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Wednesday, August 27, 2008
 Latest
Gallstones Medical and Health News Headlines
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Gallstones Medical and Health News Headlines
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All Recent Gallstones Medical Condition News Headlines |
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Improving the management of acute gallstone disease
(Source: ANZ Journal of Surgery)...
POSTED 08/20/2008 at 11:00 PM --
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Acute laparoscopic cholecystectomy: preferred treatment for acute biliary disease*
Background: Early laparoscopic cholecystectomy has been shown to be the treatment of choice for acute presentations of gallstone disease. However, currently this practice is not common in many centres. The aim of the study was to evaluate surgical management of patients presenting with acute symptomatic gallstone disease to Middlemore Hospital in 2005.Methods: A retrospective case review of acute presentations of symptomatic gallstone disease was carried out between 1 January and 31 December 2005.Results: Four hundred and two patients were included in the final analysis. Forty-six of these patients were unfit for surgery, 26 were solely admitted to the emergency department without being referred to a surgical team and 25 declined surgery. Therefore, 305 patients (76%) were eligible for surgery at index admission (IA). Two hundred and four (67%) received surgery during IA with a median time to surgery of 3 days. From the 198th patient who did not have acute surgery at IA, 112 had delayed surgery. When comparing those with surgery at IA with those who did not receive surgery at IA, median length of stay for IA was significantly longer in acute surgical group (5 vs 3 P = 0.05); however, there was no significant difference in duration of total hospital stay (6 vs 6 P > 0.05). For those who had acute surgery the conversion rate was 3% (six) compared with 7% (seven) in delayed surgery group (P = 0.09).Conclusion: Acute surgery remains the treatment of choice for acute biliary disease. This approach requires a committed team approach but is safe and effective. (Source: ANZ Journal of Surgery)...
POSTED 08/20/2008 at 11:00 PM --
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Inhibiting intestinal npc1l1 activity prevents diet-induced increase in biliary cholesterol in golden syrian hamsters.
Inhibiting intestinal NPC1L1 activity prevents diet-induced increase in biliary cholesterol in Golden Syrian hamsters.
Am J Physiol Gastrointest Liver Physiol. 2008 Aug 21;
Authors: Valasek MA, Repa JJ, Quan G, Dietschy JM, Turley SD
Niemann-Pick C1-like 1 (NPC1L1) facilitates the uptake of sterols into the enterocyte and is the target of the novel cholesterol absorption inhibitor, ezetimibe. These studies used the Golden Syrian hamster as a model to delineate the changes in the relative mRNA expression of NPC1L1 and other proteins that regulate sterol homeostasis in the enterocyte during and following cessation of ezetimibe treatment, and also to address the clinically important question of whether the marked inhibition of cholesterol absorption alters biliary lipid composition. In hamsters fed a low-cholesterol, low-fat basal diet, the abundance of mRNA for NPC1L1 in the small intestine far exceeded that in other regions of the gastrointestinal tract, liver, and gallbladder. In the first study, female hamsters were fed the basal diet containing ezetimibe at doses up to 2.0 mg/day/kg body weight. At this dose, cholesterol absorption fell by 82%, fecal neutral sterol excretion increased by 5.3-fold, and hepatic and intestinal cholesterol synthesis increased more than 2-fold, but there were no significant changes in either fecal bile acid excretion or biliary lipid composition. The ezetimibe induced changes in intestinal cholesterol handling were reversed when treatment was withdrawn. In a second study, male hamsters were given a diet enriched in cholesterol and safflower oil without or with ezetimibe. The lipid-rich diet raised the absolute and relative cholesterol levels in bile more than 4-fold. This increase was largely prevented by ezetimibe. These data are consistent with the recent finding that ezetimibe treatment significantly reduced biliary cholesterol saturation in patients with gallstones. Key words: enterocyte, cholesterol absorption, gallbladder bile, liver.
PMID: 18718997 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Gastrointestinal and Liver Physiology)...
