Gallensteine – interdisziplinäre Behandlung

2020 ◽  
Vol 145 (05) ◽  
pp. 287-295
Author(s):  
Philipp Robert Scherber ◽  
Silvia Eugenia Zúniga ◽  
Matthias Glanemann ◽  
Frank Lammert
Keyword(s):  
Physical Inactivity ◽  
Genetic Factors ◽  
Acute Cholangitis ◽  
Gallstone Formation ◽  
Current Treatment ◽  
Bile Pigment ◽  
Biliary Pancreatitis ◽  
Interdisziplinäre Behandlung ◽  
Treatment Algorithms ◽  
Life Threatening

AbstractGallstones develop in the gallbladder or the bile ducts. According to their chemical composition, gallstones can be divided into cholesterol stones, which are common, and the rare bile pigment stones. Altogether, up to 20 % of all adults develop gallstones and more than 20 % of them symptoms or complications. Female sex, age, pregnancy, physical inactivity, obesity, overnutrition and genetic factors such as ABCB4 deficiency of the hepatic lecithin transporter are kown risk factors for gallstone formation. In about one half of all patients biliary symptoms precede the three common and potentially life-threatening complications (acute cholecystitis, acute cholangitis and biliary pancreatitis). Although our knowledge about the genetics and pathophysiology of gallstones has improved, current treatment algorithms are predominantly invasive (ERC and surgery). Thus, better strategies are needed to prevent the formation of gallstones in general.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

scholarly journals Immunogenetic Predictors of Severe COVID-19

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 211
Author(s):  
Anna Malkova ◽  
Dmitriy Kudlay ◽  
Igor Kudryavtsev ◽  
Anna Starshinova ◽  
Piotr Yablonskiy ◽  
...  
Keyword(s):  
Genetic Factors ◽  
Virus Disease ◽  
Analysis Data ◽  
Published Data ◽  
Diagnostic Significance ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Angiotension Converting Enzyme ◽  
Related Proteins

According to an analysis of published data, only 20% of patients with the new coronavirus infection develop severe life-threatening complications. Currently, there are no known biomarkers, the determination of which before the onset of the disease would allow assessing the likelihood of its severe course. The purpose of this literature review was to analyze possible genetic factors characterizing the immune response to the new coronavirus infection that could be associated with the expression of angiotension-converting enzyme 2 (ACE-2) and related proteins as predictors of severe Corona virus disease 2019 (COVID-19). We analyzed original articles published in Medline, PubMed and Scopus databases from December 2019 to November 2020. For searching articles, we used the following keywords: New coronavirus infection, Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), COVID-19, severe course, complications, thrombosis, cytokine storm, ACE-2, biomarkers. In total, 3714 publications were selected using the keywords, of which 8 were in congruence with all the criteria. The literature analysis of the association of immunogenic characteristics and the expression of ACE-2 and related proteins with the development of severe COVID-19 revealed following genetic factors: HLA-B*46:01 genotype, CXCR6 gene hypoexpression, CCR9 gene expression, TLR7, rs150892504 mutations in the ERAP2 gene, overexpression of wild-type ACE-2, TMPRSS2 and its different polymorphisms. Genes, associated with the severe course, are more common among men. According to the analysis data, it can be assumed that there are population differences. However, the diagnostic significance of the markers described must be confirmed with additional clinical studies.

scholarly journals Hepatoblastoma—The Evolution of Biology, Surgery, and Transplantation

Children ◽  
2018 ◽  
Vol 6 (1) ◽  
pp. 1 ◽  
Author(s):  
Irene Isabel P. Lim ◽  
Alexander J. Bondoc ◽  
James I. Geller ◽  
Gregory M. Tiao
Keyword(s):  
Liver Transplantation ◽  
Disease Free Survival ◽  
International Study ◽  
Current Treatment ◽  
Oncology Group ◽  
Malignant Liver Tumor ◽  
Treatment Algorithms ◽  
Free Survival ◽  
Malignant Liver ◽  
Disease Free

