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hyperbilirubinemia adult

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https://www.readbyqxmd.com/read/28333690/diagnosis-and-evaluation-of-hyperbilirubinemia
#1
Jeremy I Sullivan, Don C Rockey
PURPOSE OF REVIEW: Jaundice, the physical finding associated with hyperbilirubinemia, results when the liver is unable to properly metabolize or excrete bilirubin. The purpose of this review is to examine some of the most common causes of jaundice in adults, provide insight into the diagnostic evaluation of jaundice, and review information on the outcomes of patients with jaundice. RECENT FINDINGS: An elevated level of bilirubin almost always indicates the presence of an underlying disease state...
May 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28314169/increased-mortality-in-critically-ill-patients-with-mild-or-moderate-hyperbilirubinemia
#2
Charalampos Pierrakos, Dimitrios Velissaris, Peter Felleiter, Massimo Antonelli, Philippe Vanhems, Yasser Sakr, Jean-Louis Vincent
PURPOSE: Increased bilirubin concentrations may be related to outcome, but this has not been well studied. We evaluated the relationship between total serum bilirubin levels and outcome in critically ill patients. MATERIALS AND METHODS: Data were analyzed from adult critically ill patients included in a 1-day international prevalence study after excluding those with an obvious underlying cause of hyperbilirubinemia. RESULTS: Serum bilirubin concentrations were >1 mg/dL in 2803 (31%) of 8973 patients, and these patients had higher mortality rates than patients with lower bilirubin concentrations (30% vs 21%, P<...
February 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28303655/cholangiohepatitis-in-dairy-cattle-13-cases
#3
D E Gomez, E Doré, D Francoz, A Desrochers, H Pierre, G Fecteau
BACKGROUND: The signalment, clinicopathologic, bacteriological, histopathological, ultrasonographic characteristics, and the treatment and outcomes of adult cattle with cholangiohepatitis are poorly defined. ANIMALS: Thirteen Holstein cows with cholangiohepatitis. METHODS: Retrospective study of medical records of cattle admitted to the CHUV and the AVC between 1992 and 2012 and 2000 and 2012, respectively, for cattle older than 3 months of age with a histopathological diagnosis of cholangiohepatitis...
March 16, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28217609/acute-pancreatitis-due-to-malaria-a-case-report-of-five-patients-and-review-of-literature
#4
Kundavaram Paul Prabhakar Abhilash, Atif Shaikh Iqbal Ahmed, Sowmya Sathyendra, Ooriapadickal Cherian Abraham
Malaria is endemic in large parts of India and can cause multiorgan failure and death. Acute pancreatitis as a complication is rare and is potentially fatal. This case series describes five adult patients between 2005 and 2010 who presented with a short duration febrile illness and diagnosed to have malaria with acute pancreatitis. The mean age of the five patients with acute pancreatitis was 40.4 years and four of them were males. None of them were alcohol consumers and did not have any other risk factor for acute pancreatitis...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28145671/evaluation-of-jaundice-in-adults
#5
Matthew V Fargo, Scott P Grogan, Aaron Saguil
Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include fractionated bilirubin, a complete blood count, alanine transaminase, aspartate transaminase, alkaline phosphatase, ?-glutamyltransferase, prothrombin time and/or international normalized ratio, albumin, and protein. Imaging with ultrasonography or computed tomography can differentiate between extrahepatic obstructive and intrahepatic parenchymal disorders...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28093842/gilbert-syndrome-in-patients-with-type-1-diabetes-prevalence-glycemic-control-and-microalbuminuria
#6
Sigal Singer, Nurit Pilpel, Orit Pinhas-Hamiel
BACKGROUND: Gilbert syndrome (GS) is a common hereditary condition, characterized by intermittent unconjugated hyperbilirubinemia. In adults with type 2 diabetes and GS, a markedly lower prevalence of nephropathy was documented, suggesting a beneficial effect of hyperbilirubinemia. We investigated the prevalence of GS among individuals with type 1 diabetes mellitus (T1DM), and the prevalence of microalbuminuria. METHODS: The prevalence of GS was assessed in 401 (204 female) patients with T1DM, median age 21...
