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Cholangitis

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https://www.readbyqxmd.com/read/28220692/diagnostic-approach-using-ercp-guided-transpapillary-forceps-biopsy-or-eus-guided-fine-needle-aspiration-biopsy-according-to-the-nature-of-stricture-segment-for-patients-with-suspected-malignant-biliary-stricture
#1
Yun Nah Lee, Jong Ho Moon, Hyun Jong Choi, Hee Kyung Kim, Seo-Youn Choi, Moon Han Choi, Tae Hee Lee, Tae Hoon Lee, Sang-Woo Cha, Sang-Heum Park
In malignant biliary stricture (MBS), the diagnostic accuracy of ERCP-based tissue sampling is insufficient. EUS-guided fine needle aspiration biopsy (EUS-FNAB) is emerging as a reliable diagnostic procedure. This study aimed to evaluate the usefulness of a diagnostic approach using ERCP-guided transpapillary forceps biopsy (TPB) or EUS-FNAB according to the characteristics of suspected MBS. Consecutive patients diagnosed with suspected MBS with obstructive jaundice and/or cholangitis were enrolled prospectively...
February 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28220208/abcb4-missense-mutations-d243a-k435t-g535d-i490t-r545c-and-s978p-significantly-impair-the-lipid-floppase-and-likely-predispose-to-secondary-pathologies-in-the-human-population
#2
Edward J Andress, Michael Nicolaou, Farrell McGeoghan, Kenneth J Linton
Bile salts are natural detergents required to solubilise dietary fat and lipid soluble vitamins. They are synthesised in hepatocytes and secreted into the luminal space of the biliary tree by the bile salt export pump (BSEP), an ATP-binding cassette (ABC) transporter in the canalicular membrane. BSEP deficiency causes cytotoxic accumulation of bile salts in the hepatocyte that results in mild-to-severe forms of cholestasis. The resulting inflammation can also progress to hepatocellular cancer via a novel mechanism involving upregulation of proliferative signalling pathways...
February 20, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#3
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28216968/complications-and-management-of-forgotten-long-term-biliary-stents
#4
Se Hoon Sohn, Jae Hyun Park, Kook Hyun Kim, Tae Nyeun Kim
AIM: To evaluate complications and management outcomes of retained long-term plastic biliary stents. METHODS: Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28215616/incidence-and-determinants-of-hepatocellular-carcinoma-in-autoimmune-hepatitis-a-systematic-review-and-meta-analysis
#5
REVIEW
Aylin Tansel, Lior H Katz, Hashem B El-Serag, Aaron P Thrift, Mayur Parepally, Mohammad H Shakhatreh, Fasiha Kanwal
BACKGROUND: The risk of hepatocellular carcinoma (HCC) in patients with autoimmune hepatitis (AIH) is unclear. We conducted a systematic review and meta-analysis of the incidence of HCC and associated risk factors among patients with AIH. METHODS: We searched PubMed, Embase, and reference lists from relevant articles through June 2016 to identify cohort studies that examined the incidence of HCC in patients with AIH. We used random effects models to estimate pooled incidence rates overall and in subgroup of patients with cirrhosis...
February 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28213923/diagnostic-accuracy-of-charcot-s-triad-a-systematic-review
#6
REVIEW
Steva Rumsey, Joel Winders, Andrew D MacCormick
BACKGROUND: Charcot's triad is a well-established diagnostic tool for acute cholangitis (AC). It has been recognized as an inaccurate test in clinical practice; however, its exact sensitivity and specificity remain unclear. This knowledge is key to informing the value of its continued clinical application. The objectives of this study are to calculate an estimate of the sensitivity and specificity of Charcot's triad based on published research and consider its applicability to clinical practice and medical education...
