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1.
Zhonghua Gan Zang Bing Za Zhi ; 29(9): 825-829, 2021 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-34638199

RESUMO

Due to its insidious nature, chronic liver disease usually only appears after a decompensating event, and delays in diagnosis lead to a high mortality. Non-invasive examination can help diagnose and intervene early stage liver fibrosis in patients with chronic liver disease. In a hospital population, this test has been widely used and appropriate; however, its value is unclear in the general community population. In recent years, there have been many studies on non-invasive examinations for foreign community populations. These non-invasive examination tools can screen patients with chronic liver disease and liver cirrhosis among the general community population. Further studies have found that screening community populations with liver disease risk factors (heavy alcohol consumption, type 2 diabetes mellitus, and obesity) can more efficiently screen out patients with chronic liver disease in the community population. In brief, these noninvasive examination can find a large number of previously undiscovered liver disease patients in the community population, compared to traditional community screening that rely on abnormal liver function testing. This paper discusses the non-invasive examination in the screening of chronic liver disease among the community population, so as to find a pioneering community non-invasive liver disease screening path for our country.


Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatias , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Programas de Rastreamento
2.
Intern Med ; 60(20): 3195-3203, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34657905

RESUMO

Objective This study evaluated cases of pruritus, which is known to be associated with sleep disorder, in chronic liver disease (CLD) patients. Methods Questionnaires were given to 339 enrolled CLD outpatients in winter (November 2019 to March 2020) and again in summer (April to October 2020) (median interval: 104 days). Relative changes in symptoms shown by a visual analogue scale (VAS) and Kawashima's pruritus score between winter and summer were evaluated in Study 1 (n=199), while Study 2 examined the clinical features of patients with sleep disorder based on the results of the second questionnaire (n=235, median age 70 years old; 141 men, liver cirrhosis 37%). Results Study 1. There was a significant relationship in VAS between daytime and nighttime for each season, as well as between winter and summer for each time period (p<0.001). A comparison of Kawashima's pruritus scores for the daytime and nighttime showed no significant seasonal differences (p=0.436 and 0.828, respectively). When Kawashima's score increased, so did the average VAS for both daytime (0:1:2:3:4=0.4±0.2:1.4±0.9:3.0±1.8:5.9±2.1:6.2±2.3) and nighttime (0:1:2:3:4=0.3±0.1:1.4±1.5:3.5±2.3:6.7±2.6:6.9±1.8) (p<0.001 for both). Study 2. Twenty subjects (8.5%) complained of sleep disorder. An elevated FIB-4 index (≥3.07) showed a good predictive value for sleep disorder (p<0.01). The cut-off for the daytime and nighttime VAS values for existing sleep disorder were 1.6 [area under the curve (AUC) 0.901] and 3.4 (AUC 0.931). The respective sensitivity, specificity, and positive and negative predictive values for sleep disorder based on Kawashima's score (≥2) were 0.85, 0.28, 0.10, and 0.95 for the daytime and 1.00, 0.29, 0.12, and 1.00 for the nighttime. Conclusion Intervention against pruritus is recommended in CLD patients with a high Kawashima's score (≥2) in any season, especially with an elevated FIB-4 index.


Assuntos
Hepatopatias , Transtornos do Sono-Vigília , Idoso , Humanos , Hepatopatias/complicações , Hepatopatias/epidemiologia , Masculino , Medição da Dor , Prurido/diagnóstico , Prurido/epidemiologia , Prurido/etiologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários
3.
World J Gastroenterol ; 27(30): 4985-4998, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34497430

RESUMO

Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia. The presence of malnutrition causes a severe impact on patients with liver cirrhosis. The etiology of cirrhosis differs in the South Asian region compared to the West, with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time. Comorbid malnutrition worsens outcomes for cirrhosis patients. Urgent attention to address malnutrition is needed to improve patient outcomes. The etiology and pathophysiology of malnutrition in liver diseases is multifactorial, as reduction in liver function affects both macronutrients and micronutrients. A need for nutritional status assessment for liver disease patients exists in all parts of the world. There are many widely studied tools in use to perform a thorough nutritional assessment, of which some tools are low cost and do not require extensive training. These tools can be studied and evaluated for use in the resource limited setting of a country like Pakistan. Treatment guidelines for proper nutrition maintenance in chronic liver disease exist for all parts of the world, but the knowledge and practice of nutritional counseling in Pakistan is poor, both amongst patients and physicians. Emphasis on assessment for nutritional status at the initial visit with recording of vital signs is needed. Simultaneously, treating physicians need to be made aware of the misconceptions surrounding nutritional restrictions in cirrhosis so that patient education is done correctly based on proper scientific evidence.


