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1.
Cas Lek Cesk ; 161(2): 52-56, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35728957

RESUMO

Liver function tests are among the most determined biochemical parameters, and it is essential that their interpretation is always performed correctly. The presence of liver disease is indicated not only by the well-known basic panel of liver function tests (bilirubin, ALT, AST, GGT and ALP), but also by other biochemical parameters, especially albumin, INR and platelet count. The latter analytes are often overlooked, as is the fact that normal values in the baseline liver test panel do not yet rule out advanced chronic liver disease - liver fibrosis or cirrhosis. In contrast, high levels of liver function tests do not automatically indicate liver failure. Considering the increasing incidence of liver disease as well as the rising mortality from liver causes in many European countries, it is desirable to update the diagnostic algorithm when pathological liver function tests are detected.


Assuntos
Cirrose Hepática , Hepatopatias , Bilirrubina , Biomarcadores , Humanos , Fígado/patologia , Hepatopatias/complicações , Hepatopatias/diagnóstico , Hepatopatias/patologia , Testes de Função Hepática
2.
Artigo em Inglês | MEDLINE | ID: mdl-35728866

RESUMO

BACKGROUND: Despite the evidence for adverse pregnancy outcomes, non-alcoholic fatty liver disease (NAFLD) is not routinely addressed in early pregnancy. The Fatty Liver Index (FLI) has been proposed as a screening tool for NAFLD in the general population. We aim to develop mathematical models for predicting NAFLD in pregnancy and validate the FLI for first-trimester pregnant women. METHODS: Biochemical and biophysical parameters were analysed in pregnant women with period of gestation <12 weeks was done among Rajarata Pregnancy Cohort, Sri Lanka. Fatty liver was graded as (FLG) 0, I or II by ultrasound scan. Binary logistic regression models were employed to identify the factors predicting FLG-II. Six FLIs were developed to predict FLG-II. Validity of the FLIs was compared using the receiver operating characteristic curves. RESULTS: The study sample consisted of 632 pregnant women with a mean age of 28.8 years (SD: 5.8 years). Age (OR: 1.6, 95% CI 1.1 to 2.3), body mass index (OR: 1.7, 95% CI 1.1 to 2.5) and gamma-glutamyl transferase levels (OR: 2.1, 95% CI 1.5 to 3.0) were the independent predictors of FLG-II. While the model with liver enzymes provided the best prediction of NAFLD (both FLG I and II) (area under the curve [(AUC]): -0.734), the highest AUC (0.84) for predicting FLG-II was observed with the full model (model with all parameters). The proposed budget model (AUC >0.81) is the best model for screening fatty liver in community health setup. CONCLUSION: FLIs could be used as screening tools for NAFLD based on resource availability in different settings. External validation of the FLI and further investigation of the proposed FLI as a predictor of adverse pregnancy outcomes are recommended.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Adulto , Feminino , Humanos , Testes de Função Hepática , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Gravidez , Triglicerídeos , Circunferência da Cintura , gama-Glutamiltransferase
3.
J Cancer Res Ther ; 18(2): 461-469, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35645115

RESUMO

Objective: This meta-analysis comprehensively summarizes the current clinical research on compound glycyrrhizin (CG) treatment for liver cancer and protecting liver function to guide clinical treatment. Methods: Eighteen English-language articles were retrieved from PubMed, SinoMed, Cochrane, Embase, Web of Science, and three Chinese databases: The Wan Fang database, China National Knowledge Infrastructure (CNKI), and the VIP database. Results: CG treatment improved the patient's alanine aminotransferase (ALT) level (in the metastatic liver cancer group: mean deviation (MD) = -13.78, 95% confidence interval (CI) = [-17.29, 10.27]; in the primary liver cancer group: MD = -32.15, 95% CI = [-35.48, 28.81]); aspartate aminotransferase (AST) level (in the primary liver cancer group: MD = -21.63, 95% CI = [-24.29, 18.96]; in the metastatic liver cancer group: MD = -15.64, 95% CI = [-19.08, -12.20]); serum total bilirubin (TBIL) level (MD = -1.61, 95% CI = [-2.71, -0.51]); and serum albumin (ALB) level (MD = 2.80, 95% CI = [1.85, 3.74]). CG treatment was efficient than the control (relative risk [RR] = 1.66, 95% CI = [1.35, 2.04]). Although adverse reactions, including fever, were higher than in the control group (RR = 1.13, 95% CI = [0.89, 1.43]), they were controllable. Conclusion: CG affects liver preservation in treating liver cancer, which can reduce ALT, AST, and TBIL levels in patients; increase the ALB level; and protect liver cells. The CG-treated group showed improvement compared with the control group; although adverse reactions occurred in the treated group, the duration was shortened.


