scholarly journals A rare case of duodenal diaphragm in an adult during ERCP treatment for choledocholithiasis

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liying Wu ◽  
Guofa Jia ◽  
Yiheng Hu ◽  
Liangsong Zhu ◽  
Shuhai Wang
Keyword(s):  
Acute Cholangitis ◽  
Clinical Manifestations ◽  
Endoscopic Retrograde ◽  
Case Summary ◽  
Inflammatory Drugs ◽  
Cbd Stone ◽  
Duodenal Diaphragm ◽  
Upper Abdominal ◽  
Endoscopic Balloon

Abstract Background Duodenal Diaphragm in adults is very uncommon, caused by congenital and acquired changes. It is reported that acquired duodenal diaphragm is related to the long-term use of nonsteroidal anti-inflammatory drugs. Case summary We report an adult presentation of duodenal diaphragm in a 77-year-old woman, suffered from acute cholangitis and choledocholithiasis. She was performed endoscopic retrograde cholangiopancreatography (ERCP) procedure to remove the stone in common bile duct (CBD). After the stenosis ring dilated by endoscopic balloon dilatation, ERCP procedure was applied, and the CBD stone was removed successfully. Conclusion Duodenal diaphragm is difficult to diagnose in clinic. Although the patient in this case had relatively mild symptoms of incomplete upper hemi-abdominal obstruction, these symptoms could be obscured by the emergency acute upper abdominal pain with fever as clinical manifestations of acute cholangitis.

scholarly journals Use of adjunctive prednisolone in the management of a cat with bilateral quadriceps contracture following trauma

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691769587 ◽  
Author(s):  
Penelope LC Tisdall ◽  
Cameron P Rogowski
Keyword(s):  
Physical Therapy ◽  
Clinical Improvement ◽  
Successful Treatment ◽  
Corticosteroid Treatment ◽  
Muscle Contracture ◽  
Prednisolone Treatment ◽  
Case Summary ◽  
Inflammatory Drugs ◽  
Muscle Biopsies

Case summary A 6-month-old cat was successfully treated for bilateral quadriceps contracture. Conventional treatments including surgery, dynamic flexion apparatus and physical therapy along with analgesics and non-steroidal anti-inflammatory drugs resulted in temporary clinical improvement that was relapsing. The initiation of supplementary corticosteroid treatment with prednisolone coincided with an immediate and sustained clinical improvement and long-term resolution. Relevance and novel information Successful treatment of bilateral quadriceps contracture has not previously been reported in a cat. Quadriceps contracture remains a challenging condition to treat with some cases unresponsive to therapy. Systemic prednisolone treatment appeared to be of benefit in the management of this case and may have a role in some cats where muscle contracture appears relapsing in nature. Further prospective investigations in cats with muscle contracture, including muscle biopsies of affected cats, are warranted.

scholarly journals Sump Syndrome: A Rare Long-Term Complication of Choledochoduodenostomy

2017 ◽  
Vol 11 (2) ◽  
pp. 428-433 ◽  
Author(s):  
Hrudya Abraham ◽  
Sajan Thomas ◽  
Amit Srivastava
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
History Of ◽  
The Common

Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called “sump” prone to accumulation of debris. These patients are prone to cholangitis. We present a 64-year-old man with a history of side-to-side choledochoduodenostomy who presented with manifestations of cholangitis. An endoscopic retrograde cholangiopancreatography confirmed a diagnosis of sump syndrome. The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.

scholarly journals ENGLISH VERSION: PERSONALIZED DESENSITIZATION WITH ACETYLSALICYLIC ACID IN PATIENTS WITH HYPERSENSITIVITY TO NON-STEROIDAL ANTI-INFLAMMATORY DRUGS

2020 ◽  
Vol 24 (1-2) ◽  
pp. 40-43
Author(s):  
A.V. Lavrenko ◽  
Ya.M. Avramenko ◽  
O.A. Borzykh ◽  
I.P. Kaidashev
Keyword(s):  
Adverse Reactions ◽  
Initial Dosage ◽  
Clinical Manifestations ◽  
Aspirin Therapy ◽  
English Version ◽  
Drug Induced ◽  
Clinical Syndromes ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Aims: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) has various mechanisms and represents different clinical syndromes from anaphylaxis to severe bronchospasm. The prevalence of aspirin hypersensitivity among patients with asthma and nasal polyps reaches 25.6%. Respiratory reactions associated with aspirin or other NSAIDs are not immunological. The basis of these reactions is non-allergic hypersensitivity of the cross-reactive type. Desensitization followed by long-term aspirin therapy is an effective method of treating hypersensitivity to aspirin or other NSAIDs. Using aspirin 600-1200 mg/day can significantly alleviate the symptoms of asthma, allergic rhinitis. Methods: We successfully applied aspirin desensitization for method of patients with hypersensitivity to NSAIDs. According to the method, an hour before the desensitization, daily montelukast 10 mg was taken orally, then aspirin every 3 hours. Results: Three patients underwent desensitization of aspirin. The dose was selected individualy depending on the clinical manifestations of drug-induced adverse reactions (AR). ARs during desensitization were treated by iv dexamethasone administration. Subsequent doses did not cause AR. Doses of aspirin were increased to a maximum of 1250 mg daily, and were continued for the long-term use. Conclusion: It is possible to conclude that the initial dose of aspirin should be 16-40mg; it is possible to increase the dose if the initial dosage is well tolerated; symptoms of moderate intolerance are treated by 4-8 mg iv dexamethasone; prior to desensitization, we recommended to use montelukast 10 mg, it is safe to practice desensitization of aspirin according to a personalized technique by a specialist in an intensive care unit.

