scholarly journals Ceftriaxone-Induced Gallbladder Stones in Children

2021 ◽  
pp. 23-27
Author(s):  
Dr. Maryam Al Saidi ◽  
Dr. Samiya Al Hashmi ◽  
Dr. Nuha Al Tahir ◽  
Dr. Hilal AL Hashami
Keyword(s):  
Liver Disease ◽  
Pediatric Patients ◽  
Extended Period ◽  
Gallbladder Stone ◽  
Gallbladder Stones ◽  
Long Duration ◽  
High Doses ◽  
Long Course ◽  
Systemic Bacterial Infection ◽  
Secondary Complication

Gallbladder stones in children is one complication that is mostly seen in diseases such as hemolytic diseases, liver disease, and obesity. It can also be a secondary complication of long-duration use of antibiotics like ceftriaxone. However, gallbladder stone, together with sludge themselves, is unusual within the children's population. We observed three children with gallbladder stones who were on along course of intravenous ceftriaxone. In this study, we present the three cases of children aged between eleven months to seven years who were treated with high doses and for an extended period (more than two weeks) of intravenous ceftriaxone for a complicated systemic bacterial infection. The goal of this study is to raise awareness about the possibility of developing gallbladder stones in pediatric patients who receive a long course of intravenous ceftriaxone.

Fatigue As A Performance Shaping Factor In Human Reliability Analysis For Long-Duration Spaceflight

2020 ◽  
Vol 64 (1) ◽  
pp. 1681-1685
Author(s):  
Ronald Boring ◽  
Thomas Ulrich ◽  
Torrey Mortenson ◽  
David German
Keyword(s):  
Reliability Analysis ◽  
Meta Analysis ◽  
Extended Period ◽  
Human Reliability ◽  
Human Reliability Analysis ◽  
Space Applications ◽  
Performance Shaping Factors ◽  
Long Duration ◽  
Starting Point ◽  
Chronic Sleep

This paper provides background on the process to enhance human reliability analysis (HRA) for long-duration space applications. While short-duration missions largely mirror ground activities and fit well with existing HRA methods, new missions to the Moon or Mars entail a significantly longer duration of time in space for astronauts. This extended period in space presents opportunities to affect astronaut performance that require consideration of new performance shaping factors (PSFs). In the present paper, we conducted a meta-analysis on fatigue and developed a new PSF to account for chronic sleep deprivation associated with long-duration space missions. Fatigue provides a starting point for additional PSFs needed for space HRA.

Hepatoadrenal syndrome in pediatric patients with end-stage liver disease*

2012 ◽  
Vol 13 (3) ◽  
pp. e145-e149 ◽  
Author(s):  
Gabriel J. Hauser ◽  
Hannah M. Brotzman ◽  
Stuart S. Kaufman
Keyword(s):  
Liver Disease ◽  
Pediatric Patients ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Clinical Impact of Additional Cytogenetic Aberrations, cKIT and RAS Mutations, and Treatment Elements in Pediatric t(8;21)-AML: Results From an International Retrospective Study by the International Berlin-Frankfurt-Münster Study Group

2015 ◽  
Vol 33 (36) ◽  
pp. 4247-4258 ◽  
Author(s):  
Kim Klein ◽  
Gertjan Kaspers ◽  
Christine J. Harrison ◽  
H. Berna Beverloo ◽  
Ardine Reedijk ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Remission ◽  
Pediatric Patients ◽  
Lower Probability ◽  
Event Free Survival ◽  
End Points ◽  
Free Survival ◽  
Ras Mutations ◽  
Cytogenetic Aberrations ◽  
High Doses

