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1.
Medicine (Baltimore) ; 98(27): e16018, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277096

RESUMO

There have been reports linking nonalcoholic fatty liver disease (NAFLD) with gallstone disease (GD) owing to shared risk factors. However, there are no reported associations between the different NAFLD grades and GD. This study aimed to determine whether NAFLD grade is an independent risk factor for GD in a Korean population.This study enrolled 7886 participants who completed a questionnaire and underwent medical examination and ultrasound scanning at the Health Promotion Center of Jeju National University Hospital in Korea, from January 2009 to December 2017. Fatty liver grading and presence of gallstones were investigated using abdominal ultrasound. Body mass index and biochemical parameters were measured, and age, sex, and metabolic syndrome status were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors for GD.The estimated prevalences of NAFLD and GD were 40.6% and 4.5%, respectively. In the univariate analysis, factors associated with GD were age; NAFLD; presence of metabolic syndrome; and levels of fasting blood glucose, high-density lipoproteins, aspartate aminotransferase, and alanine aminotransferase. Multivariate logistic regression analysis revealed older age and higher NAFLD grade as independent risk factors for GD.Older age and higher grade of NAFLD were independent risk factors for GD in our cohort. There was a strong correlation between grade of NAFLD on abdominal ultrasonography and GD.


Assuntos
Colelitíase/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Índice de Gravidade de Doença , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Colelitíase/diagnóstico por imagem , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/classificação , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Razão de Chances , República da Coreia/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
2.
J Microbiol Immunol Infect ; 52(5): 720-727, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31358463

RESUMO

BACKGROUND: To determine the prevalence of chronic comorbidities and associated medication costs in Taiwanese HIV patients in order to increase awareness of the disease burden among healthcare providers and patients. METHODS: HIV-diagnosed patients receiving highly active antiretroviral therapy (HAART; 2010-2013) were identified from the Taiwan National Health Insurance Research Database with the corresponding International Classification of Diseases, ninth revision (ICD-9) code. Comorbidities (type II diabetes mellitus, hypertension, dyslipidemia, major depressive disorder, acute coronary syndrome, and cholelithiasis/nephrolithiasis) were identified according to ICD-9 or relevant medication use. Comorbidity medication and associated costs were identified using the drug classification code from the Anatomical Therapeutic Chemical classification system code series and series outpatient prescriptions. RESULTS: Of 20,726 HIV-diagnosed Taiwanese patients (2010-2013), 13,142 receiving HAART were analyzed. Prevalence of all chronic comorbidities was significantly greater (p < 0.0001) in patients aged ≥40 years versus <40 years (diabetes mellitus, 14.95% vs. 3.30%; hypertension, 46.73% vs. 26.83%; dyslipidemia, 34.93% vs. 18.37%; depression, 23.75% vs. 19.88%; acute coronary syndrome, 1.16% vs. 0.21%; nephrolithiasis/cholelithiasis, 7.26% vs. 4.56%; >2 comorbidities, 24.80% vs. 7.21%). An increase in comorbidity medication spending (2010 vs. 2013 medication costs) was observed (antidyslipidemia, $88,878 vs. $168,180; antihyperglycemia, $32,372 vs. $73,518; antidepressants, $78,220 vs. $125,971; sedatives, $60,009 vs. $85,055; antihypertension, $47,115 vs. $95,134), contributing to overall treatment costs increasing almost two-fold from 2010 to 2013. CONCLUSIONS: Among HIV-infected Taiwanese patients receiving HAART, significant increases in comorbidity prevalence with age, along with rising comorbidity medication costs, suggest the need for preventative as well as chronic care.


Assuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Diabetes Mellitus Tipo 2/epidemiologia , Custos de Medicamentos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Síndrome Coronariana Aguda/epidemiologia , Adulto , Colelitíase/epidemiologia , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Dislipidemias/epidemiologia , Feminino , Custos de Cuidados de Saúde , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Nefrolitíase/epidemiologia , Prevalência , Taiwan/epidemiologia , Adulto Jovem
3.
Medicine (Baltimore) ; 98(25): e16153, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232971

RESUMO

This study aimed to evaluate the association between cholelithiasis and sialolithiasis using a national sample cohort in Korea.The Korean National Health Insurance Service-National Sample Cohort (patients ≥20 years old) was collected from 2002 to 2013. In study I, we extracted cholelithiasis patients (n = 21,170) and 1:4 matched control I subjects (n = 84,680) and analyzed the occurrence of sialolithiasis. In study II, we extracted sialolithiasis patients (n = 761) and 1:4 matched control II subjects (n = 3044) and analyzed the occurrence of cholelithiasis. Hazard ratios (HRs) were determined using the stratified Cox proportional hazard model.The HR for sialolithiasis was 1.49 (95% CI = 0.88-2.52) in the cholelithiasis group (P = .14), and the HR for cholelithiasis was 1.18 (95% CI = 0.53-2.59) in the sialolithiasis group (P = .69).We did not find an association between cholelithiasis and sialolithiasis.


