scholarly journals Indirect Fist Percussion of the Liver Is a More Sensitive Technique for Detecting Hepatobiliary Infections than Murphy’s Sign

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Takeshi Ueda ◽  
Eri Ishida
Keyword(s):  
Acute Cholecystitis ◽  
Acute Cholangitis ◽  
Clinical Findings ◽  
Hepatic Cyst ◽  
Charcot’S Triad ◽  
Hepatobiliary Diseases ◽  
Murphy’S Sign ◽  
Low Sensitivity ◽  
High Level ◽  
Murphy's Sign

Background. Murphy’s sign and Charcot’s triad are established clinical findings of acute cholecystitis and cholangitis, respectively, but both show low sensitivity and limited clinical application. We evaluated if indirect fist percussion of the liver improves the efficiency of diagnosing cholecystitis and cholangitis when used as a diagnostic adjunct.Methods. The presence/absence of right upper quadrant (RUQ) tenderness, Murphy’s sign, and pain induced by indirect fist percussion of the liver was assessed, and the results were compared with the definite diagnosis based on ultrasound and additional examinations in patients aged over 18 who visited our outpatient clinic with suspected hepatobiliary diseases.Results. Four hundred and eight patients were investigated, and 40 had hepatobiliary infection (acute cholecystitis: 10, acute cholangitis: 28, liver abscess: 1, and hepatic cyst infection: 1). The sensitivity of indirect fist percussion of the liver for diagnosing hepatobiliary infection was 60%, being significantly higher than that of RUQ tenderness (33%) and Murphy’s sign (30%), and its specificity was 85%. There was no significant improvement in sensitivity or diagnostic accuracy when Murphy’s sign was combined with indirect fist percussion of the liver.Conclusion. Indirect fist percussion-induced liver pain is a useful clinical finding to diagnose hepatobiliary infection, with high-level sensitivity.

Sonography of Acute Cholecystitis: Murphy's Sign or Murphy's Law?

2011 ◽  
Vol 37 (8) ◽  
pp. S87
Author(s):  
A.C. Friedman ◽  
P. Mukerji ◽  
A. Buadu ◽  
C. Grandone
Keyword(s):  
Acute Cholecystitis ◽  
Murphy’S Sign ◽  
Murphy's Sign

scholarly journals The Relationship between Inflammatory Cytokines and Coagulopathy in Patients with COVID-19

2021 ◽  
Vol 10 (9) ◽  
pp. 2020
Author(s):  
Fariba Rad ◽  
Ali Dabbagh ◽  
Akbar Dorgalaleh ◽  
Arijit Biswas
Keyword(s):  
Inflammatory Cytokines ◽  
Interleukin 1 ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Necrosis Factor Alpha ◽  
Coagulation Parameters ◽  
Increased Risk ◽  
Cytokine Levels ◽  
Α Level ◽  
High Level

Coronavirus disease 2019 (COVID-19), with a broad range of clinical and laboratory findings, is currently the most prevalent medical challenge worldwide. In this disease, hypercoagulability and hyperinflammation, two common features, are accompanied by a higher rate of morbidity and mortality. We assessed the association between baseline inflammatory cytokine levels and coagulopathy and disease outcome in COVID-19. One hundred and thirty-seven consecutive patients hospitalized with COVID-19 were selected for the study. Baseline interleukin-1 (IL-1), IL-6, and tumor necrosis factor alpha (TNF-α) level were measured at time of admission. At the same time, baseline coagulation parameters were also assessed during the patient’s hospitalization. Clinical findings, including development of thrombosis and clinical outcome, were recorded prospectively. Out of 136 patients, 87 (~64%) had increased cytokine levels (one or more cytokines) or abnormal coagulation parameters. Among them, 58 (~67%) had only increased inflammatory cytokines, 12 (~14%) had only coagulation abnormalities, and 17 (19.5%) had concomitant abnormalities in both systems. It seems that a high level of inflammatory cytokines at admission points to an increased risk of developing coagulopathy, thrombotic events, even death, over the course of COVID-19. Early measurement of these cytokines, and timely co-administration of anti-inflammatories with anticoagulants could decrease thrombotic events and related fatal consequences.

