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Indian Journal of Medical Microbiology Jul 2021A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea,...
A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea, hypoxia, hypotension, conjunctival congestion and mild erythematous flush over the skin. She had very high WBC counts and CRP's with direct hyperbilirubinemia and azotemia. Investigations for infectious causes of fever were negative. RT-PCR for SARS-CoV-2 in the nasopharynx was negative. However her SARS-CoV-2 antibodies were reactive. She also had echocardiographic and biochemical evidence of cardiac dysfunction. The diagnosis of Multisystem inflammatory syndrome-Adult (MIS-A) was thus established. She rapidly improved with intravenous immunoglobulin (2 gm/kg) and high dose steroids.
Topics: Azotemia; COVID-19; Echocardiography; Fever; Humans; Hyperbilirubinemia; Immunoglobulins; Jaundice; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Steroids
PubMed: 33617927
DOI: 10.1016/j.ijmmb.2021.02.001 -
Gaceta Medica de Mexico 2022At the beginning of 2022, in the United Kingdom, and later in several European countries, a group of pediatric patients who developed acute hepatitis of so far unknown...
At the beginning of 2022, in the United Kingdom, and later in several European countries, a group of pediatric patients who developed acute hepatitis of so far unknown origin was reported. Clinical data include nausea, vomiting, jaundice, and liver failure; some patients require liver transplantation. The affected population is younger than 10 years of age. The probable etiological agent is adenovirus genotype F41, and toxic factors have been ruled out, as well as a relationship with COVID-19. There are several theories to explain this phenomenon, which are being investigated.
Topics: Humans; Child; COVID-19; Hepatitis; Jaundice; Liver Transplantation; Acute Disease
PubMed: 36572034
DOI: 10.24875/GMM.M22000703 -
JAMA Jun 2022
Topics: Humans; Jaundice
PubMed: 35696255
DOI: 10.1001/jama.2022.8384 -
The New England Journal of Medicine Jul 2021
Topics: Anemia, Hemolytic, Autoimmune; Child; Epstein-Barr Virus Infections; Humans; Jaundice; Male; Tongue
PubMed: 34297493
DOI: 10.1056/NEJMicm2034755 -
Medicine Jul 2022The impact of Tuina on neonatal jaundice is not yet comprehensively understood, and its clinical application is rather limited. This study systematically assessed the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The impact of Tuina on neonatal jaundice is not yet comprehensively understood, and its clinical application is rather limited. This study systematically assessed the relevant literature and conducted a meta-analysis to study the influence of Tuina on neonatal jaundice and provide convincing clinical evidence for promoting its clinical application.
METHODS
We searched Pubmed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM from the establishment of the database up to July 2021. Studies that are randomized controlled trials were included. However, duplicate publications; manuscripts with no full text, incomplete information, or inability to extract data; animal experiments; and reviews and systematic reviews were excluded. STATA 15.1 was used to analyze the data.
RESULTS
The pooled results showed that compared with the treatment of neonatal jaundice solely with blue light, Tuina combined with blue light significantly improved the total effective rate and frequency of defecation on days 1, 2, 3, 4, and 5 and significantly decreased the traditional Chinese medicine syndrome score; the third serum total bilirubin on days 3, 4, and 7; and duration of jaundice. Moreover, the incidence of adverse events in neonatal jaundice treated with Tuina combined with blue light was significantly lower than that with blue light alone.
CONCLUSION
Tuina combined with blue light for treating neonatal jaundice can increase the effect of clinical treatment and reduce the adverse events caused by blue light therapy. Thus, the clinical application of traditional Chinese medicine Tuina in neonatal jaundice should be further promoted.
Topics: Humans; Infant, Newborn; Jaundice; Jaundice, Neonatal; Medicine, Chinese Traditional; Phototherapy; Syndrome
PubMed: 35866789
DOI: 10.1097/MD.0000000000029675 -
Pancreas Jul 2016The aim of this study was to quantify the risk of pancreatic cancer in patients presenting in primary care with symptoms that may indicate pancreatic cancer. (Review)
Review
OBJECTIVES
The aim of this study was to quantify the risk of pancreatic cancer in patients presenting in primary care with symptoms that may indicate pancreatic cancer.
METHODS
We searched MEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Web of Science, and ISI Proceedings (1980 to August 2014) and PsychINFO (1980 to May 2013) for diagnostic studies of symptomatic adult patients in primary care. Study quality was assessed using QUADAS-II, and data were extracted to calculate the positive predictive values (PPVs) of symptoms, singly or in combination, for pancreatic cancer.
