / Blood parameters of dairy cows supplemented with different fat sources

O objetivo deste trabalho foi avaliar a utilização de diferentes fontes de gordura nas rações de vacas em lactação e seus efeitos sobre o consumo de matéria seca e as concentrações dos parâmetros sangüíneos. Foram utilizadas 12 vacas da raça Holandês, agrupadas em três quadrados latinos balanceados 4x4 e alimentadas com as seguintes rações: 1) controle; 2) óleo de soja refinado; 3) grão de soja in natura; e 4) sais de cálcio de ácidos graxos (Megalac-E). As concentrações de colesterol total, colesterol, lipoproteína de baixa densidade (LDL) e colesterol de alta densidade (HDL) foram maiores (P<0,05) para as vacas alimentadas com as rações contendo fontes de gordura em relação à ração controle. As concentrações de uréia e nitrogênio ureico no soro foram semelhantes entre as rações utilizadas, com exceção da ração contendo sais de cálcio de ácidos graxos, que apresentou concentrações menores (P<0,05). O consumo de matéria seca foi menor (P<0,05) nas vacas que receberam sais de cálcio nas rações. Os animais que receberam a ração contendo grão de soja como fonte de gordura apresentaram menor (P<0,05) produção de leite quando comparada às demais rações utilizadas. A utilização de fontes de gordura em rações de vacas em lactação alterou os parâmetros sanguíneos, dependendo da fonte de gordura utilizada.

This study was carried out to evaluate the use of different fat sources in dairy cows rations and its effects on dry matter intake, milk yield and composition, and blood parameter. Twelve Holstein cows were allocated in three balanced latin square 4x4, and fed with the following rations: 1) Control, with 2.5 percent; 2) Refined soybean oil; 3) Whole soybean; and 4), Calcium salts of fatty acids (Megalac-E). The concentrations of total cholesterol and lipoprotein low density (LDL) were higher (P<0.05) for cows that received rations with fat sources, which also causes increased (P<0.05) e concentration of high density lipoprotein (HDL). The concentrations of urea and blood urea nitrogen were similar among the rations, except for the diet containing calcium salts of fatty acids, which showed lower (P<0.05). The dry matter intake was lower (P<0.05) in cows that received calcium salts in the rations. The animals that received a diet containing whole soybeans as a source of fat had lower (P<0.05) yield milk when compared to other rations used. The use of fat sources in dairy cows rations influenced the blood parameters, especially for parameters related to lipidogram.

Alteraciones bioquímicas en individuos expuestos al arsénico en el agua de bebida en Tucumán, Argentina / Biochemical alterations in individuals consuming high levels of arsenic in drinking water in Tucuman, Argentina

El objetivo de esta investigación fue evaluar los niveles del ácido siálico (S) y enzimas hepáticas en individuos que consumieron agua con arsénico (As) relacionándolos con la presencia ("I con H") o no de hepatomegalia ("I sin H"). Se incluyeron 200 individuos, 85 correspondieron al Grupo Control (GC), 32 "I con H" y 83 "I sin H" quienes habían consumido agua con niveles mayores a 0,01 mg/L. Se les tomó una muestra de sangre venosa y se les realizó el dosaje del S y de las enzimas alaninaninotransferasa (ALT), aspartatoaminotransferasa (AST), fosfatasa alcalina (FAL), gamma glutamil transferasa (GGT), bilirrubina directa (BD) y total (BT), lactato deshidrogenasa (LDH) y 5' nucleotidasa (5'Nu). En los individuos que consumieron agua contaminada se encontró un aumento de los niveles del S. En el grupo "I con H", la FAL, la GGT y la LDH se encontraron aumentadas. En el grupo "I sin H", la GGT y la LDH tuvieron niveles elevados. En los individuos expuestos al As, no se encontraron alteraciones en los otros parámetros bioquímicos estudiados y la prevalencia de hepatomegalia no fue significativa. Los cambios bioquímicos encontrados fueron compatibles con la presencia de un patrón colestásico. Estos datos muestran que la concentración del S sérico podría servir como un indicador de exposición al arsénico que podría ser utilizado en forma conjunta con otros marcadores.

