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https://www.readbyqxmd.com/read/28350710/physical-chemistry-of-bile-detailed-pathogenesis-of-cholelithiasis
#1
Malak Itani, Theodore J Dubinsky
Despite the overwhelming prevalence of cholelithiasis, many health care professionals are not familiar with the basic pathophysiology of gallstone formation. This article provides an overview of the biochemical pathways related to bile, with a focus on the physical chemistry of bile. We describe the important factors in bile synthesis and secretion that affect the composition of bile and consequently its liquid state. Within this biochemical background lies the foundation for understanding the clinical and sonographic manifestation of cholelithiasis, including the pathophysiology of cholesterol crystallization, gallbladder sludge, and gallstones...
March 27, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28343425/ppar-%C3%AE-agonists-are-still-on-the-rise-an-update-on-clinical-and-experimental-findings
#2
Nicola Ferri, Alberto Corsini, Cesare Sirtori, Massimiliano Ruscica
Non-fasting plasma triglyceride (TG) and remnant cholesterol levels, cholesterol content of triglyceride-rich lipoproteins, have been suggested to be an additional cause of cardiovascular diseases; thus, pharmacological TG-lowering with fibrates, activators of PPAR-alpha system, has been linked to risk reduction. Areas covered: This manuscript reviews available evidence on clinical trials involving highly selective PPAR-α agonists (i.e., pemafibrate) and drugs used in the pre-clinical and experimental setting (e...
March 27, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28336180/an-important-intestinal-transporter-that-regulates-the-enterohepatic-circulation-of-bile-acids-and-cholesterol-homeostasis-the-apical-sodium-dependent-bile-acid-transporter-slc10a2-asbt
#3
Ling Xiao, Guoyu Pan
The enterohepatic circulation of bile acids (BAs) is governed by specific transporters expressed in the liver and the intestine and plays a critical role in the digestion of fats and oils. During this process, the majority of the BAs secreted from the liver is reabsorbed in intestinal epithelial cells via the apical sodium-dependent bile acid transporter (ASBT/SLC10A2) and then transported into the portal vein. Previous studies revealed that regulation of the ASBT involves BAs and cholesterol. In addition, abnormal ASBT expression and function might lead to some diseases associated with disorders in the enterohepatic circulation of BAs and cholesterol homeostasis, such as diarrhoea and gallstones...
March 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28331267/laparoscopic-management-of-a-proximal-jejunal-gallstone-ileus-with-patulous-ampulla-and-choledochal-cyst-a-report-of-unusual-presentation-and-a-review
#4
REVIEW
Rajvilas Anil Narkhede, Vijaykumar C Bada, Lakshmi Kumari Kona
Gallstone ileus is a diagnosis of rarity, and a proximal site of obstruction in a young patient is even rare. Of the three cases in our experience, we found two cases of gallstone ileus (GSI) with typical epidemiology and presentation, one had combination of multiple rare associations. We report such a case, suspected to have gallstone ileus on ultrasound and confirmed diagnosis on computed tomography. Presence of biliary-enteric fistula, old age, and obstructive features, as in typical cases, was a bigger asset for diagnosis, but it was difficult to entertain diagnosis of GSI in young girl in absence of a demonstrable biliary-enteric fistula, with uncommon association of choledochal cyst and sickle cell disease...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28327561/erratum-osteopontin-deficiency-alters-biliary-homeostasis-and-protects-against-gallstone-formation
#5
Jing Lin, Ming Lu, Wei-Qing Shao, Zong-You Chen, Wen-Wei Zhu, Lu Lu, Hu-Liang Jia, Duan Cai, Lun-Xiu Qin, Jin-Hong Chen
No abstract text is available yet for this article.
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28326468/day-case-laparoscopic-cholecystectomy-analysis-of-the-factors-allowing-early-discharge
#6
Giovanni Domenico Tebala, Angela Belvedere, Sean Keane, Abdul Qayyum Khan, Abdelsalam Osman
Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed. Primary endpoints were: postoperative length of stay, rate of patients discharged within 24 h, and rate of those discharged on the same day...
