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Liver Disease Research Paper Example
Type of paper: Research Paper
Topic: Nutrition , Disease , Health , Diet , Vitamins , Food , Medicine , Nursing
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Pathophysiology of the Disease Liver disease is a major concern all over the world. The initial stages are referred to as hepatic fibrosis. In case of severe and critical advancement, the stage is called cirrhosis. In this stage the disease is not reversible; the fibrous is scarred and the hepatic structure is characterized with interconnecting bands (Regenstein & Dickerson, 2006). Normal working of the liver is hindered by the resulting insufficient blood flow and continuous destruction of hepatocytes (Sorrell, Maddrey & Schiff, 2011). The etiological factors which lead to cirrhosis include Hepatitis B, Hepatitis C and abuse of alcohol. Genetic abnormalities are also a potential cause. Non-alcoholic steatohepatitis damage that is immune mediated can also lead to liver failure. Cirrhosis and liver fibrosis are characterized by liver collagen numbers increasing concurrently with matrix proteins causing liver structure failure. The functions of the liver are subsequently inhibited. Hepatocellular carcinoma and portal hypertension result due to complications in cirrhosis (Regenstein & Dickerson, 2006). The abnormality function of the liver is also a factor of the disease.Variceal hemorrhage, hepatic encephalopathy and ascites are caused by portal hypertension. In severe cases there is hemorrhage usually in the esophagus from varices (Paul, 2007). Due to poor nitrogenous compounds removal from the hepatic, end result is hepatic encephalopathy and cirrhosis. Other toxins in the hepatic which are not adequately removed will also have a similar effect. Stellate cells found in the hepatic normally store retinoid; they form in the Disse spaces. They change to being myfibroblastic after injury and the protein expressed becomes contractile. The proliferation of the stellate cells is the source of cirrhosis and fibrosis. Fibrillar collagens released from the stellate cells contribute to the diseases. Inflammatory cells release cytokines in injury areas enhancing activation of stellate cells.
Hereditary chromatosis is characterized by iron metabolism defects. The defects prevent the absorption of iron deposits and thus various organs are affected. These include pancreas, liver, kidney and the heart. Accumulated iron can cause diabetes mellitus, cirrhosis and cardiomyopathy. Iron metabolism defects are due to HFE gene mutations. Hyper-pigmentation and hepatomelagy are other diseases which are caused by HFE gene mutations (Paul, 2007). This will be severe in the legs, face, neck and forearms.
Environmental and genetic factors like donation of blood increase the severity of liver disease. Blood loss due to physiological reasons and iron intake may also contribute to the great impact. Men are affected earlier as compared to women. In patients diagnosed with cirrhosis and hemachromatosis there is an association between hepatocellular carcinoma and hemachromatosis; lack of iron in foci is the main cause of hepatocellular carcinoma in hemochromatosis patients.
Liver cirrhosis is chronic in nature and destroys cells and causes scarring. The scarring is referred to as fibrosis. The liver structure is altered and lymph flow impaired. Portal vein hypertension and hepatic insufficiency occur. The disease undergoes three major stages: Laennes is caused by abusing alcohol which leads to scarring in portal areas and central veins. Laennes is quite common especially in patients with poor nutrition; Postnechrotic cirrhosis occurs when scarring occurs broadly due to viral hepatitis. It can also be caused by hepatic necrosis which is drug induced; Biliary cirrhosis results from liver lobes and bile ducts scarring causing obstruction of the chronic biliary. Infection of the cholangitis also results in biliary cirrhosis although it is not common. Hepatitis, liver tumors, cirrhosis and abscess of liver are some of the disorders of the liver. The ones which occur mostly are cirrhosis and hepatitis.
Nutrition requirements for a person living with the condition
All foods eaten must be processed by the liver. The liver protects the body from harmful substances; it acts as a filter as it functions to produce various nutrients. The diet of an individual should be towards promoting a healthy liver. Nutrition is vital to be able to make sound choices. Liver disease patients should know the content of every food they purchase.
FDA has set regulations that each food product must have its nutritional content clearly shown. They should limit themselves from harmful diets. They should work to promote their health and not see it as a form of punishment.
Generally a person with liver disease should incorporate the following: complex carbohydrates should be eaten such as bread which is whole grain and pasta; the percentage in the meal should be sixty to seventy percent; and, protein should be twenty to thirty percent- they should be vegetable protein and lean animal protein.
Fat should be polyunsaturated with a percentage of ten to twenty. Water taken must be ten to twelve ounce glasses per day. Sodium intake must be between one thousand five hundred milligrams and one thousand milligrams. Intake of excessive vitamins should be avoided; minerals, Vitamin B3 and Vitamin A and iron must be consumed moderately (Worman, 2006).