Assuntos
Colelitíase/fisiopatologia , Cálculos das Glândulas Salivares/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colelitíase/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Cálculos das Glândulas Salivares/epidemiologia
4.
Reumatol. clín. (Barc.) ; 15(2): 84-89, mar.-abr. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184354

RESUMO

Objective: To assess the prevalence of gallstone disease and identify associated risk factors in rheumatoid arthritis (RA) patients compared to the general population. Methods: Eighty-four women with rheumatoid arthritis were included in the study. Each patient was assessed via a structured interview, physical examination, abdominal ultrasound and blood test including lipid profile. The prevalence of gallstone disease in rheumatoid arthritis was compared with data from a study of the Spanish population matched by age groups. Results: Twenty-eight of the 84 women had gallstone disease (33.3%). RA women with and without gallstone disease were similar in most of the variables assessed, except for older age and menopausal status in the former. A greater prevalence of gallstone disease was seen in rheumatoid arthritis patients compared to the general population of the same age; however, the differences were significant only in women aged 60 or older (45.5% versus 23.1% respectively, P-value .008). The age-adjusted OR of developing gallstone disease in RA women compared with general population women was 2,3 (95% CI: 1.3-4.1). A significantly higher HDL3-c subfraction and higher apoA-I/HDL and HDL3-c/TC ratios were observed in patients with gallstone disease. Conclusion: Women with rheumatoid arthritis may have a predisposition to gallstones that can manifest in middle or older age compared with women in the general population. This situation could be related to chronic inflammation and HDL metabolism


Objetivo: Evaluar la prevalencia de litiasis biliar e identificar los factores de riesgo asociados en pacientes con artritis reumatoide (AR) en comparación con la población general. Métodos: Ochenta y cuatro mujeres con AR fueron incluidas en el estudio. Cada paciente fue evaluada a través de una entrevista estructurada, un examen físico, una ecografía abdominal y un análisis de sangre que incluía el perfil lipídico. La prevalencia de litiasis biliar en AR se comparó con los datos de un estudio de la población española emparejada por grupos de edad. Resultados: Veintiocho de las 84 mujeres tenían litiasis biliar (33,3%). Las pacientes con y sin colelitiasis fueron similares en la mayoría de las variables evaluadas, a excepción de la edad más avanzada y mayor prevalencia de estado menopáusico en las pacientes con AR. Las pacientes con AR presentaban una mayor prevalencia de litiasis biliar en comparación con la población general de la misma edad; sin embargo, estas diferencias solo fueron significativas en mujeres de 60 años o más (45,5% vs. 23,1% respectivamente, p-valor 0,008). La OR ajustada por edad de presentar litiasis biliar en mujeres con AR respecto a mujeres de la población general fue de 2,3 (IC del 95%: 1,3-4,1). Se observó una subfracción de c-HDL3 significativamente más alta y una relación mayor de apoA-I/HDL y c-HDL3/TC en las pacientes con litiasis biliar. Conclusión: Las mujeres con AR pueden tener una mayor predisposición a la presencia de litiasis biliar en comparación con las mujeres en la población general, sobre todo en edades más avanzadas. Esta situación podría estar relacionada con la inflamación crónica y el metabolismo de las HDL


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Artrite Reumatoide/complicações , Colelitíase/epidemiologia , Dislipidemias/epidemiologia , Artrite Reumatoide/epidemiologia , Dislipidemias/complicações , Lipídeos/sangue , Colecistectomia/estatística & dados numéricos , Comorbidade , Fatores de Risco
5.
Am J Surg ; 218(3): 567-570, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30728100

RESUMO

BACKGROUND: Recent rapid increases in the aging population have created an impending "Silver Tsunami" in advanced countries. The overall prevalence of gallstone disease and its related complications will soon increase, and there will be a larger demand for gallbladder surgery. METHODS: We examined the outcomes of cholecystectomy according to age among patients with cholelithiasis to determine how a patient's age influences the outcome of cholecystectomy. All patients with gallstone disease who presented for cholecystectomy at our institute from January 2006 to December 2018 were analyzed. RESULTS: All perioperative outcomes (operation length, length of hospital stay, rate of open surgery, urgent surgery, postoperative complications, incidental gallbladder cancer, postoperative hospital death, concomitant bile duct stones, and total medical costs per patient) increased as patients aged. CONCLUSIONS: To prevent the progression of biliary disease, elective laparoscopic cholecystectomy is recommended before patients with cholelithiasis advance in age.


