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Different Toxicity of Aristolochic Acids in Kidney and Liver

  Introduction Aristolochic acid (AAs) is a group of nitrophenanthrene compounds comprised of AAI, AAII, AAIII and AAIV, which are widely found in Aristolochia plants and used in herbal therapy and traditional Chinese medicine [1]. Consistent use of aristolochic acids- containing drugs could lead to aristolochic acid nephropathy and subsequent urinary tract tumors [2-4]. Active metabolites of AAs form adducts with DNA, inducing characteristic A-T transversion (A:T to T:A mutation) known as AA mutational signature [5]. In 2017, a study has analyzed AA mutational signature of several datasets and concluded that AAs and their derivatives were widely implicated in liver cancers in Taiwan and throughout Asia [6]. Ever since the paper published, there has been an intensive debate on whether the prevalence of AA signature mutation is high in HCC patients and if this mutation spectra is really correlate with traditional Chinese medicine consumption in Asia. Since no case report...

The Use of Sodium-Glucose Cotransporter 2 Inhibitors in Non-Alcoholic Fatty Liver Disease

  Opinion Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of progressive liver abnormalities from simple hepatic steatosis to non-alcoholic steatohepatitis (NASH) to advanced fibrosis, cirrhosis, and/or hepatocellular carcinoma [1]. Parallel to the rising burden of obesity and metabolic syndrome, NAFLD has emerged as the leading cause of chronic liver disease at an estimated global prevalence of 24% [2]. Besides its known clinical burden for liver-related morbidity and mortality, NAFLD is potentially linked with other extra-hepatic chronic diseases and may be considered a multisystem condition. Particularly, NAFLD increases the risk of type 2 diabetes, cardiovascular diseases, chronic kidney disease, and all-cause mortality [1]. Potential pathophysiologic mechanisms underlying the detrimental effects of NAFLD include hyperglycemia, systemic inflammation, and increased oxidative stress [3]. Sodiumglucose cotransporter 2 (SGLT2) inhibitors are a new class of ...

Post-COVID-19 GI Manifestations: Are We in for the “Long Haul”?

Abstract Post-COVID-19 gastrointestinal (GI) disease management remains a clinical challenge as the medical literature continues to evolve and expand. Reports of excess GI disease burden across the population, as well as prescribed use of pharmaceuticals for symptom relief, have proven “long-haul” GI disease is prevalent across the population. This article will help to summarize the current medical literature as it pertains to post-COVID-19 GI clinical presentations, dysbiosis, functional disorders and evidence of lasting liver and biliary injury implications. Increased awareness of the GI implications for this paradigm hopefully will lead to a better understanding of the pathophysiology, as well as natural history and potential therapeutic approaches. Read more about this article: https://lupinepublishers.com/gastroenterology-hepatology-journal/fulltext/post-covid-19-gi-manifestations-are-we-in-for-the-long-haul.ID.000158.php  Read more about Lupine Publishers Go...

Acute Upper Gastrointestinal Bleeding (UGIB) In A Resource Limited Setting Highly Endemic for Viral Hepatitis B: Which Etiologies for Which Real Clinical Practices?

  Abstract Aim : To determine the aetiologies of acute upper gastrointestinal bleeding (UGIB) in a setting highly endemic for hepatitis B and to describe actual clinical practices in a resource-limited setting. Patients and methods: This study was conducted in two parts. The first part was retrospective from January 1st 2010, to December 31st 2019 on the epidemiological profile of UGIB and the second was a prospective study from December 1st 2017 to May 31st 2018 to evaluate, in a blinded experiment, the actual clinical practices in front of an acute UGIB at the emergency units in Yaounde (Cameroon), and included: recognizing UGIB, assessing for severity, taking emergency measures and prescribing emergency Eosogastroduodenal endoscopy (EGDE). Results : During the retrospective period, 506 patients (prevalence of acute UGIB in the services 5.6%) were included of which 71.3% were men (sex ratio 2.5). The mean age was 49.9 +/- 8 years. Haematemesis was inaugural in 35...

Improvement of Liver Function by a Short-term Administration of Luseogliflozin in Patients with Type 2 Diabetes: A Single-arm Study and the Mini-literature Review

  Abstract Background : Non-alcoholic fatty liver disease is not simply the hepatic manifestation of obesity and diabetes but also linked to hepatocellular carcinoma. Yet, its effective treatment has not been established. In this study, we evaluated the effect of a short-term administration of luseogliflozin to patients with type 2 diabetes having non-alcohol fatty liver disease. Luseogliflozin is a unique sodium-glucose cotransporter 2 inhibitor which is metabolized in and excreted by the liver in addition to the kidney. Therefore, the drug might possess an additional effect on other agents of the same class which are exclusively metabolized in the kidney. Methods : Using alanine aminotransferase >20 IU/L as a diagnostic basis for non-alcoholic fatty liver disease, 19 patients, not taking alcohol, with type 2 diabetes (male/female 15/4, the median age 57 years) was treated with 2.5 mg luseogliflozin for 12 weeks. Results : Pre- and post-treatment median values...

Is there a utility of Nordin’s Index in the evaluation of osteoporosis in patients with post viral cirrhosis? Results of a pilot study in Cameroonians

  Abstract Background : Metabolic bone disorders are frequent in patients with cirrhosis. These two conditions are usually misdiagnosed in Sub-Saharan Africa before the onset of complications. A full evaluation of metabolic bone disorders in patients with liver cirrhosis is difficult in our milieu and osteodensitometry is rarely available. In this preliminary study, we sought to determine the necessity of a cost-effective method, the Nordin’s Index, in the evaluation of osteoporosis in patients with liver cirrhosis. Methods : This was a prospective cross-sectional study from January to May 2017 in Yaoundé. We compared the data of 19 patients (15 men, 4 women) with post viral liver cirrhosis and 17 controls (13 men, 4 women) paired with age, gender and body mass index (BMI). Data collected included vitamin D levels, serum and urine concentrations of calcium and phosphorus, Nordin’s Index and results of the bone mineral density using an x-ray absorptiometry sc...

Case of Application of Syrolimus in a Patient with Progressing Pultifocal Pepatic Nodular Hyperplasia

  Abstract Introduction: A case presented to the public demonstrates the possibility of treatment with Sirolimus in a patient with progressive multifocal liver Focal Nodular Hyperplasia (FNH) with progressive growth and a tendency to formation of liver function insufficiency after splenorenal shunt for portal hypertension. Material and Methods: Patient E. 08.03.2001 year of birth c Diagnosed with multifocal bilobar nodular liver hyperplasia after splenorenal bypass surgery for portal hypertension, established in 2018/ Sirolimus treatment was prescribed from 06.22.18 to the present. Conclusion: As a result of the treatment with Sirolimus, a normalization of the level of liver enzymes, bilirubin in the blood is noted. According to radiation methods, a reduction in liver size and FNH size is up to 30%. Read more about this article: https://lupinepublishers.com/gastroenterology-hepatology-journal/fulltext/case-of-application-of-syrolimus-in-a-patient-with-progres...