Liver injury in COVID-19: A Direct hit or Collateral damage?

2021 ◽  
Vol 21 ◽  
Author(s):  
Balasubramaniyan Vairappan ◽  
Gavin Wright ◽  
Douglas Corrigal ◽  
Ravikumar TS
Keyword(s):  
Liver Injury ◽  
Liver Dysfunction ◽  
De Novo ◽  
Significant Feature ◽  
Extensive Literature ◽  
Collateral Damage ◽  
Drug Induced ◽  
Pubmed Database ◽  
Extensive Literature Search ◽  
Novel Coronavirus

: SARS-CoV-2 is a novel coronavirus identified in December 2019 in Wuhan, China, and since becoming a worldwide pandemic with far-reaching impacts on global human health and socio-economic activity. Worldwide there are over 2 million Covid-19 related deaths. Recently published case studies have reported that Covid-19 patients develop different degrees of liver dysfunction. Inevitably, in hospitalized Covid-19 patients who develop acute liver derangement, there are a plethora of potential pathogenic causes such as direct-viral, immune-driven, and drug-induced and/or ischaemic liver injury. Patients with advanced chronic liver diseases (e.g. cirrhosis) and/or autoimmune liver disease have a poor immune function and associated poorer outcomes compared to other critically ill cohorts. However, largely any immediate liver derangement tends to be relatively mild, and as such any de novo liver injury may not be a significant feature of Covid-19. There is an immediate necessity, therefore, to better understand the liver-specific pathophysiology of COVID-19. This review focuses on the up-to-date information about Covid-19 and associated indices for liver dysfunction, possible mechanisms, and potential drug targeted therapies in Covid-19 patients with and without liver dysfunction. PubMed database was used to perform an extensive literature search using the keywords liver and SARS-CoV-2, liver and Covid-19, Covid 19 and treatment etc.

scholarly journals Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

2021 ◽  
Vol 10 (13) ◽  
pp. 2947
Author(s):  
Adela Magdalena Ciobanu ◽  
Vlad Dionisie ◽  
Cristina Neagu ◽  
Otilia Maria Bolog ◽  
Sorin Riga ◽  
...  
Keyword(s):  
At Risk ◽  
Intraocular Pressure ◽  
Adverse Effects ◽  
Current Knowledge ◽  
Glaucoma Patient ◽  
New Drugs ◽  
Extensive Literature ◽  
Drug Induced ◽  
Psychopharmacological Treatment ◽  
Pubmed Database

Through the years, the available psychopharmacological treatments have expanded with numerous new drugs. Besides weight gain, gastro-intestinal problems or Parkinson-like symptoms, ocular adverse effects of psychiatric drugs have been reported. These adverse effects are not common, but can be dangerous for the patient. This review summarises the current knowledge on the risk of raised intraocular pressure and glaucoma entailed by psychopharmacological treatment. Also, it provides updated data for clinicians involved in the treatment of patients with glaucoma or glaucoma risk factors. For this purpose, we performed an extensive literature search in the PubMed database using specific terms. Selective serotonin and noradrenaline reuptake inhibitors are the best evidenced as having no association with glaucoma. Antipsychotics, and especially first generation, seem to have no correlation with an increased intraocular pressure and therefore possibly with a risk of glaucoma, although a special attention should be paid when using ziprasidone. Tricyclic antidepressants, benzodiazepines and topiramate should be avoided in patients diagnosed with glaucoma or at risk. Clinicians should be aware of the possible psychotropic drug induced glaucoma and monitor at risk patients closely in order to prevent this condition. Irrespective of the psychopharmacological regimen taken into consideration, the glaucoma patient should be under the strict supervision of the ophthalmologist.

scholarly journals Liver Injury and Elevated Levels of Interleukins, Interleukin-2 Receptor, and Interleukin-6 Predict the Severity in Patients With COVID-19

2021 ◽  
Vol 9 ◽  
Author(s):  
Kuan Luo ◽  
Yongfeng Chen ◽  
Junjie Yang ◽  
Quan Tao ◽  
Min Luo
Keyword(s):  
Liver Injury ◽  
Liver Dysfunction ◽  
Interleukin 6 ◽  
Clinical Characteristics ◽  
Interleukin 2 ◽  
Liver Disorder ◽  
The Novel ◽  
Interleukin 2 Receptor ◽  
New Vision ◽  
Novel Coronavirus

The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide, and the WHO declared it a pandemic on March 11, 2020. Clinical characteristics and epidemiology features of patients infected with SARS-CoV-2 have been explored in the previous study. However, little is known about the combinative association of liver dysfunction and abnormal interleukins (ILs) in severe patients with COVID-19. This study was designed to estimate whether liver dysfunction and abnormal ILs could predict the severity of COVID-19. This study integrated liver function data and ILs data in patients with COVID-19 and found that liver injury and two ILs, interleukin-2 receptor (IL-2R) and interleukin-6 (IL-6), were closely related to the prognosis of patients with COVID-19. This study may give more exact information to clinicians about the prognosis of patients with COVID-19. In addition, this correlational study between liver disorder and ILs may provide a new vision to diagnosis and treatment in patients.