Influence of Irrational Beliefs and Sensitivity to a Person on Future Psychology Students’ Propensity to Coercion or Nonviolence

2021 ◽  
pp. 143-165
Author(s):  
V.G. Maralov ◽  
◽  
V.A. Sitarov ◽  
Keyword(s):  
Irrational Beliefs ◽  
High Sensitivity ◽  
Daily Practice ◽  
Psychology Students ◽  
State Universities ◽  
Low Level ◽  
Level Of Understanding ◽  
Low Sensitivity ◽  
High Level ◽  
Dependent Type

The relevance of the problem is due to the importance of identifying factors that determine the propensity of students to coercion or nonviolence, creating psychological and pedagogical conditions for the formation of the socionomic sphere of nonviolent competencies for future specialists at universities. The theoretical basis of the study was the position of nonviolence as a daily practice of interaction, by which we understand the ability of a person to choose from a number of possible alternatives that carry the least charge of coercion. The aim of the work was to study the influence of irrational beliefs and sensitivity to a person (interest, empathy, understanding and assistance) on the students’ tendency to coercion, manipulation, non-violence and non-interference in the processes of interaction with people. The hypothesis was tested that the tendency of students to coercion, manipulation, and noninterference will be due to expressed irrational beliefs and low level of sensitivity to a person and the tendency to non-violence will be explained by the absence of irrational beliefs and a high level of sensitivity to a person. The study involved 125 students of pedagogical and psychological faculties of the Moscow Humanitarian and Cherepovets State universities. The authors used questionnaires to identify the positions of interaction among students and sensitivity to a person, as well as a list of irrational beliefs proposed by A. Beck and A. Freeman. It is established that the tendency to both coercion and manipulation are determined by the beliefs of anti-social type and low sensitivity to the person. The tendency to manipulate the narcissistic beliefs, high interest in people and understanding them, at the same time the tendency to non-violence and non-interference are determined by beliefs of avoidant and dependent types with a low level of understanding people. And a tendency to non-interference is determined by beliefs of dependent type with unexpressed orientation on helping. The tendency to nonviolence is determined by the high sensitivity to a person and the absence of irrational beliefs of antisocial, passive-aggressive and narcissistic types. As a result, the conclusion is made about the need to form purposefully the ability to nonviolent interaction among students, which should include the work on awareness and overcoming irrational beliefs and the development of sensitivity to a person. The obtained results can be used in practical work with students on the formation of their nonviolent competencies.

Changes in Serum Succinyltrialanine P-Nitroanilide Hydrolysing Activity in Hepatobiliary Diseases

1979 ◽  
Vol 16 (1-6) ◽  
pp. 320-324 ◽  
Author(s):  
Michio Ogawa ◽  
Kenjiro Iwaki ◽  
Naoko Saito ◽  
Shigenori Tanaka ◽  
Goro Kosaki
Keyword(s):  
Alkaline Phosphatase ◽  
Intrahepatic Cholestasis ◽  
Acute Cholangitis ◽  
Phosphatase Activities ◽  
Hepatobiliary Diseases

Serum succinyltrialanine p-nitroanilide hydrolysing activity was elevated in patients with hepatobiliary diseases. The highest activities were seen in acute cholangitis and intrahepatic cholestasis. The change in succinyltrialanine p-nitroanilide hydrolysing activity was closely associated with those in γ-glutamyltranspeptidase and alkaline phosphatase activities. In some cases, however, the former was more sensitive than the latter.

scholarly journals A focus on acute cholecystitis and acute cholangitis

2012 ◽  
Vol 1 (1) ◽  
pp. 77-81
Author(s):  
Massimo Sartelli ◽  
Cristian Tranà
Keyword(s):  
Acute Cholecystitis ◽  
Acute Cholangitis

scholarly journals Right Upper Quadrant Pain With Positive Murphy’s Sign in a 19-Year-Old Woman

2020 ◽  
Vol 158 (5) ◽  
pp. e3-e4
Author(s):  
Hiroki Matsuura ◽  
Masayuki Kishida ◽  
Waku Shimizu
Keyword(s):  
Quadrant Pain ◽  
Murphy’S Sign ◽  
Murphy's Sign
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