Assuntos
Hepatopatias , Desnutrição , Países em Desenvolvimento , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Hepatopatias/terapia , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/terapia , Avaliação Nutricional , Paquistão/epidemiologia
5.
BMJ Open ; 11(9): e045165, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493501

RESUMO

OBJECTIVES: The aim was to elucidate the relationship between liver function and idiopathic pulmonary arterial hypertension (IPAH). DESIGN AND SETTING: Retrospective, longitudinal study in urban tertiary care centre in Shanghai, China. PARTICIPANTS: 407 IPAH consecutive incident patients age 18-65 years were retrospectively enrolled from January 2008 to December 2018. OUTCOME MEASUREMENTS: The primary endpoint was all-cause mortality. The cut-off value was determined by receiver operating characteristic curve (ROC), which was validated by Cox proportional hazard model was internally validated by bootstrap analysis and used for survival analysis. The Cox model was (internally) validated and cross-validated areas under the curve (AUC) should be reported. RESULTS: The prevalence of abnormal liver function tests (LFTs) at baseline was 77.6%. Hyperbilirubinaemia is the most common abnormal biochemical liver test: abnormal total bilirubin (TBIL in 51.6% patients). During the follow-up, 160 patients died. Patients with mixed liver dysfunction have worse prognosis than those with normal LFTs or isolated abnormal bilirubin metabolism. Comparing with patients with hepatocellular injury, the survival of patients with abnormal bilirubin metabolism is lower. Multivariable Cox models revealed a positive association between TBIL, γ-glutamyltransferase (GGT) and mortality showing that each Ig increment in TBIL and GGT was associated with a higher all-cause mortality (TBIL: HR 4. 29 (95% CI 1. 21 to 15. 27), p=0. 02; GGT: HR 2. 76 (95% CI 1. 18 to 6. 45), p=0. 02). A novel formula named Liver Function Predict Index (LFPI) was constructed (LFPI=-0.002*6MWD+1.014*lg GGT+1.458*lg TBIL) to predict prognosis. ROC curve analysis did further identify 2.729 as the best cut-off value for LFPI (AUC 0.75, p<0.001, sensitivity 79%, specificity 70%). CONCLUSIONS: Liver dysfunction is frequent in IPAH, and characterised by a predominantly cholestatic enzyme profile. LFTs abnormalities are associated with worse survival and LFPI was a new and simple predictor for prognosis of IPAH.


Assuntos
Hepatopatias , Adolescente , Adulto , Idoso , China/epidemiologia , Hipertensão Pulmonar Primária Familiar , Humanos , Hepatopatias/epidemiologia , Estudos Longitudinais , Pessoa de Meia-Idade , Prevalência , Prognóstico , Curva ROC , Estudos Retrospectivos , Adulto Jovem
6.
Nutrients ; 13(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34578865

RESUMO

The association between bone mineral density (BMD) and hepatic glycogen storage diseases (GSDs) is still unclear. To evaluate the BMD of patients with GSD I, IIIa and IXα, a cross-sectional study was performed, including 23 patients (GSD Ia = 13, Ib = 5, IIIa = 2 and IXα = 3; median age = 11.9 years; IQ = 10.9-20.1) who underwent a dual-energy X-ray absorptiometry (DXA). Osteocalcin (OC, n = 18), procollagen type 1 N-terminal propeptide (P1NP, n = 19), collagen type 1 C-terminal telopeptide (CTX, n = 18) and 25-OH Vitamin D (n = 23) were also measured. The participants completed a 3-day food diary (n = 20). Low BMD was defined as a Z-score ≤ -2.0. All participants were receiving uncooked cornstarch (median dosage = 6.3 g/kg/day) at inclusion, and 11 (47.8%) presented good metabolic control. Three (13%) patients (GSD Ia = 1, with poor metabolic control; IIIa = 2, both with high CPK levels) had a BMD ≤ -2.0. CTX, OC and P1NP correlated negatively with body weight and age. 25-OH Vitamin D concentration was decreased in seven (30.4%) patients. Our data suggest that patients with hepatic GSDs may have low BMD, especially in the presence of muscular involvement and poor metabolic control. Systematic nutritional monitoring of these patients is essential.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Doença de Depósito de Glicogênio/epidemiologia , Hepatopatias/epidemiologia , Absorciometria de Fóton , Adolescente , Adulto , Densidade Óssea , Doenças Ósseas Metabólicas/sangue , Brasil/epidemiologia , Criança , Pré-Escolar , Colágeno Tipo I/sangue , Comorbidade , Estudos Transversais , Feminino , Doença de Depósito de Glicogênio/sangue , Humanos , Hepatopatias/sangue , Masculino , Osteocalcina/sangue , Fragmentos de Peptídeos/sangue , Pró-Colágeno/sangue , Vitamina D/sangue , Adulto Jovem
7.
World J Gastroenterol ; 27(28): 4504-4535, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34366621

