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https://www.readbyqxmd.com/read/27920640/intussuscepting-ampullary-adenoma-an-unusual-cause-of-gastric-outlet-obstruction-leading-to-cavitating-lung-lesions
#1
Simon J McCluney, Vickna Balarajah, Alex Giakoustidis, Joanne Chin-Aleong, Bryony Lovett, Hemant M Kocher
Ampullary adenomas are a rare clinical entity, occurring at a rate of 0.04-0.12% in the general population. They are premalignant lesions which have the capability to progress to malignancy, and they should be excised if they are causing immediate symptoms and/or are likely to degenerate to carcinoma. Intestinal intussusception in adults is rare and, unlike in children, is often due to a structural pathology. Intussuscepting duodenal/ampullary adenomas have been reported in the literature on 13 previous occasions, however never before with this presentation...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27919851/urgent-ercp-for-acute-cholangitis-reduces-mortality-and-hospital-stay-in-elderly-and-very-elderly-patients
#2
Chan Sun Park, Hee Seok Jeong, Ki Bae Kim, Joung-Ho Han, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
BACKGROUND: Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients. METHODS: We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients' demographics, severity grading, methods and timing of biliary drainage, mortality, and hospital stay were retrospectively obtained from medical records...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27914884/clinical-presentation-diagnosis-and-survival-in-cholangiocarcinoma-a-prospective-study
#3
Larisa Vasilieva, Stefanos I Papadhimitriou, Alexandra Alexopoulou, Ioannis Kostopoulos, Konstantinos Papiris, Dimitrios Pavlidis, Dimitrios Xinopoulos, Andreas Romanos, Spyridon P Dourakis
BACKGROUND AND STUDY AIMS: The diagnosis of cholangiocarcinoma (CCA) is difficult. The present study aimed to assess the clinical features, diagnosis, and survival in CCA. PATIENTS AND METHODS: This is a prospective study on 46 patients with CCA who underwent endoscopic retrograde cholangiopancreatography (ERCP) or surgical resection and 20 controls with a clinical and ERCP suspicion for CCA in whom surgical biopsy and/or 4-year follow-up showed a benign biliary stricture...
November 30, 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27909995/solithromycin-a-novel-fluoroketolide-for-the-treatment-of-community-acquired-bacterial-pneumonia
#4
REVIEW
George G Zhanel, Erika Hartel, Heather Adam, Sheryl Zelenitsky, Michael A Zhanel, Alyssa Golden, Frank Schweizer, Bala Gorityala, Philippe R S Lagacé-Wiens, Andrew J Walkty, Alfred S Gin, Daryl J Hoban, Joseph P Lynch, James A Karlowsky
Solithromycin is a novel fluoroketolide developed in both oral and intravenous formulations to address increasing macrolide resistance in pathogens causing community-acquired bacterial pneumonia (CABP). When compared with its macrolide and ketolide predecessors, solithromycin has several structural modifications which increase its ribosomal binding and reduce its propensity to known macrolide resistance mechanisms. Solithromycin, like telithromycin, affects 50S ribosomal subunit formation and function, as well as causing frame-shift errors during translation...
December 1, 2016: Drugs
https://www.readbyqxmd.com/read/27909644/primary-squamous-cell-carcinoma-of-the-pancreas-as-a-cause-of-biliary-obstruction
#5
Kyle Rowe, Jeet Mehta, Fredy Nehme, William Salyers
Primary squamous cell carcinoma of the pancreas (SCCP) is a rare neoplasm, given a lack of naturally occurring squamous cells within the pancreas, accounting for only 0.2% of all pancreatic cancers. The etiology is unknown. Symptomatology is non-specific and similar to other pancreatic neoplasms. No non-invasive testing can adequately rule in SCCP, and workup should proceed similarly to any pancreatic mass. Tissue sampling is required for diagnosis and guidance of further management, most commonly by endoscopic ultrasound with fine needle aspirate...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#6
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27905307/oriental-cholangiohepatitis-recurrent-pyogenic-cholangitis-a-case-series-from-the-netherlands-and-brief-review-of-the-literature
#7
K E Verweij, H van Buuren
Oriental cholangiohepatitis is a condition occurring in the Asian population, characterised by recurrent bacterial cholangitis and presence of calculi within the intrahepatic bile ducts, biliary strictures and an increased risk for cholangiocarcinoma. It is an uncommon disease in the West that may not always be considered. The therapeutic approach is multidisciplinary and highly individual, and includes antibiotic therapy, endoscopic and percutaneous biliary drainage with stone removal and dilation of strictures, and in selected cases surgical resection of affected liver segments...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27905019/multi-disciplinary-concurrent-management-of-recurrent-hepatocellular-therapy-is-superior-to-sequential-therapy
