The liver in systemic disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Palak Trivedi
Keyword(s):  
Inflammatory Response ◽  
Biliary Obstruction ◽  
Systemic Disease ◽  
Hepatic Function ◽  
Vascular Supply ◽  
Systemic Diseases ◽  
Venous Infiltration ◽  
Hepatic Venous Congestion ◽  
Healthy Functioning ◽  
Circulatory Disturbances

The liver may be involved in systemic diseases that primarily affect other organs. In most cases, the systemic disease should be treated effectively first. Circulatory disturbances can cause liver dysfunction by ischaemia (due to arterial hypoperfusion) and hepatic venous congestion. The liver is a key organ in sepsis, both as source of inflammatory mediators and as a victim of the inflammatory response. An oncological process may affect hepatic function in a number of ways. For example, tumours in and around the liver can affect function by directly reducing the volume of healthy, functioning tissue or by causing biliary obstruction, and portal venous infiltration or hypercoagulability may compromise the liver’s vascular supply. This chapter discusses the liver in systemic disease, including sections on etiology, symptoms, demographics, complications, diagnosis, and treatment.

scholarly journals Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 271
Author(s):  
Saverio Capodiferro ◽  
Luisa Limongelli ◽  
Gianfranco Favia
Keyword(s):  
Early Diagnosis ◽  
Oral Cavity ◽  
Head And Neck ◽  
Clinical Outcomes ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Systemic Diseases ◽  
Special Issue ◽  
Hard Tissues ◽  
Current Special Issue

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.

scholarly journals Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on?

2021 ◽  
Vol 28 (1) ◽  
pp. 903-917
Author(s):  
Mitchell Sabloff ◽  
Steven Tisseverasinghe ◽  
Mustafa Ege Babadagli ◽  
Rajiv Samant
Keyword(s):  
Cell Transplantation ◽  
Total Body Irradiation ◽  
Hematopoietic Cell Transplantation ◽  
Conditioning Regimen ◽  
Late Toxicity ◽  
Hepatic Function ◽  
Vascular Supply ◽  
Entire Body ◽  
Hematopoietic Stem ◽  
Total Body

Total body irradiation (TBI), used as part of the conditioning regimen prior to allogeneic and autologous hematopoietic cell transplantation, is the delivery of a relatively homogeneous dose of radiation to the entire body. TBI has a dual role, being cytotoxic and immunosuppressive. This allows it to eliminate disease and create “space” in the marrow while also impairing the immune system from rejecting the foreign donor cells being transplanted. Advantages that TBI may have over chemotherapy alone are that it may achieve greater tumour cytotoxicity and better tissue penetration than chemotherapy as its delivery is independent of vascular supply and physiologic barriers such as renal and hepatic function. Therefore, the so-called “sanctuary” sites such as the central nervous system (CNS), testes, and orbits or other sites with limited blood supply are not off-limits to radiation. Nevertheless, TBI is hampered by challenging logistics of administration, coordination between hematology and radiation oncology departments, increased rates of acute treatment-related morbidity and mortality along with late toxicity to other tissues. Newer technologies and a better understanding of the biology and physics of TBI has allowed the field to develop novel delivery systems which may help to deliver radiation more safely while maintaining its efficacy. However, continued research and collaboration are needed to determine the best approaches for the use of TBI in the future.

Systemic Diseases Associated with Nasal Symptoms

1987 ◽  
Vol 1 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Guy A. Settipane
Keyword(s):  
Differential Diagnosis ◽  
Fungal Infections ◽  
Systemic Disease ◽  
Systemic Diseases ◽  
Proper Treatment ◽  
Csf Rhinorrhea ◽  
Nasal Symptoms ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Careful History

