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[PMID]:28453918
[Au] Autor:Vannas MJ; Boyd S; Färkkilä MA; Arola J; Isoniemi H
[Ad] Endereço:Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland.
[Ti] Título:Value of brush cytology for optimal timing of liver transplantation in primary sclerosing cholangitis.
[So] Source:Liver Int;37(5):735-742, 2017 May.
[Is] ISSN:1478-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Primary sclerosing cholangitis is associated with a high risk of cholangiocarcinoma. Here, we investigated the value of surveillance for dysplasia using brush cytology, to determine the optimal timing of liver transplantation in primary sclerosing cholangitis. We compared our preoperative findings, with the final explanted liver histopathology. METHODS: 126 consecutive patients were transplanted for primary sclerosing cholangitis from 1984 to 2012. Patients were divided into two groups: symptomatic (n=91), and asymptomatic (n=35). RESULTS: Brush cytology was available for 101 patients; 66 symptomatic and 35 asymptomatic. Suspicious cytological findings were found in nine patients (14%) in the symptomatic group and 17 (49%) in the asymptomatic group. DNA flow cytometry was available for 49 patients (25 symptomatic, 24 asymptomatic), with aneuploidy detected in six patients (24%) in the symptomatic group and 15 (63%) in the asymptomatic group. Explanted liver histology showed biliary dysplasia or cholangiocarcinoma in 11 symptomatic patients (12%) and 15 asymptomatic patients (43%). A combination of cytological and DNA flow cytometry findings resulted in a test sensitivity of 68%, with a specificity of 86%. Ten-year survival in the asymptomatic group was 91%. CONCLUSIONS: Dysplasia surveillance using brush specimens may help to select those patients likely to benefit from early liver transplantation. It remains unclear as to whether surveillance with brush cytology improves long-term survival, but there is presently no better method with which to predict transplantation timing.
[Mh] Termos MeSH primário: Sistema Biliar/patologia
Colangite Esclerosante/patologia
Colangite Esclerosante/cirurgia
Citodiagnóstico/métodos
Células Epiteliais/patologia
Transplante de Fígado
[Mh] Termos MeSH secundário: Adulto
Neoplasias dos Ductos Biliares/patologia
Carcinoma Hepatocelular/patologia
Colangiocarcinoma/patologia
Colangiopancreatografia Retrógrada Endoscópica
Diagnóstico Diferencial
Feminino
Finlândia
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/patologia
Masculino
Meia-Idade
Sistema de Registros
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/liv.13276


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[PMID]:27778443
[Au] Autor:Krawczyk M; Liebe R; Wasilewicz M; Wunsch E; Raszeja-Wyszomirska J; Milkiewicz P
[Ad] Endereço:Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
[Ti] Título:Plasmapheresis exerts a long-lasting antipruritic effect in severe cholestatic itch.
[So] Source:Liver Int;37(5):743-747, 2017 May.
[Is] ISSN:1478-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND & AIMS: The amelioration of refractory cholestatic pruritus after plasmapheresis has been reported in single patients. Here, we analyse the efficacy of plasmapheresis in a cohort of patients with primary biliary cholangitis (PBC). METHODS: Seventeen consecutive patients with PBC (age range 39-85 years, 16 females, 9 with cirrhosis) and refractory pruritus underwent 129 plasmapheresis procedures during 40 admissions. Pruritus was quantified by the 10-point numeric rating scale (NRS) before and after plasmapheresis, as well as ~30 and ~90 days later. RESULTS: The mean pruritus before plasmapheresis did not differ between patients with and without cirrhosis (P>.05). Cirrhotics presented, however, with significantly higher serum alanine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and bilirubin before plasmapheresis. Plasmapheresis decreased itching to NRS≤5 in all but five admissions: Mean pruritus decreased from 8.3±1.4 to 3.1±2.2 (P<.0001) in the entire cohort. It also led to a significant decrease in serum ALT, ALP, AST, GGT (all P<.001) and bilirubin (P=.002). Antipruritic effect persisted throughout the 90-days follow-up (P<.0001). The amelioration of pruritus was not affected by the presence of cirrhosis. CONCLUSIONS: Plasmapheresis is a promising method for reducing intractable itch in a significant proportion of PBC patients regardless of liver fibrosis. Long-lasting improvement of symptoms requires repeated procedures.
