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В научном обзоре представлен мир микроРНК гепатобилиарной системы. Для написания статьи осуществлялся поиск информации с использованием баз данных Scopus, Web of Science, MedLine, PubMed, Google Scholar, EMBASE, Global Health, The Cochrane Library, CyberLeninka. Было подчеркнуто, что микроРНК в клетках играют важную роль в регуляции активности экспрессии генов и контролируют многочисленные физиологические процессы, такие как обмен веществ, пролиферация, дифференцировка, апоптоз клеток. Отражена ассоциация некоторых заболеваний с изменением содержания микроРНК в периферическом русле крови. В статье представлена краткая характеристика группы некодирующих РНК. Дана характеристика основных баз данных микроРНК с отображением электронных адресов. Для определения микроРНК используют как традиционные методы, основанные на технологии амплификации, так и новые методы детекции (секвенирование нового поколения, электрохимическое детектирование на основе усиления ферментатного сигнала, идентификация с помощью лигирования и применения золотых наночастиц). Авторы проводят сравнения различных методов детекции микроРНК. Отмечено, что надэкспрессия или ингибирование генерации специфических микроРНК сопровождаются нарушениями важнейших функций печени и развитием заболеваний пищеварительной системы. Продемонстрировано, что изменения некоторых микроРНК в сыворотке крови или ткани печени являются высокодиагностическими маркерами некоторых заболеваний печени. Таким образом, идентификация изменения уровня представительности определенных микроРНК может дать ценную диагностическую информацию практикующему врачу, а влияние на процессы образования и матурации микроРНК при помощи лекарственных средств представляет собой новое направление терапии широкого спектра заболеваний. Особый интерес вызывает современное представление о диагностическом значении микроРНК при заболеваниях билиарного тракта у детей и возможностях медикаментозного управления активностью процесса их генерации.

Enzim SGPT (Serum Glutamic Pyruvat Transminase) terdapat pada jaringan hati, jantung, otot dan ginjal. SGPT memiliki spesifitas yang relatif tinggi untuk kerusakan hati. Penggunaan kontrasepsi pil KB dalam jangka waktu yang panjang dapat menimbulkan kerusakan jaringan hati. Gangguan fungsi hati terjadi karena adanya hormon progesteron yang menyebabkan aliran empedu menjadi lambat, dan bila berlangsung lama saluran empedu akan tersumbat, maka cairan empedu dalam darah meningkat. Tujuan dari penelitian ini adalah untuk mengetahui kadar SGPT pada akseptor kontrasepsi pil KB di Wilayah Kabupaten Ciamis. Metode penelitian ini merupakan penelitian deskriptif. Berdasarkan hasil penelitian pemeriksaan kadar SGPT yang dilakukan terhadap 30 akseptor pil KB di wilayah Kabupaten Ciamis didapatkan hasil 9 orang (30%) mempunyai kadar SGPT yang tinggi dan didapatkan hasil 21 orang (70%) mempunyai kadar SGPT normal.

East Nusa Tenggara is a province of high alcohol abuse in Indonesia. Ngada Regency has a prevalence of 38.8%. The high prevalence is inseparable from traditional factors and socio-cultural norms which strongly influence the habit of consuming alcohol, the cold temperature in this area further strengthens this habit. The impact of alcohol consumption is the emergence of various types of diseases, one of which is impaired liver function such as alcoholic liver disease. The objective of this study is to determine the relationship between alcohol consumption and impaired liver function in communities in Bajawa and Golewa Districts, Ngada Regency. This research method is an observational analytic with cross-sectional design. The research subjects were 55 people who consumed alcohol in Golewa and Bajawa Districts, who had met the inclusion criteria. Alcohol consumption was measured by the AUDIT (The Alcohol Use Disorders Identification Test) questionnaire, while the parameter for liver disorders was the level of Gamma Glutamyl Transferase (GGT). The prevalence of liver dysfunction based on GGT examination was 15%. Meanwhile, the relationship between alcohol consumption and impaired liver function was tested with the Spearman correlation with α 0.05, the correlation value was p = 0.413, which means it has a moderate or significant, not too strong relationship. It is recommended that the people of Ngada Regency reduce alcohol consumption so that it can reduce the risk of impaired liver function.

Liver disorders in children will affect the pharmacokinetics and pharmacodynamics of drugs that are metabolized in the liver. Chronic liver disease in children such as chronic hepatitis, cirrhosis of the liver can affect the absorption and disposition (pharmacokinetics) of drugs and the efficacy and safety (pharmacodynamics) of drugs in the body. Dosage modification is determined based on clinical studies examining the effects of impaired liver function on the pharmacodynamics and pharmacokinetics of a drug.

Based on data in the literature, this article provides criteria for assessing persistent digestive system dysfunction. This issue must be considered when referring or conducting a sociomedical examination of patients with gastrointestinal tract pathology to establish a disability group, taking into account the aspects of the existing Order No. 585 of the Ministry of Labor of Russia, On classifications and criteria used in the implementation of sociomedical examination of citizens by federal state institutions of sociomedical examination.