Assuntos
Colecistectomia , Colelitíase/cirurgia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Colelitíase/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
6.
Expert Rev Gastroenterol Hepatol ; 13(2): 157-171, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30791781

RESUMO

INTRODUCTION: Cholesterol gallstone disease have relationships with various conditions linked with insulin resistance, but also with heart disease, atherosclerosis, and cancer. These associations derive from mechanisms active at a local (i.e. gallbladder, bile) and a systemic level and are involved in inflammation, hormones, nuclear receptors, signaling molecules, epigenetic modulation of gene expression, and gut microbiota. Despite advanced knowledge of these pathways, the available therapeutic options for symptomatic gallstone patients remain limited. Therapy includes oral litholysis by the bile acid ursodeoxycholic acid (UDCA) in a small subgroup of patients at high risk of postdissolution recurrence, or laparoscopic cholecystectomy, which is the therapeutic radical gold standard treatment. Cholecystectomy, however, may not be a neutral event, and potentially generates health problems, including the metabolic syndrome. Areas covered: Several studies on risk factors and pathogenesis of cholesterol gallstone disease, acting at a systemic level have been reviewed through a PubMed search. Authors have focused on primary prevention and novel potential therapeutic strategies. Expert commentary: The ultimate goal appears to target the manageable systemic mechanisms responsible for gallstone occurrence, pointing to primary prevention measures. Changes must target lifestyles, as well as experimenting innovative pharmacological tools in subgroups of patients at high risk of developing gallstones.


Assuntos
Bile/metabolismo , Colelitíase/prevenção & controle , Colesterol/metabolismo , Fármacos Gastrointestinais/uso terapêutico , Prevenção Primária/métodos , Comportamento de Redução do Risco , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Animais , Colelitíase/diagnóstico , Colelitíase/epidemiologia , Colelitíase/metabolismo , Exercício , Fármacos Gastrointestinais/efeitos adversos , Humanos , Fatores de Proteção , Fatores de Risco , Resultado do Tratamento
7.
Eur J Gastroenterol Hepatol ; 31(5): 577-585, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30664021

RESUMO

OBJECTIVE: This study aimed to investigate whether a novel method including prophylactic pancreatic stent (PS) placement prevents postendoscopic papillary balloon dilation pancreatitis. PATIENTS AND METHODS: This study enrolled 200 consecutive patients with bile duct stones measuring up to 8 mm in diameter and retrospectively recruited 113 patients undergoing ordinary endoscopic papillary balloon dilation (EPBD) without PS placement from our previous study. In the novel method, EPBD and PS placement was attempted with a guidewire left in the main pancreatic duct for patients in whom stable guidewire placement in the main pancreatic duct was possible. EST was performed for patients in whom stable guidewire placement was impossible. The incidence rate of pancreatitis was compared between the novel method and ordinary EPBD, and risk factors for pancreatitis were analyzed. RESULTS: Of 194 patients undergoing the novel method, EPBD and EST were performed in 180 and 14 patients, respectively. Following EPBD, PS placement was successful in 177/180 (98.3%) of patients. Pancreatitis occurred in 7/194 (3.6%) of patients after the novel method and 9/113 (8.0%) of patients after ordinary EPBD. There was a trend toward lower incidence rate of pancreatitis in the novel method. Stent dislodgement by the first postoperative morning and no previous endoscopic nasobiliary drainage (ENBD) were identified as risk factors for pancreatitis after EPBD with PS placement. No previous ENBD was also identified as a risk factor for pancreatitis after ordinary EPBD. CONCLUSION: Our novel method is likely to be superior to ordinary EPBD in preventing pancreatitis. Previous ENBD may prevent post-EPBD pancreatitis regardless of PS placement.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação , Colelitíase/cirurgia , Drenagem/instrumentação , Endoscopia/instrumentação , Pancreatite/prevenção & controle , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos , Colelitíase/diagnóstico por imagem , Colelitíase/epidemiologia , Dilatação/efeitos adversos , Drenagem/efeitos adversos , Endoscopia/efeitos adversos , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/epidemiologia , Estudos Prospectivos , Desenho de Prótese , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
8.
Pan Afr Med J ; 30: 123, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30374369