[Mh] Termos MeSH primário: Colestase/complicações
Cirrose Hepática Biliar/complicações
Plasmaferese
Prurido/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Fosfatase Alcalina/sangue
Aspartato Aminotransferases/sangue
Bilirrubina/sangue
Feminino
Seres Humanos
Fígado/patologia
Masculino
Meia-Idade
Polônia
Prurido/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.6.1.1 (Aspartate Aminotransferases); EC 3.1.3.1 (Alkaline Phosphatase); RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1111/liv.13281


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[PMID]:29465558
[Au] Autor:Xiao J; Xu P; Li B; Hong T; Liu W; He X; Zheng C; Zhao Y
[Ad] Endereço:Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
[Ti] Título:Analysis of clinical characteristics and treatment of immunoglobulin G4-associated cholangitis: A retrospective cohort study of 39 IAC patients.
[So] Source:Medicine (Baltimore);97(8):e9767, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Immunoglobulin (Ig)G4-associated cholangitis (IAC) is one of the common organ manifestations of IgG4-related systemic disease (ISD). IAC and autoimmune pancreatitis (AIP) may mimic sclerosing cholangitis, cholangiocarcinoma, or pancreatic carcinoma. Diagnosis is based on a combination of clinical, biochemical, radiological, and histological findings.To study the clinical presentation of and treatment strategy for IAC, we reviewed clinical, serologic, and imaging characteristics, as well as treatment response, in 39 patients with IAC. The majority of patients were men (82%). Clinical features on presentation included obstructive jaundice in 26 patients (67%) and abdominal pain in 20 (51%). Positive IgG4 immunostaining was seen in 27 patients. The median serum IgG4 level before treatment was 769.4 mg/dL (range, 309.1-1229.7 mg/dL). After the steroid therapy, the median serum IgG4 level in 23 patients was 247.0 mg/dL (range, 139.0-355.0 mg/dL). Cholangiograms were available in 36 (92%) patients. Stenosis of the lower part of the common bile duct was found in 26 of 39 patients. Stenosis was diffusely distributed in the intra- and extrahepatic bile ducts in 14 of 39 patients. Additionally, strictures of the bile duct were detected in the hilar hepatic lesions in 27 of 39 patients. AIP was the most frequent comorbidity (35/39 in this study) of IAC. Other affected organs included eyes (n = 6), salivary glands (sialadenitis, n = 10), lymph nodes (mediastinal and axillary, n = 3), kidneys (n = 2), and the retroperitoneum (retroperitoneal fibrosis, n = 2).Regarding treatment, 29 patients were treated with steroids, of whom one underwent pancreatoduodenectomy, and one underwent choledochojejunostomy. Eight patients were treated with biliary stents. The remaining 19 patients took prednisolone alone. Eight patients achieved spontaneous resolution. Four patients with suspected pancreatic cancer or cholangiocarcinoma underwent surgery, including 2 patients who also received postoperative steroids. All patients were regularly followed up for 9 to 36 months. Only 2 patients in the steroids treatment group relapsed to manifest obstructive jaundice and high serum IgG4 levels. These 2 patients were treated with steroids and biliary stents, resulting in complete remission.We also review the diagnostic and therapeutic management and discuss recent pathophysiological findings, which might aid in understanding the molecular mechanisms contributing to IAC and other manifestations of IgG4-related diseases (IgG4-RD). Biomarkers that are more accurate are needed to correctly diagnose IAC and prevent misdiagnoses and unnecessary therapeutic interventions.
[Mh] Termos MeSH primário: Doenças Autoimunes/imunologia
Doenças Autoimunes/terapia
Colangite/imunologia
Colangite/terapia
Imunoglobulina G/sangue
[Mh] Termos MeSH secundário: Adulto
Anti-Inflamatórios/uso terapêutico
Doenças Autoimunes/patologia
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colangite/patologia
Coledocostomia
Ducto Colédoco/patologia
Constrição Patológica
Feminino
Seres Humanos
Masculino
Meia-Idade
Pancreaticoduodenectomia
Pancreatite/imunologia
Prednisolona/uso terapêutico
Estudos Retrospectivos
Stents
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009767


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[PMID]:29465536
[Au] Autor:Yan X; Jin J
[Ad] Endereço:Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, China.
