scholarly journals Features and Outcome of Hepatobiliary Tuberculosis among Filipino Children: Report of a Six-year Experience

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Evangeline P. Capul ◽  
Germana Emerita V. Gregorio ◽  
Ma. Liza Antoinette M. Gonzales
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Medical Records ◽  
Complete Resolution ◽  
Granulomatous Inflammation ◽  
Tb Treatment ◽  
Filipino Children ◽  
Lost To Follow Up ◽  
Radiologic Evidence

Background. The features and outcome of hepatobiliary tuberculosis (HBTB) have not been extensively reportedin children. Objective. To describe the clinical, biochemical, radiologic, microbiologic and histologic features and outcome ofchildren diagnosed with HBTB. Methods. Data of HBTB patients aged 0-18 years were collected by review of medical records and as they wereadmitted. Cases were classified as bacteriologically-confirmed (positive AFB smear, TB culture or PCR of bile/livertissue) or clinically-diagnosed (clinical, histologic and/or radiologic evidence). Results. A total of 36 patients were included (mean age: 13yrs; 64% males): three bacteriologically-confirmed and33 clinically-diagnosed. Most common signs/symptoms were weight loss (69%), fever (67%), hepatomegaly (61%)and jaundice (53%). Of the total, 68% had hypoalbuminemia, 50% increased transaminases and 47% prolongedprothrombin time. Fifteen (42%) patients were AFB positive on various microbiologic specimens. Most commonimaging finding was hepatic calcification (64%). Of 11 patients with liver biopsy, seven (64%) had chronic/granulomatous inflammation. All 36 were managed medically. Eight were lost to follow up, six died, and 22 (61%)are alive, nine with complete resolution of liver disease. Conclusion. Hepatobiliary tuberculosis presents with non-specific clinical and biochemical findings. Severalinvestigations are necessary to confirm the diagnosis. Overall response to anti-TB treatment is satisfactory withpossible resolution of liver disease.

Predicting the risk of becoming lost to follow-up in a lifestyle weight-loss intervention

2013 ◽  
Author(s):  
Danielle M. Lespinasse ◽  
Kristen E. Medina ◽  
Stacey N. Maurer ◽  
Samantha A. Minski ◽  
Renee T. Degener ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Loss Intervention ◽  
Lost To Follow Up

scholarly journals Utility of Fibroscan XL to assess the severity of non-alcoholic fatty liver disease in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew Yang ◽  
Melinda Nguyen ◽  
Irene Ju ◽  
Anthony Brancatisano ◽  
Brendan Ryan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Post Surgery

AbstractSignificant weight loss can modify the progression of Nonalcoholic fatty liver disease (NAFLD) with the most convincing evidence coming from bariatric surgery cohorts. Effective ways to non-invasively characterise NAFLD in these patients has been lacking, with high Fibroscan failure rates reported. We prospectively evaluated the utility of Fibroscan using XL-probe over a two-year period. 190 consecutive patients undergoing bariatric surgery were followed as part of their routine care. All patients had Fibroscan performed on the day of surgery and at follow-up a mean of 13 months (± 6.3) later. The majority of patients were female (82%) with mean age of 42. Fibroscan was successful in 167 (88%) at baseline and 100% at follow up. Patients with a failed Fibroscan had higher body mass index (BMI) and alanine transaminase (ALT), but no difference in FIB-4/NAFLD score. Mean baseline Liver stiffness measurement was 5.1 kPa, with 87% of patients classified as no fibrosis and 4% as advanced fibrosis. Mean baseline controlled attenuation parameter was 291, with 78% having significant steatosis, 56% of which was moderate-severe. Significant fibrosis was associated with higher BMI and HbA1c. Significant steatosis was associated with higher BMI, ALT, triglycerides and insulin resistance. Mean follow up time was 12 months with weight loss of 25.7% and BMI reduction of 10.4 kg/m2. Seventy patients had repeat fibroscan with reductions in steatosis seen in 90% and fibrosis in 67%. Sixty-four percent had complete resolution of steatosis. Fibroscan can be performed reliably in bariatric cohorts and is useful at baseline and follow-up. Significant steatosis, but not fibrosis was seen in this cohort with substantial improvements post-surgery.