POSTED 08/20/2008 at 11:00 PM --
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Cholangiocyte bile salt transporters in cholesterol gallstone–susceptible and resistant inbred mouse strains
Background and Aim: We investigated the dietary and gender influences on the expression and functionality of cholangiocyte bile salt transporters and development of biliary hyperplasia in cholesterol gallstone-susceptible C57L/J and resistant AKR/J mice.Methods: C57L and AKR mice were fed chow, a lithogenic diet, or a cholic acid-containing diet for 14 days. Expression of cholangiocyte bile salt transporter proteins ASBT (SLC10A2), ILBP (FABP6), and MRP3 (ABCC3) were studied by Western blot analysis. Taurocholate uptake studies were performed using microperfusion of isolated bile duct units. The pre- and post-perfusion taurocholate concentrations were analyzed by high performance liquid chromatography. Biliary proliferation in liver sections was scored.Results: The lithogenic diet induced ductular proliferation in C57L mice. On chow, SLC10A2 and ABCC3 were overexpressed in male and female C57L compared to AKR mice. A lithogenic diet reduced the expressions of FABP6 in both male and female C57L mice, SLC10A2 in female C57L mice, and ABCC3 in male C57L mice. These alterations in transporter expressions were not associated with changes in taurocholate uptake. The lithogenic diet induced biliary hyperplasia and reduced bile salt transporter expressions in C57L mice.Conclusions: Although bile salt uptake was not increased in the bile duct unit, we speculate that the biliary hyperplasia on the lithogenic diet may lead to an increase in intrahepatic bile salt recycling during cholesterol cholelithogenesis. (Source: Journal of Gastroenterology and Hepatology)...
POSTED 08/19/2008 at 11:00 PM --
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Is herniosis the single etiology of saint’s triad?
Abstract
Background Sixty years ago, Saint’s triad (hiatus hernia, diverticulosis of the colon, and gallbladder disease) was first described in
three patients. Since then, the association of these conditions has been questioned. We tested the hypothesis that these conditions
are associated, and, based on recent research, propose a common etiology.
Methods Data from the U.S. Veterans Integrated Service Network (VISN) 16 Data Warehouse were analyzed. Chi-square tests and calculated
odds ratios (ORs) were utilized to describe the magnitude of association, and multivariable logistic regression models were
used to determine the variables associated with Saint’s triad.
Results Among 637,518 patient records (1996–2005), any hernia was diagnosed among 22,181 (3.5%) patients, hiatus hernia among 1,661
(0.3%), diverticulosis of the colon among 14,375 (2.3%), and gallbladder disease among 5,284 (0.8%). The following associations
were observed: diverticulosis, hiatus hernia (OR: 6.9), hiatus hernia, gallbladder disease (OR = 3.8), and gallbladder disease,
diverticulosis (OR = 5.9). Patients with both diverticulosis and gallbladder disease were more likely to have hiatus hernia
(OR = 3.8; P = 0.0012) or any hernia (OR = 10.7; P < 0.0001). Diseases associated with Saint’s triad (incorporating any hernia) included chronic obstructive pulmonary disease
(OR = 4.3), hypertension (OR = 3.1), aortic aneurysm (OR = 2.2), and diabetes (OR = 1.8).
Conclusions Herniosis, the systemic connective tissue disease known to cause diverticulosis and herniae, may be responsible for Saint’s
triad. Diabetes, like aging, enhanced herniosis. Further research on the gallbladder wall pathology in patients with cholelithiasis
or cholecystitis is needed.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10029-008-0421-xAuthors
M. Hauer-Jensen, Central Arkansas Veterans Healthcare System Surgical Service Little Rock AR USAZ. Bursac, University of Arkansas for Medical Sciences Department of Biostatistics Little Rock AR USAR. C. Read, Central Arkansas Veterans Healthcare System Surgical Service Little Rock AR USA
Journal HerniaOnline ISSN 1248-9204Print ISSN 1265-4906 (Source: Hernia)...
