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LIVER FUNCTION TEST ABNORMAL and Ramipril

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LIVER FUNCTION TEST ABNORMAL Symptoms and Causes

What is fatty liver disease?

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

  • Nonalcoholic fatty liver disease (NAFLD)
  • Alcoholic fatty liver disease, also called alcoholic steatohepatitis
What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

  • Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
  • Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.
What is alcoholic fatty liver disease?

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

Who gets fatty liver disease?

Researchers do not know the cause of nonalcoholic fatty liver (NAFLD). They do know that it is more common in people who

  • Have type 2 diabetes and prediabetes
  • Have obesity
  • Are middle aged or older (although children can also get it)
  • Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
  • Have high levels of fats in the blood, such as cholesterol and triglycerides
  • Have high blood pressure
  • Take certain drugs, such as corticosteroids and some cancer drugs
  • Have certain metabolic disorders, including metabolic syndrome
  • Have rapid weight loss
  • Have certain infections, such as hepatitis C
  • Have been exposed to some toxins

NAFLD affects about 25 percent of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

What are the symptoms of fatty liver disease?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

How do I know if I have fatty liver disease?

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use

  • Your medical history
  • A physical exam
  • Various tests, including blood and imaging tests, and sometimes a biopsy

As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as

  • An enlarged liver
  • Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow

You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

What are the treatments for fatty liver disease?

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

What are some lifestyle changes that can help with fatty liver disease?

If you have any of the types of fatty liver disease, there are some lifestyle changes that can help:

  • Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains
  • Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.
  • Get regular exercise, which can help you lose weight and reduce fat in the liver
  • Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

