We present data from our 4-month research for the effect of Tenofovir, Lamivudine and Entecavir on protection from SARS-CoV-2. We analyzed with rapid antibodies test the status of all patient with liver disease. The total number of examined patients is 478. Their average age is 55,19 ± 12,68. Just 17 from 343 (5%) of those on therapy have antibodies for SARS-CoV-2. 8 from the Tenofovir-treated patients were IgM (+) on a rapid test and 3-IgG (+)(5%). From those on therapy with Lamivudine, 5 were IgM (+) and 1-IgG (+) (6,5%). No patients on Entecavir were positive for IgM or IgG antibodies for SARS-CoV-2.In contrast 14 from 135(10,3%) from the patients without therapy have antibodies. We divided the patients by decades. In almost all decades the percentage of antibodies is two times lower in those on therapy than in those without.
Acute liver failure is a critical condition due to severe hepatic impairment in a person who does not have a history of liver disease. We present a 27-year-old woman with a two-week history of weakness, fatigue, jaundice and pruritus, as well as nausea and vomiting. The patient decided to try bioresonance diagnostic and alternative holistic medicine to rid her body of toxins and parasites. She started taking for 1 month 9 products containing about 40 herbal and medicinal ingredients. Around 40 days after the start of this therapy the patient was transferred to our unit due to the prolonged high levels in liver enzymes. Upon admission she has low hemoglobin, total protein, albumin, high CRP, liver enzymes, bilirubin, platelets, disturbed coagulation. All viral and immunological markers were negative. We assume that in the presented case the main cause for liver disease and cholestasis is herbal (HILI) and / or drug-induced liver damage (DILI).There is no definitely a clear answer how these ingredients damaged the hepatic function. The cause of hepatotoxicity is thought to be due to a genetic polymorphism in the cytochrome P 450 enzymes or in the immune response, a synergistic effect on multiple supplements. The probable mechanism for cholestasis involves compromised activity of Bile acids transporters.The simultaneous administration of so many substances confuses the detoxifying function of the liver, which can be expected. The natural origin of herbs does not deprive them of chemical structure and interactions.
Objective: This study aimed to explore the diagnostic role of D-dimers and ferritin in ascitic fluid. We analyzed ascitic and blood samples from twenty cirrhotic patients, using the Child-Pugh classification to assess liver cirrhosis severity. Methods: Blood tests evaluated platelets, albumin, INR, fibrinogen, CRP, ferritin, and D-dimers, while ascitic fluid analysis incorporated total protein, albumin, LDH, cholesterol, leukocytes, with a focus on D-dimers and ferritin. Results: The results showed a significant positive correlation between ascitic D-dimers and ferritin concentrations and ascitic albumin, total protein, and cholesterol. A correlation was also observed between ascitic ferritin and LDH. These correlations suggest a potential relationship between D-dimers and ferritin levels, disease severity, and the local production of these markers. Conclusion: This study proposes that evaluating D-dimers and ferritin in ascitic fluid might reveal underlying inflammation, even when other inflammatory laboratory markers are normal. Our findings suggest that ascitic D-dimers and ferritin levels could offer valuable insights into inflammatory processes in ascitic fluid, potentially enhancing diagnostic and prognostic approaches for patients with ascites from liver cirrhosis or other causes. Further studies with larger and more diverse cohorts are needed to validate and extend our findings.
Ascites, regardless of its source (hepatic, neoplastic, cardiac or inflammatory), is a clinical indicator of disease progression. In cirrhosis, ascites forms due to portal hypertension and low circulating blood albumin, which leads to so called third spacing. This study compared blood and ascites samples from 20 consecutive and unselected liver cirrhosis patients and 5 cancer patients.Significant correlations were found in cirrhotic ascites between albumin/D-dimer, albumin/ferritin, albumin/total protein, ferritin/Ddimer, total protein/ferritin, and total protein/D-dimer.Three out of five malignant ascites patients had low ascitic total protein values (below 25 g/L), whereas five out of twenty cirrhotic ascites patients had high values above 25 g/L. The protein composition of our oncology patients was likely altered due to treatment.Half of our cirrhotic patients and two cancer patients had high serum ferritin levels. We also observed ascitic ferritin levels up to 100 μg/l in half of the patients and values above the upper reference level for serum (280.00 μg/l) in six of our liver cirrhosis patients. Individual ascites values overlapped in cirrhotic and malignant ascites. D-dimer levels in ascites were 500-1000 times the plasma upper limit of normal (ULN) in three cancer patients and four cirrhosis patients.This study is the first to simultaneously examine ferritin and D-dimer levels in blood and uncomplicated ascites. Abnormal levels of D-dimer and ferritin in ascites, even in the absence of clinical symptoms, may indicate underlying processes in the ascitic peritoneal fluid such as inflammation and fibrinolysis. Additional research may be needed.
The liver is responsible for the synthesis and clearance of most of the proteins involved in the two cascadescoagulation and fibrinolysis. Some patients with liver cirrhosis can experience severe bleeding whilst other may have thrombotic complication.Evaluating the coagulation activity in ascitic fluid, there were solid evidences, that ascitic fluid is a procoagulant. PT and INR in serum increased significantly fromChild A to C, while fibrinogen decreased. Serum D-Dimer levels were founded higher in cirrhotics with ascites, especially in Child C group, in HCC, in SBP condition and decrease after resolution of ascitic fluid. D-Dimer levels can be lower in serum than in ascitic fluid. In oncology there are solid evidences for the prognostic value of D-Dimer. Serum D-Dimer is qualified there as a prognostic factor associated with increased mortality risk and shorter overall survival. More in-depth research is needed towards which levels of D-Dimer in serum or ascites could be a prognostic factor for SBP, for an increased likelihood of portal thrombosis or bleeding from GIT. It can be speculated, that D-Dimer levels can be used as prognostic factor for various complications in liver diseases. The study of D-dimer in hepatology could influence future therapeutic regimens.
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