scholarly journals Serology and ultrasound for diagnosis of choledocholithiasis

2014 ◽  
Vol 96 (3) ◽  
pp. 224-228 ◽  
Author(s):  
J Isherwood ◽  
G Garcea ◽  
R Williams ◽  
M Metcalfe ◽  
AR Dennison
Keyword(s):  
Liver Function ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Liver Function Tests ◽  
Abdominal Ultrasonography ◽  
Cbd Stones ◽  
Test Parameters ◽  
Function Test ◽  
Chi Squared

Introduction Magnetic resonance cholangiopancreatography (MRCP) is not a routine investigation to exclude choledocholithiasis unless there is clinical or biochemical suspicion of common bile duct (CBD) stones. This study attempted to determine which radiological or serological parameters best predicted CBD stones. Methods All patients undergoing MRCP from 2005 to 2011 were selected. Patients with pancreatitis were excluded. Liver function tests (LFTs) at admission and prior to MRCP were recorded, as was abdominal ultrasonography and MRCP results. Parameters measured routinely on LFTs included alkaline phosphatase (ALP), alanine transaminase (ALT) and bilirubin. Receiver operating characteristic curve area analysis (area under the curve [AUC]) and chi-squared analysis were undertaken. Results Overall, 195 patients were identified, 71 of whom had CBD stones on MRCP. Raised ALP levels on admission demonstrated a correlation with CBD stones (AUC: 0.619, odds ratio [OR]: 3.16, p=0.06). At ultrasonography, a dilated CBD (OR: 3.76, p<0.001) and intrahepatic duct dilation (OR: 5.56, p<0.001) were highly significant predictors. However, only 37% of patients had a dilated CBD on ultrasonography. Ongoing elevation of LFT parameters, particularly ALP (AUC: 0.707, OR: 4.64, p<0.001) and ALT (AUC: 0.646, OR: 5.40, p<0.001), displayed a significant correlation with CBD stones. Conclusions Ongoing (even if minor) elevations of liver function test parameters should prompt the need to exclude CBD stones even in the presence of a normal CBD diameter on ultrasonography.

scholarly journals Biochemical liver function tests parameters do not indicate any difference in the degree of hepatotoxicity in patients with metastatic colorectal carcinoma treated with conventional anticancer drugs regardless the use of bevacizumab

2017 ◽  
Vol 74 (8) ◽  
pp. 757-762
Author(s):  
Kristina Denic ◽  
Dino Tarabar ◽  
Slobodan Obradovic ◽  
Nemanja Stanic ◽  
Jelena Spasic ◽  
...  
Keyword(s):  
Liver Function ◽  
Anticancer Drugs ◽  
Treatment Protocol ◽  
Liver Function Tests ◽  
The Other ◽  
Function Tests ◽  
Test Parameters ◽  
Function Test ◽  
Group 2 ◽  
Group 1

Background/Aim. Colorectal carcinoma (CRC) is one the most frequent malignant disease with early liver metastasis. It requires the timely use of anticancer drugs. Current treatment of metastatic CRC consists of conventional anticancer drugs use, but they cause liver damage which is manifested by disorder in biochemical liver function parameters. The addition of one of monoclonal antibodies, e.g. bevacizumab improves their therapeutic effect, but its influence on caused biochemical disturbances is not completely known. Therefore the aim of this study was to compare the level of liver function test parameters in patients treated with conventional anticancer drugs with parameters in patients additionally treated with bevacizumab. Methods. The study was performed on the two groups of adult patients with liver metastatic CRC assigned according to the treatment protocol. One group of the patients (n = 44) was treated with FOLFOX4 (the group 1), and the other one (n = 52) with bevacizumab added to FOLFOX4 treatment protocol (the group 2). Depending on the response of patients, the duration of treatment varied from 2 to 6 months. Standard liver function tests were performed before and after the completion of the treatment. Results. Initial values of some biochemical function test parameters [alkaline phosphatase (ALP) in the group 1 of patients, gamma-glutamyl transferase (GGT) and lactate dehydrogenase (LDH) in both groups] were increased in relation to the normal reference values, with some intergroup differences (p = 0.001). Biochemical disturbances of liver function tests in the group of patients treated with conventional anticancer drugs were due to not only their metastases but also due to the hepatotoxic effect of drugs used. After the treatment, significant differences in biochemical liver tests parameters were found in aspartate aminotransferase (AST), alanine aminotransferase (ALP), GGT and LDH, being lower in the group 2 (patients additionally treated by bevacizumab) (p values were: 0.002 for AST; 0.001 for ALP and GGT; 0.000 for LDH). The levels of the other studied parameters, alanine aminotransferase (ALT) bilirubin, and proteins did not differ significantly between groups both pre- or post-treatment. Conclusion. Both, metastatic CRC and treatment with the conventional anticancer drugs induce significant disturbances of several liver function parameters. The addition of bevacizumab to the conventional anticancer drugs did not affect these disturbances.