Case Report: Progressive Dysphonia and Dysphagia due to Laryngeal Leishmaniasis

2021 ◽  
Author(s):  
Laura Renard ◽  
Adrien Lemaignen ◽  
Guillaume Desoubeaux ◽  
David Bakhos
Keyword(s):  
Polymerase Chain Reaction ◽  
Weight Loss ◽  
Case Report ◽  
Amphotericin B ◽  
Laryngeal Cancer ◽  
Complete Resolution ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Histopathology Examination

Laryngeal leishmaniasis is an unusual form of the disease. We report the case of a patient who consulted for dysphonia and dysphagia in a context of asthenia and weight loss. The patient had lesions that were suggestive of laryngeal cancer but were revealed to be leishmaniasis by histopathology examination and polymerase chain reaction. Treatment with amphotericin B and miltefosine permitted complete resolution of the lesions and no recurrence during the 18-month follow-up period.

scholarly journals Medication Event Monitoring System for Infectious Tuberculosis Treatment in Morocco: A Retrospective Cohort Study

2019 ◽  
Vol 16 (3) ◽  
pp. 412 ◽  
Author(s):  
Seup Park ◽  
Ilham Sentissi ◽  
Seung Gil ◽  
Won-Seok Park ◽  
ByungKwon Oh ◽  
...  
Keyword(s):  
Success Rate ◽  
Monitoring System ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Control Group ◽  
Event Monitoring ◽  
Tb Treatment ◽  
The Mean ◽  
Lost To Follow Up

Non-adherence to tuberculosis (TB) treatment is a barrier to effective TB control. We investigated the effectiveness of a Medication Event Monitoring System (MEMS) as a tailored adherence-promoting intervention in Morocco. We compared patients who received a MEMS (n = 206) with patients who received standard TB care (n = 141) among new active TB patients with sputum smear-positive. The mean total medication days were 141.87 ± 29.5 in the control group and 140.85 ± 17.9 in the MEMS group (p = 0.7147), and the mean age and sex were not different between the two groups (p > 0.05). The treatment success rate was significantly higher in the MEMS group than in the control group (odds ratio (OR): 4.33, 95% confidence interval (CI): 2.13–8.81, p < 0.001), and the lost to follow-up rate was significantly lower in the MEMS group than in the control group (OR: 0.03, 95% CI: 0.05–0.24, p < 0.001) after adjusting for sex, age, and health centers. The mean drug adherence rate in the first month was significantly higher in the MEMS group than in the control group (p = 0.023). MEMS increased TB treatment success rate and decreased the lost to follow-up rate overall for infectious TB patients in a Moroccan rural area.

Surgical Management of Fusiform Aneurysms of the Peripheral Posteroinferior Cerebellar Artery

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 831-835 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Alejandro Mendez ◽  
Paul Camarata ◽  
Leslie Sebring
Keyword(s):  
Medical Records ◽  
Occipital Artery ◽  
Pica Pica ◽  
Acute Hydrocephalus ◽  
Cerebellar Artery ◽  
Acute Subarachnoid Hemorrhage ◽  
Pica Aneurysms ◽  
Individualized Management ◽  
Lost To Follow Up

Abstract OBJECTIVE To describe the management and outcomes of seven patients with fusiform aneurysms of the peripheral posteroinferior cerebellar artery (PICA). METHODS Medical records and neuroimaging studies of seven patients who underwent surgical treatment of fusiform aneurysms of the peripheral PICA were reviewed. Average follow-up time was 1.5 years, and no patient was lost to follow-up. RESULTS All patients presented with acute subarachnoid hemorrhage, and most had acute hydrocephalus. All underwent surgery, which entailed distal revascularization in six of the seven patients. Revascularization techniques included occipital artery–PICA bypass, side-to-side PICA-PICA anastomosis, and aneurysm excision with direct end-to-end PICA reanastomosis. Outcome was good in six patients and fair in one. CONCLUSION Fusiform, peripheral PICA aneurysms are rare lesions. Distal revascularization was used in most cases because of the uncertain adequacy of collateral supply. Careful, individualized management allows for a good outcome in the majority of cases.