The most common primary malignant liver tumor of childhood, hepatoblastoma has increased in incidence over the last 30 years, but little is still known about its pathogenesis. Discoveries in molecular biology provide clues but have yet to define targeted therapies. Disease-free survival varies according to stage, but is greater than 90% in favorable risk populations, in part due to improvements in chemotherapeutic regimens, surgical resection, and earlier referral to liver transplant centers. This article aims to highlight the principles of disease that guide current treatment algorithms. Surgical treatment, especially orthotopic liver transplantation, will also be emphasized in the context of the current Children’s Oncology Group international study of pediatric liver cancer (AHEP-1531).

scholarly journals Gallstone disease as a clinical marker of metabolic syndrome

2018 ◽  
Vol 15 (3) ◽  
pp. 3-8
Author(s):  
Andrey A. Svistunov ◽  
Miсhail A. Osadchuk ◽  
Natalia V. Kireeva ◽  
Alexey M. Osadchuk
Keyword(s):  
Metabolic Syndrome ◽  
Prognostic Model ◽  
Clinical Medicine ◽  
Gallstone Disease ◽  
Acute Cholangitis ◽  
Economic Losses ◽  
Additional Risk ◽  
The Metabolic Syndrome ◽  
Life Threatening ◽  
Complications Of Cholelithiasis

The prevalence of cholelithiasis, its close pathogenetic connection with metabolic syndrome, high frequency of surgical intervention, significant economic losses put forward this comorbid pathology in a number of leading problems of modern clinical medicine. The factors associated with the metabolic syndrome not only increase the risk of developing cholelithiasis, but also form the basis of non-drug and drug therapy. Metabolic syndrome often determines the occurrence of three common and potentially life-threatening complications of cholelithiasis: acute cholecystitis, acute cholangitis and biliary pancreatitis. Therefore, the solution of this problem is associated with the need for early detection of additional risk factors for cholelithiasis, optimization of the early diagnostic and prognostic model of existing multi-organ pathology with the aim of reducing the progression of the disease and its complications. The data obtained in recent years on the human genome with metabolic syndrome and cholelithiasis make it possible to predict the development of comorbid pathology and to fully ensure the effectiveness of primary prevention.

scholarly journals Su1439 DOES EARLY ERCP AFFECT OUTCOMES IN PATIENTS WITH ACUTE BILIARY PANCREATITIS WITHOUT ACUTE CHOLANGITIS? ANALYSIS OF NATIONWIDE DATABASE

2020 ◽  
Vol 91 (6) ◽  
pp. AB347-AB348
Author(s):  
Sachit Sharma ◽  
Muhammad Aziz ◽  
Zubair Khan ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Simcha Weissman ◽  
...  
Keyword(s):  
Acute Cholangitis ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Nationwide Database

Prevention of Obesity and Physical Inactivity

2017 ◽  
Author(s):  
Ambika Satija ◽  
Frank B. Hu
Keyword(s):  
Body Weight ◽  
Physical Inactivity ◽  
Individual Autonomy ◽  
New Paradigm ◽  
Traditional Concept ◽  
Physical Context ◽  
Life Threatening ◽  
Healthy Body Weight ◽  
The Individual ◽  
Individual Choices

Energy imbalance, obesity, and physical inactivity are key risk factors for at least eight types of cancer as well as other life-threatening conditions. Obesity results from an excess of energy intake relative to energy expenditure over time. Until recently, the onus for maintaining a healthy body weight was placed predominantly on the individual. The traditional concept of individual autonomy cannot explain the rapid worldwide increase in obesity and physical inactivity over the last 40 years. A new paradigm has emerged, in which individual choices are important, but these choices are made within a social, economic, and physical context that profoundly influences the options. Food choices are affected by the availability and pricing of different products and by social norms about eating patterns body weight. Urbanization and a more rapid pace of life reduce access to homegrown and home-cooked foods, and mechanization replaces the need for walking and manual labor.