#8
Tyler D Fields, Prejesh Philips, Charles R Scoggins, Cliff Tatum, Lawrence Kelly, Kelly M McMasters, Robert C G Martin
BACKGROUND: Recurrent hepatocellular carcinoma after a patient's initial therapy, whether it is transplantation, resection, or ablation, remains a challenging clinical problem. Since recurrence occurs in 70% of all initially treated disease within 5 years, optimal management to treat this recurrence is needed. Currently, a bias exists toward mono-therapy (i.e., ablation alone, hepatic arterial therapy alone, or sorafenib therapy alone) instead of concurrent sequential therapy-as is common in other primary and metastatic disease to the liver...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904308/laparoscopic-transcystic-treatment-biliary-calculi-by-laser-lithotripsy
#9
Jun Liu, Lan Jin, Zhongtao Zhang
BACKGROUND AND OBJECTIVES: Laparoscopic transcystic common bile duct exploration (LTCBDE) is a complex procedure requiring expertise in laparoscopic and choledochoscopic skills. The purpose of this study was to investigate the safety and feasibility of treating biliary calculi through laparoscopic transcystic exploration of the CBD via an ultrathin choledochoscope combined with dual-frequency laser lithotripsy. METHODS: From August 2011 through September 2014, 89 patients at our hospital were treated for cholecystolithiasis with biliary calculi...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27895774/a-case-of-distal-extrahepatic-cholangiocarcinoma-with-two-positive-resection-margins
#10
Wayne A Warner, Wesley Ramcharan, Dave Harnanan, Srikanth Umakanthan, Ravi Maharaj
Cholangiocarcinoma is an uncommon primary malignancy of the biliary tract that is challenging to diagnose and treat effectively due to its relatively silent and late clinical presentation. The present study reports a case of a 60-year-old male with distal extrahepatic cholangiocarcinoma with a 3-week history of painless obstructive jaundice symptoms and subjective weight loss. Imaging revealed an obstructing lesion in the common bile duct, just distal to the entrance of the cystic duct. Pathology revealed moderately differentiated cholangiocarcinoma with two positive proximal resection margins...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27894959/inhibition-of-the-apelin-apelin-receptor-axis-decreases-cholangiocarcinoma-growth
#11
Chad Hall, Laurent Ehrlich, Julie Venter, April O'Brien, Tori White, Tianhao Zhou, Tien Dang, Fanyin Meng, Pietro Invernizzi, Francesca Bernuzzi, Gianfranco Alpini, Terry Lairmore, Shannon Glaser
PURPOSE: Cholangiocarcinoma (CCA) is a malignancy of the biliary epithelium that is associated with low five-year survival. The apelin receptor (APLNR), which is activated by the apelin peptide, has not been studied in CCA. The purpose of this study is to determine if inhibition of the apelin/APLNR axis can inhibit CCA growth. METHODS: Immunohistochemistry, rtPCR, immunofluorescence, flow cytometry, and ELISA was used to measure APLNR expression in human CCA cells and tissues...
November 26, 2016: Cancer Letters
https://www.readbyqxmd.com/read/27890981/neonatal-cholestasis-single-centre-experience-in-central-india
#12
Mayank Jain, Sagar Adkar, Chandrashekhar Waghmare, Jenisha Jain, Shikhar Jain, Kamna Jain, Gouri Rao Passi, Rashmi Shad Vinay, M K Soni
BACKGROUND: Neonatal cholestasis syndrome (NCS) is a major cause of morbidity and mortality in infants. The disorder has rarely been studied in centers from Central India. OBJECTIVES: To study the prevalence, clinical presentation and etiology of NCS at a tertiary referral center in Central India. MATERIALS AND METHODS: The study was carried out at a tertiary referral center in Central India. The study is a descriptive study. The records of all patients with suspected NCS treated in the Department of Pediatrics from 2007-2012 were analyzed...
October 2016: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/27890483/a-23-year-experience-with-laparoscopic-common-bile-duct-exploration
#13
Silvia Quaresima, Andrea Balla, Mario Guerrieri, Roberto Campagnacci, Emanuele Lezoche, Alessandro M Paganini
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) during laparoscopic cholecystectomy (LC) is as effective as two-stage endo-laparoscopic treatment, but with shorter hospital stay, lower cost and recurrent stone rate. Aim of this paper was to report the authors' experience with LCBDE during LC. METHODS: A retrospective analysis of patients who underwent LCBDE for ductal stones was performed. Recurrent stones were defined as CBD stones detected beyond 6 months from the procedure...
