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.
Bile contains water, cholesterol, fats, bile salts, proteins, and bilirubin. Bile salts breaks up fats, and bilirubin gives bile and stool a yellowish color. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, under certain conditions it can harden into stones. They may occur as a simple, large stone or many small ones. Gallstones are mixtures of compound, but are mostly cholesterol.
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A 46-year-old Hispanic man presented to the clinic for a routine physical and a review of his recent laboratory studies. His medical history was significant for high cholesterol. His daily medication regimen included a multivitamin, aspirin 81 mg, and simvastatin (Zocor) 40 mg for high cholesterol. His family history was remarkable for type 2 diabetes, hypertension, and hyperlipidemia in his mother, maternal grandmother, maternal aunt, and maternal uncle. Physical examination revealed a height of 69 inches, weight of 199 pounds, body mass index (BMI) of 29.4 kg/m2, waist circumference of 36 inches and blood pressure of 125/72 mm Hg. Initial laboratory results were: total cholesterol 195 mg/dL; triglycerides 136 mg/dL; low-density lipoprotein cholesterol (LDL), 124 mg/dL; high-density lipoprotein cholesterol (HDL), 44 mg/dL; and fasting plasma glucose (FPG), 119 mg/dL. Complete blood count, renal function and liver function tests were all normal. Additional studies included an oral glucose tolerance test (OGTT) of 157 mg/dL and hemoglobin A1c (HbA1c) of 5.9%. The patient’s physical exam was unremarkable with no abnormalities noted.
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
In the journal article, A Staging System for Congenital Cholesteatoma, the researchers aimed to develop a staging system for congenital cholesteatoma in order to determine an association between stage and residual disease. They defined four stages: Stage 1, single quadrant affected; stage 2, multiple quadrants affected, but not affecting the ossicles or mastoid extension; stage 3, ossicles are affected but not the mastoid extension; stage 4, mastoid disease. The creation of this staging system helps in standardizing the reporting of congenital cholesteatoma (Potsic, Samadi, Marsh, & Wetmore, 2002). Patients with higher stages of the disease have been shown to have worse postoperative hearing and a higher chance of having a cholesteatoma present during a second look follow up visit.
(What is....2016). The first documented case of Crohn’s disease suspected was King Alfred in 850 A.D. This disease is named after a Jewish man named Dr. Burrill Bernard Crohn (1884-1983) who became interested in the condition as his father, also a Dr, suffered from a disorder of the bowel. He devoted his career to “regional enteritis” the disease that now bares his name. It is necessary to understand the disease to be able to provide care for people who are afflicted by it (de Campos and Kotze 2013). Especially since Crohn’s is a chronic disease or a lifelong affliction it’s important to understand etiology, it’s symptoms, treatments, and to maintain the disease and the psychological well being of the patient managed (Crohn’s...2015).
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.
After seeing the recent post by Aimee Rouski on facebook. I became curious about Crohn 's Disease. I had little to no knowledge of the disease, and had heard little about it. In this article I will share my research into Symptoms of Chrons, Chrons Diet, and Medicine for Crohns.
Hypercholesterolemia is the presence of high levels of cholesterol in the blood. Cholesterol is a waxy fat-like substance and is a major class of lipid, so it gets into the blood by lipoproteins [1]. A high level of lipoproteins is unhealthy. A high level can result in an elevated risk of atherosclerosis and coronary heart disease [2]. The high levels of lipoproteins are often influenced by a combination of genetic and environmental factors such as obesity or dieting habits [2]. High cholesterol can be caused by mutations in the following genes: APOB, LDLR, LDLRAP1, and PCSK9 [3]. Mutations in the LDLR gene are responsible for causing familial hypercholesterolemia, which is the most commonly seen form of inherited high cholesterol [3]. The LDLR gene contains instructions for making LDL receptors or low-density lipoprotein receptors. LDL receptors play critical roles in regulating levels of cholesterol in the blood by removing low-density lipoproteins from the bloodstream. Mutations in the LDLR gene can make the amount of LDL receptors produced less than normal or affect their job of removing the low-density lipoproteins in the blood [4]. People who have these mutations will have higher levels of cholesterol. There are many ways that the environment can affect the levels of cholesterol in the blood. Reducing the amount of dietary fat you consume lowers the total amount of cholesterol in the blood [5]. Sucrose and fructose can raise the amount of LDL in the blood. Reducing fatty foods will however lower the amount of LDL [5]. Having a healthy body and maintaining physical exercise plays a key role in keeping your cholesterol at a healthy level. If you are overweight or obese you can lower your cholesterol levels by simply losing ...
IBS is a functional GI disorder, meaning it cannot be explained by any specific structural or biochemical abnormality. The disorder is subdivided into three different types, which are named on the basis of the predominant symptom – IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), IBS-M (mixed diarrhea and constipation). Clinical presentation varies considerably with regard to the quality of the predominant feature and the overall severity of symptoms. Formal diagnosis is based on the most recent Rome III criteria, which require that a patient experience recurrent abdominal discomfort of at least 3 days per month over the previous 3 months, with a total symptom duration of at least 6 months, in...
Wakefield, A. J., Murch, S. H., Anthony, M. A., Linnell, J., Casson, D. M., Malik, M., Berelowitz, M., Dhillon, A. P., Thomson, M. A., Harvey, P., Valentine, A., Davies, S. E., & Walker-Smith, J. A. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, 351(9103), 637–641.
The sonographic appearance varies depending on of the Hepatitis is acute or chronic. In acute hepatitis you will see a normal texture or portal veins will be more prominent. The liver appears hypoechoic. Attenuation might be present in acute Hepatitis. Gallbladder walls are thickened and hepatosplenomegaly. In chronic Hepatitis the parenchyma will appear coarsed with decreased brightness of the portal triad. Attentuaion is not as great in chronic Hepatitis. Fibrosis may occur with soft shadowing. The size of the liver is decreased and appears hyperechoic.
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).
The tendency to build up high cholesterol may run in families, but extremely high levels are usually the result of a poor diet high in saturated fats and calories, along with little or no exercise. In some cases, high levels of cholesterol may be associated with undiagnosed medical symptoms such as diabetes or low thyroid function. According to the American Heart Association, there would eventually be a 50 percent lower rate of heart disease if Americans would lower their blood cholesterol levels by 25 percent. These statements find confirmation in a 1984 report done by the National Heart, Lung and Blood Institution on the results of a 10 year study. It showed that for every 1 percent of lowered cholesterol, the chances of a heart attack are lowered by 2 percent.
The presentation of HCC has changed significantly over recent years especially in developed countries. In the past, HCC generally presented at an advanced stage with right upper quadrant pain, weight loss, and signs of decompensated liver disease. It is currently more regularly identified at an earlier stage as a result of routine screening of patients with known cirrhosis. This screening usually comes in the form of imaging studies and serum alpha-fetoprotein measurements2.