POSTED 08/15/2008 at 01:27 AM --
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[patient-oriented and epidemiological research] reduced ileal expression of ost{alpha}-ost{beta} in non-obese gallstone disease
Cholelithiasis is a multifactorial process, and several mechanisms have been postulated. A decreased expression of the ileal apical sodium-dependent bile acid transporter (ASBT) and of the cytosolic ileal lipid binding protein (ILBP) was recently described in female non-obese patients. The role of the recently identified organic solute transporters and β (OST, OSTβ) in gallstone pathogenesis remains unclear. Therefore, we performed analysis of OST-OSTβ in gallstone patients according to body weight. Ileal mucosal biopsies were collected during routine colonoscopy from female gallstone carriers (n = 19) and controls (n = 34). OST-OSTβ mRNA expression was measured using the LightCycler sequence detection system; protein was analyzed by immunohistochemistry and Western blot. The mRNA expression of OST-OSTβ was significantly reduced (OST: 3.3-fold, P = 0.006; OSTβ: 2.6-fold, P = 0.03) in normal-weight but not overweight gallstone carriers compared with controls. OST-OSTβ protein levels also showed a reduction by 40–67%. The expression of OST-OSTβ correlated positively with ASBT (r = 0.65, 0.58, respectively), ILBP (r = 0.77, 0.67), and the farnesoid X receptor (r = 0.58, 0.50). Fibroblast growth factor-19 showed a 2.8-fold reduction (P = 0.06), and liver receptor homolog-1 showed a 2-fold reduction (P = 0.04) in non-obese patients. In conclusion, an impaired function of all three ileal bile acid transporters may lead to low ileal bile acid reabsorption and an altered bile acid pool composition and therefore may contribute to the formation of gallstones in non-obese patients. (Source: The Journal of Lipid Research)...
POSTED 08/14/2008 at 11:00 PM --
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The internal biliary fistula – reappraisal of incidence, type, diagnosis and management of 33 consecutive cases
To reevaluate the current features of spontaneous internal biliary fistulas, we reviewed 1,929 consecutive patients who had been treated for biliary tract diseases during the recent 12-year period. Thirty-three patients had internal biliary fistulas and the incidence was 1.9%. Of 33 patients, 20 were women and 13 were men with the average age 63 years, and their mean duration of illness was 4 years. A total of 37 fistulas were found and the most common type was choledochoduodenal (62%), followed by cholecystoduodenal (19%), cholecystocholedochal (11%) and cholecystocolonic (8%) fistulas. Internal biliary fistulas of thirty-one patients were caused by biliary stones and those of two patients by malignant tumors. All of the 17 bile samples examined were bacteria positive and the majority of calculi were brown pigment stones. All of the choledochoduodenal fistulas were correctly diagnosed by endoscopic retrograde cholangiography. In 14 patients with cholecystoenteric or cholecystocholedochal fistulas, direct evidence of the internal fistula was obtained only in 7 patients (50%) preoperatively. Pneumobilia, a small atrophic gallbladder adherent to the neighboring organs and a history of spontaneous disappearance of jaundice in elderly patients may indicate the presence of a cholecystoentric fistula. Since the preoperative diagnostic rate for internal biliary fistula involving the gallbladder is still low, care is necessary before and at the time of surgery especially during laparoscopic cholecystectomy for elderly patients with cholelithiasis. (Source: HPB Surgery)...
POSTED 08/12/2008 at 08:12 AM --
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Octreotide: nausea, cholelithiasis and glucose intolerance: case report
(Source: Reactions)...
POSTED 08/12/2008 at 03:12 AM --
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The one-stop trial: does electronic referral and booking by the general practitioner (gps) to outpatient day case surgery reduce waiting time and costs? a randomized controlled trial protocol.
Background:
Waiting time and costs from referral to day case outpatient surgery are at an unacceptably high level. The waiting time in Norway averages 240 days for common surgical conditions. Furthermore, in North Norway the population is scattered throughout a large geographic area, making the cost of travel to a specialist examination before surgery considerable. Electronic standardised referrals and booking of day case outpatient surgery by GPs are possible through the National Health Network, which links all health care providers in an electronic network. New ways of using this network might reduce the waiting time and cost of outpatient day case surgery.Material and methodsIn a randomised controlled trial, selected patients (inguinal hernia, gallstone disease and pilonidal sinus ) referred to the university hospital are either randomised to direct electronic referral and booking for outpatient surgery (one stop), or to the traditional patient pathway where all patients are seen at the outpatient clinic several weeks ahead of surgery.
