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Hepatitis C
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Rebecca Pierce-Williams, Neil Silverman, Raja Dhanekula, Jonathan M. Fenkel, Danielle Tholey
Any woman who tests positive for anti-HCV antibody should have HCV RNA quantitative evaluation (via PCR) performed. An HCV genotype is also recommended, as treatment is tailored to the genotype and subtype. She should be screened for co-infection with HIV (HIV antibody) and hepatitis A and B (hepatitis B surface antigen), as well as other STIs. Patients with chronic HCV infection are at high risk of liver failure if they are infected with other forms of viral hepatitis. Screening for immunity to hepatitis A (hepatitis A total antibody) and hepatitis B (hepatitis B surface antibody), and vaccinating if non-immune, is also recommended. Blood tests to measure liver function include aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, platelet count and international normalized ratio (INR). Imaging of the liver to evaluate for cirrhosis can be completed with ultrasound during pregnancy, or liver elastography preconception or postpartum. Patients with cirrhosis should receive the pneumococcal vaccination [5]. A hepatology referral is recommended for assessment of disease severity, counseling on risk reduction behaviors, and treatment.
Liver Function Tests and Physiological Features of Liver Failure
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Aminotransferases (transaminases) are enzymes present in the hepatocytes which leak out into the circulation with liver cell damage. The two enzymes measured are: Aspartate aminotransferase (AST) is a mitochondrial (80%) enzyme. As high blood levels are seen in hepatic necrosis, myocardial infarction, congestive heart failure and muscle injury, it is not specific for liver disease.Alanine aminotransferase (ALT) is a cytosol enzyme which is more specific to the liver. A rise in ALT occurs only in liver disease.
Acetaminophen, Salicylates, and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
The Rumack–Mathew treatment nomogram is the primary tool used to guide treatment after acute ingestion of APAP (Table 18.1). Although essential in the management of APAP exposure, its apparent margins limit the nomogram’s clinical use. Consequently, a thorough understanding of the guidelines in treatment management is of importance. Acute APAP poisoning is generally regarded as a single ingestion of APAP over less than a 4 h time period. Regardless of whether APAP exposure occurs as a result of a single O.D. or after repeated supratherapeutic ingestion, however, the progression of acetaminophen poisoning is categorized into four stages: 1. preclinical toxic effects (a normal serum alanine aminotransferase concentration); 2. hepatic injury (an elevated alanine aminotransferase concentration); 3. hepatic failure (hepatic injury with hepatic encephalopathy; and 4. recovery. Also, the Rumack–Mathew nomogram can only be used to determine the need for N-acetyl cysteine (NAC) treatment after an acute ingestion; thus, all other APAP ingestions are not applicable to the nomogram. Typically, a toxic dose is about 150 mg/kg, or 15 g in an otherwise normal 70 kg adult, corresponding to a potentially toxic level (Stage 1, Table 18.1) on the nomogram.
Evaluation of non-clinical toxicity of extract and vouacapans from fruits of Pterodon pubescens Benth
Published in Drug and Chemical Toxicology, 2022
Vanessa Helena da Silva Souza, Rosanna Tarkany Basting, Ilza Maria de Oliveira Sousa, Núbia de Cássia Almeida Queiroz, João Ernesto de Carvalho, Mary Ann Foglio
For the biochemical parameters analyzed, some values were statistically different when compared to the vehicle-treated group, especially for the group treated with the highest dose (300 mg/Kg) as presented in Table 4. Levels of AST and ALT parameters were significantly increased, where ALT presented values outside the standard reference adopted. Alanine aminotransferase (ALT) is an enzyme that catalyzes the reversible transfer reaction of amino groups from one amino acid to β-ketoglutarate, forming keto acid and glutamic acid. This enzyme is found in high concentrations in hepatocyte cytoplasm and mitochondria, but also in skeletal, cardiac muscle, kidneys, pancreas, and red blood cells. Although this enzyme is a marker of liver damage, when any of these tissues are damaged, ALT is released into the blood increasing the concentration (Evans 2009). Taken the values from hematological and biochemical analyses, the highest dose group (VDFI mixture 300 mg/Kg) has results that may be indicative of toxicity and further toxicological studies should be performed.
Safety evaluation of long-term temperature controlled whole-body thermal treatment in female Aachen minipig
Published in International Journal of Hyperthermia, 2021
Marcia Weber Carneiro, Luigi Brancato, Britta Wylleman, Eke van Zwol, Liesbet Conings, Peter Vueghs, Ivana Gorbaslieva, Johan Van den Bossche, Oleg Rudenko, Michel Janicot, John-Paul Bogers
Liver function tests, also known as liver chemistry, help determine the health of the liver by measuring the blood levels of liver enzymes (amongst others). Detection of liver enzymes in the blood is often part of an initial screening for liver disease[44], in addition the surgical transient implantation of liver temperature sensors pushed us to carefully monitor liver functions. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are both normally found inside liver cells. However, when the liver is damaged or inflamed, ALT/AST can be released into the bloodstream, causing serum levels to rise. The liver function test demonstrated a delayed and limited increase (up to 3-fold) in both AST and ALT serum levels suggesting transient and mild stress liver response to WBTT (Figure 6).
Effects of silymarin and mesenchymal stem cells on hematological and some biochemical changes induced by gamma radiation in albino rats
Published in International Journal of Radiation Biology, 2020
A. Z. Mahmoud, H. A. Ibrahim, M. R. El-Sawi, M. N. Habza
On the other hand, natural antioxidants play a major role by continuously inactivating ROS, to keep only a small amount necessary to maintain normal cell function (Oyagbemi et al. 2010). Silymarin exhibited improvement in hematological parameters after irradiation which probably due to antioxidant properties enabling regeneration of cells, reducing oxidative stress and protection against apoptosis (Gharagozloo et al. 2013). Also, the active component of silymarin acting majorly on hematological and biochemical experiments is silibinin which exhibits anti-hematological disorders effects via inhibiting oxidative stress or inducing differentiation and growth arrest in these disease model cell lines. In hematological disorders, silibinin also can suppress the activation of some pathways, such as NPM-ALK (Nucleophosmin-anaplastic lymphoma kinase), and then suppress its key downstream pSTAT3 (Zou et al. 2017). Also, silibinin increases ribosomal protein synthesis by means of stimulating RNA polymerase. Silibinin inhibits elevated intra-hepatic messenger RNA (mRNA) levels of IL-2, IL-4, IFN-γ and TNF-α significantly. It also reduces the alanine aminotransferase and aspartate aminotransferase levels and suppressed the apoptosis in hepatocytes (Karimi et al. 2011).