Assuntos
Medicamentos de Ervas Chinesas , Neoplasias Hepáticas , Medicamentos de Ervas Chinesas/uso terapêutico , Ácido Glicirrízico/uso terapêutico , Humanos , Testes de Função Hepática , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia
4.
BMC Gastroenterol ; 22(1): 297, 2022 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-35701742

RESUMO

BACKGROUND: A precise evaluation of liver reserve function in patients with hepatic alveolar echinococcosis (HAE) prior to hepatectomy could substantially increase the success rate of the operation and reduce the incidence of postoperative complications. The present study aimed to investigate the significance of the indocyanine green retention test at 15 min (ICG-R15) and the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting severe posthepatectomy liver failure (PHLF) and postoperative mortality in HAE patients undergoing liver resection. METHODS: A total of 105 HAE patients undergoing hepatectomy were enrolled in this study. The value of each variable in predicting severe PHLF was evaluated by univariate and multivariate logistic regression analyses. The area under the receiver operating characteristic (ROC) curves (AUC) were calculated to evaluate the predictive ability of the Child-Pugh grade, ICG-R15, and ALICE grading system. Also, patients were classified using the optimal cutoff value for ICG-R15 and different ALICE grades, and the incidence of severe PHLF and postoperative mortality were compared with the predicted values. RESULTS: Out of the 105 HAE patients enrolled in this study, 34 patients (32.4%) developed severe PHLF. The ALICE grade and operative time were identified as independent predictors of severe PHLF. According to ROC analysis, the AUCs of the Child-Pugh grade, ICG-R15, and ALICE grade for predicting severe PHLF were 0.733 (95% confidence interval (CI), 0.637-0.814), 0.823 (95% CI, 0.737-0.891), 0.834 (95% CI, 0.749-0.900). The incidence of severe PHLF and postoperative 90-day mortality in patients with ICG-R15 > 7.2% were significantly higher than those with ICG-R15 ≤ 7.2% (P < 0.001; P = 0.008). Likewise, the incidence of severe PHLF and postoperative 90-day mortality in patients with ALICE grade 2 were higher than those with ALICE grade 1 within the Child-Pugh grade A (P < 0.001; P = 0.083). CONCLUSION: ICG-R15 and ALICE grading system are powerful predictors of severe PHLF and postoperative mortality among HAE patients undergoing hepatectomy. Furthermore, a combination of the preoperative Child-Pugh grade and ALICE grading system may provide an even more precise and objective guidance and facilitate surgical decision-making for HAE patients.


Assuntos
Carcinoma Hepatocelular , Equinococose Hepática , Falência Hepática , Neoplasias Hepáticas , Albuminas , Carcinoma Hepatocelular/complicações , Equinococose Hepática/cirurgia , Hepatectomia/efeitos adversos , Humanos , Verde de Indocianina , Falência Hepática/etiologia , Falência Hepática/cirurgia , Testes de Função Hepática , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos
5.
Zhonghua Gan Zang Bing Za Zhi ; 30(5): 527-533, 2022 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-35764545

RESUMO

Objective: To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia. Methods: 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group (n=40), normal group (n=71), abnormal liver function group (n=86) and normal liver function group (n=25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Results: Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group (P<0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group (P>0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group (P<0.05). Conclusion: Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.


