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Biliary disease

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https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#1
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28531808/prenatal-diagnosis-of-biliary-atresia-a-case-series
#2
O Shen, H Y Sela, H Nagar, R Rabinowitz, E Jacobovich, D Chen, E Granot
BACKGROUND: Biliary atresia is a progressive disease presenting with jaundice, and is the most common indication for liver transplantation in the pediatric population. Prenatal series have yielded conflicting results concerning a possible association between BA and prenatal nonvisualization of the gallbladder. AIMS: This retrospective case series was performed to assess the association between biliary atresia, prenatal nonvisualization of the gallbladder and other sonographic signs...
May 19, 2017: Early Human Development
https://www.readbyqxmd.com/read/28530215/takotsubo-cardiomyopathy-after-intravenous-epinephrine-administration-following-cardiac-arrest-provoked-by-pneumoperitoneum-a-case-report
#3
Waldemar Elikowski, Malgorzata Małek-Elikowska, Jacek Karoń, Maria Mrozińska, Alina Baszko, Karolina Horbacka
In stress-induced takotsubo cardiomyopathy (TC) high levels of catecholamines, including epinephrine, may be detected in blood. On the other hand, administration of exogenous epinephrine may occasionally result in TC. A CASE REPORT: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. She was admitted 3 days earlier due to biliary colic following a dietary mistake...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529808/mirrizi-syndrome-and-markedly-elevated-levels-of-carbohydrate-antigen-19-9-in-the-absence-of-malignant-disease
#4
Natasha Shah, Eula Tetangco, Hafiz Muhammad Sharjeel Arshad, Hareth Raddawi
Elevated carbohydrate antigen 19-9 (CA19-9) beyond 1000 U/L occurs in nonneoplastic conditions which is causing questioning of the use of CA19-9 as a marker for screening. We report a case where a 51-year-old male with Mirrizi Syndrome (MS) presented with markedly increased CA19-9 level (4,618 U/mL). MS is a rare complication characterized by compression of the common bile or hepatic duct caused by an impacted gallstone in the cystic duct or neck of the gallbladder. Biliary epithelial cells secrete CA19-9: it is hypothesized that increased proliferation of such cells caused by inflammation leads to increased secretion...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28529750/phase-i-study-of-weekly-palliative-chemotherapy-with-low-dose-third-line-paclitaxel-for-biliary-tract-cancer
#5
Hidehiro Tajima, Tetsuo Ohta, Hiroyuki Shinbashi, Atsushi Hirose, Mitsuyoshi Okazaki, Takahisa Yamaguchi, Yoshinao Ohbatake, Koichi Okamoto, Shinichi Nakanuma, Seisho Sakai, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Hironori Hayashi, Katsunobu Oyama, Masafumi Inokuchi, Tomoharu Miyashita, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Hiroyuki Nakamura
The prognosis of patients with unresectable and recurrent biliary tract cancer (BTC) is very poor. Although gemcitabine (GEM) plus cisplatin therapy is useful for unresectable cases, the median overall survival (OS) of the patients is <1 year, and third-line chemotherapy following failure of 5-fluorouracil (5-FU) and GEM plus cisplatin is currently unavailable. The clinical efficacy and basic effects of low-dose paclitaxel (PTX) therapy for patients with BTC was previously reported. We herein present the results of a phase I clinical trial of weekly low-dose PTX as third-line palliative chemotherapy...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28527109/erratum-to-clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#6
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a twofold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
May 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28526690/emerging-concepts-in-biliary-repair-and-fibrosis
#7
Luca Fabris, Carlo Spirli, Massimiliano Cadamuro, Romina Fiorotto, Mario Strazzabosco
Chronic diseases of the biliary tree (cholangiopathies) represent one of the major unmet needs in clinical hepatology and a significant knowledge gap in liver pathophysiology. The common theme in cholangiopathies is that the target of the disease is the biliary tree. After damage to the biliary epithelium, inflammatory changes stimulate a reparative response with proliferation of cholangiocytes and restoration of the biliary architecture, owing to the re-activation of a variety of morphogenetic signals. Chronic damage and inflammation, will ultimately result in pathologic repair, with generation of biliary fibrosis and clinical progression of the disease...