Many systemic diseases are associated with nasal symptoms, Rhinitis associated with asthma is probably the most common with leprosy and fungal infections being the rarest. A careful history and nasal examination in a patient with rhinitis may lead to the discovery of more significant systemic diseases. Proper treatment of systemic disease will often cure or improve the associated rhinitis. Similarly, appropriate treatment of the rhinitis/sinusitis may reduce systemic complaints such as asthma. At times, identification of the cause of rhinitis as in CSF rhinorrhea, Wegeners’ syndrome, etc., alerts one to a life-threatening entity. Thus, it is apparent that the nose is an excellent mirror of some systemic diseases and identifying and understanding the differential diagnosis of nasal symptoms may be a tremendous help in diagnosing the disease and treating the whole patient.

scholarly journals Qual o melhor anestésico local para meu paciente? Tabela das condições sistêmicas encontradas na clínica odontológica e a sua relação na escolha do sal anestésico e vasoconstritor

2020 ◽  
Author(s):  
Rodrigo Resende
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Oral Surgery ◽  
Systemic Disease ◽  
Systemic Diseases ◽  
Dental Clinic ◽  
National Market ◽  
Dental Professionals

RESUMOO uso de soluções anestésicas é realizada quase que diariamente pelos profissionais de odontologia. Entretanto, os anestésicos locais disponíveis no mercado apresentam-se sob a forma de soluções com composições e concentrações variadas, tanto com relação ao sal anestésico, vasoconstritor e seu preservativo. Talvez, pela grande variedade de associações, possa surgir diversas dúvidas quanto à melhor escolha durante a prática clínica diária, principalmente quando o mesmo apresenta algum tipo de doença sistêmica. Com isso, o objetivo desse trabalho é realizar uma revisão de literatura das melhores indicações e possíveis contraindicações de soluções  anestésicas locais disponíveis no mercado nacional, relacionando com doenças sistêmicas que comumente são atendidas na clínica odontológica.Palavras – Chave: Odontologia; Anestésico local; Cirurgia oral. ABSTRACT The use of anesthetic solutions is performed almost daily by dental professionals. However, the local anesthetics available on the market come in the form of solutions with varying compositions and concentrations, both with respect to the anesthetic salt, vasoconstrictor and its preservative. Perhaps, due to the wide variety of associations, several doubts may arise regarding the best choice during daily clinical practice, especially when it presents some type of systemic disease. Thus, the objective of this work is to carry out a literature review of the best indications and possible contraindications for local anesthetic solutions available in the national market, relating to systemic diseases that are commonly seen in the dental clinic. Key words: Dentistry; Local anesthetic; Oral surgery.

scholarly journals Umbelliferone alleviates hepatic injury in diabetic db/db mice via inhibiting inflammatory response and activating Nrf2-mediated antioxidant

2018 ◽  
Vol 38 (4) ◽  
Author(s):  
Jiangning Yin ◽  
Hanqing Wang ◽  
Guoyuan Lu
Keyword(s):  
Blood Glucose ◽  
Inflammatory Response ◽  
Protective Effect ◽  
High Mobility ◽  
Hepatic Function ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Stress Indicators ◽  
Tnf Α ◽  
Oxidative Stress Indicators

The current study was designed to investigate the protective effect and possible mechanisms of umbelliferone (Umb) on liver injury in diabetic C57BL/KsJ-db/db (dbdb) mice. Mice were divided into five groups: wild-type mice group (WY), dbdb mice group, dbdb mice + Metformin (100 mg/kg) group, dbdb mice + Umb (20, 40 mg/kg) group. Blood glucose regulation was assessed by an oral glucose tolerance test (OGTT). At 28 days after drug administration, blood samples were obtained for the analysis of lipids and enzymes related to hepatic function, including alanine aminotransferase (ALT), aspartate aminotransaminase (AST) and total cholesterol (TC) and triglyceride (TG). Expression levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and oxidative stress indicators (SOD and MDA) were measured with ELISA kit. The expressions of high-mobility group box 1 (HMGB1), Toll-like receptor (TLR) 4 (TLR4), Myd88, NF-κB, IκB, Nrf2, and HO-1 proteins were also evaluated by Western blotting analysis. The results showed that Umb significantly restored the blood glucose in OGTT, and inhibited the levels of insulin, TG, TC, as well as activities of ALT and AST. Moreover, Umb inhibited diabetic inflammation through down-regulating the expression of HMGB1, TLR4, NF-κB, and IκB. In addition, Umb alleviated oxidative damage in the liver by activating Nrf2-mediated signal pathway. These findings demonstrated that Umb exhibited protective effect against diabetic live injury, which may be through inhibiting HMGB1-induced inflammatory response and activating Nrf2-mediated antioxidant.