scholarly journals Comparison of pre-operative ultrasonography and magnetic resonance cholangiopancreatography with intra-operative surgical findings among patients suspicious to choledocholithiasis

2020 ◽  
Vol 7 (6) ◽  
pp. 1977
Author(s):  
Pulak Kumar Samanta ◽  
Rathin Sarkar ◽  
Sabyasachi Bakshi
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Stone Disease ◽  
Exclusion Criteria ◽  
Abdominal Ultrasonography ◽  
Cbd Stones ◽  
Function Test ◽  
The Mean ◽  
Cbd Stone ◽  
Operative Findings

Background: Choledocholithiasis with cholelithiasis is a common problem in the middle and older age group people. Aim of this study is to assess the usefulness of ultrasonography in the diagnosis of choledocholithiasis in resource poor set up.Methods: After matching the inclusion and exclusion criteria, all cases of diagnosed choledocholithiasis were taken for this prospective, single center, observational study.Results: Out of total 130 subjects, 41 were male and 89 were female. Increased incidence of choledocholithiasis was found in females (M:F=1:2.08). The mean age of presentation was 49.27±10.60 years. Ultrasonography was able to diagnose common bile duct (CBD) stones in 57 patients (43.84%) and ductal dilatation in 89 (68.46%). Whereas, magnetic resonance cholangiopancreatography (MRCP) detected CBD stones in 112 (86.15%). Cholelithiasis was associated with choledocholithiasis in 108 patients (83.07%).Conclusions: In the evaluation of choledocholithiasis, in our study particularly trans-abdominal ultrasonography (USG) seemed to have a lower yield than expected for accuracy in determining choledocholithiasis when compared to MRCP and Intra-operative findings. So, a negative USG in a particular may not exclude choledocholithiasis. So, MRCP is the ‘investigation of choice’ among the suspicious patients for CBD stone disease. That is why prior to cholecystectomy in symptomatic patients with deranged liver function test, MRCP always to be done, to detect the missed stone in CBD.

scholarly journals Biochemical liver function test parameter levels in relation to treatment response in liver metastatic colorectal patients treated with FOLFOX4 with or without bevacizumab

2016 ◽  
Vol 144 (11-12) ◽  
pp. 615-620 ◽  
Author(s):  
Kristina Denic ◽  
Dino Tarabar ◽  
Slobodan Obradovic ◽  
Marija Ristic ◽  
Jelena Spasic ◽  
...  
Keyword(s):  
Liver Function ◽  
Clinical Outcome ◽  
Liver Function Test ◽  
Disease Progression ◽  
Treatment Response ◽  
Stable Disease ◽  
Aspartate Aminotransferase ◽  
Gamma Glutamyltransferase ◽  
Test Parameters ◽  
Function Test

