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Cirugia Y Cirujanos 2015Gallbladder agenesis is a very rare congenital abnormality of the biliary tract. The diagnosis is made during surgery, because all preoperative studies have failed to... (Review)
Review
BACKGROUND
Gallbladder agenesis is a very rare congenital abnormality of the biliary tract. The diagnosis is made during surgery, because all preoperative studies have failed to identify this malformation. The purpose of this article is to present a case of gallbladder agenesis diagnosed during surgery, its management, and a review of the literature.
CLINICAL CASE
The case involves a sixty-two year- old female, referring to repeated biliary colic symptoms. The abdominal ultrasound diagnosed cholelithiasis. It was impossible to identify the gallbladder during surgery. Diagnosis was confirmed by intra-operative cholangiography.
DISCUSSION
Preoperative diagnostic workup has failed to recognise patients with gallbladder agenesis. It is currently recommended to abandon the surgery once this diagnosis is suspected and confirm it by a cholangio-magnetic resonance scan in order to avoid a bile duct injury.
CONCLUSIONS
Agenesis of the gallbladder is a rare congenital abnormality of the biliary tree. Every surgeon must keep this rare entity in mind when a "difficult dissection" or an anatomic variant is identified during surgery, and make use of an intra-operative cholangiography, mainly to prevent a bile duct injury.
Topics: Biliary Tract Diseases; Cholangiography; Cholecystectomy, Laparoscopic; Cholelithiasis; Colic; Congenital Abnormalities; Cystic Duct; Diagnostic Errors; Female; Gallbladder; Humans; Intraoperative Care; Middle Aged; Postoperative Complications; Ultrasonography
PubMed: 26162488
DOI: 10.1016/j.circir.2015.05.043 -
Nutricion Hospitalaria Feb 2015Infant colic is a prevalent physiological event of healthy children under 3 months of age which can disrupt the child's home environment. Despite its benign natural... (Review)
Review
Infant colic is a prevalent physiological event of healthy children under 3 months of age which can disrupt the child's home environment. Despite its benign natural history, sometimes requires a therapeutic approach. Numerous therapeutical lines have been proposed although its pathogenesis remains unknown and multifactorial. The gut microbiota plays an important role in the infant colic. Several studies have shown less bifidobacteria and lactobacilli in infant colic meanwhile Escherichia, Klebsiella, Serratia, Vibrio, Yersinia and Pseudomonas are more prominent in colon. The probiotic strain L. reuteri DSM 17938, when administered once daily to 10⁸ cfu / day, seems to have the most scientific evidence up to date in the treatment of infant colic, without significant side effects.
Topics: Colic; Humans; Infant; Infant, Newborn; Male; Microbiota; Probiotics
PubMed: 25659059
DOI: 10.3305/nh.2015.31.sup1.8712 -
Acta Veterinaria Scandinavica Oct 2014Despite increased focus on cardiac arrhythmias in horses, the nature and prevalence is still poorly described. Case reports suggest that arrhythmias occurring secondary...
BACKGROUND
Despite increased focus on cardiac arrhythmias in horses, the nature and prevalence is still poorly described. Case reports suggest that arrhythmias occurring secondary to systemic disease are seen more commonly in the clinic than arrhythmias caused by cardiac disease. The aim of this study was to investigate the prevalence of arrhythmias in colic horses referred for hospital treatment. Associations between electrolyte disturbances and arrhythmias were also investigated.
RESULTS
Heart rate was 37.4 ± 3.7 bpm in the control group, and 51.6 ± 11.8 bpm, in the colic group, which was significantly different (P < 0.0001). AV blocks and SVPCs were found in both groups, however only colic horses showed VPCs. No significant difference between the two groups was found for AV blocks, SVPCs, and VPCs (P = 0.08 - 0.76). The mean levels of potassium, sodium, ionized calcium, and chloride were significantly lower in the colic group compared to the control group at admission. Mean levels of glucose and L-lactate were significantly elevated in the colic group (P < 0.05).