Non-O1, non-O139 Vibrio cholerae (NOVC) does not agglutinate with O1 and O139 antisera and can cause intestinal and extraintestinal infections in immunocompromised individuals. NOVC bacteremia has the highest mortality among NOVC infections, and the number of reports has increased in recent years. Nevertheless, some clinicians are poorly informed about this disease. Herein, we describe a documented case of NOVC bacteremia in a male patient with impaired liver function. Blood cultures revealed the presence of V. cholerae, but this strain showed self-coagulation on the serum agglutination test. To our knowledge, this phenomenon is unreported among cases of NOVC infections. This pathogen was finally confirmed as NOVC via PCR. Because the patient worked as a garbage transporter, he was likely infected after contact with contaminated water through a foot wound. The patient developed septic shock shortly after admission and ultimately died from the illness. This paper reviews 23 cases of NOVC bacteremia from 2015 to 2019. To improve the accuracy of identifying NOVC and analyze its virulence factors, relevant detection methods were reviewed and analyzed.

Pre-eclampsia induced liver disease is a disorder unique to pregnancy and is frequently seen in third trimester. Severe pre-eclampsia is defined by extreme elevation in systemic blood pressure and evidence of organ compromise. HELLP syndrome is a unique liver related disorder of pregnancy that was first described by Weinstein in1982 as a constellation of clinical and laboratory abnormalities in pregnant women in their third trimester. This disorder was termed HELLP syndrome with (H) for haemolysis, (EL) for elevated liver enzymes and (LP) for low platelet counts. This is a severe variant of pre-eclampsia. Objective of this study was to determine the alteration of liver function in preeclampsia and its correlation with the clinical severity as well as the perinatal outcome. This was a one-year prospective observational cross sectional study included 100 patients with pre-eclampsia. Severity of the pre-eclampsia clarified clinically. Pre-eclampsia patients having history of hepatitis, cirrhosis of liver, gallbladder diseases and other pre-existing medical disorders that altered liver function were excluded from this study. The mean age of the patients was 25.3+4.9 years ranging from 18 to 37 years. One third of the patients (33.3%) were in the age group 28 to 32 years. Out of 100 patients, 58% belongs to poor income group. Among the studied samples 17% had epigastric pain and discomfort, 13% had complaints of vomiting and 43% develop severe pre-eclampsia. Among the Patients with altered hepatic enzyme level, 8.33% had complaints of epigastric pain, 6.66% complains vomiting. Maximum patients (66.6%) with elevated liver enzyme had no major complications whereas 33.4% of patients developed major complications. Patients with severe pre-eclampsia have elevated liver enzyme whereas patients of mild symptoms had normal liver enzymes level. Cases with raised serum biochemical markers had strong association with complications of severe pre-eclampsia. Pregnancy outcome in severe pre-eclampsia with hepatic involvement is grievous. Graves sequlae of pre-eclampsia can be prevented and minimized by timely institutional intervention. Post-partum followup would help to find out other parameters of pregnancy outcome. Bangladesh Med J. 2020 May; 49(2) : 9-13

Hepatocellular carcinoma (HCC) is the sixth most common malignant tumor worldwide and the third leading cause of cancer-related death. Despite the significant progress that has been achieved with local therapies, treatment remains limited by impaired liver function and high rate of recurrence. The purpose of the manuscript is to describe the current status of using living donor liver transplantation in patients with advanced HCC.

Objective : This study analysed Vincristine-induced peripheral neuropathy (VIPN) risk factors in Acute Lymphoblastic Leukaemia (ALL) children. Method : This cross-sectional study design was performed at Dr. Soetomo Hospital, Surabaya, Indonesia, from August to October 2019. It included ALL children, aged 4-18 years, undergoing the 2013 or 2018 ALL Indonesian Protocol of Chemotherapy, with a cumulative vincristine dose ≥ 12 mg / m2. VIPN diagnosis is based on complaints, the Total Neuropathy Score Pediatric Vincristine (TNS-PV), and nerve conduction studies (NCS). The examined risk factors were sex, age, ALL classification, nutritional status, impaired liver function, and cumulative vincristine dose. Results : There were 52 ALL children : median age 7 years, 59.6% boys, 59.6% ALL standard risk, 44.2% experienced impaired liver function at initial ALL diagnosis. Based on a single parameter for diagnosis, 26.9% had VIPN based on complaints, 76.9% had it based on the TNS-PV, and 100% had it based on NCS. VIPN was diagnosed in 25% of children, with predominantly motor impairment and located in lower extremities. Impaired liver function is a risk factor for VIPN in ALL children (p = 0.046, prevalence ratio (PR) 2.84). Conclusion : Impaired liver function is a significant risk factor for VIPN in ALL children. J. Med. Invest. 68 : 232-237, August, 2021.

