Background and Purpose: T2DM is the most common cause of end- stage liver diseases, and different mechanisms contribute to diabetic hepatopathy's wide spectrum presentation. In this study, we aimed to identify abnormalities in liver function tests (LFTs) for a group of Iraqi T2DM patients, determine their prevalence, and investigate the influence of some independent co-variables (duration of DM, HbA1c, BMI, age, and gender). Methods: This case-control study enrolled 43 T2DM patients alongside 40 healthy, age- and sex- matched non-diabetic subjects. After overnight fasting, blood was collected, and fasting plasma glucose (FPG), HbA1c, and serum LFTs (AST, ALT, ALP, total proteins, albumin, and bilirubin) were measured in addition to serum lipids.Results: T2DM patients exhibited significantly higher FPG, HbA1c, AST, and ALT mean values than the controls. Serum aminotransferases were increased in 30% of patients. Serum albumin and total bilirubin (TSB) decreased in 18.6 and 37.2% respectively. Diabetics with HbA1c>7.0% had significantly higher AST, ALT, ALP, and STP values and lower serum albumin and TSB. The logistic regression analysis revealed that duration, BMI, HbA1c, and age are independent co-variables significantly linked to increased ALT activity. Conclusions: LFTs (mainly aminotransferases) are altered in DM. The duration of diabetes, the age of the patient, BMI, and glycemic control influence this change. We recommend monitoring LFTs in DM and maintaining good glycemic control.
- MeSH
- biochemická analýza krve * statistika a číselné údaje MeSH
- diabetes mellitus 2. typu * krev MeSH
- dospělí MeSH
- glykovaný hemoglobin analýza MeSH
- jaterní testy statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- transaminasy krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
The precise method of action of dienogest on the production and development of endometriosis lesions is unknown, and its controversial effect on endometrial thickness has been under investigation. In the following study the Dienogest's effects on the target animal's histology of female reproductive organs, including the tissues from the Fallopian tubes, ovaries, and uterus, as well as the impact of drug administration on the liver's enzymes and the drug's effects on triglycerides, body weight, and HbA1c, have all been studied. The findings of the following experiment indicated that there was no significant elevation of liver enzymes. The little to no elevation of the liver enzymes indicated that the drug did not induce stress on the hepatic cells and according to the subsequent experiment it is safe for clinical use. Moreover, after 10, 20, and 30 days of blood administration, the level of blood TG significantly decreased, and after 30 days of intake, the level of blood sugar significantly decreased. However, there were no appreciable changes after 10 and 20 days. After 30 days of treatment, the rats' weight also showed a very minor drop. In addition to it, the results of histological changes in the tissue in the following study represented that there were evident changes in the tissues which comprised of decline in blood circulation, fibrosis in tissues, and degeneration of follicles.
- Klíčová slova
- dienogest,
- MeSH
- histologické techniky MeSH
- jaterní testy metody přístrojové vybavení MeSH
- játra enzymologie účinky léků MeSH
- kontraceptiva * farmakologie krev metabolismus MeSH
- modely u zvířat MeSH
- potkani Sprague-Dawley MeSH
- progesteron farmakologie krev metabolismus MeSH
- statistika jako téma MeSH
- transaminasy analýza krev účinky léků MeSH
- ženské pohlavní orgány * patologie účinky léků MeSH
- Check Tag
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- Klíčová slova
- ribociclib,
- MeSH
- alanintransaminasa analýza MeSH
- aminopyridiny farmakologie terapeutické užití MeSH
- aspartátaminotransferasy analýza MeSH
- cytomegalovirové infekce diagnóza terapie MeSH
- fulvestrant farmakologie terapeutické užití MeSH
- infekční mononukleóza diagnóza terapie MeSH
- jaterní testy MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory prsu * farmakoterapie MeSH
- protinádorové látky terapeutické užití toxicita MeSH
- protokoly protinádorové kombinované chemoterapie MeSH
- puriny farmakologie terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Pembrolizumab plus axitinib improved efficacy over sunitinib in treatment-naive advanced renal cell carcinoma in the KEYNOTE-426 (NCT02853331) study. However, a relatively high incidence of grade 3/4 aminotransferase elevations was observed. OBJECTIVE: To further characterize treatment-emergent aminotransferase elevations in patients treated with pembrolizumab-axitinib. DESIGN, SETTING, AND PARTICIPANTS: Patients enrolled in KEYNOTE-426 were included in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Three Standardized MedDRA Queries for potential hepatic disorders were used to identify patients for the hepatic event analysis subpopulation (HEAS). Alanine aminotransferase events were characterized for time to onset, time to recovery, corticosteroid use, and rechallenge with study treatment(s). RESULTS AND LIMITATIONS: The HEAS comprised 189/429 (44%) pembrolizumab-axitinib patients and 128/425 (30%) sunitinib patients. Grade 3/4 hepatic adverse events were more common in the combination arm: 22% (94/429) versus 7% (29/425); 3% (13/429) discontinued the combination due to hepatic adverse events. In the pembrolizumab-axitinib arm, 125/426 patients (29%) had alanine aminotransferase (ALT) ≥3× upper limit of normal (ULN), with median time to onset of 84 d (range, 7-840 d). Among patients with ALT ≥3× ULN, 120/125 (96%) recovered to <3× ULN following study treatment interruption/discontinuation, with a median time to recovery of 15 d (3-176 d): 68/120 (57%) received corticosteroids. One hundred patients were rechallenged with one or both study treatment(s): 45/100 (45%) had ALT ≥3× ULN recurrence, and all 45 recovered to ALT <3× ULN following study treatment interruption/discontinuation. No fatal hepatic events occurred. CONCLUSIONS: A higher incidence of grade 3/4 aminotransferase elevations occurs with pembrolizumab-axitinib. These events should be carefully evaluated and managed with prompt study treatment interruption or discontinuation, with or without corticosteroid treatment. The decision to rechallenge with one or both drugs should be based on severity of event and thorough causality assessment. PATIENT SUMMARY: Renal cell carcinoma patients receiving pembrolizumab-axitinib are at a higher risk of liver enzyme elevations, which could be reversed with appropriate management.
