Complication Rate after Percutaneous Liver Biopsy Using a Real-time Ultrasound Approach and Introducing a Uniform Methodology: A Brief Report

Following the initial liver biopsy attempts, several techniques using a wide range of methodologies and materials were developed. Many studies on the evaluation of post-liver biopsy complications were conducted. However, their fundamental limitation was significant variance in patient demographics and methodology, which might account for the inconsistent outcomes. Therefore, a uniform methodology to perform percutaneous liver biopsies that result in comparable outcomes around the world is required. This study aimed to determine the precise complication rate following percutaneous liver biopsy using a consistent method in all individuals. It also aimed to establish a consistent operating procedure for a percutaneous liver biopsy that yielded comparable outcomes. Between July 2018 and July 2019, 116 patients were enrolled in this retrospective study for percutaneous liver biopsy. All individuals underwent a biopsy using the same procedure. There was an attempt to exclude elements that could have an impact on the complication rate. For this purpose, the same type and size of needle were utilized. Moreover, a single needle pass, a subcostal approach, deep inspiration breath holding, identical pre- and post-biopsy preparation, real-time ultrasonography guidance, the use of a single operator, and the absence of sedation or general anesthesia were the other approaches that were used to minimize the impact of variables that could raise complication rates. The overall complication rate was 19.8%, of which 18.9% of patients experienced pain and mild bleeding, and one patient (0.9%) experienced hematoma necessitating precautionary hospitalization. The overall percentage of patients who experienced pain was 13.8%. No further complications were observed. The findings of this study could provide an accurate estimate of the post-liver biopsy complication rate. Furthermore, due to a lower complication rate than other practiced procedures, this uniform methodology could be an attractive alternative in clinical practice. However, more research is required to confirm these results.

The Histopathological and Oxidative Stress Profiles in Japanese Quails (Coturnix japonica) Induced by Dietary Lead

In their native habitat, avians are exposed to external toxicity factors, the most prominent of which are chemical lead compounds that threaten human and animal health. The goal of this investigation was to estimate the adverse effects of lead acetate (Pb(CH3COO)2 (H2O)3) on the health status of Japanese quail (Coturnix japonica). 18 adult male Japanese quails (Coturnix coturnix japonica) were employed in this investigation. After two weeks of acclimatization, the birds were randomly divided into three groups: the control group received no Pb+2, the Low Dose Group received 50 mg/kg of Pb+2 as lead acetate Pb(CH3COO)2 (H2O)3 in the diet, and the High Dose Group received 100 mg/kg of Pb+2 as lead acetate Pb(CH3COO)2(H2O)3 in the diet, for 30 days. Results showed that the Pb bioaccumulation was recorded at the highest values in the liver compared with the kidney, and as expected, the ranges of the lead accumulation were significantly higher in the animals who received 100 mg/kg Pb compared with animals who received 50 mg/kg Pb and the control group. In the high dose group, serum content showed significantly increased levels (P≤0.05) of aminotransferase enzymes (ALT and AST ), glucose, creatinine, and uric acid levels compared to other groups, while antioxidant enzymes (CAT, GSH, and GSH-PX) levels in the liver and kidney were significantly reduced (P≤0.05). The results showed that the MDA appeared to be significantly increasing (P≤0.05) in the high dose group compared to the other groups. Compared to the low dose and control groups, the high dosage group produced substantial histological abnormalities in the liver and kidney.

The Effects of Metformin Treatment on Diabetic Albino Rats' Pancreas, Liver, and Kidney Histology

