Introduction:
Hepatocellular carcinoma (HCC) is representing more than 70 % of primary malignant tumors of the liver and ranks the fifth most frequent malignancy worldwide and the third fatal one(1). Its prevalence is increasing in the developed countries particularly in United States and west Europe. Cirrhosis is the strongest and the most commonly known risk factor for HCC, particularly, cirrhosis related to hepatitis C virus (HCV) and hepatitis B virus infections (2). Egypt has rising trend of HCC incidence due to the high prevalence of HCV infection(3,4) among the general population(5). According to the stage of the cancer in terms of tumor size vascular invasion and distant metastasis the available therapeutic choices determined, aiming
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Although HCC surveillance programs are controversial, most international societies – the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases recommend the use of ultrasound and α-fetoprotein(AFP) in high risk patients, at 6–12 months frequency (6). The use of AFP alone is strongly discouraged, and its use, in addition to ultrasound, is controversial. Patients with abnormal screening tests require additional investigations. Although the optimal methods of screening and the cost effectiveness of surveillance for HCC remain to be established, screening still offers the best hope for early diagnosis, treatment eligibility, and improved survival (7-9). GP73 is a resident Golgi protein, shown to be upregulated in hepatocytes of patients with acute, chronic hepatitis and cirrhosis(10,11) with a significant increase in the sera of patients with hepatitis B virus and HCV-related HCC (12), providing a marker for its early detection (13). In this study, we aimed to evaluate the presence of GP73 in the serum of all patients with cirrhosis and to determine its sensitivity and specificity as a screening tool for the …show more content…
21.0, IBM Corp., USA, 2012). Results had been represented in tables, figures and graphics using Microsoft Excel. Data had been presented using Microsoft power point. Statistics: Quantitative variables were expressed as mean and standard deviation for parametric data and median for nonparametric data. Qualitative variables were expressed as frequency and percentage. The w2 (goodness-of-fit) test compares the observed and expected frequencies in each category to test whether all categories contain the same proportion of values. Descriptive statistics for HCC and non-HCC [liver cirrhosis (LC) and normal] groups as regards GP73 were compared using box plots. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for predicting GP73, and AFP, receiver operating characteristic curves were constructed to assess the power of the GP73 and AFP in predicting HCC by calculating the area under the curve.
Ethical considerations: Data had been collected without any harm to the patients and after explaining the aim of the study to the patients and had an informed consent from them, in group of blood volunteers the samples was taken from the blood bags as the other routine samples, so they didn't exposed to any harm or additional
This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the liver that interferes with its normal functions including alcoholism. Most people who drink large amounts of alcohol cause harm to the liver in some way (Heidelbaugh & Bruderly, 2006). The cause of cirrhosis is not yet known, but the connection between cirrhosis and excessive alcohol ingestion is established (Jenkins & Johnson, 2010). Common causes of cirrhosis include: alcohol abuse, hepatitis B infection, hepatitis C infection and non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (Schuppan & Afdhal, 2008).
They claim the reason these conflicts are brought to court is because of confusion over who has the rights of the samples so if there were laws about tissue samples and research there wouldn’t be as much confusion (Gantz 301). One example of this confusion is William Catalona, a prostate cancer researcher at Washington University. Caralona decided to leave Washington University and research at Northwestern University. Gantz and co-authors note, before leaving, Catalona sent out consent forms to the patient’s whom he had tissue and/or blood samples from saying “I have donated a tissue and/or blood sample for Dr. William J. Catalona's research studies. Please release all samples to Dr. Catalona at Northwestern University upon his request. I have entrusted these samples to Dr. Catalona to be used only at his direction and with his express consent for research projects" (Gantz 300). They go on to note, nearly 6,000 people returned consent forms and Washington University filed a lawsuit against Catalona claiming the University had rights to the tissue/blood (Gantz 300). Gantz, Roche, and George include this story to show that after the tissue leaves the body, it’s hard to tell who “owns” or has rights to
The liver plays central role in each of these phases of clotting process, as it synthesizes the majority of coagulation factors and proteins involved in fibrinolysis as well as thrombopoietin., which is responsible for platelet production from megakaryocytes. In cirrhosis, liver is badly get damaged. So the production of coagulation factors and proteins is impaired. Many pathological processes associated with cirrhosis, such as portal hypertension and endothelial dysfunction as well as co-morbid conditions, may also alter the coagulation process. Consequently, patients with liver disease as in cirrhosis, have a disturbed balance of procoagulant and anti- coagulant factors which deviates from the normal coagulation cascade.
