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Hyperbilirubinemia

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https://www.readbyqxmd.com/read/27922757/hemophagocytic-lymphohistiocytosis-triggered-by-gaucher-disease-in-a-preterm-neonate
#1
Simone Schüller, Andishe Attarbaschi, Angelika Berger, Caroline Hutter, Katrin Klebermass-Schrehof, Manuel Steiner
OBJECTIVE: To present the diagnostic workup in an extremely low birth weight infant patient with signs of both sepsis and hemophagocytosis. PARTICIPANTS: A preterm infant presented with clinical and laboratory signs of early-onset sepsis including hepatosplenomegaly, thrombocytopenia, direct hyperbilirubinemia, and elevated liver enzymes. METHODS: Despite extensive septic workup, no underlying infection was detected. Additional hyperferritinemia and other elevated inflammatory parameters raised the suspicion of a primary or secondary hemophagocytic lymphohistiocytosis (HLH)...
December 6, 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27904243/a-systematic-approach-to-patients-with-jaundice
#2
REVIEW
Bilal Gondal, Andrew Aronsohn
Jaundice is a clinical manifestation of disorders of underlying bilirubin metabolism, hepatocellular dysfunction, or biliary obstruction. As clinical presentations of yellowing of eyes or skin can be somewhat nonspecific for the underlying etiology of disease, a stepwise approach to evaluation is necessary for accurate diagnosis and effective treatment plan. In this review, we discuss underlying mechanisms of cholestasis and jaundice as well as laboratory and imaging modalities needed to evaluate a patient presenting with hyperbilirubinemia...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27902955/extrahepatic-biliary-obstrution-secondary-to-neuroendocrine-tumor-of-the-common-hepatic-duct
#3
Faraz A Khan, Anastasia Stevens-Chase, Rahman Chaudhry, Asra Hashmi, David Edelman, Donald Weaver
INTRODUCTION: Primary neuroendocrine tumors (NET) of the extrahepatic biliary tree are a rare entity with less than 100 reported cases in the literature. PRESENTATION OF CASE: Here, we report a case of NET of the extrahepatic bile duct in a 64-year-old male patient presenting with painless jaundice, direct hyperbilirubinemia, and mildly elevated transaminases. Diagnostic workup with an ultrasound revealed dilation of the intrahepatic biliary ducts, without cholelithiasis or choledocholithiasis...
November 23, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27892440/urinary-tract-infection-in-asymptomatic-newborns-with-prolonged-unconjugated-hyperbilirubunemia-a-hospital-based-observational-study-from-western-region-of-nepal
#4
T Malla, B Sathian, K Karmacharya Malla, S Adhikari
Background Urine culture is usually not a part of work-up for neonatal unconjugated hyperbilirubinemia; hence its prevalence remains unknown. Objective This study was done to determine the incidence of urinary tract infection (UTI) in asymptomatic newborns with prolonged unconjugated hyperbilirubinemia and to evaluate which other laboratory parameters are associated with UTIs. Method A prospective observational study where jaundiced newborns otherwise clinically well, were evaluated for UTI. The study was carried out in neonatal intensive care unit of Manipal Teaching Hospital, Pokhara from June 2012 -April 2013...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27891281/septooptic-dysplasia-with-an-associated-arachnoid-cyst
#5
Skyler V McLaurin-Jiang, Julie K Wood, David F Crudo
A 4-week-old male infant presented with hypothermia, hypoglycemia, and hyperbilirubinemia. His medical history was remarkable for hydrocephalus secondary to an arachnoid cyst, intermittent hypoglycemia, hypothermia, and poor feeding requiring nasogastric tube for nutrition. Physical exam revealed retrognathia, mild hypotonia, micropenis, and clinodactyly. Ophthalmologic exam demonstrated bilateral optic nerve hypoplasia (ONH). Laboratory data confirmed inadequate cortisol and growth hormone response to hypoglycemia, a low thyroxine level, and direct hyperbilirubinemia...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27881297/a-randomized-controlled-clinical-trial-investigating-the-effects-of-omega-3-fatty-acids-and-vitamin-e-co-supplementation-on-biomarkers-of-oxidative-stress-inflammation-and-pregnancy-outcomes-in-gestational-diabetes
#6
Mehri Jamilian, Shahrzad Hashemi Dizaji, Fereshteh Bahmani, Mohsen Taghizadeh, Mohammad Reza Memarzadeh, Maryam Karamali, Maryam Akbari, Zatollah Asemi
OBJECTIVES: Limited data are available for assessing the effects of omega-3 fatty acids and vitamin E co-supplementation on metabolic profiles and pregnancy outcomes in gestational diabetes (GDM). This study was designed to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on biomarkers of oxidative stress, inflammation and pregnancy outcomes in women with GDM. METHODS: This randomized, double-blind, placebo-controlled clinical trial was conducted in 60 patients with GDM who were not taking oral hypoglycemic agents...