Repeated lifestyle interventions lead to progressive weight loss: A retrospective review chart study

2017 ◽  
Vol 45 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Sune Dandanell ◽  
Christian Ritz ◽  
Elisabeth Verdich ◽  
Flemming Dela ◽  
Jørn W. Helge
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Retrospective Review ◽  
Fat Free Mass ◽  
Lifestyle Interventions ◽  
Weight Cycling ◽  
Weight Loss Programme ◽  
Progressive Weight Loss ◽  
Lost To Follow Up

Aims: This study aimed to investigate whether repeated lifestyle interventions lead to progressive weight loss or to weight cycling. Methods: A retrospective review chart study with follow-up on 2120 participants (mean±SD age 36±15 years; body weight 116±28 kg; fat 43±6%). All had participated in one to four 11–12 week lifestyle interventions (residential weight loss programme, mixed activities). Weight loss was promoted through a hypocaloric diet (−500 to −700 kcal/day) and daily physical activity (1–3 hours/day). Primary outcomes were weight loss and change in body composition (bioimpedance measurements) after the intervention periods and at follow-up. Results: A total of 2120, 526, 139 and 47 people participated in one to four interventions with mean±SEM times from start to follow-up of 1.3±0.1, 2.9±0.2, 4.2±0.3 and 5.2±0.4 years respectively. Overall 50, 41, 18 and 11% of the participants were lost to follow-up after one to four interventions, respectively. The cumulated weight loss at follow-up increased with the number of interventions from one to four: 12.2±0.1, 15.9±0.7, 16.1±1.2 and 18.5±2.0 kg ( p<0.001). The ratios between cumulated loss of fat and fat free mass after one to four interventions decreased with the number of interventions (2.4, 2.2, 2.1 and 1.4). Rates of weight loss during the interventions ranged from 0.70±0.06 to 1.06±0.01 kg/week and the maximum weight regain during the follow-up periods was 0.039±0.007 kg/week. Conclusions: Repeated relatively short lifestyle interventions in a selected and motivated group can be an efficient method for weight loss maintenance with only limited body weight cycling in the interim periods. However, the relationship between loss of fat and fat free mass might change in an unfavourable direction.

scholarly journals Canine pemphigus folliaceus: report of five clinical case

2018 ◽  
Vol 52 (4) ◽  
pp. 273 ◽  
Author(s):  
M. V. LIAPI (Μ.Β. ΛΙΑΠΗ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
A. F. KOUTINAS (Α. Φ. ΚΟΥΤΙΝΑΣ) ◽  
S. LEKKAS (Σ. ΛΕΚΚΑΣ)
Keyword(s):  
Complete Resolution ◽  
Clinical Case ◽  
Spontaneous Remission ◽  
Skin Lesions ◽  
Response To Treatment ◽  
Allergic Dermatitis ◽  
Lost To Follow Up ◽  
Cleft Formation ◽  
Upper Third