Characterized by progressive tissue injury and scarring, cirrhosis is among the leading causes of chronic liver failure in the United States. Recent research conducted by the National Institutes of Health indicated that the prevalence of cirrhosis, especially in clients diagnosed with Hepatitis C, has increased steadily throughout the past decade and will likely continue to increase in the future (Kanwal et al., 2011). Caused by recurrent tissue damage and inflammation, cirrhosis occurs as healthy hepatocytes (liver cells) are replaced by fibrotic and non-functional scar tissue through natural healing processes. Although liver tissue is normally very resilient, sustained injury eventually outpaces restorative capacity and a majority of functional tissue is replaced with collagenous tissue and liver failure occurs. In the United States, cirrhosis is most commonly caused by Hepatitis C, alcoholism, fatty liver disease, and biliary obstruction (Kanwal et al., 2011). Due to the increase in prevalence and the seriousness of the condition, cirrhosis represents a significant healthcare issue. The treatment and care of clients diagnosed with cirrhosis is complex. The following information addresses several of the major aspects of nursing care associated with the treatment of clients diagnosed with cirrhosis. Additionally, current studies regarding the treatment of cirrhosis will be evaluated in an effort to assess their readiness to be incorporated into current evidenced-based nursing practice.
The Hepatitis B virus is a disease that affects the liver and results in swelling and loss of normal function in the liver. It is estimated that 350 million people are infected with Hepatitis B worldwide, with 50 million new cases diagnosed every year.(1) In the Unit...
As chronic viral hepatitis has a high prevalence in patients with HIV, clinicians should assess the risk of development of hepatotoxicity in these patients whenever HAART is initiated.7
Hepatitis A is a virus or an infection that causes liver disease and inflammation of the liver. According to Centers for Disease and Prevention, hepatitis A is a self- limited disease that does not cause a chronic infection and it is rarely fatal. The virus is an infectious disease of the liver which cannot be transmitted by sneezing and coughing. It is usually transmitted from person to person through the feces or the mouth, from consuming contaminated food or water. Many people do not experience any symptoms of hepatitis A, but if someone was to get it, then the symptoms could last from 2 weeks to 6 weeks. The blood is tested to determine how the liver is functioning. The blood is usually taken from the vein in the arm and
Hepatitis A is a virus or an infection that causes liver disease and inflammation of the liver. According to Centers for Disease and Prevention, hep A is a self- limited disease that does not cause a chronic infection and it is rarely fatal. The virus is an infectious disease of the liver which cannot be transmitted by sneezing and coughing. It is usually transmitted from person to person through the feces or the mouth, from consuming contaminated food or water. Many people do not experience any symptoms of hepatitis A, but if someone was to get it, then the symptoms could last from 2 weeks to 6 weeks. The blood is tested to determine how the liver is functioning. The blood is usually taken from the vein in the arm and is taken to the lab
Blackwell, Wiley. "Alcoholic Cirrhosis Patients Had High Prevalence of Complications at Diagnosis." ScienceDaily. ScienceDaily LLC, Apr. 27,2010. Web. 4 Nov 2011. .
There is a disease spreading out in the world called Hepatitis C. It affects the liver and may cause the liver to fail. This disease is caused by a virus called Hepatitis C virus which is also known as HCV. About 32,000 people are affected with this disease per year only in the United States area. Some It’s a disease with many symptoms and many causes. of these symptoms are easy bruising, upset stomach and fever. These are just some of the many symptoms that come from the virus. Hepatitis Cs nature of the causative agent is determined by many things. The biological data of this disease is filled so much information. It is estimated that over 180 million people have gotten Hepatitis C and it is growing.
...BeAg), bilirubin level, and platelet count (Pyrsopoulos and Reddy). The disease prognosis can be done by calculating the prognostic index based on the status of these six variables.
Autoimmune hepatitis is life threatening form of liver inflammation, in which the body’s immune system attacks liver cells causing scarring otherwise known as cirrhosis, liver failure, and if not caught in time transplantation (Mayo Clinic Staff). “Scientists don’t know why the body attacks itself in this way, although heredity and prior infections may play a role” (American Liver Foundation).Type 1 of AIH is the most classic case. It can occur at any age and is often developed very fast. Type 2 is less common and is mainly found in young women (American Liver Foundation).Type 3 occurs in adults between the ages of thirty to fifty (Frey, Longe, and Ricker). Type 1 is often accompanied by other autoimmune disorders. Type 1 diabetes, Rheumatoid arthritis, Graves disease, Sjogren syndrome, and inflammatory bowel syndrome are often also seen in patients with autoimmune hepatitis (PubMed Health). About 70 percent of p...
The health of liver determined by measuring the levels of proteins , liver enzyme or bilirubin in blood is referred to as the Liver Function test .LFTs is oftenly done in following situations including to screen the liver functions such as hepatitis etc , to identify the side effects of certain medications known to affecr the liver , to measure the degree of scarring on liver ,to diagnose lsome liver disease and others.LFTs include many of the tests but sometimes they don’t measure the overall function of liver .Most commonly used tests are alanine transaminase (ALT) , aspartate aminotransferase (AST) , albumin , bilirubin tests and others may also includes
Zein, N. N., & Edwards, K. (2009). The Cleveland Clinic guide to liver disorders. New York: Kaplan Pub.
Physical examination is used to evaluate enlargement and/or tenderness liver by touch and visual inspection. An enlarged or tender liver is a ...