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Hepatic disease in pregnancy

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https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#1
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29735580/natural-history-clinical-manifestations-and-pathogenesis-of-hepatitis-e-virus-genotype-1-and-2-infections
#2
Rakesh Aggarwal, Amit Goel
Infection with genotype 1 or 2 hepatitis E virus (HEV) results primarily from human-to-human transmission through the fecal-oral route in low-resource countries. It presents primarily as "acute viral hepatitis" syndrome, usually a self-limiting illness. A few cases progress to acute liver failure, a serious illness with high fatality. Clinical disease is infrequent among children. Infection during pregnancy is associated with a higher risk of symptomatic disease, severe liver injury, and mortality...
May 7, 2018: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/29720579/congenital-esophageal-atresia-and-microtia-in-a-newborn-secondary-to-mycophenolate-mofetil-exposure-during-pregnancy-a-case-report-and-review-of-the-literature
#3
Musaed Mohammed Alsebayel, Faisal Abdulrahman Abaalkhail, Faisal Mohammed Alsebayel, Dema A Alissa, Ahmed Hamdan Al-Jedai, Hussien Elsiesy
BACKGROUND Mycophenolate mofetil (MMF) is one of the most commonly prescribed drugs to prevent organ transplant rejection in combination with calcineurin inhibitors and steroids. It has a different toxicity profile than tacrolimus and cyclosporine.  Gastrointestinal tract disturbances are the most common adverse effects. The use of MMF in pregnant women, however, holds great risk of miscarriage and fetal development defects such as external ear malformation, ocular anomalies, cleft lip and palate, and abnormality of distal limbs, heart, esophagus, and kidneys...
May 3, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29685043/hepatitis-e-virus-in-neurological-disorders-a-case-of-parsonage-turner-syndrome
#4
María Sánchez Azofra, Miriam Romero Portales, Lucia Tortajada Laureiro, Javier García-Samaniego, Pedro Mora Sanz
Hepatitis E virus (HEV) infection is an emerging disease in developed countries with a broad clinical spectrum. In the absence of immunodeficiency or pregnancy, it is a mild and almost asymptomatic condition in most cases. However, extrahepatic manifestations, including neurological conditions, are common and may occasionally lead to permanent neurological sequelae. Herein, we report the case of an immunocompetent patient who was admitted to our hospital with paresthesia and weakness in both the upper extremities associated with anicteric-elevated transaminases...
April 24, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29682309/australasian-society-for-hiv-viral-hepatitis-and-sexual-health-medicine-hiv-pre-exposure-prophylaxis-clinical-guidelines-update-april-2018
#5
EDITORIAL
Edwina Wright, Andrew Grulich, Katy Roy, Mark Boyd, Vincent Cornelisse, Darren Russell, Darryl O'Donnell, Bill Whittaker, Levinia Crooks, Iryna Zablotska
Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines are an updated adaptation of the 2014 US Centers for Disease Control's PrEP guidelines and are designed to: •Support the prescription of PrEP using forms of coformulated tenofovir and emtricitabine that have been registered in Australia by the Therapeutic Goods Administration and other bioequivalent generic drugs that are available in Australia through self-importation, private prescription or Australian PrEP clinical trials•Assist clinicians in the evaluation of patients who are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs (PWID) at substantial risk of HIV acquisition...
April 1, 2018: Journal of Virus Eradication
https://www.readbyqxmd.com/read/29656685/maternal-hepatitis-c-hcv-infection-and-anti-d-immunoglobulin-therapy-study-testing-antibodies-rna-and-genotype-of-hcv-in-baghdad
#6
Waqar Al-Kubaisy, Suzanna Daud, Mustafa Waseem Al-Kubaisi, Omar Waseem Al-Kubaisi, Nik Nairan Abdullah
INTRODUCTION: Hepatitis C virus (HCV) infection is a serious health problem. It is a major contributor to end-stage liver disease. Worldwide, 1-8% of all pregnant women were infected. Women with viral hepatitis may be at an increased risk of pregnancy complications. There are several obstetrics intervention act as risk factors which are specific to women pertaining the HCV infection; anti-D immunoglobulin (Ig) therapy may be one of them. Our objectives were to estimate the prevalence of HCV antibodies (anti-HCV), RNA, and genotype distribution among women with anti-D Ig therapy...
April 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29611616/the-pregnant-traveller
#7
Krzysztof Korzeniewski
Travelling during pregnancy has become increasingly common. Many pregnant women travel for pleasureand recreation and a lot of them continue to work and therefore often travel on business, sometimes to areas with poor standards of sanitation and limited access to health care providers. During pregnancy, it is extremely important that a woman has a regular access to maternal health care, also in temporary destinations, especially in areas characterised by harsh environmental conditions, and places where the prevalence of infectious diseases is high...
