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Hepatobiliary diseases

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https://www.readbyqxmd.com/read/28634727/safety-and-efficacy-of-chemosaturation-in-patients-with-primary-and-secondary-liver-tumors
#1
Martha M Kirstein, Steffen Marquardt, Nils Jedicke, Silke Marhenke, Wolfgang Koppert, Michael P Manns, Frank Wacker, Arndt Vogel
BACKGROUND: Chemosaturation with percutaneous hepatic perfusion (CS-PHP; hepatic CHEMOSAT(®) delivery system; Delcath Systems Inc, USA) is a novel medical device, which delivers high doses of melphalan directly to the liver in patients with primary and secondary liver tumors while limiting systemic toxicity through hemofiltration of the hepatic venous blood. The aim of this study was to analyze the safety and efficacy of the second-generation CS-PHP after 54 treatments at Hannover Medical School, Germany...
June 20, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28625717/clinical-impact-of-non-antibiotic-recommendations-by-a-multi-disciplinary-antimicrobial-stewardship-team
#2
Tat Ming Ng, Vanessa Y Phang, Barnaby Young, Sock Hoon Tan, Hui Lin Tay, Michelle W Tan, Li Min Ling, Brenda S Ang, Christine B Teng, David C Lye
INTRODUCTION: The multi-disciplinary antimicrobial stewardship team at the study hospital conducts prospective review and feedback on all inpatient orders of piperacillin-tazobactam and carbapenems. In addition, the team provides non-antibiotic recommendations (i.e. additional investigations and infectious disease reviews). This study aimed to describe the impact of these recommendations on patient outcomes. METHODS: Patients on carbapenem and piperacillin-tazobactam who received at least one non-antibiotic recommendation between January 2012 and August 2014 were included in this study...
June 15, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28624924/evaluation-of-hepatic-fibrosis-a-review-from-the-society-of-abdominal-radiology-disease-focus-panel
#3
REVIEW
Jeanne M Horowitz, Sudhakar K Venkatesh, Richard L Ehman, Kartik Jhaveri, Patrick Kamath, Michael A Ohliger, Anthony E Samir, Alvin C Silva, Bachir Taouli, Michael S Torbenson, Michael L Wells, Benjamin Yeh, Frank H Miller
Hepatic fibrosis is potentially reversible; however early diagnosis is necessary for treatment in order to halt progression to cirrhosis and development of complications including portal hypertension and hepatocellular carcinoma. Morphologic signs of cirrhosis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) alone are unreliable and are seen with more advanced disease. Newer imaging techniques to diagnose liver fibrosis are reliable and accurate, and include magnetic resonance elastography and US elastography (one-dimensional transient elastography and point shear wave elastography or acoustic radiation force impulse imaging)...
June 17, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28623758/a-massive-hepatic-tumor-demonstrating-hepatocellular-cholangiocarcinoma-and-neuroendocrine-lineages-a-case-report-and-review-of-the-literature
#4
Rachel E Beard, Sydney D Finkelstein, Amir A Borhani, Marta I Minervini, J Wallis Marsh
INTRODUCTION: Mixed hepatocellular and cholangiocarcinoma tumors (MHCC) are described in the literature, as are the more rare mixed adenoneuroendocrine carcinomas (MANC) of hepatobiliary origin. Only two cases of tumors with characteristics of all three histologies/phenotypes have been previously described in one Chinese study. PRESENTATION OF CASE: Herein we report clinical, microscopic and molecular features of a 25cm mixed hepatic tumor with hepatocellular, cholangiocarcinoma and neuroendocrine differentiation arising in an otherwise healthy 19-year-old North American Caucasian male without any identifiable risk factors...