CONCLUSIONS
This study describes prevalence of cardiac arrhythmias and electrolytes concentrations in colic horses compared to healthy controls. Although we only observed VPCs in the colic horses, no significant differences between colic horses and controls were found. Despite the colic horses having electrolyte changes at admission no correlation was found between the electrolyte disturbances and cardiac arrhythmias. Although no clear conclusions can be drawn from the present study, the results indicate that relatively mild colic per se is not pro-arrhythmogenic, whereas severe colic probably are more likely to result in ventricular arrhythmia.
Topics: Animals; Arrhythmias, Cardiac; Colic; Electrolytes; Horse Diseases; Horses
PubMed: 25274423
DOI: 10.1186/s13028-014-0058-y -
Complementary Therapies in Medicine Dec 2021To investigate evidence for the treatment of childhood colic by supplementing Lactobacillus reuteri in infants breastfed with breast milk. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate evidence for the treatment of childhood colic by supplementing Lactobacillus reuteri in infants breastfed with breast milk.
METHODS
The study was conducted according to the PRISMA protocol. The databases used for acquiring data were PubMed and Web of Science, applying MeSH terms and free terms. Meta-analysis was conducted using Stata ™ 12.0. The risk of bias was evaluated by the Review Manager (RevMan) 5.3 tool, and the strength of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
Ten clinical trials were included in the review. The administration of L. reuteri (DSM 17938 or ATCC55730) was tested in infants (n = 248) versus the control/placebo group (n = 229). Eight articles were included in the meta-analysis. There was a significant response in reducing crying time (minutes/day) and treatment effectiveness (reduction ≥ 50% in average daily crying time) in the first week (p = 0.001 and p = 0.003, respectively). These results were similar in the second, third weeks (p < 0.001 for both outcomes) and fourth weeks (p<0.001 and p = 0.002, respectively). The risk of bias was low for the majority of the studies. Confidence in evidence was considered very low for crying time and low for effectiveness treatment.
CONCLUSIONS
The evidence shows that the administration of Lactobacillus reuteri to babies fed with breast milk reduces the crying time in babies diagnosed with colic. But our confidence in the effect estimate is limited.
Topics: Breast Feeding; Colic; Crying; Female; Humans; Infant; Limosilactobacillus reuteri; Probiotics
PubMed: 34627993
DOI: 10.1016/j.ctim.2021.102781 -
Acta Medica Portuguesa 1999The appropriate approach to renal colic, which should be known by the family doctor, is presented. The incidence of this condition in the emergency department of a large...
The appropriate approach to renal colic, which should be known by the family doctor, is presented. The incidence of this condition in the emergency department of a large general hospital is described as well as the physiopathology of pain, its clinical aspects and the therapeutic attitudes. Renal colic is frequent, it is often possible to diagnose the clinical aspects and general practitioners have the competence for treatment. The use of analgesic drugs, in the correct dosage, is enough to relieve pain and suffering in most of the patients.
Topics: Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Colic; Diclofenac; Drug Therapy, Combination; Humans; Kidney Diseases; Meperidine
PubMed: 10423866
DOI: No ID Found -
BMC Veterinary Research Apr 2022Peritonitis in horses secondary to non-strangulating infarction (NSII) has a guarded prognosis, even after intestinal resection. In contrast, horses with idiopathic...
Clinical features and treatment response to differentiate idiopathic peritonitis from non-strangulating intestinal infarction of the pelvic flexure associated with Strongylus vulgaris infection in the horse.