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered the causative pathogen of coronavirus disease 2019 (COVID-19) and has become an international danger to human health. Although respiratory transmission and symptoms are still the essential manifestations of COVID-19, the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested, most likely due to the presence of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract. In addition, SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes, antibody-dependent enhancement of infection, systemic inflammatory response syndrome, inflammatory cytokine storms, ischemia/reperfusion injury, and adverse events of treatment drugs. Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, which are unusual in patients with COVID-19, and some digestive signs may occur without other respiratory symptoms. Furthermore, SARS-CoV-2 can be found in infected patients' stool, demonstrating the likelihood of transmission through the fecal-oral route. In addition, liver function should be monitored during COVID-19, particularly in more severe cases. This review summarizes the evidence for extra-pulmonary manifestations, mechanisms, and management of COVID-19, particularly those related to the gastrointestinal tract and liver.


Assuntos
COVID-19 , Gastroenteropatias , Hepatopatias , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Trato Gastrointestinal , Humanos , Hepatopatias/epidemiologia , Hepatopatias/terapia , Pandemias , SARS-CoV-2
8.
Nutrients ; 13(7)2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34371925

RESUMO

Renal dysfunction and sarcopenia are important prognostic factors in patients with chronic liver disease (CLD). Muscle atrophy can cause the overestimation of renal function based on serum creatinine. However, the frequency of overestimated renal function in Japanese patients with CLD and its relationship with sarcopenia are unclear. In present study, we evaluated the frequency of overestimated renal function, defined as a >20% higher eGFR using creatinine than using cystatin C, in 307 patients with CLD as well as its relationship with indicators of sarcopenia. In total, 24.8% of patients had overestimated renal function. In a multivariate regression analysis, liver cirrhosis (p = 0.004) and psoas muscle mass index (p = 0.049) were significantly associated with overestimated renal function. Loss of skeletal muscle mass was significantly more frequent in both male and female patients with overestimated renal function than without. In males, the loss of muscle strength and rate of sarcopenia, defined as loss of muscle mass and strength, were significantly higher in patients with than without overestimated renal function. The high frequency of overestimated renal function in Japanese patients suggests that indicators of renal function should be carefully considered; furthermore, monitoring and interventions for both renal function and sarcopenia are needed in patients with CLD.


Assuntos
Composição Corporal , Taxa de Filtração Glomerular , Nefropatias/fisiopatologia , Rim/fisiopatologia , Hepatopatias/fisiopatologia , Músculos Psoas/fisiopatologia , Sarcopenia/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doença Crônica , Creatinina/sangue , Cistatina C/sangue , Feminino , Humanos , Japão/epidemiologia , Nefropatias/diagnóstico , Nefropatias/epidemiologia , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Músculos Psoas/diagnóstico por imagem , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sarcopenia/diagnóstico por imagem , Sarcopenia/epidemiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
BMC Gastroenterol ; 21(1): 318, 2021 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-34364363

