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Simple Summary: In a retrospective study of 86 patients, we identified independent predictors of recurrence-free survival (RFS) and overall survival (OS) after the resection of liver metastases of uveal melanoma using a multivariable Cox model. A disease-free interval of ≤24 months and a chromosome 8q surgain were associated with worse survival. With these two parameters, we built a novel clinico-genetic score that defined three risk groups with distinct prognoses. This novel score identified patients with a high risk of relapse after surgery. These patients may benefit from neoadjuvant or adjuvant systemic therapy following complete surgical resection with the hope of improving survival outcomes. Surgical treatment of liver metastases of uveal melanoma (LMUM) could be proposed for selected patients. This retrospective study examined the prognostic significance of the genetic profiles of liver metastases after LMUM resection. A total of 86 patients treated with resection for LMUM, who underwent genetic analysis of liver metastasis, were included. A multivariable Cox model identified the independent predictors of recurrence-free survival (RFS) and overall survival (OS). The disease-free interval (DFI) and a chromosome 8q surgain (>3 copies) were independent predictors and categorized patients into three risk groups with distinct postoperative prognoses. For the low-, intermediate-, and high-risk scores of recurrence, the median RFS values were 15 months (95% CI: 10–22), 6 months (95% CI: 4–11), and 4 months (95% CI: 2–7), and the median OS values were 86 months (95% CI: 55-NR), 25 months (95% CI: 17–48), and 19 months (95% CI: 12–22), respectively. The predictive accuracy of this scoring system was demonstrated by a mean area under the curve (AUC(t)) of 0.77 (95% CI: 0.65–0.90) for RFS and 0.81 (95% CI: 0.70–0.92) for OS. This novel score, based on a DFI of ≤24 months combined with a chromosome 8q surgain, identifies patients at a high risk of early recurrence and could help clinicians to propose perioperative treatment. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is a multifaceted disease, and integration of AUD treatment between mental health and hepatology is necessary to improve outcomes. We aimed to ascertain whether patients with excessive alcohol use (EAU) and high FIB‐4, which is a non‐invasive method to identify advanced liver disease, are appropriately referred to hepatology and detect which clinical barriers, if any, might pertain. Methods: Records of patients with excessive alcohol use between 2013 and 2023 were extracted from a large public system. Demographics, alcohol‐related hospitalizations, mental health conditions, Charlson comorbidity index (CCI) and referral patterns were evaluated. Comparisons were made between those referred to hepatology versus not. Results: 1131 subjects showed evidence of EAU but on further review, 189 were in alcohol‐remission. The remaining 942 (636 men, age 55.7 ± 14.5 years, 548 white, 363 black, 19 Hispanic) subjects with CCI 2.61 ± 2.23 were further analyzed for FIB‐4 score and referral patterns. 316 patients had active EAU and a high FIB‐4, of whom only 116 (37%) were referred to hepatology. Patients with alcohol‐related mental health concerns and admitted for trauma were less likely to be referred. Logistic regression showed referral was higher with alcohol‐related liver hospitalizations (OR: 9.25, 95% CI: 4.90–17.47, p < 0.001), higher CCI (OR: 6.23, 95% CI: 3.00–12.94, p < 0.0001) and lower with mental health admissions (OR: 0.36, 95% CI: 0.15–0.48, p < 0.001) or mental health diagnoses (OR: 0.36, 95% CI: 0.15–0.82, p = 0.02) and increasing age (OR: 0.95, 95% CI: 0.92–0.97, p < 0.001). Conclusions: In a large public health system, almost 63% of patients with EAU and FIB‐4 >2.67 are not referred to hepatology for evaluation. Patients not referred were more likely to have alcohol‐related mental‐health hospitalizations and mental health diagnoses, while those with liver‐related hospitalizations and comorbidities were more likely to be referred. Greater education of mental health providers and for teams taking care of inpatients admitted with alcohol‐related mental health concerns would better integrate care and improve outcomes for patients with higher risk for advanced liver disease. [ABSTRACT FROM AUTHOR]

Background: This meta-analysis was dedicated to evaluating the effectiveness and safety of Atezolizumab plus Bevacizumab (Atez/Bev) and Lenvatinib (LEN) as first-line systematic therapy for unresectable hepatocellular carcinoma (u-HCC). Methods: The prospective protocol for this study was registered with the PROSPERO (Registration number: CRD42022356874). Literature searches were conducted in PubMed, EMBASE database Cochrane Library, and Web Science to determine all clinical controlled studies that reported Atez/Bev and LEN for treating u-HCC. We. evaluated as primary end-point overall survival (OS) and progression-free survival (PFS), as well as other outcomes such as tumor response and adverse events (AEs).Quality assessment and data extraction of studies were conducted independently by three reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. Results: 12 retrospective cohort studies (RCSs) involving a total of 4948 patients were finally included. The results showed that compared with LEN, Atez/Bev can improve the patient's PFS (HR = 0.80, 95% CI: 0.72 ~ 0.88; p < 0.0001) and reduce the rate of overall AEs (OR = 0.46 95% CI: 0.38 ~ 0.55, p < 0.00001) and grade ≥ 3 AEs (OR = 0.43; 95% CI: 0.36 ~ 0.51, p < 0.00001), while there is no difference between OS and treatment responses rate (objective response rate, disease control rate, complete response, partial response, progressive disease, and stable disease) between two groups. In addition, the subgroup analysis shows that Atez/Bev can promote the OS of patients with viral hepatitis. (HR = 0.79, 95% CI: 0.67 ~ 0.95; p = 0.01), while LEN has an advantage in improving OS in patients with Child-Pugh grade B liver function (HR = 1.98, 95% CI: 1.50 ~ 2.63; p < 0.00001). Conclusion: Current evidence shows that compared with LEN, Atez/Bev has more advantages in PFS and safety in treating u-HCC and can improve the OS of patients with viral. LEN has advantages in improving the OS of patients with grade B liver function. However, more multicenter randomized controlled experiments are needed in the future to verify our results. [ABSTRACT FROM AUTHOR]

Background Rising global temperatures due to climate change pose a health risk. Mortality and morbidity increase during heat events affects various organ systems. While warmer countries face higher risks, even colder regions show elevated mortality during hot periods. This study examines physiological responses to heat exposure using data from the general Danish population cohort Lolland–Falster Health Study (LOFUS) during the summers of 2016–2019. Methods In this cross-sectional study, we analysed health data from 3804 individuals aged ≥15 years. Data were analysed across organ systems: cardiovascular system, lung function, renal system, inflammation, coagulation, and liver function. Meteorological data from the Danish Meteorological Institute provided information on temperature and humidity. Heat exposure was defined as one day ≥28°C heat index the day prior to examination. Adjusted multiple linear regression was applied to analyse differences between the two groups. Results There were 46 of 368 days with temperatures ≥28°C heat index. In total, 396 participants were heat-exposed (exposure group), while 3408 constituted the unexposed group. Heat exposure was associated with lower systolic blood pressure (−3.82 mm Hg [−5.72; −1.93]), higher heart rate (1.71 beats/min [0.45; 2.98]), lower oxygen saturation (−0.28% [−0.45; −0.10]), higher sodium (0.56 mmol/l [0.33; 0.79]), and higher urine albumin (0.14 mg/l [0.02; 0.27]). No significant differences were observed in inflammation, coagulation, or liver function. Conclusion This study reveals early physiological responses to heat with one day of heat exposure ≥28°C, particularly in the cardiovascular, pulmonary, and renal systems. These findings underline the need for tailored strategies to mitigate health risks associated with rising temperatures. [ABSTRACT FROM AUTHOR]