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LIVER FUNCTION TEST ABNORMAL Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Ramipril and Clopidogrel in Oxidative Stress, Vascular Inflammation and Endothelial Dysfunction in Type 2 Diabetes and Diabetic Nephropathy
Conditions: Diabetes Type 2;   Diabetic Nephropathy;   Vascular Disease
Interventions: Drug: Ramipril;   Drug: Clopidogrel
Outcome Measures: Changes in Asymmetric dimethylarginine (ADMA) blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in High-sensitivity C-reactive protein (HsCRP) blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in soluble CD40 Ligand (sCD40L)blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in urine 8-isoprostane-F2 levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Reduction in albumine to creatine ratio after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in ADMA blood levels after treatment with Ramipril;   Increase of Glomerular Filtration Rate (GFR) after combined treatment with Ramipril and clopidogrel and after Ramipril monotherapy;   Change from baseline in carotid intima-media thickness after combined therapy with Ramipril and clopidogrel and after Ramipril monotherapy
2 Recruiting Mechanisms of Ramipril Reduction in the Onset of Type 2 Diabetes
Condition: Metabolic Syndrome
Interventions: Drug: Ramipril;   Drug: HCTZ-hydrochlorothiazide;   Drug: Ramipril+HCTZ
Outcome Measure: Changes in Insulin Sensitivity
3 Recruiting Ramipril for the Treatment of Oligospermia
Conditions: Oligospermia;   Teratospermia;   Asthenozoospermia;   Male Infertility
Interventions: Drug: Ramipril;   Drug: Placebo
Outcome Measures: Sperm density in infertile men with documented oligospermia.;   Total Motile Sperm Count(TMSC), total sperm count, sperm motility, and morphology in the ejaculate.;   Pregnancy rate;   Hormonal profile
4 Unknown  Clinical and Cost Effectiveness of ACE Inhibitor, Ramipril, in Intermittent Claudicants
Condition: Intermittent Claudicants
Intervention: Drug: Ramipril
Outcome Measures: The primary outcome measure for this trial is the Maximum Walking Distance (MWD). Treadmill exercise test will be used to estimate the maximum distance the participant can walk at a speed of 2.5 km/h with a 10 degree incline.;   Other clinical indicators of lower limb ischaemia: a) Patient Reported Walking Distance (PRWD) b) Treadmill Intermittent Claudication Distance (ICD) c) Ankle Brachial Pressure Index at rest (ABPI- r) and following treadmill testing (ABPI - t);   Quality of life: a) Generic - measured using the SF36, SF8 and EuroQol (EQ5D) instruments b) Disease specific - measured using the VascuQol;   Cardiovascular prognosis using: a) Framingham, PROCAM, QRISK and Manchester charts scoring systems b) B-type Natriuretic Peptide (BNP) and N- terminal prohormone BNP (NT-proBNP) and a Lipid profile ( LDL, HDL, Total Cholesterol, Triglycerides);   Markers of endothelial function and ischaemia reperfusion a) IL6 b) soluble Intercellular Adhesion Molecule-1 (sICAM -1) c) sE selectin d) Urine Albumin Creatinine Ratio ( UACR);   Arterial effects: a) Arterial stiffness by measuring the Pulse Wave Velocity and assessing the effects on the extracellular matrix by measuring Metalloproteinases (MMPs) and Tissue Inhibitor Metalloproteinases (TIMPs). b) Flow mediated vasodilatation;   Health economics (cost effectiveness / utility)
5 Unknown  Left Atrial Remodelling in Hypertension: Effects of Ramipril or Irbesartan
Conditions: Left Atrial Volume;   Hypertensive Heart Disease;   Antihypertensive Drugs;   Diastolic Function;   Renin Angiotensin System
Interventions: Drug: Ramipril;   Drug: irbesartan
Outcome Measures: left atrial volume;   diastolic function;   systolic and diastolic blood pressure
6 Unknown  Antiproteinuric Effect of Imidapril Versus Ramipril in Type 2 Diabetic and Hypertensive Patients With Microalbuminuria
Conditions: Hypertension;   Type 2 Diabetes Mellitus;   Microalbuminuria
Interventions: Drug: Ramipril;   Drug: Imidapril
Outcome Measures: Size of the reduction of urinary albumin in 24 hours to the various controls;   1. Size of the reduction of mean 24-hour average daytime and nighttime average. 2. Size of the reduction of central blood pressure. 3. Magnitude of changes in plasma concentrations of angiotensin II, bradykinin and BNP after 24 weeks of treatment.
7 Not yet recruiting Aliskiren Study of Safety and Efficacy in Senior Hypertensives
Condition: Hypertension
Interventions: Drug: Aliskiren;   Drug: Amlodipine;   Drug: Ramipril;   Drug: Hydrochlorothiazide
Outcome Measures: Change from baseline in mean sitting systolic blood pressure (MSSBP) to week 8;   Number of patients with serious adverse events and adverse events;   Number of patients with hyperkalemia, hypotension and reduction of estimated glomerular filtration rate (eGFR);   Change from baseline in mean sitting systolic blood pressure (MSSBP) at the end of double blind period;   Percentage of patients achieving blood pressure control;   Percentage of patients with major cardiovascular events;   Number of patients with gastrointestinal tract cancer
8 Unknown  Ramipril Versus Carvedilol in Duchenne and Becker Patients
Conditions: Duchenne Muscular Dystrophy;   Becker Muscular Dystrophy
Interventions: Drug: carvedilol;   Drug: Ramipril
Outcome Measures: Left ventricular Ejection Fraction, systolic and diastolic left ventricular volumes and LGE (as a quantitative measure) detected by MRI and myocardial Ultrasound Tissue Characterisation data by Echocardiography.;   Prevalence of LGE in DMD and BMD patients,the effects of pharmacological therapy both on LGE evolution and myocardial UTC analysis.