Consultants in gastrointestinal surgery designed standardised referral forms and guidelines. New software has been designed making it possible to implement referral forms, guidelines and patient information in the GP's electronic health record. For "one-stop" referral, GPs must provide mandatory information about the specific condition. Referrals were linked to a booking system, enabling the GPs to book the hospital, day and time for outpatient surgery. The primary endpoints are waiting time and costs. The sample size calculation was based on waiting time. A reduction in waiting time of 60 days (effect size), 25%, is significant, resulting in a sample size of 120 patients in total.DiscussionPoor communication between primary and secondary care often results in inefficiencies and unsatisfactory outcomes. We hypothesised that standardised referrals would improve the quality of information, making it feasible to use a one-stop approach for all patients undergoing surgery on an outpatient basis for inguinal hernia, pilonidal sinus and gallstones.
In this study we wanted to investigate the waiting time and cost-effectiveness of direct electronic referral and booking of outpatient surgery compared to the traditional patient pathway, where the patient is seen at the outpatient clinic prior to surgery.
Trial registration: This trial has been registered at ClinicalTrials.gov. The trial registration number is: NCT00692497 (Source: BMC Surgery)...
POSTED 08/10/2008 at 11:00 PM --
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Cholelithiasis, a rare cause of haematobilia: a case report
(Source: ANZ Journal of Surgery)...
POSTED 08/09/2008 at 11:00 PM --
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Octreotide: nausea, cholelithiasis and glucose intolerance: case report.
Page: 25 (Source: Reactions Weekly)...
POSTED 08/09/2008 at 04:25 AM --
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The health and economic consequences of moderate alcohol consumption in germany 2002
Objective: Moderate alcohol consumption is associated with both positive and negative health effects. This study aims to estimate the positive and negative consequences on mortality, years of potential life (YPL), quality-adjusted life-years (QALYs), resource utilization, and societal costs attributable to moderate alcohol consumption in Germany in 2002.Methods: The concept of attributable risks and a prevalence-based approach was used to calculate age- and sex-specific alcohol attributable mortality and resource utilization for a wide range of disorders, and avoided mortality and resource utilization for diabetes mellitus, coronary heart disease, stroke, and cholelithiasis. The literature provided prevalence of moderate alcohol consumption in Germany by age and sex and relative risks. Direct costs were calculated using routine utilization and expenditure statistics. Indirect costs were calculated using the human capital approach.Results: Due to moderate alcohol consumption, 14,457 lives, 205,691 YPL, and 179,964 QALYs were lost, whereas 29,918 lives, 300,382 YPL, and 258,284 QALYs were gained. Up to an age of 55 to 60 (62.5[ndash]67.5) years, more lives were lost than gained among men (women), whereas in older age groups more lives were gained than lost. Moderate alcohol consumption caused [euro]3049 million of direct and [euro]2630 million of indirect costs, whereas [euro]2094 million of direct and [euro]2604 million of indirect costs were avoided.Conclusion: Despite considerable uncertainty, moderate alcohol consumption seems to result in an overall net effect of gained lives, YPL, and QALYs, realized among the elderly, but overall increased societal costs. Thus, moderate alcohol consumption should still be seen critical, especially among youths. (Source: Value in Health)...
POSTED 08/07/2008 at 11:00 PM --
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Emphysematous cholecystitis: a case report
A 65-year-old Greek man with a history of diabetes mellitus and hypertension was admitted because of right upper quadrant pain, nausea and palpable right quadrant mass. On admission the patient was febrile (38.8oC) with a total bilirubin level of 1.99 mg/dl (direct 0.59mg/dl); SGOT 1.26mg/dl; Na 135mmol/l and K 2.9mmol/l. The white blood count was 15200/mul with 92.2% neutrophiles. Axial sections of single slice CT imaging (section thickness 10mm), revealed emphysematous cholecystitis with thickening of gallbladder wall and wall enhancement after iv contrast enhancement, as well as, dilatation of the gallbladder with multiple gallstones precipitate and intraluminal air. The patient underwent subtotal cholecystectomy and a cholecystostomy was placed. The culture of the bile showed positivity to toxin A of Clostridium Difficile and to Escherichia Coli. The postoperative course of the patient was uneventful. (Source: Cases Journal)...