Pemphigus folliaceus (PF), which is considered the most common autoimmune skin disease in the dog, is associated with the formation of autoantibodies directed against the desmosomes of the upper third of the epidermis, that result in loss of keratinocyte adhesion (acantholysis) and subsequent epidermal cleft formation. The clinical and histopathological findings, along with the response to treatment in 5 PF cases, either idiopathic (3/5) or secondary to trimethoprim-sulfonamides (1/5) and to allergic dermatitis (1/5), are presented and discussed, accordingly. All the 5 dogs exhibited hypotrichosis-alopecia (4/5), erythema (4/5), vesicles (1/5), pustules (5/5), crusts (5/5), epidermal collarettes (3/5), excoriations (1/5), erosions (3/5), ulcers (1/5), fissures (1/5), lichenification, thickening and folding of the skin (1/5), and footpad hyperkeratosis (1/5), that were pruritic in 3 of them. These lesions were located on the head (4/5), pinnae (4/5), limbs (3/5), body trunk (3/5) and the footpads (2/5). Diagnosis was based on the results of lesionai histopathology where the most striking finding was the presence of subcorneal pustules filled with normally looking neutrophils and acanthocytes. Moreover, pustule or crust cytology that was carried out in 3 cases, revealed clusters of acantholytic cells in 2 dogs. The treatment, that was instituted in 2/5 dogs and resulted in a complete resolution of skin lesions, was based on prednisolone in immunosuppressive dosage along with azathioprine (PF secondary to allergic dermatitis), or on a combination of dapsone, Oxytetracycline and vitamin E (idiopathic PF). The remaining 3 cases were left untreated, because one showed a spontaneous remission following withdrawal of the offending medication and the other 2 were lost to follow-up.

Gastrointestinal Basidiobolomycosis: An Unusual Fungal Infection Mimicking Colon Cancer

2009 ◽  
Vol 133 (12) ◽  
pp. 1938-1942
Author(s):  
Dalal Nemenqani ◽  
Nausheen Yaqoob ◽  
Hatem Khoja ◽  
Osama Al Saif ◽  
Nasir K. Amra ◽  
...  
Keyword(s):  
Fatal Outcome ◽  
Granulomatous Inflammation ◽  
Endoscopic Biopsy ◽  
Diagnostic Significance ◽  
Abdominal Disease ◽  
Typical Morphology ◽  
Diagnostic Difficulties ◽  
Lost To Follow Up ◽  
Histopathologic Findings

Abstract Context.—Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum, an environmental saprophyte found worldwide. Patients with B ranarum infection may present with subcutaneous, gastrointestinal, or systemic lesions. Gastrointestinal basidiobolomycosis poses diagnostic difficulties, as its clinical presentation is nonspecific, with no identifiable risk factors. Objective.—To discuss and compare the clinical features and histopathologic findings and other ancillary techniques that could be helpful in identifying gastrointestinal basidiobolomycosis. Design.—We report 3 cases of gastrointestinal basidiobolomycosis and describe the clinical and morphologic findings while emphasizing the importance of identifying this unusual entity on endoscopic biopsies, thus avoiding unnecessary major surgeries. Fungal cultures were also performed, which are of diagnostic significance. Our first patient was lost to follow-up; however, patients 2 and 3 were followed up for 4 and 2 years, respectively. Results.—In all 3 cases, patients presented with a clinical profile suggestive of malignancy. None of the patients gave any specific history. There was widespread abdominal disease with peritoneal involvement and colonic masses. Colonoscopic biopsy specimens showed nonspecific inflammation in 1 case; however, they showed only granulomatous inflammation in a second case and granulomas associated with fungal hyphae in a third. Typical morphology included hyphae, irregularly branched, thin-walled, occasionally septated and surrounded by a thick eosinophilic cuff (Splendore-Hoeppli phenomenon). Conclusion.—Gastrointestinal basidiobolomycosis can be detected on small endoscopic biopsy. The unequivocal diagnosis requires microbiologic cultivation of the fungus obtained from tissues. The prognosis for this disease is usually favorable as seen in 3 of our cases; however, cases with fatal outcome are on record.

TP6.2.20 UK- single centre experience with the ElipseTM intragastric balloon; Early safety and effectiveness

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Bankole Oyewole ◽  
Irena Stefanova ◽  
Anu Sandhya ◽  
Shannon Mangat ◽  
Simon Monkhouse
Keyword(s):  
Weight Loss ◽  
Final Analysis ◽  
Total Body Weight ◽  
Acid Reflux ◽  
Abdominal Radiograph ◽  
Balloon Expulsion ◽  
Total Body ◽  
The Uk ◽  
Lost To Follow Up