RESULTS
Eight studies with 3,438,363 patients were included. The PPV of jaundice was more than 4.1% in patients 40 years or older and increased with age, although only 30% of patients reported jaundice. The PPVs of other single symptoms were low, with the highest PPV being 1% for repeated attendance with abdominal pain in patients 60 years or older. Excluding jaundice, symptom combinations with high PPVs were those including weight loss, ranging from 1.5% to 2.7% in patients 60 years or older, apart from when weight loss was combined with malaise (PPV, 0.9%).
CONCLUSION
The only high-risk feature of pancreatic cancer in primary care was jaundice, and this clearly warrants investigation. Weight loss accompanied by a second symptom may warrant investigation, although this would probably require abdominal computed tomography.
Topics: Abdominal Pain; Adult; Diagnosis, Differential; Humans; Jaundice; Pancreatic Neoplasms; Primary Health Care; Risk Factors; Sensitivity and Specificity
PubMed: 26495795
DOI: 10.1097/MPA.0000000000000527 -
BMJ (Clinical Research Ed.) Feb 2024
Topics: Humans; Jaundice; Exanthema
PubMed: 38423567
DOI: 10.1136/bmj-2023-077368 -
World Journal of Gastroenterology Feb 2015To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice. English language literature was reviewed using... (Review)
Review
To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice. English language literature was reviewed using MEDLINE, PubMed, EMBASE and clinicaltrials.gov for papers and trails addressing the pathophysiology and potential treatments for pruritis associated with jaundice. Recent advances in the understanding of the peripheral anatomy of itch transmission have defined a histamine stimulated pathway and a cowhage stimulated pathway with sensation conveyed centrally via the contralateral spinothalamic tract. Centrally, cowhage and histamine stimulated neurons terminate widely within the thalamus and sensorimotor cortex. The causative factors for itch in jaundice have not been clarified although endogenous opioids, serotonin, steroid and lysophosphatidic acid all play a role. Current guidelines for the treatment of itching in jaundice recommend initial management with biliary drainage where possible and medical management with ursodeoxycholic acid, followed by cholestyramine, rifampicin, naltrexone and sertraline. Other than biliary drainage no single treatment has proved universally effective. Pruritis associated with jaundice is a common but poorly understood condition for which biliary drainage is the most effective therapy. Pharmacological therapy has advanced but remains variably effective.
Topics: Animals; Antipruritics; Cholagogues and Choleretics; Combined Modality Therapy; Drainage; Humans; Jaundice; Neural Pathways; Practice Guidelines as Topic; Pruritus; Risk Factors; Severity of Illness Index; Treatment Outcome
PubMed: 25663760
DOI: 10.3748/wjg.v21.i5.1404 -
Journal of Nepal Health Research Council Sep 2021Hyperbilirubinemia is a common problem in neonates. Phototherapy and exchange transfusion are the primary treatment modalities. Less known, but one of the potential...
BACKGROUND
Hyperbilirubinemia is a common problem in neonates. Phototherapy and exchange transfusion are the primary treatment modalities. Less known, but one of the potential complications of phototherapy is hypocalcemia. Most of the neonates with hypocalcemia are asymptomatic. Though asymptomatic, treatment should be initiated immediately when serum calcium level is reduced. This study was conducted to detect the incidence of hypocalcemia in jaundiced neonates receiving phototherapy.
METHODS
It is a hospital-based cross-sectional study conducted from May 2020 to December 2020 in the neonatal intensive care unit of Nepal Medical College Teaching Hospital. A total of 128 full-term neonates with jaundice and a normal serum calcium level before initiating phototherapy were enrolled in the study. Serum calcium level was measured before starting conventional phototherapy and after 48 hours of continuous phototherapy.
RESULTS
Hyperbilirubinemia was present in 23.3% of neonates admitted to the neonatal unit. Hypocalcemia was seen in 26 (20.3%) of term jaundiced neonates receiving phototherapy. Signs of hypocalcemia were present only in 3 (2.3%) neonates.
CONCLUSIONS
Hypocalcemia is a common complication of phototherapy. Serum calcium levels should be monitored in all the full-term neonates receiving phototherapy.
Topics: Cross-Sectional Studies; Humans; Hypocalcemia; Infant, Newborn; Jaundice; Nepal; Phototherapy
PubMed: 34601517
DOI: 10.33314/jnhrc.v19i2.3423 -
Clinical Gastroenterology and... Jul 2022
Topics: Diagnosis, Differential; HIV Infections; Humans; Jaundice
PubMed: 35123092
DOI: 10.1016/j.cgh.2022.01.031