The aim of this study was to investígate the relationship between the levels of serum sialic acid (S) and hepatic enzymes in individuáis who drink As contaminated water. Two hundred individuáis were selected: 85 were the control group, 32 presented hepatomegaly (I with H) and 83 did not present hepatomegaly (I without H) who had consumed drinking water containing As levels higher than O.Ol mg/L. Blood samples were collected for the determination of S and hepatic enzymes in serum: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (FAL), gamma glutamil transpeptidase (GGT), direct (BD) and total bilirrubin (BT), lactate deshydrogenase (LDH) and 5'nucleotldase (5'Nu). The populatlon exposed to As in drinking water presented high levels of S, FAL, GGT, LDH and GGT, LDH were increased in I with H and I without H respectively. No significant changes were observed in the other parameters studied. Prevalence of hepatomegaly was not significantly higher and the hepatic biochemical changes were related with the presence of cholestasis in As-exposed people. These data show that people with high As level intake would have an increased sialoprotein replacement which could be an marker with other one of the alterations caused by arsenic.

Hemograma, proteinograma, ionograma e dosagens bioquímicas e enzimáticas de ovinos acometidos por conidiobolomicose no nordeste do Brasil: [revisão] / Hematology and blood biochemistry in sheep with conidiobolomycosis in northeastern Brazil: [revision]

Foram realizados eritrogramas, leucogramas, dosagens séricas de proteínas totais, albumina, globulinas, cálcio, fósforo, magnésio, cloretos, uréia, creatinina, bilirrubina total, direta e indireta e atividade sérica de aspartato aminotransferase (AST), fosfatase alcalina (FA) e gama-glutamiltransferase (GGT) de 56 ovinos afetados por conidiobolomicose e de 371 ovinos sadios provenientes dos mesmos rebanhos dos casos da doença. Os resultados revelaram que os ovinos com conidiobolomicose apresentam anemia arregenerativa normocítica normocrômica, leucocitose com neutrofilia e discreto desvio à esquerda regenerativo, com elevação da relação neutrófilo:linfócito, monocitose moderada, trombocitose, hipoproteinemia (hipoglobulinemia), hipomagnesemia, hipocalcemia e elevação dos teores de fósforo. As atividades séricas de AST e GGT estavam aumentadas e as de FA diminuídas. Não houve alteração nos níveis de uréia e creatinina, mas ocorreu hipoglicemia e hiperbilirrubinemia. Estes resultados podem ser utilizados para estudos experimentais da doença, em ensaios com tratamentos e para identificar casos precoces da enfermidade que não apresentem sinais clínicos. Além disso, os valores encontrados em 371 ovinos deslanados hígidos podem ser utilizados como valores referenciais para este tipo de ovinos na região semi-árida do Brasil.

Hematologic values, serum levels of albumin, globulins, total proteins, calcium, phosphorus, magnesium, chloride, urea nitrogen, creatinine, total, direct and indirect bilirrubin, and serum activities of aspartate aminotransferase (AST), alkalin phosphatase (AF) and gama-glutamyltransferase (GGT) were determined in 56 hair sheep with conidiobolomycosis and 371 healthy hair sheep from the same flocks. Sheep with conidiobolomycosis had nonregenerative, normocytic and normochromic anemia, leucocytosis with neutrophilia and increased nutrophil:lymphocyte rate, moderate monocytosis, moderate thrombocytosis, hypoproteinemia (hypoglobulinemia), hypomagnesemia, hypocalcemia and increased values of phosphorus. Serum activities of AST and GGT were increased and serum activity of FA decreased. Serum values of urea and creatinine were within normal values. Hypoglycemia and hyperbilirrubinemia were also observed. These results can be used for experimental studies with the disease, for treatments trials, and to detect early cases of the disease without clinical signs. Otherwise the hematologic and blood biochemistry values of healthy sheep can be used as reference values for hair sheep in the semi-arid region of Brazil.

Esporotricose experimental sistêmica em ratos Wistar: avaliação hematológica e perfil hepático / Systemic experimental sporotrichosis in Wistar rats: hematological evaluation and hepatic profile

Alanine aminotransferase (ALT) and alkaline phosphatase (AP) hepatic enzymes, hematological values, and total plasmatic proteins (TPP) of 12 Wistar rats with systemic experimental sporotrichosis were evaluated. Inoculation was performed at 2x10³ cells of S. schenckii/ml. The values ranged from 35 to 48UI/l for ALT and 67 to 251.3UI/l for AP. Fifty percent of the AP values were above the physiological limits. TPP was elevated in 66.7 percent (8/12) of the rats with values varying from 7.9 to 8.5g percent. In 75 percent (9/12) of the animals, it was observed that hemoglobin and red blood cells count were below the physiologic limits, and 8.3 percent (1/12) of the animals showed anemia masked by dehydration. At the necropsy, it was observed local and/or disseminated nodular lesions. At the histological analysis, cells compatible to S. schenckii were found. The observed alterations are aggravating factors for the recurrence and treatment of the mycosis.