Abstract Introduction The ElipseTM gastric balloon (EIGB) is an established outpatient, non-invasive, non-surgical device for weight-loss not requiring endoscopy nor sedation. This study reports the early safety and effectiveness from the largest and only reported UK cohort treated with the EIGB. Methods A retrospective study of 224 consecutive patients undergoing EIGB insertion between May 2018 and December 2020 was performed. EIGB placement involved swallowing of the ElipseTM capsule followed by a pre-inflation abdominal radiograph to confirm position. Inflation was performed with 550mls of sterile water followed by a post-inflation radiograph. Patients had weekly follow-up to assess symptoms, weight-loss, time and route of balloon expulsion. Results 224 patients underwent EIGB insertion during the study period; 39 patients were lost to follow-up. 185 patients (28 male and 157 female) were included in the final analysis with a mean age of 38.1 years. Mean study follow-up was 10 weeks, mean weight at insertion was 97.7 kg. Mean %Total Body Weight (TBW) loss was 6.5% at 4 weeks and 9% at last follow-up. 32 patients had 15.3 %TBW loss at 16 weeks follow-up. Frequently experienced symptoms during the first week were acid reflux, abdominal pain and bloating, nausea and vomiting. One patient had early expulsion at 8 weeks. Seven patients required early deflation due to severe symptoms (5), pancreatitis (1) and hyperinflation (1). Conclusion EIGB is a safe and effective method of weight loss. Longer follow-up studies in the UK population are required to assess overall patient outcomes and associated factors for weight loss.

Rituximab Treatment in Childhood Chronic Immune Thrombocytopenic Purpura (ITP).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4461-4461 ◽  
Author(s):  
Ji Yoon Kim ◽  
Kun Soo Lee ◽  
Hyoung Jin Kang ◽  
Hoon Kook ◽  
Hong Hoe Koo ◽  
...  
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Medical Records ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Thrombocytopenic Purpura ◽  
Chronic Itp ◽  
New Treatment ◽  
Lost To Follow Up

Abstract Abstract 4461 Background Immune thrombocytopenic purpura (ITP) is characterized by mucocutaneous purpura and thrombocytopenia caused by circulating anti-platelet auto-antibodies. ITP is usually self-limited in children, but around 20% of patients will develop chronic ITP. The conventional treatments for children chronic ITP include intravenous immunoglobulin (IVIG), corticosteroid therapy, anti-D immune globulin, or splenectomy. Some children with chronic ITP are refractory to these treatments and nowadays begun to try new treatment agents such as rituximab. Rituximab as a monoclonal antibody to CD-20, has shown promising reports to these patients with refractory chronic ITP in adults groups and a few children groups. We investigated this study to evaluate the efficacy of rituximab for childhood chronic ITP in Korea. Methods We reviewed the questionnaires and medical records about the clinical progresses and results in thirteen children from eight clinical institutes, retrospectively. Complete response (CR) was considered if the platelet count was > 100,000/uL. Results Thirteen patients with chronic thrombocytopenia who had been treated with rituximab were investigated. Two patients were lost to follow-up after rituximab. Finally eleven patients were evaluated including one patient with Evans syndrome. Median age was 6.5 year (range, 0.5 ∼ 15.4). Median platelet count at baseline was 13,700/uL (3,000∼46,000). All patients had been treated with conventional therapy including IVIG and steroids. One had done splenectomy. Median follow-up duration was 2.8 years (1.1-5.9). Among 11 patients, CR was achieved in 3 patients (27%). Their platelet count prior to rituximab were < 10,000/uL. They were treated as the regimen of 375 mg/m2/dose weekly for 4 doses. Time from the first rituximab dose to achievement of complete response was 3.9, 4.9 and 5.7 weeks respectively. One patient who was relapsed 6months after the first course of rituximab was received second course of rituximab using the same regimen and achieved a new CR at 9.3 weeks after. There were no reports about severe complication or interruption of medication. Conclusions Therefore, we suggest that rituximab is effective treatment choice in childhood refractory chronic ITP and well tolerated. Disclosures: No relevant conflicts of interest to declare.

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