Malignant conditions include hepatocellular carcinoma – to be suspected in the setting of cirrhosis – as well as cholangiocarcinoma and metastatic tumors. A stepwise approach Proteasome structure to the liver
mass will usually lead to an accurate diagnosis. Furthermore, the capabilities of modern imaging, though not without some risk of patient harm, permit a noninvasive diagnosis in a substantial percentage of cases. “
“Several randomized, controlled trials that evaluated the effectiveness of l-ornithine-l-aspartate (LOLA) in the treatment of hepatic encephalopathy (HE) have been published recently. The purpose of this study was to update the meta-analysis to reevaluate the safety and efficacy of LOLA on HE in patients with cirrhosis. The following databases were searched from inception to June 2012: Medline, Embase, and the Cochrane Central Register of Controlled Trials (Issue 6). Differences
between groups Carfilzomib were assessed by the pooled risk ratio (RR) or mean difference (MD). Possible sources of heterogeneity were assessed by sensitivity analyses. Eight randomized controlled trials with 646 patients were included. When comparing placebo/no-intervention control, LOLA was significantly more effective in the improvement of HE in the total (RR: 1.49, 95% confidence interval [CI]: 1.10 to 2.01), overt HE (RR: 1.33, 95% CI: 1.04 to 1.69), and minimal HE patients (RR: 2.25, 95% CI: 1.33 to 3.82). Furthermore, the reduction of fasting ammonia significantly favored LOLA (post-treatment value, MD: −18.26, 95% CI: −26.96 to −9.56; change, MD: 8.59, 95% CI: 5.22 to 11.96). The tolerance ratio, incidence of adverse events, and mortality were not significantly different between LOLA and the placebo/no-intervention
control. LOLA and lactulose demonstrated similar effectiveness in the improvement of HE (RR: 0.88, 95% CI: 0.57 to 1.35). LOLA benefits both overt and minimal HE patients in the improvement of HE by reducing the serum ammonia concentration compared with the placebo/no-intervention control. Further, evaluations between LOLA and other effective treatments are needed. “
“Tokyo University of Pharmacy and Life Science, Tokyo, Japan US Food and Drug Administration, Center of Food Safety and Nutrition, College Park, MD The organic anion–transporting polypeptide 1b family (Oatp1b2 in medchemexpress rodents and OATP1B1/1B3 in humans) is liver-specific and transports various chemicals into the liver. However, the role of the Oatp1b family in the hepatic uptake of bile acids (BAs) into the liver is unknown. Therefore, in Oatp1b2-null mice, the concentrations of BAs in plasma, liver, and bile were compared with wild-type (WT) mice. It was first determined that livers of the Oatp1b2-null mice were not compensated by altered expression of other hepatic transporters. However, the messenger RNA of Cyp7a1 was 70% lower in the Oatp1b2-null mice.
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