RESUMO

BACKGROUND: The symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. Currently there is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. Moreover, the ongoing advances in CLD treatment, and its effect on HRQOL, highlight the need for further studies. Therefore, the aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms. METHODS: A cross-sectional study was conducted. Patients with CLDs were identified at their regular visits to the outpatient clinic of the Sant'Orsola-Malpighi Hospital in Bologna, between September 2016 and July 2017. HRQOL was measured with Short Form 12 (SF-12) and Nottingham Health Profile (NHP) questionnaires; depressive symptoms were measured with Beck Depression Inventory-II (BDI). CLD severity was measured using the MELD score and the sample was stratified into five classes according to it. Group comparisons were conducted using the Kruskal-Wallis test. RESULTS: Two hundred and fifty-four patients were included. Mean age was 62.84 years (SD 11.75) and 57.9% were male. Most participants were affected by compensated cirrhosis (140.2%) and chronic hepatitis (40.2%), with a disease duration ≥ 5 years (69.3%). Regarding the MELD score, 67.7% of patients belonged to Class I, 29.9% to Class II, and 2.4% to Class III. There were not patients belonging to the Classes IV and V. No statistically significant differences were found in all SF-12 and NHP domains between the MELD classes, except for CLD impact on sexual life and holidays (p = 0.037 and p = 0.032, respectively). A prevalence rate of 26% of depressive symptoms was reported, no statistically significant differences were found in BDI-II total scores between the three MELD classes. CONCLUSIONS: All domains of HRQOL and depression were altered in CLDs patients, nevertheless CLD severity was not confirmed as an affecting factor for HRQOL.


Assuntos
Hepatopatias , Qualidade de Vida , Doença Crônica , Estudos Transversais , Humanos , Hepatopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Inquéritos e Questionários
10.
Nutrients ; 13(8)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34444944

RESUMO

Despite recent advances, the causes of and effective therapies for pediatric chronic cholestatic diseases remain elusive, and many patients progress to liver failure and need liver transplantation. Malnutrition is a common complication in these patients and is a well-recognized, tremendous challenge for the clinician. We undertook a narrative review of both recent and relevant older literature, published during the last 20 years, for studies linking nutrition to pediatric chronic cholestasis. The collected data confirm that malnutrition and failure to thrive are associated with increased risks of morbidity and mortality, and they also affect the outcomes of liver transplantation, including long-term survival. Malnutrition in children with chronic liver disease is multifactorial and with multiple potential nutritional deficiencies. To improve life expectancy and the quality of life, patients require careful assessments and appropriate management of their nutritional statuses by multidisciplinary teams, which can identify and/or prevent specific deficiencies and initiate appropriate interventions. Solutions available for the clinical management of these children in general, as well as those directed to specific etiologies, are summarized. We particularly focus on fat-soluble vitamin deficiency and malnutrition due to fat malabsorption. Supplemental feeding, including medium-chain triglycerides, essential fatty acids, branched-chain amino acids, and the extra calories needed to overcome the consequences of anorexia and high energy requirements, is reviewed. Future studies should address the need for further improving commercially available and nutritionally complete infant milk formulae for the dietary management of this fragile category of patients. The aid of a specialist dietitian, educational training regarding nutritional guidelines for stakeholders, and improving family nutritional health literacy appear essential.


Assuntos
Colestase/epidemiologia , Hepatopatias/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Adolescente , Criança , Pré-Escolar , Colestase/complicações , Doença Crônica , Dieta/métodos , Ingestão de Energia , Feminino , Humanos , Lactente , Fórmulas Infantis , Hepatopatias/complicações , Falência Hepática/epidemiologia , Falência Hepática/etiologia , Transplante de Fígado , Masculino , Desnutrição/etiologia , Necessidades Nutricionais , Qualidade de Vida , Vitaminas/administração & dosagem
11.
Avian Dis ; 65(2): 269-280, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34412458

RESUMO

Hemorrhagic hepatopathy is a syndrome reported in layer pullets resulting in mortality and lesions including hepatic, splenic, and intestinal necrosis; hepatic and splenic enlargement; hemorrhages; amyloidosis of the muscle, spleen, and liver; accumulation of noncoagulated hemorrhagic fluid in the coelom; and frequently, granulomatous myositis at bacterin injection sites. The syndrome is characterized in the literature in table egg layer pullets and is thought to be associated with the administration of bacterin vaccines, namely, frequently Salmonella enterica subsp. enterica bacterins. Hemorrhagic hepatopathy is recognized by industry veterinarians as also occurring infrequently in broiler breeder pullets in the United States. As the condition is likely due to an inflammatory process in response to bacterial lipopolysaccharide inoculation, it is important to characterize both the pathologic changes and predisposing factors for the condition in broiler breeds, which are immunologically different from table egg layer breeds. In this study, we characterize the gross and microscopic lesions observed in a series of diagnostic laboratory cases of hemorrhagic hepatopathy in broiler breeder pullets and suggest a possible pathophysiology for the condition. Additionally, we report results from a case survey of the United States broiler industry that suggest that the condition is due to a reaction to bacterin vaccination and that certain bacterin products may predispose pullet flocks to develop the condition. Although further research is indicated, these findings establish hemorrhagic hepatopathy as a pathologic condition of broiler breeder pullets and may aid in the diagnosis and prevention of the syndrome.