March 21, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28324273/acute-pancreatitis-caused-by-mycoplasma-pneumoniae-an-unusual-etiology
#7
Teresa Valdés Lacasa, María Alejandra Duarte Borges, Alicia García Marín, Covadonga Gómez Cuervo
It is well known that the most important etiologies of acute pancreatitis are gallstones and alcohol consumption. Once these causes have been ruled out, especially in young adults, it is important to consider less frequent etiologic factors such as drugs, trauma, malformations, autoimmunity or systemic diseases. Other rare and less well studied causes of this pathology are infections, among which Mycoplasma pneumoniae has been reported to cause acute pancreatitis as an unusual extrapulmonary manifestation. Here, we report the case of a 21-year-old patient who had acute idiopathic pancreatitis associated with an upper respiratory tract infection...
March 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28321066/gilbert-syndrome-with-concomitant-hereditary-spherocytosis-presenting-with-moderate-unconjugated-hyperbilirubinemia
#8
Mitsuhiko Aiso, Minami Yagi, Atsushi Tanaka, Kotaro Miura, Ryo Miura, Toshihiko Arizumi, Yoriyuki Takamori, Sayuri Nakahara, Yoshihiro Maruo, Hajime Takikawa
We experienced a case of a 19-year-old man with Gilbert syndrome with concomitant hereditary spherocytosis. The patient presented with moderate unconjugated hyperbilirubinemia, and inherited etiology was strongly suspected. The diagnosis of Gilbert syndrome was confirmed by the genetic analysis of the UGT1A1 gene, demonstrating UGT1A1*28 and compound heterozygote UGT1A1*6. In addition, since the laboratory findings and imaging studies revealed lysemia as well as gallstone and splenomegaly, a diagnosis of hereditary spherocytosis was made as a comorbidity...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#9
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28314823/body-size-indicators-and-risk-of-gallbladder-cancer-pooled-analysis-of-individual-level-data-from-19-prospective-cohort-studies
#10
Peter T Campbell, Christina C Newton, Cari M Kitahara, Alpa V Patel, Patricia Hartge, Jill Koshiol, Katherine A McGlynn, Hans-Olov Adami, Amy Berrington de González, Laura E Beane Freeman, Leslie Bernstein, Julie E Buring, Neal D Freedman, Yu-Tang Gao, Graham G Giles, Marc J Gunter, Mazda Jenab, Linda M Liao, Roger L Milne, Kim Robien, Dale P Sandler, Catherine Schairer, Howard D Sesso, Xiao-Ou Shu, Elisabete Weiderpass, Alicja Wolk, Yong-Bing Xiang, Anne Zeleniuch-Jacquotte, Wei Zheng, Susan M Gapstur
Background: There are few established risk factors for gallbladder cancer beyond gallstones. Recent studies suggest a higher risk with high body mass index (BMI), an indicator of general heaviness, but evidence from other body size measures is lacking.Methods: Associations of adult BMI, young adult BMI, height, adult weight gain, waist circumference (WC), waist-height ratio (WHtR), hip circumference (HC), and waist-hip ratio (WHR) with gallbladder cancer risk were evaluated. Individual-level data from 1,878,801 participants in 19 prospective cohort studies (14 studies had circumference measures) were harmonized and included in this analysis...
March 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28301778/risk-stratified-versus-non-risk-stratified-diagnostic-testing-for-management-of-suspected-acute-biliary-obstruction-comparative-effectiveness-costs-and-the-role-of-mr-cholangiopancreatography
#11
Stella K Kang, David Hoffman, Bart Ferket, Michelle I Kim, R Scott Braithwaite
Purpose To analyze the cost effectiveness of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification guidelines versus magnetic resonance (MR) cholangiopancreatography-based treatment of patients with possible choledocholithiasis. Materials and Methods A decision-analytic model was constructed to compare cost and effectiveness of three diagnostic strategies for gallstone disease with possible choledocholithiasis: noncontrast MR cholangiopancreatography, contrast material-enhanced MR imaging/MR cholangiopancreatography, and ASGE risk stratification guidelines for diagnostic evaluation recommending endoscopy (high risk), MR cholangiopancreatography (intermediate risk), or no test (low risk)...
