Liver disorders

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  • Non-alcoholic fatty liver disease (NAFLD), like hepatitis C and HIV, is a disease of our generation. Mostly unrecognized prior to 1980 and seldom taken seriously until the past few years, NAFLD has seemingly been thrust upon us unexpectantly like an orphaned child left at our clinical bedside. In fact, NAFLD was conceived during the industrial revolution, which caused food to be processed differently, provided that food more abundantly and made physical work less demanding.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: The association of complex liver disorders with HBV genotypes prevalent in Pakistan

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  • Tham khảo tài liệu 'báo cáo hóa học: " the association of complex liver disorders with hbv genotypes prevalent in pakistan"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Deferasirox is a promising oral iron-chelating agent. Single daily doses of 20 or 30 mg deferasirox produced reductions in liver iron concentration comparable to desferoxamine in chronically transfused adult and pediatric patients. Deferasirox produces some elevations in liver enzymes and slight but persistent increases in serum creatinine, without apparent clinical consequence. Other toxicities are similar to those of desferoxamine. Its toxicity profile is acceptable, although long-term effects are still being evaluated.

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  • Gastrointestinal and Liver Disease Up to 90% of pregnant women experience nausea and vomiting during the first trimester of pregnancy. Occasionally, hyperemesis gravidarum requires hospitalization to prevent dehydration, and sometimes parenteral nutrition is required. Crohn's disease may be associated with exacerbations in the second and third trimesters. Ulcerative colitis is associated with disease exacerbations in the first trimester and during the early postpartum period.

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  • Table 76-1 Common Characteristics of Anorexia Nervosa and Bulimia Nervosa Anorexia Nervosaa Bulimia Nervosa Clinical Characteristics Onset Mid-adolescence Late adolescence/early adulthood Female:male 10:1 10:1 Lifetime prevalence 1% 1–3% in women Weight Markedly decreased Usually normal Menstruation Absent Usually normal Binge eating 25–50% Required diagnosis for Mortality 5% per decade Low Physical and Laboratory Findingsa Skin/extremities Lanugo Acrocyanosis Edema Cardiovascular Bradycardia Hypotension Gastrointestinal Salivary enlargement glan...

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  • The central mechanism of DIC is the uncontrolled generation of thrombin by exposure of the blood to pathologic levels of tissue factor (Fig. 110-3). Simultaneous suppression of physiologic anticoagulant mechanisms and abnormal fibrinolysis further accelerate the process. Together these abnormalities contribute to systemic fibrin deposition in small and mid-sized vessels. The duration and intensity of the fibrin deposition can compromise the blood supply of many organs, especially the lung, kidney, liver, and brain, with consequent organ failure.

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  • Differential Diagnosis The differential diagnosis between DIC and severe liver disease is challenging and requires serial measurements of the laboratory parameters of DIC. Patients with severe liver disease are at risk for bleeding and manifest laboratory features including thrombocytopenia (due to platelet sequestration, portal hypertension, or hypersplenism), decreased synthesis of coagulation factors and natural anticoagulants, and elevated levels of FDP due to reduced hepatic clearance. However, in contrast to DIC, these laboratory parameters in liver disease do not change rapidly.

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  • Coagulation Disorders Associated with Liver Failure The liver is central to hemostasis because it is the site of synthesis and clearance of most procoagulant and natural anticoagulant proteins and of essential components of the fibrinolytic system. Liver failure is associated with a high risk of bleeding due to deficient synthesis of procoagulant factors and enhanced fibrinolysis. Thrombocytopenia is common in patients with liver disease and may be due to congestive splenomegaly (hypersplenism), or immune-mediated shortened platelet life span (primary biliary cirrhosis).

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  • Treatment with FFP is the most effective way to correct hemostasis in patients with liver failure. Infusion of FFP (5–10 mL/kg; each bag contains ~200 mL) is sufficient to ensure 10–20% of normal levels of clotting factors but not correction of PT or aPTT. Even high doses of FFP (20 mL/kg) do not correct the clotting times in all patients.

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  • Of the four heart valves, the mitral valve is the only valve that has a distinguishable annulus. However, the presence of a fibrous annular structure is variable and discontinuous. The firmest site of support for the mitral valve is the region of fibrous continuity between the aortic and mitral valves, the extent of which is delineated by the right and left fibrous trigones (Fig. 2). Nevertheless, for surgical purposes, the annulus is considered the area of attachment of the valve leaflets to the atrial muscle. The annulus is a functional component of the mitral valve.