Alteraciones clínicas y bioquímicas en ratas tratadas con dosis altas de vitamina A / Clinical and biochemical alterations in rats treated with high doses of vitamin A

En el presente trabajo se estudió el efecto de la administración intramuscular de 30.000, 50.000 y 100.000 UI de palmitato de vitamina A/día, durante 7 días, respectivamente, sobre la actividad enzimática hepática en 45 ratas Wistar machos, de 12 semanas de edad, con pesos entre 180 y 200 gramos. El grupo control estuvo integrado por 15 ratas Wistar sanas, con género, edad y peso similares a los animales tratados. El consumo de alimentos y de agua, y el peso de las ratas se determinó al finalizar el período experimental. Las ratas se examinaron en busca de manifestaciones clínicas de toxicidad. Al final el estudio, las ratas se sacrificaron bajo anestesia con éter y se tomaron muestras de tejido hepático para la determinación de la actividad enzimática. La administración de vitamina A en exceso incrementó de manera significativa (p menor que 0,05) el contenido hepático del retinol, determinó diversos y variados signos clínicos (tales como: anorexia, pérdida de peso, alopecia, conjuntivitis, hemorragias internas y externas, alteraciones cutáneas y muerte de los animales) e incrementó (p menor que 0,05) la actividad de las siguientes enzimas: alanina aminotransferasa, aspartato aminotransferasa, maltasa ácida (alfa-1,4-glucosidasa ácida), proteasas ácidas, lactato dehidrogenasa y fosfatasa alcalina mientras que las actividades de la glucosa-6-fosfatasa, glucógeno fosforilasa, alfa-amilasa, colinesterasa y arginasa disminuyeron (p menor que 0,05) al comparar con los controles no tratados. Estos cambios son proporcionales a las dosis inyectadas de vitamina A. En conclusión, nuestros resultados proporcionan evidencias que la administración de dosis altas de vitamina A a corto plazo determina diversos y variados signos clínicos y produce una marcada alteración de la actividad enzimática hepática.

In the present work the effect of intramuscular administration of 30.000, 50.000 and 100.000 IU of vitamin A palmitate daily for seven days, respectively, on the liver enzyme activity in 45 white male Wistar rats, aged 12 weeks and weighing 180-200 g, have been studied. The group control was integrated by 15 healthy rats with similar characteristics (strain, gender, age and weight) to treated animals. Food and water consumption and body weights were recorded at the end of the experimental period. Rats were observed for clinical signs of toxicity. At the end of the study, rats were sacrificed under ether anesthesia. Liver samples were taken for the determination of enzyme activity. Administration of excess of vitamin A produced a significant (p menor 0.05) increase in the content of liver vitamin A, determined diverse and variable clinical signs (such as, anorexia, loss of body weight, alopecia, conjunctivitis, external and internal hemorrhages, skin abnormalities and death) and increased (p menor que 0.05) the activity of the following enzymes: alanine aminotransferase, aspartate aminotransferase, acid maltase (acid alfa-1,4-glucosidase), acid proteases, lactate dehydrogenase and alkaline phosphatase while glucose-6-phosphatase, glycogen phosphorylase, alfa-amylase, cholinesterase and arginase decreased (p menor que 0.05) as compared with untreated controls. These changes depend on the doses given of vitamin A. In conclusion, our results provide evidence that short-term administration of high doses of vitamin A determined diverse and variable clinical signs and produces a marked alteration of activity of liver enzymes.

Abordagem de anormalidades laboratoriais das enzimas hepáticas em pacientes assintomáticos / Evaluation of abnormal liver-enzyme results in asymptomatic patients

É crescente a procura, na clínica diária, de pacientes assintomáticos com alteração de enzimas hepáticas. Parcialmente, este fato pode ser explicado pelo aumento na solicitação e pela adição de testes bioquímicos que avaliam injúria hepática em exames de triagem de "rotina", pré-admissionais, pré-operatórios. A abordagem destas alterações depende de uma avaliação clínica criteriosa, seguida de propedêutica apropriada e convenientemente indicada. Este artigo visa uma abordagem sistemática dessa situação clínica, fundamentada nas atuais evidências.