Assuntos
COVID-19 , Hepatopatias , Idoso , Fosfatase Alcalina , Aspartato Aminotransferases , Bilirrubina , Humanos , Testes de Função Hepática , Masculino , Estudos Retrospectivos , gama-Glutamiltransferase
7.
World J Gastroenterol ; 28(16): 1625-1640, 2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35581963

RESUMO

Hepatic dysfunction represents a wide spectrum of pathological changes, which can be frequently found in hepatitis, cholestasis, metabolic diseases, and focal liver lesions. As hepatic dysfunction is often clinically silent until advanced stages, there remains an unmet need to identify affected patients at early stages to enable individualized intervention which can improve prognosis. Passive liver function tests include biochemical parameters and clinical grading systems (e.g., the Child-Pugh score and Model for End-Stage Liver Disease score). Despite widely used and readily available, these approaches provide indirect and limited information regarding hepatic function. Dynamic quantitative tests of liver function are based on clearance capacity tests such as the indocyanine green (ICG) clearance test. However, controversial results have been reported for the ICG clearance test in relation with clinical outcome and the accuracy is easily affected by various factors. Imaging techniques, including ultrasound, computed tomography, and magnetic resonance imaging, allow morphological and functional assessment of the entire hepatobiliary system, hence demonstrating great potential in evaluating hepatic dysfunction noninvasively. In this article, we provide a state-of-the-art summary of noninvasive imaging modalities for hepatic dysfunction assessment along the pathophysiological track, with special emphasis on the imaging modality comparison and selection for each clinical scenario.


Assuntos
Doença Hepática Terminal , Hepatopatias , Doença Hepática Terminal/patologia , Humanos , Verde de Indocianina , Fígado/patologia , Hepatopatias/patologia , Testes de Função Hepática , Índice de Gravidade de Doença
8.
Pediatrics ; 149(6)2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35506333

RESUMO

BACKGROUND: Early detection of biliary atresia (BA) is important for optimal treatment. Direct bilirubin (D-bil) levels are used for BA screening. In this study, we aimed to determine the sensitivity and specificity of elevated D-bil and the direct-to-total bilirubin (D/T) ratio for BA detection in high-risk infants. METHODS: This retrospective, cross-sectional study was conducted in a tertiary medical center in Taiwan. Infants indicated for total bilirubin and D-bil measurements before age 60 days were included. The first bilirubin assessment was considered the test point. BA diagnosis was based on International Classification of Diseases, Ninth and Tenth Revision, codes 751.61 and Q44.0 to Q44.3, respectively. RESULTS: Between January 2009 and December 2016, 4468 infants were enrolled, including 38 with BA. Among infants aged 3 to 60 days, a sensitivity of 100% (95% confidence interval, 90.3-100.0) was found for D-bil ≥1.0 mg/dL and either D-bil ≥1.0 mg/dL or D/T ratio ≥20%. However, D-bil ≥1.0 mg/dL had higher specificity (77.3% [76.0-78.5] vs 68.3% [66.8-69.7], respectively). In newborns aged <3 days, D-bil ≥0.5 mg/dL was considered a positive result, with a sensitivity of 50%. D-bil >0.45 mg/dL was a better cutoff point in receiver operating characteristic analysis, with a sensitivity and specificity of 100% (95% CI: 15.8-100) and 15.4% (95% CI, 11.8-19.7), respectively. CONCLUSIONS: D-bil ≥1.0 mg/dL was better for BA detection than the D/T ratio in infants aged 3 to 60 days. For newborns aged <3 days, a more definitive cutoff point is required.


Assuntos
Atresia Biliar , Atresia Biliar/diagnóstico , Bilirrubina , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Testes de Função Hepática , Estudos Retrospectivos
9.
Front Cell Infect Microbiol ; 12: 864933, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493732

RESUMO

Objective: The longitudinal effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the liver are unknown. This study aimed to characterize dynamic changes in liver function test abnormalities in patients with COVID-19 at the acute phase and recovery phase. Methods: A prospective cohort study involved patients with COVID-19 who were admitted to Shenzhen Third People's Hospital between January 11, 2020, and April 27, 2020. Patients underwent liver function tests at hospitalization and at the outpatient visit at the 1-month, 3-month, 6-month, and 12-month follow-ups. Results: Among 461 patients, 28.4% of patients had any kind of liver function tests abnormality at admission, manifested as elevated ALT (13.0%), AST (17.6%), and GGT (15.8%) levels. The trajectory analysis indicated a marked improvement in liver function after discharge, with any kind of liver function test abnormalities of 25.1% at 1 month, 13.2% at 3 months, 16.7% at 6 months, and 13.2% at 12 months after discharge. Persistent liver function abnormalities were observed in patients with pre-existing conditions during follow-up. A significantly higher prevalence of ultrasound determined fatty liver disease was found in those patients with more frequent LFT abnormalities at follow-up. Conclusion: In this study of patients with COVID-19, liver damage in COVID-19 was usually temporary and could return to normal at the end of the 12-month follow-up.