9 Unknown  Aliskiren Versus Ramipril on Antiproteinuric Effect in Hypertensive, Type 2 Diabetic Patients With Microalbuminuria
Conditions: Hypertension;   Type 2 Diabetes
Interventions: Drug: Ramipril;   Drug: Experimental
Outcome Measures: Antiproteinuric effect as well as antihypertensive effect of aliskiren 300 mg / daily versus Ramipril 10 mg daily in hypertensive patients with type 2 diabetes and microalbuminuria.;   Average of 24 hours by ABPM, systolic and diastolic blood pressure;   Average daytime, systolic and diastolic blood pressure;   Average night, systolic and diastolic blood pressure
10 Recruiting Efficacy and Safety Study to Delay Renal Failure in Children With Alport Syndrome
Condition: Renal Insufficiency, Chronic
Interventions: Drug: Ramipril;   Drug: placebo to Ramipril
Outcome Measures: Time to next disease level;   Incidence of Adverse Drug Events before progression;   Albuminuria after three years;   Adverse Drug Events over three years
11 Unknown  Telmisartan Versus Ramipril After Acute Coronary Syndrome
Conditions: Acute Coronary Syndrome;   Myocardial Infarction;   Coronary Disease
Interventions: Drug: TELMISARTAN;   Drug: Ramipril
Outcome Measures: High sensitivity C-Reactive Protein;   Endothelial Progenitor Cells
12 Recruiting Impact of Body Composition on Bisoprolol and Ramipril Pharmacokinetics in Patients With Chronic Heart Failure
Conditions: Chronic Heart Failure;   Cachexia
Intervention:
Outcome Measures: Pharmacokinetic parameters of bisoprolol and Ramipril;   Body composition;   Cachexia diagnosis;   Renal function
13 Not yet recruiting Statin and Angiotensin-converting Enzyme Inhibitor on Symptoms in Patients With SCAD
Condition: Coronary Artery Dissection, Spontaneous
Interventions: Drug: Ramipril;   Drug: rosuvastatin;   Drug: placebo
Outcome Measures: Angina frequency domain of the SAQ;   Acute coronary syndrome or hospitalization for angina
14 Recruiting Sevelamer in Proteinuric CKD
Condition: Chronic Kidney Disease
Interventions: Drug: Sevelamer;   Drug: Ramipril and Irbesartan
Outcome Measures: 24-h urinary protein excretion;   Office blood pressure;   Glomerular Filtration Rate
15 Recruiting Genes, Fibrinolysis and Endothelial Dysfunction- Dialysis Aim 3
Conditions: Oxidative Stress;   Endothelial Dysfunction
Interventions: Drug: Ramipril (ACE inhibitor);   Drug: valsartan (ARB);   Drug: Placebo
Outcome Measures: To compare the long term effects of ACE inhibition or angiotensin receptor blockade versus placebo on biomarkers of fibrinolysis, oxidative stress and inflammation in patients with chronic kidney disease undergoing maintenance hemodialysis;   To compare the long term effects of ACE inhibition or AT1 receptor blockade versus placebo on carotid intima-media thickness (IMT) in patients with chronic kidney disease undergoing maintenance hemodialysis;   Track safety endpoints- hyperkalemia, hypotension, nonfatal myocardial infarction, nonfatal stroke, death from cardiac causes, fatal stroke, death due to any cause.
16 Unknown  Defining Strategies for Improving Endothelial and Fibrinolytic Dysfunction in Obesity
Condition: Metabolic Syndrome X
Interventions: Drug: Eplerenone;   Drug: Ramipril
Outcome Measures: Secreted factors from adipocytes have autocrine, paracrine and endocrine effects that have a deleterious effect on the fibrinolytic system, either by enhancing PAI-1 production or impairing endothelial t-PA release;   This study will analyze patients' genetic make up to identify who may be at greater risk for heart disease and strokes in relationship to high blood pressure and central obesity.
17 Not yet recruiting Cardiac Energetics and Function in Normal Human Ageing
Conditions: Left Ventricular Function Systolic Dysfunction;   Left Ventricular Function Diastolic Dysfunction;   Ageing
Intervention: Drug: Ramipril
Outcome Measures: Vascular Stiffness;   Left Ventricular Energetics;   Left Ventricular Function;   Effects of ACE inhibitor on left ventricular energetics and function in those subjects aged 40 and over
18 Not yet recruiting Effect of Chronic ACE and DPP4 Inhibition on Blood Pressure
Conditions: Type 2 Diabetes Mellitus;   Hypertension
Interventions: Drug: Placebo;   Drug: Sitagliptin;   Drug: Aprepitant
Outcome Measures: Blood pressure;   heart rate;   norepinephrine (NE) concentrations;   Low frequency variability of blood pressureactivity, aldosterone;   glucose;   insulin;   DPP4 activity;   ACE
19 Recruiting Prevention of Atrial Fibrillation by Inhibition Conversion Enzyme (ICE) After Radiofrequency Ablation of Atrial Flutter
Conditions: Atrial Fibrillation;   Atrial Flutter
Interventions: Drug: Ramipril;   Drug: Placebo
Outcome Measures: At least one relevant symptomatic or asymptomatic atrial fibrillation event;   All relevant cardiovascular event;   Secondary effects of the treatment
20 Recruiting Fixed Dose Combination Drug (Polypill)for Secondary Cardiovascular Prevention.
Condition: Myocardial Infarction
Interventions: Drug: FDC;   Drug: Separately drugs, simvastatin, aspirin and Ramipril
Outcome Measures: Proportion of patients receiving AAS, an ACE inhibitor and a statin among those without contraindications to any of these drugs Adherence to treatment measured by: Morinsky-Green test and Pill accountability.;   Adherence to treatment measured by the Morisky-Green questionnaire;   Treatment adherence measured by: Morisky-Green test: (Good adherence score 16-20) at 1 and 9 months.;   Treatment adherence measured by: Pill counts at 1-4-9 months. (Good adherence 80-110% PC);   Blood Pressure and Lipid Profile (LDL-cholesterol) at 1 and 9 months;   Safety and tolerability: Adverse events and rate of treatment withdrawal.