Assuntos
Galinhas , Hepatopatias/veterinária , Doenças das Aves Domésticas/patologia , Amiloidose/veterinária , Animais , Autopsia/veterinária , Feminino , Hemorragia , Incidência , Intestinos/patologia , Fígado/patologia , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Hepatopatias/patologia , Doenças Musculares/epidemiologia , Doenças Musculares/etiologia , Doenças Musculares/patologia , Doenças Musculares/veterinária , Necrose , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/etiologia , Estudos Retrospectivos , Baço/patologia , Inquéritos e Questionários , Síndrome , Vacinação/efeitos adversos , Vacinação/veterinária
12.
Sci Rep ; 11(1): 14054, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253741

RESUMO

During the coronavirus disease 2019 (COVID-19) pandemic, there have been health concerns related to alcohol use and misuse. We aimed to examine the population-level change in cases of alcohol-related liver disease and pancreatitis that required admission during the COVID-19 epidemic by interrupted time series (ITS) analysis using claims data. We defined the period from April 2020, when the Japanese government declared a state of emergency, as the beginning of the COVID-19 epidemic. This ITS analysis included 3,026,389 overall admissions and 10,242 admissions for alcohol-related liver disease or pancreatitis from 257 hospitals between July 2018 and June 2020. The rate of admissions per 1000 admissions during the COVID-19 epidemic period (April 2020-June 2020) was 1.2 times (rate ratio: 1.22, 95% confidence interval: 1.12-1.33) compared to the pre-epidemic period. Analyses stratified by sex revealed that the increases in admission rates of alcohol-related liver disease or pancreatitis for females were higher than for males during the COVID-19 epidemic period. The COVID-19 epidemic in Japan might associates an increase in hospital admissions for alcohol-related liver disease and pancreatitis. Our study could support the concern of alcohol consumption and health problems during the COVID-19 pandemic.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , COVID-19/epidemiologia , Hepatopatias/epidemiologia , Pancreatite/epidemiologia , Adulto , Idoso , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/virologia , COVID-19/complicações , COVID-19/virologia , Serviço Hospitalar de Emergência , Feminino , Política de Saúde , Hospitalização , Humanos , Hepatopatias/complicações , Hepatopatias/virologia , Masculino , Pessoa de Meia-Idade , Pancreatite/complicações , Pancreatite/virologia , Pandemias/prevenção & controle , Admissão do Paciente , SARS-CoV-2/patogenicidade
14.
Lancet Gastroenterol Hepatol ; 6(10): 850-863, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34273289

RESUMO

Sleep is a complex, highly regulated process essential for human health and wellbeing. Increasingly, sleep-wake disturbance has been implicated in the pathogenesis of chronic liver disease, particularly the development and progression of non-alcoholic fatty liver disease and alcohol-related liver disease. Patients with cirrhosis also have a high burden of sleep abnormalities with substantial implications for their quality of life and physical health. This Review summarises the epidemiology and pathophysiology of sleep-wake disturbance in liver disease and discusses the multiple converging pathways leading to abnormal sleeping patterns in patients with cirrhosis. This includes contributions from altered melatonin metabolism, neuromuscular complications, and aberrant thermoregulation. In turn, a vicious cycle is established whereby disrupted sleep can further contribute to liver disease progression. We also begin to unravel the complex, interlinking relationship between sleep-wake disturbance and hepatic encephalopathy, discussing both overlapping and distinct mechanisms and clinical features. Finally, we summarise the current and future therapeutic approaches aiming to improve sleep quality in patients with cirrhosis.