POSTED 08/06/2008 at 11:00 PM --
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Management of preoperatively suspected choledocholithiasis: a decision analysis
Abstract
Background The management of symptomatic or incidentally discovered common bile duct (CBD) stones is still controversial. Of patients
undergoing elective cholecystectomy for symptomatic cholelithiasis, 5–15% will also harbor CBD stones, and those with symptoms
suggestive of choledocholithiasis will have an even higher incidence. Options for treatment include preoperative endoscopic
retrograde cholangiopancreatography (ERCP) with sphincterotomy (ERCP/ES) followed by laparoscopic cholecystectomy, laparoscopic
cholecystectomy with intraoperative cholangiogram (LC/IOC), followed by either laparoscopic common bile duct exploration (LCBDE)
or placement of a common bile duct double-lumen catheter with postoperative management. The purpose of this analysis was to
determine the optimal management of such patients.
Methods A decision analysis was performed to analyze the management of patients with suspected common bile duct stones. The basic
choice was between preoperative ERCP/ES followed by LC, LC/IOC followed by LCBDE, or common duct double-lumen catheter (Fitzgibbons
tube) placement with either expectant management or postoperative ERCP/ES. Data on morbidity and mortality was obtained from
the literature. Sensitivity analysis was done varying the incidence of positive CBD stones on IOC with associated morbidity
and mortality.
Results One-stage management of symptomatic CBD stones with LC/LCBDE is associated with less morbidity and mortality (7% and 0.19%)
than two-stage management utilizing preoperative ERCP/ES (13.5% and 0.5%). Sensitivity analysis shows that there is an increase
in morbidity and mortality for LC/LCBDE as the incidence of positive IOC increases but are still less than two-stage management
even with a 100% positive IOC (9.4%, 0.5%). If a double-lumen catheter is to be used for positive IOC, the morbidity would
be higher than two-stage management only if the positive IOC incidence is more than 65% but still with no mortality.
Conclusion LCBDE has lower morbidity and mortality rates compared to preoperative ERCP/ES in the management of patients with suspected
CBD stones even if the chance of CBD stones reaches 100%. Using a common duct double-lumen catheter may be considered if LCBDE
is not feasible and the chance of CBD stone is less than 65%.
Content Type Journal ArticleCategory ssat poster presentationDOI 10.1007/s11605-008-0624-6Authors
Bilal Kharbutli, Henry Ford Hospital Division of General Surgery, K-8 2799 West Grand Blvd. Detroit MI 48202 USAVic Velanovich, Henry Ford Hospital Division of General Surgery, K-8 2799 West Grand Blvd. Detroit MI 48202 USA
Journal Journal of Gastrointestinal SurgeryOnline ISSN 1873-4626Print ISSN 1091-255X (Source: Journal of Gastrointestinal Surgery)...
POSTED 08/06/2008 at 12:51 AM --
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Patients with iron deficiency anemia have an increased prevalence of gallstones
Abstract We determined the frequency of gallstones (GS) in iron deficiency anemia (IDA) patients and evaluated factors that could affect
GS formation—like lipid levels and gallbladder (GB) motilities of the patients. One hundred and eleven IDA patients (88 females,
23 males; median age, 42) and 81 healthy controls (68 females, 13 males; median age, 42) were included into our study. The
clinical findings of all IDA patients were recorded down; biochemical values and body mass index (BMI) were determined; and
abdominal ultrasonography was performed. In addition, GB emptying was monitored by ultrasound at 30-min intervals for 2 h
after a mixed meal in randomly chosen, age-matched 25 IDA patients and 26 controls. Fasting volume (FV), residual volume (RV),
and ejection fraction (EF) for all GBs were determined. The frequency of GS plus cholecystectomy was significantly higher
in IDA patients (15 cases, 13.5%) than in the control group (five cases, 6.2%, p = 0.048). IDA patients with GS plus cholecystectomy were older than those without GS plus cholecystectomy (p < 0.001). FV and EF did not differ between IDA and control groups (p > 0.05). On the other hand, RV was significantly higher in IDA group than in controls (p = 0.035). The frequency of GS in IDA patients was significantly higher than in controls. The increased prevalence of GS in
IDA might be explained with impaired GB motility.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00277-008-0557-xAuthors
Gülsüm Emel Pamuk, Trakya University Medical Faculty Division of Hematology Edirne TurkeyHasan Ümit, Trakya University Medical Faculty Division of Gastroenterology Edirne TurkeyFerda Harmandar, Trakya University Medical Faculty Department of Internal Medicine Edirne TurkeyNesibe Yeşil, Trakya University Medical Faculty Department of Internal Medicine Edirne Turkey
Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555 (Source: Annals of Hematology)...