Favism is a metabolic disease and this study evaluates the effectiveness of palm oil and its triacylglycerol constituent in favism-induced female rats to restore serum female hormones, ovarian antioxidants, inflammatory markers, and DNA fragmentation. Animals were 36 female albino rats. They classified to two equal (normal and favism) groups. The normal group was divided into three equal subgroups: the control, palm oil, and triacylglycerol subgroups. The normal rats were given 1 mL of saline, 1 mL of palm oil, and 1 mL of triacylglycerol orally, respectively. The Favism group was classified also into three equal subgroups: the favism group, the favism + palm oil, the Favism + triacylglycerol. The favism rats were given 1 mL of saline, 1 mL of palm oil, and 1 mL of triacylglycerol orally. For four weeks, all treatments were administered orally via oral gavage once daily. The hemoglobin, hematocrite, the blood cells, glucose and glucose-6-phosphate dehydrogenase, and liver function were decreased in favism. Female hormones such as serum luteinizing hormone, follicle stimulating hormone, Estrone, Estriol, 17α-Estradiol, 17β-Estradiol, and Estradiol-17-β-stearate were decreased in favism. Ovarian antioxidants were decreased while ovarian inflammatory markers were increased in favism. Favism induced ovarian DNA apoptosis. Furthermore, oral administration with palm oil or its triacylglycerol constituent in favism-induced female rats restored all these parameters to be approached the control levels. Palm oil restored serum female hormones, ovarian antioxidants, inflammatory markers, and DNA fragmentation in favism-induced female rats and this effect related to oil triacylglycerol constituent. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disturbance that affects many women worldwide and is characterized by chronic anovulation, hyperandrogenism, and ovarian dysfunction. Placenta-derived mesenchymal stem cells (PDMSCs) are derived from the placenta and have advantages over other sources of MSCs in terms of availability, safety, and immunomodulation. Materials and methods: In this experimental study, twenty female Wistar rats were assigned to four groups (n = 5) including control, sham, PCOS, and PCOS+PDMSCs groups. Then, PCOS was induced in the rats through administering letrozole for 21 days. PDMSCs (1 × 106 cells) were injected through the tail vein. Fourteen days after the cell infusion, evaluation was performed on the number of healthy follicles, corpus luteum, and cystic follicles as well as the levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), fasting blood glucose, fasting insulin, and insulin resistance. Moreover, the serum levels of cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. Liver function was also determined by the evaluation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Results: The number of corpus luteum and primordial, primary, secondary, and antral follicles was significantly elevated in the PCOS+PDMSCs group compared to the PCOS group. However, the number of cystic follicles significantly decreased in the PCOS+PDMSCs group. The LH and testosterone levels also decreased significantly, while FSH levels increased significantly in the PCOS+PDMSCs group. The levels of fasting blood glucose, fasting insulin, and insulin resistance notably decreased in the PCOS+PDMSCs group. Moreover, the lipid profile improved in the PCOS+PDMSCs group along with a significant decrease of cholesterol, LDL, and TG and an increase in HDL. The PCOS+PDMSCs group exhibited marked decreases in the AST and ALT levels as well. Conclusion: The results of this study suggest that PDMSCs are a potential treatment option for PCOS because they can effectively restore folliculogenesis and correct hormonal imbalances, lipid profiles and liver dysfunction in a rat model of PCOS. However, further research is needed to establish the safety and effectiveness of PDMSCs for treating PCOS. [ABSTRACT FROM AUTHOR]

Background: Alzheimer’s disease (AD) is a complex neurodegenerative disorder influenced by various factors, including liver function, which may impact the clearance of amyloid-β (Aβ) in the brain. This study aimed to explore how the apolipoprotein E (APOE) ε4 allele affects the relationship of liver function markers with AD pathology and cognition. Methods: We analyzed data from two independent cohorts, including 732 participants from the Hallym University Medical Center and 483 from the Alzheimer’s Disease Neuroimaging Initiative, each group consisting of individuals with and without the APOE ε4 allele. Cross-sectional analyses evaluated the associations of liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase, total bilirubin, and albumin) with AD diagnosis, amyloid positron emission tomography (PET) burden, and cerebrospinal fluid biomarkers for AD (Aβ42, total tau, and phosphorylated tau181) at baseline. Longitudinally, we investigated the associations between these liver enzymes and changes in cognitive performance over the course of a year. Logistic and linear regression models were used to analyze these associations and mediation analyses were conducted to assess whether age and amyloid PET burden mediated these associations. Results: Only in the APOE ε4 carrier group, a high AST to ALT ratio and low ALT levels were significantly associated with AD diagnosis, increased amyloid PET burden, and faster longitudinal decline in cognitive function in both cohorts. In particular, the AST to ALT ratio was associated with cerebrospinal fluid Aβ42 levels exclusively in the APOE ε4 carrier group in the Alzheimer’s Disease Neuroimaging Initiative cohort but not with phosphorylated tau181 or total tau levels. Moreover, mediation analyses from both cohorts revealed that in the APOE ε4 carriers group, age did not mediate the associations between liver enzymes and AD diagnosis or amyloid PET burden. However, amyloid PET burden partially mediated the association between liver enzymes and AD diagnosis exclusively in the APOE ε4 carriers group. Conclusion: This study provides valuable insights into the significant association of the APOE ε4 allele with liver enzymes and their potential role in Aβ-related pathogenesis and cognition in AD. Further research is required to elucidate the underlying mechanisms and potential therapeutic implications of these findings. [ABSTRACT FROM AUTHOR]

Simple Summary: We present in this study novel data which demonstrates that the most common type of tumor of the salivary glands may be accurately diagnosed using a specific type of radiological imaging. This may be used to help discriminate this tumor or recurrent versions of it amid various types of benign and malignant tumors. Furthermore, this data suggest that new avenues of minimally invasive therapy may be viable for these tumors and potentially even malignant versions of these tumors and should be examined in further studies. Introduction: Currently, the diagnosis of salivary gland tumors using imaging techniques is unreliable. Methods: In this monocentric retrospective study, we examined patients who received a 68Ga-DOTATOC PET/CT and subsequently underwent a salivary gland tumor resection between 1 January 2010 and 31 December 2021. PET/CT image assessment was compared with somatostatin receptor (SSTR) expression and histology. Results: Thirteen patients (five pleomorphic adenoma (PA) and eight other parotid lesions (OPL)) received a 68Ga-DOTATOC PET/CT. Imaging displayed strong focal tracer uptake in all PA except for one with strong tumor to background discrimination. PA revealed higher SUVmax, SUVmean, liver and blood pool quotients than those of Warthin tumors (WT) and of OPL. In comparison to the contralateral parotid, SUVmax (p = 0.02), SUVmean (p = 0.02), liver quotient (p = 0.03) and blood pool quotient (p = 0.03) were all significantly higher. In contrast, WT and OPL showed in relation to the contralateral parotid no significant differences of SUVmax (WT p = 0.79; OPL p = 0.11), SUVmean (WT p = 1.0; OPL p = 0.08), liver quotient (WT p = 0.5; OPL p = 0.08) and blood pool quotient (WT p = 0.8; OPL p = 0.19). Two PA and one granuloma were not available for examination. In the immunohistochemal analysis, all PA demonstrated the highest intensity of SSTR2 expression (grade 3). Furthermore, PA had a high percentage of cells expressing SSTR2 (20%, 80% and 55%). Conclusions: A strong tracer uptake in PA was shown in 68Ga-DOTATOC PET/CT. This may allow physicians to utilize radioligated somatostatin analogue PET CT/MR imaging to accurately diagnose PA. Additionally, it may be possible in the future to treat the PA with a noninvasive peptide receptor radionuclide therapy or with somatostatin analogues. [ABSTRACT FROM AUTHOR]

Background: The efficacy and safety of direct oral anticoagulants (DOACs) in atrial fibrillation (AF) patients with impaired liver function (ILF) have not been sufficiently studied. The aim of this study was to evaluate the efficacy and safety of DOACs for stroke prevention in patients with AF and ILF. Method: This study was based on data from 15 centers in China, including 4,982 AF patients. The patients were divided into 2 subgroups based on their liver function status: patients with normal liver function (NLF)(n = 4213) and patients with ILF (n = 769). Logistic regression analysis was used to investigate the risk of total bleeding, major bleeding, thromboembolism, and all-cause deaths in AF patients with NLF and ILF after taking dabigatran or rivaroxaban, respectively. Results: Among AF patients treated with dabigatran or rivaroxaban, patients with ILF were associated with significantly higher major bleeding, compared with NLF patients (aOR: 4.797; 95% CI: 2.224–10.256; P < 0.001). In patients with NLF, dabigatran (n = 2011) had considerably lower risk of total bleeding than rivaroxaban (n = 2202) (aOR: 1.23; 95% CI: 1.002–1.513; P = 0.049). In patients with ILF, dabigatran (n = 321) significantly favored lower risks of major bleeding compared with rivaroxaban(n = 448) (aOR: 5.484; 95% CI: 1.508–35.269; P = 0.026). Conclusion: After using dabigatran or rivaroxaban, patients with ILF had remarkably increased risk of major bleeding compared with patients with NLF. In AF patients with NLF, dabigatran had the distinct strength of significantly reduced risk of total bleeding compared with rivaroxaban. In patients with AF and ILF, dabigatran use was associated with lower risk for major bleeding compared with rivaroxaban. [ABSTRACT FROM AUTHOR]

The article discusses a study on the effects of ethanol extract of moringa leaf on liver histopathology white rats induced by meloxicam, a class of nonsteroidal anti-inflammatory drugs (NSAIDs). Topics discussed include histopathological preparation of the liver, types of liver damage caused by meloxicam, and average data on the effect of ethanol extract of moringa leaves on the liver histopathology of meloxicam-induced male white rats.

