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https://www.readbyqxmd.com/read/27904243/a-systematic-approach-to-patients-with-jaundice
#1
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
#2
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/27891281/septooptic-dysplasia-with-an-associated-arachnoid-cyst
#3
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
#4
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/27872769/mantle-cell-hyperplasia-of-peripheral-lymph-nodes-as-initial-manifestation-of-sickle-cell-disease
#5
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/27866642/genetic-susceptibility-to-gilbert-s-syndrome-in-a-valencian-population-efficacy-of-the-fasting-test
#6
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/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#7
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
#8
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
#9
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
#10
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/27830550/gunn-rats-as-a-surrogate-model-for-evaluation-of-hepatocyte-transplantation-based-therapies-of-crigler-najjar-syndrome-type-1
#11
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
#12
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/27805562/acute-kidney-injury-in-leptospirosis-the-kidney-disease-improving-global-outcomes-kdigo-criteria-and-mortality%C3%A2
#13
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
https://www.readbyqxmd.com/read/27804185/early-post-transplant-hyperbilirubinemia-is-a-possible-predictive-factor-for-developing-neurological-complications-in-pediatric-living-donor-liver-transplant-patients-receiving-tacrolimus
#14
Kazushige Sato, Yoshinobu Kobayashi, Atsushi Nakamura, Daizo Fukushima, Susumu Satomi
The cause of post-transplant CNI-NCs is multifactorial and not ascribed solely to CNI toxicity. A total of 90 children (aged <20 years) who underwent LDLT were evaluated to investigate the predictive factors associated with CNI-NCs. Twelve patients (13.3%) developed CNI-NCs after LDLT (age range, 2-15 years). The symptoms of CNI-NCs were seizures, VD, and stupor. The median onset of CNI-NCs was 10 days (range, 5-30 days) post-transplant. In the univariate analysis, higher recipient age at LDLT, donor age and recipient's BW, lower actual GV/SLV and TAC dosage/BW, and higher mean T-Bil and sodium level for 7 days after transplantation were independently significantly associated with TAC-NCs...
November 1, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27803558/current-status-of-percutaneous-transhepatic-biliary-drainage-in-palliation-of-malignant-obstructive-jaundice-a-review
#15
REVIEW
S H Chandrashekhara, S Gamanagatti, Anuradha Singh, Sushma Bhatnagar
Malignancies leading to obstructive jaundice present too late to perform surgery with a curative intent. Due to inexorably progressing hyperbilirubinemia with its consequent deleterious effects, drainage needs to established even in advanced cases. Percutaneous transhepatic biliary drainage (PTBD) and endoscopic retrograde cholangiopancreatography (ERCP) are widely used palliative procedures each with its own merits and lacunae. With the current state-of-the-art PTBD technique consequent upon procedural and hardware improvement, it is equaling ERCP regarding technical success and complications...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#16
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
October 31, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27755775/spurious-reticulocyte-profiles-in-a-dog-with-babesiosis
#17
Laetitia Piane, Marie-Laure Théron, Marcel Aumann, Catherine Trumel
A 9-year-old, female Maltese dog was referred to the Veterinary School of Toulouse with a 2-day history of anorexia and weakness. On clinical examination, the dog had hyperthermia (39.7°C), abdominal discomfort, and polypnea. Significant laboratory findings included pigmenturia, hyperbilirubinemia, hypercreatininemia, hyperfibrinogenemia, abnormal Snap canine pancreas-specific lipase, and pancytopenia with a nonregenerative anemia. A peripheral blood smear revealed numerous intraerythrocytic large Babesia but no polychromasia...
October 18, 2016: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/27750343/-acute-kidney-injury-in-liver-failure
#18
Christoph R Werner, Verena Wagner, Bence Sipos, Maike Büttner-Herold, Kerstin Amann, Michael Haap, Nisar P Malek, Michael Bitzer, Ferruh Artunc
History and admission findings: We report on a 76-year-old man presenting with painless jaundice who developed dialysis-dependent acute kidney injury. Investigations: Biliary tract was examined with endoscopy, in addition kidney biopsy was performed. Diagnosis, treatment and course: A stenosing process could be seen in the biliary tract, leading to stent implantation. However, jaundice did not resolve. Kidney biopsy revealed bile casts indicating cholemic nephropathy. After switch of concomitant medication, hyperbilirubinemia resolved and kidney function was completely restored...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27734714/bone-measurements-of-infants-with-hyperbilirubinemia-by-quantitative-ultrasound-the-influence-of-phototherapy
#19
Fatma İnci Arıkan, Semra Kara, Hüseyin Bilgin, Fatma Özkan, Yıldız Dallar Bilge
OBJECTIVE: The purpose of the current study was to investigate the possible effects of phototherapy on bone status of term infants evaluated by measurement of tibial bone SOS. MATERIALS AND METHODS: The phototherapy group (n = 30) consisted of children who had undergone phototherapy for at least 24 hours and the control group (n = 30) comprised children who had not received phototherapy. Blood samples were obtained from all infants for serum calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone and vitamin D concentrations...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27727716/study-of-prevalence-and-pattern-of-hyperbilirubinemia-in-patients-undergoing-open-heart-surgery
#20
Yadlapalli C Deepak, Swargam Venu, Manne Sriharibabu, P Vijaya Kumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
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