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Liver Disease—Viral Hepatitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hepatitis refers to inflammation of liver cells and damage to the liver. It encompasses a broad range of clinico -pathologic conditions resulting from viral, toxic (e.g., excessive alcohol, drugs, chemicals), or immune-mediated damage to the liver. There are five common types of hepatitis caused by viruses (A, B, C, D, and E), but the most common are A, B, and C. Each type has different characteristics and transmission happens in different ways, but the symptoms tend to be similar.1
The patient with acute gastrointestinal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Rebecca Maindonald, Adrian Jugdoyal
The liver is dark reddish-brown in colour and is divided into two main lobes (the larger right and the smaller left) which are further subdivided into approximately 100,000 small lobes, or lobules. About 60% of the liver is made up of liver cells called hepatocytes, which absorb nutrients and detoxify and remove harmful substances from the blood. A hepatocyte has an average lifespan of 150 days. There are approximately 202,000 hepatocytes in every milligram of liver tissue. The liver receives its blood supply via the hepatic artery and portal vein. Instead of capillaries, the liver has large endothelium lined spaces (sinusoids) through which blood passes. The sinusoids also contain fixed phagocytes called stellate reticuloendothelial (Kupffer) cells which perform several functions, including the breakdown of worn out red blood cells, bacteria and other foreign matter which can then pass into the venous circulation.
Medical Problems in Alcoholics
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Nonspecific liver cell injury is the most common type of injury and is related to alcohol intake, not malnutrition. It is manifest clinically by mild hepatomegaly with or without tenderness and minimal abnormalities of the liver tests. The ALT and AST are rarely as high as three times normal, the bilirubin is < 3 mg/dl (50 μm/L), and the prothrombin time is usually normal. The GGPT is nearly always elevated, and the alkaline phosphatase may be any value. All of the chemical abnormalities will disappear by the eighth day of abstinence. This injury occurs in about 25% of all heavy drinkers (> 50 g/day) and may occur in a single weekend binge of drinking. It has no long-term prognostic significance and has no relationship to the subsequent development of cirrhosis. I envision this as patchy liver cell damage and death but only focal, never sufficient to produce submassive collapse essential to the formation of alcoholic hepatitis.
Efficacy of bile acid profiles in diagnosing and staging of alcoholic liver disease
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2023
Gaixia Zhang, Haizhen Chen, Wenbo Ren, Jing Huang
Prolonged excessive alcohol consumption leads to alcoholic liver disease (ALD), which is characterized by several histopathological changes, from simple steatosis to alcoholic steatohepatitis, progressive liver fibrosis and even cirrhosis. One of the features of alcoholic liver injury is the presence of oxidative stress, which leads to lipid peroxidation, steatosis, liver cell damage and death that in turn leads to the release of damage-related molecular patterns. Moreover, alcohol consumption promotes changes in the composition of the microbiota, increases intestinal permeability as well as the displacement of bacterial products. All these aspects activate Kupffer cells and promote the release of inflammatory cytokines, further exacerbating the inflammatory and fibrotic processes in the liver [3,4]. Patients with ALD may also suffer from cholestasis, mainly due to the accumulation of bile acids (BAs) due to the abnormal intestinal and hepatic circulation of BAs, which accelerates the progression of ALD [5]. Current studies found that ALD is rarely detected in the early stages compared with other liver diseases, leading to a poor prognosis in advanced patients, and alcohol consumption is also one of the causes of the progression of other liver diseases [6,7]. Therefore, accurate and noninvasive diagnostic indicators are urgently needed for the diagnosis of ALD and the evaluation of ALD staging.
Hepatotoxicity and renal toxicity induced by radiation and the protective effect of quercetin in male albino rats
Published in International Journal of Radiation Biology, 2022
Munevver Baran, Arzu Yay, Gozde Ozge Onder, Fazile canturk Tan, Betul Yalcin, Esra Balcioglu, Oguz Galip Yıldız
Histopathological changes of both tissues of rats exposed to 10 Gy of gamma rays showed abnormalities in all groups in accordance with the control. Examining the liver sections of the control and sham group have a normal histological appearance. The main liver cells, hepatocytes, with well-defined nuclei were regularly arranged in the lobule. In sections of the radiation-treated liver indicated degenerative changes such as sinusoidal dilatations, vacuolization, and hepatic parenchyma necrosis were observed after exposure to radiation. It was observed that in the presence of quercetin mild degeneration in the liver tissue. These appearances indicate that exposure to radiation causes severe damage to the liver of the rat. Figure 1 shows that the liver of the rat basically returned to a normal state. Additionally, whereas the liver tissue of the radiation group showed accumulation of collagen fibers around veins in MT staining sections, other groups' significant improvement in fibrosis was observed compared with the group exposed to radiation in Figure 1. According to the results of the PAS reaction, it was observed that there were healthy hepatocytes containing stored glycogen in the control group, while the amount of glycogen present in the radiation group decreased. In the quercetin administration to radiation exposed rats, increased glycogen storage was observed.
Eosinopenia and increased markers of endothelial damage are characteristic of COVID-19 infection at time of hospital admission
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Marouscha P. de Vries, Nieky Mohammadnia, Suat Simsek, Marianne Schoorl
After recovery, there have been reports of persistent fatigue, independent on the severity of the infection. Together with muscle pain and dry syndrome, it is associated with a systemic autoimmune disease, which can be developed during an infection and persist after its control [3]. There are also some cases of autoimmune disease reported after a COVID-19 infection in which autoantibodies against smooth muscles (SMA) were produced. These autoantibodies are usually found in patients with hepatitis or other liver diseases [4]. Although liver cells by itself seem not to be affected, because the lungs are the main target of infection, it is hypothesized that they play a role in the raise of a systemic disease [5]. Histopathological findings suggest that the intrahepatic blood vessel network is disturbed [5]. In addition to targeting the lung parenchyma, the virus may be able to induce changes in the cardiovascular system, coagulation cascade and endothelial layer of blood vessels. A correlation between the levels of vascular adhesion molecules and the severity of the infection is found. Up to now, it is not known whether these changes are directly related to the virus infection or whether SARS‐CoV‐2 triggers a series of reactions leading to striking vascular alterations. [6]