Assuntos
COVID-19 , Hepatopatias , Assistência ao Convalescente , Humanos , Testes de Função Hepática , Alta do Paciente , Estudos Prospectivos , SARS-CoV-2
10.
Am J Otolaryngol ; 43(3): 103456, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35417838

RESUMO

OBJECTIVES: While jaundice is frequently described in the sclera and skin, there are few reports of true vocal fold jaundice in patients with high bilirubin, and no reports by otolaryngologists in the literature. Here we describe a case of a patient with bilateral true vocal fold jaundice and discuss the potential pathogenesis and implications of this finding. METHODS: A 29-year-old man with history of Dubin-Johnson Syndrome presented with cough and difficulty breathing and was incidentally found to have persistent yellow discoloration of the true vocal folds bilaterally. RESULTS: Videolaryngoscopic exam demonstrated bilateral true vocal fold yellow discoloration with sparing of nearby laryngeal structures on initial presentation and follow-up exam. Direct and total bilirubin levels were found to be elevated. CONCLUSION: A patient with benign Dubin-Johnson Syndrome and elevated total and direct bilirubin was incidentally found to have bilateral vocal fold jaundice. Jaundice and the presence of bilirubin do not appear to cause harm to the function or health of the true vocal folds and may be related to the high concentration of elastin present in the true vocal folds.


Assuntos
Icterícia Idiopática Crônica , Icterícia , Adulto , Bilirrubina , Humanos , Icterícia/diagnóstico , Icterícia/etiologia , Icterícia/patologia , Icterícia Idiopática Crônica/complicações , Icterícia Idiopática Crônica/patologia , Testes de Função Hepática , Masculino , Prega Vocal/patologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-35487590

RESUMO

OBJECTIVE: If non-invasive markers of liver fibrosis were recorded frequently enough in clinical practice, it might be feasible to use them for opportunistic community screening for liver disease. We aimed to determine their current pattern of usage in the national primary care population in Wales. DESIGN: Using the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University (2000-2017), we quantified the frequency of common liver blood tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count and albumin) used in fibrosis marker algorithms. We examined measurement variation by age and sex. RESULTS: During the 18-year study period, there were 2 145 178 adult patients with at least one blood test available for analysis. Over the study period, the percentage of SAIL patients receiving an ALT test in each year increased from 2% to 33%, with platelet count and albumin measurement increasing by a similar factor. AST testing, although initially rising, had decreased to 1% by the end of the study. AST and ALT values varied by age and sex, particularly in males with the upper normal range of ALT values decreasing rapidly from 90 U/L at age 30 to 45 U/L by age 80. CONCLUSION: The reduction in AST testing to only 1% of the adult population limits the use of many non-invasive liver marker algorithms. To enable widespread screening, alternative algorithms for liver fibrosis that do not depend on AST should be developed. Liver fibrosis markers should be modified to include age-specific and sex-specific normal ranges.


Assuntos
Albuminas , Cirrose Hepática , Adulto , Idoso de 80 Anos ou mais , Biomarcadores , Feminino , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , País de Gales/epidemiologia
12.
PLoS One ; 17(4): e0267124, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35482741

