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Liver disease in pregnancy

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https://www.readbyqxmd.com/read/28399088/-the-forensic-medical-evaluation-of-traumatic-and-spontaneous-ruptures-of-the-organs-affected-by-the-tumours
#1
Yu I Pigolkin, O V Dolzhansky, E M Pal'tseva, M A Shilova, D N Fedorov, S E Boeva
The present article was designed to report the results of the analysis of the cases of traumatic and spontaneous ruptures of the organs affected by the tumours based on the original observations and the literature data. It is shown that the probability of the tumour rupture depends on its histological type, localization, the size, and the distance from the capsule of the affected organ, the degree of involvement of the major blood vessels, the severity of the necrotic changes, the presence of cysts in the neoplasm, and the regimens of radio- and chemotherapy...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#2
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28395793/visceral-aneurysms-old-paradigms-new-insights
#3
REVIEW
M J E van Rijn, S Ten Raa, J M Hendriks, H J M Verhagen
True visceral artery aneurysms (VAAs) are a rare entity with an incidence of 0.01-2%. The risk of rupture varies amongst the different types of VAAs and is higher for pseudo aneurysms compared with true aneurysms. Size, growth, symptoms, underlying disease, pregnancy and liver transplantation have all been associated with increased risk of rupture. Mortality rates after rupture are around 25%. The splenic artery is most commonly affected and the etiology is predominantly atherosclerosis. Open repair can be done by simple ligation or reconstruction of the artery, while endovascular options include embolization or using a stent graft...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28376740/maternal-27-hydroxycholesterol-concentrations-during-the-course-of-pregnancy-and-in-pregnancy-pathologies
#4
Brigitte Sophia Winkler, Ulrich Pecks, Laila Najjari, Nicola Kleine-Eggebrecht, Nicolai Maass, Markus Mohaupt, Geneviève Escher
BACKGROUND: The oxysterol 27-hydroxycholesterol (27-OHC) plays an important role in the regulation of cholesterol homeostasis. Pregnancy pathologies like preeclampsia (PE), HELLP-syndrome (HELLP), intrauterine growth restriction (IUGR) and intrahepatic cholestasis in pregnancy (ICP) are linked to disturbances in lipid metabolism. In the present study, we hypothesized a specific gestational regulation of 27-OHC and compromised 27-OHC levels due to placental and hepatic diseases in pregnancy resulting in a dysregulation of lipid metabolism...
April 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28372806/multiple-immune-disorders-after-natalizumab-discontinuation-after-the-ciris-the-siris
#5
E K Van Obberghen, M Cohen, F Rocher, C Lebrun-Frenay
Natalizumab (NTZ) is an effective treatment for patients with highly active relapsing remitting multiple sclerosis (MS). However, when the therapy must be interrupted, it is important to anticipate the withdrawal to avoid reactivation or disease rebound. Described here is the case of a 35-year-old woman, with a past history of beta thalassemia, bulimia and asthma, who was diagnosed with MS at age 26. She was treated initially with first-line subcutaneous (sc) immunomodulatory treatments. However, due to liver toxicity, interferon beta-1a sc was interrupted and replaced by glatiramer acetate treatment, which was well tolerated and used for several years...
March 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#6
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28344965/tuberculous-peritonitis-in-the-first-trimester-of-pregnancy
#7
Sukyung Jung, Nae Ri Yun, Jeong Ok Kim, Jeong Hoon Lee, Ho Yeon Kim, Eunseop Song, Byoung Ick Lee, Sung Ook Hwang, Soo Ran Choi
Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28326516/elevated-red-blood-cell-distribution-width-is-associated-with-intrahepatic-cholestasis-of-pregnancy
#8
Zehra Vural Yilmaz, Gulenay Gencosmanoglu Turkmen, Korkut Daglar, Elif Yılmaz, Ozgur Kara, Dilek Uygur
OBJECTIVES: Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28317816/hemophagocytic-syndrome-secondary-to-tuberculosis-at-24-week-gestation
#9
Alexandra Arteaga Fernández, David Fernández de Velasco Pérez, M C Jiménez Fournier, J C Moreno Del Prado, B Paraíso Torras, M L Cañete Palomo
Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28314442/-adult-congenital-heart-disease-medical-and-psychosocial-issues
#10
Magalie Ladouceur, Florence Pontnau, Laurence Iserin
The population of adults with congenital heart disease (ACHD) is continuously increasing with now a higher prevalence than that of the pediatric population. This concerns above all complex congenital heart diseases. Heart failure is the primary cause of death followed by arrhythmia, which is very common in ACHD. A specialized follow-up by dedicated centers is significantly associated with an improvement of survival of ACHD patients compared to non-expert follow-up. Extracardiac disorders (liver, kidney, respiratory) are frequent and require an accurate and specific management...