scholarly journals TO ANALYSE PATIENT OF POST CHOLECYSTECTOMY SYMPTOMS AFTER CHOLECYSTECTOMY

2020 ◽  
pp. 72-73
Author(s):  
Jitendra K. Mangtani ◽  
Ketan Patel ◽  
Anshul Mathur ◽  
Heet Amlani ◽  
Vartika Gupta ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Common Cause ◽  
Abdominal Symptoms ◽  
Common Causes ◽  
Cbd Stone ◽  
Oddi Dysfunction ◽  
Upper Abdominal

Introduction: Post-cholecystectomy syndrome (PCS) comprise of a group of abdominal symptoms that occur after cholecystectomy. Post cholecystectomy syndrome is defined as group of heterogeneous symptoms. It is consists of upper abdominal pain, vomiting and dyspepsia, which occur after cholecystectomy. Although, this term is not accurate, as it comprises biliary and non-biliary disorders, possibly not related to cholecystectomy. AIM : To analyse the clinical evaluation for post cholecystectomy Symptoms. Objectives : To identify the causes for post cholecystectomy symptoms.To identify pre-operative factors (h/o ERCP, attacks of cholecystitis) associated with post cholecystectomy symptoms. Materials & Methods : A Prospective clinical hospital based study was done in 100 patients at tertiary care referral hospital in the department of general surgery. All cases of post- cholecystectomy who had clinical symptoms of PCS Cases in which on follow up USG and LFT were done. Result: In our study 100 patients were taken who developed PCS after cholecystectomy. Among all patients, 16% patient developed PCS due to biliary etiology. Among 16% patients most common cause is recurrent CBD stone (6%) and second most common causes is retained CBD Stone (3%) & spincter Of Oddi dysfunction (3%). Discussion : This analysis provides a qualitative overview of etiologies of abdominal symptoms after cholecystectomy. Based on the etiologies of persistent and incident symptoms after cholecystectomy provided in this review, we identified the cause of long-term symptoms after cholecystectomy. Conclusion : In our study, PCS developed mainly due to non-biliary etiology considered 84% and biliary etiology considered only 16%. Female has higher risk to developing post cholecystectomy symptoms compared to male after cholecystectomy.

NEUROENDOCRINE TUMORS OF THE PANCREAS: ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND CURRENT TREATMENT APPROACHES

2018 ◽  
Vol 64 (6) ◽  
pp. 830-839
Author(s):  
Temuri Morgoshiya
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Manifestations ◽  
Gastrointestinal Hormones ◽  
Current Treatment ◽  
High Potential ◽  
Long Term Results ◽  
Considerable Part ◽  
Treatment Approaches ◽  
By Products

The overview of literature on modem classification issues, diagnostics and treatments of neuroendocrinal tumors of a pancreas is provided. According to modern views all neuroendocrinal tumors of a pancreas having clinical manifestations (in the form of the syndromes caused by products of specific hormones; increases in level of hormones in blood of patients without clinical manifestations; in the form of signs of existence of volume education in various departments of PZh) and/or the researches (more than 5 mm) revealed by means of beam methods are malignant in the biology as they have high potential to innidiation. In article it is shown that a considerable part of neuroendocrinal tumors of a pancreas are nonfunctioning, i.e. not cosecreting various gastrointestinal hormones and polypeptides in blood and thereof not followed characteristic clinical manifestations. It is noted that diagnostics of neuroendocrinal tumors of a pancreas is extremely difficult task on which solution the choice of a method of treatment and its long-term results depends...

NF-κB as a Key Mediator of Brain Inflammation in Alzheimer’s Disease

2019 ◽  
Vol 18 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Chul Ju Hwang ◽  
Dong-Young Choi ◽  
Mi Hee Park ◽  
Jin Tae Hong
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Treatment Strategies ◽  
Close Correlation ◽  
Specific Protein ◽  
Brain Inflammation ◽  
Cytokines And Chemokines ◽  
Inflammatory Drugs ◽  
Peptide Fibrils

Alzheimer’s disease is the most common form of dementia. It is characterized by betaamyloid peptide fibrils which are extracellular deposition of a specific protein, accompanied by extensive neuroinflammation. Various studies show the presence of a number of inflammation markers in the AD brain: elevated inflammatory cytokines and chemokines, and an accumulation of activated microglia in the damaged regions. NF-κB is a family of redox sensitive transcriptional factors, and it is known that NF-κB has binding sites in the promoter region of the genes involved in amyloidogenesis and inflammation. Long-term use of non-steroidal anti-inflammatory drugs prevents progression of AD and delays its onset, suggesting that there is a close correlation between NF-κB and AD pathogenesis. This study aims to (1) assess the association between NF-κB activity and AD through discussion of a variety of experimental and clinical studies on AD and (2) review treatment strategies designed to treat or prevent AD with NF-κB inhibitors.

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