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Jaundice icterus [keywords]
- [Leptospirosis with necro-haemorrhagic cholecystitis in a Boxer puppy.] [JOURNAL ARTICLE]
- Tierarztl Prax Ausg K Kleintiere Heimtiere 2014 Nov 25; 42(6):399-405.
A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis.
- Internal-external percutaneous transhepatic biliary drainage for patients with malignant obstructive jaundice. [Journal Article]
- Asian Pac J Cancer Prev 2014; 15(21):9391-4.
To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice.During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD.Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05).The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.
- A single center study of the effects of trained fathers' participation in constant breastfeeding. [Journal Article]
- Acta Med Iran 2014 Sep; 52(9):694-6.
Constant breastfeeding that depends on the family support. Fathers' involvement is as an important factor of successful breastfeeding. The aim of this study was to evaluate the influence of fathers' participation in constant breastfeeding in Vali-E-Asr Hospital, Tehran, Iran. This interventional study was piloted on spouses of pregnant women participating in pregnancy courses. The case group consisted of fathers attending training courses of breastfeeding during pregnancy (Group A), and the control group was made up of fathers who did not take part in training courses (Group B). The courses were held three times from the 30th week of gestation to the end of pregnancy in a family health research center. Fathers attended three training sessions where they were trained by brochures. After delivery newborns were weighted and examined for jaundice (3-5 days, 30 days, three and six months after birth). According to mothers' views, spouses' participation, encouragement and support in group A, was 11 times more than group B. It means that 47 (94%) of spouses in the group A participated in mothers' constant breastfeeding, but fathers' participation in group B was 60% (30 spouses). This study showed that breastfeeding was more constant in the group that fathers participated in breastfeeding training course. One of the reasons for such a significant difference was spouses' participation, encouragement and support in the trained group. This study showed that fathers' involvement in training programs may influence constancy of breastfeeding.
- [A case of fascioliasis in the intrahepatic duct with concurrent clonochiasis]. [English Abstract, Journal Article]
- Korean J Gastroenterol 2014 Nov 25; 64(5):298-301.
The main causes of biliary obstruction are stones and cancers. Fascioliasis is a very rare case which causes biliary obstruction. Fascioliasis is a zoonosis caused by Fasciola hepatica which infects herbivores like sheep and cattle. F. hepatica lives in the biliary system or the liver parenchyma of a host. In Korea, the occurrence of this infection in human is very rare and only few cases have been reported. A 32-year-old male presented with upper abdominal pain and jaundice. His laboratory finding revealed elevated liver transaminases. Abdomen CT scan showed mild left intrahepatic bile duct dilatation. On ERCP, adult F. hepatica worms were found and were thus removed. Concurrently, clonorchiasis was diagnosed by stool exam and serologic enzyme-linked immunosorbent assay test. Clonorchiasis was treated with praziquantel. Herein, we report a case of intrahepatic bile duct dilatation due to F. hepatica infection with concurrent Clonorchis sinensis infestation. (Korean J Gastroenterol 2014;64:298-301).
- Effect of Yin-Zhi-Huang on up-regulation of Oatp2, Ntcp, and Mrp2 proteins in estrogen-induced rat cholestasis. [JOURNAL ARTICLE]
- Pharm Biol 2014 Nov 25.:1-7.
Abstract Context: Yin-Zhi-Huang (YZH), a prescription of traditional Chinese medicine, is widely used to treat neonatal jaundice or cholestasis. Objective: This study investigates the regulatory effect of YZH on the localization and expression of organic anion transporting polypeptides 2 (Oatp2), Na(+)-taurocholate co-transporting polypeptide (Ntcp), multidrug-resistance-associated protein 2 (Mrp2), and bile salt export pump (Bsep) in estrogen-induced cholestasis rats. Material and methods: Cholestasis model rats were induced via subcutaneous injection of estradiol benzoate (EB, 5 mg/kg/d) for 5 d. Other EB-induced rats were treated with saline (2 ml) or YZH (1.5 g/kg, two times a day) for 7, 14, and 21 d. The biochemical and pathologic examinations were performed. Moreover, the localization and expression of Oatp2, Ntcp, Mrp2, and Bsep were determined by immunohistochemisty and Western blotting, respectively. Results: YZH treatment could significantly decrease the serum total bile acids (TBA) (4.9 ± 0.6-2.8 ± 0.8) and direct bilirubin (DBIL) (2.6 ± 0.7-1.0 ± 0.1) levels, improve the histological disorganization, and, respectively, increase the expression of Oatp2 and Ntcp by 46% and 28% compared with saline-treated (p < 0.05) rats at 14 d. The expression of Mrp2 increased by 45% was observed in YZH treated compared with saline-treated (p < 0.05) rats at 7 d. However, there was a little change in the expression of Bsep (p > 0.05) after YZH treatment for 7, 14, and 21 d. Discussion and conclusion: In conclusion, the therapeutic effect of YZH to cholestasis could be attributed to the regulation of Oatp2, Ntcp, Mrp2, and Bsep.