Introduction The objective of this study was to describe the surgical techniques for a thoracoscopic approach to treat hepatocellular carcinoma in the hepatic dome. Also, safety, feasibility, and long-term outcomes were evaluated. Methods Surgical procedures were selected based on liver function, the extent and location of the tumor, and each patient's general condition. Thoracoscopic hepatic resection was performed under direct vision through a diaphragmatic incision. Thoracoscopic radiofrequency ablation (TRFA) was performed either with a transdiaphragmatic puncture for deeply located tumors or under direct vision through a diaphragmatic incision for subcapsular tumors. Results Thoracoscopic surgery was indicated for 107 patients with hepatocellular carcinoma in the hepatic dome. Among these patients, 5 underwent hepatectomy and 102 underwent radiofrequency ablation, which was more frequently employed in patients with impaired liver function. Of the patients who underwent radiofrequency ablation, 43 (42.2%) required a diaphragmatic incision. In the thoracoscopic hepatic resection group and TRFA group, the median operating time was 350 and 197 minutes, the median blood loss was 200 and 5 mL, and the complication rate was 12.7% and 20.0%, respectively. The 5-year overall and disease-free survival rates were 100% and 50.0% in the thoracoscopic hepatic resection group, respectively, and 60.7% and 18.1% in the TRFA group, respectively. Local recurrence after TRFA was observed in 10 patients (9.8%). Conclusion The thoracoscopic approach is safe and feasible, with promising short- and long-term outcomes. It could serve as a treatment option for hepatocellular carcinoma in the hepatic dome.

The study was aimed to investigate insulin resistance development in drug-susceptible newly diagnosed pulmonary tuberculosis patients. Those patients who developed insulin resistance during the 30 days of antitubercular therapy have expressed metabolic changes, that may be associated with impaired liver function due to the toxic effects of antitubercular drugs.

In the last few years, immunotherapy has become part of everyday clinical practice for the treatment of many solid tumors including metastatic non-small-cell lung cancer. These drugs, however, can yield a specific toxicity profile that consists of immune-related adverse events (irAEs). Hepatotoxicity is one of irAEs and occurs in about 1-3% of cases and may be manifested by the presence of increate levels of liver enzymes (aspartate aminotransferase, alanine aminotransferase) and/or biliary stasis evidence; in these cases, a differential diagnosis with other hepatic diseases must be considered. We present the case of a 73-year-old man who presented with an alteration in liver function during treatment with pembrolizumab (anti-programmed death 1 monoclonal antibody) for a stage IV nonsquamous non-small-cell lung cancer, which was initially mistaken for drug-induced irAEs hepatic toxicity.

Background and objectives Portal vein embolization (PVE) is a safe and effective procedure used to increase the safety of extensive hepatectomy for selected patients. However, it is unknown whether PVE is safe for patients with impaired liver functional reserve. Methods Patients who underwent PVE from April 2007 to September 2016 in our hospital were retrospectively assessed. According to indocyanine green retention rate at 15 min (ICG-R15), we divided patients into Group A (≤10%), Group B (10%-20%), and Group C (>20%). We described and compared the treatment course and the outcome among the three groups. Results A total of 106 patients were assessed and divided into groups A (n = 46), B (n = 49), and C (n = 11). The morbidity and mortality after PVE showed no significant differences among the three groups (A:B:C = 37%:53%:64%, p = .16; A:B:C = 0%:0%:0%, p = 1.00, respectively). The morbidity and mortality after successive hepatectomy also showed no significant differences among the three groups (A:B:C = 55%:71%:78%, p = .19; A:B:C = 0%:2%:0%, p = 1.00, respectively). Conclusion A patient with impaired liver functional reserve (ICG-R15 > 20%) can be a candidate for PVE and successive hepatectomy, as safely as a patient with normal and slightly impaired liver functional reserve (ICG-R15 ≤ 20%).

The objectives of this study were to examine the effects of varying dietary energy supply as well as the impacts of subclinical ketosis (SCK) on blood chemistry and liver health. A total 63 German-Holstein cows were housed from three weeks antepartum until sixteen weeks postpartum. After calving, cows were assigned to one of four treatment groups receiving either moderate or high energy concentrations in roughage and secondly moderate or high amounts of concentrates. Retrospectively, cows were additionally grouped according to their &beta, hydroxybutyrate concentration (SK: cows with SCK vs. CON: cows without SCK). The different energy supply of treatment groups had little effects on blood and liver variables, greater differences occurred between SK and CON cows. Liver fat content of SK cows was 34% higher compared to CON cows. Also, the activity of aspartate aminotransferase and &gamma, glutamyl transferase, bilirubin concentration, and percentage of granulocytes were increased in SK cows. The results indicate that cows were able to adjust their metabolism to different dietary energy supplies without having a clearly increased risks for metabolic disorders. However, individual animals of all groups developed a metabolic derailment during the postpartum period resulting in SCK, which is closely connected with impaired liver function, compromised immune-responsiveness, and elevated oxidative stress.