Purpose This retrospective cohort study aimed to determine the predictive relevance of clinical characteristics, additional cytogenetic aberrations, and cKIT and RAS mutations, as well as to evaluate whether specific treatment elements were associated with outcomes in pediatric t(8;21)-positive patients with acute myeloid leukemia (AML). Patients and Methods Karyotypes of 916 pediatric patients with t(8;21)-AML were reviewed for the presence of additional cytogenetic aberrations, and 228 samples were screened for presence of cKIT and RAS mutations. Multivariable regression models were used to assess the relevance of anthracyclines, cytarabine, and etoposide during induction and overall treatment. End points were the probability of achieving complete remission, cumulative incidence of relapse (CIR), probability of event-free survival, and probability of overall survival. Results Of 838 patients included in final analyses, 92% achieved complete remission. The 5-year overall survival, event-free survival, and CIR were 74%, 58%, and 26%, respectively. cKIT mutations and RAS mutations were not significantly associated with outcome. Patients with deletions of chromosome arm 9q [del(9q); n = 104] had a lower probability of complete remission (P = .01). Gain of chromosome 4 (+4; n = 21) was associated with inferior CIR and survival (P < .01). Anthracycline doses greater than 150 mg/m2 and etoposide doses greater than 500 mg/m2 in the first induction course and high-dose cytarabine 3 g/m2 during induction were associated with better outcomes on various end points. Cumulative doses of cytarabine greater than 30 g/m2 and etoposide greater than 1,500 mg/m2 were associated with lower CIR rates and better probability of event-free survival. Conclusion Pediatric patients with t(8;21)-AML and additional del(9q) or additional +4 might not be considered at good risk. Patients with t(8;21)-AML likely benefit from protocols that have high doses of anthracyclines, etoposide, and cytarabine during induction, as well as from protocols comprising cumulative high doses of cytarabine and etoposide.

scholarly journals Duodenal bulbar necrosis with hemorrhage caused by cholecystolithiasis: a case report

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110434
Author(s):  
Liang Chen ◽  
Wen Zhang ◽  
Zhenguo Qiao
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Diagnosis ◽  
Gastrointestinal Bleeding ◽  
Digestive System ◽  
Present Report ◽  
Duodenal Bulb ◽  
Gallbladder Stone ◽  
Gallbladder Stones ◽  
Common Diseases

Gastrointestinal bleeding and gallbladder stones are common diseases of the digestive system. However, duodenal necrosis and bleeding caused by gallbladder stone compression is relatively rare. The present report describes a patient with repeated hematemesis and melena that relapsed after several symptomatic treatments. The patient and his family elected surgical treatment. Intraoperative examination revealed necrosis of the duodenal bulb with hemorrhage, which was related to compression of the gallbladder neck. Because the imaging manifestations of this disease lack specificity, early diagnosis is difficult.

Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease

2019 ◽  
Vol 49 (13) ◽  
pp. 1742-1753 ◽  
Author(s):  
Shannon G. Farmakis ◽  
Paula M. Buchanan ◽  
Miguel A. Guzman ◽  
Anna K. Hardy ◽  
Ajay K. Jain ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Pediatric Patients ◽  
Shear Wave Elastography

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 &lt;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 Primary sclerosing cholangitis

2008 ◽  
Vol 22 (8) ◽  
pp. 689-698 ◽  
Author(s):  
Marina G Silveira ◽  
Keith D Lindor
Keyword(s):  
Liver Disease ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Serum Alkaline Phosphatase ◽  
Cholestatic Liver Disease ◽  
Biliary Strictures ◽  
Vitamin Deficiencies ◽  
Metabolic Bone ◽  
High Doses ◽  
End Stage

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts, resulting in end-stage liver disease and reduced life expectancy. PSC primarily affects young and middle-aged men, often in association with underlying inflammatory bowel disease. The etiology of PSC includes immune-mediated components and elements of undefined nature. A cholestatic picture of liver biochemistries with elevations in serum alkaline phosphatase, nonspecific autoantibodies such as perinuclear antineutrophilic antibody, antinuclear antibodies and smooth muscle antibodies, and diffuse multifocal biliary strictures, resulting in a ‘beaded’ appearance on radiographic studies, are the hallmarks of the disease. No effective medical therapy is currently available, although clinical studies are in progress. Ursodeoxycholic acid at high doses (28 mg/kg/day to 30 mg/kg/day) is the most promising agent but is unproven so far. Liver transplantation is currently the only life-extending therapy for patients with end-stage disease, although recurrent disease can be observed in the transplanted liver. The multiple complications of PSC include pruritus, fatigue, vitamin deficiencies, metabolic bone disease, peristomal varices, bacterial cholangitis, dominant biliary strictures, gallbladder stones and polyps, and malignancy, particularly cholangiocarcinoma, which is the most lethal complication of PSC.

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