November 21, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27878783/prediction-of-significant-hyperbilirubinemia-in-term-neonates-by-early-non-invasive-bilirubin-measurement
#7
Manish Jain, Akash Bang, Anju Tiwari, Shuchi Jain
BACKGROUND: Neonatal jaundice is a common problem. We evaluated the utility and best cut-off values of 24-and 48-hour transcutaneous bilirubin indices (TcBI) in predicting subsequent significant hyperbilirubinemia and evaluated various associated maternal and fetal risk factors. METHODS: TcBI at 24 and 48 hours and serum bilirubin levels at 72 hours of age were obtained for healthy, term, appropriate for gestational age neonates. Neonates with prematurity, birth weight <2500 g, ABO or Rh incompatibility, onset of clinical jaundice <24 hours, clinical suspicion of septicemia, positive pressure ventilation at birth, admission in neonatal intensive care unit and contraindications for BiliChek were excluded...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27872769/mantle-cell-hyperplasia-of-peripheral-lymph-nodes-as-initial-manifestation-of-sickle-cell-disease
#8
Ahmad Monabbati, Sadat Noori, Akbar Safaei, Mani Ramzi, Seyedsajjad Eghbali, Ali Adib
Sickle cell disease (SCD) is a well known hemoglobinopathy with usual manifestations including anemia, hyperbilirubinemia, and vasoocclusive complications. Despite presence of mild splenomegaly in early phase of the disease, lymphadenopathy is not an often finding of SCD. We introduce an undiagnosed case of SCD who presented in third decade of his life with multiple cervical lymphadenopathies and mild splenomegaly persistent for about five years. Histopathologic examination of the resected lymph nodes showed expansion of the mantle cell layers of secondary follicles as well as several monomorphic mantle cell nodules...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27869251/an-increased-genotoxic-risk-in-lymphocytes-from-phototherapy-treated-hyperbilirubinemic-neonates
#9
Seyed Alireza Mesbah-Namin, Maryam Shahidi, Maryam Nakhshab
BACKGROUND: Phototherapy is believed to be a safe method for the management of hyperbilirubinemia. However, there are some controversial issues regarding the genotoxic effects of phototherapy on DNA. The aim of this study was to investigate morphologically both phototherapy-induced DNA double-strand breaks (DSBs) and apoptosis in lymphocytes derived from jaundiced and non-jaundiced neonates. METHODS: Newborns were divided into three groups, including phototherapy-treated (PT, n=30) jaundiced newborns with total serum bilirubin (TSB) levels >15 mg/dl, non-treated jaundiced newborns (C+, n=27), as positive, as well as healthy negative (C-, n=30) controls with TSB levels ranging from 10 and 15 mg/dl and less than 5 mg/dl, respectively...