scholarly journals Magnification in endodontics: A review of its application and acceptance among dental practitioners

2018 ◽  
Vol 12 (04) ◽  
pp. 610-616 ◽  
Author(s):  
Jun Fay Low ◽  
Tuti Ningseh Mohd Dom ◽  
Safura Anita Baharin
Keyword(s):  
Present State ◽  
Literature Search ◽  
Review Paper ◽  
Extensive Literature ◽  
Visual Enhancement ◽  
Pubmed Database ◽  
Dental Practitioners ◽  
Operating Space ◽  
Extensive Literature Search ◽  
Improved Outcome

ABSTRACTThe application of magnification devices in endodontics is mainly meant for visual enhancement and improved ergonomics. This is crucial especially when long hours are spent in a narrow operating space to treat obscure microanatomy. Nevertheless, application of magnification in endodontics has yet to be introduced into the mainstream practice due to various influences in behavioral patterns. By conducting an extensive literature search in the PubMed database, this narrative review paper depicts the present state of magnification devices, their applications within the endodontic practice, factors that influence their usage, the advantages, and shortcomings, as well as the significances of magnification in the field of endodontics. This review paper will encourage clinicians to employ magnification in their practice for improved outcome.

scholarly journals Artificial Intelligence in Small Bowel Endoscopy: Current Perspectives and Future Directions

2020 ◽  
Vol 11 (04) ◽  
pp. 245-252
Author(s):  
Dinesh Meher ◽  
Mrinal Gogoi ◽  
Pankaj Bharali ◽  
Prajna Anirvan ◽  
Shivaram Prasad Singh
Keyword(s):  
Artificial Intelligence ◽  
Small Bowel ◽  
Published Data ◽  
Extensive Literature ◽  
Pubmed Database ◽  
Examination Time ◽  
Extensive Literature Search ◽  
Small Bowel Endoscopy ◽  
Wireless Capsule ◽  
Google Search

AbstractArtificial intelligence (AI) is a computer system that is able to perform tasks which normally require human intelligence. The role of AI in the field of gastroenterology has been gradually evolving since its inception in the 1950s. Discovery of wireless capsule endoscopy (WCE) and balloon enteroscopy (BE) has revolutionized small gut imaging. While WCE is a relatively patient-friendly and noninvasive mode to examine the nonobstructed small gut, it is limited by a lengthy examination time and the need for expertise in reading images acquired by the capsule. Similarly, BE, despite having the advantage of therapeutic intervention, is costly, invasive, and requires general sedation. Incorporation of concepts like machine learning and deep learning has been used to handle large amounts of data and images in gastroenterology. Interestingly, in small gut imaging, the application of AI has been limited to WCE only. This review was planned to examine and summarize available published data on various AI-based approaches applied to small bowel disease. We conducted an extensive literature search using Google search engine, Google Scholar, and PubMed database for published literature in English on the application of different AI techniques in small bowel endoscopy, and have summarized the outcome and benefits of these applications of AI in small bowel endoscopy. Incorporation of AI in WCE has resulted in significant advancements in the detection of various lesions starting from dysplastic mucosa, inflammatory and nonmalignant lesions to the detection of bleeding with increasing accuracy and has shortened the lengthy review time in image analysis. As most of the studies to evaluate AI are retrospective, the presence of inherent selection bias cannot be excluded. Besides, the interpretability (black-box nature) of AI models remains a cause for concern. Finally, issues related to medical ethics and AI need to be judiciously addressed to enable its seamless use in future.

scholarly journals Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

Medicines ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 62 ◽  
Author(s):  
Rolf Teschke ◽  
Gaby Danan
Keyword(s):  
Liver Injury ◽  
Causality Assessment ◽  
Assessment Method ◽  
Comprehensive Analysis ◽  
Regulatory Agencies ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Pubmed Database ◽  
The Us ◽  
Key Terms

Background: A large number of idiosyncratic drug induced liver injury (iDILI) and herb induced liver injury(HILI) cases of variable quality has been published but some are a matter of concern if the cases were not evaluated for causality using a robust causality assessment method (CAM) such as RUCAM (Roussel Uclaf Causality Assessment Method) as diagnostiinjuryc algorithm. The purpose of this analysis was to evaluate the worldwide use of RUCAM in iDILI and HILI cases. Methods: The PubMed database (1993–30 June 2020) was searched for articles by using the following key terms: Roussel Uclaf Causality Assessment Method; RUCAM; Idiosyncratic drug induced liver injury; iDILI; Herb induced liver injury; HILI. Results: Considering reports published worldwide since 1993, our analysis showed the use of RUCAM for causality assessment in 95,885 cases of liver injury including 81,856 cases of idiosyncratic DILI and 14,029 cases of HILI. Among the top countries providing RUCAM based DILI cases were, in decreasing order, China, the US, Germany, Korea, and Italy, with China, Korea, Germany, India, and the US as the top countries for HILI. Conclusions: Since 1993 RUCAM is certainly the most widely used method to assess causality in IDILI and HILI. This should encourage practitioner, experts, and regulatory agencies to use it in order to reinforce their diagnosis and to take sound decisions.