Introduction. Combined use of bevacizumab and conventional anticancer drugs leads to a significant improvement of treatment response in patients with metastatic colorectal carcinoma (CRC). Conventional treatment protocols exert undesired effects on the liver tissue. Hepatotoxic effects are manifested as a disturbance of liver function test parameters. The relation between clinical outcome and disorder of biochemical parameters has not been completely evaluated. Objective. The objective of our study was to examine whether clinical outcome in patients with liver metastatic CRC correlates with the level of liver function test parameters. Methods. The study included 96 patients with untreated liver metastatic CRC who received FOLFOX4 protocol with or without bevacizumab. Biochemical liver parameters were performed before and after the treatment completion. Treatment response was evaluated as disease regression, stable disease, and disease progression. The patients were divided into three groups according to the accomplished treatment response. Results. In the group of patients with disease regression the post-treatment levels of aspartate aminotransferase, alanine aminotransferase, and bilirubin were statistically significantly increased. In contrast to this, gamma-glutamyltransferase and protein post-treatment values were significantly lower in relation to initial values. In patients with stable disease, difference was found only in the level of proteins being lower after the treatment. In patients with disease progression, values of aspartate aminotransferase and bilirubin were significantly increased after completed treatment. Conclusion. Treatment responses are not completely associated with the level of liver function test parameters. The only parameter which correlated with treatment response is gamma-glutamyltransferase. Its decrease is accompanied with disease regression.

scholarly journals Assessment of Liver Function Tests in Children with Typhoid Fever: A Hospital Based Study

2019 ◽  
Vol 17 (2) ◽  
pp. 21-22
Author(s):  
Shakil Ahmad
Keyword(s):  
Liver Function ◽  
Typhoid Fever ◽  
Liver Function Test ◽  
Liver Function Tests ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Medical College ◽  
Endemic Diseases ◽  
Function Tests ◽  
Function Test ◽  
Loss Of Appetite

Background: Typhoid fever is among the most endemic diseases in the tropics and which causes significant morbidity and mortality. It can lead to liver damage if not properly treated. Therefore, the liver function test assessment was conducted in children with typhoid fever. Our study aimed to evaluate the liver function test abnormalities in typhoid fever. Material and methods: This was a prospective observational study conducted at the department of paediatrics, Nepalgunj Medical College and Teaching hospital, Nepalgunj for a period of one year August 2018-July 2019.In the present study total 60 children of Typhoid fever were included on the basis of inclusion and exclusion criteria. On admission a detailed history and complete physical examination was carried out. Routine investigations were also carried out. The diagnosis was confirmed by serum Widal test. Liver function tests were performed i.e. Serum glutamic oxaloacetic transaminase [SGOT] and serum glutamic pyruvic transaminase [SGPT] estimation. Result: In the present study total children were 60 in which 43.33% were boys and 56.66% were girls. Fever was present in all the cases loss of appetite, cough, vomiting was present in majority of cases. On admission, SGOT and SGPT levels were found > 35 IU/L in 26 cases (43.33%) and 34 cases (56.66%) respectively. On discharge after 7 days of antibiotic, majority of patients had SGOT and SGPT levels < 35 IU/L. Conclusion: Our study concluded that on admission of children SGOT and SGPT levels were found > 35 IU/L in 43.33% and 56.66% respectively. On discharge after 7 days of antibiotic, majority of patients had SGOT and SGPT levels < 35 IU/L.

scholarly journals Effect of Ramadan Fasting on Body Composition, Biochemical Profile, and Antioxidant Status in a Sample of Healthy Individuals

2020 ◽  
Vol 18 (4) ◽  
Author(s):  
Asna Urooj ◽  
Namratha Pai Kotebagilu ◽  
Lohith Mysuru Shivanna ◽  
Satish Anandan ◽  
Akshatha Nagaraja Thantry ◽  
...  
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Liver Function ◽  
Biochemical Parameters ◽  
Liver Function Tests ◽  
Free Living ◽  
Ramadan Fasting ◽  
Random Blood Sugar ◽  
Function Tests ◽  
Function Test

