Impossibility of the treatment of inoperable liver multicystic echinococcosis due to adverse reactions to antihelminitics

Introduction. In some cases of multicystic forms of liver echinococcal disease, the advanced method for treatment of cystic echinococcosis faces great problems relating to the final outcome of the treatment. Case report. In May 2005, a computerized tomography of the abdomen obtained in a 27-year -old famale patient with abdominal pain revealed more than 20 echinococcal cysts measuring up to 6.7 cm in both lobes of the liver. Laboratory analyses found the value of eosinophils 6.8%, gamma globulins 29.9%, immunoglobulin E 29 600 IU/mL and the indirect hemagglutination for echinococcosis 1 : 8 196. The treatment started in December that year with the continuous administration of a daily dose of 800 mg (14.5 mg/kg body weight) of albendazole, but it was terminated two months later due to high serum transaminases values. By the end of 2006, the largest cyst detected in the left lobe of the liver had a diameter of 5.7 cm and the one in the right lobe of the liver measured 4.1 cm. There were lesions of germinative membrane found on both cysts. Six months later, praziquantel at daily dose of 2 500 mg (45.3 mg/kg body waight) was introduced into the therapy, but the treatment was terminated after eight days because of the development of exanthema. The computerized tomography of the abdomen obtained in February 2008 revealed the presence of a large number of echinococcal cysts in the liver. The largest among those cysts measured 3.5 cm while calcifications of the cyst walls were observed on some of them. None of the remaining therapeutic options for further treatmetnt of echinococcal disease could be applied. Conclusion. The presented case confirms medical therapy as the only option for the treatment of some forms of cystic echinococcosis. Benzimidazole carbamates (albendazole, mebendazole) and praziquantel are only efficacious antihelminitics currently available, and when they have to be withdrawn due to serious adverse offects, futher treatment of a patient with liver multicystic echinococcosis is impossible. Because of that there is a need to search for new and more efficient drugs for the treatment of ehinococcal disease

Protective effects of pumpkin (Cucurbita pepo L.) seed oil on rat liver damage induced by chronic alcohol consumption

Pumpkin seed oil (PSO) possesses a protective potential against liver injury due to the presence of biologically active ingredients. Adult male albino rats were administrated PSO (per os, 2 mL/kg b.w./day) and a 12% ethanol solution in water, ad libitum, with an average intake of 8.14 g of ethanol/kg bw/day for 6 weeks. Congestion, hepatic central vein dilation, portal vein branch dilation, Kupffer cell hyperplasia, fatty liver changes, hepatocyte focal necrosis were observed after daily alcohol intake. All observed changes were reduced when PSO was ingested with ethanol. PSO intake itself induced discrete cellular edema, congestion and slight dilatation of the central and portal vain branches. Chronic ethanol intake elevated catalase (CAT) activity and glutathione reductase (GR) protein expression; concomitant PSO intake had no effect on CAT activity or GR protein expression. PSO intake decreased the activities of GR, glutathione-S-transferase (GST) and xanthine oxidase (XOD) in the liver, probably due to the ingestion of antioxidants. Intake of PSO and ethanol significantly decreased cytosolic superoxide dismutase (SOD1) and increased NF-?B protein expression compared to ethanol intake, suggesting that the protective effects of PSO were mediated by the NF-?B signaling pathway. Our results reveal a therapeutic potential of PSO in alcoholic liver disease

The effects of whey and pumpkin seed oil on blood biochemical parameters of liver function and lipid profile in rats chronically drinking low concentrations of ethanol