Simple Summary: Colorectal cancer is a common illness. It can spread to the liver in about a quarter of people with colorectal cancer, known as metastases. Previously, people with liver metastases did not survive for long. Thankfully, this is changing. As we understand more about the underlying causes and genetics of the disease, we can tailor treatments to patients on a more individual basis. Treatments like chemotherapy have made a difference in patients' survival, and now newer treatments like immunotherapy can have even greater benefits. Surgery is also changing, with more advanced techniques allowing for better recovery for patients and more aggressive surgery. It is important for surgeons to consider a large number of individual factors when making decisions with patients about their treatment—this is what we mean by "precision surgery". The incidence of colorectal cancer and colorectal liver metastases (CRLM) is increasing globally due to an interaction of environmental and genetic factors. A minority of patients with CRLM have surgically resectable disease, but for those who have resection as part of multimodal therapy for their disease, long-term survival has been shown. Precision surgery—the idea of careful patient selection and targeting of surgical intervention, such that treatments shown to be proven to benefit on a population level are the optimal treatment for each individual patient—is the new paradigm of care. Key to this is the understanding of tumour molecular biology and clinically relevant mutations, such as KRAS, BRAF, and microsatellite instability (MSI), which can predict poorer overall outcomes and a poorer response to systemic therapy. The emergence of immunotherapy and hepatic artery infusion (HAI) pumps show potential to convert previously unresectable disease to resectable disease, in addition to established systemic and locoregional therapies, but the surgeon must be wary of poor-quality livers and the spectre of post-hepatectomy liver failure (PHLF). Volume modulation, a cornerstone of hepatic surgery for a generation, has been given a shot in the arm with the advent of liver venous depletion (LVD) ensuring significantly more hypertrophy of the future liver remnant (FLR). The optimal timing of liver resection for those patients with synchronous disease is yet to be truly established, but evidence would suggest that those patients requiring complex colorectal surgery and major liver resection are best served with a staged approach. In the operating room, parenchyma-preserving minimally invasive surgery (MIS) can dramatically reduce the surgical insult to the patient and lead to better perioperative outcomes, with quicker return to function. [ABSTRACT FROM AUTHOR]

Monochorionic twins (MC) have higher risk of perinatal morbi-mortality compared to singletons and dichorionic twins (DC). Selective fetal growth restriction (sFGR) increases the chances of adverse outcome. Hepatic arterial buffer response (HABR) is an important mechanism for maintaining liver perfusion. We hypothesised that HABR is active in monochorionic diamniotic twins (MCDA) with sFGR where restricted fetus may have liver hypoperfusion. The objective of this study is to test whether the HAV-ratio is diminished in pregnancies affected by selective fetal growth restriction pointing to activation of HABR in the growth-restricted fetus. sFGR was defined according to a consensus definition. Hepatic artery (HA) peak systolic velocity (PSV) was measured and its correlation with fetal Dopplers and pregnancy characteristics were determined. A ratio using HA-PSV (HAV-ratio) was calculated and its association with sFGR was established. Further analysis of HA-PSV was performed comparing z-scores between normal and growth restricted fetuses. We included 202 MCDA pregnancies, 160 (79 %) normal and 42 (21 %) with sFGR. HAV-ratio was significant different between groups. The mean HAV-ratio was 1.01 (±0.20) for normal twins and 0.77 (±0.25) for sFGR. Furthermore, HA-PSV z-scores was significant increased in in growth-restricted fetus (0.94±1.45), while in normal fetuses was −0.16 (±0.97). Our findings demonstrate that, in pregnancies with sFGR, HAV-ratio is significantly lower than in normal MCDA pregnancies. The lower HAV-ratio is due to an increase in HA PSV in the growth restricted fetus. This observation indicates an activation of HABR in the small fetus. [ABSTRACT FROM AUTHOR]

Background Long-term outcomes of tenofovir-containing antiretroviral therapy (ART) for hepatitis B virus (HBV)/human immunodeficiency virus (HIV) coinfection were evaluated in Zambia. Methods A prospective cohort of adults with HIV and hepatitis B surface antigen (HBsAg)-positivity was enrolled at ART initiation. On tenofovir-containing ART, we ascertained HBV viral load (VL) non-suppression, alanine aminotransferase (ALT) elevation, serologic end-points, progression of liver fibrosis based on elastography, and hepatocellular carcinoma (HCC) incidence. We also described a subgroup (low HBV VL and no/minimal fibrosis at baseline) that, under current international guidelines, would not have been treated in the absence of their HIV infection. Results Among 289 participants at ART start, median age was 34 years, 40.1% were women, median CD4 count was 191 cells/mm3, 44.2% were hepatitis B e antigen-positive, and 28.4% had liver fibrosis/cirrhosis. Over median 5.91 years of ART, 13.6% developed HBV viral non-suppression, which was associated with advanced HIV disease. ALT elevation on ART was linked with HBV VL non-suppression. Regression of fibrosis and cirrhosis were common, progression to cirrhosis was absent, and no cases of HCC were ascertained. HBsAg seroclearance was 9.4% at 2 and 15.4% at 5 years, with higher rates among patients with low baseline HBV replication markers. Conclusions Reassuring long-term liver outcomes were ascertained during tenofovir-based ART for HBV/HIV coinfection in Zambia. Higher than expected HBsAg seroclearance during ART underscores the need to include people with HIV in HBV cure research. [ABSTRACT FROM AUTHOR]

The clearance of peripheral beta amyloid (Aβ) is a potential target for the treatment of Alzheimer's disease (AD). The liver has been implicated in the elimination of Aβ from the peripheral circulation. Here, the single-pass uptake of Aβ40 in perfused livers from young and old rats (6 to 10 rats per group) was investigated with the multiple indicator dilution technique. Aβ40 had volumes of distribution between those of the vascular marker Evans Blue and the extracellular marker sucrose. The hepatic extraction of Aβ40 was negligible, explained in part by the small permeability surface area products consistent with a high endothelial barrier to liver uptake. There were no substantial effects of age on any of these results. In vitro experiments with isolated hepatocytes and liver sinusoidal endothelial cells showed only very small amounts of Aβ uptake consistent with low intrinsic clearance. These results indicate that the hepatic clearance of Aβ is capacity-limited, explained by the low-permeability surface area products and hepatocyte uptake. However, this does not preclude an effect of aging in longer-term in vivo studies where age-related changes in liver blood flow and protein binding influence liver clearance. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) or due modern nomenclature – metabolic dysfunction-associated steatotic liver disease (MASLD) and atrial fibrillation are interconnected health problems that require reassessment of treatment strategies to address their common underlying causes. Lifestyle changes and pharmacotherapy are used to manage NAFLD, while treatment for atrial fibrillation focuses on anticoagulation and rhythm control. Aim. To evaluate the efficacy of combining ursodesoxycholic acid and quercetin with standard treatment to improve liver health and heart function in patients with non-alcoholic fatty liver disease and atrial fibrillation. Material and methods. A prospective, randomized controlled trial was conducted on patients with NAFLD and atrial fibrillation at two hospitals from January 2020 to December 2023. The study involved 127 patients who were divided into three groups: standard treatment, standard treatment + ursodesoxycholic acid (UDCA), and standard treatment + UDCA + quercetin. Results. The average age and sex distribution were similar among the three groups, suggesting that the randomization process successfully balanced the demographic characteristics. Paroxysmal atrial fibrillation was the most common form in all groups, followed by persistent atrial fibrillation and permanent atrial fibrillation, with no statistically significant differences between the groups. The body mass index was comparable across all three groups as well. The results showed a decrease in liver stiffness in all groups, with groups 2 and 3 showing the most significant improvements. Fibrosis stages also shifted after treatment, with group 3 showing a marked reduction in progressive fibrosis. Groups 2 and 3 also showed significant reductions in steatosis levels, with an increase in the proportion of patients without steatosis. Left atrial diameter decreased in all groups, with group 3 showing the most significant reduction. Left ventricular ejection fraction improved in all groups, with the most significant increase in group 3. Group 3 also showed improvements in diastolic filling and left ventricular filling pressure. Overall, the combined treatment regimen in group 3 appeared to have the most favourable effects on liver and cardiac health. Conclusions. The addition of UDCA and quercetin to standard treatment regimens for NAFLD and atrial fibrillation shows promising improvements in liver health and cardiac function. [ABSTRACT FROM AUTHOR]