Consumption of alcohol is prohibited. Vegetables and organic fruits should be consumed liberally. Beverages with caffeine are to be limited to three cups a day whereas calcium and Vitamin D supplements are encouraged. Vitamin C is important in the diet; CoQ 10 or vitamin E must be taken to act as antioxidants. Glucosamine chondroitin is also a requirement (Golla, Epstein & Cabay, 2004).
Since people normally consume a lot of food, the liver must therefore balance the nutrients to right organs and in the correct amounts. The balancing of nutrients takes place automatically in a healthy person; however, a person who has liver disease undergoes difficulties in juggling the nutrients. Nutrition is critical to ensure the weak and already overburdened liver is stable. The diet must be already balanced so as to promote the liver in its functions. A person has control on what they eat to ensure that they limit further injury to their liver.
There is no optimal diet for people with liver disease. This is because the disease is caused by various factors and patients are usually in different stages. The nutritional requirements are individualistic in nature; the diet is also flexible and changes over time. In most patients, eating small portions of food distributed evenly through the day allows for maximum benefits. The different calories in each food group should be considered. Fat provides per grams about nine calories. Carbohydrates and protein each gives four calories. Alcohol provides a lot of energy about seven calories per gram with empty nutritional value.
Drugs and treatments that is required for treating liver disease.
In liver cirrhosis the management is helped heavily when patients give up the consumption of alcohol all together. The patients should also have limited physical activity. Bed rest is not the ultimate cure but makes on feel much better. Fluids should be taken in high amounts. If a patient cannot eat or drink, they should be hospitalized.
Patients with Hepatitis B or C may take drugs that will inhibit the virus from replicating itself. The benefits and risks from the medication must be analyzed before prescription is issued (Golla, Epstein & Cabay, 2004). Patients with Hepatitis B or C should undergo frequent blood checkups to ensure their blood is clean and it has no inflammation. Although patients should not be isolated, the care givers must be informed on how the virus spreads.
Health professionals are giving vaccines to fight the virus. Blood has to be screened to test Hepatitis C. Hepatitis A has effective immunization programs. Hepatitis B has in place immunization programs which are global (Golla, Epstein & Cabay, 2004). Health workers are at a high risk of infection and therefore should undergo immunization. Also, hand washing is encouraged to those exposed to patients with Hepatitis.
There are some medications which make liver disease worse; acetaminophen makes liver disease worse especially in cirrhosis. Hence, doctors have to direct patients on the correct dosages that are safe to take. Treatment in liver cirrhosis lays emphasis on salt restriction to avoid fluid retention. Diuretic medications help to remove excess body water. Diets are to be low in protein and supplements of vitamins such as D, A and K.
Special medications can be prescribed to control itching. Toxins can be removed faster through the administration of laxatives. In severe cases, transplanting of the liver is done. Each liver disease condition has to be dealt with separately. In patients with gallstones, surgery has to be done to get them out.
Parancetesis is done to patients with high ascites fluid: local anesthetic is used, and fluid is withdrawn through the abdominal wall by inserting a needle. Portal hypertension is minimized through operation to control bleeding. In essence liver disease is not curable, it can only be managed.
Paul, D. (2007). Liver Transplantation. American Association for the Study of Liver Diseases 13(11), 69-75
Golla, K., Epstein, D. & Cabay, R. (2004). Liver disease: Current perspective on medical and dental management. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endondotology 98(5), 516-521
Worman, H. (2006). The Liver Disorders and Heptatitis Sourcebook. New York: McGraw-Hill
Regenstein, F. & Dickerson, J. (2006). The First Year: Cirrhosis: An Essential Guide for the Newly Diagnosed. Massachusetts: Da Capo Press Sorrell, M., Maddrey, W. & Schiff, E. (2011). Schiff’s Disease of the Liver. New Jersey: Wiley.
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The diagnostic utility of serum ascites albumin gradient against ascitic fluid total protein for detection of liver disease in patients of ascites- A comparative study
- Dr Archana Kansal Associate Professor, Department of Medicine, Department of Medicine, G. R .Medical College, Gwalior, M.P, India
- Dr. Sandeep Aharwar Assistant Professor, Department of Medicine, G. R .Medical College, Gwalior, M.P, India
- Dr Sushma Trikha Associate Professor, Department of Medicine, G. R .Medical College, Gwalior, M.P, India
- Dr. Ashish Sharma Resident, Department of Medicine, G. R .Medical College, Gwalior, M.P, India
- Dr Shweta Sahai Assistant Professor, Department of Medicine, G. R .Medical College, Gwalior, M.P, India
Introduction: Various studies have demonstrated superiority of SAAG (serum ascites albumin gradient) in classifying ascites compared to transudate-exudate concept but with conflicting observations. Ascitic fluid total protein (AFTP) level in ascitic fluid is a much cheaper alternative to the serum ascites albumin gradient ratio. Hence in the study, we have compared the diagnostic accuracy of the old cheaper traditional method against the new method.