scholarly journals Dietary Intake of Vegetables and Cooking Oil Was Associated With Drug-Induced Liver Injury During Tuberculosis Treatment: A Preliminary Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinyu Wang ◽  
Ke Xiong ◽  
Lei Xu ◽  
Chao Zhang ◽  
Shanliang Zhao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Injury ◽  
Dietary Intake ◽  
Liver Dysfunction ◽  
Vegetable Intake ◽  
Dietary Factors ◽  
Tuberculosis Treatment ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Cooking Oil

Background and Purpose: Drug-induced liver injury is challenging during tuberculosis treatment. There is no epidemiological data investigating the relation between dietary intake and the risk of drug-induced liver injury during tuberculosis treatment. The aim of this study is to investigate the association of food and nutrient intake with the incidence of tuberculosis-drug-induced liver injury.Methods: A cohort study was conducted in two city-level tuberculosis-specialized hospitals in Linyi City and Qingdao City, China from January 2011 to December 2013. The dietary intake was assessed by a 3-day 24-h food recall survey and a standard food-frequency questionnaire. The liver functions including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were monitored throughout the 6-month tuberculosis therapy. Liver injury was defined as ALT or AST higher than two times of the upper limit of normal (ULN). Liver dysfunction was defined as ALT or AST higher than the ULN. The ULN for ALT and AST is 40 U/L. Multivariate logistic regression analyses were performed to determine the dietary factors associated with the incidence of liver injury and liver dysfunction.Results: A total of 605 patients were included in the analysis. During the treatment, 8.1% patients exhibited liver injury and 23.3% patients exhibited liver dysfunction. A lower intake of vegetables was associated with a higher risk of liver injury [OR (95% CI): 3.50 (1.52–8.08), P = 0.003) and liver dysfunction [OR (95% CI): 2.37 (1.31–4.29), P = 0.004], while a lower intake of cooking oil was associated with a lower risk of liver injury [OR (95% CI): 0.44 (0.20–0.96), P = 0.040)] and liver dysfunction [OR (95% CI): 0.51 (0.31–0.85), P = 0.009].Conclusion: The current study indicated that the higher risks of tuberculosis-drug-induced liver injury and liver dysfunction were statistically associated with decreased vegetable intake and increased cooking oil intake.

scholarly journals Lorazepam as a Cause of Drug-Induced Liver Injury

2018 ◽  
Vol 12 (2) ◽  
pp. 546-550 ◽  
Author(s):  
Toshio Arai ◽  
Kazutoyo Kogi ◽  
Yuki Honda ◽  
Takao Suzuki ◽  
Koji Kawai ◽  
...  
Keyword(s):  
Liver Injury ◽  
Ursodeoxycholic Acid ◽  
Liver Dysfunction ◽  
Clinical Presentation ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Pathologic Findings ◽  
Old Japanese

Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia. A 51-year-old Japanese man with yellowish discoloration of the eyes and skin and pruritus was admitted due to liver dysfunction. He had taken lorazepam approximately 5 months prior to this admission. The clinical presentation and pathologic findings in the liver were consistent with drug-induced liver injury. After cessation of lorazepam, treatment with Stronger neo-minophagen C and ursodeoxycholic acid was started, and his liver injury resolved after 59 days. This case must serve as a warning to physicians to be aware of the possibility of unexpected liver injury caused by lorazepam.

Leberschaden unter oraler Antikoagulation, Statin- und ACE-Hemmertherapie

Praxis ◽  
2010 ◽  
Vol 99 (21) ◽  
pp. 1259-1265 ◽  
Author(s):  
Bruggisser ◽  
Terraciano ◽  
Rätz Bravo ◽  
Haschke
Keyword(s):  
Liver Injury ◽  
Wird Eine ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Ein 71-jähriger Patient stellt sich mit Epistaxis und ikterischen Skleren auf der Notfallstation vor. Der Patient steht unter einer Therapie mit Phenprocoumon, Atorvastatin und Perindopril. Anamnestisch besteht ein langjähriger Alkoholabusus. Laborchemisch werden massiv erhöhte Leberwerte (ALAT, Bilirubin) gesehen. Der INR ist unter oraler Antikoagulation und bei akuter Leberinsuffizienz >12. Die weiterführenden Abklärungen schliessen eine Virushepatitis und eine Autoimmunhepatitis aus. Nachdem eine Leberbiopsie durchgeführt werden kann, wird eine medikamentös-toxische Hepatitis, ausgelöst durch die Komedikation von Atorvastatin, Phenprocoumon und Perindopril bei durch Alkohol bereits vorgeschädigter Leber diagnostiziert. Epidemiologie, Pathophysiologie und Klink der medikamentös induzierten Leberschäden (drug induced liver injury, DILI), speziell von Coumarinen, Statinen und ACE-Hemmern werden im Anschluss an den Fallbericht diskutiert.

Drug-induced liver injury network (DILIN)

Hepatology ◽  
2004 ◽  
Vol 40 (4) ◽  
pp. 773-773 ◽  
Author(s):  
Jay H. Hoofnagle
Keyword(s):  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury
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