Background: Previously, we demonstrated that Spp1−/− mice exhibit a greater susceptibility to alcohol‐induced liver injury than wild‐type (WT) mice. Notably, alcohol triggers the expression of osteopontin (encoded by SPP1) in hepatocytes. However, the specific role of hepatocyte‐derived SPP1 in either mitigating or exacerbating alcohol‐associated liver disease (AALD) has yet to be elucidated. We hypothesized that hepatocyte‐derived SPP1 plays a role in AALD by modulating the regulation of steatosis. Methods: We analyzed hepatic SPP1 expression using four publicly available datasets from patients with alcoholic hepatitis (AH). Additionally, we examined SPP1 expression in the livers of WT mice subjected to either a control or ethanol Lieber‐DeCarli (LDC) diet for 6 weeks. We compared the relationship between SPP1 expression and significantly dysregulated genes in AH with controls using correlation and enrichment analyses. To investigate the specific impact of hepatocyte‐derived SPP1, we generated hepatocyte‐specific Spp1 knock‐out (Spp1ΔHep) mice and subjected them to either a control or ethanol Lieber‐DeCarli diet for 6 weeks. Results: Alcohol induced hepatic SPP1 expression in both humans and mice. Our analysis, focusing on genes correlated with SPP1, revealed an enrichment of fatty acid oxidation (FAO) in three datasets, and peroxisome proliferator‐activated receptor signaling in one dataset. Notably, FAO genes correlating with SPP1 were downregulated in patients with AH. Ethanol‐fed WT mice exhibited higher serum‐free fatty acids (FFAs), adipose tissue lipolysis, and hepatic fatty acid (FA) transporters. In contrast, ethanol‐fed Spp1ΔHep mice displayed lower liver triglycerides, FFAs, and serum alanine transaminase and greater FAO gene expression than WT mice, indicating a protective effect against AALD. Primary hepatocytes from Spp1∆Hep mice exhibited heightened expression of genes encoding proteins involved in FAO. Conclusions: Alcohol induces the expression of SPP1 in hepatocytes, leading to impaired FAO and contributing to the development of AALD. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the research was to see how a nano-extract (zinc oxide) of oleander leaves affected the histological structure of the liver in male laboratory mice aged (7-8) weeks and weighing (28-35 g). Methods: They were split up into three groups, with ten mice in each. The control group made the first group. The second group was treated with an oleander leaf nano-extract at a concentration of (20 mg/kg). The group that was administered a 30 mg/kg dosage of oleander leaf nano-extract is the third group. For 30 to 45 days on a daily basis, a (30 mg/kg) concentration of the oleander leaf nano-extract was used. Half of the rodents were sacrificed at the end of the initial thirty days, and histological sections of the liver were obtained. Results: Histological sections of the liver were obtained from the residual half, which was sacrificed after 45 days when the experiment ended. Animals injected with a Nano-extract of oleander leaves at a dose of (20 mg/kg) for 40 days had aberrant liver structure, cells, and histological abnormalities. Animals that received a 45-day injection of a (30 mg/kg) dosage of oleander leaf nano-extract also had pathological alterations and aberrant liver and central vein cell morphology. Conclusions: The results showed the toxic effects of the Nano-extract of the oleander plant and the xistence of histological alterations in the histological structure of the liver in groups treated with varying amounts of oleander leaf nano-extract. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder, affecting approximately 25 % of the population. Coffee-drinking obese smokers exhibit lower body weights and decreased NAFLD rates, but the reasons behind this remain unclear. Additionally, the effect of nicotine, the main component of tobacco, on the development of NAFLD is still controversial. Our study aimed to explore the possible reasons that drinking coffee could alleviate NAFLD and gain weight and identify the real role of nicotine in NAFLD of obese smokers. A NAFLD model in mice was induced by administering nicotine and a high-fat diet (HFD). We recorded changes in body weight and daily food intake, measured the weights of the liver and visceral fat, and observed liver and adipose tissue histopathology. Lipid levels, liver function, liver malondialdehyde (MDA), superoxide dismutase (SOD), serum inflammatory cytokine levels and the expression of hepatic genes involved in lipid metabolism were determined. Our results demonstrated that nicotine exacerbated the development of NAFLD and caffeine had a hepatoprotective effect on NAFLD. The administration of caffeine could ameliorate nicotine-plus-HFD-induced NAFLD by reducing lipid accumulation, regulating hepatic lipid metabolism, alleviating oxidative stress, attenuating inflammatory response and restoring hepatic functions. These results might explain why obese smokers with high coffee consumption exhibit the lower incidence rate of NAFLD and tend to be leaner. It is essential to emphasise that the detrimental impact of smoking on health is multifaceted. Smoking cessation remains the sole practical and effective strategy for averting the tobacco-related complications and reducing the risk of mortality. [ABSTRACT FROM AUTHOR]

Garcinia dulcis (GD) extract possesses anti-hypertensive property that are poorly characterized. This study aimed to investigate an anti-inflammatory effect of GD flower extract in the 2-kidney-1-clip (2K1C) hypertensive compared to sham operative (SO) rat. Male Wistar rats were divided into 2 groups; the 2K1C group in which a silver clip was placed around renal artery to induce hypertension, and the SO normotensive group. Four weeks later, each group of rats were further divided into 2 subgroups, each subgroup was orally gavaged of either corn oil (vehicle) or 50 mg/kg BW GD extract daily for 4 weeks. The malondialdehyde (MDA) levels in serum, liver, and kidney were determined. Hematoxylin and eosin staining was carried out for histological examination, Periodic acid – Schiff staining for glomerular injury, Masson's trichrome staining for renal fibrosis, and immunohistochemistry for either tumor necrosis factor alpha (TNF-α) or endothelial nitric oxide synthase (eNOS) investigation. Taken together, our results demonstrated that GD flower extract decreased the MDA level in both serum and liver and kidney tissue and suppressed the expression of TNF-α in both liver and kidney of 2K1C hypertensive rats. Mesangial cell proliferation, expansion of mesangial matrix, widening Bowman's capsule space, congestion of glomerular capillary and vessel, cloudy swelling of renal tubular epithelial cell, and renal fibrosis were observed in the kidneys of 2K1C rats. Therefore, we concluded that GD flower extract can alleviate liver and kidney inflammation in which partially attenuates the glomerular injury in the 2K1C rat. [ABSTRACT FROM AUTHOR]