RESUMO

Introduction: The aim of the study was to determine the frequency of gallstones in patients with decompensated cirrhosis and to know about mean Body mass index (BMI) in patients of decompensated cirrhosis i.e End stage liver disease (ESLD) with and without gallstones. Methods: it is a cross sectional descriptive study, conducted at the department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi from 1st August 2014 to 28 February 2015. Two hundred patients were enrolled from outpatient clinics of Hepato-gastroenterology that fulfilled the defined selection criteria. Questionnaire was filled for data collection. SPSS version 20.0 was used to analyze data. Mean value of age and BMI was calculated by mean ± S.D. values. Mean ± SD was also calculated for BMI in patients with and without gallstones. Stratification of the age, gender, and liver disease severity were done and chi-Square test was applied. p-values less than 0.05 considered statistically significant. Results: Two hundred consecutive patients were enrolled among them 112(56%) were male. Mean age was 46.89 ± 11.9, BMI 23.59 ± 4.7 and CTP score was 9.7 ± 1.9. Most of the patient had Child class 'B' cirrhosis 102(51%), most common etiology was found to be Hepatitis C 133 (66.5%), cholelithiasis was found in 59(29.5%), sludge in 36 (18%) and both stone and sludge in 24(12%) of the cases. Advanced liver disease that is, more CTP score and child class 'C' was associated with increased frequency of gall stone formation (p-value = 0.012), and advancing age on age stratification (p-value = 0.024) however no relation was observed with increase BMI, gender, ethnicity, cause or duration of disease in this population. Conclusion: Gallstone formation is associated with advanced stage of cirrhosis and hepatitis C Virus related CLD, contrary to the established risk factors, no relation of gender or BMI was found in decompensated liver disease.


Assuntos
Doença Hepática Terminal/epidemiologia , Cálculos Biliares/epidemiologia , Hepatite C/complicações , Cirrose Hepática/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Colelitíase/epidemiologia , Estudos Transversais , Doença Hepática Terminal/fisiopatologia , Feminino , Cálculos Biliares/etiologia , Hepatite C/epidemiologia , Humanos , Cirrose Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais
9.
Dig Dis Sci ; 63(12): 3465-3473, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30171402

RESUMO

BACKGROUND AND AIM: Cholangiocarcinoma (CCA) often develops after the hepatic resection for hepatolithiasis as well as indwelling it. We studied the incidence and prognosis of subsequent CCA in patients with hepatolithiasis in South Korea. METHODS: We identified individuals with diagnosed CCA at the time of or after surgery, during 2002-2016, from the Korean National Health Insurance. The incidences and survival rates of subsequent CCA were analyzed and compared with concomitant CCA. The standardized incidence ratios (SIRs) of CCA in this cohort were evaluated in the standard Korean population. All data were stratified by the presence of intrahepatic or extrahepatic CCA, age and sex. RESULTS: Of the 7852 patients with hepatectomy for BDS, 433 (5.84%) had concomitant CCA. Over the 12-year follow-up, 107 of 7419 (1.98%) patients were diagnosed with subsequent CCA. Patients with hepatic resection for BDS revealed higher SIRs for subsequent CCA (12.89, 95% CI 10.96-15.15) in cases of both intrahepatic CCA (13.40, 10.55-17.02) and extrahepatic CCA (12.42, 9.98-15.46). The median survival time for subsequent CCA was 0.87 years, while that for concomitant CCA was 2.79 years. Having subsequent CCA (HR 2.71, 95% CI 2.17-3.40) and being male (HR 1.28, 1.05-1.57) were related to a shorter survival time. The CCA site and age at CCA diagnosis were not related to prognoses. CONCLUSIONS: Subsequent CCA developed in 2% of the patients with hepatic resection for benign BDS until 10 years and was associated with poorer prognoses than concomitant CCA. Future studies focused on the long-term surveillance for CCA in such patients are needed.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Colelitíase , Hepatectomia , Idoso , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/mortalidade , Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/mortalidade , Colangiocarcinoma/patologia , Colelitíase/diagnóstico , Colelitíase/epidemiologia , Colelitíase/cirurgia , Feminino , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Humanos , Incidência , Revisão da Utilização de Seguros/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais , Análise de Sobrevida
10.
BMJ Open ; 8(9): e020798, 2018 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-30185568

