Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Retrospective review of the first 210 patients treated by laparoscopic cholecystectomy revealed 55 patients (26%) with acute cholecystitis diagnosed preoperatively or intraoperatively. Average age was 52 years amongst 38 women and 17 men. Cardiac history was present in 4%, pulmonary disease was noted in 9%, and other significant medical history was found in 10%. Abnormal preoperative laboratory values (white blood cell count, liver function) were seen in 80%. Operations averaged 104 minutes. Dissection was performed with the potassium titanyl phosphate (KTP) laser in 9%, neodymium-doped yttrium aluminum garnet (Nd Yag) laser in 20%, and electrocautery alone in 71%. Average body habitus was 5 ft 9 in, 178 lb for men and 5 ft 5 in, 155 lb for women. Average length of stay was 2.6 days. Thirty-eight patients (69%) left the hospital in < 2 days. Postoperative complications included one case each of urinary retention, pneumonia, myocardial infarction, and three cases of postoperative fever. Drains were placed in 10 patients (18%). There was no mortality. Suggestions are made for technical considerations that make laparoscopic cholecystectomy a safe and efficient approach to acute cholecystitis.
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PMID:Laparoscopic treatment of acute cholecystitis. 166 69

Acute cholecystitis associated with gallbladder carcinoma is very rare in young patients (younger than 30 years of age). Moreover, a definitive preoperative diagnosis is difficult. A 26-year-old man was referred to our hospital with a 5-day history of right upper quadrant pain. Computed tomography and ultrasonography demonstrated an enlarged gallbladder with a diffuse thick wall and a 2-cm gallstone obstructing the cystic duct. Magnetic resonance cholangiopancreatography showed no evidence of an anomalous pancreaticobiliary junction. The patient showed an elevation in the white blood cell count, serum C-reactive protein, and alkaline phosphate; however, total bilirubin, alanine aminotransferase, and tumor markers including carcinoembryonic antigen and carbohydrate antigen 19-9 were all within the normal ranges. The preoperative diagnosis of gallstone-induced acute cholecystitis was made and an open cholecystectomy was thus performed 2 days after admission. The macroscopic findings showed a necrotic enlarged gallbladder with a thick wall and a gallstone, but no intraluminal nodular lesion. Histologic examinations revealed well-differentiated focal adenocarcinoma in the gallbladder mucosa, but no venous, lymphatic, or perineural invasion. The postoperative course has been uneventful with no recurrence 18 months postoperatively.
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PMID:Latent gallbladder carcinoma in a young adult patient with acute cholecystitis: report of a case. 1764 22

Bixalomer is a nonabsorbable polymer that binds phosphate in the gastrointestinal tract and lowers the serum phosphate level by inhibiting phosphate absorption. The safety and efficacy of long-term bixalomer treatment were assessed in Japanese hemodialysis patients with hyperphosphatemia. This was a multicenter open-label study with a 48-week treatment period. The main efficacy endpoints were the serum phosphate level and rate of achieving the target serum phosphate range (3.5-6.0 mg/dL). Bixalomer was initiated at a dose of 1.5 g/day, which was increased to a maximum of 7.5 g/day depending on the serum phosphate response. Of 248 subjects who started treatment, 179 completed the study. The mean serum phosphate level decreased over time and remained around 5.5 mg/dL from weeks 16 to 48. The target serum phosphate level was reached in >50% of subjects by week 7 and was maintained in 65.2% to 75.9% until week 48. The incidence of adverse events and adverse drug reactions was 94.4% and 29.4%, respectively. There was a potential relationship with the study drug for four serious adverse events (ischemic colitis, hemorrhagic intestinal diverticulum, esophageal ulcer, and acute cholecystitis), which occurred in one patient each. Constipation was the most common adverse drug reaction (21.0%). Most adverse events and adverse drug reactions occurred soon after starting administration, and their incidence did not increase during long-term treatment. Bixalomer did not reduce the bicarbonate level or promote metabolic acidosis. Bixalomer is clinically useful for the long-term treatment of hyperphosphatemia.
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PMID:Long-term treatment of hyperphosphatemia with bixalomer in Japanese hemodialysis patients. 2433 May 56

Gallstone disease is a major surgical problem in many populations; it is probably related to diet, especially excessive consumption of meat. The objective of this study was to determine the chemical composition of gallstones and their association with neoplastic changes including cholangiocarcinomas in cholecystectomised patients. The chemical composition of gallstones from 40 patients (8 males and 32 females) was analyzed. This is a prospective study performed in Baquba teaching hospital in the period from 1/10/2012 to 1/1/2013 in which we collected the gallstones for the patients who underwent cholecystectomy, whether open or laparoscopic. The stones were classified according to their chemical composition as a mixed stones (MS), and examined using a stone analysis set (chemical qualitative method) for calcium, magnesium, phosphate, uric acid and oxalate which was used reagent for qualitative determination of main individual components of stones. The results of this study showed the highest incidence of gallstones in the age group 40-49 was 13 cases followed by 11, 8 and 4 cases for age groups 30-39, 50-59, 20-29 and 60 and above, respectively. The chemical analysis showed the majority of gallstones were mixed, 38 containing calcium followed by 37 cases with uric acid, 28 with magnesium, and 25 and 22 stones with oxalate and phosphate, respectively. Microscopically, we confirmed neoplastic changes (17.5%) as cholangiocarcinomas (CCCs) (7.55%) and dysplastic cells of carcinoma in situ in 4 (10%), 31 (77.5%) cases were chronic cholecystitis and 2 (5%) cases were acute cholecystitis with empyema out of bile duct disorders patients. In conclusion, majority of cases had mixed gallstones that involved five and four of inorganic chemicals of calcium, magnesium and phosphate, the highest incidence of gallstones in age group 40-49 years old was 13 cases, and neoplastic changes were confirmed (17.5%) including CCCs, (7.5%) and dysplastic cells of carcinoma in situ (10%), while 31 (77.5%) cases were chronic cholecystitis.
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PMID:Determination of chemical composition of gallbladder stones and their association with induction of cholangiocarcinoma. 2437 14

Calcium oxalate phosphate is extremely rare composition of gall stones, with only one case reported in pediatric population till date. We report a case of pediatric cholelithiasis with a unique composition of calcium oxalate phosphate, detected at eight years of age. Its etiology remains unknown. An 8-year girl presented in Emergency Room with complaints of acute pain in right upper quadrant and nausea without any complaints of jaundice or fever. She was admitted to the hospital with the provisional diagnosis of acute cholecystitis keeping in view her symptoms and obesity, which was later found to be true after an ultrasound report; but the uniqueness and rarity of this case was determined after cholecystectomy, when the specimen containing her gall bladder along with stones was sent for analysis of the composition, which showed the rarest composition i.e., calcium oxalate phosphate. We report our experience on the unique composition of gallstones in a young girl with no known risk factors except obesity. These rare pediatric gallstones have not been associated with obesity in any literature earliar. Key Words: Gallstones, Calcium oxalate phosphate, Pediatric.
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PMID:Unique Pediatric Gallstones Composed of Calcium Oxalate Phosphate. 3289 5