Ursodeoxycholic Acid and Atorvastatin in the Treatment of Nonalcoholic Steatohepatitis

BACKGROUND/AIMS: Nonalcoholic steatohepatitis (NASH) is a serious disorder with the potential to gradually progress to cirrhosis. It is generally associated with obesity, diabetes and hyperlipidemia. Currently, there is no established therapy for NASH. The aim of the present study was to evaluate the effectiveness of atorvastatin and ursodeoxycholic acid (UDCA) in the treatment of NASH.METHODS: This prospective study included 44 adult patients (24 men, 20 women) with a mean age of 48.90±7.69 years and mean body mass index (BMI) of 29.40±3.82. Ten patients had a history of diabetes. Serological markers for viral hepatitis were negative in all patients and there was no history of alcohol or drug abuse. Patients who had autoimmune hepatitis were excluded from the study. Liver biopsy was performed before therapy to confirm the diagnosis. Among NASH patients, 17 normolipidemic cases received UDCA 13 to 15 mg/kg/day (group 1), while hyperlipidemic cases (n=27) received atorvastatin 10 mg/day (group 2) for six months. The BMI, serum lipids, liver function tests and liver density, assessed by computerized tomography, were evaluated before and after the treatment period. The BMI, serum aminotransferase levels, histological parameters (steatosis, inflammation, fibrosis scores) and liver densities were not statistically different between the groups at the beginning of therapy.RESULTS: The BMI, serum glucose, and triglyceride levels did not change in either group after the treatment period. In group 1, serum alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT) levels reduced significantly, and in group 2, serum cholesterol, aspartate aminotransferase, ALT, alkaline phosphatase and GGT levels reduced significantly. Liver densities increased only in group 2, probably as a result of diminishing fat content of liver. The normalization of transaminases was also more prevalent in group 2. Liver steatosis was closely correlated with liver density, but inflammation and fibrosis were not.CONCLUSIONS: The use of atorvastatin in NASH patients with hyperlipidemia was found to be both effective and safe. The benefit of statin and UDCA therapy in normolipidemic patients with NASH requires confirmation with further placebo-controlled trials.

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Serum Gamma-Glutamyl Transferase and Ferritin Synergistically Associated with the Rate of Chronic Kidney Disease

Disease Markers ◽

10.1155/2017/9765259 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Tao Chen ◽

Yan Ren ◽

Yun Gao ◽

Haoming Tian

Keyword(s):

Gamma Glutamyl Transferase ◽

Multiple Logistic Regression ◽

Increased Risk ◽

Quartile Group ◽

Group 3 ◽

Group 2 ◽

Glutamyl Transferase ◽

Fourth Quartile ◽

Different Levels ◽

Group 1

The present study investigated the effects of GGT and SF on the risk of CKD. 1024 participants (436 men and 588 women) were divided into three groups according to GGT and SF levels: group 1 (both GGT and SF not in the fourth quartile), group 2 (only GGT or SF in the fourth quartile), and group 3 (both GGT and SF in the fourth quartile). The risks of CKD in different levels of GGT and SF and in groups 2-3 compared with group 1 were analyzed by multiple logistic regression. GGT or SF in the highest quartile was associated with increased risk of CKD. Such associations attenuated after adjustment for confounding factors. The incidences of CKD, especially albuminuria, increased across the three groups. Correspondingly, malondialdehyde (MDA) levels gradually increased from group 1 to group 3. The risks of CKD were higher in groups 2 and 3 than that in group 1. In group 3, the increased rate was independent of age, BMI, alcohol drinking, diabetes mellitus, hypertension, hypertriglyceridemia, and metabolic syndrome (odds ratios from 1.887 to 2.293,P<0.05). In summary, this study suggested that GGT and SF synergistically influence the rate of CKD.

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Evaluation of Hematological and Biochemical Changes in Dromedary Camel during the Different Stages of Lactation

Mansoura Veterinary Medical Journal ◽

10.35943/mvmj.2020.21.320 ◽

2020 ◽

Vol 21 (3) ◽

pp. 121-124

Author(s):

Ahmed El-Sayed

Keyword(s):