BACKGROUND
Peritonitis in horses secondary to non-strangulating infarction (NSII) has a guarded prognosis, even after intestinal resection. In contrast, horses with idiopathic peritonitis respond well to medical treatment. Affected horses in both cases often show signs of both colic and systemic inflammation, but early diagnosis is crucial for optimal treatment and an accurate prognosis. One cause of NSII is thrombus formation secondary to Strongylus vulgaris larval migration. There has been a documented increase in S. vulgaris prevalence in Sweden since the implementation of selective anthelmintic treatment in 2007, which subsequently could result in a rise in NSII cases. In a retrospective clinical study, medical records from cases diagnosed with NSII of the pelvic flexure or idiopathic peritonitis from three equine referral hospitals in Sweden during 2017-2020 were reviewed. Information including demographic data, relevant medical history, and clinical- and laboratory parameters were obtained from patient records. To facilitate the differentiation between cases of idiopathic peritonitis and cases with confirmed NSII of the pelvic flexure, the aim of the study was to compare clinical and laboratory parameters, clinical progression and initial response to antimicrobial treatment. A secondary aim was to compare survival-rates.
RESULTS
Horses with NSII (n = 20) were significantly more likely to present during the winter months with a poorer response to medical treatment within 48 h. Cases of idiopathic peritonitis (n = 107) had a 100% survival rate with medical treatment, although one case required surgical correction of a colon displacement. In comparison, all confirmed NSII cases were non-responsive to antimicrobial treatment, with a survival rate to discharge of 50% after colon resection. Specific rectal findings and peripheral blood neutropenia were strongly associated with NSII.
CONCLUSIONS
In Sweden, idiopathic peritonitis cases still predominate over S. vulgaris associated NSII cases and have an excellent survival rate with antimicrobial treatment. However, horses presenting with septic peritonitis during the winter months with a palpable rectal mass and displaying fever and colic signs beyond 48 h of medical treatment are likely to suffer from NSII of the pelvic flexure and should be considered for abdominal surgery.
Topics: Animals; Colic; Gastrointestinal Diseases; Horse Diseases; Horses; Infarction; Peritonitis; Retrospective Studies; Strongylus; Vascular Diseases
PubMed: 35461295
DOI: 10.1186/s12917-022-03248-x -
The Canadian Veterinary Journal = La... Oct 2022This study describes the clinicopathological findings, diagnostic approach, treatment, and factors associated with non-survival of diarrheic horses admitted to 4...
This study describes the clinicopathological findings, diagnostic approach, treatment, and factors associated with non-survival of diarrheic horses admitted to 4 Canadian university teaching hospitals between 2015 and 2019. A total of 300 horses, ≥1-year-old, with acute diarrhea were included and represented 1.6% (300/18 481; range: 0.7 to 3%) of admissions during that period, 70% of the horses survived to discharge. Testing for enteropathogens was limited to a single fecal culture for spp. in most cases. An enteropathogen was identified in 14% (42/300) of the horses, but in the hospital with higher testing rates enteropathogens were detected in 29% (16/55) of cases. was the pathogen most frequently detected (31%, 32/102). Antimicrobial drugs and plasma were administered to 57 and 8% of the cases, respectively. Laminitis occurred in 24/298 (8%) of the horses. A multivariable regression model identified an association between non-survival of diarrheic horses and colic signs, increased heart rate, packed cell volume, creatinine concentration, and decreased total protein concentration. A standardized approach for pathogen detection in diarrheic horses is not consistent among Canadian veterinary teaching hospitals, and testing for known pathogens is limited. Signs of colic, severe dehydration, endotoxemia, and hypoproteinemia are associated with non-survival of diarrheic horses.
Topics: Animals; Anti-Infective Agents; Canada; Colic; Creatinine; Diarrhea; Horse Diseases; Horses; Retrospective Studies
PubMed: 36185796
DOI: No ID Found -
BMC Pediatrics Oct 2017Regional evidence-based guidelines for the prophylaxis and management of infantile colic are not available for the Middle East and North Africa (MENA) region. The Allied...