RESUMO

BACKGROUND: Thrombocytosis is often an incidental finding in primary care with a range of causes. Despite evidence of a strong association between thrombocytosis and malignancy, guidelines for investigating thrombocytosis in the absence of red flag symptoms remain unclear. A novel automated system of laboratory analysis, intelligent Liver Function Testing (iLFT), launched in Tayside in 2018 and has identified a patient group with thrombocytosis and abnormal liver test (LFT) results. This study analysed the outcome of these patients and investigated the use of thrombocytosis combined with LFTs in predicting risk of cancer. METHODS AND FINDINGS: Between August 2018 and August 2020, 6792 patients underwent iLFT, with 246 found to have both thrombocytosis and at least one abnormal LFT. A random case-matched control group of 492 iLFT patients with normal platelet count and at least one abnormal LFT was created. 7.7% (95% CI 4.7-11.8%) of patients with thrombocytosis had cancer compared to 2.0% (1.0-3.7%) of controls. Patients <40 years or with pre-existing causes of thrombocytosis were then excluded. Subsequent analysis revealed a 10.8% (6.6-16.3%) incidence of cancer in thrombocytosis patients (n = 176) compared to 2.5% (1.2-4.6%, p = 0.00014) in patients with normal platelet count (PLT) (n = 398). When thrombocytosis is combined with elevated alkaline phosphatase (ALP), there is a positive predictive value (PPV) of 20% for cancer. These rules were subsequently applied to a validation cohort of 71,652 patients, of whom 458 had thrombocytosis and elevated ALP. There was a 30.6% cancer incidence, confirming the strong predictive value of the combined test of PLT and ALP. CONCLUSIONS: These findings suggest a substantial increased risk of cancer in patients with thrombocytosis and raised ALP. This could be developed as an adjunct to current investigation algorithms, highlighting high-risk patients and prompting further investigation (such as computed tomography scans) where indicated.


Assuntos
Hepatopatias , Neoplasias , Trombocitose , Humanos , Hepatopatias/complicações , Testes de Função Hepática , Neoplasias/complicações , Neoplasias/epidemiologia , Trombocitose/complicações
13.
Updates Surg ; 74(3): 937-944, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35415799

RESUMO

Liver function tests help in the follow-up of postoperative patients with iatrogenic bile duct injury. There is not clear evidence regarding their predictive role on anastomosis dysfunction. We describe our experience with postoperative liver function tests and a predictive model of long-term patency after repair. This is retrospective cohort study of patients with bilioenteric anastomosis for bile duct injury and their long-term follow-up. A binomial logistic regression model was performed to ascertain the effects of the grade of bile duct injury and liver function test in the postoperative period. A total of 329 patients were considered for the analysis. In the logistic regression model two predictor variables were statistically significant for anastomosis stenosis: type of bilioenteric anastomosis and alkaline phosphatase levels. A ROC curve analysis was made for alkaline phosphatase with an area under the curve of 0.758 (95% CI 0.67-0.84). A threshold of 323 mg/dL was established (OR 6.0, 95% CI 2.60-13.83) with a sensitivity of 75%, specificity of 67%, PPV of 20%, NPV of 96%, PLR of 2.27 and NLR of 0.37. Increased alkaline phosphatase (above 323 mg/dL) after the fourth operative week was found to be a predictor of long-term dysfunction.


Assuntos
Fosfatase Alcalina , Doenças dos Ductos Biliares , Anastomose Cirúrgica/efeitos adversos , Doenças dos Ductos Biliares/cirurgia , Ductos Biliares/lesões , Ductos Biliares/cirurgia , Humanos , Testes de Função Hepática , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos
14.
BMJ Open ; 12(3): e055216, 2022 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-35354618

RESUMO

OBJECTIVES: To determine (1) if liver function tests (LFTs) are ordered in the emergency department (ED) in patients with suspected acute decompensated heart failure (ADHF) and (2) if the pattern of LFT abnormalities are meaningfully associated with a discharge diagnosis of ADHF among patients for whom these tests were ordered. SETTING: We conducted a single-centre retrospective cohort study of patients with suspected ADHF who were seen in an academic tertiary ED using electronic medical records. PARTICIPANTS: All ED patients admitted with suspected ADHF from January 2017 to May 2018, defined as any patient who had a brain natriuretic peptide (BNP) ordered. PRIMARY OUTCOME: The primary outcome was ADHF diagnosis at discharge. RESULTS: In 5323 ED patients with suspected ADHF, 60% (n=3184) had LFTs ordered; 34.6% were abnormal. Men comprised 56% of patients with abnormal LFTs and the average age was 67 years. The odds of a final diagnosis of ADHF in the univariate analysis was 59% higher in patients with abnormal LFTs (OR=1.59, (95% CI 1.35 to 1.87) p<0.001) and remained significant though attenuated after adjusting for BNP, race and ethnicity and age (ORadj=1.31 (95% CI 1.09 to 1.57), p=0.004). Likelihood ratios for abnormal and normal LFTs were 1.2 (95% CI 1.21 to 1.28) and 0.76 (95% CI 0.68 to 0.84), respectively. CONCLUSIONS: A significant proportion (40%) of patients with suspected ADHF was missing LFTs in their ED workup. Among patients with LFTs, abnormal LFTs are associated with discharge diagnosis of ADHF after accounting for potential confounders, but their diagnostic value was relatively low. Future prospective studies are warranted to explore the role of LFTs in the workup of ADHF.


