CO4 THREE YEAR FOLLOW-UP AFTER KASAI PORTOENTEROSTOMY FOR BILIARY ATRESIA: OUTCOMES AND ROLE OF HIGH DOSE STEROID THERAPY

2009 ◽  
Vol 41 ◽  
pp. S200
Author(s):  
M. Colusso ◽  
E. Zaranko ◽  
C. Terzi ◽  
M. Cheli ◽  
P. Stroppa ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Steroid Therapy ◽  
High Dose ◽  
Kasai Portoenterostomy ◽  
High Dose Steroid

scholarly journals Does Adjuvant Steroid Therapy Post-Kasai Portoenterostomy Improve the Outcome of Biliary Atresia? A Systematic Review and Meta-Analysis

2011 ◽  
Vol 25 (8) ◽  
pp. 440-444 ◽  
Author(s):  
Ahmed Sarkhy ◽  
Richard A Schreiber ◽  
Ruth Milner ◽  
Collin C Barker
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Biliary Atresia ◽  
Steroid Therapy ◽  
Observational Studies ◽  
Serum Bilirubin ◽  
Meta Analysis ◽  
Kasai Portoenterostomy ◽  
Significant Difference

BACKGROUND: The role of adjuvant steroid therapy in the postoperative management of patients with biliary atresia (BA) is unclear.OBJECTIVE: To systematically review the literature and perform a meta-analysis to determine the efficacy of adjuvant steroid therapy post-Kasai portoenterostomy (KP) on BA outcome.METHODS: A systematic review and meta-analysis of randomized trials and/or observational studies that examined the role of steroids on BA outcomes published between January 1969 and June 2010 was conducted. Studies were identified using the Medline, PubMed, EMBASE and Cochrane databases.RESULTS: Sixteen observational studies and one randomized controlled trial (RCT) were found. Four of the 16 observational studies (160 participants) and the RCT (73 participants) met the entry criteria and were eligible to be included in the analysis. There was no statistically significant difference in the effect of steroids either on normalizing serum bilirubin levels at six months (pooled OR 1.48 [95% CI 0.67 to 3.28]) or in delaying the need for early liver transplantation (within the first year post-KP (pooled OR 0.59 [95% CI 0.21 to 1.72]).CONCLUSION: The present meta-analysis did not find a significant effect of steroid over standard therapy, either in normalizing serum bilirubin levels at six months or at delaying the need for early liver transplantation post-KP. RCT studies of sufficient size and comprehensive design using high-dose steroids are needed to determine the effectiveness of steroids on the short and intermediate post-KP outcomes for BA patients.

scholarly journals The role of high-dose steroid therapy in Covid-19 pneumonia

2021 ◽  
Author(s):  
Ayperi Ozturk ◽  
Figen Ozturk Ergur ◽  
Suna Kavurgacı ◽  
Melahat Uzel Şener ◽  
Murat Yıldız
Keyword(s):  
Mortality Rate ◽  
Low Dose ◽  
High Dose ◽  
Efficacy And Safety ◽  
Short Term ◽  
High Dose Steroid ◽  
Younger Age ◽  
Observation Period

Introduction: Today, whereas hypoxemia and respiratory failure is the major challenging problem in the course of severe COVID-19 pneumonia, to control the disease at a mild-moderate stage or to stop the inflammation by recognizing the cytokine storm early should be the most prominent goal. We aimed to reveal the clinical efficacy and safety of short-term high-dose corticosteroids in severe COVID-19. Material and Methods: This retrospective observational study consisted of 54 patients who were given high-dose steroid (HDS (>250 mg/day methylprednisolone, 3 days.). Low-dose steroid (LDS) therapy (dexamethasone 8 mg ) was applied to all patients. HDS group was reviewed in terms of decreasing hospital mortality and preventing fibrosis development in follow-up. Results: During the observation period, out of 317 severe COVID-19 pneumonia hospitalized, HDS and LDS were administered to 54 and 216 patients, respectively. Higher body mass index, younger age, more oxygen need of patients at admission, and more need for advanced oxygen therapy during hospitalization were found in the HDS group (p<0.001). Furthermore, 18.5% of patients in the HDS group had need transfer to the intensive care unit whereas it was 3.8% in LDS (p<0.001). Additionally, the mortality rate was determined higher in the HDS group (25. 9% vs 9.9%, p<0.001). The HDS group had lower saturated O2 [IQR, 85% (76-89), p <0.001], and higher ferritin at admission. It was found that HDS was given simultaneously with the increased ferritin with deepening lymphopenia on the third and fifth days. There was no difference in fibrosis development between HDS patients receive and not (15.4% vs 26.2%, p=0.11) Conclusion: The use of HDS in hospitalized COVID-19 patients remains unclear. Along with this, our study demonstrated the use of high-dose corticosteroids might not be associated with a lower mortality rate among hospitalized severe COVID-19 patients.