February 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28213609/gut-microbial-profile-is-altered-in-primary-biliary-cholangitis-and-partially-restored-after-udca-therapy
#7
Ruqi Tang, Yiran Wei, Yanmei Li, Weihua Chen, Haoyan Chen, Qixia Wang, Fan Yang, Qi Miao, Xiao Xiao, Haiyan Zhang, Min Lian, Xiang Jiang, Jun Zhang, Qin Cao, Zhuping Fan, Maoying Wu, Dekai Qiu, Jing-Yuan Fang, Aftab Ansari, M Eric Gershwin, Xiong Ma
OBJECTIVE: A close relationship between gut microbiota and some chronic liver disorders has recently been described. Herein, we systematically performed a comparative analysis of the gut microbiome in primary biliary cholangitis (PBC) and healthy controls. DESIGN: We first conducted a cross-sectional study of 60 ursodeoxycholic acid (UDCA) treatment-naïve patients with PBC and 80 matched healthy controls. Second, an independent cohort composed of 19 treatment-naïve patients and 34 controls was used to validate the results...
February 17, 2017: Gut
https://www.readbyqxmd.com/read/28210765/refractory-long-term-cholangitis-after-pancreaticoduodenectomy-a-retrospective-study
#8
Hiroki Ueda, Daisuke Ban, Atsushi Kudo, Takanori Ochiai, Shinji Tanaka, Minoru Tanabe
BACKGROUND: Postoperative cholangitis is one of the major late complications after pancreaticoduodenectomy (PD), and recurrent cholangitis has a negative impact on patients' quality of life. However, detailed reports are scarce. The aim of this study was to investigate the clinical features of postoperative cholangitis after PD. METHODS: Between January 2007 and December 2013, 155 consecutive patients underwent PD. Of these, 113 patients were included in this study...
February 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#9
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28202062/isolated-igg4-related-sclerosing-cholangitis-misdiagnosed-as-malignancy-in-an-area-with-endemic-cholangiocarcinoma-a-case-report
#10
Narongsak Rungsakulkij, Pattana Sornmayura, Penampai Tannaphai
BACKGROUND: The most common cause of perihilar obstruction is cholangiocarcinoma, especially in Thailand. Benign perihilar stricture represents less than 20% of cases. IgG4-related disease and IgG4-related sclerosing cholangitis, however, have been receiving increased recognition. Isolated IgG4-related sclerosing cholangitis is less common. The preoperative diagnosis of IgG4-related sclerosing cholangitis without pancreatic involvement is very difficult because the clinical presentation and preoperative evaluation are extremely difficult to distinguish from perihilar cholangiocarcinoma...
February 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28201850/novel-treatment-strategies-for-primary-biliary-cholangitis
#11
Albert Parés
Despite the presumed immunological pathogenesis of primary biliary cholangitis, no clear or even harmful consequences have resulted from treatments designed to modify the immunological condition. Ursodeoxycholic acid (13-16 mg/kg/d) has, however, clear favorable effects that not only improve biochemical cholestasis, but also delay histological progression. Long-term treatment with ursodeoxycholic acid is associated with excellent transplant-free survival in cases showing a biochemical response at 1 year. Data on the effects of obeticholic acid and fibrates are encouraging...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28194423/effects-of-liver-fibrosis-progression-on-tissue-relaxation-times-in-different-mouse-models-assessed-by-ultrahigh-field-magnetic-resonance-imaging
#12
Andreas Müller, Katrin Hochrath, Jonas Stroeder, Kanishka Hittatiya, Günther Schneider, Frank Lammert, Arno Buecker, Peter Fries
Recently, clinical studies demonstrated that magnetic resonance relaxometry with determination of relaxation times T1 and T2(⁎) may aid in staging and management of liver fibrosis in patients suffering from viral hepatitis and steatohepatitis. In the present study we investigated T1 and T2(⁎) in different models of liver fibrosis to compare alternate pathophysiologies in their effects on relaxation times and to further develop noninvasive quantification methods of liver fibrosis. MRI was performed with a fast spin echo sequence for measurement of T1 and a multigradient echo sequence for determination of T2(⁎)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28192501/correction-risk-factors-for-multi-drug-resistant-pathogens-and-failure-of-empiric-first-line-therapy-in-acute-cholangitis
#13
Philipp A Reuken, Dorian Torres, Michael Baier, Bettina Löffler, Christoph Lübbert, Norman Lippmann, Andreas Stallmach, Tony Bruns
[This corrects the article DOI: 10.1371/journal.pone.0169900.].