Assuntos
Insuficiência Cardíaca , Idoso , Serviço Hospitalar de Emergência , Humanos , Fígado , Testes de Função Hepática , Masculino , Estudos Retrospectivos
15.
Toxins (Basel) ; 14(3)2022 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-35324659

RESUMO

The assessment of aflatoxin B1 (AFB1) exposure using isotope-dilution liquid chromatography-mass spectrometry (LCMS) of AFB1-lysine adducts in human serum albumin (HSA) has proven to be a highly productive strategy for the biomonitoring of AFB1 exposure. To compare samples across different individuals and settings, the conventional practice has involved the normalization of raw AFB1-lysine adduct concentrations (e.g., pg/mL serum or plasma) to the total circulating HSA concentration (e.g., pg/mg HSA). It is hypothesized that this practice corrects for technical error, between-person variance in HSA synthesis or AFB1 metabolism, and other factors. However, the validity of this hypothesis has been largely unexamined by empirical analysis. The objective of this work was to test the concept that HSA normalization of AFB1-lysine adduct concentrations effectively adjusts for biological and technical variance and improves AFB1 internal dose estimates. Using data from AFB1-lysine and HSA measurements in 763 subjects, in combination with regression and Monte Carlo simulation techniques, we found that HSA accounts for essentially none of the between-person variance in HSA-normalized (R2 = 0.04) or raw AFB1-lysine measurements (R2 = 0.0001), and that HSA normalization of AFB1-lysine levels with empirical HSA values does not reduce measurement error any better than does the use of simulated data (n = 20,000). These findings were robust across diverse populations (Guatemala, China, Chile), AFB1 exposures (105 range), HSA assays (dye-binding and immunoassay), and disease states (healthy, gallstones, and gallbladder cancer). HSA normalization results in arithmetic transformation with the addition of technical error from the measurement of HSA. Combined with the added analysis time, cost, and sample consumption, these results suggest that it may be prudent to abandon the practice of normalizing adducts to HSA concentration when measuring any HSA adducts-not only AFB1-lys adducts-when using LCMS in serum/plasma.


Assuntos
Aflatoxina B1 , Lisina , Aflatoxina B1/análise , Biomarcadores , Humanos , Testes de Função Hepática , Albumina Sérica/metabolismo
17.
Toxicol Ind Health ; 38(1): 29-40, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35100896

RESUMO

The cement industry is one of the main world industries with exposure to a wide range of hazardous chemical and physical occupational agents that may increase free radicals and lead to disease. The aim of this study was to evaluate oxidative stress, biochemical markers, and psychological parameters among cement plant workers. In this cross-sectional study, 40 workers exposed to cement and 40 office employees were selected as the exposed and non-exposed groups, respectively. Exposure to cement dust, silica, and noise were, respectively, assessed using the NIOSH 0600, NIOSH 7601, and noise dosimetry methods. Oxidative stress biomarkers including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), and biochemical parameters were measured in the serum of all participants. Depression, anxiety, and stress were assessed by the Depression Anxiety Stress Scales (DASS-21) questionnaire. The results demonstrated that the level of MDA as a marker of oxidative stress was significantly higher in the exposed group. The level of antioxidant enzymes including SOD and CAT were also significantly higher in the exposed group. The level of TAC was lower in the exposed group, but the difference was not statistically significant. The levels of alkaline phosphatase (ALP), aspartate transaminase (AST), and the scores of depression and stress were also significantly higher in the exposed group. According to our results, noise, cement dust, and silica exposure were associated with oxidative stress, and this may be one of the mechanisms in which they adversely affect liver function and mental health.


