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Hookworm Infection as a Rare Cause of Acute Pancreatitis
Mónica Andreia Pereira Da Silva Laureano,
João Miguel Salvador Nobre,
Inês Coelho Gonçalves,
Nuno Henrique Ventura Ferreira,
Tânia Raquel Telmo Valente,
Sandra Maria Martins Amado,
Maria Fernanda Cunha E Silva,
Sandra Maria Maurício Hilário Pires,
Miguel Nuno Lages Coelho Dos Santos
Issue:
Volume 3, Issue 1, June 2019
Pages:
1-3
Received:
18 December 2018
Accepted:
21 January 2019
Published:
15 February 2019
Abstract: The aim of this case report is to alert physicians to the possibility that hookworm disease can lead to acute pancreatitis. Method: We report a case of hookworm infestation associated with acute pancreatitis and food intolerance. Result: The patient presented on the emergency department complaining of anorexia, asthenia, nausea, vomiting, epigastric pain and fever. Blood test showed a amylase of 512U/L and a lipase of 1902, normal levels of hepatic aminotransferases, bilirubin and alkaline phosphatase and a slight elevation of the Creactive protein. An ultrasound showed no cholelithiasis, thickening of vesicular wall or dilation of the common bile duct and the computed tomography (CT) showed a normal pancreas with no evidence of cholecystitis or peripancreatic fluid. An upper digestive endoscopy was done because of food intolerance and revealed gastric stasis and duodenal mucosa congestive, friable, with loss of the usual pleating with biopsies revealing the presence of Ancylostoma duodenale. The patient was treated with albendazole and remains asymptomatic in a 3-year follow-up. Conclusion: Hookworm infestation is usually asymptomatic. Ampulla of Vater-migrating hookworms resulting in acute pancreatitis is a very rare event.
Abstract: The aim of this case report is to alert physicians to the possibility that hookworm disease can lead to acute pancreatitis. Method: We report a case of hookworm infestation associated with acute pancreatitis and food intolerance. Result: The patient presented on the emergency department complaining of anorexia, asthenia, nausea, vomiting, epigastri...
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Characterization of EDP-305, a Highly Potent and Selective Farnesoid X Receptor Agonist, for the Treatment of Non-alcoholic Steatohepatitis
Mary Chau,
Yang Li,
Manuel Roqueta-Rivera,
Kelsey Garlick,
Ruichao Shen,
Guoqiang Wang,
Yat Sun Or,
Li-Juan Jiang
Issue:
Volume 3, Issue 1, June 2019
Pages:
4-16
Received:
31 January 2019
Accepted:
25 March 2019
Published:
10 May 2019
Abstract: Non-alcoholic steatohepatitis (NASH), characterized by hepatocyte injury, inflammation, and fibrosis, is the main cause of chronic liver disease in the Western world. There are currently no approved pharmacological therapies for NASH, underscoring the urgent need for effective treatments. The farnesoid X receptor (FXR) has emerged as an attractive target for the treatment of metabolic and chronic liver diseases. EDP-305 is an FXR agonist currently in phase 2 clinical trials for Primary Biliary Cholangitis (PBC) and NASH. Here, we demonstrate that EDP-305 is a selective and potent FXR agonist that regulates multiple pathways relevant to NASH progression. EDP-305 exhibits anti-fibrotic and anti-inflammatory gene signatures in human macrophage and stellate cell lines, as well as favorable effects on lipid metabolism in hepatocytes, including enhanced low density lipoprotein (LDL)-cholesterol uptake and decreased triglyceride accumulation. The therapeutic potential of EDP-305 was further evaluated in two murine models of NASH: a streptozotocin-high fat diet STAMTM model and a dietary induced NASH (DIN) model driven by high fat, cholesterol, and fructose feeding. In both NASH models, EDP-305 significantly decreased hepatocyte ballooning and lowered the non-alcoholic fatty liver disease (NAFLD) activity score. EDP-305 also significantly attenuated hepatic steatosis and dyslipidemia observed in the DIN mouse model. Conclusion: EDP-305 is a potent FXR agonist with a favorable gene expression profile for NASH treatment as evidenced by the hepato-protective and anti-steatotic effects observed in vivo. The preclinical characterization of EDP-305 presented here suggests that it holds promise for the treatment of NASH.
Abstract: Non-alcoholic steatohepatitis (NASH), characterized by hepatocyte injury, inflammation, and fibrosis, is the main cause of chronic liver disease in the Western world. There are currently no approved pharmacological therapies for NASH, underscoring the urgent need for effective treatments. The farnesoid X receptor (FXR) has emerged as an attractive ...
