Natural Ways to Treat Fatty Liver
The use of herbs and nutritional supplements to treat various disorders is common. Herbs are used for various effects, such as to boost the immune system, treat depression, and for relaxation. Individuals are becoming more aware of the benefits of herbal therapies and nutritional supplements. Advertisements, books, magazines, and Internet sites abound concerning these topics. People, eager to cure or control various disorders, take herbs, teas, megadoses of vitamins, and various other natural products. Although much information is available on nutritional supplements and herbal therapy, obtaining the correct information sometimes is difficult. Medicinal herbs and nutritional substances are available at supermarkets, pharmacies, health food stores, specialty herb stores, and through the Internet. The potential for misinformation abounds. Because these substances are natural products, many individuals may incorrectly assume that they are without adverse effects. When any herbal remedy...
As shown in figure 5.15, glutamic acid can be formed through transamination by the combination of an amine group with a-ketoglutaric acid. Glutamic acid is also produced in the liver from the ammonia that is generated by intestinal bacteria and carried to the liver in the hepatic portal vein. Since free ammonia is very toxic, its removal from the blood and incorporation into glutamic acid is an important function of a healthy liver.
Depending on the patient, around 2 risk of death. In some, it may be higher, particularly the elderly if they are having other heart procedures, for example, a valve replacement too. The risks are higher in patients who have had a heart attack within two months this is why the operation should be postponed if possible. A freshly damaged heart muscle is soft and electrically irritable and may tear and go into dangerous rhythms. The risk of heart bypass increases in older patients, those with lung, kidney, or liver damage. The risks of stroke are higher in the elderly and in those who have narrowing in their neck or brain arteries, or who have fat deposits in their aorta, or a calcified, hard aorta.
Alanine aminotransferase (ALT also called glutamate-pyruvate transaminase, GPT) and aspartate aminotransferase (AST also called glutamate-oxaloacetate transaminase, GOT) are important in the diagnosis of heart and liver damage caused by heart attack, drug toxicity, or infection. After a heart attack, a variety of enzymes, including these aminotransferases, leak from the injured heart cells into the bloodstream. Measurements of the blood serum concentrations of the two aminotransferases by the SGPT and SGOT tests (S for serum) and of another enzyme, creatine kinase, by the SCK test can pro The SGOT and SGPT tests are also important in occupational medicine, to determine whether people exposed to carbon tetrachloride, chloroform, or other industrial solvents have suffered liver damage. Liver degeneration caused by these solvents is accompanied by leakage of various enzymes from injured hepato-cytes into the blood. Aminotransferases are most useful in the monitoring of people exposed to...
Ed simultaneously but not as a composite graft. Combined liver-intestinal transplantation is performed in patients with intestinal failure together with liver damage (considered irreversible), usually due to parenteral nutrition. Severe fibrosis on histology with bilirubin of more than 10 mg dl may indicate a point of no recovery for liver function.
The most common cause of liver damage requiring transplantation is chronic active non-A, non-B, viral, hepatitis. However, liver transplantation has been performed also in individuals with primary biliary cirrhosis, hepatitis B, cirrhosis, and inborn errors of metabolism.
Surveys of Vibrio illness in Florida during 1981-1988 and the Gulf Coast in 1989 found that V. damsela was responsible for only 1 of 52 and 1 of 29 wound infections, respectively (26,95). The pathogen was associated with 5 of the 386 and 3 of the 551 Vibrio infections reported to the CDC in 1997 and 1998, respectively (96). All 3 cases in 1998 and 2 of the cases in 1997 were associated with wound infections. Surprisingly, one case in 1997 was associated with gastroenteritis. Five of the 6 cases reported by Morris et al. (39) were patients who were injured in or near seawater or brackish water. Most infections were the result of injuries sustained while coming in contact with marine life (e.g., stingray bite, stepping on catfish barb, filleting fish, fish fin puncture, cleaning catfish) (39,74-76,78,79). A case of primary septicemia in a man with underlying diabetes and alcoholic liver disease was associated with consumption of raw eels (77). Eels have been reported to succumb to...