scholarly journals COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series

2020 ◽  
Vol 39 (11) ◽  
pp. 3195-3204 ◽  
Author(s):  
Clodoveo Ferri ◽  
◽  
Dilia Giuggioli ◽  
Vincenzo Raimondo ◽  
Massimo L’Andolina ◽  
...  
Keyword(s):  
Immune System ◽  
General Population ◽  
Connective Tissue ◽  
Inflammatory Arthritis ◽  
Systemic Disease ◽  
Management Strategies ◽  
Connective Tissue Diseases ◽  
Systemic Diseases ◽  
High Exposure ◽  
Disease Modifying

Abstract Introduction Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients during the Covid-19 pandemic. Method This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany), and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19 disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test. Results A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid-19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to “Italian general population” (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease, in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was found either in patients with various “connective tissue diseases” compared to “inflammatory arthritis group” (p < .000), or in patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs treatments (p = .011). Conclusions The finding of a higher prevalence of Covid-19 in patients with autoimmune systemic diseases is particularly important, suggesting the need to develop valuable prevention/management strategies, and stimulates in-depth investigations to verify the possible interactions between Covid-19 infection and impaired immune-system of autoimmune systemic diseases. Key Points• Significantly higher prevalence of Covid-19 is observed in a large series of patients with autoimmune systemic diseases compared to the Italian general population, mainly due to patients’ increased susceptibility to infections and favored by the high exposure to the virus at medical facilities before the restriction measures on individual movement.• The actual prevalence of Covid-19 in autoimmune systemic diseases may be underestimated, possibly due to the wide clinical overlapping between the two conditions, the generally mild Covid-19 disease manifestations, and the limited availability of virological testing.• Patients with “connective tissue diseases” show a significantly higher prevalence of Covid-19, possibly due to deeper immune-system impairment, with respect to “inflammatory arthritis group”.• Covid-19 is more frequent in the subgroup of autoimmune systemic diseases patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs, mainly hydroxyl-chloroquine and methotrexate, which might play some protective role against the most harmful manifestations of Covid-19.

Diagnosing systemic diseases.

2021 ◽  
pp. 224-243
Author(s):  
Shou-Hua Wang
Keyword(s):  
Abiotic Stresses ◽  
Systemic Disease ◽  
Laboratory Diagnosis ◽  
Pathogenicity Test ◽  
Systemic Diseases ◽  
Beet Curly Top Virus ◽  
Management Measures ◽  
Leaf Chlorosis ◽  
Resistant Varieties ◽  
Contact Transmission

Abstract A systemic disease is defined as one where a pathogen infects a plant systemically or affects the plant as a whole. There are certain types of diseases in hemp and cannabis crops that are viewed more as systemic rather than localized, based on both infection behaviour and symptom development. This chapter deals with diagnosing systemic diseases of cannabis crops, including vascular wilt caused by Fusarium Species, witches' broom caused by phytoplasmas, leaf curl caused by Beet curly top virus, plant stunting caused by Hop latent viroid, leaf chlorosis caused by Lettuce chlorosis virus and other viral diseases. Field diagnosis through symptom observation, problem classification, sampling, laboratory diagnosis by visual and microscopic examinations, isolation and colony observation, identification (PCR/DNA-based, morphological, ELISA), pathogenicity test, and key diagnostic evidence are described. Systemic disease management measures are discussed, focusing on inoculum prevention and vector control, monitoring mother plant health, managing insect vectors, controlling weeds, use of resistant varieties, avoiding contact transmission and reducing abiotic stresses.

