miroslav lazarevski

The aim of this study was to find the difference between the liver function test (LFT) and hepatorenal index (HRI), before and after the administration of Prunus mume (PM) and choline i.e., to find the predictors of the non-alcoholic fatty liver disease (NAFLD) severity according its HRI, during the three-month follow-up period.

LFT, glucose, and lipid tests were determined in 168 NAFLD patients, at baseline and after three-month drug treatment. HRI was calculated by Image J software analyzing the ultrasound images, and according its value, 3 groups of NAFLD were formed.

The HRI at baseline (1.3598±0.1744) and after 3 months therapy (1.3061±0.1923) differs significantly (p<0.0001). Plasma glucose (FPG) (p<0.0001), glycated hemoglobin (HbA1c) (P=0.002), alanine aminotransferase (ALT) (p<0.0001), aspartate aminotransferase (AST) (P=0.0006), gamma-glutamil transferase (γ-GT) (P=0.0053), high density lipoprotein cholesterol (HDL-Ch) (p<0.0001) and triglycerides (P=0.041) differ significantly, too. HRI is positively correlated with: HbA1c (P=0.035), ALT (P=0.002), AST (P=0.003), γ-GT (P=0.043), and triglycerides (P=0.002) and inversely correlated with HDL-Ch (P=0.011). In multiple regression results (standard coefficient and p-value), the independent predictors for HRI in NAFLD patients were: HbA1c (0.1443, 0.0004), ALT (0.001142, 0.0081), triglycerides (0.0431, 0.0235) and γ-GT (0.001376, 0.0329).

Three-month administration of PM and choline have beneficial effects on the regulation of glucose and lipid metabolism (HDL-Ch), and on LFT. This plant extract significantly reduces the levels of FPG, HbA1c, ALT, AST, γ-GT, triglycerides and increases HDL-Ch. The triglycerides, ALT, γ-GT and HbA1c are positive independent predictors for the severity of NAFLD

The Eustachian valve (EV) remnant, when present in adults, is usually rudimentary. However, in echocardiographic examinations, it may appear as a mobile long structure in the right atrium, and it rarely protrudes into the right ventricle. When it is quite large, the EV remnant could be misdiagnosed as a right atrial tumor, thrombus, or vegetation.. An 83-year-old patient was referred to the surgical ward for the excision of a gastric adenocarcinoma. In the course of preoperative assessment, transthoracic echocardiography showed a right atrial mobile filamentous mass that was protruding into the right ventricle. Differential diagnosis included a tumor or thrombus. After a precise evaluation through multiple views, the mass was demonstrated to be a giant EV, 7.3 cm in length.. The giant EV remnant can persist in adults and is often diagnosed incidentally via echocardiography. Transthoracic echocardiography is a reliable noninvasive method for the diagnosis of the EV remnant and could help avoid its misdiagnosis as a tumor or thrombus. Nevertheless, sometimes transesophageal echocardiography is necessary to confirm the diagnosis or to demonstrate the existence of an additive clot on it..