Background: Muslims fast during the month of Ramadan by abstinence from food and drink every day from dawn to sunset. Studies have reported contradictory results with respect to the changes in body weight and biochemical parameters. No study has been conducted on the association between fasting and body weight and biochemical parameters in the Indian setting on healthy Muslim subjects. Objectives: To assess the effect of fasting during Ramadan on biochemical parameters such as lipid profile, liver function test, renal function test, antioxidant status, random blood sugar, hemoglobin, body composition, and blood pressure in a sample of healthy individuals. Methods: In this study, 52 healthy free-living participants (25 males, 27 females, 21-64 years) who met the inclusion and exclusion criteria and completed both follow-ups (before and after Ramadan) were studied. Participants were fasting 12 hours a day for at least 21 days, including menstruating women. It was a free-living study with no dietary restrictions. Anthropometry, lipid profile, liver and renal function tests were measured by standard methods. Body composition was analyzed by bioelectrical impedance. Results: Significant beneficial changes in albumin, alanine aminotransferase, creatinine, and high-density lipoprotein (HDL) were observed, while total cholesterol, random blood sugar, aspartate aminotransferase, and alkaline phosphatase enzymes remained unchanged after Ramadan. Fasting did bring in some changes in body composition; among both men and women, mean weight loss ranged from 0.81 - 1.4 kg in majority of the subjects, which was due to loss in muscle mass. Moderate changes in intra- and extracellular water content was observed after fasting. Conclusions: Significant improvements were observed in HDL levels and liver function tests, which can be attributed to the loss of body weight. Improvement in liver function tests may be related to the changes in cytokines and alteration in sleep patterns. Ramadan-like fasting, along with the nutritional education prior to fasting, may be beneficial and effective in the spiritual and overall well-being.

scholarly journals Oral antifungal: the safety and efficacy of oral itraconazole in dermatophytosis

2019 ◽  
Vol 8 (11) ◽  
pp. 2470
Author(s):  
Vaishali Thakare ◽  
Nandita K. Patel ◽  
Sharmila Patil ◽  
Navin Modi
Keyword(s):  
Liver Function ◽  
Liver Function Test ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Hepatic Function ◽  
Care Hospital ◽  
Hepatic Transaminases ◽  
Function Test ◽  
History Of ◽  
Oral Itraconazole

Background: The systemic antifungals like Griseofulvin, Itraconazole, Terbinafine, Ketoconazole and Fluconazole are widely used for superficial fungal infection. Hepatotoxicity with oral antifungals is well established fact. The rate of transient asymptomatic changes in liver function tests accounts for about 0.5 - 10% of all patients treated with systemic antifungals. Clinical hepatic toxicity is seen less frequently. The aim of this study is to evaluate the effect of oral Itraconazole on hepatic function and it’s efficacy in patients with extensive dermatophytosis.Methods: The total of 524 patients with extensive dermatophytosis were included in our study which was conducted in a tertiary care hospital in Navi Mumbai.Results: Itraconazole, a systemic antifungal agent is efficiently used in treatment of superficial and deep mycoses. It inhibits fungal cytochrome P450 dependent enzyme and thus impaires conversion of lanosterol to ergosterol. Adverse reactions to itraconazole includes drug reactions, gastrointestinal upset, headache, dizziness, thrombocytopenia, gynecomastia, reversible edema of extremities and metabolic side effects like hypokalemia, and hypertriglyceridemia. The level of hepatic transaminases increases in about 1%-5% of patients who have received continuous therapy with systemic itraconazole. Clinical hepatitis rarely occurs in patients and, recovery generally ensues with the cessation of medication.Conclusions: The baseline and post treatment liver function test is important to monitor if patient is on higher dose and longer duration of itraconazole therapy. The screening for high risk patients like poor liver function test, history of alcoholism, history of liver disease should be taken before stating the therapy.