Assuntos
Biomarcadores/sangue , Materiais de Construção , Transtornos Mentais/diagnóstico , Exposição Ocupacional , Estresse Oxidativo , Adulto , Estudos Transversais , Poeira , Humanos , Indústrias , Irã (Geográfico) , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Ruído Ocupacional , Dióxido de Silício
18.
J Med Chem ; 65(4): 3332-3342, 2022 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-35133835

RESUMO

The blood levels of microRNA-122 (miR-122) is associated with the severity of cardiovascular disorders, and targeting it with efficient and safer miR inhibitors could be a promising approach. Here, we report the generation of a γ-peptide nucleic acid (γPNA)-based miR-122 inhibitor (γP-122-I) that rescues vascular endothelial dysfunction in mice fed a high-fat diet. We synthesized diethylene glycol-containing γP-122-I and found that its systemic administration counteracted high-fat diet (HFD)-feeding-associated increase in blood and aortic miR-122 levels, impaired endothelial function, and reduced glycemic control. A comprehensive safety analysis established that γP-122-I affects neither the complete blood count nor biochemical tests of liver and kidney functions during acute exposure. In addition, long-term exposure to γP-122-I did not change the overall adiposity, or histology of the kidney, liver, and heart. Thus, γP-122-I rescues endothelial dysfunction without any evidence of toxicity in vivo and demonstrates the suitability of γPNA technology in generating efficient and safer miR inhibitors.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Endotélio Vascular/efeitos dos fármacos , MicroRNAs/antagonistas & inibidores , Ácidos Nucleicos Peptídicos/farmacologia , Adiposidade/efeitos dos fármacos , Animais , Contagem de Células Sanguíneas , Glicemia/metabolismo , Peso Corporal , Dieta Hiperlipídica , Desenho de Fármacos , Testes de Função Renal , Testes de Função Hepática , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/sangue , Músculo Liso Vascular/efeitos dos fármacos , Ácidos Nucleicos Peptídicos/efeitos adversos
19.
Vet Rec ; 190(10): e1381, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35102558

RESUMO

BACKGROUND: Diagnosing a congenital portosystemic shunt (cPSS) in dogs can be challenging. The current study aims to report diagnostic performance of fasting ammonia (FA), preprandial, postprandial and paired serum bile acids (SBA) and abdominal ultrasound (aUS) in dogs suspected of having a cPSS. METHODS: Medical records of dogs suspected of having a cPSS at initial presentation were retrospectively reviewed. RESULTS: In total, 192 dogs suspected of cPSS were included: a cPSS was confirmed in 147 dogs and excluded in 45 dogs. FA had the best combined sensitivity and specificity (77.4 and 93.3%, respectively) to diagnose cPSS. The sensitivity and negative predictive value were 100.0% for paired SBA, making paired SBA the best test to exclude cPSS in this population. Sensitivity and specificity of aUS were 80.8 and 90.0%, respectively. CONCLUSIONS: In dogs with clinical signs compatible with cPSS, elevated FA is suggestive of cPSS, whereas normal paired SBA makes the presence of a cPSS unlikely. Although aUS is a useful tool to diagnose cPSS, additional imaging is required to visualize cPSS in almost 20% of cases. Furthermore, the localisation of cPSS can be misdiagnosed, especially in case of extrahepatic cPSS that do not insert into the prehepatic vena cava.


Assuntos
Doenças do Cão , Derivação Portossistêmica Transjugular Intra-Hepática , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Testes de Função Hepática , Sistema Porta/anormalidades , Derivação Portossistêmica Transjugular Intra-Hepática/veterinária , Estudos Retrospectivos , Ultrassonografia/veterinária
20.
Rev Esp Enferm Dig ; 114(4): 191-194, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35187942

RESUMO

In the last two decades, several non-invasive liver fibrosis tests have been introduced in clinical practice and transformed the investigation of patients with non-alcoholic fatty liver disease. In this editorial, we summarize the role of such tests in the management of patients with non-alcoholic fatty liver disease, focusing on their strengths and pitfalls in different clinical settings and scenarios.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Biomarcadores , Biópsia , Fibrose , Humanos , Fígado/patologia , Cirrose Hepática/patologia , Testes de Função Hepática , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia
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