March 16, 2017: Radiology
https://www.readbyqxmd.com/read/28295254/methodological-overview-of-systematic-reviews-to-establish-the-evidence-base-for-emergency-general-surgery
#12
REVIEW
(no author information available yet)
BACKGROUND: The evidence for treatment decision-making in emergency general surgery has not been summarized previously. The aim of this overview was to review the quantity and quality of systematic review evidence for the most common emergency surgical conditions. METHODS: Systematic reviews of the most common conditions requiring unplanned admission and treatment managed by general surgeons were eligible for inclusion. The Centre for Reviews and Dissemination databases were searched to April 2014...
April 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28293093/clinical-features-and-natural-history-of-cryptogenic-cirrhosis-compared-to-hepatitis-c-virus-related-cirrhosis
#13
Luca Rinaldi, Fabio Nascimbeni, Mauro Giordano, Chiara Masetti, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Stefano Ballestri, Dante Romagnoli, Rosa Zampino, Riccardo Nevola, Enrica Baldelli, Natalina Iuliano, Valerio Rosato, Amedeo Lonardo, Luigi Elio Adinolfi
AIM: To characterize natural history of cryptogenic cirrhosis (CC) and compare its clinical features and outcomes to those of hepatitis C virus (HCV)-related cirrhosis. METHODS: A prospective cohort of 102 consecutive patients at their first diagnosis of CC were enrolled in this study. The clinical data and outcomes were compared to an age- and Child-Pugh class-matched cohort of 110 patients with HCV-related cirrhosis. Diagnosis of cirrhosis was based on compatible clinical and laboratory parameters, ultrasound/endoscopic parameters and, whenever possible, on histological grounds and transient elastography...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28291833/tamoxifen-use-and-acute-pancreatitis-a-population-based-cohort-study
#14
Fan-Gen Hsu, Yow-Wen Hsieh, Ming-Jyh Sheu, Che-Chen Lin, Cheng-Li Lin, Chung Y Hsu, Chang-Yin Lee, Mei-Yin Chang, Kuang-Hsi Chang
BACKGROUND: Several case reports have indicated that tamoxifen induced acute pancreatitis (AP); but no pharmacoepidemiological data support the claim. Therefore, we investigated whether tamoxifen use is correlated with the risk of AP in patients with breast cancer. METHODS: This population-based cohort study used the Taiwan National Health Insurance Research Database. A cohort of 22 005 patients aged ≥20 years with breast cancer from January 1, 2000 to December 31, 2009 was identified and the date of cancer diagnosis was set as the index date...