March 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28298829/a-cross-sectional-survey-to-study-the-relationship-of-periodontal-disease-with-cardiovascular-disease-respiratory-disease-and-diabetes-mellitus
#11
Sukhvinder Singh Oberoi, Yashoda Harish, Shivalingaswamy Hiremath, Manjunath Puranik
BACKGROUND: Periodontal deterioration has been reported to be associated with systemic diseases such as cardiovascular disease (CVD), diabetes mellitus, respiratory disease, liver cirrhosis, bacterial pneumonia, nutritional deficiencies, and adverse pregnancy outcomes. AIM: The present study assessed the periodontal disease among patients with systemic conditions such as diabetes, CVD, and respiratory disease. MATERIALS AND METHODS: The study population consisted of 220 patients each of CVD, respiratory disease, and diabetes mellitus, making a total of 660 patients in the systemic disease group...
July 2016: Journal of Indian Society of Periodontology
https://www.readbyqxmd.com/read/28291236/acute-fatty-liver-disease-of-pregnancy-updates-in-pathogenesis-diagnosis-and-management
#12
REVIEW
Joy Liu, Tara T Ghaziani, Jacqueline L Wolf
Acute fatty liver of pregnancy (AFLP) is an obstetric emergency characterized by maternal liver failure and may have complications for the mother and fetus, including death. This review examines recent literature on the epidemiology, pathogenesis, diagnosis, and treatment of acute fatty liver of pregnancy. Pathogenesis of this disease has been linked to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty acid oxidation. The value of screening all patients for these genetic defects remains to be determined...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28270873/predictors-of-fetal-and-maternal-outcome-in-the-crucible-of-hepatic-dysfunction-during-pregnancy
#13
Indrajit Suresh, Vijaykumar Tr, Nandeesh Hp
BACKGROUND: Hepatic dysfunction during pregnancy places both the mother and the fetus at risk. Investigations which are efficient, cost effective and easily available for prognostication are required to tackle this global problem. We studied the etiologies and evaluated investigations for predictive efficiency. METHODS: One hundred ninety-seven pregnant women with hepatic dysfunction during pregnancy were identified. All patients were followed up till 8 weeks after termination of pregnancy or death...
February 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28262241/hemostatic-issues-in-pregnancy-induced-liver-disease
#14
Ton Lisman, William Bernal
Liver diseases may be accompanied by profound changes in the hemostatic system including thrombocytopenia, decreased plasma levels of pro- and anticoagulants, and alterations in plasma levels of fibrinolysis. The net effect of the hemostatic changes in chronic and acute liver diseases is a hemostatic system that is in relative balance due to the simultaneous decline in pro- and antihemostatic drivers. A unique category of liver diseases are those induced by pregnancy. In acute fatty liver of pregnancy, profound hemostatic changes occur, which may be caused by a combination of liver failure and disseminated intravascular coagulation...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238808/hypophosphatasia-an-overview-for-2017
#15
Michael P Whyte
Hypophosphatasia (HPP) is the inborn-error-of-metabolism that features low serum alkaline phosphatase (ALP) activity (hypophosphatasemia) caused by loss-of-function mutation(s) of the gene that encodes the tissue-nonspecific isoenzyme of ALP (TNSALP). Autosomal recessive or autosomal dominant inheritance from among >300 TNSALP (ALPL) mutations largely explains HPP's remarkably broad-ranging severity. TNSALP is a cell-surface homodimeric phosphohydrolase richly expressed in the skeleton, liver, kidney, and developing teeth...