POSTED 08/05/2008 at 02:10 AM --
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Cholelithiasis is a risk factor for colorectal adenoma
OBJECTIVES: Postcholecystectomy patients show moderate risk of colorectal cancer. However, few studies have investigated the relationship between cholelithiasis and colorectal adenoma. We examined this possibility through a combination of colonoscopy and ultrasonography in asymptomatic Japanese. METHODS: We reviewed a subgroup of subjects drawn from a prospective annual colonoscopy screening survey. Subjects who underwent both ultrasonography and colonoscopy, and completed a questionnaire regarding lifestyle habits were entered. We investigated whether subjects with cholelithiasis or a previous cholecystectomy showed an increased risk of colorectal adenoma, as compared with subjects with normal gallbladders. RESULTS: Data of 4,458 subjects (men 3,053, women 1,405, mean age ± SD 46.1 ± 8.62 yr) were analyzed. Cholelithiasis was detected in 206 subjects, 4,189 subjects had normal gallbladders, and 63 subjects had cholecystectomies. The prevalence of colorectal adenoma was 29.6% (61/206) in subjects with cholelithiasis, which was significantly higher when compared with normal subjects, with a prevalence of 17.7% (741/4,189, P < 0.001). In cholecystectomy patients, only 15.9% (10/63) developed colorectal adenomas, which was not significantly different from the control group. In a multivariate analysis controlling for sex, age, family history of colorectal cancer, alcohol, smoking, and body mass index, cholelithiasis was shown to be an independent risk factor for colorectal adenoma (adjusted OR 1.57, 95% CI 1.14[ndash]2.18). Cholelithiasis was strongly associated with multiple ([ge]3 lesions, adjusted OR 2.39, 95% CI 1.21[ndash]4.72) and left-sided colorectal adenomas (adjusted OR 1.82, 95% CI 1.28[ndash]2.59). CONCLUSIONS: Cholelithiasis is a risk factor for colorectal adenoma. (Source: The American Journal of Gastroenterology)...
POSTED 08/04/2008 at 11:00 PM --
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Comment on: bartter syndrome and cholelithiasis in an infant: is this a mere coincidence? (eur j pediatr 2008;167(1):109–110)
Comment on: Bartter syndrome and cholelithiasis in an infant: is this a mere coincidence? (Eur J Pediatr 2008;167(1):109–110)
Content Type Journal ArticleCategory CorrespondenceDOI 10.1007/s00431-008-0793-zAuthors
Jae Il Shin, Yonsei University College of Medicine The Institute of Kidney Disease, Department of Pediatrics, Severance Children’s Hospital Seoul South KoreaJae Seung Lee, Yonsei University College of Medicine The Institute of Kidney Disease, Department of Pediatrics, Severance Children’s Hospital Seoul South Korea
Journal European Journal of PediatricsOnline ISSN 1432-1076Print ISSN 0340-6199 (Source: European Journal of Pediatrics)...
POSTED 08/01/2008 at 01:10 AM --
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[effects of different chinese herbal medicines on biochemical parameters in guinea-pig with pigment gallstones.]
[Effects of different Chinese herbal medicines on biochemical parameters in guinea-pig with pigment gallstones.]