- Early additional food and fluids for healthy breastfed full-term infants. [JOURNAL ARTICLE]
- Cochrane Database Syst Rev 2014 Nov 25.:CD006462.
Widespread recommendations from health organisations encourage exclusive breastfeeding for six months. However, the addition of other fluids or foods before six months is common in many countries and communities. This practice suggests perceived benefits of early supplementation or lack of awareness of the possible risks.To assess the benefits and harms of supplementation for full-term healthy breastfed infants and to examine the timing and type of supplementation.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 March 2014) and reference lists of all relevant retrieved papers.Randomised or quasi-randomised controlled trials in infants under six months of age comparing exclusive breastfeeding versus breastfeeding with any additional food or fluids.Two review authors independently selected the trials, extracted data and assessed risk of bias.We included eight trials (984 randomised infants/mothers). Six trials (n = 613 analysed) provided data on outcomes of interest to this review. The variation in outcome measures and time points made it difficult to pool results from trials. Data could only be combined in a meta-analysis for one secondary outcome (weight change). The trials that provided outcome data compared exclusively breastfed infants with breastfed infants who were allowed additional nutrients in the form of artificial milk, glucose, water or solid foods.In relation to the majority of the older trials, the description of study methods was inadequate to assess the risk of bias. The two more recent trials, were found to be at low risk of bias for selection and detection bias. The overall quality of the evidence for the main comparison was low.In one trial (170 infants) comparing exclusively breastfeeding infants with infants who were allowed additional glucose water, there was a significant difference favouring exclusive breastfeeding up to and including week 20 (risk ratio (RR) 1.45, 95% confidence interval (CI) 1.05 to 1.99), with more infants in the exclusive breastfed group still exclusively breastfeeding. Conversely in one small trial (39 infants) comparing exclusive breastfed infants with non-exclusive breastfed infants who were provided with artificial milk, fewer infants in the exclusive breastfed group were exclusively breastfeeding at one week (RR 0.58, 95% CI 0.37 to 0.92) and at three months (RR 0.44, 95% CI 0.26 to 0.76) and there was no significant difference in the proportion of infants continuing any breastfeeding at three months between groups (RR 0.76, 95% CI 0.56 to 1.03).For infant morbidity (six trials), one newborn trial (170 infants) found a statistically, but not clinically, significant difference in temperature at 72 hours (mean difference (MD) 0.10 degrees, 95% CI 0.01 to 0.19), and that serum glucose levels were higher in glucose supplemented infants in the first 24 hours, though not at 48 hours (MD -0.24 mmol/L, 95% CI -0.51 to 0.03). Weight loss was also higher (grams) in infants at six, 12, 24 and 48 hours of life in the exclusively breastfed infants compared to those who received additional glucose water (MD 7.00 g, 95% CI 0.76 to 13.24; MD 11.50 g, 95% CI 1.71 to 21.29; MD 13.40 g, 95% CI 0.43 to 26.37; MD 32.50 g, 95% CI 12.91 to 52.09), but no difference between groups was observed at 72 hours of life. In another trial (47 infants analysed), we found no significant difference in weight loss between the exclusively breastfeeding group and the group allowed either water or glucose water on either day three or day five (MD 1.03%, 95% CI -0.18 to 2.24) and (MD 0.20%, 95% CI -1.18 to 1.58).Three trials with four- to six-month-old infants provided no evidence to support any benefit from the addition of complementary foods at four months versus exclusive breastfeeding to six months nor any risks related either morbidity or weight change (or both).None of the trials reported on the remaining primary outcomes, infant mortality or physiological jaundice.We were unable to fully assess the benefits or harms of supplementation or to determine the impact from timing and type of supplementation. We found no evidence of benefit to newborn infants and possible negative effects on the duration of breastfeeding from the brief use of additional water or glucose water, and the quality of the evidence from a small pilot study on formula supplementation was insufficient to suggest a change in practice away from exclusive breastfeeding. For infants at four to six months, we found no evidence of benefit from additional foods nor any risks related to morbidity or weight change. Future studies should examine the longer-term effects on infants and mothers, though randomising infants to receive supplements without medical need may be problematic.We found no evidence for disagreement with the recommendation of international health associations that exclusive breastfeeding should be recommended for healthy infants for the first six months.