Background: Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity. Objectives: To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet. Methods: This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25–40 kg/m2, 40–75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition. Results: At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity. Conclusions: Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity. Trial registration: NCT03708419 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Aim: The present study examined the protective potential of human adipose tissue-derived mesenchymal stem cells (hASCs) modified to overexpress alpha-1 antitrypsin (AAT), in a mouse model of the liver fibrosis. Background: For the treatment of end-stage liver diseases, cell therapy has emerged as a promising noninvasive alternative to liver transplantation. Mesenchymal stem cells (MSCs) are being evaluated due to their dual capabilities of promoting liver regeneration and modulating the pathogenic inflammation of the immune system. Methods: Liver fibrosis was induced in mice via the intraperitoneal injection of carbon tetrachloride (CCl4). MSCs were extracted from the human adipose tissue. After stemness confirmation, the cells were transduced with the lentiviruses containing the AAT gene, and then injected into the mice's tail vein. Fourteen days' post-transplantation, mice were sacrificed, and blood and tissue samples were collected for analysis. Important liver enzymes, including alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, and total bilirubin (TB), were measured. Histological studies were carried out using the hematoxylin and eosin (H&E), as well as Masson's trichrome (MT) staining. Results: Compared to hASCs, treatment with AAT-hASCs resulted in greater reductions in ALT, AST, ALP, and TB, as well as normalized albumin levels. AAT-hASCs promoted enhanced liver regeneration histologically, likely attributable to anti-inflammatory and anti-proteolytic properties of AAT. Conclusion: These findings indicate AAT-engineered hASCs as a promising cell-gene therapy candidate for further study in liver cirrhosis models. [ABSTRACT FROM AUTHOR]

Background: The potent antiplasmodial activity of 1-hydroxy-5,6,7-trimethoxyxanthone (HTX), isolated from Mammea siamensis T. Anders. flowers, has previously been demonstrated in vitro. However, its in vivo activity has not been reported. Therefore, this study aimed to investigate the antimalarial activity and acute toxicity of HTX in a mouse model and to evaluate the pharmacokinetic profile of HTX following a single intraperitoneal administration. Methods: The in vivo antimalarial activity of HTX was evaluated using a 4-day suppressive test. Mice were intraperitoneally injected with Plasmodium berghei ANKA strain and given HTX daily for 4 days. To detect acute toxicity, mice received a single dose of HTX and were observed for 14 days. Additionally, the biochemical parameters of the liver and kidney functions as well as the histopathology of liver and kidney tissues were examined. HTX pharmacokinetics after intraperitoneal administration was also investigated in a mouse model. Liquid chromatography triple quadrupole mass spectrometry was used to quantify plasma HTX and calculate pharmacokinetic parameters with the PKSolver software. Results: HTX at 10 mg/kg body weight significantly suppressed parasitemia in malaria-infected mice by 74.26%. Mice treated with 3 mg/kg HTX showed 46.88% suppression, whereas mice treated with 1 mg/kg displayed 34.56% suppression. Additionally, no symptoms of acute toxicity were observed in the HTX-treated groups. There were no significant alterations in the biochemical parameters of the liver and kidney functions and no histological changes in liver or kidney tissues. Following intraperitoneal HTX administration, the pharmacokinetic profile exhibited a maximum concentration (Cmax) of 94.02 ng/mL, time to attain Cmax (Tmax) of 0.5 h, mean resident time of 14.80 h, and elimination half-life of 13.88 h. Conclusions: HTX has in vivo antimalarial properties against P. berghei infection. Acute toxicity studies of HTX did not show behavioral changes or mortality. The median lethal dose was greater than 50 mg/kg body weight. Pharmacokinetic studies showed that HTX has a long elimination half-life; hence, shortening the duration of malaria treatment may be required to minimize toxicity. [ABSTRACT FROM AUTHOR]

What is Known and Objective. Voriconazole (VRC) increases the blood concentration of Tacrolimus (TAC). However, the patterns of changes in TAC trough concentration (TAC C0) and dose-adjustment regimens after VRC discontinuation have not been reported. We aimed to explore the changing pattern of TAC C0 after VRC discontinuation and provide strategies for TAC dose adjustment and blood concentration monitoring in renal transplant recipients. Methods. The clinical data of 46 renal transplant patients pre- and during VRC medication and VRC discontinuation were retrospectively recorded, including doses and concentrations 0 of TAC and VRC; biochemical indicators such as liver and kidney function; and CYP3A5, CYP3A4, and CYP2C19 gene types. Results and Discussion. After discontinuing VRC for 2–4 days, 81% of the patients returned to their initial TAC dose, although TAC C0 and TAC dose-adjusted trough concentration (C/D) were 2.43-fold and 3.35-fold higher, respectively, than pre-VRC administration. After 5–7 days, TAC C0 and C/D gradually recovered. TAC C/D was significantly higher after VRC discontinuation when the VRC trough concentration (VRC C0) was greater than 2.43 mg/L; CYP3A5, CYP3A4, and CYP2C19 genotypes and the administration of erythromycin did not affect the change in TAC C/D. What is New and Conclusion. TAC C/D remains elevated 2–4 days after discontinuing VRC compared to pre-VRC administration, with gradual recovery observed 5–7 days after VRC discontinuation. To avoid excessive blood TAC C0 , the initial TAC dose should not be immediately reinstated upon VRC discontinuation for 2–4 days. VRC C0 are a critical factor influencing the change in TAC C/D ratio after VRC discontinuation. [ABSTRACT FROM AUTHOR]

Introduction: Systemic therapy is recommended for patients with Child-Pugh A in hepatocellular carcinoma (HCC). We analyzed the outcomes of a cohort of patients with HCC who received either sorafenib (Sor), lenvatinib (Len) or atezolizumab plus bevacizumab (Atezo + Bev) as first-line systemic therapy for HCC, with the aim of identifying prognostic factors for survival. Methods: A total of 825 patients with advanced HCC and Child-Pugh A or B received either Sor, Len or Atezo + Bev as first-line systemic therapy. Liver function was assessed according to the Child-Pugh score and the modified albumin-bilirubin (mALBI) grade. Results: Prognosis was analyzed according to liver function such as Child-Pugh classifications, scores, and mALBI grades that worsened with a decline in liver function (p <0.001 for all). A Child-Pugh score of 7 was a factor significantly associated with OS. In patients with a Child-Pugh score of 7, an mALBI grade of 3 was an independent predictor of OS. In Child-Pugh B patients with HCC, receiving Atezo + Bev was identified as a factor associated with PFS. Conclusion: Determining the hepatic reserve of patients with unresectable HCC might be useful for identifying patents suitable for systemic treatment for HCC. Atezo + Bev might prolong the PFS of patients with a Child-Pugh score of 7. [ABSTRACT FROM AUTHOR]

Background: The positive effects of prolonged every-other-day (EOD) feeding include decreased body weight and prolonged life span, but also changes in liver metabolism and functions. In the present paper, our aim was to examine the expression of adiponectin (ADIPOQ), leptin, and their receptors (ADIPOR1, ADIPOR2, and LEPR) in the liver tissue of EOD-fed mice in comparison to ad libitum (AL)-treated mice. Methods: After 9 months of EOD treatment, liver tissue was harvested and prepared for analysis. RT-PCR, protein semi-quantitative estimation, and cellular immunolocalization was performed. Results: We noted a decreased expression of leptin in the liver tissue of the EOD male mice in comparison to the AL mice on the protein level. ADIPOQ receptor R1 protein expression was decreased in the liver of EOD-fed male mice, while the expression of ADIPOR2 on the protein level was increased in the EOD animals. Conclusions: To the best of our knowledge, this is the first report showing ADIPOQ and leptin immunolocalization in the liver tissue in a dietary regime experiment. Decreases in leptin expression and IL-6 expression in liver tissue and increases in ADIPOR2 expression may be partly responsible for the beneficial effects of EOD treatment in the liver, including the decrease in inflammation. Further studies are needed to establish whether these changes depend on factors like the type of treatment, species, strain, gender, time of treatment, and others. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In our study, we examined the effect of perceived social support on psychological resilience and surgical fear in surgical oncology patients. This study was performed with 139 patients planning to have surgery at the oncology unit of a research and practice hospital in Turkey. The Personal Information Form, the Multi-Dimensional Perceived Social Support Scale, the Brief Resilience Scale, and the Surgical Fear Questionnaire were used in the data collection process. Of all surgical oncology patients participating in our study, 51.8% were aged 45–64 years, 60.4% were male, 41.7% were diagnosed with a malignancy in the last 4–7 months, 66.9% had comorbidities alongside the malignancy, and 21.6% had colorectal tumors whilst 20.1% had malignant tumors in the liver. Surgical oncology patients' psychological resilience had statistically significant relationships with their surgical fear and perceived social support (p = 0.000). It was determined that the independent variable of perceived social support explained 59% of the total variance (R2 = 0.593, p = 0.000) in the resilience dependent variable and 35% of the variance in the surgical fear dependent variable (R2 = 0.353, p = 0.000). The increase in perceived social support of surgical oncology patients increases their psychological resilience. The increasing psychological resilience of the patients and the increase in perceived social support also reduce their fear of surgery. In this context, it is recommended that patients who will undergo oncological surgery should increase their social support in the early period and take initiatives to increase their psychological resilience. [ABSTRACT FROM AUTHOR]