[Ti] Título:Primary cutaneous amyloidosis associated with autoimmune hepatitis-primary biliary cirrhosis overlap syndrome and Sjögren syndrome: A case report.
[So] Source:Medicine (Baltimore);97(8):e0004, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Primary cutaneous amyloidosis (PCA) is a localized skin disorder characterized by the abnormal deposition of amyloid in the extracellular matrix of the dermis. The association between PCA and other diseases, although rare, has been documented for various autoimmune diseases. PCA associated with autoimmune hepatitis-primary biliary cirrhosis (AIH-PBC) overlap syndrome and Sjögren syndrome (SS) has not been previously reported in the literature. PATIENT CONCERNS: A 50-year-old woman presented with progressive abnormal liver enzyme levels and was referred to our department. DIAGNOSES: Due to the patient's symptoms, laboratory test results, radiographic findings, and pathologic results, she was diagnosed with PCA associated with AIH-PBC overlap syndrome and SS. INTERVENTIONS: She was subsequently treated with a combination of ursodeoxycholic acid (UDCA), prednisone, and azathioprine. OUTCOMES: While this treatment can achieve therapeutic success, it cannot prevent complications from cirrhosis. This patient remains alive but experienced an emergent gastrointestinal hemorrhage. LESSONS: While we acknowledge that this is a single case, these findings extend our knowledge of immunological diseases associated with PCA and suggest a common, immune-mediated pathogenic pathway between PCA, AIH-PBC overlap syndrome, and SS. After 12 years of follow up, clinical manifestations have developed, and these autoimmune diseases have progressed. The combination of UDCA, prednisone, and azathioprine can achieve therapeutic success but cannot prevent disease progression. Routine follow up for this patient is necessary to document disease progression.
[Mh] Termos MeSH primário: Amiloidose Familiar/imunologia
Hepatite Autoimune/complicações
Cirrose Hepática Biliar/complicações
Síndrome de Sjogren/complicações
Dermatopatias Genéticas/imunologia
Doenças do Tecido Conjuntivo Indiferenciado/complicações
[Mh] Termos MeSH secundário: Amiloidose Familiar/tratamento farmacológico
Anti-Inflamatórios/administração & dosagem
Azatioprina/administração & dosagem
Colagogos e Coleréticos/administração & dosagem
Quimioterapia Combinada
Feminino
Hepatite Autoimune/tratamento farmacológico
Hepatite Autoimune/imunologia
Seres Humanos
Imunossupressores/administração & dosagem
Cirrose Hepática Biliar/tratamento farmacológico
Cirrose Hepática Biliar/imunologia
Meia-Idade
Prednisona/administração & dosagem
Síndrome de Sjogren/tratamento farmacológico
Síndrome de Sjogren/imunologia
Dermatopatias Genéticas/tratamento farmacológico
Resultado do Tratamento
Doenças do Tecido Conjuntivo Indiferenciado/tratamento farmacológico
Doenças do Tecido Conjuntivo Indiferenciado/imunologia
Ácido Ursodesoxicólico/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Cholagogues and Choleretics); 0 (Immunosuppressive Agents); 724L30Y2QR (Ursodeoxycholic Acid); MRK240IY2L (Azathioprine); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010004


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[PMID]:28470667
[Au] Autor:Tanaka T; Zhang W; Sun Y; Shuai Z; Chida AS; Kenny TP; Yang GX; Sanz I; Ansari A; Bowlus CL; Ippolito GC; Coppel RL; Okazaki K; He XS; Leung PSC; Gershwin ME
[Ad] Endereço:Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA.
[Ti] Título:Autoreactive monoclonal antibodies from patients with primary biliary cholangitis recognize environmental xenobiotics.
[So] Source:Hepatology;66(3):885-895, 2017 09.