2017: PloS One
https://www.readbyqxmd.com/read/28192189/mir-425-regulates-inflammatory-cytokine-production-in-cd4-t-cells-via-n-ras-upregulation-in-primary-biliary-cholangitis
#14
Ryo Nakagawa, Ryosuke Muroyama, Chisato Saeki, Kaku Goto, Yoshimi Kaise, Kazuhiko Koike, Masanori Nakano, Yasuo Matsubara, Keiko Takano, Sayaka Ito, Masayuki Saruta, Naoya Kato, Mikio Zeniya
BACKGROUND & AIM: Primary biliary cholangitis (PBC) is an autoimmune liver disease of unknown pathogenesis. Consequently, therapeutic targets for PBC have yet to be identified. Because CD4(+) T cells play a pivotal role in immunological dysfunction observed in PBC, we analysed microRNA (miRNA) and mRNA expression in CD4(+) T cells to investigate PBC pathogenesis and identify novel therapeutic targets. METHODS: We performed integral miRNA and mRNA analysis of 14 PBC patients and 10 healthy controls using microarray and quantitative real time polymerase chain reaction (qRT-PCR) with gene set enrichment analysis...
February 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#15
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187915/effect-of-ileal-bile-acid-transporter-inhibitor-gsk2330672-on-pruritus-in-primary-biliary-cholangitis-a-double-blind-randomised-placebo-controlled-crossover-phase-2a-study
#16
Vinod S Hegade, Stuart F W Kendrick, Robert L Dobbins, Sam R Miller, Douglas Thompson, Duncan Richards, James Storey, George E Dukes, Margaret Corrigan, Ronald P J Oude Elferink, Ulrich Beuers, Gideon M Hirschfield, David E Jones
BACKGROUND: Up to 70% of patients with primary biliary cholangitis develop pruritus (itch) during the course of their disease. Treatment of pruritus in primary biliary cholangitis is challenging and novel therapies are needed. Ursodeoxycholic acid, the standard first-line treatment for primary biliary cholangitis, is largely ineffective for pruritus. We investigated the efficacy and safety of GSK2330672, a selective inhibitor of human ileal bile acid transporter (IBAT), in patients with primary biliary cholangitis with pruritus...
February 7, 2017: Lancet
https://www.readbyqxmd.com/read/28184004/ets-proto-oncogene-1-transcriptionally-up-regulates-the-cholangiocyte-senescence-associated-protein-cyclin-dependent-kinase-inhibitor-2a
#17
Steven P O'Hara, Patrick L Splinter, Christy E Trussoni, Maria J Lorenzo Pisarello, Lorena Loarca, Noah S Splinter, Bryce F Schutte, Nicholas F LaRusso
Primary sclerosing cholangitis (PSC) is a chronic, fibro-inflammatory cholangiopathy (disease of the bile ducts) of unknown pathogenesis. We reported that cholangiocyte senescence features prominently in PSC and neuroblastoma RAS viral oncogene homolog (NRAS) is activated in PSC cholangiocytes. Additionally, persistent microbial insult (e.g., lipopolysaccharides [LPS]) induces Cyclin Dependent Kinase Inhibitor 2A (CDKN2A/p16INK4a) expression and senescence in cultured cholangiocytes in an NRAS-dependent manner...
February 8, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28176451/epidemiology-and-risk-factors-for-infection-after-living-donor-liver-transplantation
#18
Cybele Lara R Abad, Brian D Lahr, Raymund R Razonable
BACKGROUND: The epidemiology of infections after living donor liver transplantation is limited. We aimed to study the epidemiology and risk factors of infections after living donor liver transplantation. METHODS: The medical records of 223 adult patients who underwent living donor liver transplantation from January 1, 2000 - August 31, 2015 were reviewed for all infections occurring up to 1 year. We estimated the cumulative incidence of infection using the Kaplan Meier product limit method...
February 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28175233/p747-extracolonic-and-colonic-cancer-risk-in-patients-with-ulcerative-colitis-and-primary-sclerosing-cholangitis
#19
M Jelaković, M Brinar, N Turk, R Prijić, Z Krznarić, N Rustemović, S Cukovic-Cavka
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28175019/p162-early-onset-of-disease-and-higher-risk-for-colorectal-dysplasia-in-ibd-patients-with-coincidental-primary-sclerosing-cholangitis-evidence-from-a-large-cohort-study
#20
A F Cordes, T Laumeyer, J Gerß, T Kucharzik, D Bettenworth
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
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