January 17, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#7
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/27980881/obstetric-obesity-is-associated-with-neonatal-hyperbilirubinemia-with-high-prevalence-in-native-hawaiians-and-pacific-island-women
#8
Luc Ra Rougée, Shogo J Miyagi, Abby C Collier
Obesity and pregnancy both place the liver under metabolic stress, but interactions between obstetric obesity and bilirubin metabolism have not been studied. We determined associations between obesity, maternal/neonatal bilirubin levels, and uridine 5'diphosphate-glucuronosyltransferase 1A1 (UGT1A1) enzyme that eliminates bilirubin. Adult livers were analyzed for UGT1A1 expression, activity, and bilirubin clearance by pharmacokinetic modeling. Then, matched maternal and neonatal sera (N = 450) were assayed for total and unconjugated bilirubin...
December 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/27943244/genetic-variations-in-bilirubin-metabolism-genes-and-their-association-with-unconjugated-hyperbilirubinemia-in-adults
#9
Ashish S Chiddarwar, Selma Z D'Silva, Roshan B Colah, Kanjaksha Ghosh, Malay B Mukherjee
OBJECTIVE: The present study was undertaken to investigate the genotype and allele frequencies of the variants in the four bilirubin metabolism genes (UGT1A1, OATP2, HMOX1, and BLVRA) and their association with hyperbilirubinemia. MATERIAL AND METHODS: Genotyping of 17 genetic variants was performed in 115 adults with hyperbilirubinemia and 150 controls by PCR-RFLP, GeneScan analysis, and direct DNA sequencing. RESULTS: Genetic polymorphisms of the UGT1A1 promoter, specifically the T-3279G phenobarbital-responsive enhancer module and (TA)7 dinucleotide repeat, as well as the intron and coding region variants of the OATP2, HMOX1, and BLVRA genes, were significantly higher among the cases than the controls...
December 12, 2016: Annals of Human Genetics
https://www.readbyqxmd.com/read/27704169/hepatic-expression-of-transcription-factors-affecting-developmental-regulation-of-ugt1a1-in-the-han-chinese-population
#10
Ya-Li Nie, Hang He, Jiang-Feng Li, Xiang-Guang Meng, Liang Yan, Pei Wang, Shu-Jie Wang, Hong-Zheng Bi, Li-Rong Zhang, Quan-Cheng Kan
PURPOSE: Complete or partial inactivity of UGT1A1, the unique enzyme responsible for bilirubin glucuronidation, is commonly associated with hyperbilirubinemia. We investigated the dynamic expression of UGT1A1, and that of the transcription factors (TFs) involved in its developmental regulation, during human hepatic growth in Han Chinese individuals. METHODS: Eighty-eight prenatal, pediatric, and adult liver samples were obtained from Han Chinese individuals. Quantitative real-time polymerase chain reaction was used to evaluate mRNA expression of UGT1A1 and TFs including PXR, CAR, HNF1A, HNF4A, PPARA, etc...
January 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27677263/atazanavir-and-cardiovascular-risk-among-human-immunodeficiency-virus-infected-patients-a-systematic-review
#11
REVIEW
Dominic Chow, Cecilia Shikuma, Corey Ritchings, Muxing Guo, Lisa Rosenblatt
INTRODUCTION: Patients with human immunodeficiency virus (HIV) infection have an increased risk of cardiovascular disease (CVD). While viral suppression with antiretroviral therapy decreases CVD risk overall, several studies have suggested that certain antiretrovirals, particularly certain protease inhibitors, may be associated with an increased relative risk of CVD. In AIDS Clinical Trials Group 5260 s, ritonavir-boosted atazanavir (ATV) was associated with slower atherosclerosis progression compared to ritonavir-boosted darunavir and raltegravir, potentially due to hyperbilirubinemia...