We studied the effects of whey and pumpkin seed oil supplementation on the biochemical parameters in blood serum of male rats after chronic ad libitum alcohol consumption. The levels of AST, ALT, total bilirubin, ALP, LDH, triglycerides, total cholesterol, HDL, LDL, VLDL, triglyceride/HDL ratio, total cholesterol/HDL ratio (cholesterol ratio) and LDL/HDL ratio (index of atherosclerosis) were determined in rats after six weeks of treatment with: (i) ethanol (12% ethanol, ad libitum), (ii) whey (2 g/kg per day), (iii) pumpkin seed oil (2 mL/kg per day), (iv) both ethanol and whey, and (v) both ethanol and pumpkin seed oil. The results showed no changes in the levels of AST, ALT, total bilirubin, ALP, total cholesterol, HDL and VLDL in alcoholic rats when compared to the controls (fed with a standard laboratory diet ad libitum) and rats supplemented with whey and pumpkin seed oil. Our results suggest that alcohol consumption in small doses for 6 weeks changes lipid metabolism and significantly elevates the LDL/HDL ratio (index of atherosclerosis) but does not induce extensive liver damage. Ethanol consumption in our experimental conditions lowered the triglyceride level as well as the triglyceride/HDL ratio, suggesting lipid redistribution and the induction of some cardio-protective effect. However, ethanol induced a higher index of atherosclerosis. Pumpkin seed oil showed some protective potential in alcoholic rats by lowering the total cholesterol/HDL ratio, but it elevated the LDH. Whey consumption prevented elevation of the atherosclerosis index, pointing to its protective role, probably through the redistribution of lipids. However, whey in combination with ethanol elevated LDH

Inhibitori protonske pumpe – primena i bezbednost

Uvod. Inhibitori protonske pumpe (IPP) primenjuju se u terapiji acido peptičkihporemećaja uključujući peptički ulkus, gastroezofagusni reflex, erozivni ineerozivni ezofagitis, Zollinger-Elissonov sindrom, Helicobacter pylori infekcijei profilaksu stres ulkusa. Dobro dokumentovana efikasnost i relativna bezbednostprimene, doprineli su značajnom propisivanju IPP u praksi. Neželjenadejstva IPP nisu ozbiljna i javljaju se kod približno 1-3% lečenih pacijenata,bez značajnijih razlika među pojedinačnim predstavnicima. Dugotrajnaterapija IPP povećava rizik od razvoja rebound hipersekrecije želudačnekiseline, pneumonije i enteralnih bakterijskih infekcija (dijareja izazvana saClostridium difficile), preloma kostiju i kardiovaskularni rizik pri istovremenojprimeni sa klopidogrelom. IPP ne izazivaju deficit gvožđa i vitamina B12,ali povećavaju rizik od razvoja hipomagnezemije. Većina iznetih podatakapotiče iz retospektivnih kohort i case-control studija. Da bi se utvrdila tačnauzročno posledična povezanost između IPP i neželjenih događaja neophodnoje sprovesti velika prospektivna, randomizirana, kontrolisana klinička ispitivanja.Mnogo racionalnija upotreba IPP smanjila bi troškove u zdravstvu iosigurala njihovu bezbedniju primenu

Osteoporoza prouzrokovana lekovima

Sve je veći broj istraživanja koja otkrivaju da mnogi lekovi ispoljavaju neželjeneefekte na mineralnu gustinu i strukturu koštanog tkiva. Brojne studije supokazale da neki lekovi mogu biti „štetni za kost” kao što su: glukokortikoidi,hormoni štitaste žlezde, antiepileptici, antidepresivi, aromatični inhibitori,gonadotropin oslobađajući agensi, kontraceptivi, antiretrovirusni lekovi, diureticiHenleove petlje, inhibitori protonske pumpe (IPP) i drugi. Uravnoteženibalans u primeni lekova za vreme dugotrajne terapije izazovan je i zahtevanposao lekara u primarnoj i sekundarnoj praksi i zavisi od njihove upućenostio odnosu između koristi i štetnosti primenjenih medikamenata. Određivanjestatusa skeleta pacijenta pre započinjanja terapije nekim od tzv. ”lekovaštetnih za kost”, veoma je važno i omogućava individualan pristup u terapiji

JSCS–3838 Original scientific paper

Phytochemical analysis and gastroprotective activity of an olive leaf extrac