The problem of the spread of skin diseases in Russia and abroad in the last period is quite acute. Among the reasons for the development of this group of diseases, researchers determine genetic factors, poor ecology, impaired liver function, etc. In this regard, those suffering from this group of diseases are necessarily provided with qualified medical care, and pharmacy institutions form the necessary range of drugs that can improve the standard of living of patients. For this reason, we consider it necessary to analyze the level of demand for certain drugs used for the treatment of skin diseases in the pharmacy network of Belgorod, as well as factors that allow us to assess certain aspects that affect the formation of the range of these drugs in pharmacies. The purpose of the work was defined as follows: to conduct a study of meeting the demand of the population for groups of medicines intended for the treatment of skin diseases. The conducted analysis shows the following. Drugs intended for the treatment of skin diseases are in high demand (59.09%); 22.73% of drugs are in low demand, the lack of demand was observed in 18.18% of the studied group of drugs. In this paper, recommendations were formulated to optimize the assortment policy of the World of Medicines pharmacy chain in Belgorod. Since it was determined that high demand drugs such as Argosulfan, Belosalic, Avekort, Cinocap, Candiderm, Alorom, Lomaherpan, Metrogyl, Nitrofungin. It is for this reason that it is necessary to increase the volume of their purchases to better meet the demand of the population for these drugs. It was also revealed that it is necessary to reduce the volume of purchases of drugs, the demand for which is reduced. It is drugs such as Daktarin, Adolen, Camadol, Ammifurin, Bramisil, Batrafen, Berestin, Hiporhamin (they came in the results of ABC-analysis to the group C). In addition, the pharmacy should promote this group of drugs to familiarize consumers with them and offer them at a reduced price, so as not to burden the turnover of medicines and not to reduce the effectiveness of the pharmacy. The paper concluded that, according to the study, the demand for medicines used in the treatment of skin diseases is quite high. At the same time, the administration of the pharmacy chain should pay more attention to the analysis of the purchased groups of medicines in this category in order to prevent overloading the pharmacy balance with drugs, the demand for which is reduced, as this negatively affects the effectiveness of the pharmacy organization. In this regard, it is advisable to conduct an ABC analysis of the assortment groups of drugs at least once a quarter, as well as take the necessary measures to promote drugs used in the treatment of skin diseases that are in insufficient demand among the population.

Background Several inflammation-based scores are used to assess the surgical outcomes of hepatocellular carcinoma (HCC). The aim of the present study was to elucidate the prognostic value of the prognostic nutritional index (PNI) in HCC patients who underwent hepatectomy with special attention to preoperative liver functional reserve. Methods Preoperative demographic and tumor-related factors were analyzed in 189 patients with HCC undergoing initial hepatectomy from August 2005 to May 2016 to identify significant prognostic factors. Results Multivariate analysis for overall survival (OS) revealed that female sex (p = 0.005), tumor size (p Conclusions PNI was an independent prognostic factor for HCC patients who underwent hepatectomy. Patients with PNI lower than 37 were at high risk for early recurrence and poor patient survival, especially in the patients with preserved liver function of LHL ≥ 0.9.

Portal vein embolization (PVE) was developed for patients with insufficient future liver remnant volume and function and has gained relevant support worldwide before major hepatectomy. However, the efficacy of preoperative PVE for hepatocellular carcinoma (HCC) patients with impaired liver function remains uncertain. Ninety-seven HCC patients who were scheduled for PVE followed by hepatectomy were enrolled in this study. Their short- and long-term outcomes were investigated, according to the liver damage classification defined by the Liver Cancer Study Group of Japan. Of 97 patients who underwent preoperative PVE, 30 (32.4%) could not undergo subsequent hepatectomy. Dropout rate from treatment strategy was significantly higher in patients with liver damage B (n = 13, 61.5%) than in those with liver damage A (n = 84, 26.2%) (P = 0.014). Among the 67 patients who underwent planned hepatectomy after PVE, 53 were categorized to liver damage A, and 14 were categorized to liver damage B at the point of hepatectomy. Although major complication and mortality rates were comparable between the two groups, the cumulative overall survival (OS) and disease-free survival (DFS) after hepatectomy were markedly worse in patients with liver damage B than in those with liver damage A (5-year OS rate: 23.1% vs 74.6%, P = 0.014, 5-year DFS rate: 7.8% vs 33.5%, P = 0.054, respectively). The treatment strategy of PVE followed by hepatectomy might be a contraindication for HCC patients with impaired liver function categorized as liver damage B because of the higher dropout rate and poorer long-term outcomes after hepatectomy.