November 21, 2016: Iranian Biomedical Journal
https://www.readbyqxmd.com/read/27866642/genetic-susceptibility-to-gilbert-s-syndrome-in-a-valencian-population-efficacy-of-the-fasting-test
#10
A K Torres, N Escartín, C Monzó, C Guzmán, I Ferrer, C González-Muñoz, P Peña, V Monzó, G Marcaida, R Rodríguez-López
OBJECTIVE: To describe the populational distribution of the UGT1A1*28 variant (genetic variant code rs8175347) located in the promotor of the UGT gene and correlate its genotypes with the results of the fasting test, as well as its relationship with the biochemical disorder of Gilbert's syndrome (GS) in a Valencian population. PATIENTS AND METHODS: We studied the prevalence of the genotypes (TA)6/6 (TA)6/7 and (TA)7/7 of the deleterious variant rs8175347 in 144 patients with hyperbilirubinemia, 38 of whom had previously undergone the fasting test to diagnose GS, and in 150 control patients...
November 17, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27863965/robustness-of-the-reichert-unistat-bilirubinometer-for-analysis-of-hemolyzed-samples-from-neonates
#11
Christopher R McCudden, Kathy Fleming, Michelle Warr
BACKGROUND AND OBJECTIVES: Bilirubin is routinely measured in neonates to avoid the irreversible effects of kernicterus. Grossly hemolyzed samples are routinely rejected under the assumption that bilirubin cannot be accurately measured in hemolyzed samples. The objective of this study was to determine the effect of hemolysis on bilirubin measurement in neonates. METHODS: Data included 2-years of paired bilirubin results (n=70) where hemolyzed and non-hemolyzed samples were collected and measured within 6h of each other...
November 15, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#12
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
October 7, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27858496/inverse-association-between-platelet-lymphocyte-ratio-and-prognosis-in-terminally-ill-cancer-patients-a-preliminary-study
#13
Yoonjoo Lee, Ye Won Kim, Dong Kyun Park, In Cheol Hwang
BACKGROUND: An elevated platelet-lymphocyte ratio (PLR) is an indicator for worse outcomes in cancer, but its significance at the end of life remains unclear. OBJECTIVE: This study aimed to investigate the value of PLR as an independent prognostic factor in terminally ill cancer patients. METHODS: This retrospective cohort study included 312 terminal cancer patients and was conducted in a palliative care unit of a tertiary cancer center. Patient demographic data, clinical information, and laboratory values, including complete blood cell count, were obtained...
November 18, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27849659/a-new-proposal-of-criteria-for-the-future-remnant-liver-volume-in-older-patients-undergoing-major-hepatectomy-for-biliary-tract-cancer
#14
Yoshihiro Watanabe, Satoshi Kuboki, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Masaru Miyazaki
OBJECTIVE: To evaluate whether advanced age increases the risk of severe complications after major hepatectomy with bile duct resection (BDR) in patients with biliary tract cancer, and to establish new criteria for the percentage of the future remnant liver volume (%FLV) in older patients undergoing this operation. BACKGROUND: Advanced age is reported to inhibit liver regeneration and suppress immune function; however, little is known about the risk of aging in high-stress surgery, such as biliary tract surgery...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27842770/management-of-acute-hepatotoxicity-including-medical-agents-and-liver-support-systems
#15
REVIEW
Humberto C Gonzalez, Syed-Mohammed Jafri, Stuart C Gordon
Drug-induced liver injury (DILI) can be predictable or idiosyncratic and has an estimated incidence of approximately 20 cases per 100,000 persons per year. DILI is a common cause of acute liver failure in the United States. No accurate tests for diagnosing DILI exist, and its diagnosis is based on exclusion of other conditions. Managing DILI includes discontinuing the suspected causative agent and in selected cases administering an antidote. Liver support systems are used for long-term support or as a bridge to transplantation and are effective for improving encephalopathy, hyperbilirubinemia, and other liver-related conditions, but whether they improve survival remains uncertain...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842454/the-role-of-ugt1a1-promoter-polymorphism-and-exon-1-mutations-in-neonatal-jaundice
#16
Hülya Halis, Hacer Ergin, Aylin Köseler, Erol Ömer Atalay
OBJECTIVE: In the present study we investigated the effects of promoter polymorphism and an exon-1 mutation (G71R) in the UGT1A1 gene in neonates with unexplained hyperbilirubinemia and direct coombs-negative [DC(-)] ABO incompatibility. METHODS: Two hundred term neonates in their first week of life and without additional icterogenic factors were included in the study. Neonates with a serum total bilirubin (STB) level≥17 mg/dL constituted the hyperbilirubinemia group (n = 100) while the control group comprised healthy neonates with a STB level < 12...