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Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy
Fatma Daoud,
Mehdi Somai,
Ines Ben Hassen,
Imene Rachdi,
Dorra Trad,
Sarra Bejaoui,
Raja Jouini,
Hana Zoubeidi,
Ehsen Ben Brahim,
Dalila Gargouri,
Mohamed Habib Daghfous,
Achraf Chedli-Debbiche,
Fatma Boussema
Issue:
Volume 3, Issue 1, June 2019
Pages:
17-22
Received:
24 July 2019
Accepted:
14 August 2019
Published:
28 August 2019
Abstract: The liver biopsy (LB) still keeps some indications today, in spite of the progress of the non-invasive explorations. Several LB techniques have been studied. Some techniques use medical imaging. These techniques also differ in the material used to collect the hepatic sample. This study aimed to determine the current indications of LB, the interest using ultrasound guidance and an automatic device in order to improve its performance and its contribution to the diagnosis. This was a retrospective study including percutaneous LB performed under ultrasound guidance using automatic system equipped with a sharp needle. The study involved 50 patients with 26 diffuse liver diseases (DLD) and 24 focal liver lesions (FLL). The indications for DLD biopsy were dominated by suspicion of hepatic sarcoidosis, primary biliary cirrhosis and hepatic tuberculosis. FLL were dominated by the exploration of nodules or masses. The number of passes made was three in 96% of cases, otherwise it was four, with an average size of 1.3 cm for cores. DLD were dominated by chronic liver disease (42%), granulomatous hepatitis (23%), steatohepatitis (11%) and primary biliary cirrhosis (8%). FLL were dominated by secondary malignancies (46%) and primary malignant lesions (25%). For FLL, LB sensitivity, specificity, positive predictive value and negative predictive value were respectively 81%, 100%, 100% and 20%. LB confirmed 45% of DLD diagnoses, when they were well oriented by clinical and paraclinical data. The LB allowed to rectify the diagnosis in 54% of cases. When no initial diagnosis was suspected, LB enabled a specific diagnosis in 75% of cases. Major complications were void in our study. In conclusion, the use of ultrasound guidance and an automatic device with a sharp needle has increased the number of passes, improved the quality of sampling and reduced complications.
Abstract: The liver biopsy (LB) still keeps some indications today, in spite of the progress of the non-invasive explorations. Several LB techniques have been studied. Some techniques use medical imaging. These techniques also differ in the material used to collect the hepatic sample. This study aimed to determine the current indications of LB, the interest ...
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Management of Hepatopulmonary Syndrome in a Child Due to a Large Congenital Intrahepatic Porto-Systemic Shunt
Chandan Kumar Kedarisetty,
Rajeev Kamble,
Santhosh Joseph,
Jayanthi Venkataraman
Issue:
Volume 3, Issue 1, June 2019
Pages:
23-26
Received:
17 August 2019
Accepted:
10 September 2019
Published:
24 September 2019
Abstract: Background: Abernethy malformations are rare vascular anomalies of the portal system which present as extra-hepatic congenital portosystemic venous shunts (CPSS). Sometimes they can be intra-hepatic anomalies. There is scarcity of literature on management of these rare anomalies especially intra-hepatic shunts. Case: A five years old child came with the complaints of progressive breathlessness on exertion with effort-intolerance for the past two years. There was no history suggestive of underlying cardiopulmonary illness. On examination, there was cyanosis and clubbing. On evaluation, the imaging showed a large congenital intra-hepatic portosystemic shunt from the left portal vein draining directly into intrahepatic inferior vena cava (IVC) and a hypoplastic right branch of the portal vein leading to a clinical presentation of hepatopulmonary syndrome. Result: The shunt was occluded by placing a covered stent in the IVC across the shunt opening, making sure the openings of hepatic veins and renal vein also were not being covered. There was a significant improvement in oxygenation post procedure with complete disappearance of cyanosis. Conclusion: Covered IVC stent placement is a novel technique for large fusiform dilated intra-hepatic CPSS by closing the shunt flow into the IVC, thereby restoring the physiological flow in the liver.
Abstract: Background: Abernethy malformations are rare vascular anomalies of the portal system which present as extra-hepatic congenital portosystemic venous shunts (CPSS). Sometimes they can be intra-hepatic anomalies. There is scarcity of literature on management of these rare anomalies especially intra-hepatic shunts. Case: A five years old child came wit...
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