Objective: This cross‐sectional study investigated the association of periodontitis with the metabolic status and hepatic function in pregnant women. Materials and Methods: Full‐mouth periodontal conditions, metabolic profiles, and hepatic function were assessed in 219 self‐reported healthy pregnant females. The association of periodontal status with the systemic parameters was evaluated by parametric and non‐parametric tests, and multivariate logistic regression analysis. Results: Overall, periodontal status was positively associated with the metabolic profiles and hepatic function test results. The subjects with periodontitis exhibited higher levels of body mass index (BMI) (p < 0.01) and serum aspartate transaminase (AST) (p < 0.05), elevated diastolic blood pressure (DBP) (p < 0.05), and lower levels of high‐density lipoprotein cholesterol (p < 0.05) than those of the counterparts. The periodontitis severity was strongly correlated with BMI and AST levels, and the extent of periodontal inflammation was related to DBP (p < 0.01). The periodontitis patients at 34–36 gestational weeks showed higher blood pressure and AST levels than those of non‐periodontitis subjects (p < 0.05). Conclusion: Our findings on the notable links of periodontitis to concurrent metabolic disorders and abnormal liver function in pregnant women highlight the need of proactive integration of regular periodontal screening and healthcare in maternal programs for promoting optimal health and wellbeing of mothers‐to‐be and newborns. [ABSTRACT FROM AUTHOR]

Vitis vinifera L has been used traditionally in Pakistan, Italy, and Turkey as laxatives. Carminatives are used as drug therapy for many diseases. The study aims to determine the hepatoprotective potential of the hydroalcoholic extract of Vitis viniferaL (EVV) seeds in paracetamol-induced hepatotoxicity in albino rats. The hepatoprotective effect of the hydroalcoholic extractof Vitis vinifera L (EVV) seeds was tested in vivo by assessing the antioxidant parameters, liver enzymes, biochemical parameters, and histopathological examinations. Wistar rats-induced hepatotoxicity with paracetamol treated with Vitis vinifera L seeds at 200 and 400 mg/kg exhibited decrease in in vivo antioxidant parameters, liver enzymes, and biochemical parameters due to the presence of phytoconstituents such asflavonoids, steroids, glycosides, quinine, phenol, and saponin. The histological examinations of liver tissue revealed increased necrosis in untreated animals, whereas the central vein, surrounded by normal cells with good architecture, was observed in EVV-treated animals compared to silymarin-treated groups (25 mg/kg body weight). The scientific findings revealed that the hydroalcoholic extract of Vitis vinifera L. seed possesses hepatoprotective potential. [ABSTRACT FROM AUTHOR]

Objectives: Pre-procedure liver impairment has been revealed as a poor prognostic factor post-percutaneous coronary intervention (PCI). Recent investigations discovered that the aspartate aminotransferase-to-alanine aminotransferase ratio (De-Ritis ratio) indicates the severity of liver impairment and was related to adverse outcomes. We aimed to evaluate the predictive value of the De-Ritis ratio for contrast-associated acute kidney injury (CA-AKI). Materials and Methods: We prospectively enrolled 150 patients undergoing elective PCI between June 2022 and August 2022. Contrast-induced AKI: It is defined as an acute decline in renal function, defined as an increase in creatinine of =0.5 mg/dL or =25% compared to baseline. It usually develops 24-72 h post administration of an IV contrast agent in the absence of other identifiable causes. Results: The incidence of CA-AKI was 8% (n = 12). The De-Ritis ratio >1.30 was identified as the best cutoff value for CA-AKI prediction. Conclusion: The De-Ritis ratio was an independent risk factor for CA-AKI in patients undergoing elective PCI. [ABSTRACT FROM AUTHOR]

Top‐class athletes have optimized their athletic performance largely through adequate training, nutrition, recovery, and sleep. A key component of sports nutrition is the utilization of nutritional ergogenic aids, which may provide a small but significant increase in athletic performance. Over the last decade, there has been an exponential increase in the consumption of nutritional ergogenic aids, where over 80% of young athletes report using at least one nutritional ergogenic aid for training and/or competition. Accordingly, due to their extensive use, there is a growing need for strong scientific investigations validating or invalidating the efficacy of novel nutritional ergogenic aids. Notably, an overview of the physiological considerations that play key roles in determining ergogenic efficacy is currently lacking. Therefore, in this brief review, we discuss important physiological considerations that contribute to ergogenic efficacy for nutritional ergogenic aids that are orally ingested including (1) the impact of first pass metabolism, (2) rises in systemic concentrations, and (3) interactions with the target tissue. In addition, we explore mouth rinsing as an alternate route of ergogenic efficacy that bypasses the physiological hurdles of first pass metabolism via direct stimulation of the central nervous system. Moreover, we provide real‐world examples and discuss several practical factors that can alter the efficacy of nutritional ergogenic aids including human variability, dosing protocols, training status, sex differences, and the placebo effect. Taking these physiological considerations into account will strengthen the quality and impact of the literature regarding the efficacy of potential ergogenic aids for top‐class athletes. [ABSTRACT FROM AUTHOR]

Introduction: Stimulation of liver regeneration after hepatectomy may provide important advantages, especially in cases where liver tissue is at a critical level. Some studies have reported that vascular endothelial growth factor (VEGF) might ameliorate liver regeneration in animals. In this study, we aimed to examine the effects of exogenous VEGF164 on the regeneration of liver tissue after a 70% hepatectomy in rats. Methods: Twenty Wistar Albino male rats, weighing 300-350 g, were randomly divided into four groups, each having five animals. Group 1 and Group 3 were designated as control groups, and Group 2 and Group 4 as experimental groups. All rats underwent laparotomy and 70% partial hepatectomy. Postoperatively, control groups were administered saline through the tail vein at 0 and 6 hours, and VEGF164 was administered to the experimental groups in the same manner at 0 and 6 hours. Blood samples were collected by sacrificing the rats at 24 hours for Group 1 and Group 2, and at 72 hours for Group 3 and Group 4. Subsequently, relaparotomy was performed and the remaining liver tissues were completely removed in all groups. Then, the resected liver tissues were used to determine morphological regeneration rates. The histopathological proliferation of the liver was evaluated by calculating the Ki-67 proliferative index. Results: In the histopathological evaluation, it was revealed that the liver proliferation index was significantly higher in the VEGF164 group at 72 hours (p=0.028). Although liver weights were higher in the experimental groups, no statistically significant results were obtained in terms of morphological liver regeneration rates (p>0.05). Discussion and Conclusion: Although the positive effects of exogenous VEGF on liver regeneration were not found in this rat model, statistically significant increases in the liver proliferation index are promising. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of accessory fissures (AFs) in the liver ranges from 6% to 56%, as reported by cadaveric studies, which is much higher than the prevalence of 25% on computed tomography (CT) scans. Despite reporting many morphological variations in the liver by various cadaveric studies worldwide, the imaging studies are very few. Radiological imaging of patients undergoing liver surgery is a routine preoperative investigation. Despite there are several occasions where liver variations occur as a surprise during surgery which reflects on the diagnostic capacity of CT. Materials and Methods: Sixty cadaveric livers removed and stored in 10% Formalin were studied for all morphological abnormalities. The same livers were analyzed separately by anatomists by gross examination and radiologists by plain CT imaging. The radiologists were blinded from the gross examination findings. The data obtained by both methods were compared and the diagnostic accuracy of CT was estimated. Results: The common surface morphological variations detected were AFs, accessory lobes (ALs), pons hepatis (PH), and multilobed caudate and quadrate lobes (QLs). Out of the total 89 AFs identified by gross examination, only 73 could be detected by CT scan, thus the sensitivity of CT scan in detecting AFs is 82%. Similarly, the sensitivity of CT scan in detecting ALs, PH, and multilobed caudate, and QL was 64% (low), 81%, and 19% (very low), respectively. Thus, plain CT has variable sensitivity depending on the morphological variation. Conclusions: This study has highlighted some of the diagnostic inaccuracies that may arise during plain CT examination of the liver in a person posted for liver surgery or a person with abdominal trauma. Contrast-enhanced CT scans can circumvent many of these problems. Lack of awareness of these issues may affect the normal course of treatment and prognosis in such patients. [ABSTRACT FROM AUTHOR]