2018: International Maritime Health
https://www.readbyqxmd.com/read/29605070/nonviral-or-drug-induced-etiologies-of-acute-liver-failure
#8
REVIEW
Russell Rosenblatt, Robert S Brown
Acute liver failure (ALF) is a rare but highly fatal condition. The most common causes include drug-induced and viral hepatitis, but other less common etiologies, especially autoimmune hepatitis, Budd-Chiari syndrome, and Wilson disease, need to be considered. Because diagnosis is frequently tied to potential for reversibility of ALF and prognosis, early identification in a timely manner is crucial. Other causes of ALF are more easily recognizable based on specific circumstances, such as ALF in pregnancy or ischemic hepatitis...
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29577863/hepatic-elimination-of-drugs-in-gestational-diabetes
#9
Claudio Daniel Gonzalez, Jorge Alvarinas, Ricardo Bolanos, Guillermo Di Girolamo
BACKGROUND: The liver is the major metabolic clearance organ for chemical agents from the human body. Pregnancy is associated with several physiological changes that may affect one or more of these factors, and also induces changes in the hepatic clearance of certain drugs.The aim of this paper was to review some of the currently available information in the field to provide some insights about the relevance of these changes on the clearance of some drugs. METHODS: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1970 first semester...
March 25, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29560262/recent-advances-in-the-diagnosis-and-management-of-pre-eclampsia
#10
REVIEW
Kate Duhig, Brooke Vandermolen, Andrew Shennan
Pre-eclampsia is a leading cause of maternal mortality, responsible annually for over 60,000 maternal deaths around the globe. Pre-eclampsia is a multisystem disease featuring hypertension, proteinuria, and renal, hepatic, and neurological involvement. Diagnosis is often elusive, as clinical presentation is highly variable. Even those with severe disease can remain asymptomatic. Angiogenic factors are emerging as having a role in the diagnosis of pre-eclampsia and in prognostication of established disease. In this article, we summarize new developments and focus on angiogenic biomarkers for prediction of disease onset...
2018: F1000Research
https://www.readbyqxmd.com/read/29557200/new-therapies-versus-first-generation-biologic-drugs-in-psoriasis-a-review-of-adverse-events-and-their-management
#11
J M Carrascosa, E Del-Alcazar
Biologic drugs have revolutionized the treatment of moderate to severe psoriasis in recent years because of their high efficacy and low risk of toxicity. However, even within the group of biologic therapies, there are differences related to the different mechanisms of action. Areas covered: We review the main adverse events associated with the biologic agents currently available for the treatment of psoriasis and the new inhibitors targeting the p19 subunit of interleukin (IL) 23 and the IL-17A receptor. This review covers injection site reactions, infections, cardiovascular events, demyelinating disorders, tumours, class effects secondary adverse events, immunogenicity, safety in pregnancy and vaccines efficacy...
March 20, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29550150/effect-of-vitamin-d3-supplementation-in-pregnancy-on-risk-of-pre-eclampsia-randomized-controlled-trial
#12
Aisha Mansoor Ali, Abdulaziz Alobaid, Tasnim Nidal Malhis, Ahmad Fawzi Khattab
BACKGROUND: Vitamin D plays pivotal role in decidualization and implantation of the placenta. Recent researches have shown that low level of vitamin D3 "25-hydroxyvitamin D (25[OH]D)" in serum is a risk factor for pre-eclampsia. Latest evidence supports role of vitamin D3 deficiency treatment in reducing the risk of pre-eclampsia. The aim of this study is to determine the effect of antenatal supplementation of vitamin D3 on the risk of pre-eclampsia and to explore the dose effect in attaining the vitamin D3 normal level...
March 2, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29540601/positive-regulation-of-hepatitis-e-virus-replication-by-microrna-122
#13
Bangari Haldipur, Prudhvi Lal Bhukya, Vidya Arankalle, Kavita Lole
Molecular mechanisms of liver pathology and clinical disease in HEV infection remain unclear. MicroRNAs are known to modulate viral pathogenesis either by directly altering viral gene expression or by enhancing cellular antiviral responses. Given the importance of microRNA-122 (miR-122) in liver pathobiology, we investigated possible role of miR-122 in HEV infection. In silico predictions using genotype 1, 2, 3 and 4 HEV sequences showed that majority of genomes (203/222) harbor at least one miR-122/miR-122* target site...
March 14, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29534433/maternal-consumption-of-low-isoflavone-soy-protein-isolate-confers-the-increased-predisposition-to-alcoholic-liver-injury-in-adult-rat-offspring
#14
Sae Bom Won, Young Hye Kwon
Offspring of female rats fed either a casein (CAS) diet or a low-isoflavone soy protein isolate (SPI) diet were compared in an animal model of chronic ethanol consumption to investigate whether maternal diet regulates the adaptive responses of offspring to postnatal ethanol exposure and potentially affects the development of liver disease in later life. Female rats were fed either a CAS or an SPI diet before mating, and during pregnancy and lactation. Male offspring from the same litter were pair-fed either a control or ethanol diet for six weeks (CAS/CON, CAS/EtOH, SPI/CON, and SPI/EtOH groups)...
