scholarly journals PTBD During COVID-19 Pandemic: A Life Saving Procedure in Malignant Obstructive Jaundice Patients

2021 ◽  
Vol 6 (S1) ◽  
pp. 17-19
Author(s):  
Khushboo Rani ◽  
Kumar Gaurav ◽  
Naveen Kumar
Keyword(s):  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Percutaneous Drainage ◽  
Positive Impact ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Endoscopic Drainage ◽  
Malignant Obstructive Jaundice ◽  
Abdominal Ultrasonography ◽  
Almost All

Objective: PTBD is an important lifesaving alternative for biliary tract decompression to endoscopic drainage in the treatment of malignant obstructive jaundice patients. The aim of this study was to evaluate the usefulness of PTBD in terms of the relief of symptoms and laboratory data, survival after PTBD, and the relationship between patient characteristics and survival during COVID-19 pandemic. Methods: During this study, in total thirteen patients’ procedures of percutaneous drainage were applied during a three-month period. The average age of men was 59 years and women was 55 years. The causes of obstructive jaundice were investigated using both abdominal computed tomography and abdominal ultrasonography. Results: In examined group percutaneous drainage was successful in 92.3% (12 patients) and drainage procedure application was ineffective in 7.7% (1 patient). After PTBD, almost all the symptoms of obstructive jaundice were relieved, except in one patient. Transient haemobilia was the only complication seen in one patient. Conclusion: In present scenario of COVID-19 pandemic, PTBD emerges as an effective method of biliary tract decompression and an important alternative to endoscopic drainage. It decreased the jaundice and relieved the symptoms caused by biliary tract obstruction. Thus, our study shows a positive impact in quality of life of patients after PTBD.

Preoperative endoscopic drainage for malignant obstructive jaundice

1995 ◽  
Vol 82 (1) ◽  
pp. 134-135 ◽  
Author(s):  
A. N. Kimmings ◽  
S. J. H. Van Deventer ◽  
E. A. J. Rauws ◽  
D. J. Gouma ◽  
E. C. S. Lai
Keyword(s):  
Obstructive Jaundice ◽  
Endoscopic Drainage ◽  
Malignant Obstructive Jaundice

scholarly journals Malignant obstructive jaundice: justification of the method of biliary decompression

2020 ◽  
Vol 25 (2) ◽  
pp. 124-136
Author(s):  
P. N. Romashchenko ◽  
N. A. Maistrenko ◽  
A. I. Kuznetsov ◽  
A. S. Pryadko ◽  
A. A. Filin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Optimal Algorithm ◽  
Tnm Classification ◽  
Postoperative Mortality ◽  
Endoscopic Stenting ◽  
Malignant Obstructive Jaundice ◽  
Primary Surgery ◽  
Complications And Mortality

Aim. To show the optimal algorithm of diagnostic and treatment of malignant obstructive jaundice, which allows to increase the effectiveness of primary surgery, reducing the number of complications and mortality in the operated patients.Materials and methods. The results of examination and surgical treatment of 325 patients with malignant obstructive jaundice who underwent minimally invasive decompression of the biliary tract were studied. Based on the results of treatment, an algorithm for examining and treating patients with malignant obstructive jaundice has been formed and tested.Results. Using such criterial like severity of obstructive jaundice by E.I. Galperin, anatomical level of biliary tract occlusion and staging oncology process by TNM classification could help to choose the rational method for its surgical treatment and determine the risk of complications and mortality. At the level of biliary occlusion I and II, endoscopic stenting is a fairly successful inter-vention with a minimum of complications. For a level III block, the operation of choice is percutaneous transhepatic drainage. Cholecystostomy is advisable in case of level I block below the cystic duct in flow level and class “C” obstructive jaundice or for technical impossibility to apply a different method.Realization of the developed algorithm allowed resolving obstructive jaundice in a palliative option in 71.4% of patients and preparing 28.6% for surgical treatment.Conclusion. Implementation of an improved algorithm for the diagnosis of malignant obstructive jaundice makes it possible to justify the choice of a rational option for its surgical treatment, increase the effectiveness of interventions and reduce postoperative mortality.

scholarly journals Rhabdophis tigrinus (Yamakagashi) Bites in Japan Over the Last 50 Years: A Retrospective Survey

2022 ◽  
Vol 9 ◽  
Author(s):  
Toru Hifumi ◽  
Atsushi Sakai ◽  
Akihiko Yamamoto ◽  
Kazunori Morokuma ◽  
Norio Otani ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Course ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Scientific Data ◽  
Definitive Treatment ◽  
Related Factors ◽  
Epidemiological Features ◽  
Rhabdophis Tigrinus ◽  
Almost All

Introduction:Rhabdophis snakes, which include 27 species, are rear-fanged venomous snakes that are widely distributed from India to East Asia and Russia. Severe envenomation by R. tigrinus (Yamakagashi snake) in Japan and R. subminiatus in Southeast Asia has been reported. The epidemiology of R. tigrinus bites, such as geographical features, the incidence, and changes in the number of bites over time have not been comprehensively examined. Hence, we intended to clarify the epidemiological features of R. tigrinus bites through a careful review of scientific data over the last 50 years in Japan.Methods: Patient records of R. tigrinus bites between 1971 and 2020 at the Japan Snake Institute were examined retrospectively. The following were ascertained: patient characteristics, clinical symptoms, laboratory data, treatment-related factors, and hospital mortality. These variables were compared in the antivenom and the without-antivenom groups.Results: Over the 50-year study period, 43 R. tigrinus bites, including five fatal cases, were encountered. Severe cases of R. tigrinus bites have been treated with antivenom since 1985; however, fatalities occurred in 2006 and 2020. R. tigrinus bite cases have been well-distributed in the western part of Japan since 2000. The mortality rate in the antivenom group was significantly lower in the patient group that was not administered the antivenom (0 vs. 23.8%, p = 0.048).Conclusion: This study clarified the epidemiology of R. tigrinus bites in Japan over a 50-year period. Almost all severe cases of R. tigrinus bites have been treated with the antivenom in the current situation, and fatalities occurred in cases not treated with the antivenom. It is important to diagnose R. tigrinus bites in the early phase of the clinical course. The antivenom, the definitive treatment for R. tigrinus bites, is an unapproved drug. Hence, approval needs to be obtained for the drug.

