Hemostasis and thrombosis in patients with liver disease: The ups and downs

Lisman, Ton; Caldwell, Stephen H.; Burroughs, Andrew K.; Northup, Patrick G.; Senzolo, Marco; Stravitz, R. Todd; Tripodi, Armando; Trotter, James F.; Valla, Dominique; Porte, Robert J.

doi:10.1016/j.jhep.2010.01.042

Cited by 318 publications

(255 citation statements)

References 125 publications

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“…Apigenin has shown better preservation of hepatocytes when compared to diabetic rats treated with glipizide. In diabetes, degradation of liver glycogen and gluconeogenesis are increased while glucose utilization is inhibited (Lisman et al, 2010). The pathological alteration of diabetic liver is due to glycosylation of proteins leading to abnormalities in hepatic ultrastructures (Ntimbane et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Apigenin Causes Biochemical Modulation, Glut4 and Cd38 Alterations to Improve Diabetes and to Protect Damages of Some Vital Organs in Experimental Diabetes

Hossain

Ghosh

Satapathy

et al. 2014

American Journal of Pharmacology and Toxicology

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Diabetes mellitus gradually leads to dysfunction and failure of some vital organs specially the eyes, kidneys, pancreas, brain, heart, liver and lungs. The study was aimed to evaluate the antidiabetic potential of apigenin and its mechanistic role in controlling damages of vital tissues in streptozotocin-induced diabetic rats. Streptozotocin-induced diabetic rats were treated with apigenin and glipizide. Various biochemical changes, GLUT4 and CD38 protein expression patterns and histopathological alterations in some vital organs such as liver, kidneys and pancreas were investigated to compare the antidiabetic potentials of those two chemicals and to understand their capability to control the damages of the vital organs during diabetes. Effective control of blood glucose level along with the alteration of hepatic phase I and phase II drug metabolizing enzymes, antioxidant defense enzyme activities and lipid peroxidation level towards their normal values and enhanced GLUT4 translocation and downregulated CD38 expression by apigenin were observed. Apigenin was also found to prevent the deterioration of vital organs during diabetes. In conclusion, apigenin has predominant role in controlling blood glucose level along with the protection of vital organs eventually damaged during diabetes, by minimizing toxicities and associated diabetic complications in streptozotocin-induced diabetic rats and may explore as a potential antidiabetic agent in near future.

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Section: Discussionmentioning

confidence: 99%

Apigenin Causes Biochemical Modulation, Glut4 and Cd38 Alterations to Improve Diabetes and to Protect Damages of Some Vital Organs in Experimental Diabetes

Hossain

Ghosh

Satapathy

et al. 2014

American Journal of Pharmacology and Toxicology

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“…A target INR of 2-3 is advocated, but this recommendation is based on empirical rules. (2) In the studies on vitamin K antagonists, such as the SPORTIF study, (3) the time in INR therapeutic range reflected the quality of anticoagulation. However, these studies excluded patients with liver disease, and given the nature of the coagulopathy of liver disease, there is no rationale to presume that INR works in a similar way than in patients without cirrhosis.…”

Section: Replymentioning

confidence: 99%

“…Of note, the INNO-LiPA/NS5B genotype discordances belong to the only two patients from the prior relapsed subgroup (n 5 14), carriers of ITPA rs1127354, a variant entailing a moderate ITPase deficiency. (2) Interestingly, a recent study (3) has shown that reduced ITPase activity was associated with a lower risk of relapse in HCV patients with genotypes 2 and 3.…”

Section: To the Editormentioning

confidence: 99%

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et al. 2016

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1.84%, P < 0.01; and versus 1.69%, P < 0.01). (4) In another study, the poor anticoagulation control group had a significantly higher cumulative risk of major adverse cardiovascular events than the moderate and good anticoagulation control groups (P < 0.001, by log-rank test). (5) More notably, the quality of anticoagulation is poor in about one-third of the general population with atrial fibrillation. (4,5) If patients had a concomitant diagnosis of liver cirrhosis and a risk of variceal bleeding, the proportion of those with poor anticoagulation control would be increased.Additionally, as shown in Cerini et al.'s Tables 3 and 4, (1) the subgroup analysis of patients treated with anticoagulation for cardiovascular diseases demonstrated that anticoagulation significantly increased the 6-week mortality. (1) Thus, the quality of anticoagulation, which is evaluated according to the time in the therapeutic range, should be taken into account to clarify how anticoagulation impacts the outcomes of UGIB in liver cirrhosis.

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“…59,60 Thrombotic complications in cirrhosis manifest usually as deep vein thrombosis, pulmonary embolism, and acute portal vein thrombosis. These can be carefully and safely treated with anticoagulants.…”

Section: Management Of Peri-operative Bleeding In Patients With Cirrhmentioning

confidence: 99%

Surgery in a Patient with Liver Disease

Rai

Nagral

2012

Journal of Clinical and Experimental Hepatology

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Surgery is often needed in patients with concurrent liver disease. The multiple physiological roles of the liver places these patients at an increased risk of morbidity and mortality. Diseases necessitating surgery like gallstones and hernia are more common in patients with cirrhosis. Assessment of severity of liver dysfunction before surgery is important and the risk benefit of the procedure needs to be carefully assessed. The disease severity may vary from mild transaminase rise to decompensated cirrhosis. Surgery should be avoided if possible in the emergency setting, in the setting of acute and alcoholic hepatitis, in a patient of cirrhosis who is child class C or has a MELD score more than 15 or any patient with significant extrahepatic organ dysfunction. In this subset of patients, all possible means to manage these patients conservatively should be attempted. Modified Child-Pugh scores and model for end-stage liver disease (MELD) scores can predict mortality after surgery fairly reliably including nonhepatic abdominal surgery. Pre-operative optimization would include control of ascites, correction of electrolyte imbalance, improving renal dysfunction, cardiorespiratory assessment, and correction of coagulation. Tests of global hemostasis like thromboelastography and thrombin generation time may be more predictive of the risk of bleeding compared with the conventional tests of coagulation in patients with cirrhosis. Correction of international normalized ratio with fresh frozen plasma does not necessarily mean reduction of bleeding risk and may increase the risk of volume overload and lung injury. International normalized ratio liver may better reflect the coagulation status. Recombinant factor VIIa in patients with cirrhosis needing surgery needs further study. Intra-operatively, safe anesthetic agents like isoflurane and propofol with avoidance of hypotension are advised. In general, nonsteroidal anti-inflammatory drug (NSAIDs) and benzodiazepines should not be used. Intra-abdominal surgery in a patient with cirrhosis becomes more challenging in the presence of ascites, portal hypertension, and hepatomegaly. Uncontrolled hemorrhage due to coagulopathy and portal hypertension, sepsis, renal dysfunction, and worsening of liver failure contribute to the morbidity and mortality in these patients. Steps to reduce ascitic leaks and infections need to be taken. Any patient with cirrhosis undergoing major surgery should be referred to a specialist center with experience in managing liver disease. ( J CLIN EXP HEPATOL 2012;2:238-246)

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Hemostasis and thrombosis in patients with liver disease: The ups and downs

Cited by 318 publications

References 125 publications

Apigenin Causes Biochemical Modulation, Glut4 and Cd38 Alterations to Improve Diabetes and to Protect Damages of Some Vital Organs in Experimental Diabetes

Apigenin Causes Biochemical Modulation, Glut4 and Cd38 Alterations to Improve Diabetes and to Protect Damages of Some Vital Organs in Experimental Diabetes

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Surgery in a Patient with Liver Disease

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