June 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28616421/cystic-fibrosis-prevalence-among-a-group-of-high-risk-children-in-the-main-referral-children-hospital-in-iran
#5
Mohammad Reza Modaresi, Jamal Faghinia, Mohsen Reisi, Majid Keivanfar, Shiva Navaie, Javad Seyyedi, Faride Baharzade
BACKGROUND: Knowledge about cystic fibrosis (CF) in Iran is very limited. The objective of this study was to determine the prevalence of CF among a group of high-risk children with suggestive clinical features in the main referral hospital in Iran. MATERIALS AND METHODS: This study children consisted of 505 patients who had presented with one or more of the following symptoms: chronic or recurrent respiratory symptoms, gastrointestinal symptoms as rectal prolapse, steatorrhea, hepatobiliary disease as prolonged jaundice, failure to thrive, hyperglycemia and glycosuria, hypochloremic metabolic alkalosis, hypoprothrombinemia, anemia or edema, and positive family history of CF...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28614231/incidence-prevalence-and-natural-history-of-primary-sclerosing-cholangitis-in-the-united-kingdom
#6
Huifang Liang, Sudhakar Manne, Jesse Shick, Trevor Lissoos, Paul Dolin
Primary sclerosing cholangitis (PSC) is a rare obliterative fibrotic condition of the bile ducts. We assessed PSC epidemiology and natural history within the UK Clinical Practice Research Datalink (CPRD).Incidence and natural history of PSC were evaluated in a retrospective cohort study using linkage of CPRD, Hospital Episode Statistics, and Office for National Statistics data. Data from age, sex, and general practice-matched population controls provided a context for the incident PSC patients. Liver disease other than PSC was defined as autoimmune hepatitis, hepatitis, hepatomegaly, liver failure, cirrhosis, portal hypertension, cholangiocarcinoma, or hepatobiliary cancer...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28611971/diagnosis-and-management-of-hepatobiliary-complications-in-autosomal-recessive-polycystic-kidney-disease
#7
REVIEW
Andrew Wehrman, Alyssa Kriegermeier, Jessica Wen
Autosomal recessive polycystic kidney disease (ARPKD) is a congenital hepatorenal fibrocystic disease. The hepatic manifestations of ARPKD can range from asymptomatic to portal hypertension and massively dilated biliary system that results in liver transplantation. Hepatic complications of ARPKD typically present with signs of portal hypertension (splenomegaly and thrombocytopenia) or cholangitis. Liver disease in ARPKD does not always correlate with severity of renal disease. Management of ARPKD-related liver disease is largely treating specific symptoms, such as antibiotics for cholangitis or endoscopic treatment for variceal bleeding...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28611937/stauffer-s-syndrome-in-pancreatic-cancer-first-case-report
#8
David Harris, Muhammad W Saif
Stauffer's syndrome is a rare paraneoplastic syndrome classically associated with renal cell carcinoma. It presents as abnormal hepatic panel in the absence of hepatic disease, which improves with treatment of the cancer and worsens with recurrence. Here, we describe a case of hepatic panel abnormalities in a patient with pancreatic cancer with no evidence of metastatic disease to the liver, primary hepatobiliary etiology, or clear offending medications. We believe this to be the first reported case of Stauffer's syndrome in patients with pancreatic cancer...
May 8, 2017: Curēus
https://www.readbyqxmd.com/read/28611566/periorbital-ecchymosis-raccoon-eye-and-orbital-hematoma-following-endoscopic-retrograde-cholangiopancreatography
#9
Jafar Nasiri, Farhad Zamani
Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28604925/association-of-adverse-events-with-antibiotic-use-in-hospitalized-patients
#10
Pranita D Tamma, Edina Avdic, David X Li, Kathryn Dzintars, Sara E Cosgrove
Importance: Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. Objective: To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. Design, Setting, and Participants: Retrospective cohort of adult inpatients admitted to general medicine wards at an academic medical center. Exposures: At least 24 hours of any parenteral or oral antibiotic therapy...
June 12, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28602703/clinical-predictors-and-outcomes-of-klebsiella-pneumoniae-bacteraemia-in-a-regional-hospital-in-hong-kong
#11
M Y Man, H P Shum, Y H Chan, K C Chan, W W Yan, R A Lee, S K P Lau
BACKGROUND: Klebsiella pneumoniae (KP) infection is associated with high morbidity and mortality. Multidrug resistance, especially extended spectrum beta-lactamase (ESBL) production, in KP is endemic worldwide. Our study aimed to evaluate the clinical characteristics and outcomes of patients with KP bacteraemia in critical care and general ward settings. METHODS: Adult patients admitted to a regional hospital in Hong Kong from 1 January 2009 to 30 June 2016 (7.5 years) with KP bacteraemia were included...
June 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28594875/analytical-evaluation-of-three-enzymatic-assays-for-measuring-total-bile-acids-in-plasma-using-a-fully-automated-clinical-chemistry-platform
#12
Elisa Danese, Gian Luca Salvagno, Davide Negrini, Giorgio Brocco, Martina Montagnana, Giuseppe Lippi
BACKGROUND: Although the clinical significance of measuring bile acids concentration in plasma or serum has been recognized for long in patients with hepatobiliary disease and/or bile acid malabsorption, the reference separation techniques are expensive and mostly unsuitable for early diagnosis and for measuring large volumes of samples. Therefore, this study was aimed to evaluate the analytical performance of three commercial enzymatic techniques for measuring total bile acids in plasma using a fully-automated clinical chemistry platform...
2017: PloS One
https://www.readbyqxmd.com/read/28573819/use-of-eltrombopag-for-secondary-immune-thrombocytopenia-in-clinical-practice
#13
Tomás J González-López, María T Alvarez-Román, Cristina Pascual, Blanca Sánchez-González, Fernando Fernández-Fuentes, Gloria Pérez-Rus, José A Hernández-Rivas, Silvia Bernat, José M Bastida, María P Martínez-Badas, Violeta Martínez-Robles, Inmaculada Soto, Pavel Olivera, Estefanía Bolaños, Rafael Alonso, Laura Entrena, Marta Gómez-Nuñez, Arancha Alonso, María Yera Cobo, Isabel Caparrós, María Tenorio, Esther Arrieta-Cerdán, Elsa Lopez-Ansoar, Javier García-Frade, José R González-Porras
Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated...