Metformin, an oral hypoglycemic drug, has traditionally been considered the standard therapy for hyperglycemia. Metformin's several modes of action include inhibition of hepatic gluconeogenesis, anti-glucagon activity, and insulin-sensitizing effect. This study aims to assess the effectiveness of Metformin on the liver, pancreatic, and kidney tissues of alloxan-induced diabetic albino rats. Twenty mature albino white male rats were allocated at random into two groups. Intraperitoneal injections of alloxan monohydrate were utilised to induce diabetic Mellitus type II in the first ten rats. The second group of rats were injected intraperitoneally with normal saline. Both groups were then separated into four subgroups: Group 1 consisted of non-diabetic rats that were only administered distilled water (control), Group 2 consisted of non-diabetic rats that were administered metformin at a dose of 1000 mg/kg/day, and Group 3 consisted of diabetic control animals that were administered alloxan intravenously and distilled water orally, but were not given any medications. After seven days of DM induction, diabetic rats were administered Metformin at a dose of 1000 mg/kg/day orally. After one month of therapy, the animals were slaughtered and their organs were harvested. Compared to the control group, the histological results of pancreatic tissue were normal in the treatment groups. In contrast, liver and kidney sections from non-diabetic control, non-diabetic, and diabetic animals given 1000 mg/kg/day of Metformin had normal histology. Still, both tissues of untreated diabetic control mice exhibited lymphocyte infiltration. Metformin has been found to have significant blood glucose lowering properties and the capacity to protect several organs from the negative consequences of diabetes.

Investigation of TNFα Level and Metallothionein Gene Expression in Livers of Rats Exposed to Dietary Aluminum

Aluminum chloride is a chemical compound widely used in both pharmaceutical and industrial sectors. The present study aimed to assess the effect of aluminum chloride on TNF levels and metallothionein gene expression in rat livers. A total of 16 Wistar rats were used as an experimental model and assigned to four groups (n=4). The treated groups received aluminum chloride (Sigma/USA) at a dose of 25g/kg body weight via a feeding tube as follows: group 1: Non-treated rats as the control group, group 2 were treated with aluminum chloride for 8 weeks, group 3 were treated with aluminum chloride for 12 weeks, and group 4 received aluminum chloride for 16 weeks. The TNF-α was measured in liver tissue using an enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry and real-time polymerase chain reaction (RT-PCR) were used to analyze metallothionein gene expression in rat liver. To estimate TNF levels, the results revealed that levels were considerably higher (P<0.01) in all experimental groups, especially in group 4 which underwent treatment for 16 weeks (401±22.1 ng/ml), as compared to that in the control group. For the immunohistochemistry assay, a gradient intensity of staining for liver tissue was observed, ranging from zero staining in the control group to moderate, medium, and high staining in the experimental groups after 8, 12, and 16 weeks of aluminum chloride treatment, respectively. The greatest amount of methylothionine expression was observed in the livers of group 4 which received aluminum chloride for 16 weeks (15.5-fold), with a significant difference (P<0.01) from the other experimental groups. In both immunohistochemical and RT-PCR experiments, aluminum administration had a substantial influence on TNFα levels and metallothionein expression in rat livers.

Effect of Eggshell Nanoparticles on Healing Bone Fracture

Eggshell waste is considered the most abundant waste material from food processing technologies. Despite the freakish features that its components possess, it is very often discarded without further application. Nowadays, most researchers are focusing their research on pollution-free environment, biodegradable character, and balanced ecological aspects while fabricating the composite materials rather than mechanical strengths, costs, and processing methodologies. This study aimed to investigate the impact of the eggshell nanoparticles on the enhanced treatment of a bone fracture. The samples included 10 healthy female New Zealand white rabbits with an average body weight of 3 kg and age of 4 months years old. The animals were kept in an open place. All these ten rabbits had a fracture by making a surgical operation conducted by opening and excluding the muscle and anther tissue, followed by cutting the bone using a special small saw. After the operational step, the animals were divided into two groups (n=5). The fractures were checked by X-ray. The negative control group was left without treatment, however, was given 0.2 mL intraperitoneal saline injection weekly. The experimental group underwent treatment with 200 mg/kg of calcium carbonate nanoparticles (CaCO₃-NPs) for 4 weeks. The animals were sacrificed at the end of the study period to collect organs for histological studies. Considering the results of the radiographic examination before and after treatment with CaCO₃-NPs, the recorded data showed the speed of healing in the experimental group, compared to the control group. Regarding the histological study that was carried out on the vital organs, such as the liver, kidneys, heart, and lung, no side effects appeared when comparing the treatment group with the control group, except for some slight changes. In conclusion, the recorded data in the current study demonstrated that CaCO₃-NPs had a beneficial effect on the pace of fracture recovery.

