scholarly journals Changes of liver transaminases levels during one year follow up of Deferasirox treatment in children with β-thalassemia major

2020 ◽  
Vol 19 (3) ◽  
pp. 453-457
Author(s):  
Nashwan M Al Hafidh ◽  
Mozahim S Younis
Keyword(s):  
Relative Risk ◽  
Pediatric Patients ◽  
Medical Science ◽  
Liver Function Tests ◽  
Thalassemia Major ◽  
Abnormal Liver Function ◽  
Weekly Interval ◽  
Liver Transaminases ◽  
One Year

Objectives: Abnormal liver function tests lead to interruptions of Deferasirox therapy. The aim of this study is to determine the changes in liver transaminases levels in pediatric patients with β -thalassemia major during one year follow up of Deferasirox treatment. Material and methods: This study was conducted at Ibn Al Atheer center of thalassemia, Mosul city, Iraq during the period from 3rd of February 2013 till 2nd of February 2014. Seventy one pediatric patients with β -thalassemia major were included in the study. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured every 4 weeks after starting Deferasirox therapy dose of 30 mg /kg/day for one year. Results: In comparison to mean baseline ALT values, there were significant elevations of mean ALT values in each of the subsequent 4-weekly interval readingsafter Deferasirox therapy. There was nearly eleven times relative risk of having ALT ≥ 5 upper normal level (UNL) in patient with abnormal baseline ALT (Odd ratio 10.96,95% Confidence Interval: lower 2.05, upper 58.58). During a year of study, Deferasirox therapy was associated withALT readings of ≥ 5UNL in 22(31%) of pediatric β-thalassemia patients and that elevation lasted for 4 weeks in 95.5% of patients. Conclusions: Elevated ALT of ≥ 5UNL after Deferasirox therapy was short- lived, and lasted for 4 weeks in 95.5% of patients. It is advisable to start Deferasirox therapy at a dose of 30 mg /kg / day when baseline ALT level is normal. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.453-457

Efficacy of deferasirox median dose of 30 mg/kg /day in pediatric patients with β- thalassemia major during one year follow- up therapy.

2019 ◽  
Vol 10 (03) ◽  
Author(s):  
Nashwan M Al-Hafidh ◽  
Mozahim S. Younis
Keyword(s):  
Serum Ferritin ◽  
Pediatric Patients ◽  
Ferritin Level ◽  
Thalassemia Major ◽  
Mean Value ◽  
Median Dose ◽  
Baseline Serum ◽  
Significant Difference ◽  
One Year

Objective: To assess the efficacy of deferasirox median dose of 30 mg /kg /day in pediatric patients with β- thalassemia major during one year of follow up Patients and methods: This study was conducted at Ibn Al Atheer center of thalassemia, Mosul city, Iraq during the period from 3rd of February 2013 to 2nd of February 2014. Serum ferritin was measured at baseline and at four weekly intervals thereafter among 49 transfusion dependent children with β-thalassemia major, who were treated with median deferasirox dose of 30 mg /kg /day. Results: No statistically significant difference was detected between mean serum ferritin level at baseline (2189.39 ± 85.7) ng/mL and its mean value at four weekly intervals during forty-eight weeks of deferasirox therapy. There was significant (p = 0.027) improvement of serum ferritin at fifty – two weeks reading (1750.6 ± 202.8 ng/mL) compared to baseline reading. Percentage of patients with baseline serum ferritin levels of >2,500 ng/ml was 32.7% (16/49), which increased significantly (p=0.000) to 65% at four weeks of therapy, and ranged between 32.1% - 46.2 % in the remaining readings. Conclusions: There was no significant reduction of serum ferritin during initial forty-eight weeks of deferasirox median dose of 30 mg /kg /day among patient with baseline mean serum ferritin above 2000 ng /ml.

scholarly journals Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Function Tests ◽  
Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

scholarly journals Pyogenic granuloma - report of three cases in rare sites

2013 ◽  
Vol 12 (4) ◽  
pp. 445-448
Author(s):  
AN Sulabha ◽  
S Choudhari ◽  
G Suchitra
Keyword(s):  
Oral Cavity ◽  
Buccal Mucosa ◽  
Hard Palate ◽  
Medical Science ◽  
Surgical Excision ◽  
Pyogenic Granuloma ◽  
Patient Treatment ◽  
Young Females ◽  
One Year

Pyogenic granuloma is a benign, localized mass of exuberant granulation tissue produced in response to various stimuli. It is inflammatory hyperplasia of oral cavity commonly seen on gingival area and rarely on other parts of oral cavity such as lips, tongue, palate and buccal mucosa. It is seen predominantly in 2nd to 3rd decade of life in young females. Clinically manifesting as small red erythematous exophytic lesion, it must be biopsied to rule out other serious conditions. This article aims to present three cases of extra gingival pyogenic granulomas occurring in rare sites such as buccal mucosa, anterior hard palate and alveolar mucosa of completely edentulous ridge in maxilla. Pyogenic granuloma on buccal mucosa and anterior hard palate were seen in female patients with age of 40 years and 34 years respectively and pyogenic granuloma on alveolar mucosa of edentulous ridge in maxilla was noted in 70 years old male patient. Surgical excision was performed for all the lesion and follow up of one year did not show any recurrence. Please add little description of patient + treatment + followup results. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16667 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 445-448

scholarly journals Utility of uroflowmetry during the follow-up of children affected by balanitis xerotica obliterans (BXO)