Background: Impaired liver function in LC (Liver Cirrhosis) can cause Zinc deficiency (Zn). One of the causes of Zn deficiency in LC is decreased albumin synthesis, whereas albumin is required as the main Zn binding protein in plasma. However, some studies of the severity of LC with Zn serum levels still provide controversial results. Objective: To determine the association between the degree of LC severity and Zn serum level. Methods: The subjects of this study were LC patients in Gastroentero-Hepatology Unit and In ternal medicine wards in of Dr. Soetomo General Hospital Surabaya for three months. Diagnosis of LC was based on clinical examination according to Soehardjno- S oebandiri criteria and other findings (ultrasound or endoscopy). The degree of LC severity was determined based on the CTP score (Child-Turcotte-Pugh). Serum Zn concentration was measured by atomic absorption spectrophotometry method. The research design used the cross-sectional method. The statistical test used was Spearman correlation. Results: Forty-three patients fulfilled the study criteria. The subjects consisted of 27 males (62.8%) and 16 females (37.2%) with the mean age of 53.81 ± 8.67 years. Based on the CTP scores, we obtained CTP A of 4 patients (9.3%), CTP B of 19 patients (44.2%) and CTP C of 20 patients (46.5%). The mean of Zn serum level in CTP A, CT P B, and CT P C score was 58.3 ± 19.6 μg/dl, 43.4 ± 14.5 μg/dl and 31.6 ± 10 μg/dl respectively. The result of the statistical test showed a significant correlation between LC severity and Zn serum level (p

Liver ischaemia reperfusion injury (IRI) is a dreaded pathophysiological complication which may lead to an impaired liver function. The level of oxygen hypoperfusion affects the level of cellular damage during the reperfusion phase. Consequently, intraoperative localisation and quantification of oxygen impairment would help in the early detection of liver ischaemia. To date, there is no real-time, non-invasive, and intraoperative tool which can compute an organ oxygenation map, quantify and discriminate different types of vascular occlusions intraoperatively. Hyperspectral imaging (HSI) is a non-invasive optical methodology which can quantify tissue oxygenation and which has recently been applied to the medical field. A hyperspectral camera detects the relative reflectance of a tissue in the range of 500 to 1000 nm, allowing the quantification of organic compounds such as oxygenated and deoxygenated haemoglobin at different depths. Here, we show the first comparative study of liver oxygenation by means of HSI quantification in a model of total vascular inflow occlusion (VIO) vs. hepatic artery occlusion (HAO), correlating optical properties with capillary lactate and histopathological evaluation. We found that liver HSI could discriminate between VIO and HAO. These results were confirmed via cross-validation of HSI which detected and quantified intestinal congestion in VIO. A significant correlation between the near-infrared spectra and capillary lactate was found (r = − 0.8645, p = 0.0003 VIO, r = − 0.7113, p = 0.0120 HAO). Finally, a statistically significant negative correlation was found between the histology score and the near-infrared parameter index (NIR) (r = − 0.88, p = 0.004). We infer that HSI, by predicting capillary lactates and the histopathological score, would be a suitable non-invasive tool for intraoperative liver perfusion assessment.

Pesticides are substances used to kill or control the sharing of pests, said pestisida derived from the word pest which means pest and word cide which means killer, so simply the pesticide is defined as a pest killer that is mites. Cholinitesrase is a liver enzyme used to help determine whether liver function is still good or not. When cholinesterase levels decrease, there is impaired liver function. The type of research used for this research is descriptive, population and sample of research are potato farmer in Kilometer XI Kota Sungai Penuh with 30 samples taken is 10ul capillary blood. And the results obtained are 21 people normal levels (70%), 7 people are mild poisoning(23,%%) and 2 people are poisoned(6,7%).

Colorectal cancer is the third most common cancer and the fourth leading cause of death from cancer worldwide. This study provides an overview of changes in sociod-demographic parameters in patients with colorectal cancer (henceforth CRC) disease in a local cancer hospital in Sulaymaniyah province of Kurdistan region of Iraq. The study included 113 patients admitted to Hiwa Cancer Hospital, Sulaymaniyah from January 2014 to December 2015. The data collection lasted for 3 weeks (from 19/12/2015 to 11/01/2016) and was obtained from the management department of Hiwa Cancer Hospital. Several socio-demographic parameters including age, gender, and smoking, as well as biochemical parameters such as liver function, renal function and blood glucose level were studied and statistically analyzed. Results have shown that the majority of CRC patients were neither current smoker nor x-smoker (P-value < 0.05). Males suffered from CRC at an earlier age compared to females (P-value < 0.05). Regarding the biochemical tests, there was no significant correlation between CRC and impaired liver function during the diagnosis process and most of the study patients had a normal liver function test on presentation. In contrast, the correlation between CRC and impaired renal function on presentation was statistically siginificant (P-value < 0.05). No significant difference was noted in the means of hematological and biochemical parameters between males and females, except for white blood cells and serum Aspartate Aminotransferase. White blood cells and total serum bilirubin showed significant differences (P-value < 0.05) between smoker and nonsmoker sub-populations. It was concluded that CRC is one of the common cancers in Sulaymaniyah province. Males develop it at an earlier age compared to females, and the impaired renal function is a significant finding on presentation.

