Background and objectives: Many liver diseases are accompanied by jaundice. Differentiation of cholestatic from non-cholestatic jaundice is important. Cholestatic jaundice most probably occurs due to a pathological condition and the most frequent causes in early infancy are neonatal hepatitis and biliary atresia in early life. Early diagnosis and treatment of infantile cholestasis can improve prognosis of liver diseases by prevention of the complications of these disorders.
Patients and Methods: In this retrospective study, 122 infants under 3 months of age with cholestasis in Nemazi Hospital (affiliated to Shiraz University of Medical Sciences) during the years 2001-2011 were studied. Demographic data, duration of jaundice, liver biopsy and the causes of cholestasis were recorded.
Results: There were 76 males (62.3%) and 46females (37.7%) with a mean age of 54.4 ± 23.7 days. The most common clinical finding was Jaundice that was seen in all patients (100%) .The onset of jaundice was the first day to the fifty two days of age, with an average age of 15.6 ± 16.1 days. Other findings included hepatomegaly in 92 patients (76.4%), claycolor stool in 54 (44.3%), and splenomegaly in 29 patients (23.8%). In this study, the most common causes of cholestasis were biliary atresia (30=24.6%), idiopathic neonatal hepatitis (30= 24.6%) and bile ducts paucity (16=10.3) .
Conclusions: The results of this study showed that neonatal hepatitis and biliary atresia are the most common causes of infantile cholestasis in this area. This is a crucial warning that necessitates defining and implementing a regular system for faster diagnosis for patient management in golden time.
Keywords: Cholestasis, Biliary atresia, neonatal hepatitis.
Introductio...
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...most important causes of cholestasis in this region; therefore, more attention to them can help physicians to manage patients better and more effectively. In general, the results of this study are consistent with those of previous studies and it seems that the most important factor in managing patients is defining and implementing a regular system for faster diagnosis.
Finally the shortages of this study are its retrospective nature and the lack of patients’ survival reviews. Due to the sensitive nature of the disease and the need for education of GPs and pediatricians about the causes of cholestasis and its diagnosis, there is a need for more accurate studies. It is suggested that more attention should be paid to genetically determining the metabolic disorders and the facilities should be provided for diagnosis of these diseases in great centers of r medical cares.
I. Introduction: It is estimated that approxiamately 10 to 20 percent of the population in the United States and Western Europe are currently being affected by Gallbladder attacks.
Strasberg SM (2008). "Acute Calculous Cholecystitis". New England Journal of Medicine 358 (26): 2804–2811. doi: 10.1056/NEJMcp0800929. PMID 18579815
Acute pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) appears to be the most frequent major complication, occurring in 1-10% of patients overall, with a mortality rate ranging from 0.2-0.6% and an annual healthcare expenditure cost reaching $150 million in USA alone (1) (2). Several risk factors have been reported to play a role in ERCP-induced pancreatitis; some are patient-related (i.e. sphincter of Oddi dysfunction (SOD), female gender, history of pancreatitis, pancreatic acinar opacification), while others are procedure-related (i.e. precut or needle-knife endoscopic sphincterotomy, repeated pancreatic duct injection, difficult cannulation), and this may be useful in stratifying patients into low-risk or and high-risk categories (3).
This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the liver that interferes with its normal functions including alcoholism. Most people who drink large amounts of alcohol cause harm to the liver in some way (Heidelbaugh & Bruderly, 2006). The cause of cirrhosis is not yet known, but the connection between cirrhosis and excessive alcohol ingestion is established (Jenkins & Johnson, 2010). Common causes of cirrhosis include: alcohol abuse, hepatitis B infection, hepatitis C infection and non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (Schuppan & Afdhal, 2008).
Cabaltica, R, Lange C, Lange J. AAFP.org. American Academy of Family Physicians. September 1, 2000. < http://www.aafp.org/afp/20000901/1035.html>
This patient has been seen every 6 months for a focused physical examination with a total cholesterol, liver function panel and a FPG to evaluate his diabetes status and cholesterol management program. He has attended nutrition counseling in the past and has complied with lifestyle modifications including diet and exercise resulting in a weight loss of eight pounds over the past year. Over the pasts twelve months, this patient’s total cholesterol levels have significantly improved from 280 mg/dL to 190 mg/dL. This is the second time h...