Methods: Total 102 patients of Ascites were included in the study from J.A. group of hospital, G.R. Medical College (M.P.) in year 2013-15. All medical causes of ascites were included in our study and Non medical causes were excluded. The collected data was analyzed by using Pearson Chi-square statistical analysis to determine correlation between variables.
Result: For prediction of liver disease it was found that SAAG was significantly (p value 0.0341) more predictive of Liver disease compared to AFTP. SAAG (p value<0.0009) and AFTP (p value 0.49) were both significant for differentiating cause of ascites when comparison was done between liver and non-liver disease.
Conclusion: AFTP is a good surrogate marker for detection of liver disease in ascites. AFTP is an excellent diagnostic test for detection of certain extra hepatic diseases leading to ascites like tubercular peritonitis sub-acute bacterial peritonitis and anaemia-hypo-proteinemia.
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- Immune Response Against HIV
Immune Response Against HIV - Research Paper Example
- Subject: Health Sciences & Medicine
- Type: Research Paper
- Level: College
- Pages: 2 (500 words)
- Downloads: 3
- Author: dkub
Extract of sample "Immune Response Against HIV"
Immune Response Against HIV The immune system is a defense mechanism of a body. It works against the invasion and threats of viruses, bacteria and other microscopic organisms recognized as non-self. A good example of a virus that the immune system fights against is HIV (human immunodeficiency virus), which is responsible for causation of AIDS. The body immune system is comprised of a complex system of white blood cells as well as blood proteins that work together in response to, and reduce the damage caused by disease causing organisms.
The white blood cells constitute of phagocytes which are part of the non-specific defense mechanism, and two types of lymphocytes (T-cells and B-cells) which are part of the specific defense mechanism. The immune system fights and eliminates non-self materials in different stages. During the 1st stage, the phagocytes try to engulf and destroy the non-organic enemies that they detect in the body. Unfortunately, phagocytes lack the ability to destroy organic invaders such viruses. Therefore, the phagocytes call for help from other macrophages by sending signals when organic invaders such as HIV invade the body.
The macrophages then engulf the virus and displays pieces of it on their surfaces (antigen presentation). The portions of the virus that are displayed on the surface of the macrophage inform the T-cells of the foreign invaders that need immediate attention. The naïve T-cells then chip in to save the body from the foreigner; the CD4 T Helper cells recognize the foreign antigen and send signals to mobilize other troops to fight the disease causing microorganisms (Milley, 2003). Stage II of the fight against viruses takes place after the CD4 have received information concerning foreign invaders in the body.
During this stage, the CD4 divides and send signals that activate other components required in the defense system. The additional forces include B-Cells and CD8 T-cells (killer cells). It is also during this stage that B-cells divide to form antibodies that surround and immobilize bacteria and virus that are moving in the blood before invading a cell. The antibodies achieve this by neutralizing as well as attaching to the surfaces of the viruses. HIV virus is known of invading a human cell and making it a factory for viruses.
Responding to the instructions given by T-helper cells, “CD-8 T-cells destroy the infected cells by chemically piercing their membranes so that the contents spill out” (Milley, 2003 p. 9). The spilling out of the cell contents controls the replication cycle of the HIV virus. However, it is evident that some HIV viruses do manage to escape the activities of the killer T-cells. These are the viruses that interrupt the action of the immune system by infecting the helper T-cells. “Once the infected helper T-cells are activated, they work to create new viruses instead of doing the job they are supposed to do in a human’s immune system” (“Immune System 101” 2011).
Additionally, many helper T-cells are also destroyed in the division (replication) of the HIV viruses. The destruction of CD4 T-cells results to destruction of many cells by the replicating HIV viruses. In conclusion, the immune system is the defense mechanism for a human body. It protects the body from foreigners such as viruses and bacteria. Its destruction of the HIV virus in the body involves different stages. Phagocytes are involved in destruction of non-organic materials in the body. The macrophages then aid in presenting the information on the virus on their surfaces.
The CD-4 then uses the information presented on the surface of the macrophages to activate many soldiers such as killer T-cells. Killer T-cells do manage to kills HIV viruses, but some do escape, multiply and destroy T-helper cells. References Immune System 101. (2011). AIDS.gov. Retrieved from http://www.aids.gov/hiv-aids- basics/just-diagnosed-with-hiv-aids/hiv-in-your-body/immune-system-101/ Milley, L. (2003). The Science of HIV/AIDS Vaccines. International Council of AIDS Service Organizations (ICASO).
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Result: For prediction of liver disease it was found that SAAG was significantly (p value 0.0341) more predictive of Liver disease compared to AFTP
Check Journal of Gastrointestinal and Liver Diseases Impact Factor, Overall Ranking, Rating, h-index, Call For Paper, Publisher, ISSN, Scientific Journal Ranking (SJR), Abbreviation, other Important Details at Resurchify
“A thread on our recent @Cell_Metabolism paper showing that gut metagenomic sequencing may have potential clinical validity for risk prediction of liver diseases. https://t.co/HLvoBvuUCL”
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