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Septic cholestasis

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https://www.readbyqxmd.com/read/26965761/early-enteral-nutrition-in-neonates-with-partial-gastrectomy-a-multi-center-study
#1
MULTICENTER STUDY
Weiwei Jiang, Jie Zhang, Qiming Geng, Xiaoqun Xu, Xiaofeng Lv, Yongwei Chen, Xiang Liu, Weibing Tang
BACKGROUND AND OBJECTIVES: Compared with total parenteral nutrition (TPN), enteral nutrition is more suitable for patients post-operatively. Our aim was to determine the safety and feasibility of early enteral nutrition (EEN) using a jejunum feeding tube in neonates after undergoing a partial gastrectomy. METHODS AND STUDY DESIGN: This was a retrospective review of 46 patients who underwent partial gastrectomies for gastric perforation in our hospital. These patients were categorized into two groups (EEN group [n=24 patients], a jejunal feeding tube was inserted during surgery; and a control group [n=22 patients], a jejunal feeding tube was not placed)...
2016: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/26367025/recurrent-pyogenic-cholangitis-as-a-differential-diagnosis-in-biliary-tract-diseases
#2
V Wagner, R R Plentz, C Schraml, N P Malek, M Goetz
Recurrent Pyogenic Cholangitis (RPC) or Primary Hepatolithiasis is a common disease of the biliary tract in Asia, whereas it is usually not seen in Europeans. With increasing global mobility, the disease will be encountered in Europe more frequently, too. It should therefore be considered as a differential diagnosis in patients from endemic countries with recurrent symptoms of cholestasis/cholangitis and bile duct dilations, strictures and hepatolithiasis. In this case report, we present the history of a 37-year old patient from Sri Lanka and describe typical aspects of RPC...
September 2015: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/26259626/characteristics-of-neonates-with-culture-proven-bloodstream-infection-who-have-low-levels-of-c-reactive-protein-%C3%A2-10-mg-l
#3
Mei-Yin Lai, Ming-Horng Tsai, Chiang-Wen Lee, Ming-Chou Chiang, Reyin Lien, Ren-Huei Fu, Hsuan-Rong Huang, Shih-Ming Chu, Jen-Fu Hsu
BACKGROUND: Elevated C-reactive protein (CRP) level is widely used in clinical practice as a marker to distinguish between neonates with or without sepsis. However, some neonates with bacteremia have a CRP level within the normal range and they are not well characterized. METHODS: All episodes of neonatal culture-proven bloodstream infections (BSIs) between July 2004 and June 2012 were enrolled. Patients characteristics were compared for three CRP groups (low, ≤ 10 mg/L; intermediate, 11-100 mg/L; and high, > 100 mg/L) using the Chi-square test and one-way ANOVA...
2015: BMC Infectious Diseases
https://www.readbyqxmd.com/read/25375059/biliary-cast-complication-of-cholangitis-and-pancreatitis-in-a-pancreas-divisum-patient
#4
F Graur, H Neagos, A Cavasi, N Al Hajjar
We report a rare cause of biliary cast secondary to cholangitis and pancreatitis, in a 60 year old female patient with pancreas divisum. She was admitted in our hospital with an acute pancreatitis (alcoholic etiology was excluded) complicated with pancreatic abscess and obstructive jaundice. The patient had undergone a complex surgical intervention: cholecystectomy,choledocotomy with extraction of the biliary thrombus,external biliary drainage through a T tube, evacuation of the pancreatic abscess, sequestrectomy, peritoneal lavage and multipledrainages...
September 2014: Chirurgia
https://www.readbyqxmd.com/read/24770888/-shock-liver-and-cholestatic-liver-in-critically-ill-patients
#5
REVIEW
A Drolz, T Horvatits, K Roedl, V Fuhrmann
Liver dysfunction is frequently observed in critically ill patients. Its occurrence is associated with high morbidity and mortality. The most frequent entities of hepatic dysfunction in the intensive care unit are shock liver and cholestatic liver dysfunction with incidence rates up to 10 and 30 %, respectively.Both conditions are frequently triggered by hypoxic and/or ischemic events, most commonly cardiogenic shock and sepsis/septic shock. However, several other potential contributors have been identified especially for cholestatic liver dysfunction...