Tokuhara, K., Hamada, Y., Yui, R., Tanano, A., Takada, K. and Kamiyama, Y. 2005. Congenital biliary dilatation in dizygotic twins. Pediatric surgery international, 21 (1), pp. 17-19.
•The forty five year old patient is diagnosed with the progressive cirrhosis inflaming the liver along with the parenchymal cells. The plain symptoms is manifested primarily because of the augmentation of edema internally in the lower abdomen.
Celiac Disease, also known as gluten intolerance, is an autoimmune disorder and it affects nearly 1 in every 133 people. A protein in wheat known as gliadin causes a person’s immune system to attack its own bowel and digestive system. This protein is also found in other grains such as rye, barley and oats. There are villi in the small intestine whose job is to absorb nutrients from the foods eaten. Since the body is attacking itself it causes the villi to atrophy and it erodes the nutrient absorbing villi, as it actually shortens and flattens the villi. Due to the affect of the gliadin proteins, it can cause irreversible damage to the lining of the small intestines and its villi. This condition seems to be genetic and can be passed down through generations. It was traditionally thought that this condition only affected People of European dissent, but recent studies show that it is also seen in people of Hispanic, Asian and African American dissent as well. There are blood tests that can be done to determine if one has celiac disease which is very helpful. If getting a blood test or an endoscopy done it is very important that gluten is still being consumed so as the see what affects it has on the body. Celiac disease can cause a myriad of other conditions like intestinal lymphoma; osteoporosis; anemia and it can stunt growth in children due to the fact that the body cannot absorb nutrients causing severe malabsorption of essential nutrients and vitamins.
There are many different types of diseases that dental hygienist have to be aware of. It is important to know the basic information about the disease and how the disease affects the patient’s oral cavity as well as how to treat the patient. This paper will be addressing liver disease and more specifically, liver disease caused by hepatitis. “The term liver disease applies to many diseases and disorders that cause the liver to function improperly or stop functioning.” (U.S. National Library of Medicine. “Liver Disease.”) A couple signs and symptoms include fever, dark urine, abdominal pain and jaundice, which is the yellowing of the eyes and skin. (U.S. National Library of Medicine. “Liver Disease.”)
The bile that is made in the liver travels to the small intestine by the bile ducts (these are small, tube-like structures where they carry bile from the gall bladder and empty it into the first part of the small intestine, called the duodenum). However, if the small intestine doesn’t need the bile, it will enter the gall bladder where it waits for a signal from the intestines that the food is present.
A working diagnosis of coeliac disease has been made for patient MJ, in this report I will explain and analyse the patient’s immune responses and attempt to suggest several treatments. Coeliac disease is usually triggered by the ingestion of gluten which contains the peptide gliadin found in wheat, alternatively other peptides in the prolamin family are able to elicit an immune response in CD sufferers (C. Gianfrani, 2005). The gliadin antigen works by enlarging tight junctions, allowing larger proteins to permeate through the membrane (Lammers, K.M., 2008), thus inducing an immune response and leading to small intestine enteropathy (C. Gianfrani, 2005). CD is a relatively common disease, it’s estimated that 1% of the population in the US and in Europe suffer from the condition (Catassi, C., et al., 2001). It is a multifactorial disease hence depending upon several aspects such as environmental and genetic input (Sollid, L.M., 2000).
All the conditions previously mentioned are highly correlated to hyperinsulinemia or Insulin resistance group. Also cancer specially in female patients with a high mortality rate still been studied to find out it’s correlation to genetics or to the Omega 6 fatty acids
Zein, N. N., & Edwards, K. (2009). The Cleveland Clinic guide to liver disorders. New York: Kaplan Pub.
Many of the disorders identified by newborn screening programs are heterogeneous. For proper screening, specialized laboratory testing, interpretation, and treat...