Quality of Life and Its Determinants in Liver Transplantation Candidates: A Missed Link in Liver Care Program during the Waiting Time for Liver Transplantation

Background

The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage.

Methods

As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018-2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. P<0.05 was considered to be significant.

Results

The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (P<0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively.

Conclusion

The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates.

Histopathological Study of Liver and Kidney Tissues in C57 Mice via Chronic Exposure to Cadmium and Zinc

Heavy metals have a wide application in the industrial world, affecting the health and longevity of living organisms. The current study assessed the possible effects of Cadmium (Cd) and Zinc (Zn) on the liver and kidney. Therefore, 150 male and female white mice C57BL were treated in three different groups with 0.685 mg/L CdCl₂. 2.5H₂O (group 1), and 0.567 mg/L ZnSO₄.7H₂O (group 2) in drinking water, while the control group only received water for 90 days to investigate how these elements accumulated in the liver/kidney and evaluate the possible histological changes in the liver and kidney. During 90 days, the histopathological consequences of Cd and Zn on the liver and kidneys were recorded. The results pointed out that exposure to heavy metals, such as Cd and Zn, led to organ accumulation of these elements. The histological evaluations demonstrated significant detrimental effects on the liver and kidney. Under the influence of Cd, light microscopic examination revealed significant histological alterations in both organs. In the animals exposed to Cd and Zn, histopathological alterations were observed in the liver, including extensive degeneration, necrosis, depletion, and necrosis of hepatocytes with significant nuclear hypertrophy. When animals are exposed to Cd and Zn, histological alterations in the kidneys include severe vascular degeneration and renal tubule necrosis. In conclusion, heavy metal intoxication has been shown to cause histopathological changes in the liver and kidneys of experimental animal models.

Histological Study of the Effect of Aqueous Extract of the Beetle Cocoon on Liver Tissue of Male Mice

Traditional medicine has been long used to prevent and/or treat diseases worldwide based on a wealth of experiences, principles, and beliefs in different cultures. Among the extracts used in traditional medicine, we can refer to the aqueous beetle cocoon extract of Larinus maculates popularly known as Tihan in Iraq. To determine the histological effect of this extract on mice liver tissue, the animals were assigned to four groups (n=5) treated with (150,200,400) mg/kg of Cocoon aqueous extract of Larinus maculates for 14 days, respectively. Histology and immunohistochemistry test was performed to evaluate changes in liver tissue and tumor necrosis factor alpha (TNF-α) levels.The results showed various pathological dose-depended changes in the liver tissue, including infiltrations, congestion, and vacuolation, along with some dead cells; moreover, necrotic hepatocytes were observed in the liver of highly concentrated treatment group (400 mg kg^-1). In addition, the TNF-α level in the liver tissue was elevated by the increased concentration of the extract. The immunohistochemistry result of positive reaction to TNF-α revealed high reaction in the liver tissue of mice treated with 200 mg kg^-1 and 400 mg kg^-1, as compared to the control group. Furthermore, as evidenced by the obtained results, changes in hepatocytes and the severity of pathological changes in the liver depends on the concentration of the extract of Larinus maculates.

Reciprocal organ interactions during heart failure: a position paper from the ESC Working Group on Myocardial Function

Heart failure-either with reduced or preserved ejection fraction (HFrEF/HFpEF)-is a clinical syndrome of multifactorial and gender-dependent aetiology, indicating the insufficiency of the heart to pump blood adequately to maintain blood flow to meet the body's needs. Typical symptoms commonly include shortness of breath, excessive fatigue with impaired exercise capacity, and peripheral oedema, thereby alluding to the fact that heart failure is a syndrome that affects multiple organ systems. Patients suffering from progressed heart failure have a very limited life expectancy, lower than that of numerous cancer types. In this position paper, we provide an overview regarding interactions between the heart and other organ systems, the clinical evidence, underlying mechanisms, potential available or yet-to-establish animal models to study such interactions and finally discuss potential new drug interventions to be developed in the future. Our working group suggests that more experimental research is required to understand the individual molecular mechanisms underlying heart failure and reinforces the urgency for tailored therapeutic interventions that target not only the heart but also other related affected organ systems to effectively treat heart failure as a clinical syndrome that affects and involves multiple organs.