November 24, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27888532/biliary-strictures-complicating-liver-transplantation-in-pediatric-patients-experience-in-a-south-american-transplant-center
#14
A Holguin, S Rodriguez-Takeuchi, L Ospina, D Acosta, V Botero, L Thomas, J Villegas, G Echeverri, L Caicedo
OBJECTIVE: To describe the experience of percutaneous transhepatic cholangiography (PTC) with biliary dilatation and drainage after pediatric liver transplantation, and to determine the long-term outcome of this procedure. METHODS: Retrospective study from 2001 to 2013. Follow-up after treatment was also undertaken. A survival analysis was performed in patients in whom the procedure and eventual removal of the catheter were successful. RESULTS: In all, 196 children received liver transplants; 40 of them (20 boys and 20 girls; median age of 4 years) were treated using PTC due to biliary complications...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27888081/bow-hunter-s-syndrome-from-a-tortuous-v1-segment-vertebral-artery-treated-with-stent-placement
#15
Rouzbeh Motiei-Langroudi, Christoph J Griessenauer, Abdulrahman Alturki, Nimer Adeeb, Ajith J Thomas, Christopher S Ogilvy
Bow Hunter's syndrome is a dynamic and reversible occlusion of the vertebral artery occurring after rotation or extension of the neck. The V3 segment is the most common site of compression, especially at the atlanto-axial joint. Surgical decompression with or without cervical fusion has been the mainstay of therapy and endovascular intervention such as placement of stents is rarely performed. We report a patient with Bow Hunter's Syndrome from tortuosity of the V1 segment of the VA treated with a self-expanding biliary stent placement...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27873011/laparoscopic-resection-of-choledochal-cyst-with-roux-en-y-hepaticojejunostomy-a-case-report-and-review-of-the-literature
#16
Bestoun Ahmed, Priya Sharma, Cynthia L Leaphart
BACKGROUND: Choledochal cysts are associated with ductal strictures, stone formation, cholangitis, rupture, secondary biliary cirrhosis and increased incidence of cholangiocarcinoma. The surgical approach to choledochal cysts has evolved from the cyst-enterostomy to a complete excision with more recent use of minimally invasive approaches. We report a complete minimally invasive approach to a Type 1 choledochal cyst and summarize the literature containing large case series of similar approaches...
November 21, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27865544/central-liver-toxicity-after-sbrt-an-expanded-analysis-and-predictive-nomogram
#17
Diego A S Toesca, Evan C Osmundson, Rie von Eyben, Jenny L Shaffer, Albert C Koong, Daniel T Chang
PURPOSE: To further explore the correlation of central biliary tract (cHBT) radiation doses with hepatobiliary toxicity (HBT) after stereotactic body radiation therapy (SBRT) in a larger patient dataset. METHODS: We reviewed the treatment and outcomes of all patients who received SBRT for primary liver cancer (PLC) and metastatic liver tumors between July 2004 and November 2015 at our institution. The cHBT was defined as isotropic expansions (5, 10, 15, 20 and 25mm) from the portal vein (PV)...
November 16, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27864873/hereditary-haemorrhagic-telangiectasia-to-transplant-or-not-to-transplant-is-there-a-right-time-for-liver-transplantation
#18
Yannick D Muller, Roland Oppliger, Romain Breguet, Philippe Meyer, Laura Rubbia-Brandt, Pierre-Auguste Petignat, Thomas Harr, Eric Dayer, Jörg D Seebach
BACKGROUND & AIMS: Hereditary haemorrhagic telangiectasia is characterized by arterio-venous malformations (AVM). It frequently involves the liver without clinical symptoms, but may lead to biliary ischaemia, portal hypertension, or fatal high-output heart failure. The indication of liver transplantation is controversial. METHODS: Herein, we report the case of a 65-year-old female patient with a 'double Osler syndrome' consisting of hereditary haemorrhagic telangiectasia (HHT) and type I hereditary angioedema diagnosed at the age of 25 and 22 years respectively...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27861387/open-arterial-reconstruction-of-multiple-hepatic-artery-aneurysms-in-a-patient-with-hereditary-hemorrhagic-telangiectasia-a-case-report
#19
Hirotsugu Ozawa, Takao Ohki, Yuji Kanaoka, Koji Maeda, Shin Hagiwara
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasia and visceral vascular malformations (VMs). Liver involvement with VMs may lead to high-output cardiac failure, portal hypertension, and biliary disease. There is no curative treatment for the disease, and liver transplantation is indicated for life-threatening complications. Herein, we report a case of multiple hepatic artery aneurysms (HAAs) in a patient with HHT in which open arterial reconstruction was performed...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27861347/the-safety-and-efficacy-of-nasobiliary-drainage-versus-biliary-stenting-in-malignant-biliary-obstruction-a-systematic-review-and-meta-analysis
#20
Huapeng Lin, Shengwei Li, Xi Liu
BACKGROUND: Preoperative biliary drainage (PBD) has been widely used to treat patients with malignant biliary obstruction. However, it is still unclear which method of PBD (endoscopic nasobiliary drainage or endoscopic biliary stenting) is more effective. Thus, we carried out a meta-analysis to compare the safety and efficacy of endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stenting (EBS) in malignant biliary obstruction in terms of preoperative and postoperative complications...
November 2016: Medicine (Baltimore)
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