- MeSH
- alanintransaminasa terapeutické užití MeSH
- axitinib terapeutické užití MeSH
- humanizované monoklonální protilátky MeSH
- karcinom z renálních buněk * farmakoterapie patologie MeSH
- lidé MeSH
- nádory ledvin * farmakoterapie patologie MeSH
- sunitinib škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- alanintransaminasa krev MeSH
- alkalická fosfatasa fyziologie krev MeSH
- aspartátaminotransferasy krev MeSH
- bilirubin fyziologie krev MeSH
- diferenciální diagnóza MeSH
- gama-glutamyltransferasa fyziologie krev MeSH
- hyperbilirubinemie klasifikace MeSH
- jaterní testy * klasifikace MeSH
- lidé MeSH
- nemoci jater diagnóza prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Infekce virem SARS-CoV-2 způsobila celosvětově nevídanou zdravotní krizi. Infekce může mít závažný dopad prakticky na všechny orgánové systémy, gastrointestinální trakt a játra nevyjímaje. Virus se velmi snadno dokáže množit v enterocytech a cholangiocytech. Navzdory přítomnosti menšího množství receptorů angiotenzin konvertujícího enzymu 2 (angiotensin-converting enzyme 2, ACE2) v hepatocytech však není replikace viru v jaterním parenchymu bezpečně prokázána. Na jaterní postižení mají vliv systémová imunitní reakce, hepatotoxická medikace, ischemie s tvorbou mikrotrombů a preexistující chronické jaterní onemocnění, zejména dekompenzovaná cirhóza jater, při které mají pacienti s covidem-19 velmi vysokou mortalitu. Následky pandemie mají ale v hepatologii zásadní dopad i na omezení screeningu hepatocelulárního karcinomu, vyhledávání pacientů s chronickou hepatitidou C, nárůst alkoholismu a zvýšení incidence nealkoholické tukové choroby jater, jejichž následky teprve v budoucnu pocítíme.
SARS-CoV-2 infection has caused an unprecedented health crisis worldwide. The infection can affect and damage nearly every organ system in the body, including gastrointestinal tract and the liver. The virus can replicate in the cholangiocytes and enterocytes. Despite of the presence of small amount of angiotensin-converting enzyme 2 (ACE2) receptors on the hepatocyte surface, its replication in the liver has not certainly been proved. The liver injury is caused by systemic immune reaction, hepatotoxicity of the drugs, ischemia with microthrombi in the liver vessels and pre-existing liver disease. Especially decompensated liver cirrhosis is associated with high morbidity and mortality. Nevertheless, the pandemic has even further consequences, such as postponement of the screening of the hepatocellular carcinoma, searching for patients with chronic hepatitis C, growth of alcohol consumption as well as higher incidence of non-alcoholic fatty liver disease. The overall impact of the pandemic will be therefore fully revealed in the future.
BACKGROUND AND AIMS: Recurrent primary sclerosing cholangitis (rPSC) following liver transplant (LT) has a negative impact on graft and patient survival; little is known about risk factors for rPSC or disease course in children. APPROACH AND RESULTS: We retrospectively evaluated risk factors for rPSC in 140 children from the Pediatric PSC Consortium, a multicenter international registry. Recipients underwent LT for PSC and had >90 days of follow-up. The primary outcome, rPSC, was defined using Graziadei criteria. Median follow-up after LT was 3 years (interquartile range 1.1-6.1). rPSC occurred in 36 children, representing 10% and 27% of the subjects at 2 years and 5 years following LT, respectively. Subjects with rPSC were younger at LT (12.9 vs. 16.2 years), had faster progression from PSC diagnosis to LT (2.5 vs. 4.1 years), and had higher alanine aminotransferase (112 vs. 66 IU/L) at LT (all P < 0.01). Inflammatory bowel disease was more prevalent in the rPSC group (86% vs. 66%; P = 0.025). After LT, rPSC subjects had more episodes of biopsy-proved acute rejection (mean 3 vs. 1; P < 0.001), and higher prevalence of steroid-refractory rejection (41% vs. 20%; P = 0.04). In those with rPSC, 43% developed complications of portal hypertension, were relisted for LT, or died within 2 years of the diagnosis. Mortality was higher in the rPSC group (11.1% vs. 2.9%; P = 0.05). CONCLUSIONS: The incidence of rPSC in this cohort was higher than previously reported, and was associated with increased morbidity and mortality. Patients with rPSC appeared to have a more aggressive, immune-reactive phenotype. These findings underscore the need to understand the immune mechanisms of rPSC, to lay the foundation for developing new therapies and improve outcomes in this challenging population.