Restart at 50 dose, when liver enzyme values decrease to 2.5-5.0 times normal values and bilirubin is less than 1.5 times the normal value. If toxicity persists, a liver biopsy should be performed to determine the histologic findings to assess the extent of liver damage.
On the above view, NLSD is primarily a disease of defective phospholipid metabolism and the TAG-derived route of phospholipid biosynthesis is essential for the normal functioning of skin, muscle, liver, and the central nervous system. Further studies on the fatty liver dystrophic mouse which bears a close resemblance to human NLSD 103 may identify the defective gene. Defective neutral phospholipid metabolism in this mouse model is reflected by a decreased phospholipid content of peripheral nerve myelin 109 . The nature of the lipase(s) involved in normal TAG-to-phospholipid acyltransfer has not been characterized, but may be similar to a previously described microsomal neutral lipase 110 or to a carboxylesterase 111 .
Glycogen is the main carbohydrate store in the liver, and may amount to as much as 7 to 10 of the weight of a normal, healthy liver. The glycogen molecule resembles a tree with many branches (see Fig. 27.19). Glucose units are linked via a-1,4- (to form a straight chain) or a-1,6 (to form a branched chain) glycosidic bonds. The advantage of such a configuration is that the glycogen chain can be broken down at multiple sites, making the release of glucose much more efficient than would be the case with a straight-chain polymer.
The circulation much more slowly if bound to a protein. Any type of liver damage or disease will generally reduce SHBG production. The latter can upset the hormonal balance between LH and testosterone. For example, if SHBG declines acutely, then free testosterone may increase while the total amount of circulating testosterone would decrease. In response to the increase in free testosterone, LH levels would decline in a homeostatic attempt to reduce testosterone production.
The diacylglycerol formed by the action of PAP can be used either for TAG synthesis (Fig. 3.6), or for glycerophospholipid synthesis (Fig. 7.1). The biosynthesis of phospholipids takes precedence over that of TAG when the rate of synthesis of diacylglycerol is relatively low. This ensures the maintenance of membrane turnover and bile secretion, which are more essential processes in physiological terms than the accumulation of TAG. The precise mechanisms for the preferred synthesis of phosphoglycerides are not certain, however. Among the factors involved is probably a relatively low Km of choline phospho-transferase for diacylglycerol. A factor that may eventually limit the biosynthesis of phosphati-dylcholine is a limitation in the supply of cho-line and it is well recognized that a major effect of choline deficiency is fatty liver indicating a diversion away from phospholipid biosynthesis into TAG biosynthesis.
There are a number of possible outcomes (Fig. 22-4). Less than 1 of the icteric cases die of fulminant hepatitis. Most recover uneventfully following complete regeneration of the damaged liver within 2-3 months, but some progress to chronic infection. This may take the form of an asymptomatic carrier state, defined as HBs antigenemia persisting for at least 6 months, or of chronic persistent hepatitis or chronic active hepatitis causing progressive liver damage, which may lead eventually to cirrhosis and or to primary hepatocellular carcinoma. A proportion of those with chronic persistent or chronic active hepatitis develop manifestations of immune-complex disease, systemic necrotizing vasculitis (polyarteritis nodosa) and membranoproliferative glomerulonephritis being the two most common.
For patients with baseline abnormal liver function test results of unknown cause, a biopsy would be performed to define the following disorders hepatotoxin-induced liver disease, liver damage from prior or ongoing viral infections, and occult alcoholic liver disease. viii. Opportunistic infections have been reported in some RA patients treated with weekly, low-dose MTX. The combined immunosuppression of corticosteroids and MTX may contribute to the risk for such infection. Appropriate immunizations should be offered to RA patients taking MTX. ix. Nodulosis. The development of multiple, new, small, painful nodules on the hands and elsewhere can be quite uncomfortable and functionally limiting. These often occur despite excellent disease control elsewhere. The addition of hydroxychloroquine or colchicine has, in rare patients, led to some control of the development of nodules.