November 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27830550/gunn-rats-as-a-surrogate-model-for-evaluation-of-hepatocyte-transplantation-based-therapies-of-crigler-najjar-syndrome-type-1
#17
Zsuzsanna Polgar, Yanfeng Li, Xia Li Wang, Chandan Guha, Namita Roy-Chowdhury, Jayanta Roy-Chowdhury
Liver transplantation has been established as a curative therapy for acute and chronic liver failure, as well as liver-based inherited metabolic diseases. Because of the complexity of organ transplantation and the worldwide shortage of donor organs, hepatocyte transplantation is being developed as a bridging therapy until donor organs become available, or for amelioration of inherited liver-based diseases. The Gunn rat is a molecular and metabolic model of Crigler-Najjar syndrome type 1, which is characterized by lifelong unconjugated hyperbilirubinemia due to the lack of uridinediphosphoglucuronate glucuronosyltransferase-1 (UGT1A1)-mediated bilirubin glucuronidation...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27824587/failure-to-achieve-therapeutic-levels-with-high-dose-posaconazole-tablets-potentially-due-to-enhanced-clearance
#18
Sam Maleki, Carmela Corallo, John Coutsouvelis, Jasmine Singh
AIM: To describe a case of persistent sub-therapeutic posaconazole levels in setting of salvage chemotherapy for relapsed acute myeloid leukemia. CASE DETAILS: A 57-year-old male was admitted for the management of relapsed acute myeloid leukemia and ongoing pulmonary aspergillosis. While continuing on posaconazole tablet 300 mg daily, he received a course of salvage chemotherapy. The initial steady state posaconazole trough level was therapeutic at 0.84 mg/L (target >0...
October 18, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27806795/-infantile-cholestasis-caused-by-cftr-mutation-case-report-and-literature-review
#19
L Li, N L Wang, J Y Gong, J S Wang
Objective: To study the clinical presentation, biochemical features and genetic analysis of an infant with cholestasis related to the CFTR mutations. Method: The clinical presentation, laboratory investigations and management of a case with infantile cholestasis caused by CFTR mutations were summarized and the relevant literature was reviewed. Result: (1) The patient was a 5 months old boy with cholestasis which developed in neonatal period with delayed meconium exclusion.The laparoscopic exploration was performed to exclude biliary atresia because of acholic stool when he was two months old...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27805562/acute-kidney-injury-in-leptospirosis-the-kidney-disease-improving-global-outcomes-kdigo-criteria-and-mortality%C3%A2
#20
Flávio Teles, Júlia Vanessa de Mendonça Uchôa, Darina Mirelli Barreto Mendonça, André Falcão Pedrosa Costa
Acute kidney injury (AKI) is one of the most serious complications of leptospirosis. In recent years, studies have evaluated this complication using the risk, injury, failure, loss, and end-stage kidney disease and the acute kidney injury network classification systems. More recently, the kidney disease improving global outcomes (KDIGO) criteria have been developed to increase accuracy in detecting AKI. The aim of the present study was to determine the prevalence and factors associated with AKI and mortality in patients with leptospirosis, using KDIGO criteria...
November 2, 2016: Clinical Nephrology
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