Organic Phosphorus ◽

Hemoglobin Concentration ◽

Controlled Study ◽

Mean Corpuscular Hemoglobin ◽

Dromedary Camel ◽

Gamma Glutamyl Transferase ◽

Corpuscular Hemoglobin ◽

Stage Of Lactation ◽

Group 2 ◽

Glutamyl Transferase

Objective: To assess the potential hematobiochemical alterations in healthy dromedary camel during the different stages of lactation. Design: Randomized controlled study. Animals: Fifteen healthy female dromedary camels, with mean body weight of 499.6 kg and mean age of 20 years. Procedures: Camels were categorized into 3 groups' according to their stage of lactation: group 1, early lactation (1-3 months), group 2, mid-lactation (four-6 months) and group3, late lactation (≥ 7 months). Blood samples were collected from every animals for hematological and biochemical evaluation. Results: Total erythrocyte count (TEC), hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), total leukocytes (TLC), lymphocytes, neutrophils, monocytes, Calcium, glucose, aspartate aminotransferase (AST), alanine transaminase (ALT), gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) confirmed significant (p < 0.05) variation between different stages of lactation. However, non-notable (p > 0.05) dissimilarity were located in packed cell volume (PCV), mean corpuscular hemoglobin concentration (MCHC), in organic phosphorus (P), magnesium (Mg), cholesterol, total protein (TP), albumen, globulin, blood urea nitrogen (BUN) and creatinine kinase (CK) in the course of different ranges of lactation, Conclusion and clinical relevance: The results of this investigation may be useful as reference guide for dromedary camel to evaluate the metabolic health status at different stages of lactation.

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Myeloid neoplasms in the setting of chronic lymphocytic leukaemia/chronic lymphocytic leukaemia-like disease: a clinicopathological study of 66 cases comparing cases with prior history of treatment to those without

Journal of Clinical Pathology ◽

10.1136/jclinpath-2020-207334 ◽

2021 ◽

pp. jclinpath-2020-207334

Author(s):

Catherine Luedke ◽

Yue Zhao ◽

Jenna McCracken ◽

Jake Maule ◽

Lian-He Yang ◽

...

Keyword(s):

Chronic Lymphocytic Leukaemia ◽

Lymphocytic Leukaemia ◽

The Other ◽

Prior History ◽

Myeloid Neoplasm ◽

Myeloid Neoplasms ◽

History Of ◽

Cytogenetic Profile ◽

Group 2 ◽

Group 1

AimsMyeloid neoplasms occur in the setting of chronic lymphocytic leukaemia (CLL)/CLL-like disease. The underlying pathogenesis has not been elucidated.MethodsRetrospectively analysed 66 cases of myeloid neoplasms in patients with CLL/CLL-like disease.ResultsOf these, 33 patients (group 1) had received treatment for CLL/CLL-like disease, while the other 33 patients (group 2) had either concurrent diagnoses or untreated CLL/CLL-like disease before identifying myeloid neoplasms. The two categories had distinct features in clinical presentation, spectrum of myeloid neoplasm, morphology, cytogenetic profile and clinical outcome. Compared with group 2, group 1 demonstrated a younger age at the diagnosis of myeloid neoplasm (median, 65 vs 71 years), a higher fraction of myelodysplastic syndrome (64% vs 36%; OR: 3.1; p<0.05), a higher rate of adverse unbalanced cytogenetic abnormalities, including complex changes, −5/5q- and/or −7/7q- (83% vs 28%; OR: 13.1; p<0.001) and a shorter overall survival (median, 12 vs 44 months; p<0.05).ConclusionsMyeloid neoplasm in the setting of CLL/CLL-like disease can be divided into two categories, one with prior treatment for CLL/CLL-like disease and the other without. CLL-type treatment may accelerate myeloid leukaemogenesis. The risk is estimated to be 13-fold higher in patients with treatment than those without. The causative agent could be attributed to fludarabine in combination with alkylators, based on the latency of myeloid leukaemogenesis and the cytogenetic profile.

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Role of biometric characteristics of the uterine junctional zone in fertility outcomes in patients with adenomyosis

Journal of obstetrics and women s diseases ◽

10.17816/jowd65046 ◽

2021 ◽

Vol 70 (3) ◽

pp. 41-50

Author(s):