RESUMO

OBJECTIVE: To investigate the relation of Hashimoto's thyroiditis (HT) to cholelithiasis and cholecystectomy in a retrospective population-based study. SETTING: Cohort study. PARTICIPANTS: We identified 1268 patients aged ≥20 years with HT between 2000 and 2010 as the study cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Patients without HT were randomly selected from a database and propensity-matched with the study cohort at a 1:4 ratio according to age, sex, comorbidities and year of the index date to measure the incidence of cholelithiasis and cholecystectomy. RESULTS: The cumulative incidence of cholelithiasis was higher in the HT cohort than that in the non-HT cohort (log-rank test, p<0.001), with a 1.91-fold higher risk of choleithiasis (95% CI 1.58 to 2.33) after adjustment for comorbidities. The age-specific relative risk of cholelithiasis in the HT cohort was higher than that in the non-HT cohort for patients aged ≥50 years (adjusted HR (aHR)=2.59, 95% CI 1.33 to 5.03). The sex-specific relative risk of cholelithiasis in the HT cohort was higher than that in the non-HT cohort for women (aHR=1.99, 95% CI 1.63 to 2.44). Compared with those in the non-HT cohort, patients with HT without (aHR=1.95, 95% CI 1.53 to 2.49) and with (aHR=1.94, 95% CI 1.51 to 2.49) thyroxine treatment were associated with a higher risk of cholelithiasis. Compared with those in the non-HT cohort, patients with HT had a higher risk of cholecystectomy (aHR=1.28, 95% CI 1.02 to 1.61). CONCLUSIONS: Inability to obtain information on several potential confounding factors and misclassification of important covariates are the major limitations of the study. Our study indicates HT per se was associated with the development of cholelithiasis, which has been validated by the association between cholecystectomy and HT. Surveys and health education on cholelithiasis in women aged ≥50 years with HT should be considered by clinicians, and further prospective research should be done on this topic.


Assuntos
Colecistectomia/estatística & dados numéricos , Colelitíase/epidemiologia , Colelitíase/cirurgia , Doença de Hashimoto/epidemiologia , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia
11.
BMC Nephrol ; 19(1): 158, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29970034

RESUMO

BACKGROUND: According to the literature the three stone diseases, sialolithiasis (SL), urolithiasis (UL) and cholelithiasis (CL) share comorbidities. We assess familial and spouse risks between these stone disease and compare them to familial risks for concordant (same) stone disease. METHODS: Study population including familiar relationships was obtained from the Swedish Multigeneration Register and stone disease patients were identified from nation-wide medical records. Standardized incidence ratios (SIRs) were calculated for 0-83 year old offspring when their first-degree relatives were diagnosed with stone disease and the rates were compared to individuals without a family history of stone disease. Numbers of offspring with SL were 7906, for UL they were 170,757 and for CL they were 204,369. RESULTS: SIRs for concordant familial risks were 2.06 for SL, 1.94 for UL and 1.82 for CL. SIRs for SL and UL were slightly higher for women than for men. Familial risks between stone diseases were modest. The highest risk of 1.17 was for UL when family members were diagnosed with CL, or vice versa. The SIR for UL was 1.15 when family members were diagnosed with SL. Familial risks among spouses were increased only for UL-CL pairs (1.10). CONCLUSIONS: Familial risks for concordant SL were 2.06 and marginally lower for the other diseases. Familial risks between stone diseases were low but higher than risks between spouses. The data show that familial clustering is unique to each individual stone disease which would imply distinct disease mechanisms. The results cast doubt on the reported comorbidities between these diseases.


Assuntos
Colelitíase/genética , Predisposição Genética para Doença/genética , Vigilância da População , Cálculos das Glândulas Salivares/genética , Urolitíase/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colelitíase/diagnóstico , Colelitíase/epidemiologia , Feminino , Predisposição Genética para Doença/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/epidemiologia , Suécia/epidemiologia , Urolitíase/diagnóstico , Urolitíase/epidemiologia , Adulto Jovem
12.
Semin Liver Dis ; 38(3): 270-283, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30041279

RESUMO

Pyogenic liver abscess (PLA) of biliary origin in Southeast Asia mainly occurs in patients with intrahepatic bile duct stone (IBDS) and extrahepatic bile duct stone (EBDS), bilioenteric anastomosis, or biliary stent. IBDS, as an endemic to Southeast Asia, remains a frequent etiology of acute cholangitis and PLA. PLA related to IBDS is characterized by high incidences of PLA recurrence and death related to infection, and difficulties in diagnosis of concomitant cholangicarcinoma. PLA of biliary origin is more likely caused by Escherichia coli, more often presented as polymicrobial infections, and more associated with extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae isolates. In this review, the authors summarize the differences on the presumed causes, pathogens, multidrug resistance, treatment, and prognosis of PLA between biliary origin and cryptogenic origin, the latter serving as a first and foremost presumed etiology of PLA. The authors also discuss the existing problems on early diagnosis of concomitant cholangicarcinoma related to IBDS.