Prevalence and clinical features of systemic diseases in Chinese patients with uveitis

2020 ◽  
Vol 105 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Peizeng Yang ◽  
Zhenyu Zhong ◽  
Liping Du ◽  
Fuzhen Li ◽  
Zhijun Chen ◽  
...  
Keyword(s):  
Large Scale ◽  
Primary Outcome ◽  
Systemic Disease ◽  
Mainland China ◽  
Nationwide Survey ◽  
Chinese Patients ◽  
National Database ◽  
Systemic Diseases ◽  
The Mean ◽  
Epidemiological Profile

PurposeSystemic diseases are frequently associated with uveitis but are often not recognised by clinicians. An estimate of the prevalence in a large-scale uveitis population is essential for understanding the epidemiological profile and may be helpful for clinical practice.DesignA nationwide survey.MethodsData were obtained from a national database which included the registration of uveitis cases from 23 provinces, 5 autonomous regions and 4 municipalities across mainland China. The primary outcome was identification of a systemic disease associated with uveitis.ResultsFrom April 2008 through August 2018, 15 373 uveitis patients were included in the study. Males accounted for 52.9%, and the mean (SD) age of uveitis onset was 35.4 (15.9) years. After standardisation for age, the prevalence of systemic disease among patients with uveitis was 30.8% (95% CI, 30.1% to 31.6%). Vogt-Koyanagi-Harada disease (VKH; age-standardised prevalence, 12.7%; 95% CI, 12.1% to 13.2%), Behçet’s disease (BD; 8.7%; 95% CI, 8.3% to 9.2%), ankylosing spondylitis (AS; 5.0%; 95% CI, 4.6% to 5.3%) and juvenile idiopathic arthritis (JIA; 1.2%; 95% CI, 1.0% to 1.3%) were the most common entities among 36 different forms of systemic diseases identified. The prevalence was significantly higher in males (37.0%; 95% CI, 36.0% to 38.1%) than in females (23.6%; 95% CI, 22.6% to 24.6%), and also higher in bilateral uveitis patients (41.2%; 95% CI, 40.2% to 42.2%) compared with unilateral cases (14.3%; 95% CI, 13.4% to 15.2%), and was highest in panuveitis (59.5%; 95% CI, 58.2% to 60.8%).ConclusionApproximately one third of uveitis patients in this nationwide survey have an associated systemic disease, whereby VKH, BD, AS and JIA are the most frequent entities seen in China.

scholarly journals Hydroxychloroquine-induced podocytopathy mimicking Fabry disease

2019 ◽  
Vol 12 (5) ◽  
pp. e228876 ◽  
Author(s):  
Justine Serre ◽  
David Buob ◽  
Jean-Jacques Boffa
Keyword(s):  
Fabry Disease ◽  
Genetic Test ◽  
Systemic Disease ◽  
Systemic Lupus Erythematous ◽  
Systemic Diseases ◽  
Electronic Microscopy ◽  
Systemic Lupus ◽  
Zebra Bodies ◽  
Sjögren’S Disease ◽  
Cytoplasmic Vacuolisation

Hydroxychloroquine (HCQ) is largely prescribed as an immunomodulator to prevent systemic diseases flares in patients with systemic lupus erythematous, rheumatoid arthritis, Sjogren’s disease. Among reported side effects, HCQ can accumulate in lysosomes and induced phospholipidosis. Here, we report an HCQ-induced podocytopathy mimicking Fabry disease (FD). They share the same histological lesions: cytoplasmic vacuolisation of the podocytes and zebra bodies on light and electronic microscopy. FD has been ruled out by measuring enzymatic activity and genetic test. The persistence of proteinuria after immunological remission of a systemic disease treated with HCQ could suggest this HCQ-induced podocytopathy.

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