BACKGROUND
Regional evidence-based guidelines for the prophylaxis and management of infantile colic are not available for the Middle East and North Africa (MENA) region. The Allied Against Infantile Functional GI Disorders (ACT) Working Group was created in January, 2015 to determine the knowledge gaps and the current management practices of infantile colic by physicians in the MENA region. The ACT group determined the need for a survey to address these questions. The objectives of the survey were to highlight current clinical practices on the management of infantile colic and to raise awareness on colic severity in the MENA region.
METHODS
The ACT working group developed the survey which included respondent characteristics and closed questions on practice in colic prevention. The survey was subject to validation and ethics committee approval in all countries.
RESULTS
A total of 1628 physicians (mostly pediatricians (75.4%), neonatologists (2.4%) and general practitioners (19.8%)) responded to the survey. The 5 most represented countries were KSA (27.9%), Kuwait (22.1%), Morocco (13.8%), Lebanon (10.6%), and Iraq (7.4%). Most of the respondents (77.8%) practiced in governmental settings. A majority of respondents (91.7%) reported that colic is diagnosed predominantly by clinical examination. Above 63%, of pediatricians surveyed, believed that the colic prevalence rate was >40%, which is greater than the 20% rate reported in worldwide surveys. Yet, most of the responding physicians (73%) prefer to simply reassure parents rather than prescribe a therapeutic agent. Most physicians were either neutral (58%) or did not endorse (18.4%) colic prophylaxis. Of those who prescribed formulae for non-breastfed children, a majority (64.3%) chose "Comfort" formulae over hydrolyzed or lactose-free formulae or formulae with probiotics.
CONCLUSIONS
The results of this survey suggest that a substantial proportion of responding physicians from the selected MENA countries do not advocate for prophylaxis of colic. The findings of this survey suggest that more educational efforts are required to increase awareness of the strong body of evidence supporting the efficacy of probiotics in the prevention and management of infantile colic.
Topics: Adult; Africa, Northern; Attitude of Health Personnel; Clinical Competence; Colic; Female; Gastrointestinal Diseases; Health Care Surveys; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Middle East; Pediatricians; Practice Patterns, Physicians'
PubMed: 29058577
DOI: 10.1186/s12887-017-0939-0 -
Journal of the American Veterinary... Sep 2018
Topics: Animals; Colic; Colonic Diseases; Diagnosis, Differential; Fecal Impaction; Horse Diseases; Horses; Humans; Laparoscopy; Male; Radiography
PubMed: 30179093
DOI: 10.2460/javma.253.6.711 -
BMJ Open Jan 2021Biliary colic (BC) is a severe pain associated with nausea and vomiting, which is the most common symptom among the gallstone population. This protocol proposes a...
INTRODUCTION
Biliary colic (BC) is a severe pain associated with nausea and vomiting, which is the most common symptom among the gallstone population. This protocol proposes a methodology for conducting a systematic review and meta-analysis that aims to assess the benefits and safety of acupuncture in patients with BC.
METHODS AND ANALYSIS
Clinical trials will be identified through nine databases from inception to December 2020, using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Allied and Complementary Medicine Database (AMED), CINAHL, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database and Wanfang Database. Search words will be used for the BC and acupuncture. The analysis would include randomised, controlled, clinical trials of adults with BC that were published in either Chinese or English. The primary outcome is to measure pain relief. Two or three reviewers should be in charge of study selection, data extraction and evaluating the risk of bias. RevMan software (V.5.4) will be used to perform the assessment of the risk of bias and data synthesis.
ETHICS AND DISSEMINATION
Ethics approval will not be required for this review, as it will only involve the collection of literature previously published. The results of this meta-analysis will be disseminated in a peer-reviewed journal or relevant conference, through publication.
TRIAL REGISTRATION NUMBER
CRD42020167510.
Topics: Acupuncture; Acupuncture Therapy; Adult; China; Colic; Humans; Meta-Analysis as Topic; Research Design; Systematic Reviews as Topic
PubMed: 33455934
DOI: 10.1136/bmjopen-2020-041931