Hepatic Medicine : Evidence and Research最新文献

Polycystic liver disease (PLD) is a clinical condition characterized by the presence of more than 10 cysts in the liver. It is a rare disease Of genetic etiology that presents as an isolated disease or associated with polycystic kidney disease. Ductal plate malformation, ciliary dysfunction, and changes in cell signaling are the main factors involved in its pathogenesis. Most patients with PLD are asymptomatic, but in 2-5% of cases the disease has disabling symptoms and a significant reduction in quality of life. The diagnosis is based on family history of hepatic and/or renal polycystic disease, clinical manifestations, patient age, and polycystic liver phenotype shown on imaging examinations. PLD treatment has evolved considerably in the last decades. Somatostatin analogues hold promise in controlling disease progression, but liver transplantation remains a unique curative treatment modality.

Background: Eighty percent of Ethiopians use traditional medicine, one of which is the leaf of Lippea adoensis.

Objective: To investigate subacute toxicity of aqueous extracts of L. adoensis leaves on the liver and kidney and biochemical parameters in Swiss albino mice.

Methods: LD₅₀ was assessed with nine experimental groups and one control group of adult female Swiss albino mice (five in each group). In the subacute study, 40 mice of both sexes were randomly divided into four groups of ten mice (both sexes) per group. Group I served as controls and received distilled water and feed only. Groups II-IV were used as treatment groups. They received calculated doses of aqueous leaf extracts orally at doses of 500 mg/kg, 1000 mg/kg, and 2000 mg/kg body weight, respectively.

Results: Since 80% of deaths occurred at the 10,000 mg/kg body-weight dose in this experiment, LD₅₀ was considered to be <10,000 mg/kg. In the subacute test, general signs of toxicity like hypoactivity, piloerection, lethargy, and a single episode of convulsion were observed at the 2000 mg/kg dose. Beginning from the third week of administration, both male and female mice receiving 500 mg/kg and 2000 mg/kg and all treatment groups in the fourth week showed significant (P<0.05) weight loss compared to controls. Biochemical parameters were found to increase in all groups treated with ethanolic leaf extracts. Several histopathological changes like congestion, hemorrhage, severe necrosis, and infiltration of inflammatory cells in both liver and kidney in the L. adoensis-treated rats were observed at all doses.

Conclusion: In the present study, the ethanolic leaf extracts of L. adoensis produced dose-dependent weight loss and histopathological and biochemical changes in Swiss albino mice.

Background: Despite Ethiopia's hepatitis endemic status with intermediate to hyperendemic level, there is no national strategy for monitoring, preventing, and controlling viral hepatitis. In order to advise community-based intervention programs, studies on the magnitude, determinant factors, and understanding of indigenous social organization are important. Thus, this study examined undiagnosed seroprevalence and associated factors for HBV and HCV infections among community members in Wolaita Zone, Southern Ethiopia.

Methods: A cross-sectional study was conducted on 320 individuals from randomly selected two woredas in the Wolaita Zone to determine the magnitude of HBV and HCV. Multistage sampling was used to select participants. Relevant clinical and sociodemographic data were collected using a structured questionnaire. One test strip technique was used for the screening of hepatitis B surface antigen and for antibodies against HCV. Both tests were confirmed by ELISA methods. The associated factors were assessed using bivariate and multivariate logistic regression analyses. P-values less than 0.05 were considered statistically significant.

Results: The seroprevalence for HBV infection was 6.6% (95% CI: 4.22%, 8.69%) using a one-step HBsAg test strip and 5.6% (95% CI: 3.47%, 8.58%) using confirmatory test (ELISA). The two tests had a very good agreement (K = 0.918; SE = 0.047; P < 0.001). The overall seroprevalence for HCV infection was 1.9% (95% CI: 0.9%, 3.0%). All four of the one-step HCV test strip positives were also positive by ELISA. One (0.3%) of the participants was co-infected with HBV and HCV. Hospital admission (AOR = 0.22; 95% CI = 0.5-0.95) and needle stick (AOR = 0.15; 95% CI = 0.07-0.72) were independently associated with HBV infections.

Conclusion: According to the current study, in Wolaita community, there is endemic to HBV at a higher-intermediate level and to HCV at a low level. It would be imperative to increase awareness of transmission modes and prevention of infection, as well as vaccination, in order to reduce the burden of both HBV and HCV.

Aim: To determine several clinical and laboratory features as well as the bacterial profile of spontaneous bacterial peritonitis (SBP) in 58 Vietnamese patients admitted to a single center due to liver cirrhosis.

Methods: We retrospectively analyzed bacteriological, clinical and laboratory characteristics of patients with SBP admitted to the Gastroenterology and Hepatology Center from July 2019 to July 2020.

Results: Out of a total 58 SBP patients, 41 (70.9%) had culture-negative neutrocytic ascites. The majority of patients experienced abdominal pain (93,1%) and large ascites (65,5%). Gram-negative bacteria formed the main pathogens (14/17). Escherichia coli (9/17) was the predominant cause followed by Burkholderia cepacia (2/17). Antibiotic sensitivity rate of E. coli for third generation cephalosporin was low but high for aminoglycoside and carbapenem antibiotics. The resistance of E. coli was significant against fluoroquinolones (100%). All 3 cases of gram-positive bacteria were sensitive to vancomycin.

Conclusion: Our study reported the bacteriological and clinical characteristics of patients with SBP and compared these findings between two groups: positive ascitic fluid culture and negative fluid culture. Ascitic fluid culture can guide for the right antibiotic choice since resistance to commonly prescribed antibiotics is common in SBP patients.

The hepatitis B virus (HBV) infection remains a global public health problem. This review presents updated recommendations for the optimal current treatment of choice with nucleos(t)ide analogues (NA). Current clinical practice guidelines on the management of chronic hepatitis B (CHB) by the Asian Pacific Association for the Study of the Liver, the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases have been considered. Patients with chronic HBV infection are at increased risk of liver disease progression to cirrhosis and hepatocellular carcinoma (HCC) development. The main goal of therapy is to improve survival preventing disease progression and HCC. The induction of long-term suppression of HBV replication represents the main endpoint of current treatment strategies, while hepatitis B surface antigen (HBsAg) loss is the optimal endpoint. The typical indication for treatment requires elevated HBV desoxyribonucleic acid (DNA), elevated alanine aminotransferase and/or at least moderate histological lesions, while all cirrhotic patients with detectable HBV DNA should be treated. The long-term administration of a potent NA with high barrier to resistance, ie, entecavir, tenofovir disoproxil fumarate or tenofovir alafenamide, represents the treatment of choice. However, HBsAg seroclearance is anecdotal with NA. Treated patients should be monitored for therapy response, adherence, risk of disease progression, and risk of HCC development. This review aims to assess the evolving trends on the potent NA and the new perspectives on finite therapy.