December 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27631159/the-use-of-erwinia-asparaginase-for-adult-patients-with-acute-lymphoblastic-leukemia-after-pegaspargase-intolerance
#12
Troy Z Horvat, Joshua J Pecoraro, Ryan J Daley, Larry W Buie, Amber C King, Raajit K Rampal, Martin S Tallman, Jae H Park, Dan Douer
Asparaginase administration has become a crucial component of front-line pediatric and pediatric-insipired multi-agent regimens for the treatment of acute lymphoblastic leukemia (ALL). The aim of this retrospective study was to assess the safety and feasibility of switching to Erwinia asparaginase after pegaspargase intolerance in adult ALL patients treated at Memorial Sloan Kettering Cancer Center. Our analysis included 10 patients, with a median age of 39 years (range 20-72), male predominance (90%), and a typical B-cell to T-cell ratio (70:30%) for ALL...
August 26, 2016: Leukemia Research
https://www.readbyqxmd.com/read/27550361/early-bactericidal-activity-of-azd5847-in-patients-with-pulmonary-tuberculosis
#13
Jennifer J Furin, Jeannine Du Bois, Elana van Brakel, Phalkun Chheng, Amour Venter, Charles A Peloquin, Abdullah Alsultan, Bonnie A Thiel, Sara M Debanne, W Henry Boom, Andreas H Diacon, John L Johnson
AZD5847 is an oxazolidinone antibiotic with in vitro activity against Mycobacterium tuberculosis The objective of this study was to evaluate the antimycobacterial activity, safety, and pharmacokinetics of AZD5847 in patients with pulmonary tuberculosis. Groups of 15 treatment-naive, sputum smear-positive adults with pulmonary tuberculosis were randomly assigned to receive AZD5847 at one of four doses (500 mg once daily, 500 mg twice daily, 1,200 mg once daily, and 800 mg twice daily) or daily standard chemotherapy...
November 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27542957/hypoalbuminemia-is-significantly-associated-with-increased-clearance-time-of-high-dose-methotrexate-in-patients-being-treated-for-lymphoma-or-leukemia
#14
Samantha N Reiss, Larry W Buie, Nelly Adel, Debra A Goldman, Sean M Devlin, Dan Douer
As a weak acid, methotrexate (MTX) is bound to serum albumin and has variable protein binding. The purpose of this study was to assess serum albumin's relationship with MTX pharmacokinetics by comparing MTX clearance and toxicities between patients with normal serum albumin to those with hypoalbuminemia. This single-center retrospective study included adult patients with leukemia or lymphoma who received their first MTX at a dose ≥1 g/m(2). Hypoalbuminemia was defined as serum albumin ≤3.4 g/dL. MTX clearance was defined as the first documented time the MTX level ≤0...
December 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27519946/favism-the-commonest-form-of-severe-hemolytic-anemia-in-palestinian-children-varies-in-severity-with-three-different-variants-of-g6pd-deficiency-within-the-same-community
#15
N Scott Reading, Mahmoud M Sirdah, Mohammad E Shubair, Benjamin E Nelson, Mustafa S Al-Kahlout, Jamal M Al-Tayeb, Lina N Aboud, Maysaa Abu Shaban, Lucio Luzzatto, Josef T Prchal
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common genetic abnormality known to predispose to acute hemolytic anemia (AHA), which can be triggered by certain drugs or infection. However, the commonest trigger is fava beans (Vicia faba) ingestion, causing AHA (favism), which may be life-threatening especially in children. G6PD deficiency is genetically highly heterogeneous, as nearly 200 different mutations have been observed. We have investigated the hematological features of acute favism in the Palestinian Gaza community that is characterized by the polymorphic coexistence of three different G6PD deficiency genes (G6PD A-, G6PD Cairo, G6PD Med)...