May 2014: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/23738412/bactibilia-due-to-enterococcus-species-in-a-case-of-periampullary-carcinoma
#6
Maitreyi Bandyopadhyay, Simit Kumar, Abhijit Bhakta, Parthajit Banerjee, Sougata Ghosh
Biliary obstruction due to pancreaticobiliary malignancy is often accompanied by bactibilia and cholangitis; which are associated with postoperative septic complications and may adversely affect the clinical course. The enterococcus species is most responsible for postoperative complications in patients with malignant biliary obstruction. Here a case of bactibilia in a 60-year-old male patient, admitted with peri-ampullary carcinoma is reported. The bile sent for Gram-stain showed the presence of pus cells and Gram-positive cocci in pairs and the bacteriological culture revealed the growth of Enterococcus faecium...
October 2012: Journal of the Indian Medical Association
https://www.readbyqxmd.com/read/23701771/the-impact-of-multi-disciplinary-intestinal-rehabilitation-programs-on-the-outcome-of-pediatric-patients-with-intestinal-failure-a-systematic-review-and-meta-analysis
#7
REVIEW
Jennifer D Stanger, Carol Oliveira, Christopher Blackmore, Yaron Avitzur, Paul W Wales
BACKGROUND: Pediatric intestinal failure (IF) is a complex clinical problem requiring coordinated multi-disciplinary care. Our objective was to review the evidence for the benefit of intestinal rehabilitation programs (IRP) in pediatric IF patients. METHODS: A systematic review was performed on Medline (1950-2012), Pubmed (1966-2012), and Embase (1980-2012) conference proceedings and trial registries. The terms short bowel syndrome, intestinal rehabilitation, intestinal failure, patient care teams, and multi-disciplinary teams were used...
May 2013: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/23674851/how-do-we-manage-post-olt-redundant-bile-duct
#8
Victor Torres, Nicholas Martinez, Gabriel Lee, Jose Almeda, Glenn Gross, Sandeep Patel, Laura Rosenkranz
AIM: To address endoscopic outcomes of post-Orthotopic liver transplantation (OLT) patients diagnosed with a "redundant bile duct" (RBD). METHODS: Medical records of patients who underwent OLT at the Liver Transplant Center, University Texas Health Science Center at San Antonio Texas were retrospectively analyzed. Patients with suspected biliary tract complications (BTC) underwent endoscopic retrograde cholangiopancreatography (ERCP). All ERCP were performed by experienced biliary endoscopist...
April 28, 2013: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/23574754/hepatic-excretory-function-in-sepsis-implications-from-biophotonic-analysis-of-transcellular-xenobiotic-transport-in-a-rodent-model
#9
Falk A Gonnert, Peter Recknagel, Ingrid Hilger, Ralf A Claus, Michael Bauer, Andreas Kortgen
INTRODUCTION: Hepatobiliary elimination of endo- and xenobiotics is affected by different variables including hepatic perfusion, hepatocellular energy state and functional integrity of transporter proteins, all of which are altered during sepsis. A particular impairment of hepatocellular transport at the canalicular pole resulting in an accumulation of potentially hepatotoxic compounds would have major implications for critical care pharmacology and diagnostics. METHODS: Hepatic transcellular transport, that is, uptake and hepatobiliary excretion, was studied in a rodent model of severe polymicrobial sepsis by two different biophotonic techniques to obtain insights into the handling of potentially toxic endo- and xenobiotics in sepsis...
2013: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/23556047/portal-hypertensive-biliopathy-a-single-center-experience-and-literature-review
#10
Vanessa Suárez, Andrés Puerta, Luisa Fernanda Santos, Juan Manuel Pérez, Adriana Varón, Rafael Claudino Botero
Portal hypertensive biliopathy (PHB) is characterized by anatomical and functional abnormalities of the intrahepatic, extrahepatic and pancreatic ducts, in patients with portal hypertension associated to extrahepatic portal vein obstruction and less frequently to cirrhosis. These morphological changes, consisting in dilatation and stenosis of the biliary tree, are due to extensive venous collaterals occurring in an attempt to decompress the portal venous blockage. It is usually asymptomatic until it progresses to more advanced stages with cholestasis, jaundice, biliary sludge, gallstones, cholangitis and finally biliary cirrhosis...