[Is] ISSN:1527-3350
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A major problem in autoimmunity has been identification of the earliest events that lead to breach of tolerance. Although there have been major advances in dissecting effector pathways and the multilineage immune responses to mitochondrial self-antigens in primary biliary cholangitis, the critical links between environmental factors and tolerance remain elusive. We hypothesized that environmental xenobiotic modification of the E2 subunit of the pyruvate dehydrogenase (PDC-E2) inner lipoyl domain can lead to loss of tolerance to genetically susceptible hosts. Previously we demonstrated that serum anti-PDC-E2 autoantibodies cross-react with the chemical xenobiotics 2-octynoic acid and 6,8-bis (acetylthio) octanoic acid and further that there is a high frequency of PDC-E2-specific peripheral plasmablasts. Herein we generated 104 recombinant monoclonal antibodies (mAbs) based on paired heavy-chain and light-chain variable regions of individual plasmablasts derived from primary biliary cholangitis patients. We identified 32 mAbs reactive with native PDC-E2, including 20 specific for PDC-E2 and 12 cross-reactive with both PDC-E2 and 2-octynoic acid and 6,8-bis (acetylthio) octanoic acid. A lower frequency of replacement somatic hypermutations, indicating a lower level of affinity maturation, was observed in the complementarity-determining regions of the cross-reactive mAbs in comparison to mAbs exclusively recognizing PDC-E2 or those for irrelevant antigens. In particular, when the highly mutated heavy-chain gene of a cross-reactive mAb was reverted to the germline sequence, the PDC-E2 reactivity was reduced dramatically, whereas the xenobiotic reactivity was retained. Importantly, cross-reactive mAbs also recognized lipoic acid, a mitochondrial fatty acid that is covalently bound to PDC-E2. CONCLUSION: Our data reflect that chemically modified lipoic acid or lipoic acid itself, through molecular mimicry, is the initial target that leads to the development of primary biliary cholangitis. (Hepatology 2017;66:885-895).
[Mh] Termos MeSH primário: Anticorpos Monoclonais/imunologia
Autoantígenos/imunologia
Autoimunidade/genética
Colangite/imunologia
Colangite/patologia
Xenobióticos/imunologia
[Mh] Termos MeSH secundário: Anticorpos Monoclonais/metabolismo
Autoantígenos/genética
Autoimunidade/imunologia
Feminino
Amplificação de Genes
Seres Humanos
Immunoblotting
Masculino
Mimetismo Molecular/genética
Reação em Cadeia da Polimerase em Tempo Real
Sensibilidade e Especificidade
Ácido Tióctico/imunologia
Ácido Tióctico/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Autoantigens); 0 (Xenobiotics); 73Y7P0K73Y (Thioctic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/hep.29245


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[PMID]:29443746
[Au] Autor:Wang Z; Liu X; Xu H; Qu L; Zhang D; Gao P
[Ad] Endereço:Department of Hepatology.
[Ti] Título:Platelet count to spleen thickness ratio is related to histologic severity of primary biliary cholangitis.
[So] Source:Medicine (Baltimore);97(7):e9843, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to evaluate the ability of noninvasive markers to identify the histological severity of primary biliary cholangitis (PBC).Fifty-eight treatment-naïve PBC patients who had undergone liver biopsy were enrolled in our study. The patients' histological stages were based on the classifications of Ludwig and Scheuer. Aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis index based on the 4 factors (FIB-4), red blood cell distribution width to platelet ratio (RPR), and platelet count to spleen thickness (PC/ST) ratio were calculated. Using the area under the receiver operating characteristic curve (AUROC) to evaluate the accuracy of different markers for predicting the histological severity.Among the 58 treatment-naïve PBC patients, the patients of Scheuer stage I/II/III/IV were 17/25/11/5, respectively. PC/ST ratio (AUROC = 0.807) was superior to RPR (AUROC = 0.717), APRI (AUROC = 0.726), FIB-4 (AUROC = 0.722), and mean platelet volume (MPV) (AUROC = 0.671) in discriminating between stage I and stage ≥II. The AUROC of PC/ST ratio, RPR, APRI, FIB-4, and MPV were 0.939, 0.872, 0.816, 0.831 and 0.572, respectively, for Scheuer stage ≥III; 0.968, 0.795, 0.744, and 0.723, respectively for stage IV. The sensitivity and specificity of PC/ST ratio were 73.4%,79.1%; 81%,100%;88.7%,100% for detection of Scheuer stage ≥ II, Scheuer stage ≥ III and Scheuer stage IV, respectively.Our study findings indicated that compared with previous noninvasive test PRP, APRI, FIB-4 and MPV, PC/ST ratio shows the most accurate for distinguish the histologic severity of PBC patients.