There are only few studies in which the effect of intermittent normobaric hypoxia on the liver status in animals and people with arterial hypertension has been investigated. That’s why it’s necessary to carry out these studies in animals with high blood pressure. The purpose of this work was to carry out comparative studies of the effect of dosed intermittent normobaric hypoxia on the morphofunctional state of hepatocytes of normotensive (line Wistar) and spontaneously hypertensive (line SHR) rats, age 4 months. The experimental rats were daily exposed to hypoxic gas mixture (12% oxygen in nitrogen) in intermittent mode: 15 minutes deoxygenation / 15 minutes reoxygenation for 2 hours. The duration of the experiment was 28 days. Histological, morphometric and biochemical research methods were used. The histological preparations were made by the standard methods. The slides were photographed using a digital camera on the microscope "Nikon" (Japan). The morphometric analysis was performed on digital images using the computer program "Image J". The activity of cytochrome oxidase and succinate dehydrogenase enzymes in a suspension of hepatocytes mitochondria was determined by the method of R. S. Krivchenkov. An increase was observed in the size of hepatocytes and their nucleus, in the number of binuclear hepatocytes and nucleolus in the liver of both experimental lines of animals after exposure to intermittent normobaric hypoxia. The distance between adjacent nuclei of hepatocytes decreased. Cytochrome oxidase activity in a suspension of mitochondria increased. These morphological changes took place in the liver parenchyma of the both experimental lines of rats. But they were more pronounced in the liver of rats of the Wistar line than in the SHR line. Our data indicated that dosed normobaric hypoxia had a one-way, stimulating effect on the morphofunctional activity of hepatocytes, but the severity of this effect in rats of different lines was not the same. The obtained data can have not only theoretical value, but also be of some practical interest when using intermittent normobaric hypoxia for medical and health purposes in patients with impaired liver function and arterial hypertension.

Background : The exposure of free radicals can induce oxidative stress. In the liver, this process will cause impaired liver function. Oxidative stress can be inhibited by antioxidants. Arrowroot tubers (Maranta arundinacea) contains phenolic, flavonoid, alkaloids and saponin compound that are potential as antioxidants. Objective : Determine the effect of ethanolic extract of arrowroot tubers (Maranta arundinacea) against oxidative stress using the parameter of MDA, SGPT and SGOT level in ethanol-induced rats. Methods : Animal models were divided into 5 groups, in which each group contained 6 rats. Group I (normal) and group II (control) was induced with CMC Na 0,5%. Group III, IV and V were given ethanolic extract of arrowroot tubers in the dosage of 125, 250 and 500 mg/Kg/day respectively. The extract was administered orally for 14 days. Induction of ethanol 5 gram/ KgBW was administered orally 1 hour after the last administration on day 14th except for group I. On day 15th, the animal blood was drawn to measure the levels of SGPT and SGOT, then the animals were sacrificed and their organs were analyzed to measure the levels of MDA in the liver. Data obtained in the form of MDA, SGPT and SGOT levels were statistically analyzed using ANOVA. Results : There is statistically significant difference between the utilization of ethanolic extract of arrowroot tubers (Maranta arundinacea) group with the control group in reducing the concentration of MDA (p

Background The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC). Methods The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients. Results Of the study subjects, 37 patients had Child–Pugh class A (CPA) liver function, and 14 patients had Child–Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1–2 months, or 2–3 months (p = 0.2368, 0.9368, and 0.9293). Conclusion The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.

Introduction Pre-eclampsia is a hypertensive disorder in pregnancy. Maternal sequelae that may occur include impaired liver function, disseminated intravascular coagulation, seizures (eclampsia), stroke, and death. Thus, providers should know how to recognize (diagnose) and treat pre-eclampsia and eclampsia. Methods A simulator with noninvasive blood pressure monitoring was used. Transducers for fetal heart rate and contraction monitoring were placed on the simulator, which represented the patient. After obtaining a history and performing a physical examination, resident physician (postgraduate years 1–4) and nurse learners had to diagnose pre-eclampsia and treat this condition. They also had to treat severe-range blood pressures and manage eclampsia. Learner performance was assessed with a checklist. Debriefing followed the simulation. Results Thirty resident learners participated in the study. Nurses did not participate. All resident learners indicated familiarity with the diagnosis and management of pre-eclampsia and emergent hypertension and managed these conditions correctly. All resident learners reported not being confident in managing eclampsia. None of the learners were able to stop the eclamptic seizure. All resident learners were more confident in managing eclampsia after the scenario compared with before (mean confidence level 3.6 ± 0.5 vs. 1.1 ± 0.4, p < .001). Discussion Resident learners were familiar with the management of pre-eclampsia and emergent hypertension but not with eclampsia. We recommend that eclampsia simulations occur in a laboratory and in situ on the labor and delivery floor with interprofessional team members including obstetricians, nurses, anesthesiologists, emergency and family medicine physicians, nurse practitioners, and physician assistants.