Assuntos
Neoplasias dos Ductos Biliares/terapia , Colangiocarcinoma/terapia , Colelitíase/terapia , Abscesso Hepático Piogênico/terapia , Ásia/epidemiologia , Técnicas Bacteriológicas , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/epidemiologia , Neoplasias dos Ductos Biliares/mortalidade , Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos , Procedimentos Cirúrgicos do Sistema Biliar/instrumentação , Biópsia , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/mortalidade , Colelitíase/diagnóstico , Colelitíase/epidemiologia , Colelitíase/mortalidade , Humanos , Abscesso Hepático Piogênico/diagnóstico , Abscesso Hepático Piogênico/epidemiologia , Abscesso Hepático Piogênico/microbiologia , Valor Preditivo dos Testes , Recidiva , Fatores de Risco , Stents/efeitos adversos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Medicine (Baltimore) ; 97(22): e10846, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29851796

RESUMO

This study investigated the effects of age and gender on the prevalence of cholelithiasis in patients with chronic HCV infection.Demographic and clinical data of 8489 subjects (3671 males, 4818 females; mean age 47.5 years) receiving township-wide health examinations between September 2012 and August 2013 were analyzed. The main endpoint was prevalence of cholelithiasis. Risk factors (age, gender, body mass index, concomitant diseases, lifestyle, laboratory parameters, and HCV status) were evaluated. Univariate and multivariate logistic regression analyses were performed to identify associations between cholelithiasis and variables.Cholelithiasis was more prevalent among HCV subjects than non-HCV subjects (females: 8.1% vs 4.2%; males: 9.1% vs 3.9%; both P < .001); rates ranged from 5.6% to 8.3% in females and 4.7% to 10.6% in males. HCV status and age were associated with cholelithiasis occurrence (OR = 2.17 for HCV vs non-HCV; OR = 2.44, 3.54 for age 45-55, and >55 vs <45 years; all P < .05). Multivariate analysis showed a significant association between cholelithiasis and age/sex interaction terms (OR = 0.517 for age >55 vs <45 for sex; P = .011). Cholelithiasis prevalence was significantly associated between age and sex interaction terms but not anymore if considering positive HCV status. All noninvasive tests for liver fibrosis were associated with cholelithiasis but only fibrosis-4 index was significantly associated (OR = 1.28, P = .019).Age, gender, and HCV infection are associated with increased risk and prevalence of cholelithiasis. After age of 55 years, cholelithiasis is more prevalent among HCV-positive males than females. Females of age 55 and more may be protected against cholelithiasis as sex hormones decrease.


Assuntos
Fatores Etários , Colelitíase/epidemiologia , Hepatite C Crônica/complicações , Fatores Sexuais , Colelitíase/virologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco
14.
Artigo em Inglês | MEDLINE | ID: mdl-29538289

RESUMO

We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn's disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011. The risk of developing cholelithiasis, either gallbladder stone disease (GSD; adjusted hazard ratio (aHR) = 1.76, 95% CI = 1.34-2.61) or common bile duct (CBD) stones and intrahepatic stones (IHSs; aHR = 2.78, 95% CI = 1.18-6.51), was higher for the CD cohort than for the non-IBD cohort after adjusting for age, sex, and comorbidities of hyperlipidemia, diabetes, liver cirrhosis, hypertension, chronic obstructive pulmonary disease, stroke, coronary artery disease, and hepatitis C virus infection. However, UC was related to the development of GSD (aHR = 1.44, 95% CI = 1.19-1.75) but not to CBD stones and IHSs (aHR = 1.70, 95% CI = 0.99-2.91). Our population-based cohort study demonstrated that CD is related to the development of cholelithiasis, including GSD alone and non-GSD-associated cholelithiasis. However, UC is only related to the development of GSD alone.