The prevention of ischemia- reperfusion injury (IRI) is a serious problem in transplantation by maintaining the integrity of the transplant. IRI is a complex phenomenon which damages the transplant already shortly after harvesting the graft from animals or patients. It leads to the production of toxic oxygen radicals, up-regulation of adhesion molecules and production of proinflammatory cytokines e.g., by resident antigen presenting cells (APC) in the liver (Kupffer cells) e.g., TNF-a. Donckier et al6 could show in a preclinical pig liver transplant model that preconditioning of the donor with IL-10 at the beginning of graft harvest followed by 5 hours of cold ischemia led to significant reduction of liver transaminases (early indicator of liver damage) in the transplant donor. However, no differences regarding the infiltration of cells and necrosis could be observed when compared to untreated controls.6
Although not an entirely homogeneous group of diseases, the hemorrhagic fevers (Table 36-5) share the common characteristic of widespread hemorrhage from the body's epithelial surfaces, including internal mucosae such as the gastrointestinal tract as well as the skin. The skin rash is often a mixture of pinpoint hemorrhages (petechiae) and massive bruising (ecchymoses), as depicted in Fig. 36-5B. The pathogenesis of these important diseases is generally not well understood. Thrombocytopenia and leukopenia are almost always present, but no general mechanism has been discovered to explain the hypovolemic shock without major blood loss which may lead to death within hours in dengue or Lassa fever, for example. Severe liver damage, extensive bleeding, and disseminated intravascular coagulation may be the key to the high mortality in the African hemorrhagic fevers, Crimean hemorrhagic fever, and the hemorrhagic form of Rift Valley fever. Encephalopathy and or pneumonia can also be...
Identification and quantification of serum components are often used in screens for immunotoxic events. The albumin globulin ratio is a common determination used in toxicology studies. Because albumin is the most abundant protein in serum, fluctuations in levels may suggest altered protein synthesis (e.g., liver damage) or increased excretion (e.g., kidney damage). The globulin fraction consists of various antibody isotypes and changes may signal a derangement in synthesis (decreases) or neoplastic conditions (increases).
The precise link between the use of halothane and the subsequent development of hepatitis remains unclear. The incidence is extremely low, being in the region of 1 10000-20000 halothane administrations. The clinical picture is one of jaundice, with a massive rise in plasma aminotransferases several days after the exposure to halothane, associated with severe hepatic necrosis. The mortality rate is approximately 50 . Severe liver damage is unlikely to occur after a single exposure in adults, but repeat administration at an interval of less than 3 months should be avoided, particularly in obese, middle-aged females. With the current range of alternatives this should no longer be necessary. The risk to children appears to be much less.
Abdominal pain is a common complaint and may reflect gastrointestinal disorders associated with medications or intrinsic SLE-related pathology. Sterile peritonitis (serositis) and mesenteric vasculitis may be difficult to document. Intestinal perforation, especially in patients on corticosteroids that can mask symptoms, must be considered in addition to spontaneous bacterial peritonitis. Pancreatitis may also occur. Hepatomegaly may occur in one-fourth of patients, but abnormal liver function test findings are often drug-related rather than indicative of intrinsic lupus-associated liver damage. Chronic active hepatitis with positive tests for LE cells or ANAs (lupoid hepatitis) is not part of the spectrum of SLE. Splenomegaly may be found in the setting of active disease and splenic infarcts can occur.