Preoperative endoscopic drainage for malignant obstructive jaundice

1994 ◽  
Vol 81 (8) ◽  
pp. 1195-1198 ◽  
Author(s):  
E. C. S. Lai ◽  
F. P. T. Mok ◽  
S. T. Fan ◽  
C. M. Lo ◽  
K. M. Chu ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Endoscopic Drainage ◽  
Malignant Obstructive Jaundice

Retrospective evaluation of 85 patients with urea cycle disorders: one center experience, three new mutations

2020 ◽  
Vol 33 (6) ◽  
pp. 721-728
Author(s):  
Özlem Saritaş Nakip ◽  
Yılmaz Yıldız ◽  
Ayşegül Tokatlı
Keyword(s):  
Mortality Rate ◽  
Urea Cycle ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Hereditary Diseases ◽  
Urea Cycle Disorders ◽  
Carbamoyl Phosphate ◽  
Term Survival ◽  
Genetic Features ◽  
Cycle Disorders

AbstractObjectivesUrea cycle disorders (UCDs) are rare hereditary diseases. This study was conducted to help identify the characteristics of UCDs in Turkey.MethodsThe primary outcome was to determine patient characteristics. Investigating the relationships between the patient outcomes and ammonia levels were the secondary outcomes. Eighty five patients from 79 families, diagnosed with UCD at a single metabolic referral center between 1979 and 2017, were included. Clinical and laboratory data were retrieved retrospectively from hospital records.ResultsClassical citrullinemia was the most common type of UCD; citrin deficiency and carbamoyl phosphate synthase 1 deficiency (CPS1D) were the rarest. One thirty one hyperammonemic episodes were recorded. The peak ammonia levels were found to be significantly associated with polycythemia and hypocalcemia at presentation. The median peak ammonia values of the patients who died were higher than those of the survivors. The highest mortality rate was in the classical citrullinemia group. The mortality rate of the first hyperammonemic crisis was 28.6%, while it was 6.7% in subsequent episodes with an odds ratio of 4.28 (95% CI: 1.67–11.0) (p=0.001). Forty-four patients underwent genetic analysis and genetic variants were detected in 42 patients (95%). Three of the detected variants have not been previously reported.ConclusionsThis is the largest UCD series in Turkey and may serve as a guide to clinical, biochemical and genetic features of UCDs in our country. Prevention of hyperammonemia may be the most influential measure to improve long term survival.

scholarly journals Similar glycaemic control and risk of hypoglycaemia with patient- versus physician-managed titration of insulin glargine 300 U/mL across subgroups of patients with T2DM: a post hoc analysis of ITAS

2021 ◽  
Author(s):  
Andrea Giaccari ◽  
R. C. Bonadonna ◽  
R. Buzzetti ◽  
G. Perseghin ◽  
D. Cucinotta ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Insulin Glargine ◽  
Patient Characteristics ◽  
Efficacy And Safety ◽  
Clinical Trial Registration ◽  
Post Hoc Analysis ◽  
Almost All ◽  
Antihyperglycaemic Drugs ◽  
Post Hoc ◽  
Patient Subgroups

Abstract Aims The Italian Titration Approach Study (ITAS) demonstrated comparable HbA1c reductions and similarly low hypoglycaemia risk at 6 months in poorly controlled, insulin-naïve adults with T2DM who initiated self- or physician-titrated insulin glargine 300 U/mL (Gla-300) in the absence of sulphonylurea/glinide. The association of patient characteristics with glycaemic and hypoglycaemic outcomes was assessed. Methods This post hoc analysis investigated whether baseline patient characteristics and previous antihyperglycaemic drugs were associated with HbA1c change and hypoglycaemia risk in patient- versus physician-managed Gla-300 titration. Results HbA1c change, incidence of hypoglycaemia (any type) and nocturnal rates were comparable between patient- and physician-managed arms in all subgroups. Hypoglycaemia rates across subgroups (0.03 to 3.52 events per patient-year) were generally as low as observed in the full ITAS population. Small increases in rates of 00:00–pre-breakfast and anytime hypoglycaemia were observed in the ≤ 10-year diabetes duration subgroup in the patient- versus physician-managed arm (heterogeneity of effect; p < 0.05). Conclusions Comparably fair glycaemic control and similarly low hypoglycaemia risk were achieved in almost all patient subgroups with patient- versus physician-led Gla-300 titration. These results reinforce efficacy and safety of Gla-300 self-titration across a range of phenotypes of insulin-naïve people with T2DM. Clinical trial registration EudraCT 2015-001167-39

Cholesterol and its esters as serum biomarkers in malignant obstructive jaundice: a single step 1H NMR metabolomic approach

Metabolomics ◽  
2013 ◽  
Vol 9 (6) ◽  
pp. 1181-1191 ◽  
Author(s):  
Shatakshi Srivastava ◽  
Raja Roy ◽  
Santosh Kumar ◽  
Hari Om Gupta ◽  
Devendra Singh ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
1H Nmr ◽  
Single Step ◽  
Serum Biomarkers ◽  
Malignant Obstructive Jaundice ◽  
Metabolomic Approach
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