Pemphigus Vulgaris: Update on Etiopathogenesis, Oral Manifestations, and Management

2002 ◽  
Vol 13 (5) ◽  
pp. 397-408 ◽  
Author(s):  
Crispian Scully ◽  
Stephen J. Challacombe
Keyword(s):  
Pemphigus Vulgaris ◽  
Intravenous Immunoglobulins ◽  
Current Treatment ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ashkenazi Jews ◽  
Normal Human Skin ◽  
Autoimmune Blistering Disease ◽  
Systemic Corticosteroids ◽  
Life Threatening ◽  
Systemic Infections

Pemphigus is a group of potentially life-threatening diseases characterized by cutaneous and mucosal blistering. There is a fairly strong genetic background to pemphigus with linkage to HLA class II alleles. Certain ethnic groups, such as Ashkenazi Jews and those of Mediterranean origin, are especially liable to pemphigus. Pemphigus vulgaris (PV), the most common and important variant, is an autoimmune blistering disease characterized by circulating pathogenic IgG antibodies against desmoglein 3 (Dsg3), about half the patients also having Dsg1 autoantibodies. Oral lesions are initially vesiculobullous but readily rupture, new bullae developing as the older ones rupture and ulcerate. Biopsy of perilesional tissue, with histological and immunostaining examinations, is essential to the diagnosis. Serum autoantibodies to either Dsg1 or Dsg3 are best detected by both normal human skin and monkey esophagus or by enzyme-linked immunosorbent assay (ELISA). Before the introduction of corticosteroids, pemphigus vulgaris was typically fatal mainly from dehydration or secondary systemic infections. Current treatment is largely based on systemic immunosuppression using systemic corticosteroids, with azathioprine, dapsone, methotrexate, cyclophosphamide, and gold as adjuvants or alternatives, but mycophenolate mofetil and intravenous immunoglobulins also appear promising.

scholarly journals Are the current diagnostic criteria for acute cholangitis applicable in patients with acute biliary pancreatitis?

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e854
Author(s):  
N.J. Schepers ◽  
O.J. Bakker ◽  
U.A. Ali ◽  
E.J.M. van Geenen ◽  
H.C. van Santvoort ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Acute Cholangitis ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis

scholarly journals A mouse model of necrotic biliary pancreatitis induced by combining gallstone formation and ligation of the biliary-pancreatic duct

2017 ◽  
Author(s):  
Zuobiao Yuan ◽  
Junyuan Zheng ◽  
Zhu Mei ◽  
Guoyong Hu ◽  
Yue Zeng
Keyword(s):  
Mouse Model ◽  
Pancreatic Duct ◽  
Gallstone Formation ◽  
Diet Group ◽  
Control Group ◽  
Chow Diet ◽  
Sham Operation ◽  
Biliary Pancreatitis ◽  
High Fat ◽  
Lithogenic Diet

AbstractObjectiveThe aim of the present investigation is to develop a mouse model of biliary pancreatitis with characteristics of both gallstone formation and pancreatitis, mimicking the human etiology and pathphysiological character.DesignMale C57BL/6 mice were fed with chow, high fat/cholesterol and lithogenic diet for 12 weeks respectively. Laparotomy was done followed by ligation of pancreatic duct (PD), bile duct and pancreatic duct (BPD), or sham operation.ResultsLittle or no evidence of pancreatitis was observed in PD group of mice fed with chow or high fat/cholesterol diet, or in the tail of pancreata removed from animals fed with lithogenic diet. In the head of pancreas, pancreas damage was dramatically more severe in the lithogenic group. When bile reflux was blocked by BPD, pancreas damage markedly reduced to level of chow diet group. The lithogenic diet group also developed significantly more severe multi organ dysfunction syndrome (MODS) in the lung, kidney and liver. The severity of pancreatitis is associated with persistent high bile level of cholesterol and bile acid after obstruction of the biliary-pancreatic duct. Cholesterol crystal aggravated injury of pancreatic acinar cells caused by taurocholate. After obstruction of the biliary-pancreatic duct, in the lithogenic diet group, liver Abcg8 and Cyp7a1 was up-regulated, compared to the control group.ConclusionWe developed a mouse model of severe biliary pancreatitis in both local pancreas damage and MODS. This model provides a sound explanation for the Opie theory dilemma and a potential therapeutical direction in clinical practice as well.Summary statementA biliary pancreatitis has characters of both gallstone and pancreatitis, mimicking human etiology and pathophysiology, which gave a clear answer to the long time Opie theory dilemma.

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