Aim: This study is done to investigate the hypolipidemic and hepatoprotective effects of corn silk extract in nicotine-administered male mice. Background: Nicotine can induce pathophysiological effects in the liver tissue through oxidative stress and damage cells. Corn silk can improve liver function with its antioxidant effects. Methods: In this experimental study, 30 male NMRI mice (25-30 gr) were divided into 5 groups: controls, sham, nicotine 2.5 mg/kg, nicotine+aqueous extract of corn silk 400 mg/kg, and nicotine+methanolic extract of corn silk 400 mg/kg for 1 month. One day after the last nicotine and extracts consumption, the serum samples were performed for biochemical measurement, and the supernatant of the homogenized liver was administered for antioxidant variables assessment. Results: There was no significant difference in the body weight of different groups. Liver weight and GSH decreased in the nicotine group compared to the control group (P<0.05). Triglycerides, total cholesterol, HDL-C, LDL-C, liver enzymes, and MDA increased in the nicotine group compared to the control group (P<0.05). Also, the expansion of sinusoids, the presence of inflammatory cells, and necrosis of liver cells were observed in the nicotine group compared to the control group. Using aqueous and methanolic extracts of corn silk in mice receiving nicotine led to the improvement of the mentioned variables (P<0.05). Conclusion: The results of this study showed that the use of nicotine can lead to the induction of hepatotoxicity. The use of aqueous and methanolic extracts of corn silk improved them through its antioxidant activity. [ABSTRACT FROM AUTHOR]

In the new coronavirus disease 2019 (COVID-19), there may be various degrees of abnormalities in liver functions. The reason for this situation may be an underlying liver disease or drugs used, or it may be due to direct liver injury from the virus. Several theories have been proposed in studies on this subject. This review summarizes the available and up-to-date information about imaging features of liver injury in COVID-19 disease. [ABSTRACT FROM AUTHOR]

Background: Bicarbonate Ringer's (BR) solution is a direct liver and kidney metabolism-independent HCO3− buffering system. We hypothesized that BR solution would be more effective in improving acid-base equilibrium and more conducive to better liver function than Acetate Ringer's (AR) solution in conventional orthotopic liver transplantation (OLT) patients. Methods: Sixty-nine adult patients underwent OLT. Patients in the bicarbonate and acetate groups received BR solution or AR solution as infused crystalloids and graft washing solution, respectively. The primary outcome was the effect on pH and base excess (BE) levels. The secondary outcome measures were the incidence and volume of intraoperative 5% sodium bicarbonate infusion and laboratory indicates of liver and kidney function. Results: The pH and absolute BE values changed significantly during the anhepatic phase and immediately after transplanted liver reperfusion in the bicarbonate group compared with the acetate group (all P < 0.05). The incidence and volume of 5% sodium bicarbonate infusion were lower in the bicarbonate group than in the acetate group (all P < 0.05). The aspartate transaminase (AST) level at 7 postoperative days and the creatine level at 30 postoperative days were significantly higher in the acetate group than in the bicarbonate group (all P < 0.05). Conclusion: Compared with AR solution, BR solution was associated with improved intraoperative acid-base balance and potentially protected early postoperative liver graft function and reduced late-postoperative renal injury. [ABSTRACT FROM AUTHOR]

Background. In Thai traditional medicine (TTM), the dominant body element called "Dhat Chao Ruean" (DCR) is an integral part in the diagnostic process of Thai traditional medicine. TTM practitioners usually use Thai herbal Benjakul formula (BKF) for adjusting and balancing the body elements. However, the effects of BKF on metabolism and individual response to it have not been studied yet. Methods. This study proposed to investigate the metabolic profiling in 24 volunteers categorized by their types of birth month DCR (bDCR) after the administration of BKF (450 mg, three tablets three times a day before meals) for seven days. Differences in metabolic profiling between bDCR groups were investigated by using liquid chromatography coupled with mass spectrometry for untargeted analysis, and in addition, the safety was assessed by testing the plasma biochemical level. Results. This study identified 57 biomarkers in positive ESI and 12 in negative ESI. Piperine was found in varying amount among the participants but it was the highest in the earth group. In addition, this study found that elemicin, phenylpropionic acid, ricinoleic acid, and β-sitosterol are important substances in a single herb of BKF. Regarding biochemical tests, the results indicated that BKF can decrease the lipid profile and it has no toxic effects on liver and kidney functions. Conclusion. The findings indicated that it is safe to use BKF which can help to improve health in chronic diseases by adjusting abnormality of the elements of the body. In addition, the information gathered from this study is valuable for further study in the field of Thai traditional medicine. [ABSTRACT FROM AUTHOR]

Background: Lichen planus (LP) is a chronic mucocutaneous inflammatory condition characterized by white striations and plaques or erythematous/erosive lesions in the oral cavity. LP has affected about 0.5 -1% of world population. Apart from the potential of autoimmune origin, the WHO classified oral LP (OLP) as a premalignant condition, with an increased risk of developing squamous cell carcinoma of the head and neck (SCCHN). Patients with LP have exhibited a higher susceptibility to other autoimmune diseases (about 25%). Case Presentation: A 51-year-old woman with a history of OLP and concurrent lupus erythematosus, transplanted Liver, and ulcerative colitis was referred to the Oral and Maxillofacial Medicine Department of Tehran Dental Faculty. A noteworthy point in this study, which was not commonly observed in previous reports, was the existence of OLP with three autoimmune diseases. The lichenoid oral ulcers of the patient were managed by modifying her drug regimen under consultation with a physician using systemic and topical corticosteroids, and, finally, cryotherapy. Conclusions: This case, not the first case of autoimmune diseases, illustrates the management of the challenges of an oral lesion accompanying other systemic diseases and highlights the importance of awareness of the oral manifestations of systemic diseases and their side effects. According to previous studies, the response of oral lesions to different treatments is unique, and the patient’s lifestyle and his/her other systemic diseases influence the treatment success or failure. The patient’s management protocol and its validity can be re-evaluated in future studies as clinical trial projects. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQoL) is known to be an important prognostic indicator and clinical endpoint for patients with hepatocellular carcinoma (HCC). However, the correlation of the Barcelona Clinic Liver Cancer (BCLC) stage with HRQoL in HCC has not been previously studied. We examined the relationship between BCLC stage, Child–Pugh (CP) score, and Eastern Cooperative Oncology Group (ECOG) performance status on HRQoL for patients who presented at a multidisciplinary liver cancer clinic. HRQoL was assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Fifty-one patients met our inclusion criteria. The FACT-Hep total and subscales showed no significant association with BCLC stages (p = 0.224). Patients with CP B had significantly more impairment in FACT-Hep than patients with CP A. These data indicate that in patients with HCC, impaired liver function is associated with reduced quality of life, whereas the BCLC stage poorly correlates with quality of life metrics. Impairment of quality of life is common in HCC patients and further studies are warranted to determine the impact of early supportive interventions on HRQoL and survival outcomes. [ABSTRACT FROM AUTHOR]