May 19, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28524930/nutrition-support-in-hospitalised-adults-at-nutritional-risk
#8
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Steven Kwasi Korang, Kirstine Halberg Engell, Marie Skøtt Nielsen, Kang Zhang, Maria Didriksen, Lisbeth Lund, Niklas Lindahl, Sara Hallum, Ning Liang, Wenjing Xiong, Xuemei Yang, Pernille Brunsgaard, Alexandre Garioud, Sanam Safi, Jane Lindschou, Jens Kondrup, Christian Gluud, Janus C Jakobsen
BACKGROUND: The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of essential nutrients and improve clinical outcome. Previous reviews have shown conflicting results with regard to the effects of nutrition support. OBJECTIVES: To assess the benefits and harms of nutrition support versus no intervention, treatment as usual, or placebo in hospitalised adults at nutritional risk...
May 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28523311/study-concerning-the-histopathological-changes-in-chronic-hepatopathies
#9
Cristian Marius Daina, Lucia Georgeta Daina, Marinela Bonta, Daniela Rahotă, Gabriela MuŢiu
Chronic liver diseases represent a public health problem both at global level and in our country. Their significance is due not only to the large number of cases but also to their severe complications and associated diseases, which increase the gravity of prognosis. Hepatopathies generally develop by formation and accumulation of fibrous tissue, which leads to architectural distortions in the structure of the liver. Hepatic fibrosis is the result of chronic injury and plays a direct role in the pathogenesis of the hepatocellular dysfunction and portal hypertension...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522915/ninety-day-readmissions-after-inpatient-cholecystectomy-a-5-year-analysis
#10
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia
AIM: To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS: We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522912/recent-upper-gastrointestinal-panendoscopy-increases-the-risk-of-pyogenic-liver-abscess
#11
Ming-Jen Tsai, Chin-Li Lu, Ying C Huang, Chung Hsien Liu, Wan-Ting Huang, Kai-Yuan Cheng, Solomon Chih-Cheng Chen
AIM: To investigate the association between a recent gastrointestinal (GI) endoscopy and the subsequent risk of pyogenic liver abscess (PLA). METHODS: We designed a nested case control study. Using the Taiwan National Health Insurance Research Database, 2135 patients with a first diagnosis of PLA were identified from 1998 to 2011. Another 10675 patients without PLA matched by age and sex were selected as reference controls. We identified and compared the possible risk factors for PLA and GI endoscopies performed before the index date (when PLA was diagnosed) between the two cohorts...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522403/multiplex-autoantibody-detection-for-autoimmune-liver-diseases-and-autoimmune-gastritis
#12
Joris Vanderlocht, Mart van der Cruys, Frans Stals, Liesbeth Bakker-Jonges, Jan Damoiseaux
Autoantibody detection for autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC) and autoimmune gastritis (AIG) is traditionally performed by IIF on a combination of tissues. Multiplex line/dot blots (LIA/DIA) offer multiple advantages, i.e. automation, objective reading, no interfering reactivities, no coincidental findings. In the current study we evaluated automated DIA (D-Tek) for detecting autoantibodies related to autoimmune diseases of the gastrointestinal tract. We tested samples of the Dutch EQC program and compared the results with the consensus of the participating labs...
May 15, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28520575/predictors-of-bile-tree-pathology-in-patients-presenting-with-gallbladder-disease
#13
Mahmoud A Rahal, Mohammad O Rammal, Walid Karaoui, Ali Hallal, Hani Tamim, Yasser Shaib
BACKGROUND: Patients with gallstone disease can present with elevated liver function tests (LFTs). It is often challenging to differentiate those with a common bile duct (CBD) stone from those without a CBD stone on the basis of the LFTs levels. In this study, we aim to evaluate the predictors of a CBD stones among patients presenting with symptomatic gallbladder disease and elevated LFTs. PATIENTS AND METHODS: We retrospectively examined all patients who had undergone a cholecystectomy between January 2010 and December 2015...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28517369/treatment-of-primary-biliary-cholangitis-non-responders-a-systematic-review
#14
Duminda Suraweera, Harman Rahal, Melissa Jimenez, Matthew Viramontes, Gina Choi, Sammy Saab
BACKGROUND: Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, is a chronic cholestatic liver disease characterized by an immune mediated destruction of intrahepatic bile ducts. Ursodeoxycholic acid (UDCA) has been the primary medication for the treatment of PBC, resulting in improved liver tests, resolution of symptoms and increased transplant free survival. However, not all patients respond to UDCA. The aim of this systematic review is to provide an evidence based assessment of the medications that have been studied in patients who are refractory to UDCA...
