RESUMO
Liver cancer caused by the hepatitis B virus (HBV) is the third most common cancer-related cause of death worldwide. Early detection of HBV-caused hepatic tumors increases the likelihood of a successful cure. Molecular and genetic signals are becoming more and more recognized as possible indicators of HBV-associated hepatic malignancy and of how well a treatment is working. As a result, we have discussed the current literature on molecular and genetic sensors, including extracellular vesicle microRNAs (EV-miRNAs), long non-coding circulating RNAs (lncRNAs), extracellular vesicles (EVs), and cell free circulating DNA (cfDNA), for the diagnosis and forecasting of HBV-related hepatic cancer. Extracellular vesicle microRNAs such as miR-335-5p, miR-172-5p, miR-1285-5p, miR-497-5p, miR-636, miR-187-5p, miR-223-3p, miR-21, miR-324-3p, miR-210-3p, miR-718, miR-122, miR-522, miR-0308-3p, and miR-375 are essential for the posttranscriptional regulation of oncogenes in hepatic cells as well as the epigenetic modulation of many internal and external signaling pathways in HBV-induced hepatic carcinogenesis. LncRNAs like lnc01977, HULC (highly up-regulated in liver cancer), MALAT1 (metastasis-associated lung adenocarcinoma transcript 1), and HOTAIR (hox transcript antisense intergenic RNA) have been demonstrated to control hepatic-tumors cell growth, relocation, encroachment, and cell death resiliency. They are also becoming more and more involved in immune tracking, hepatic shifting, vasculature oversight, and genomic destabilization. EVs are critical mediators involved in multiple aspects of liver-tumors like angiogenesis, immunology, tumor formation, and the dissemination of malignant hepatocytes. Furthermore, cfDNA contributes to signals associated with tumors, including mutations and abnormal epigenetic changes during HBV-related hepatic tumorigenesis.
RESUMO
Objective: Abnormalities in blood cells are frequently associated with thyroid hormone disorders as a result of their involvement in the proliferation and production of blood cells. This study aimed to determine the magnitude and associated factors of hematological abnormalities in patients with hypothyroidism. Methods: A cross-sectional study was conducted from January 1 to June 30, 2023, at the University of Gondar Comprehensive Specialized Hospital. The present study included a total of 300 patients with hypothyroidism prospectively using the systematic random sampling technique. The hematological parameter data were collected using data extraction sheets, whereas the associated factor data were collected using both structured questionnaires and data extraction sheets. For complete blood cell counts, 4 mL of anticoagulated venous blood was collected and analyzed. The data were entered into Epi-data version 3.1 and analyzed with Stata version 14. Both bivariate and multivariate logistic regressions were performed to identify factors associated with hematological abnormalities. A P value < 0.05 was considered to indicate statistical significance. Results: The median value of red blood cell, hemoglobin, mean cell volume, white blood cell, and platelet were 4.63 x1012/µL, 14 g/dL, 84.3fl, 5.3 x103/µL, and 228, respectively. The overall incidences of anemia, leucopoenia, and thrombocytopenia in patients with hypothyroidism were 26.3% (95% confidence interval (CI): 21-32), 15.7% (95% CI: 14.2-17.2), and 9% (95% CI: 7.5-10.5), respectively. Lymphopenia was detected in 9% (95% CI: 8.6-10.1) of the patients, and neutropenia was detected in 6% (95% CI: 4.4-7.6) of the patients. Only three factors, female sex (adjusted odds ratio (AOR) =2.1, 95% CI=1.3-3.1), alcohol consumption (AOR= 3.8, CI=1.7-8.9), and febrile illness (AOR=2.7, 95% CI=1.3-5.4), were found to be significantly associated factors for anemia. Conclusion: The present study revealed heterogeneous hematological abnormalities in patients with hypothyroidism. Thus, early diagnosis and monitoring strategies are required to minimize complications in patients.
RESUMO
BACKGROUND: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. METHODS: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood were collected and analyzed by the Genrui CA51 coagulation analyzer. Data were entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. RESULT: In this study, a total of 307 study participants were included. Of them the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anaemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. CONCLUSION: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.