Mediastinal lipomatosis: a complication of high dose steroid therapy in children

1988 ◽  
Vol 19 (1) ◽  
pp. 57-58 ◽  
Author(s):  
L. W. Shukla ◽  
J. A. Katz ◽  
M. L. Wagner
Keyword(s):  
Steroid Therapy ◽  
High Dose ◽  
High Dose Steroid

scholarly journals Role of Hepatobiliary Scintigraphy and Ultrasonography in the Diagnosis of Biliary Atresia in Infant with Neonatal Jaundice – Experiences in NINMAS

2017 ◽  
Vol 18 (1) ◽  
pp. 51-53
Author(s):  
Nasreen Sultana ◽  
Zeenat Jabin ◽  
Md Bashir ◽  
Rahima Parveen ◽  
Shamim MF Begum ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Gall Bladder ◽  
Biliary Atresia ◽  
False Positive ◽  
Hepatic Dysfunction ◽  
Hepatobiliary Scintigraphy ◽  
Hida Scan ◽  
Complementary Role

Objective: The purpose of this study was to determine whether gall bladder visualization can help to exclude the biliary atresia in hepatobiliary scintigraphic studies of infants with persistent jaundice.Methods: This is a retrospective study carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS). Study subjects include infants with neo-natal jaundice who underwent Hepatobiliary scintigraphies for suspected biliary atresia and study period was 2 years. Food was withheld for 4 hours before the examination. Anterior images of liver and gall bladder were taken after i/v administration of 2 -3 mci 99m Tc labeled Brida (HIDA) at 5 min interval for 2 hours then at 4 hours and 24 hours. Non-visualization of bowel activity in HIDA scan in 24hours delayed images was considered as cases of diagnosis of biliary atresia.Results: Thirty-six patients were included in this retrospective study. Patent biliary channels was seen by scintigraphies in 17(47%) patients and biliary atresia was seen in 19(52%) patients. By abdominal US non- visualization of gall bladder were found in 25(69%) cases and gall bladder visualized in 11(30%) cases. Eight (22%) of 36 patients had biopsy confirmed biliary atresia; all of these had positive scintigraphies and (60%) had positive sonographic findings. Among the 5 false-positive scintigraphies caused by hepatic dysfunction and 2 had normal sonography. Thirty-six patients had periscintigraphic sonography. There were 25/36 (61%) abnormal studies, which included cases with small gallbladder (n = 8) and non-visualized gallbladder (n = 17), but not periportal fibrosis.Conclusion: Gall bladder was usually visible on Hepatobiliary scintigraphy of fasting patients with biliary patency.  Both hepatobiliary scintigraphy and sonography are currently the standard imaging investigations for suspected biliary atresia. The complementary role, in which scintigraphy and sonography are important, and recommend follow-up imaging reassessment before making definitive surgical decisions. This will serve to decrease the frequency of false-positive imaging diagnoses of biliary atresia, and hence, avoid unnecessary surgeries.Bangladesh J. Nuclear Med. 18(1): 51-53, January 2015

scholarly journals Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy

2020 ◽  
Vol 6 (3) ◽  
pp. 513-516
Author(s):  
Fernando Diaz Dilernia ◽  
Martin M. Estefan ◽  
Gerardo Zanotti ◽  
Fernando Comba ◽  
Francisco Piccaluga ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Steroid Therapy ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
High Dose ◽  
High Dose Steroid ◽  
Neck Fracture

scholarly journals Long-Term Effects of Kasai Portoenterostomy for Biliary Atresia Treatment in Russia

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 686
Author(s):  
Anna Degtyareva ◽  
Alexander Razumovskiy ◽  
Nadezhda Kulikova ◽  
Sergey Ratnikov ◽  
Elena Filippova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Critical Importance ◽  
Long Term Effects ◽  
Age Related

This prospective study enrolled 144 patients after surgical treatment of biliary atresia in early infancy. We analyzed the immediate effectiveness of the surgery and the age-related structure of complications in the up to 16-year follow-up. The immediate 2-year survival rate after the surgery constituted 49.5%. At the time of this writing, 17 of the patients had celebrated their 10th birthdays with good quality of life and no indications for transplantation of the liver. The obtained results underscore the critical importance of surgical correction of biliary atresia by Kasai surgery in the first 60 days of life and subsequent dynamic follow-up of patients for the purpose of the early detection and timely correction of possible complications.

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