Zhong Xi Yi Jie He Xue Bao. 2008 Aug;6(8):856-9
Authors: Zhang JZ, Zhang XL, Liang XQ, Gu HG, Zhu PT
Objective: To observe the effects of Qingdan Capsule (QDC) and Yanggan Lidan Granule (YGLDG), two kinds of compound traditional Chinese herbal medicines, on biochemical parameters in guinea-pigs with pigment gallstones. Methods: An animal model of pigment gallstones was established in male guinea-pigs by hypodermic injection of lincomycin. The guinea-pigs were randomly divided into blank control group, untreated group, QDC group and YGLDG group. There were 8 guinea-pigs in each group. After ten-day treatment, animals were sacrificed and sampled to calculate the rate of stone formation, total bilirubin (TB), unconjugated bilirubin (UCB) and Ca(2+) density in bile of the four groups. Results: In comparison with the untreated group, the rates of stone formation in the QDC and YGLDG groups were significantly decreased (P<0.01). TBIL, UCB and Ca(2+) content of bile in both QDC and YGLD groups was also significantly decreased (P<0.05, P<0.01). Conclusion: QDC and YGLD have good effects on biochemical changes of animal model of pigment gallstone in reversing the lithogenesity of bile by reducing the content of TB, UCB and Ca(2+), hence resulting in clinical treatment and prevention of pigment gallstone disease.
PMID: 18664357 [PubMed - in process] (Source: Zhong xi yi jie he xue bao : Journal of Chinese Integrative Medicine.)...
POSTED 07/31/2008 at 11:00 PM --
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Variants in inflammation genes and the risk of biliary tract cancers and stones: a population-based study in china
To evaluate the role of chronic inflammation in the development of gallstones and biliary tract cancer, we examined the risk associated with 62 single nucleotide polymorphisms (SNPs), in 22 inflammation-related genes, in a population-based case-control study conducted in Shanghai, China, where the incidence of biliary tract cancer has been increasing in recent decades. The study included 411 cases with biliary tract cancer (237 gallbladder, 127 extrahepatic bile duct, and 47 ampulla of Vater), 895 with biliary stones, and 786 controls randomly selected from the population. Unconditional logistic regression was used to calculate odds ratios and 95% confidence intervals for the association of individual SNPs and haplotypes with biliary stones and biliary tract cancer. Of the 62 SNPs examined, 14 were related to the risk of biliary cancer and stones. Specifically, variants in the IL8, IL8RB, RNASEL, and NOS2 genes were associated with biliary stones, whereas VEGF variants were associated with gallbladder cancer. Of the 10 genes with multiple SNPs from which we inferred haplotypes, only one IL8RB haplotype, consisting of 3 SNPs (rs2230054, rs1126579, and rs1126580), was associated with the risk of bile duct cancer (P = 0.003) and biliary stones (P = 0.02), relative to the most frequent haplotype. In summary, common variants in genes that influence inflammatory responses may predispose to gallstones and biliary tract cancer, suggesting the need for future studies into the immunologic and inflammatory pathways that contribute to biliary diseases, including cancer. [Cancer Res 2008;68(15):6442–52] (Source: Cancer Research)...
POSTED 07/31/2008 at 11:00 PM --
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Fascioliasis in pregnancy.
Fascioliasis in pregnancy.
Obstet Gynecol. 2008 Aug;112(2):483-5
Authors: Alatoom A, Sheffield J, Gander RM, Shaw J, Cavuoti D
BACKGROUND: Fascioliasis is a common zoonotic infection worldwide, although cases in the United States are uncommon, sporadic, and predominantly found in the immigrant population. The small number of cases identified in the United States may reflect the unfamiliarity of physicians with this infection. CASE: A 28-year-old Hispanic woman who frequently visited northern Central Mexico presented at 36 weeks of gestation with nausea, vomiting, and right upper quadrant pain. She was diagnosed with cholelithiasis. Postpartum endoscopic retrograde cholangiopancreatography and sphincterotomy were performed, with discovery of the trematode Fasciola hepatica. The patient received triclabendazole, which led to clinical improvement. CONCLUSION: Fascioliasis often mimics another common problem in pregnancy, cholelithiasis; clinicians need to be aware of this disease in high-risk populations.
PMID: 18669773 [PubMed - in process] (Source: Obstetrics and Gynecology)...
POSTED 07/31/2008 at 11:00 PM --
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