February 24, 2017: Bone
https://www.readbyqxmd.com/read/28223455/acute-fetal-demise-with-first-trimester-maternal-infection-resulting-from-listeria-monocytogenes-in-a-nonhuman-primate-model
#16
Bryce Wolfe, Gregory J Wiepz, Michele Schotzko, Gennadiy I Bondarenko, Maureen Durning, Heather A Simmons, Andres Mejia, Nancy G Faith, Emmanuel Sampene, Marulasiddappa Suresh, Sophia Kathariou, Charles J Czuprynski, Thaddeus G Golos
Infection with Listeria monocytogenes during pregnancy is associated with miscarriage, preterm birth, and neonatal complications, including sepsis and meningitis. While the risk of these conditions is thought to be greatest during the third trimester of pregnancy, the determinants of fetoplacental susceptibility to infection, the contribution of gestational age, and the in vivo progression of disease at the maternal-fetal interface are poorly understood. We developed a nonhuman primate model of listeriosis to better understand antecedents of adverse pregnancy outcomes in early pregnancy...
February 21, 2017: MBio
https://www.readbyqxmd.com/read/28217610/disseminated-tuberculosis-in-a-newborn-infant
#17
Tanu Sagar, Kavita Gupta, Mayuri Rani, Iqbal Rajinder Kaur
Tuberculosis (TB) remaining as one of the deadliest communicable diseases. Congenital infection by vertical transmission is rare but high neonatal mortality (up to 60%) and morbidity warrant early and accurate diagnosis of newborns suffering from TB. Intrauterine infection of tuberculosis is most commonly caused by haematogenous spread from the mother causing placental seedling. The organisms reach the fetus via the umbilical vein and the primary focus is often in the fetal liver in hematgenous spread. Another route of infection is by direct ingestion or aspiration of infected amniotic fluid if the placental caseous lesion ruptures directly into the amniotic cavity...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28212920/neonatal-lupus-follow-up-in-infants-with-anti-ssa-ro-antibodies-and-review-of-the-literature
#18
REVIEW
Antonio Alberto Zuppa, Riccardo Riccardi, Simonetta Frezza, Francesca Gallini, Rita Maria Paola Luciano, Giovanni Alighieri, Costantino Romagnoli, Sara De Carolis
Neonatal Lupus Syndrome (NLS) is a distinct clinical entity caused by transplacental passage of maternal anti-SSA/Ro antibodies (Ab). Mothers may have systemic lupus erythematosus, Sjögren syndrome, or other connective tissue disease, or may be completely healthy at the time of giving birth. NLS includes several clinical manifestations: complete congenital heart block (CCHB) and cutaneous lupus are the most common, while hepatobiliary disease, hematological manifestations and central nervous system involvement may occur...
February 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28196704/toll-like-receptor-4-antagonist-tak-242-inhibits-autoinflammatory-symptoms-in-ditra
#19
Akitaka Shibata, Kazumitsu Sugiura, Yasuhide Furuta, Yoshiko Mukumoto, Osamu Kaminuma, Masashi Akiyama
BACKGROUND: IL36RN encodes the IL-36 receptor antagonist (IL-36Ra), and loss-of-function mutations in IL36RN define a recessively inherited autoinflammatory disease named "deficiency of IL-36Ra" (DITRA). DITRA causes systemic autoinflammatory diseases, including generalized pustular psoriasis (GPP), an occasionally life-threatening disease that is characterized by widespread sterile pustules on the skin, fever and other systemic symptoms. GPP can present at any age, and provocative factors include various infections, medicines and pregnancy...
February 11, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28160250/thiopurines-and-methotrexate-use-in-ibd-patients-in-a-biologic-era
#20
REVIEW
Gerassimos J Mantzaris
Although we have been living in the era of biologic therapy for several decades, the use of immunomodulators (primarily thiopurines [azathioprine and mercaptopurine] and less so methotrexate) still remains an important component of the inflammatory bowel disease (IBD) pharmaceutical arsenal. Thiopurines as monotherapy exert corticosteroid-sparing effects and can maintain long-term remission in a considerable proportion of patients who have frequent relapses and are or have become mesalazine and/or corticosteroid intolerant or refractory...
March 2017: Current Treatment Options in Gastroenterology
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