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Drug-Resistant Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Keertan Dheda, Aliasgar Esmail, Anzaan Dippenaar, Robin Warren, Jennifer Furin, Christoph Lange
Patients with significant chronic liver disease should not receive pyrazinamide. Ethionamide, prothionamide, and PAS can also be hepatotoxic while the fluoroquinolones are rarely implicated in hepatitis. Essentially, all second-line drugs may be used in chronic stable liver disease, but close monitoring of liver enzymes is mandatory and significant deterioration in liver function should trigger immediate withdrawal of the offending drug. The source of other causes of liver dysfunction, including viral hepatitis and alcohol consumption, should be addressed and treated to prevent further complications during treatment. A combination of four non-hepatotoxic drugs should ideally be used when formulating a regimen in patients with chronic liver dysfunction, including a fluoroquinolone, to ensure the efficacy of the regimen.207
Liver disorders
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
An acquired condition secondary to severe prenatal liver disease. Severe liver dysfunction, with liver transplantation usually required. Aggressive chelation and an antioxidant regimen can, rarely, avoid the need for liver transplantation. Diagnosis is most accurate by estimation of extrahepatic iron deposition, e.g. lip biopsy.
The Decision Process in the Laboratory Diagnosis and Management of Bleeding and Clotting Disorders
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Do multiple minor defects add their potential to result in bleeding or thrombosis? They often do in unanticipated ways. The history should clue you in to this problem. The patient may deny taking aspirin, but takes an antacid with aspirin. Over-the-counter medications are taken by patients without their realizing that they are taking medication that can affect bleeding. The patient with chronic alcoholism or hepatitis may have liver dysfunction to the degree that all the clotting factors, modulators, and protease inhibitors will be functionally or qualitatively abnormal, affecting all aspects of coagulation. Screening tests such as PT and aPTT do not always become more prolonged with multiple deficiencies. Factor assays for specific vitamin K versus non-vitamin K-dependent factors can be helpful in determining single or multiple deficiencies. The patient’s diet may also contribute to a lack of vitamins and calories, which can have an effect on total protein and albumin as well as detoxifying liver enzyme systems.
Diagnostic and prognostic value of the AST/ALT ratio in patients with sepsis and septic shock
Published in Scandinavian Journal of Gastroenterology, 2023
Tobias Schupp, Kathrin Weidner, Jonas Rusnak, Schanas Jawhar, Jan Forner, Floriana Dulatahu, Lea Marie Brück, Ursula Hoffmann, Thomas Bertsch, Christel Weiß, Ibrahim Akin, Michael Behnes
As the largest gland in the human body, the liver plays a cornerstone role in metabolic, immunological homeostasis and host defense activity and a central role in the pathogenesis of sepsis and septic shock [8]. In septic shock, the liver contributes to host defense and tissue repair by crosstalk between hepatic and blood cells, leading to increased synthesis of acute phase proteins [9]. Liver dysfunction, as a consequence of septic shock and tissue hypoperfusion is associated with increased risk of in-hospital death [9]. Due to the lack of a reliable diagnostic tool for an early detection of liver dysfunction, liver dysfunction is often not appropriately treated [10,11]. However, despite multiple functions of the liver in patients with sepsis, the role of the liver within the Sequential Organ Failure Assessment (SOFA) score is only reflected by the serum bilirubin as diagnostic tool for sepsis and septic shock [1]. It was demonstrated that bilirubin increases risk of mortality in septic patients [12]. However, less is known about the prognostic role of different liver parameters with regard to their diagnostic as well as prognostic performance in septic patients.
Human umbilical cord blood mesenchymal stem cells as a potential therapy for schistosomal hepatic fibrosis: an experimental study
Published in Pathogens and Global Health, 2023
Dina M. Abou Rayia, Dalia S. Ashour, Hend S. Abo Safia, Muhammad T. Abdel Ghafar, Rania S. Amer, Abeer E. Saad
Schistosomal hepatic fibrosis remains a common type of liver fibrosis, particularly in developing countries. It may cause several complications, including portal hypertension, hepatocellular failure with ascites, hepatic encephalopathy, and bleeding tendency. In most cases, concurrent infection with viral hepatitis B and C occurs, ending in liver cirrhosis [2,25]. The patient’s progression to hepatic failure or cirrhosis with irreversible liver dysfunction indicates the need for hepatic replacement procedures such as liver transplantation. Nonetheless, the increased incidence of liver disease, the decreased availability of organ donors, the complications of immunosuppressive therapy, and the poor outcomes in patients on supportive treatment regimens pave the way for developing new treatment modalities such as stem cell therapies for liver regeneration [11].
The reversed De Ritis ratio for predicting in-hospital mortality among intensive care patients with organophosphate poisoning
Published in Biomarkers, 2023
Ola Nafea, Fatma Ibrahim, Walaa Abdelhamid
The liver is the major metabolic organ in the body that is responsible for critical functions including, but not limited to, metabolism of carbohydrates, fat, and protein, oxidation of fat for energy production, and detoxification of drugs, xenobiotics, and environmental toxins (Campbell 2006, Prasanna et al.2020, Shirani et al.2020, Akiyama et al.2022, Chupradit et al.2022). According to previous research, acute and chronic exposures to OP pesticides are associated with hepatotoxicity. The postulated mechanisms include free radicals and reactive metabolites injury, apoptotic cell death, and altered mitochondrial and microsomal metabolism (Stachulski et al.2013, Leone et al.2014, Karami-Mohajeri et al.2017). Generally, the assessment of liver dysfunction depends mainly on the liver function test (LFT). Moreover, liver function test can be employed to assess non-hepatic disease-related mortality (Huang et al.2017).