The indication of endoscopic (laparoscopic and thoracoscopic) hepatic resection (HR) has been expanded in the past decade because of its low invasiveness. However, the indications of endoscopic HR and radiofrequency ablation (RFA) have not yet been determined. Among the 906 patients hospitalized for the initial treatment of hepatocellular carcinoma (HCC) between 2000 and 2017, 77 underwent endoscopic partial HR (E-pHR), and 94 underwent endoscopic RFA (E-RFA). We compared the short- and long-term outcomes between the E-pHR and E-RFA groups. The patients in the E-RFA group were characterized primarily by an impaired liver function. Among the patients with liver damage B or C, the overall survival (OS) in the E-pHR group was significantly worse than in the E-RFA group (3-year OS: 36% vs. 82%, p = 0.003). E-RFA may be recommended for the initial treatment of HCC in patients with a severely impaired liver function. However, E-pHR should be avoided as the initial treatment of HCC in such patients.

The first clinical studies on the use of electrochemotherapy to treat liver tumours that were not amenable to surgery or thermal ablation techniques have recently been published. However, there is still a lack of data on the effects of electrochemotherapy on normal liver tissue. Therefore, we designed a translational animal model study to test whether electrochemotherapy with bleomycin causes clinically significant damage to normal liver tissue, with emphasis on large blood vessels and bile ducts. We performed electrochemotherapy with bleomycin or delivered electric pulses alone using a potentially risky treatment strategy in eight pigs. Two and seven days after treatment, livers were explanted, and histological analysis was performed. Blood samples were collected before treatment and again before euthanasia to evaluate blood biomarkers of liver function and systemic inflammatory response. We found no thrombosis or other clinically significant damage to large blood vessels and bile ducts in the liver. No clinical or laboratory findings suggested impaired liver function or systemic inflammatory response. Electrochemotherapy with bleomycin does not cause clinically significant damage to normal liver tissue. Our study provides further evidence that electrochemotherapy with bleomycin is safe for treatment of patients with tumours near large blood vessels in the liver.

Vitamin D plays an important role in the pathogenesis of chronic hepatitis B (CHB) through regulating immune response. This study aimed to determine the relationship between vitamin D levels and impaired liver function in CHB patients. This was an observational analytical study conducted from March to October 2019. We included 36 CHB patients aged 38.31±12.98 years and consisted of 16 men and 20 women. Vitamin D levels were measured by enzyme-linked immune assay (ELISA) method while albumin and bilirubin levels were examined by colorimetric assay. Vitamin D levels were in normal limits in 80.6% and insufficiency/deficiency in 19.4% of CHB patients. ALBI ratio scores were good in 75% and moderate-poor in 25% of subjects. Furthermore, there was no significant association between vitamin D levels and the ALBI ratio. In conclusion, this study shows that there is no relationship between plasma vitamin D levels and impaired liver function in CHB patients.

In this study an android-based application was produced that can provide dietary information and knowledge to patients with diabetes mellitus, heart, maag, kidney, and impaired heart function deisease, that for healthy living does not have to be expensive. The habit of consuming liquor, consuming fast food, and rarely doing physical activities is the cause. Diet is the first initial method recommended by doctors to patients. Eating patterns with the right menu, exercise and adequate and regular rest can help the patient’s recovery. Based on 50 questionnaires distributed and returned by patients, 42 of the total 50 patients who went on a diet within 1 month routinely felt a very good recovery in their bodies.

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus and impaired liver function. The objective of the study was to evaluate maternal liver elasticity by acoustic radiation force impulse (ARFI) elastosonography in ICP and to compare it with that in healthy pregnant women. This descriptive, case–control study consisted of 33 women with healthy pregnancies and 22 women with ICP in the third trimester of gestation. Maternal liver elasticity measurements were performed by ARFI elastosonography. The maternal characteristics and perinatal outcomes of the participants were also collected. All maternal liver ARFI elastosonography scores were elevated in women with ICP compared to healthy controls (p = 0.015, p = 0.011, and p = 0.004, respectively). There was a significant positive correlation between maternal liver enzymes and ARFI elastosonography scores (r = 0.404, p = 0.002 and r = 0.389, p = 0.003, respectively). The optimal cut-off point of maternal liver ARFI-mean elastography score to identify the risk of ICP was >1.23 m/s, and the sensitivity and specificity were 68.2 and 69.7%, respectively [area under curve (AUC) 0.731, 95% confidence interval (CI) 0.594–0.869). The current study found that maternal liver stiffness measured by ARFI elastosonography was increased in pregnancies complicated with ICP.