Assuntos
Colelitíase/epidemiologia , Doenças Inflamatórias Intestinais/epidemiologia , Adulto , Idoso , Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Projetos de Pesquisa , Estudos Retrospectivos , Risco
15.
BMC Infect Dis ; 18(1): 64, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29390977

RESUMO

BACKGROUND: Tuberculosis (TB) remains one of the major infectious diseases worldwide. Adverse reactions are common during TB treatment. Few reports, however, are available on treatment-related acute biliary events (ABEs), such as cholelithiasis, biliary obstruction, acute cholecystitis, and cholangitis. METHODS: We first report four pulmonary TB patients who developed ABEs during anti-TB treatment. Abdominal sonography revealed multiple gall stones with dilated intrahepatic ducts in three patients and cholecystitis in one patient. To investigate the incidence of and risk factors for ABEs during anti-TB treatment, we subsequently conducted a nationwide cohort study using the National Health Insurance Research Database of Taiwan. RESULTS: A total of 159,566 pulmonary TB patients were identified from the database between 1996 and 2010, and among them, 195 (0.12%) developed ABEs within 180 days after beginning anti-TB treatment. Logistic regression analysis revealed that the risk factors associated with ABEs are older age (relative risk [RR]: 1.32 [1.21-1.44] per 10-year increment) and diabetes mellitus (RR: 1.59 [1.19-2.13]). CONCLUSIONS: Although infrequently encountered, ABEs should be considered among patients with TB who experience abdominal discomfort with hyperbilirubinemia, especially patients who have older age or diabetes.


Assuntos
Antituberculosos/efeitos adversos , Doenças Biliares/etiologia , Adulto , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Doenças dos Ductos Biliares/epidemiologia , Doenças dos Ductos Biliares/etiologia , Doenças Biliares/epidemiologia , Colangite/epidemiologia , Colangite/etiologia , Colelitíase/epidemiologia , Colelitíase/etiologia , Estudos de Coortes , Bases de Dados Factuais , Hospitais , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Taiwan/epidemiologia , Tuberculose/tratamento farmacológico
16.
Lab Invest ; 98(1): 7-14, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28892095

RESUMO

Cholecystectomy has long been regarded as a safe procedure with no deleterious influence on the body. However, recent studies provide clues that link cholecystectomy to a high risk for metabolic syndrome (MetS). In the present review, we describe the epidemiologic evidence that links cholecystectomy to MetS. Various components of MetS are investigated, including visceral obesity, dyslipidemia, elevated blood pressure, impaired fasting glucose, and insulin resistance. The possible mechanisms that associate cholecystectomy with MetS are discussed on the basis of experimental studies.


Assuntos
Colecistectomia/efeitos adversos , Síndrome Metabólica/etiologia , Modelos Biológicos , Complicações Pós-Operatórias/etiologia , Animais , Ácidos e Sais Biliares/metabolismo , Colelitíase/epidemiologia , Colelitíase/etiologia , Colelitíase/metabolismo , Colelitíase/fisiopatologia , Comorbidade , Dislipidemias/epidemiologia , Dislipidemias/etiologia , Dislipidemias/metabolismo , Dislipidemias/fisiopatologia , Metabolismo Energético , Vesícula Biliar/metabolismo , Vesícula Biliar/fisiopatologia , Intolerância à Glucose/epidemiologia , Intolerância à Glucose/etiologia , Intolerância à Glucose/metabolismo , Intolerância à Glucose/fisiopatologia , Humanos , Resistência à Insulina , Fígado/metabolismo , Fígado/fisiopatologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Síndrome Metabólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etiologia , Obesidade Abdominal/metabolismo , Obesidade Abdominal/fisiopatologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/metabolismo , Complicações Pós-Operatórias/fisiopatologia , Fatores de Risco
17.
Neurol Sci ; 39(1): 63-70, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29022143

RESUMO

Migraine can be accompanied by some gastrointestinal (GI) disorders. In this study, we aimed to investigate the relationship between migraine and tension-type headache (TTH) and different lower and upper GI disorders as well as non-alcoholic fatty liver (NAFLD) and cholelithiasis. This cross-sectional study included 1574 overweight and obese participants who were referred to the Obesity Research Center of Sina Hospital, Tehran, Iran. The diagnosis of migraine and TTH was made by an expert neurologist based on the international classification of headache disorders-III ß (ICHD III ß). GI disorders, including irritable bowel syndrome (IBS), constipation, heartburn, dyspepsia, non-alcoholic fatty liver (NAFLD), and cholelithiasis, were diagnosed by a gastroenterology specialist. The overall mean age of participants was 37.44 ± 12.62. A total of 181 (11.5%) migraine sufferers (with and without aura) and 78 (5%) TTH subjects were diagnosed. After adjusting for potential confounders by multivariable regression models, migraine had significant association with IBS (OR = 5.16, 95% CI = 2.07-12.85, P = 0.000), constipation (OR = 3.96, 95% CI = 2.25-6.99, P = 0.000), dyspepsia (OR = 4.12, 95% CI = 2.63-6.45, P = 0.000), and heartburn (OR = 5.03, 95% CI 2.45-10.33, P = 0.000), while the association between migraine and NAFLD was marginally significant (OR = 2.03, 95% CI = 0.98-4.21, P = 0.055). Furthermore, the prevalence of NAFLD (OR = 2.93, 95% CI 1.29-6.65, P = 0.010) and dyspepsia (OR = 4.06, 95% CI = 2.24-7.34, P = 0.000) was significantly higher in TTH patients than the headache-free group. These findings show an association between GI disorders and primary headaches especially migraine and are, therefore, of value to the management of migraine and TTH. Further studies should investigate the etiology of the relationship between all subtypes of primary headaches and GI disorders.