2018 ◽  
Vol 90 (2) ◽  
pp. 123 ◽  
Author(s):  
Salvatore Arena ◽  
Tiziana Russo ◽  
Pietro Impellizzeri ◽  
Saveria Parisi ◽  
Patrizia Perrone ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Voiding Dysfunction ◽  
Clobetasol Propionate ◽  
Histological Diagnosis ◽  
Balanitis Xerotica Obliterans ◽  
Urethral Stenosis ◽  
Urethral Dilatation ◽  
One Year

Introduction: To evaluate the outcome of circumcised patients with balanitis xerotica obliterans (BXO) using uroflowmetry (UF). Methods: Between 2011 and 2013, 180 children underwent a circumcision for phimosis. The foreskin was examined on microscopy. Patients with an histological diagnosis of BXO were included in the study. Patients with BXO underwent UF two weeks after surgery and treatment with clobetasol propionate ointment. Patients were re-evaluated at 6, 12, 18 and 24 months postoperatively clinically and using UF. Results: 75 of 180 circumcised patients (41.6%) were included. At two weeks, Thirtytwo of 75 patients (42.7%) displayed a pathological UF. At six months, 15 patients (20%) had pathological UF and a new cycle of clobetasol was prescribed. At one year, 10 patients (13.3%) displayed patholgocial UF and underwent progressive urethral dilatation or meatoplasty. At 18 months, 71 patients (94.7%) displayed regular UF, 3 underwent a meatoplasty and one a staged urethroplasty for a severe urethral stenosis. At two years, UF was normal in 74 out of 75 (98.7%). Conclusions: We recommend to send for hystological examination all foreskins excised after circumcision. We believe that a clinical and uroflowmetric follow-up of pediatric patients with BXO is mandatory for a prompt identification of post-voiding dysfunction.

scholarly journals Cystic fibrosis-related liver disease: a single-center experience

2011 ◽  
Vol 3 (3) ◽  
pp. 21 ◽  
Author(s):  
Paula Catarino Costa ◽  
Celeste Canha Barreto ◽  
Luisa Pereira ◽  
Maria Luisa Lobo ◽  
Maria Adília Costa ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Liver Function ◽  
Pediatric Patients ◽  
Liver Function Tests ◽  
Liver Involvement ◽  
Clinical Expression ◽  
Function Tests ◽  
Related Liver Disease

Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years) with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases). All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years), revealed by hepatomegaly or hepatosplenomegaly (3 cases) and/ or abnormalities of liver function tests (3 cases) changes of liver ultrasound (7 cases) with evidence of portal hypertension (2 cases). Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis), progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.

scholarly journals Ipsilateral Pediatric Supracondyar Humerus Fracture and Radial Head Dislocation

2018 ◽  
Vol 1 (1-3) ◽  
pp. 62-66
Author(s):  
Daniel C. Kim ◽  
Adam J. Handwerger ◽  
John T. Riehl
Keyword(s):  
Radial Head ◽  
Closed Reduction ◽  
Pediatric Patients ◽  
Humerus Fracture ◽  
Radial Head Dislocation ◽  
Supracondylar Humerus Fracture ◽  
Left Elbow ◽  
One Year

Case: A 5-year-old boy presented with left elbow pain after a fall. Radiographs revealed a radial head dislocation without ulnar involvement which was treated with closed reduction in the emergency department. Two-week follow-up radiographs revealed a periosteal reaction along the medial epicondyle at the supracondylar region, consistent with a type 1 supracondylar humerus fracture. The elbow was treated with closed reduction and casting for 2 weeks. One year after injury, the patient had full painless range of motion. Conclusion: This case report highlights an injury pattern not previously described in the literature, and no previous recommendations exist regarding treatment. Although rare, radial head dislocation with simultaneous supracondylar humerus fracture can occur in pediatric patients. Our patient obtained a good result without surgical treatment.

scholarly journals Significance of Abnormal Liver Function Tests in Hemophiliacs: A Follow-Up Study

1977 ◽  
Author(s):  
P.M. Mannucci ◽  
Z.M. Ruggeri ◽  
A. Capitanio ◽  
F. Pareti
Keyword(s):  
Liver Function ◽  
Clinical Evidence ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Function Tests ◽  
Number Of Patients ◽  
High Incidence ◽  
Therapeutic Measures ◽  
Observation Period

It was previously shown (1) that hemophiliacs have a high incidence of abnormal liver function tests unaccompanied by clinical evidence of illness. Since single measurements are of little use to access the significance of such abnormalities and their possible relationship with chronic hepatitis, hemophiliacs with abnormal liver function tests were regularly followed with measurements carried out at least once a year. 20 patients with raised SGOT-SGPT were followed for up to 3 years; in 9, the abnormalities persisted throughout the whole observation period, whereas in 2 the enzymes were occasionally increased and in 9 they were always normal since the initial abnormal measurement. Out of 39 patients with increased serum gamma-globulins, abnormal values were 1 persistently observed in 11 followed for 3 years. In 28 patients followed for 2 years, persistently abnormal values were found in 21, whereas in 7 normal values were invariably found since the initial abnormal measurement. These findings show that liver function tests are persistently abnormal in a number of patients; in these, biopsy should be considered in order to undertake suitable therapeutic measures.

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