June 1, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28567528/portal-vein-embolization-in-extended-liver-resection
#14
REVIEW
Nisha Narula, Thomas A Aloia
BACKGROUND: Liver resection of benign, primary, and metastatic tumors is challenging and places patients at risk of postoperative liver insufficiency. This risk is largely dependent on the volume and function of the future liver remnant (FLR). It is, therefore, critical that hepatobiliary surgeons are well versed in the measurement of liver volume and function, as well as various techniques for preoperative liver volume augmentation. PURPOSE: This comprehensive review of portal vein embolization (PVE) begins with an overview of FLR measurement and progresses to patient factors to consider when choosing PVE and assessment of hypertrophy...
May 31, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28566881/inflammatory-bowel-disease-in-liver-transplanted-patients
#15
REVIEW
Tajana Filipec Kanizaj, Maja Mijic
Most common hepatobiliary manifestation of inflammatory bowel disease (IBD) are primary sclerosing cholangitis (PSC) and autoimmune hepatitis, ranking them as the main cause of liver transplantation (LT) in IBD setting. Course of pre-existing IBD after LT differs depending on many transplant related factors. Potential risk factors related to IBD deterioration after LT are tacrolimus-based immunosuppressive regimens, active IBD and cessation of 5-aminosalicylates at the time of LT. About 30% patients experience improvement of IBD after LT, while approximately the same percentage of patients worsens...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28548906/beyond-the-bowel-extraintestinal-manifestations-of-inflammatory-bowel-disease
#16
Jeffrey D Olpin, Brett P Sjoberg, Sarah E Stilwill, Leif E Jensen, Maryam Rezvani, Akram M Shaaban
Inflammatory bowel disease (IBD) is a chronic, relapsing immune-mediated inflammation of the gastrointestinal tract. IBD includes two major disease entities: Crohn disease and ulcerative colitis. Imaging plays an important role in the diagnosis and surveillance of these complex disorders. Computed tomographic and magnetic resonance enterographic techniques have been refined in recent years to provide a superb means of evaluating the gastrointestinal tract for suspected IBD. Although the intestinal imaging manifestations of IBD have been extensively discussed in the radiology literature, extraintestinal imaging manifestations of IBD have received less attention...
May 26, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28537229/-genomics-and-transcriptomics-of-the-chinese-liver-fluke-clonorchis-sinensis-opisthorchiidae-trematoda
#17
G N Chelomina
The review summarizes the results of first genomic and transcriptomic investigations of the liver fluke Clonorchis sinensis (Opisthorchiidae, Trematoda). The studies mark the dawn of the genomic era for opisthorchiids, which cause severe hepatobiliary diseases in humans and animals. Their results aided in understanding the molecular mechanisms of adaptation to parasitism, parasite survival in mammalian biliary tracts, and genome dynamics in the individual development and the development of parasite-host relationships...
March 2017: Molekuliarnaia Biologiia
https://www.readbyqxmd.com/read/28527946/the-microbiome-and-hepatobiliary-pancreatic-cancers
#18
Kosuke Mima, Shigeki Nakagawa, Hiroshi Sawayama, Takatsugu Ishimoto, Katsunori Imai, Masaaki Iwatsuki, Daisuke Hashimoto, Yoshifumi Baba, Yo-Ichi Yamashita, Naoya Yoshida, Akira Chikamoto, Hideo Baba
The human intestinal microbiome encompasses at least 100 trillion microorganisms that can influence host immunity and disease conditions, including cancer. Hepatobiliary and pancreatic cancers have been associated with poor prognosis owing to their high level of tumor invasiveness, distant metastasis, and resistance to conventional treatment options, such as chemotherapy. Accumulating evidence from animal models suggests that specific microbes and microbial dysbiosis can potentiate hepatobiliary-pancreatic tumor development by damaging DNA, activating oncogenic signaling pathways, and producing tumor-promoting metabolites...
May 17, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28514402/-psychoemotional-and-autonomic-states-in-patients-with-cholelithiasis
#19
Ya M Vakhrushev, N A Khokhlacheva, N N Sergeeva
AIM: To investigate the psychoemotional and autonomic states of patients with biliary system diseases and to determine their significance in the development of cholelithiasis. SUBJECTS AND METHODS: A total of 396 patients with stage 1 cholelithiasis were examined. The results of hepatobiliary ultrasonography, multifractional duodenal probing, followed by macroscopic, microscopic, and biochemical examinations of bile (the total concentration of bile acids and cholesterol, by subsequently calculating the cholate-cholesterol ratio) were used to verify the diagnosis...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28506361/igg4-related-disease-and-the-liver
#20
REVIEW
Jonathan H Chen, Vikram Deshpande
Pathologists are likely to encounter IgG4-related disease in several organ systems. This article focuses on helping pathologists diagnose IgG4-related disease in the hepatobiliary system. Missing the diagnosis can result in unnecessary organ damage and/or unnecessary surgical and cancer therapy. In the liver, tumefactive lesion(s) involving the bile ducts with storiform fibrosis and an IgG4-enriched lymphoplasmacytic infiltrate are highly concerning for IgG4-related disease. The recent identification of oligoclonal populations of T cells and B cells in IgG4-related disease may lead to molecular tests, new therapeutics, and a greater mechanistic understanding of the disease...
June 2017: Gastroenterology Clinics of North America
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