March 27, 2013: World Journal of Hepatology
https://www.readbyqxmd.com/read/23460496/persistent-abnormal-liver-fibrosis-after-weaning-off-parenteral-nutrition-in-pediatric-intestinal-failure
#11
Annika Mutanen, Jouko Lohi, Päivi Heikkilä, Antti I Koivusalo, Risto J Rintala, Mikko P Pakarinen
UNLABELLED: The aim of this study was to evaluate the long-term effects of pediatric intestinal failure (IF) on liver histology. Altogether, 38 IF patients (median age: 7.2 years; range, 0.2-27) underwent liver biopsy, gastroscopy, abdominal ultrasound, and laboratory tests. Sixteen patients were on parenteral nutrition (PN) after 74 PN months (range, 2.5-204). Twenty-two had weaned off PN 8.8 years (range, 0.3-27) earlier, after 35 PN months (range, 0.7-250). Fifteen transplant donor livers served as controls...
August 2013: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/23279060/prognostic-value-of-biochemical-liver-parameters-in-neonatal-sepsis-associated-cholestasis
#12
Hanifah Oswari, Ruth Karisma Widjaja, Rinawati Rohsiswatmo, Geoffrey Cleghorn
AIMS: The aim of the study was to evaluate the significance of total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyltransferase (GGT) for predicting outcome in sepsis-associated cholestasis. METHODS: A retrospective cohort review of the hospital records was performed in 181 neonates admitted to the Neonatal Care Unit. A comparison was performed between subjects with low and high liver values based on cut-off values from ROC analysis...
January 2013: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/22997063/plasma-and-red-cell-exchange-transfusions-for-erythropoietic-protoporphyria-a-case-report-and-review-of-the-literature
#13
Monica B Pagano, William Hobbs, Michael Linenberger, Meghan Delaney
Erythropoietic protoporphyria (EPP) is a rare and usually autosomal dominant disorder characterized by ferrochelatase deficiency and accumulation of protoporphyrin in red blood cells (RBCs), skin, and liver. A small minority of patients develop severe liver dysfunction for which optimum treatment is lacking. Therapeutic plasma exchange (TPE) and RBC exchange (RCE) have been anecdotally reported to benefit patients with EPP and liver failure. A 50-year-old female with EPP developed severe liver dysfunction after knee replacement surgery and high-dose acetaminophen use...
2012: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/22565500/-liver-parameters-in-intensive-care-medicine
#14
REVIEW
V Penndorf, F Saner, G Gerken, A Canbay
Elevated liver function tests in ICU-bound patients are associated with a greater risk of mor-tality. Chronic liver diseases as well as acute events and complications of therapy are among the causes. The disorder could further be investigated by assessment of liver cell integrity markers (AST, ALT and GLDH), cholestasis parameters -(bilirubin, GGT, ALP) and liver synthethic function (albumin, coagulation profile). Ultrasound and elastography are cheap and mobile options to evaluate chronic liver disease, cholestasis or perfusion of the liver...
December 2013: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/22560824/intracellular-cholestasis-a-rare-complication-of-malaria-falciparum-infection
#15
Abdel Motaal Mohamed Ahmed, Mohamed B Galib
BACKGROUND: Aside from acute viral hepatitides intracellular cholestasis is seen less often with the use of certain drugs, contrast media, leptospirosis and congenital hyperbilirubinaemias. Types of liver injuries complicating malaria usually take the form of acute hepatitis or haemolytic anaemias rather than cholestasis. We report here a rare presentation where a typical intracellular cholestatic picture complicated malaria falciparum in a patient residing in an endemic area. PATIENT AND METHODS: A 55 year old bank manager presented with malaria fever and deep jaundice for investigations...