September 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27509944/incidence-and-management-of-toxicity-associated-with-lasparaginase-in-the-treatment-of-all-and-nk-tcell-lymphoma-an-observational-study
#16
MULTICENTER STUDY
Shu Hui Yeang, Alexandre Chan, Chuen Wen Tan, Soon Thye Lim, Heng Joo Ng
BACKGROUND: Lasparaginase (ASNase) is commonly used in the treatment of acute lymphoblastic leukemia (ALL) and natural killer (NK)/Tcell lymphoma. This study was designed to describe the incidence of toxicity associated with ASNase in Asian adults. Secondary objectives were to investigate the management and impact of toxicity on subsequent ASNase use, and to compare the actual management against current recommendations. MATERIALS AND METHODS: In this retrospective, multicenter, observational study, Asian patients ≥ 18 years old who received ≥ 1 dose of the native E...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27465587/risk-of-hemophagocytic-lymphohistiocytosis-in-adults-with-fevers-of-unknown-origin-the-clinical-utility-of-a-new-scoring-system-on-early-detection
#17
Hao-Yuan Wang, Ching-Fen Yang, Tzeon-Jye Chiou, Sheng-Hsiang Yang, Jyh-Pyng Gau, Yuan-Bin Yu, Po-Min Chen, Hui-Chi Hsu, Chang-Phone Fung, Hsiao-Yi Lin, Cheng-Hwai Tzeng, Jin-Hwang Liu, Liang-Tsai Hsiao
The diagnosis of hemophagocytic lymphohistiocytosis (HLH) is delayed by most physicians. This study aimed to identify early parameters and suitable scoring systems for the risk of HLH. Clinical and laboratory data collected ≤3 days after admission were defined as early parameters and used to calculate the number of HLH-2004 criteria met and bone marrow (BM) score. Between January 2006 and February 2016, 233 immunocompetent adults with naïve fever of unknown origin who underwent a BM study were enrolled to mimic patients at risk of HLH and randomly assigned into the developmental or validation cohort...
July 28, 2016: Hematological Oncology
https://www.readbyqxmd.com/read/27358786/higher-plasma-bilirubin-predicts-veno-occlusive-disease-in-early-childhood-undergoing-hematopoietic-stem-cell-transplantation-with-cyclosporine
#18
Kwi Suk Kim, Aree Moon, Hyoung Jin Kang, Hee Young Shin, Young Hee Choi, Hyang Sook Kim, Sang Geon Kim
AIM: To analyze the association between plasma bilirubin levels and veno-occlusive disease (VOD) in non-adult patients undergoing hematopoietic stem cell transplantation (HSCT) during cyclosporine therapy. METHODS: A total of 123 patients taking cyclosporine were evaluated using an electronic medical system at the Seoul National University Children's Hospital from the years 2004 through 2011. Patients were grouped by age and analyzed for incidence and type of adverse drug reactions (ADRs) including VOD...
June 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27326811/patterns-of-early-allograft-dysfunction-in-adult-live-donor-liver-transplantation-the-a2all-experience
#19
James J Pomposelli, Nathan P Goodrich, Jean C Emond, Abhinav Humar, Talia B Baker, David R Grant, Robert A Fisher, John P Roberts, Kim M Olthoff, Brenda W Gillespie, Robert M Merion
BACKGROUND: Early allograft dysfunction (EAD) after living donor liver transplantation (LDLT) has often been attributed to inadequate graft size, and termed small-for-size syndrome. Early allograft dysfunction definitions include a variable constellation of findings, including hyperbilirubinemia, coagulopathy, encephalopathy, and ascites formation. Among putative causes of EAD after LDLT are excessive portal pressure and/or flow. Our objective was to evaluate patterns of EAD after LDLT...
July 2016: Transplantation
https://www.readbyqxmd.com/read/27255829/adult-onset-hemophagocytic-lymphohistiocytosis-prognosis-is-affected-by-underlying-disease-and-coexisting-viral-infection-analysis-of-a-single-institution-series-of-35-patients
#20
Chiara Cattaneo, Margherita Oberti, Cristina Skert, Angela Passi, Mirko Farina, Alessandro Re, Paola Tozzi, Erika Borlenghi, Giuseppe Rossi
Adult onset hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome, which can develop as a complication of many disorders. Early diagnosis is essential in order to avoid a fatal outcome. To confirm the diagnosis of acquired HLH made in a single institution series of adult patients with HLH-04 criteria, we applied the HScore and evaluated prognostic factors associated with clinical outcome. The median age of 35 patients was 54 (range 17-81), M/F ratio was 20/15. In 26/35 (74.3%) patients, an underlying haematological disease was present (2 Multicentric Castleman Disease, 10 B-cell Non-Hodgkin Lymphoma [NHL] and 14 T/NK-cell NHL); an autoimmune disorder was observed in four (11...
June 3, 2016: Hematological Oncology
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