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  • The liver is the most important organ in which drugs are structurally altered. Some of the resulting metabolites may be biologically inactive, some active and some toxic (see Chapter 7).The liver is exposed to drugs in higher concentrations than are most organs because most are administered orally and are absorbed from the gastrointestinal tract.Thus the whole dose must pass through the liver to reach the systemic circulation.

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  • This chapter introduces the history, definitional and semantic issues, spectrum and general importance of non-alcoholic fatty liver diseases (NAFLD). Nonalcoholic steatohepatitis (NASH) is a form of metabolic liver disease in which fatty change (steatosis) is associated with lobular inflammation, hepatocyte injury and/or hepatic fibrosis. It comprises a pathogenic link in the chain of NAFLD that extends from bland steatosis to some cases of ‘cryptogenic cirrhosis’.

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  • Therapeutic immunosuppression has very broad applications in clinical medicine, ranging from prevention and treatment of organ and bone marrow transplant rejection, management of various autoimmune disorders (e.g., rheumatoid arthritis), skin diseases, allergies and asthma. Whereas traditionally only a small repertoire of immunosuppressive agents was available for clinical use, recent discoveries have significantly increased the number of approved agents, resulting in numerous trials to further evaluate their potential.

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  • However, cellular uptake of aglycones has been suggested to occur in their native form by passive diffusion. Absorbed polyphenols can directly undergo phase II metabolism as phenolic structures are generally unfavorable substrates to the cytochrome P450s (phase I metabolism). At nutritional doses, almost all polyphenols are conjugated to form O- glucuronides, sulfate esters and O-methyl ethers, by glucuronidation, sulfation and methylation, in the gut mucosa and later in the liver or kidney.

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  • Introduction: Acetaminophen (paracetamol, APAP) ( Figure 3.1) has been being used as an excellent analgesic-antipyretic for a long time, and is included as an ingredient in many over-the-counter drugs of analgesics and cold drugs. However, when APAP is ingested in large amounts, it was reported to cause liver disorders [1]. For analysis of APAP, HPLC [2–18], LC/MS [19], LC/MS/MS [20], GC [21], GC/MS [22, 23] and capillary electrophoresis [24, 25] are being used. Among the methods, HPLC is most popular for its analysis.

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  • In ancient Greece, people would journey to an oracle, or fortune teller, to discover what the future held. The oracle would kill an animal, perhaps a goat or a sheep, to examine the creature’s liver. A dark red liver that was smooth was a good sign. A pale liver that was bumpy foretold bad times ahead. The liver has long been linked to human courage and strength. The earliest doctors thought that the liver was one of the three main organs of the body. The others were the heart and the brain. Around a.d. 200, the famous Roman doctor Galen declared the liver to be the most important human...

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  • Ung thư này hiếm. Ở đàn ông, thường thường thì bệnh bắt đầu bằng vú sưng lớn (gynecomastia), và differentail diagnosis (1) đầu tiên thường là đi tìm có phải do thuốc gây nên hay không (hồi xưa hay dùng Digoxin, thuốc này có khi gây gynecomastia; có khi do spirinolactone, cimetidine; mechanism of action là anti estrogen), (2) rồi đến hormonal vì vú lớn lên là do hoặc tăng estrogen (adrenal tumor, testicular ca: choriocarcinoma) hay giảm testosterone (Klinerfelter's, second testicular failre; hiếm: orchitis).

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  • There have been great strides in using positional cloning to successfully identify the underlying basis of many Mendelian disorders of children. The severity of even these disorders, however, is greatly affected by genetic modifiers and gene- environment interactions. The molecular pathogenesis of many more complex disorders remains unexplained due to the often complex genetic, epigenetic and environmental interactions involved in their etiology. However, there is reason for optimism.

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  • You know that living with Parkinson’s means that some days will be better than others. A few practi- cal tips may help your kids cope with the inevitable ups and downs and come to understand that the effects of PD are not always constant. Allow All Feelings Lisa Lieberman brings a unique perspective to her work in dealing with family issues related to chronic illness. Her husband has MS and their son is autistic. “One of the tools for my journey is to allow all feelings,” she says. Old parenting wisdom says allow feelings, limit actions.

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