March 2012: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/22388910/-severe-recurrent-intrahepatic-cholestasis-in-systemic-al-amyloidosis-without-obvious-liver-involvement-unexplained-hepatic-toxicity-or-a-case-of-misdiagnosed-liver-amyloidosis
#16
Nunzia Paudice, Silvia Farsetti, Leonardo Caroti, Sandro Bandini, Gabriele Ciuti, Alessio Tempestini, Federico Perfetto, Simone Galli, Letizia Giabbani, Anna Lucia Caldini, Franco Bergesio
We report the case of a 50-year-old woman who was admitted to the hospital for acute abdominal pain with nephrotic proteinuria, rapidly progressive renal failure, and moderate anemia. Laboratory tests showed mild Bence Jones (λ) proteinuria with negative serum immunofixation and a mild increase in λ free light chains. A bone marrow biopsy and a fat tissue aspirate showed multiple myeloma and amyloidosis. Because of the end-stage renal disease, the patient began regular dialysis treatment and was started on bortezomib 1...
January 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/21985492/novel-technique-for-biliary-reconstruction-using-an-isolated-gastric-tube-with-a-vascularized-pedicle-a-live-animal-experimental-study-and-the-first-clinical-case
#17
Ashraf A Helmy, Mostafa A Hamad, Ahmed M Aly, Tahra Sherif, Mostafa Hashem, Dalia Ah El-Sers, Mohammad Semieka
BACKGROUND: Biliary tract reconstruction continues to be a challenging surgical problem. Multiple experimental attempts have been reported to reconstruct biliary defects with different materials and variable outcome. Our aim was to evaluate a new method for biliary reconstruction using an isolated pedicled gastric tube in a live animal trial and also to present the first clinical case. METHODS: Seven mongrel dogs underwent biliary reconstruction using gastric tube harvested, completely separated from the greater curvature, and based on a vascularized pedicle with the right gastroepiploic vessels...
2011: Annals of Surgical Innovation and Research
https://www.readbyqxmd.com/read/21873967/plasma-cholinesterase-correlations-in-acute-surgical-and-critical-illness
#18
COMPARATIVE STUDY
C Chiarla, I Giovannini, F Giuliante, M Vellone, F Ardito, G Nuzzo
AIM: The properties of plasma cholinesterase (CHE) are partly undiscovered. Equally unknown are the correlations between changes in CHE and other blood variables during the acute phase response related to acute surgical and critical illness. METHODS: Data from 432 measurements of CHE and other variables performed in 92 patients were systematically evaluated and processed by regression analysis. RESULTS: There was a strong direct correlation between CHE and albumin (r=0...
August 2011: Minerva Chirurgica
https://www.readbyqxmd.com/read/21560642/-intrahepatic-cholestasis-in-chronic-liver-diseases
#19
E V Golovanova, A V Petrakov, K K Noskova
The syndrome of cholestasis is a common manifestation of chronic liver disease (CLD) of any etiology: alcoholic, viral, drug, metabolic, etc. The basis of the formation of cholestasis is a violation of the synthesis, secretion or bile outflow. Accession intrahepatic cholestasis (field surgery) for chronic liver disease alters its course, aggravates the condition of the patient, reduces the immune system, leads to development of severe septic complications, significantly reduces the quality of life (QoL) and worsens the prognosis...
2011: Experimental & Clinical Gastroenterology
https://www.readbyqxmd.com/read/21350398/-the-method-of-biliary-tracts-drainage-of-patients-with-biliodigestive-anastomosis-at-obstructive-jaundice-and-acute-cholangitis
#20
B A Agaev, R M Agaev, R Sh Gasymov
The internal draining of biliary tracts of patients with obstructive jaundice and acute cholangitis is considered most acceptable, but deficiency of this method is anastomosis failure, stricture and purulent-septic complications hazard. The investigations performed on 79 patients with obstructive jaundice, 36 of which were included in control group, 43 - in main group. To patients of main group with internal draining intraoperatively through the nose and biliodigestive anastomosis into the biliary tract transmitted tube with quartz optical monofiber for endocholedocheal laser irradiation in one lumen and hollow other, serve for drainage and irrigation of bile-excreting way with ozonized physiological solution...
2011: Khirurgiia
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