Diagnostic testing to determine the presence of HCV viremia and the extent of liver pathology should be completed as early as possible in the care of a patient infected with HCV. Liver biopsy is useful in evaluating liver damage and deciding type of treatment elevation in serum transaminases in the absence of inflammation or fibrosis typically is not an indication for treatment. Patients with active HCV infection or evidence of chronic liver disease should be referred to a specialist with experience in treating hepatitis C for evaluation and guidance regarding possible treatment. Treatment recommendations should be individualized, and not all patients with HCV should receive treatment. Factors to be considered in the selection of patients for treatment include the patient's immune status the presence of moderate to severe inflammation and or fibrosis, which predicts the likelihood of progression to cirrhosis in the absence of treatment the likelihood of a favorable response to...
Kava is a popular herbal remedy used to relieve stress, anxiety, and tension promote sleep and provide relief from menstrual symptoms. Although the FDA has not made a determination about the ability of kava dietary supplements to provide such benefits, it has issued an alert indicating that the use of kava may cause liver damage. Because kava-containingproducts have been associated with liver-related injuries (eg, hepatitis, cirrhosis, and liver failure), the safest use of kava is to take the herb occasionally for episodes of anxiety, rather than on a daily basis. It is important that individuals who use a kava-containing dietary supplement and experience signs of liver disease immediately consult their primary health care provider. Symptoms of liver disease includejaundice, urine with a brownish discoloration, nausea, vomiting, light-colored stools, weakness, and loss of appetite. Adverse effects experienced with the use of dietary supplements should be reported to the FDA's MedWatch...
Patients should be monitored prior to and during treatment with methotrex-ate. Conventionally, full blood count (FBC) and liver function tests are undertaken monthly. A chest X-ray is taken at the beginning of treatment, providing a baseline against which any subsequent lung problems can be evaluated. To avoid methotrexate-induced liver damage, it is also standard practice to advise patients to drink either no or very little alcohol. The true value of these monitoring policies, in terms of evidence-based medicine, is
The liver is routinely perfused with heparinized blood from the same species, or with a perfusate comprised of washed bovine erythrocytes that are suspended in a buffer that contains albumin. Perfusion is achieved via the portal vein (and via the hepatic artery, if necessary), and the venous effluent is collected either first pass or reperfused through the liver after reoxygenation. Drugs are administered either by pulse dosing (single or cassette) or by constant infusion into the perfusate. Routinely, perfusate samples are taken at timed intervals up to 6 hours after dosing for quantitative analysis of parent drug, metabolites, and markers (of liver damage) by LC-MS MS. Bile is collected throughout the study and the parent drug or metabolites are analyzed. The results are usually expressed as the rate of hepatic uptake and biliary
Silybum marianum (Compositae Asteraceae) is a biennial thistle-like plant (milk thistle) common in the Mediterranean area of Europe. The seeds yield 1.5-3 of flavonolignans collectively termed silymarin. This mixture contains mainly silybin (Figure 4.44), together with silychristin (Figure 4.45), silydianin (Figure 4.46), and small amounts of isosilybin (Figure 4.45). Both silybin and isosilybin are equimolar mixtures of two trans diastereoisomers. Silybum marianum is widely used in traditional European medicine, the fruits being used to treat a variety of hepatic and other disorders. Silymarin has been shown to protect animal livers against the damaging effects of carbon tetrachloride, thioacetamide, drugs such as paracetamol, and the toxins a-amanitin and phalloin found in the death cap fungus (Amanita phalloides) (see page 433). Silymarin may be used in many cases of liver disease and injury, though it still remains peripheral to mainstream medicine. It can offer particular benefit...
Chronic active hepatitis is distinguished from the asymptomatic carrier state by progression of liver damage, as indicated by continuing elevation of serum transaminase levels and histologic evidence on liver biopsy. Persistence of HBV DNA, viral polymerase, HBeAg, and virions implies active viral multiplication, high infectivity, and progressive liver damage, the hallmarks of the high replicative phase, in contrast, anti-HBe, which develops only after HBeAg disappears and enzyme levels have declined, indicates a longer standing carrier state characteristic of the low replicative phase.
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