- Cholestatic hepatitis from prolonged kratom use: A case report. [JOURNAL ARTICLE]
- Hepatology 2014 Nov 22.
- The validity and reliability of "The liver disease symptom index 2.0" for Turkish society. [Journal Article]
- Turk J Gastroenterol 2014 Oct; 25(5):531-8.
Chronic liver diseases have been shown to adversely affect the quality of life. Standardized tools for patient assessment are of great importance for treatment and follow-up of these patients. In this study, we aimed to determine the validity and reliability of the Liver Symptom Index 2.0 (LDSI 2.0) for Turkish society, for use in other studies and in daily clinical practice.A total of 308 patients with chronic liver disease attending to the outpatient liver clinic of the Department of Gastroenterology, Faculty of Medicine, Dokuz Eylül University between September 2011 and May 2012 were included in this study. A sociodemographic data questionnaire, the LDSI 2.0 comprising 24 items, and the Short Form-36 (SF-36) were completed by the participating patients. After 6 weeks, these tools were re-administered to a total of 115 patients. After obtaining the required permissions, LDSI 2.0 was translated into Turkish using the translation/re-translation method.Of the 308 participants, 160 (51.9%) were male and 184 (43.1%) were female, with an average age of 48.67±13.31 years. Of all cases, 70.5% had viral hepatitis. The average Child-Pugh score was 5.9±1.2, and the average Model For End-Stage Liver Disease (MELD) score was 10.2±3.2. The assessment tool comprised the following sub-items: itching, joint pain, abdominal pain, sleepiness, worry, appetite, depression, fear, jaundice, memory, personality, financial status, use of time, sexual desire, and sexual activity. For more than 50% of the patients, worry (68.8%), depression (65.3%), joint pain (62.3%), itch (56.5%), sleepiness (54.2%), memory problems (53.6), and sexual problems (50%) were present. The internal coefficient of consistency (Cronbach alpha coefficient) was 0.908, which indicates a very high level of consistency. The correlation coefficient for the intraobserver test/re-test reliability was 0.746 (p<0.000), which denotes a significant and good level of reliability. The construct validity between each sub-item of the tool and sub-items of SF-36 was assessed using Spearman's correlation test, which showed a weak to moderate correlation (<0.04 and 0.4-0.7) in the reverse direction.Our study findings provide supportive evidence of the reliability of the assessment tool. Its validity is similar to the original construct validity and was confirmed in our sample. Therefore, it was concluded that LDSI 2.0 was an appropriate tool for daily clinical use and research purposes. Simultaneous use of this life-quality assessment tool and SF-36 will enable a comprehensive but practical assessment of our patients.
- [Biliocalculous disease as a cause of local hepatitis]. [English Abstract, Journal Article]
- Klin Khir 2014 Aug; (8):32-3.
In an acute inflammation of gallbladder inflammatory process spreads on surrounding tissues, including hepatic tissue, what causes the regional hepatitis occurrence. In some patients, suffering calculous cholecystitis on background of transition of inflammatory process from gallbladder to hepatic tissue likewise a regional hepatitis, hyperbilirubinemia, the skin yellowness are revealed, what simulates choledocholithiasis and obturation jaundice.
- [Changes of the hemostasis system in patients, suffering obturation jaundice, caused by choledocholithiasis, and possibilities of their correction with the help of miniinvasive operative interventions]. [English Abstract, Journal Article]
- Klin Khir 2014 Aug; (8):21-3.
Changes in the hemostasis system in choledocholithiasis, taking into account the obturation jaundice severity and possibility of the correction conduction, using miniinvasive operative interventions, were studied. Dynamic of changes in the hemostasis system in patients preoperatively, in 1 and 3 days after endoscopic papillosphincterotomy were monitored, using the method of a low--rate piezoelectric thromboelastography. Basing on analysis of the results, the changes in hemostasis in obturation jaundice were classified, taking into account its degree of severity, what have permitted to select a correct tactics for prophylaxis of hemorrhagic complications intraoperatively and postoperatively.