March 10, 2018: Nutrients
https://www.readbyqxmd.com/read/29529682/-second-austrian-consensus-on-the-safe-use-of-anti-tnf%C3%AE-antibodies-in-patients-with-inflammatory-bowel-diseases
#15
Wolfgang Miehsler, Clemens Dejaco, Hans-Peter Gröchenig, Harry Fuchssteiner, Christoph Högenauer, Lili Kazemi-Shirazi, Harald Maier, Andreas Mayer, Alexander Moschen, Walter Reinisch, Wolfgang Petritsch, Reingard Platzer, Pius Steiner, Herbert Tilg, Harald Vogelsang, Heimo Wenzl, Gottfried Novacek
Anti-TNFα-antibodies have revolutionized the therapy of inflammatory bowel diseases and other immune-mediated inflammatory diseases. Due to the increasing application of these substances, the Working Group of Inflammatory Bowel Diseases of the Austrian Association of Gastroenterology and Hepatology intended to update their consensus report on the safe use of Infliximab (published in 2010) and to enlarge its scope to cover all anti-TNFα-antibodies. The present consensus report summarizes the current evidence on the safe use of anti-TNFα-antibodies and covers the following topics: general risk of infection, bacterial infections (i...
March 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29526602/epigenome-wide-study-for-the-offspring-exposed-to-maternal-hbv-infection-during-pregnancy-a-pilot-study
#16
Qijun Cheng, Bin Zhao, Zhenxiang Huang, Yanhua Su, Biqin Chen, Songjing Yang, Xueqi Peng, Qilin Ma, Xiaoshan Yu, Benhua Zhao, Xiayi Ke
BACKGROUND & AIM: Hepatitis B virus (HBV) can be transmitted to infants, and is related to infants' later disease risk. Epigenetic change (such as DNA methylation) may be mechanism underlying the relationship. In this study, we aimed to investigate whether prenatal HBV infection could alter DNA methylation status in newborns. METHOD: We selected 12 neonates with intrauterine HBV infection whose mothers were HBsAg-positive during pregnancy, relative to 12 HBV-free neonates with HBsAg-negative mothers...
June 5, 2018: Gene
https://www.readbyqxmd.com/read/29516496/primate-fetal-hepatic-responses-to-maternal-obesity-epigenetic-signalling-pathways-and-lipid-accumulation
#17
Sobha Puppala, Cun Li, Jeremy P Glenn, Romil Saxena, Samer Gawrieh, Amy Quinn, Jennifer Palarczyk, Edward J Dick, Peter W Nathanielsz, Laura A Cox
KEY POINTS: Maternal obesity (MO) and exposure to a high-fat, high-simple-carbohydrate diet during pregnancy predisposes offspring to obesity, metabolic and cardiovascular disorders in later life. Underlying molecular pathways and potential epigenetic factors that are dysregulated in MO were identified using unbiased transcriptomic methods. There was increased lipid accumulation and severe steatosis in the MO baboon fetal liver suggesting that these offspring are on an early trajectory of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis...
March 7, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29512054/peripartum-care-for-mothers-diagnosed-with-hepatitis-b-during-pregnancy-a-survey-of-provider-practices
#18
Allison J Kwong, Matthew S Chang, Ruth E Tuomala, Laura E Riley, Julian N Robinson, Muthoka L Mutinga, Karin L Andersson, Robert S Brown, Emily Oken, Chinweike Ukomadu, Anna E Rutherford
Objectives Hepatitis B (HBV) remains a significant public health burden, despite effective therapy. Routine HBV screening is recommended during pregnancy to reduce the risk of vertical transmission, but the rates of follow-up care peri-partum are low. The aim of this study was to evaluate physician practices and knowledge regarding HBV in women diagnosed perinatally. Methods A survey was distributed to obstetricians and midwives within the Partners HealthCare system at Brigham and Women's Hospital and Massachusetts General Hospital...
March 6, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29501712/phenazopyridine-a-preoperative-way-to-identify-ureteral-orifices
#19
Alexandra Rehfuss, Joseph Mahon, Igor Sorokin, Cynthia Smith, Barry S Stein
OBJECTIVE: To identify difficult to see ureteral orifices (UOs), urologists need a method to stain the urine. Phenazopyridine, a urinary analgesic which discolors the urine orange, can be administered orally preoperatively. We evaluated the usefulness of phenazopyridine in identifying the UOs and optimal timing of administration. METHODS: Adult patients undergoing endoscopic procedures at the Stratton VA were prospectively enrolled. Preoperative metabolic panels were reviewed...
March 1, 2018: Urology
https://www.readbyqxmd.com/read/29493093/highlights-of-the-2017-european-aids-clinical-society-eacs-guidelines-for-the-treatment-of-adult-hiv-positive-persons-version-9-0
#20
L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
May 2018: HIV Medicine
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