Chronic liver disease and related complications, cirrhosis and hepatocellular carcinoma, are associated with high mortality. Curative treatments, partial hepatectomy or liver transplantation, have limited applicability in patients with cirrhosis due to the poor liver regenerative capacity. Thus, we need to find new diagnostic and therapeutic alternatives, to block the disease progression and to improve the survival of patients. In this context, preclinical studies have demonstrated the key role of the protein kinase B (Akt) in liver dysfunction, but the status of Akt and its targets in patients with chronic hepatopathy remains unknown. Aims: To determine the activation status of the Akt pathway and their association with liver functionality in cirrhotic patients. This retrospective study includes liver tissue samples from 36 hepatectomized patients with (n=27) and without (n=9) cirrhosis. Multiplex analysis of proteins involved in the Akt/mTOR pathway was performed using a Luminex panel and Western blot. Conventional liver function tests were determined in serum before resection surgery. Akt and forkhead box protein O1 (FoxO1) are overexpressed in the liver of cirrhotic patients: (2.1 vs. 1.0 densitometric relative units (DRU); p<0.01, and 9.5 vs. 4.4 DRU; p<0.01, respectively). FoxO1 showed the best correlation with markers of liver injury (aspartate aminotransferase (ASAT): r=0.51, p<0.05; alanine aminotransferase (ALAT): r=0.49, p<0.05), and was the only enzyme in the Akt pathway identified as an independent predictor of ASAT and ALAT levels. The intrahepatic expression of FoxO1 could have clinical utility as a potential prognostic marker for patients with advanced liver disease. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Acupuncture can improve the symptoms of alcohol-induced bodily injury and has been accepted by the World Health Organization. In this study, in vivo fluorescence imaging (IVFI) was applied to display and evaluate the effect of electroacupuncture (EA) on liver function (LF) in mice with chronic alcoholic liver injury (cALI). Methods: IVFI of the Cy5.5-galactosylated polylysine (Cy5.5-GP) probe targeting the liver asialoglycoprotein receptor (ASGPR) and liver indocyanine green (ICG) clearance was performed to visually evaluate the effect of EA at ST36 and BL18 on liver reserve function and hepatic metabolism in mice with cALI. In addition, changes in ASGPR expression, serum indexes of LF, and hepatic morphology were observed. Results: After EA at ST36 and BL18, the ASGPR-targeted fluorescence signals (FS) in the liver increased significantly in cALI mice (p < 0.05) and exhibited relationships with liver ASGPR expression, liver ICG clearance, liver histology, and serum marker levels of LF in cALI mice undergoing EA intervention. Conclusions: As displayed by IVFI, EA at ST36 and BL18 appears to improve liver reserve function and inhibit the development of liver injury in mice with cALI. EA may have potential as a treatment strategy to protect against ALI. [ABSTRACT FROM AUTHOR]

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Background/Aim: We measured interfractional liver positional motion in liver stereotactic body radiotherapy (SBRT) with exhaled breath holding (BH) based on kilovoltage (kV) cone-beam computed tomography (CBCT) images. Patients and Methods: We collected 528 pre-treatment kVCBCT images from 132 patients who underwent liver SBRT under exhaled BH using the Abches system, a non-electronic contact-based respiratory monitoring device, and analyzed them to investigate interfractional liver positional motion. Planning computed tomography (CT) scans were obtained using the Abches system when the patients were under exhaled BH. Translational 3-degree-of-freedom (DOF) soft-tissuebased image registration was performed using the kV-CBCT images under exhaled BH after 6-DOF vertebral bone image registration. Interfractional liver positional motions in the left-right (LR), anteroposterior (AP), and craniocaudal (CC) directions were defined based on the differences in the position of the liver relative to the vertebral bones. Results: For all fractions, the absolute mean±standard deviation for the interfractional liver positional motion in the LR, AP, and CC directions was 0.7±1.0 mm, 1.0±1.5 mm, and 2.8±3.1 mm, respectively. The liver interfractional systematic/random positional motions in the LR, AP, and CC directions were 0.9/1.2 mm, 1.4/1.8 mm, and 2.9/3.9 mm, respectively. For all fractions, 100.0%, 98.3%, and 86.9% of the interfractional liver positional motions in the LR, AP, and CC directions, respectively, were less than 5 mm. Conclusion: CBCT-guided online correction should be used to correct interfractional liver positions errors present in liver SBRT with exhaled BH. [ABSTRACT FROM AUTHOR]

Exposure to light-at-night (LAN) has been reported to impair blood glucose regulation. The liver modulates blood glucose through mechanisms influenced by several factors that include peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1α) and glucose-6-phosphatase (G6Pase). This study investigated the effect of intermittent exposure to green and white LAN on some hepatic glucose regulatory factors in male Wistar rats. Animals were divided into three equal groups. Group I (control) was exposed to normal housing conditions. Groups II and III were each daily exposed to either green or white LAN for 2 h (7–9 pm) for 14 days. Body weight and blood glucose was monitored on days 0, 7, and 14. Thereafter, retro-orbital sinus blood was obtained after light thiopental anaesthesia and serum insulin was determined. Liver samples were also obtained and evaluated for glycogen, PGC-1α, and G6Pase activity. Insulin resistance was estimated using the HOMA-IR equation. Body weight and blood glucose on days 7 and 14 increased in groups II and III compared to control. Hepatic PGC-1α and G6Pase increased in group II (2.33 ± 0.31; 2.07 ± 0.22) and III (2.31 ± 0.20; 0.98 ± 0.23) compared to control (1.73 ± 0.21; 0.47 ± 0.11). Hepatic glycogen was 71.8 and 82.4% reduced in groups II and III compared to control. Insulin in group II increased (63.6%) whiles group III values reduced (27.3%) compared to control. Insulin resistance increased in group II (0.29 ± 0.09) compared to control (0.12 ± 0.03) and group III (0.11 ± 0.03), respectively. Exposure to 2 h green and white LAN in the early dark phase increases hepatic glycogenolysis and gluconeogenetic activities resulting in increased blood glucose. In male Wistar rats, exposure to green but not white LAN may predispose to insulin resistance. [ABSTRACT FROM AUTHOR]

Simple Summary: The liver function reserve of patients with hepatocellular carcinoma (HCC) is heterogeneous. The preoperative accurate evaluation of liver function has a vital role in the prevention of unfavorable postoperative complications such as post-hepatectomy liver failure. In this study, unsupervised clustering analysis of radiomics features extracted from preoperative gadoxetic-acid-enhanced MRIs was performed for liver function stratification on 276 HCC patients. Two distinct subgroups were identified (i.e., subgroups 1 and 2). Subgroup 2 had impaired liver function as presented by older age, more albumin–bilirubin grades 2 and 3, and a higher indocyanine green retention rate than that of subgroup 1 (all p < 0.05). Compared with subgroup 1, subgroup 2 was associated with a higher risk of postoperative liver failure, postoperative complications, and longer hospital stays (all p < 0.05). Our findings indicate the potential for the use of radiomics features based on preoperative gadoxetic-acid-enhanced MRI for noninvasive liver function assessment in HCC patients. Objective: To identify subgroups of patients with hepatocellular carcinoma (HCC) with different liver function reserves using an unsupervised machine-learning approach on the radiomics features from preoperative gadoxetic-acid-enhanced MRIs and to evaluate their association with the risk of post-hepatectomy liver failure (PHLF). Methods: Clinical data from 276 consecutive HCC patients who underwent liver resections between January 2017 and March 2019 were retrospectively collected. Radiomics features were extracted from the non-tumorous liver tissue at the gadoxetic-acid-enhanced hepatobiliary phase MRI. The reproducible and non-redundant features were selected for consensus clustering analysis to detect distinct subgroups. After that, clinical variables were compared between the identified subgroups to evaluate the clustering efficacy. The liver function reserve of the subgroups was compared and the correlations between the subgroups and PHLF, postoperative complications, and length of hospital stay were evaluated. Results: A total of 107 radiomics features were extracted and 37 were selected for unsupervised clustering analysis, which identified two distinct subgroups (138 patients in each subgroup). Compared with subgroup 1, subgroup 2 had significantly more patients with older age, albumin–bilirubin grades 2 and 3, a higher indocyanine green retention rate, and a lower indocyanine green plasma disappearance rate (all p < 0.05). Subgroup 2 was also associated with a higher risk of PHLF, postoperative complications, and longer hospital stays (>18 days) than that of subgroup 1, with an odds ratio of 2.83 (95% CI: 1.58–5.23), 2.41(95% CI: 1.15–5.35), and 2.14 (95% CI: 1.32–3.47), respectively. The odds ratio of our method was similar to the albumin–bilirubin grade for postoperative complications and length of hospital stay (2.41 vs. 2.29 and 2.14 vs. 2.16, respectively), but was inferior for PHLF (2.83 vs. 4.55). Conclusions: Based on the radiomics features of gadoxetic-acid-enhanced MRI, unsupervised clustering analysis identified two distinct subgroups with different liver function reserves and risks of PHLF in HCC patients. Future studies are required to validate our findings. [ABSTRACT FROM AUTHOR]