[Mh] Termos MeSH primário: Colangite/sangue
Cirrose Hepática Biliar/sangue
Contagem de Plaquetas
Índice de Gravidade de Doença
Baço/patologia
[Mh] Termos MeSH secundário: Área Sob a Curva
Aspartato Aminotransferases/sangue
Biomarcadores/análise
Colangite/patologia
Índices de Eritrócitos
Feminino
Seres Humanos
Cirrose Hepática Biliar/patologia
Masculino
Meia-Idade
Valor Preditivo dos Testes
Curva ROC
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); EC 2.6.1.1 (Aspartate Aminotransferases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009843


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[PMID]:29366780
[Au] Autor:Lin YC; Wang FS; Yang YL; Chuang YT; Huang YH
[Ad] Endereço:Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, Taiwan.
[Ti] Título:MicroRNA-29a mitigation of toll-like receptor 2 and 4 signaling and alleviation of obstructive jaundice-induced fibrosis in mice.
[So] Source:Biochem Biophys Res Commun;496(3):880-886, 2018 02 12.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cholestasis and hepatitis can cause continuous liver damage that may ultimately result in liver fibrosis. In a previous study, we demonstrated that microRNA-29a (miR-29a) protects against liver fibrosis. Toll-like receptor 2 (TLR2) and TLR4 are pattern recognition receptors of bacterial lipoprotein and lipopolysaccharide, both of which participate in activating hepatic stellate cells and liver fibrosis. The purpose of this study is to characterize the biological influence of miR-29a on TLR2 and TLR4 signaling in livers injured with bile duct ligation (BDL). We performed BDL on both miR-29a transgenic mice (miR-29aTg) and wild-type mice to induce cholestatic liver injury. Primary HSCs were transfected with a miR-29a mimic and inhibitor. In the wild-type mice, the BDL demonstrated significant α-smooth muscle actin fibrotic matrix formation and hepatic high mobility group box-1 expression. However, in the miR-29aTg mice, these factors were significantly reduced. Furthermore, miR-29a overexpression reduced the BDL exaggeration of TLR2, TLR4, MyD88, bromodomain-containing protein 4 (BRD4), phospho-p65 as well as proinflammatory cytokines, IL-1ß, MCP-1, TGF-ß, and TNF-α. In vitro, miR-29a mimic transfection reduced α-SMA, BRD4,TLR2, and TLR4 expressions in HSCs. This study provides new molecular insight into the ability of miR-29a to inhibit TLR2 and TLR4 signaling, which thus slows the progression of cholestatic liver deterioration.
[Mh] Termos MeSH primário: Icterícia Obstrutiva/metabolismo
Cirrose Hepática Biliar/metabolismo
MicroRNAs/metabolismo
Receptor 2 Toll-Like/metabolismo
Receptor 4 Toll-Like/metabolismo
[Mh] Termos MeSH secundário: Animais
Citocinas/metabolismo
Icterícia Obstrutiva/complicações
Icterícia Obstrutiva/patologia
Cirrose Hepática Biliar/complicações
Cirrose Hepática Biliar/patologia
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Transdução de Sinais
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Cytokines); 0 (MIRN29 microRNA, mouse); 0 (MicroRNAs); 0 (Tlr2 protein, mouse); 0 (Tlr4 protein, mouse); 0 (Toll-Like Receptor 2); 0 (Toll-Like Receptor 4)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE


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[PMID]:29320524
[Au] Autor:Zenouzi R; von der Gablentz J; Heldmann M; Göttlich M; Weiler-Normann C; Sebode M; Ehlken H; Hartl J; Fellbrich A; Siemonsen S; Schramm C; Münte TF; Lohse AW
[Ad] Endereço:1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
[Ti] Título:Patients with primary biliary cholangitis and fatigue present with depressive symptoms and selected cognitive deficits, but with normal attention performance and brain structure.