2017: PloS One
https://www.readbyqxmd.com/read/28289402/medical-therapy-with-pasireotide-in-recurrent-cushing-s-disease-experience-of-patients-treated-for-at-least-1%C3%A2-year-at-a-single-center
#15
Chris G Yedinak, Sarah Hopkins, Jessica Williams, Aly Ibrahim, Justin Schultz Cetas, Maria Fleseriu
Subcutaneous (SC) injection of pasireotide, a somatostatin analog, is approved for the treatment of adults with Cushing's disease (CD) for whom pituitary surgery was unsuccessful or is not an option. We highlight the symptomatic and biochemical improvement of six patients with recurrent CD treated with pasireotide SC at a single center for at least 1 year. Patients were treated either through commercial use (n = 5) or through the Phase 3 trial (n = 1; http://ClinicalTrials.gov identifier, NCT00434148; study number, B2305)...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28283178/activation-of-constitutive-androstane-receptor-prevents-cholesterol-gallstone-formation
#16
Shihai Cheng, Min Zou, Qinhui Liu, Jiangying Kuang, Jing Shen, Shiyun Pu, Lei Chen, Hong Li, Tong Wu, Rui Li, Yanping Li, Wei Jiang, Zhiyong Zhang, Jinhan He
Cholesterol gallstone disease (CGD) is one of the most common gastrointestinal diseases. Lithogenic hepatic bile secretion precedes the formation of cholesterol gallstones. Constitutive androstane receptor (CAR), a member of nuclear family, plays an important role in cholesterol and bile acid metabolism. To examine whether activation of CAR can prevent cholesterol gallstone formation, we treated C57BL6/J mice maintained on a lithogenic diet with CAR agonist 1,4-bis-[2-(3, 5-dichlorpyridyloxy)] benzene and performed bile duct cannulation to study the dynamics of biliary lipids...
April 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28282237/associations-of-common-noncommunicable-medical-conditions-and-chronic-diseases-with-chronotype-in-a-population-based-health-examination-study
#17
Syaron Basnet, Ilona Merikanto, Tuuli Lahti, Satu Männistö, Tiina Laatikainen, Erkki Vartiainen, Timo Partonen
Chronotype is an emerging predictor of health and longevity, and understanding its influence on chronic diseases is important for constructing conceptual models of long-term pathways to health. We assessed the associations of chronotype with health status in the general Finnish adult population. Our population-based data were derived from the National FINRISK 2012 study and consisted of 4414 participants, aged 25-74 years, living in Finland. As part of their health examination, participants were asked about their circadian preference to the daily activities (morningness-eveningness) and a diagnosis or treatment for a set of common noncommunicable medical conditions and chronic diseases during the past 12 months...
March 10, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28281512/-specific-features-of-impaired-intestinal-digestion-absorption-and-microbiocenosis-in-patients-with-cholelithiasis
#18
Ya M Vakhrushev, A P Lukashevich
AIM: To perform a comprehensive study of intestinal digestion, absorption, and microbiocenosis in various stages of cholelithiasis (CL). SUBJECTS AND METHODS: A total of 76 patients with of CL, including 44 patients with its Stage I and 32 patients with Stage II, were examined. Mono-, di - and polysaccharide load tests and a scatological study were performed to evaluate the processes of digestion and absorption in the intestine. The hydrogen breath test using lactulose was carried out to study small intestinal bacterial overgrowth (SIBO)...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28280919/the-influence-of-clinical-and-patient-reported-outcomes-on-post-surgery-satisfaction-in-cholecystectomy-patients
#19
K A McLean, Z Sheng, S O'Neill, K Boyce, C Jones, S J Wigmore, E M Harrison
BACKGROUND: Patient-reported outcomes (PROMs) and post-operative satisfaction have become a growing focus of surgical outcome evaluation and are considered key components of the movement towards patient-centred care. The aim was to compare the association of traditional clinical outcome measures and PROMs with post-surgery satisfaction in cholecystectomy patients. METHODS: Patients who had undergone elective or emergency cholecystectomy for gallstone disease were sent validated PROM questionnaires, and telephone follow-up was performed in all cases...
March 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28274206/the-h-o-u-s-e-classification-a-novel-endoscopic-retrograde-cholangiopancreatography-ercp-complexity-grading-scale
#20
Greger Olsson, Urban Arnelo, Fredrik Swahn, Björn Törnqvist, Lars Lundell, Lars Enochsson
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging endoscopic procedure, harboring a wide range of complexities within every single investigation. Classifications of the complexity of ERCP have been presented, but do not include modern endoscopic treatment modalities. In order to be able to target resources and compare the results of different endoscopic centers, a new complexity grading system for ERCP is warranted. This study launches a new complexity grading scale for ERCP-the H...
March 9, 2017: BMC Gastroenterology
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