Ekaterina K. Orekhova ◽

Olga A. Zhandarova ◽

Igor Yu. Kogan

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Resonance Imaging ◽

Junctional Zone ◽

History Of ◽

Group 2 ◽

Adverse Pregnancy ◽

Group 1

BACKGROUND: The uterine junctional zone is the inner part of the myometrium. Dysfunction of the zone may underlie the pathogenesis of adenomyosis and its clinical manifestations, while biometric characteristics of the zone are currently considered as promising early diagnostic criteria for this disease. Adenomyosis has traditionally been associated with parity and intrauterine interventions, primarily in older patients. However, modern imaging tools often allow diagnosing the disease in young patients with infertility and an unburdened gynecological history. It is assumed that the detection of changes in the structure and function of the uterine junctional zone in adenomyosis can be the basis for predicting fertility outcomes and complications of pregnancy, as well as for the development of promising therapeutic strategies at the pregravid stage. AIM: The aim of this study was to assess the influence of biometric characteristics of the uterine junctional zone on pregnancy outcomes, depending on the parity and intrauterine interventions in patients with adenomyosis. MATERIALS AND METHODS: This prospective study included 102 patients aged 2239 years old with ultrasound features of adenomyosis who were going to conceive. The patients were divided into two groups: Group 1 (n = 58) consisted of nulliparous patients with no history of previous intrauterine interventions, and Group 2 (n = 44) comprised multipara women with a history of labor and / or intrauterine interventions. Using magnetic resonance imaging, we evaluated minimal, average and maximal junctional zone thicknesses, junctional zone deferential and a ratio of junctional zone thickness to myometrium thickness. Thresholds of biometric characteristics of the uterine junctional zone for adverse pregnancy outcomes were estimated. RESULTS: The frequencies of pregnancy and retrochorial hematoma in patients of Groups 1 and 2 in the first trimester of pregnancy did not differ significantly and amounted to 43.1% and 38.6%, 13.8% and 22.7%, respectively, p 0.05. Adverse pregnancy outcomes were diagnosed in 63.8% of patients in Group 1 and in 68.2% of patients in Group 2, p 0.05. In Group 1, the frequency of retrochorial hematoma depended on the initial junctional zone deferential, as well as on the initial average and maximal junctional zone thicknesses, junctional zone deferentials and ratios of junctional zone thickness to myometrium thickness, which, with an adverse pregnancy outcome, were 1.72.5 times higher than those in patients with a favorable outcome, p 0.05. In Group 2, adverse pregnancy outcomes were recorded with significantly higher values of average and maximal junctional zone thicknesses and junctional zone deferential. ROC curves were constructed using data of logistic regression analysis based on biometric characteristics of the uterine junctional zone to predict spontaneous abortion and infertility in patients with adenomyosis. CONCLUSIONS: Fertility outcomes in patients with adenomyosis depend on a complex of biometric characteristics of the uterine junctional zone as determined by magnetic resonance imaging.

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The Threshold of Admission Glycemia as a Predictor of Adverse Events in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome

Clinical medicine Cardiology ◽

10.4137/cmc.s2289 ◽

2009 ◽

Vol 3 ◽

pp. CMC.S2289 ◽

Cited By ~ 3

Author(s):

Taysir S. Garadah ◽

Salah Kassab ◽

Qasim M. Al-Shboul ◽

Abdulhai Alawadi

Keyword(s):

Acute Coronary Syndrome ◽

Adverse Events ◽

Diabetic Patients ◽

Stress Hyperglycemia ◽

Coronary Syndrome ◽

History Of ◽

Group 3 ◽

Group 2 ◽

High Level ◽

Group 1

Recent studies indicated a high prevalence of hyperglycemia in non-diabetic patients presenting with acute coronary syndrome (ACS). However, the threshold of admission glucose (AG) as a predictor of adverse events in ACS is unclear. Objective The aim of this study was to assess the threshold of admission glucose (AG) as a predictor of adverse events including Major Acute Cardiac Events (MACE) and mortality, during the first week of admitting patients presenting with ACS. Material and Methods The data of 551 patients with ACS were extracted and evaluated. Patients were stratified according to their blood glucose on admission into three groups: group 1: <7 mmol/L (n = 200, 36.3%) and group 2: >7 mmol/L and <15 mmol/L (n = 178, 32.3%) and group 3: ≥15 mmol/L (n = 173, 31.4%). Stress hyperglycemia was arbitrarily defined as AG levels > 7 mmol/L (group 2 and 3). Patients with ACS were sub-divided into two groups: patients with unstable angina (UA, n = 285) and those with ST segment elevation myocardial Infarction (STEMI, n = 266) and data were analyzed separately using multiple regression analysis. Results The mean age of patients was 59.7 ± 14.8 years and 63% were males. The overall mortality in the population was 8.5% (5.4% in STEMI and 3.1% in UA) patients. In STEMI patients, the odds ratio of stress hyperglycemia as predictor of mortality in group 3 compared with group 1 was 3.3 (CI 0.99-10.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.75-8.07, P = 0.065) after adjustment for age and sex. Similarly, in UA patients, the odds ratio of stress hyperglycemia in group 3 compared with group 1 was 2.7 (CI 0.37-18.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.4-15.2, P = 0.344) after adjustment for age and sex. The incidence of more than 2 MACE in both STEMI and UA patients was higher in group 3 compared with the other two groups. Regression analysis showed that history of DM, high level of LDL cholesterol, high level of HbA1c, and anterior infarction were significant predictors of adverse events while other risk factors such as BMI, history of hypertension and smoking were of no significance. Conclusion This study indicates that the stress hyperglycemia on admission is a powerful predictor of increased major adverse events and hospital mortality in patients with acute coronary syndrome.