Assuntos
Hepatopatias/complicações , Hepatopatias/patologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/fisiopatologia , Regulação da Temperatura Corporal/fisiologia , Estudos de Casos e Controles , Doença Crônica , Efeitos Psicossociais da Doença , Progressão da Doença , Feminino , Encefalopatia Hepática/complicações , Encefalopatia Hepática/epidemiologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/epidemiologia , Cirrose Hepática/patologia , Hepatopatias/epidemiologia , Hepatopatias Alcoólicas/complicações , Hepatopatias Alcoólicas/epidemiologia , Hepatopatias Alcoólicas/patologia , Masculino , Melatonina/metabolismo , Doenças Neuromusculares/complicações , Doenças Neuromusculares/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Prevalência , Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia
16.
Iran J Med Sci ; 46(4): 237-255, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34305236

RESUMO

Background: The outbreak of the coronavirus disease-2019 (COVID-19) has become a global public health challenge. Assessing the effect of COVID-19 on liver injury is of great importance. A systematic review and meta-analysis were conducted to establish the characteristics of liver function tests in COVID-19 patients. Methods: A systematic search of publications from December 2019 up to April 2020 in Web of Science, Scopus, and Medline (via PubMed) databases was performed. Both cross-sectional and case series studies reporting an association between liver injury and COVID-19 infection were included. The data were analyzed using the STATA software (version 11.0) and the random-effects model for I2>50% was used to pool the results. Results: In this meta-analysis, 42 articles comprising a total of 6,557 COVID-19 patients were studied. The prevalence of increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels was 30% and 21% in non-severe patients and 38% and 48% in severe patients, respectively. Patients with severe COVID-19 infection were 4.22, 4.96, and 4.13 times more likely to have elevated AST, ALT, and lactate dehydrogenase (LDH) levels, respectively. Conclusion: Elevation in liver function tests was higher in patients with severe than non-severe COVID-19 infection. Given the widespread use of drugs that increases the risk of hepatotoxicity, healthcare providers should be aware of changes in liver enzymes in COVID-19 patients. The inclusion of other studies from outside China could confirm the pattern of elevation in liver function tests in COVID-19 patients across the globe. Preprint of this article is available on medRxiv, https://www.medrxiv.org/content/10.1101/2020.05.20.20108357v1.


Assuntos
COVID-19/complicações , Hepatopatias/virologia , Testes de Função Hepática , Alanina Transaminase , Aspartato Aminotransferases , Humanos , L-Lactato Desidrogenase , Fígado/enzimologia , Hepatopatias/epidemiologia
17.
Clin Gastroenterol Hepatol ; 19(12): 2664-2666.e2, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34256143

RESUMO

Chronic liver disease (CLD) and cirrhosis accounts for approximately 2 million deaths annually worldwide. CLD and cirrhosis-related mortality has increased steadily in the United States.1,2 With the global pandemic of coronavirus disease 2019 (COVID-19), patients with CLD and cirrhosis represent a vulnerable population at higher risk for complications and mortality.3,4 Although high mortality from COVID-19 among patients with CLD and cirrhosis have been reported,5 national trends in mortality related to CLD and cirrhosis before and during the COVID-19 pandemic have not been assessed. This study estimated the temporal quarterly trends in CLD and cirrhosis-related mortality in the United States from 2017 Q1 to 2020 Q3 using provisional data releases from the National Vital Statistics System.6,7.


Assuntos
COVID-19 , Hepatopatias , Humanos , Cirrose Hepática/epidemiologia , Hepatopatias/epidemiologia , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia
18.
Sci Rep ; 11(1): 11734, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34083670

RESUMO

To explore the role of chronic liver disease (CLD) in COVID-19. A total of 1439 consecutively hospitalized patients with COVID-19 from one large medical center in the United States from March 16, 2020 to April 23, 2020 were retrospectively identified. Clinical characteristics and outcomes were compared between patients with and without CLD. Postmortem examination of liver in 8 critically ill COVID-19 patients was performed. There was no significant difference in the incidence of CLD between critical and non-critical groups (4.1% vs 2.9%, p = 0.259), or COVID-19 related liver injury between patients with and without CLD (65.7% vs 49.7%, p = 0.065). Postmortem examination of liver demonstrated mild liver injury associated central vein outflow obstruction and minimal to moderate portal lymphocytic infiltrate without evidence of CLD. Patients with CLD were not associated with a higher risk of liver injury or critical/fatal outcomes. CLD was not a significant comorbid condition for COVID-19.