May 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28515578/imaging-in-ductal-plate-malformations
#15
Binit Sureka, Archana Rastogi, Chhagan Bihari, Kishore G S Bharathy, Vikrant Sood, Seema Alam
Ductal plate malformations are a heterogenous group of congenital fibrocystic liver diseases resulting from insult to the ductal plate at various stages of embryogenesis. As a result various biliary malformations, cysts, hamartomas and congenital hepatic fibrosis may be seen. We present a radiological pictorial of ductal plate malformations, accurate diagnosis of which is important for clinical management.
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28515290/a-point-mutation-in-the-rhesus-rotavirus-vp4-protein-generated-through-rotavirus-reverse-genetics-system-attenuates-the-murine-model-of-biliary-atresia
#16
Sujit K Mohanty, Bryan Donnelly, Phylicia Dupree, Inna Lobeck, Sarah Mowery, Jaroslaw Meller, Monica McNeal, Greg Tiao
Rotavirus infection is one of the most common causes of diarrheal illness in humans. In neonatal mice, rhesus rotavirus (RRV) can induce biliary atresia (BA), a disease resulting in inflammatory obstruction of the extra-hepatic biliary tract and intrahepatic bile ducts. We have previously shown that the amino acid, arginine (R) within the sequence "SRL" (amino acids 445-447) on the RRV VP4 protein is required for viral binding and entry into biliary epithelial cells. To determine if the single amino acid (R) influences the pathogenicity of the virus, we generated a recombinant virus with a single amino acid mutation at this site through a reverse genetics system...
May 17, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28514402/-psychoemotional-and-autonomic-states-in-patients-with-cholelithiasis
#17
Ya M Vakhrushev, N A Khokhlacheva, N N Sergeeva
AIM: To investigate the psychoemotional and autonomic states of patients with biliary system diseases and to determine their significance in the development of cholelithiasis. SUBJECTS AND METHODS: A total of 396 patients with stage 1 cholelithiasis were examined. The results of hepatobiliary ultrasonography, multifractional duodenal probing, followed by macroscopic, microscopic, and biochemical examinations of bile (the total concentration of bile acids and cholesterol, by subsequently calculating the cholate-cholesterol ratio) were used to verify the diagnosis...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28514317/impact-of-age-on-short-term-outcomes-of-liver-surgery-lessons-learned-in-10-years-experience-in-a-tertiary-referral-hepato-pancreato-biliary-center
#18
Andrea Ruzzenente, Simone Conci, Andrea Ciangherotti, Tommaso Campagnaro, Alessandro Valdegamberi, Francesca Bertuzzo, Fabio Bagante, Guido Mantovani, Michela De Angelis, Adriano E Dorna, Marco Piccino, Corrado Pedrazzani, Alfredo Guglielmi, Calogero Iacono
We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors.Eight hundred three patients undergoing liver resection were divided into 3 groups: young patients (YP), <65 years (n = 387), elderly patients (EP), from 65 to 74 years (n = 279); very-elderly patients (VEP), ≥75 years (n = 137)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#19
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28511162/improvement-of-the-complex-medical-treatment-for-the-patients-w%C3%B1-th-chronic-biliary-pancreatitis
#20
L S Babinets, K Yu Kytsai, Yu Ya Kotsaba, I M Halabitska, N A Melnyk, I V Semenova, O S Zemlyak
INTRODUCTION: The most common reason of chronic pancreatitis is liver and bile ducts disease: functional disorders, chronic cholecystitis, cholelithiasis and cholecystectomy in medical history. All these changes are associated with the colloidal structure of bile, increased lithogenicity, gallstones formation, Oddi's sphincter dysfunction, dysmotility and inflammation in the bile ducts. THE AIM: to study the effectiveness of using medicine Liveria IC (metadoxine) in standard therapy as well as effect on spectrum of blood serum lipids and structural condition of liver (stiffness) and pancreas in patients with chronic biliary pancreatitis combined with obesity...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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