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Management of a pediatric burn center during the covid-19 pandemic

Journal of Burn Care & Research ◽

10.1093/jbcr/irab137 ◽

2021 ◽

Author(s):

Ahmet Erturk ◽

Sabri Demir ◽

Can İhsan Oztorun ◽

Elif Emel Erten ◽

Dogus Guney ◽

...

Keyword(s):

Length Of Stay ◽

Total Body Surface Area ◽

Center Staff ◽

Staff Members ◽

Burn Center ◽

History Of ◽

Group 2 ◽

Travel Abroad ◽

Pcr Test ◽

Group 1

Abstract The aim of this study was to evaluate the results of an algorithm that was created to prevent coronavirus disease-2019 (COVID-19) transmission during the management of children with burns in a tertiary pediatric burn center. Children admitted to the burn center between May 2020 and November 2020 were prospectively evaluated for cause, burn depth, total body surface area (TBSA), length of stay, symptoms suggesting COVID-19, suspicious contact history, history of travel abroad, and COVID-19 polymerase chain reaction (PCR) test results. Patients were divided into two groups: unsuspected (Group 1) and suspected (Group 2), depending on any history of suspicious contact, travel abroad, and/or presence of symptoms. A total of 101 patients were enrolled in the study, which included 59 boys (58.4%) and 42 girls (41.6%). Group 1 included 79 (78.2%) patients, and Group 2 consisted of 22 (21.8%) patients. The most common cause of the burns was scald injuries (74.2%). The mean age, TBSA, and length of stay were 4.5 years, 12.0%, and 13.2 days, respectively. Four patients (3.9%) had a positive PCR test (two patients in each group). Comparing groups, males were more commonly found in Group 2 (p=0.042), but no differences were found for the other variables. No patients or burn center staff members developed COVID-19 during the course of hospitalization. In conclusion, every child should be tested for COVID-19 upon admission to a burn unit, and a modified algorithm should be constructed for the handling and management of pediatric burn patients.

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Growth differentiation factor 15 associations with clinical features of chronic heart failure with midrange ejection fraction and preserved ejection fraction depending on the history of myocardial infarction

Kardiologiia ◽

10.18087/cardio.2021.5.n1449 ◽

2021 ◽

Vol 61 (5) ◽

pp. 59-64

Author(s):

E. A. Kuzheleva ◽

A. A. Garganeeva ◽

V. A. Aleksandrenko ◽

V. A. Fedyunina ◽

O. N. Ogurkova

Keyword(s):

Myocardial Infarction ◽

Ejection Fraction ◽

Stroke Volume ◽

Inflammatory Marker ◽

Left Ventricular Ejection ◽

Growth Differentiation Factor 15 ◽

Differentiation Factor ◽

History Of ◽

Group 2 ◽

Group 1

Aim To analyze associations between levels of the inflammatory marker, growth differentiation factor 15 (GDF-15), and echocardiographic indexes in CHF patients with mid-range and preserved left ventricular ejection fraction (LV EF) depending on the history of myocardial infarction (MI).Material and methods This study included 34 CHF patients with preserved and mid-range LV EF after MI (group 1, n=19) and without a history of MI (group 2, n=15). Serum concentration of GDF-15 was measured with enzyme immunoassay (BioVendor, Czech Republic). Statistical analysis was performed with STATISTICA 10.0.Results Patients of the study groups were age-matched [62 (58;67) and 64 (60;70) years, p=0.2] but differed in the gender; group 1 consisted of men only (100 %) whereas in group 2, the proportion of men was 53.3 % (p=0.001). Median concentration of GDF-15 was 2385 (2274; 2632.5) and 1997 (1534;2691) pg/ml in groups 1 and 2, respectively (p=0.09). Patients without MI showed a moderate negative correlation between LV EF and GDF-15 concentration (r= – 0.51, p=0.050) and a pronounced correlation between GDF-15 and LV stroke volume (r= –0.722, p=0.002). For patients after MI, a correlation between the level of GDF-15 and the degree of systolic dysfunction was not found (р>0.05).Conclusion Blood concentration of the inflammatory marker, GDF-15, correlates with LV EF and stroke volume in CHF patients with preserved or mid-range LV EF and without a history of MI while no such correlations were observed for patients with a history of MI.