scholarly journals Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital

2017 ◽  
Vol 4 (11) ◽  
pp. 3633 ◽  
Author(s):  
Ganni Bhaskara Rao ◽  
Samir Ranjan Nayak ◽  
Sepuri Bala Ravi Teja ◽  
Reshma Palacharla
Keyword(s):  
Patient Safety ◽  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Liver Function ◽  
Liver Function Test ◽  
Ultrasound Examination ◽  
Cbd Stones ◽  
Function Test ◽  
Cbd Stone

Background: Cholelithiasis is a common disease and at present the laparoscopic cholecystectomy is the gold standard treatment. The diagnosis of associated common bile duct stone for patients with gallstones is important for prompt surgical decision, treatment efficacy and patient safety. However, whether upper abdominal ultrasound and Liver function test (LFT) is adequate before doing lap cholecystectomy remains controversial. There are different opinions regarding the routine magnetic resonance cholangiopancreatography (MRCP) to detect the possible presence of common bile duct (CBD) stones before laparoscopic cholecystectomy.Methods: This study was carried on a total of 106 patients who were admitted and treated for gall stone diseases in the Department of General Surgery, GSL General Hospital over a period of 24 months. After admission all cases were subjected for liver function test, USG abdomen and MRCP. The collected observational data was analyzed.Results: Among the 106 patients, a total of 17cases showed concurrent gallstones and choledocholithiasis, 11 cases choledocholithiasis were revealed by ultrasound examination, while 6 cases of choledocholithiasis were not detected by ultrasound examination but were confirmed by MRCP.Conclusions: CBD stone may be missed even in the presence of deranged liver enzymes or dilated CBD in USG abdomen. Hence for patient safety routine preoperative MRCP examination is recommended before doing laparoscopic cholecystectomy to rule out the likelihood of concomitant CBD stones. The cost-effectiveness of such expensive investigation is to be studied further taking into consideration preventive costs and patient morbidity and mortality.

How to interpret and manage abnormal liver blood test results in older people

2021 ◽  
pp. 1-8
Author(s):  
Mohsan Subhani ◽  
Abhishek Sheth ◽  
Bilal Ahmad ◽  
Stephen Ryder
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Test Results ◽  
Older Population ◽  
The Metabolic Syndrome ◽  
Function Tests ◽  
Function Test ◽  
Common Observation

Ageing impairs liver function and reduces the liver's regenerative capacity. With the predicted increase in the older population, the burden of liver disease will proportionally rise in this age group. Elevated levels of liver enzymes in an otherwise asymptomatic older individual (≥65 years) are a common observation and positively associated with the metabolic syndrome, whereas a decline in albumin levels is linked with a rise in all-cause and liver-specific mortality. Deranged liver function tests do not always indicate liver disease, nor do normal liver function tests exclude liver disease. Therefore, clinicians need to consider individual patient risk factors during the assessment of abnormal liver function tests. This article discusses various liver function tests, their pathophysiology, and the approach to interpret and manage common abnormalities in liver function test results and liver disease in the older population.

scholarly journals Hepatic Manifestations in Hematological Disorders

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Jun Murakami ◽  
Yukihiro Shimizu
Keyword(s):  
Liver Function ◽  
Clinical Symptoms ◽  
Liver Function Tests ◽  
Hematologic Malignancies ◽  
Abnormal Liver Function ◽  
Abnormal Liver Function Test ◽  
Liver Imaging ◽  
Test Results ◽  
Hematological Disorders ◽  
Function Test

Liver involvement is often observed in several hematological disorders, resulting in abnormal liver function tests, abnormalities in liver imaging studies, or clinical symptoms presenting with hepatic manifestations. In hemolytic anemia, jaundice and hepatosplenomegaly are often seen mimicking liver diseases. In hematologic malignancies, malignant cells often infiltrate the liver and may demonstrate abnormal liver function test results accompanied by hepatosplenomegaly or formation of multiple nodules in the liver and/or spleen. These cases may further evolve into fulminant hepatic failure.

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