Background: It has been reported that anatomical resection of the liver may be preferred for primary hepatocellular carcinoma (HCC), and is at least recommended for systematic removal of a segment confined by tumor-bearing portal tributaries. However, nonanatomical resection (NAR) is often selected because of the patient's background, impairment of liver function, and tumor factors. The aims of the present study were to retrospectively compare the recurrence-free survival (RFS) rates for cases of partial resection (PR) and for small anatomical resection (SAR), which is regarded as NAR for primary HCC with impaired liver function. Patients and Methods: So-called NAR was performed for a primary and solitary (≤ 5cm) HCC in 47 patients; the patients were classified into PR (n=25) and SAR (n=22) groups. Clinicopathological factors, survival data, and recurrence patterns were compared between groups. Results: There were no significant differences in the preoperative characteristics between the two groups. Operative time was significantly longer in the SAR group than in the PR group. There was no significant difference in the postoperative morbidity and tumor pathological characteristics between the two groups. The RFS of the SAR group was significantly better than those of the PR group. Although there was no significant difference in the pattern of recurrence between the two groups, the rate of intrahepatic recurrence in the same segment as the initial tumor tended to be higher in the PR group than in the SAR group. Multivariate analysis revealed that only the PR operative procedure was significant independent risk factor for poorer RFS. Conclusion: Compared with PR, SAR effectively improves the rate of RFS after surgery for a primary and solitary HCC with impaired liver function.

Background Patients with impaired liver function ( ILF ) were excluded from clinical trials that investigated non–vitamin K antagonist oral anticoagulants ( NOAC s) for stroke prevention in patients with atrial fibrillation. The aim of this study was to evaluate the efficacy and safety of NOAC s in atrial fibrillation patients with ILF . Methods and Results A cohort study based on electronic medical records was conducted from 2009 to 2016 at a multicenter healthcare provider in Taiwan and included 6451 anticoagulated atrial fibrillation patients (aged 76.7±7.0 years, 52.5% male). Patients were classified into 2 subgroups: patients with normal liver function (n=5818) and patients with ILF (n=633, 9.8%). Cox regression analysis was performed to investigate the risks of thromboembolism, bleeding, and death associated with use of NOAC s and warfarin in patients with normal liver function and ILF , respectively. In patients with normal liver function, compared with warfarin therapy (n=2928), NOAC therapy (n=4048) was associated with significantly lower risks of stroke or systemic embolism (adjusted hazard ratio: 0.75; 95% confidence interval, 0.65–0.88; P P ILF , compared with warfarin therapy (n=394), NOAC therapy (n=342) was associated with significantly lower risk of death (adjusted hazard ratio: 0.64; 95% confidence interval, 0.49–0.83; P Conclusions In atrial fibrillation patients with ILF , NOAC therapy and warfarin therapy were associated with similar risks of stroke or systemic embolism, major bleeding, and gastrointestinal bleeding.

To shed more light on the influence of chronic cannabis use on liver function, we performed a post-hoc analysis of routine lab data of 42 inpatient treatment-seeking (9 female, median: 27 years old) pure cannabis dependents. Serum liver function tests (LFT: transaminases, bilirubin), C-reactive protein (CRP), carbohydrate-deficient transferrin (CDT), and body mass index (BMI) were considered. The LFT were correlated with CDT, BMI, and cannabis-related clinical data (CR); i.e., the serum levels of delta-9-tetrahydrocannabinol (THC) and its major metabolites 11-hydroxy-delta-9-tetrahydrocannabinol (THC-OH) and 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), plus the cannabis-history data. The LFT was normal in 32 (76.2%) patients. There was no significant association of LFT with BMI, CRP, CDT, and CR. No significant differences were found between the group with elevated LFT (N = 10) and the group without elevated LFT (N = 32) regarding BMI, CRP, CDT, and CR, except for THC-OH, which was even lower in the elevated-LFT group. These results argue against a relevant harmful impact of chronic cannabis inhalation on the liver function of relatively healthy humans (apart from nicotine dependence). Specifically, the liver function tests were not significantly influenced by THC and THC-COOH levels, both objective markers for the amount and duration of prior cannabis use.

Data from recent studies suggest rising incidence rate of hepatitis E virus (HEV) infection in the UK. HEV infection may take a severe and persistent course in immunocompromised patients, including transplant recipients on immunosuppressives, patients with HIV, haematological malignancies and in idiopathic CD4+ T lymphocytopenia. The prevalence of HEV in primary antibody deficiency (PAD) disorders is still unknown. The aim of this study was to investigate HEV infection in 27 patients with PAD with unexplained, persistently elevated liver enzymes. Although all the 27 patients tested negative for HEV-RNA, we would still strongly recommend that HEV should be considered in any immunodeficient patient with impaired liver function.

Hypertensive disorders of pregnancy complicate approximately 10% of all deliveries in the United States and are a leading cause of maternal and fetal morbidity and mortality. Preeclampsia is defined as hypertension in association with proteinuria, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral or visual disturbances. The greatest risk factor for the development of preeclampsia is a history of preeclampsia. There currently is no effective means for the prevention of preeclampsia. Approximately 39% of patients diagnosed with preeclampsia have hypertension and approximately 20% have proteinuria 3 months postpartum. Preeclampsia increases the risk of patients developing hypertension later in life.