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Abstract WP380: Thyrotoxicosis is Associated With Worse In-Hospital Mortality in Patients With Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.wp380 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Sakiru O Isa ◽

Olajide Buhari ◽

Hameem Changezi

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Length Of Hospital Stay ◽

The Body ◽

Significant Difference ◽

History Of ◽

Group 3 ◽

Group 2 ◽

Time Of Presentation ◽

Group 1

Introduction: Hyperthyroidism increases the basal metabolic rate and affects most systems in the body. Patients with hyperthyroidism have been shown to have a higher incidence of ischemic stroke. There is a paucity of information regarding its effects on the short-term outcomes of patients admitted with ischemic stroke. Hypothesis: Hyperthyroidism is associated with worse in-hospital outcomes in patients admitted for ischemic stroke. Methods: We queried the National Inpatient Sample to identify adult patients(aged 18 and above) admitted for ischemic stroke between January 2011 and December 2014. We compared those with a history of hyperthyroidism (group 1) and thyrotoxicosis on admission (group 2) with the rest of the patients (group 3). The main outcome was in-hospital mortality. Secondary outcomes included the length of hospital stay and cost of hospitalization. We used the logistic regression model and adjusted for baseline characteristics and co-morbidities. Results: There were 643,786 patients in the study, 0.44% had a history of hyperthyroidism, and 0.01% had thyrotoxicosis at the time of presentation. The odd of mortality in group 1 compared to group 3 was 0.89, 95% CI 0.75-1.05, p=0.16 while in group 2 compared to group 3, it was 2.42, 95% CI 1.29-4.52, p<0.006. The mean length of stay was also longer in group 2 with a mean difference of 8.06, 95% CI 4.74 - 11.39, p<0.0001. Conclusion: From the study, there was no significant difference in in-hospital mortality between patients with previously diagnosed hyperthyroidism and those without diagnosed hyperthyroidism. Patients who had thyrotoxicosis on admission, on the other hand, had worse outcomes compared to patients without thyrotoxicosis.

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Dysregulatory visceropathies in patients with uterine endometriosis and recurrent endometrial hyperplasia

Kazan medical journal ◽

10.17816/kazmj70697 ◽

1986 ◽

Vol 67 (5) ◽

pp. 347-349

Author(s):

N. I. Petrushkova

Keyword(s):

Endometrial Hyperplasia ◽

Digestive System ◽

Practical Significance ◽

Control Group ◽

Liver And Pancreas ◽

Rational Therapy ◽

History Of ◽

Group 2 ◽

Digestive Glands ◽

Group 1

The study of neurohormonal-visceral relationships in patients with uterine endometriosis is of practical significance in the development of rational therapy and prevention of this complex and rather frequent pathology. This study was aimed to investigate the functional state of the digestive glands of the stomach, intestines, liver and pancreas in 152 patients with uterine internal endometriosis (Group 1) and in 50 patients with recurrent endometrial hyperplasia (Group 2). Twenty healthy women were the control group. Patients with no history of diseases of the digestive system were selected for the examination.

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Psychiatric Morbidity in Sentenced Segregated HIV-Positive Prisoners

The British Journal of Psychiatry ◽

10.1192/bjp.163.6.802 ◽

1993 ◽

Vol 163 (6) ◽

pp. 802-805 ◽

Cited By ~ 6

Author(s):

Arthur Dorman ◽

Art O'Connor ◽

Eamonn Hardiman ◽

Aideen Freyne ◽

Helen O'Neill

Keyword(s):

Drug Abuse ◽

Matched Control ◽

Psychiatric Morbidity ◽

Hiv Positive ◽

Control Group ◽

Matched Control Group ◽

History Of ◽

The Mean ◽

Group 2 ◽

Group 1

In this comparative study with a control group of prisoners, psychiatric morbidity was measured in two groups of sentenced prisoners, each group completing the GHQ-30 and 21-item Beck Depression Inventory (BDI). Group 1 consisted of 40 segregated HIV-positive prisoners and group 2 a matched control group in the main prison who had no history of HIV seropositivity. All members of group 1 had a history of intravenous drug abuse. The mean GHQ-30 and BDI scores were significantly higher in group 1, and 90% of group 1 were psychiatric ‘cases’ compared with just over 42% of group 2. Levels of psychiatric morbidity present in a third group, consisting of HIV-positive prisoners who had not been segregated (prison authorities were unaware of their seropositivity) are an interesting pointer for further research.

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