Assuntos
COVID-19/epidemiologia , Hepatopatias/epidemiologia , Lesão Pulmonar Aguda/epidemiologia , Lesão Pulmonar Aguda/patologia , Idoso , COVID-19/mortalidade , Doença Crônica , Comorbidade , Feminino , Humanos , Hepatopatias/patologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estados Unidos/epidemiologia
19.
J Small Anim Pract ; 62(9): 730-736, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34155648

RESUMO

OBJECTIVES: Canine hepatobiliary disease is common; however, data determining disease frequency and breed predispositions are lacking. The primary objective was to identify the frequency of different hepatobiliary disease in a United Kingdom population of dogs and consequently determine breeds at both an increased and decreased risk of hepatobiliary disease. MATERIALS AND METHODS: Anonymised histopathology reports from a commercial veterinary diagnostic laboratory, which were submitted between August 2013 and February 2018, were analysed. Data were retrospectively categorised into hepatobiliary diseases according to World Small Animal Veterinary Association Standards and the breed, age and genders recorded. Cases with incomplete data or no definitive diagnosis were excluded. Breed predisposition was calculated using odds ratios and 95% confidence intervals against a United Kingdom-based control population of micro-chipped dogs. RESULTS: Histopathology results from 4584 cases met inclusion criteria. The most frequent histological diagnoses were reactive hepatitis (n=770); chronic hepatitis (n=735) and reversible hepatocellular injury (n=589). A number of breeds were shown to be at an increased or decreased risk of individual liver diseases. CLINICAL SIGNIFICANCE: This is the first study to document the histopathological frequency of hepatobiliary diseases in a large cohort of dogs in the United Kingdom, as well as novel possible breed and age predispositions. Despite multivariable analysis not being performed to account for confounding factors, this information hopes to inform and support future investigations for hepatic disease in particular breeds and potential predispositions.


Assuntos
Doenças do Cão , Hepatite Crônica , Hepatopatias , Animais , Doenças do Cão/epidemiologia , Cães , Feminino , Genótipo , Hepatite Crônica/veterinária , Hepatopatias/epidemiologia , Hepatopatias/veterinária , Masculino , Estudos Retrospectivos , Reino Unido/epidemiologia
20.
Aliment Pharmacol Ther ; 54(5): 689-698, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34181776

RESUMO

BACKGROUND: Liver disease is an increasing burden on population health globally. AIMS: To characterise burden of liver disease among general internal medicine inpatients at seven Toronto-area hospitals and compare it to other common medical conditions. METHODS: Data from April 2010 to October 2017 were obtained from hospitals participating in the GEMINI collaborative. Using these cohort data from hospital information systems linked to administrative data, we defined liver disease admissions using most responsible discharge diagnoses categorised according to international classification of diseases, 10th Revision-enhanced Canadian version (ICD-10-CA). We identified admissions for heart failure, chronic obstructive pulmonary disease (COPD) and pneumonia as comparators. We calculated standardised mortality ratios (SMRs) as the ratio of observed to expected deaths. RESULTS: Among 239 018 discharges, liver disease accounted for 1.7% of most responsible discharge diagnoses. Liver disease was associated with marked premature mortality, with SMR of 8.84 (95% CI 8.06-9.67) compared to 1.06 (95% CI 0.99-1.12) for heart failure, 1.05 (95% CI 0.96-1.15) for COPD and 1.28 (95% CI 1.20-1.37) for pneumonia. The majority of deaths were among patients younger than 65 years (57.7%) compared to 3.3% in heart failure, 5.6% in COPD and 10.7% in pneumonia. Liver disease patients presented with worse Laboratory-Based Acute Physiology Scores, were more frequently admitted to the intensive care unit (14.4%), incurred higher average total costs (median $6723 CAD), had higher in-hospital mortality (11.4%), and were more likely to be a readmission from 30 days prior (19.8%). Non-alcoholic fatty liver disease admissions increased from 120 in 2011-2012 to 215 in 2016-2017 (P < 0.01). CONCLUSION: In Canada's largest urban centre, liver disease admissions resulted in premature morbidity and mortality with higher resource use compared to common cardio-respiratory conditions. Re-evaluation of approaches to caring for inpatients with liver disease is timely and justified.


Assuntos
Efeitos Psicossociais da Doença , Hepatopatias , Canadá/epidemiologia , Hospitalização , Humanos , Medicina Interna , Hepatopatias/epidemiologia , Estudos Retrospectivos
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