[So] Source:PLoS One;13(1):e0190005, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In primary biliary cholangitis (PBC) fatigue is a major clinical challenge of unknown etiology. By demonstrating that fatigue in PBC is associated with an impaired cognitive performance, previous studies have pointed out the possibility of brain abnormalities underlying fatigue in PBC. Whether structural brain changes are present in PBC patients with fatigue, however, is unclear. To evaluate the role of structural brain abnormalities in PBC patients severely affected from fatigue we, therefore, performed a case-control cerebral magnetic resonance imaging (cMRI) study and correlated changes of white and grey brain matter with the cognitive and attention performance. METHODS: 20 female patients with PBC and 20 female age-matched controls were examined in this study. The assessment of fatigue, psychological symptoms, cognitive and attention performance included clinical questionnaires, established cognition tests and a computerized test battery of attention performance. T1-weighted cMRI and diffusion tensor imaging (DTI) scans were acquired with a 3 Tesla scanner. Structural brain alterations were investigated with voxel-based morphometry (VBM) and DTI analyses. Results were correlated to the cognitive and attention performance. RESULTS: Compared to healthy controls, PBC patients had significantly higher levels of fatigue and associated psychological symptoms. Except for an impairment of verbal fluency, no cognitive or attention deficits were found in the PBC cohort. The VBM and DTI analyses revealed neither major structural brain abnormalities in the PBC cohort nor correlations with the cognitive and attention performance. CONCLUSIONS: Despite the high burden of fatigue and selected cognitive deficits, the attention performance of PBC patients appears to be comparable to healthy people. As structural brain alterations do not seem to be present in PBC patients with fatigue, fatigue in PBC must be regarded as purely functional. Future studies should evaluate, whether functional brain changes underlie fatigue in PBC.
[Mh] Termos MeSH primário: Atenção
Encéfalo/patologia
Colangite Esclerosante/psicologia
Depressão/etiologia
Fadiga/etiologia
Distúrbios da Fala/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Casos e Controles
Colangite Esclerosante/patologia
Depressão/patologia
Imagem de Tensor de Difusão
Fadiga/patologia
Fadiga/psicologia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Meia-Idade
Testes Neuropsicológicos
Distúrbios da Fala/patologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190005


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[PMID]:29241849
[Au] Autor:Xu MM; Carr-Locke DL
[Ad] Endereço:The Center for Advanced Digestive Care, Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA.
[Ti] Título:Early ERCP for severe cholangitis? Of course!
[So] Source:Gastrointest Endosc;87(1):193-195, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica
Colangite
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29369874
[Au] Autor:Aschenbrenner DS
[Ad] Endereço:Diane S. Aschenbrenner is an assistant professor at Notre Dame of Maryland University in Baltimore. She also coordinates Drug Watch: daschenbrenner@ndm.edu.
[Ti] Título:Excessive Dosing of Obeticholic Acid May Increase Risk of Liver Damage.
[So] Source:Am J Nurs;118(2):46, 2018 Feb.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doença Hepática Induzida por Substâncias e Drogas/etiologia
Ácido Quenodesoxicólico/análogos & derivados
Fármacos Gastrointestinais/efeitos adversos
[Mh] Termos MeSH secundário: Ácido Quenodesoxicólico/administração & dosagem
Ácido Quenodesoxicólico/efeitos adversos
Colangite/tratamento farmacológico
Relação Dose-Resposta a Droga
Fármacos Gastrointestinais/administração & dosagem
Seres Humanos
Estados Unidos
United States Food and Drug Administration
[Pt] Tipo de publicação:NEWS
[Nm] Nome de substância:
0 (Gastrointestinal Agents); 0462Z4S4OZ (obeticholic acid); 0GEI24LG0J (Chenodeoxycholic Acid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000530245.53335.c8



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