- MeSH
- alanintransaminasa krev MeSH
- aspartátaminotransferasy krev MeSH
- časové faktory MeSH
- dítě MeSH
- gama-glutamyltransferasa krev MeSH
- glukokortikoidy terapeutické užití MeSH
- idiopatické střevní záněty epidemiologie MeSH
- internacionalita MeSH
- léková rezistence MeSH
- lidé MeSH
- mladiství MeSH
- portální hypertenze epidemiologie patofyziologie MeSH
- přežívání štěpu MeSH
- progrese nemoci MeSH
- recidiva MeSH
- registrace MeSH
- rejekce štěpu farmakoterapie epidemiologie patologie MeSH
- rizikové faktory MeSH
- sklerozující cholangitida krev epidemiologie chirurgie MeSH
- transplantace jater * MeSH
- věkové faktory MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
PURPOSE: The De Ritis ratio (aspartate aminotransferase/alanine aminotransferase, DRR) has been linked to oncological outcomes in several cancers. We aimed to assess the association of DRR with recurrence-free survival (RFS) and progression-free survival (PFS) in patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: We conducted a retrospective analysis of 1117 patients diagnosed with NMIBC originating from an established multicenter database. To define the optimal pretreatment DRR cut-off value, we determined a value of 1.2 as having a maximum Youden index value. The overall population was therefore divided into two De Ritis ratio groups using this cut-off (lower, < 1.2 vs. higher, ≥ 1.2). Univariable and multivariable Cox regression analyses were used to investigate the association of DRR with RFS and PFS. The discrimination of the model was evaluated with the Harrel's concordance index (C-index). RESULTS: Overall, 405 (36%) patients had a DRR ≥ 1.2. On univariable Cox regression analysis, DRR was significantly associated with RFS (HR: 1.23, 95% CI 1.02-1.47, p = 0.03), but not with PFS (HR: 0.96, 95% CI 0.65-1.44, p = 0.9). On multivariable Cox regression analysis, which adjusted for the effect of established clinicopathologic features, DRR ≥ 1.2 remained significantly associated with worse RFS (HR:1.21, 95% CI 1.00-1.46, p = 0.04). The addition of DRR only minimally improved the discrimination of a base model that included established clinicopathologic features (C-index = 0.683 vs. C-index = 0.681). On DCA the inclusion of DRR did not improve the net-benefit of the prognostic model. CONCLUSION: Despite the statistically significant association of the DRR with RFS in patients with NMIBC, it does not seem to add any prognostic or clinical benefit beyond that of currently available clinical factors.
- MeSH
- alanintransaminasa krev MeSH
- aspartátaminotransferasy krev MeSH
- doba přežití bez progrese choroby MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru epidemiologie MeSH
- nádory močového měchýře krev patologie chirurgie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cadmium (Cd) is a heavy metal that occurs in all areas of the environment, including the food chain. In the body, it causes oxidative stress by producing free radicals that are harmful to the cells. Grape seed extract (GSE) contains a wide range of biologically active components that help to neutralize the adverse effects of free radicals. In this study, the effects of GSE prepared form semi-resistant grapevine cultivar Cerason, which is rich in phenolics, on biochemical markers of brown rats exposed to the effects of cadmium were monitored. GSE increased the plasma antioxidant activity and, in the kidneys and the liver, Cd content was significantly lowered by GSE co-administration. Accordingly, the increase in creatinine content and alanine aminotransferase activity and the decrease of catalase and superoxide dismutase activities caused by cadmium were slowed down by GSE co-administration. The results of this work reveal that grape seed extract offers a protective effect against the intake of heavy metals into the organism.
- MeSH
- alanintransaminasa krev MeSH
- antioxidancia analýza MeSH
- aspartátaminotransferasy krev MeSH
- biologické markery metabolismus MeSH
- extrakt ze semen vinné révy farmakologie MeSH
- fytonutrienty analýza MeSH
- játra účinky léků enzymologie metabolismus MeSH
- kadmium krev MeSH
- katalasa metabolismus MeSH
- kreatinin krev MeSH
- ledviny účinky léků metabolismus MeSH
- metalothionein metabolismus MeSH
- močovina krev MeSH
- potkani Wistar MeSH
- semena rostlinná chemie MeSH
- superoxiddismutasa metabolismus MeSH
- zdraví * MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
