RESUMEN
Drug-Induced Liver Injury (DILI) constitutes hepatic damage attributed to drug exposure. DILI may be categorized as hepatocellular, cholestatic or mixed and might also involve immune responses. When DILI occurs in dose-dependent manner, it is referred to as intrinsic, while if the injury occurs spontaneously, it is termed as idiosyncratic. This review predominately focused on idiosyncratic liver injury. The established molecular mechanisms for DILI include (1) mitochondria dysfunction, (2) increased reactive oxygen species levels, (3) presence of elevated apoptosis and necrosis, (4) and bile duct injuries associated with immune mediated pathways. However, it should be emphasized that the underlying mechanisms responsible for DILI are still unknown. Prevention strategies are critical as incidences occur frequently, and treatment options are limited once the injury has developed. The aim of this review was to utilize retrospective cohort studies from across the globe to gain insight into epidemiological patterns. This review considers (1) what is currently known regarding the mechanisms underlying DILI, (2) discusses potential risk factors and (3) implications of the coronavirus pandemic on DILI presentation and research. Future perspectives are also considered and discussed and include potential new biomarkers, causality assessment and reporting methods.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Hepatopatías , Humanos , Estudios Retrospectivos , Enfermedad Hepática Inducida por Sustancias y Drogas/epidemiología , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Hepatopatías/epidemiología , Factores de RiesgoRESUMEN
Medical terminology and the language which we use, as healthcare professionals, can be deemed as disempowering towards women and their pregnancy/birthing experience. This article aims to highlight the need for a change in practice through 'thinking before we speak' and realising the importance of language choices and informal discussions in building successful relationships with the women we care for. Rebecca Allison discusses various phrases and forms of communication which need addressing.