Гепатология и наука о поджелудочной железе

A common clinical question to addiction specialists concerns whether a medication to treat a patient???s alcoholism should be used and if so, when could such be commenced given the patient has liver disease. Alcohol consumption itself is a principal driver of alcoholic liver disease and as such, should prompt treatment intervention. While there is a reasonable evidence for medications that treat alcoholism, very little evidence exists to guide the decision to use such medication in the presence of clinically significant liver disease. This presentation reviews recent literature on pharmacotherapy for alcohol dependence relating particularly to patients having comorbid liver disease and alcoholism. It concludes with an outline for a Risk versus Benefit approach to pharmacotherapy decisionmaking.

Non-Alcoholic fatty liver disease can occur in obese and lean patients. Diabetes, obesity, and hypothyroidism are major treatable risk factors which can prevent the progression of NAFLD to NASH and CLD. liver biopsy is considered as the gold standard for diagnosing NASH. Fibroscan a noninvasive technique is now being routinely used to detect the fibrosis of the liver. However, this facility is not available at every hospital. NAFLD fibrosis score and novel biomarkers cytokeratin 18 are being investigated as a marker of fibrosis. In this observational crosssectional study, we tried to find out the NAFLD fibrosis score, fibroscan values in 30 overweight (BMI> 23.5kg/ m2) and obese (BMI >28.5kg/ m2) NAFLD patients out of total 50 NAFLD patients diagnosed on the basis of ultrasonography. Blood tests including hemogram, KFT???s, LFT???s, lipid profile and ultrasonography and fibroscan were done in all cases. A value of > 0.676 was taken as significant fibrosis, -1.455 to ??? 0.675 as intermediate fibrosis, < -1.455 as absence of fibrosis. The mean age was 46.50�12.33years. There were 8 (26.7%) males and 22 (73.3%) females. The mean BMI was 30.08�5.27. The mean ALT and AST was 54.17�27.49IU/L and 47.0�21.92IU/L respectively. The mean total cholesterol and triglyceride were 181.67�49.13 and 199.63�34.67 respectively. The mean TSH was 5.87�5.09mIU/L. The prevalence of hypothyroidism and diabetes was 11(36.6%) and 20(66%) respectively. Mean NAFLD score was -1.144�1.47 and the fibroscan score was 7.5067�2.25. Based on the NAFLD fibrosis score significant, intermediate and no fibrosis was observed in 6.7%, 56.7%, and 36.7% respectively.

Antioxidant system parameters have still gained considerable importance due to their pivotal role in detoxification mechanisms. Optimization assays were carried out for antioxidant enzymes (Superoxide dismutase (SOD); Catalase (CAT); Glutathione peroxidase (GPX); Glutathione reductase (GR) and Glutathione S-transferase (GST) in the liver of Mediterranean barbel (Barbus meridionalis). The characterization of the antioxidant enzymes was carried out for several incubation media parameters. For the pH optimization, the range of 6.0-8.0 was assayed and the maximal enzyme activities were found at pH 7.0 for SOD and GPX and pH 7.5 for the CAT, GST and GR. Phosphate buffer concentrations in the range of 50-150mM were examined and generally, all enzymes showed their highest activities at 100mM phosphate buffer except SOD activity which was maximally at 150mM. Specific enzyme activity (Vmax) and Km values were also determined. Optimal values of other incubation media for each antioxidant enzyme were mostly found in similar ranges when compared to several fish species in the literature. Characterization assays of these parameters in native fish based on its physiological and ecological importance may be useful for biomonitoring of aquatic ecosystems health and also present fundamental data for utilization in further studies in the area of ecotoxicology.

Drugs are the one of the major cause of liver injury. Because with some exception all drugs are metabolized by the liver it carries inherent risk of injury or toxicity. Various Xenobiotics by various ways affect the liver, many drugs produces acute liver injury that liver may repair itself because of its fast regenerating property. DILI classified as acute, Idiosyncratic and chronic on the basis of there mechanism and duration of toxicity. Some common agents that can cause liver injury are acetaminophen, antibiotics, statins, INH and herbal drugs with different modes and duration to affect the liver. Many drugs not affect the liver when taken for short duration but on continuous consumption they leads to disruption of hepatocytes. The obvious fact that different drug utilises different enzymes to get metabolised the toxicity produced by them also varies. The liver toxicity from drugs ranges from mild injury to total dysfunction of liver. In this review we have discussed the various pathologies underlies the liver injury induced by the drugs including polymorphism, autoimmune and hapten hypothesis with the summary of drugs which are proven hepatotoxic till date.

Hepatocellular carcinoma (HCC) is the most common and aggressive type of liver tumors. It is usually diagnosed at advanced stages due to lack of clear symptoms and reliable biomarkers. HCC diagnosis is further complicated by high similarity between early HCC stages and benign liver neoplasms, especially hepatocellular adenoma. Efficient methods of HCC identification are required for establishing precise diagnosis and choosing optimal treatment strategy. Our group previously identified five genes (IQGAP3, RAB3B, GPC3, PRRX1 and CENPF) specifically overexpressed in HCC, but not in benign neoplasms or normal liver tissue. Present study evaluates the diagnostic efficiency of combinational indexes generated using expression levels of these genes and z-score approach. We examined paired samples of neoplastic and normal liver tissue collected from 50 HCC patients and 15 patients with hepatocellular adenoma or focal nodular hyperplasia. Gene expression levels were estimated using RT-qPCR, zscores were calculated for single genes and all possible gene combinations. Z-scorebased indexes were statistically processed using cohort comparison tests and ROC analysis to evaluate their usefulness for discerning HCC samples from normal liver tissue and benign neoplasms. IQGAP3, GPC3, PRRX1 and CENPF were significantly (p<0.05) overexpressed in HCC samples, but not in benign neoplasms, when compared to non-tumor liver tissue. RAB3B expression was increased in benign cohort and further elevated in HCC cohort