Assuntos
Gastroenteropatias/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Obesidade/epidemiologia , Cefaleia do Tipo Tensional/epidemiologia , Adulto , Colelitíase/complicações , Colelitíase/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Gastroenteropatias/complicações , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Transtornos de Enxaqueca/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/complicações , Cefaleia do Tipo Tensional/complicações
18.
Obes Surg ; 28(2): 469-473, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28803397

RESUMO

BACKGROUND: There is not any consensus on concomitant cholecystectomy for asymptomatic gallbladder stones during laparoscopic sleeve gastrectomy (LSG). The aim of this study was to evaluate the surveillance results of the LSG patients who have asymptomatic gallbladder stones and did not undergo cholecystectomy. METHODS: Patients who underwent laparoscopic sleeve gastrectomy with preoperatively detected gallbladder stones and completed at least 6 months follow-up were included in the study. Concomitant cholecystectomy was performed for symptomatic patients while it was not performed for asymptomatic subjects. At the end of the follow-up time, symptoms and signs related to gallbladder disease were recorded. Clinical and demographic characteristics were compared between symptomatic and asymptomatic patients. RESULTS: Between February 2012 and October 2016, 312 laparoscopic sleeve gastrectomies were performed. Among the patients, 24 were regarded as asymptomatic cholelithiasis, and cholecystectomy was not performed. The mean follow-up period was 27 (6-58) months. The mean preoperative BMI was 50.0 ± 7.6 kg/m2, and at the end of the follow-up time, it decreased to 35.6 ± 8.8 kg/m2. Five (20.8%) patients experienced biliary colic. Acute cholecystitis or obstructive jaundice was not observed in any of the patients. Characteristics of patients who developed symptomatic gallbladder disease (n = 5) were not significantly different from those of patients who remained asymptomatic (n = 19). CONCLUSIONS: The risk of becoming symptomatic for asymptomatic cholelithiasis is very close to the healthy population after sleeve gastrectomy. Although further studies with a high number of cases are needed, we suggest only observation for asymptomatic gallbladder stones in patients who will undergo sleeve gastrectomy.


Assuntos
Colecistectomia/métodos , Colelitíase/cirurgia , Gastrectomia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Adulto , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/terapia , Colecistectomia/efeitos adversos , Colelitíase/complicações , Colelitíase/epidemiologia , Feminino , Seguimentos , Cálculos Biliares/cirurgia , Gastrectomia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/epidemiologia , Estudos Retrospectivos
19.
Ann Ital Chir ; 88: 215-221, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28874618

RESUMO

BACKGROUND: The aim of this study was to ascertain the variability and to identify a trend for the outcome of cholecystectomy surgery when used to treat cholelithiasis and acute cholecystitis. METHODS: This was a large retrospective cohort study following patients up to 11 years post surgery, based on administrative data collected from 2002 to 2012 in the Emilia-Romagna Region (Northern Italy) and comparing the effectiveness and efficiency of surgical activity (laparoscopic (LC) and open cholecystectomy (OC)). Analyses included patient characteristics, length of hospital stay, type of admission and mortality risk. Outcomes considered were death from all causes (during the index hospital admission or thereafter), hospital readmissions with cholecystitis or cholelithiasis as principal diagnosis and time to surgery. RESULTS: A total of 84,628 cholecystomies were performed from 2002 to 2012 out of 123,061 admissions with primary diagnostic category of cholecystitis or cholelitiasis. Laparoscopic procedure was used in 69,842 patients. Over time there was a rising linear statistically significant trend in the use of LC. Mortality rate at 1 year of OC treated patients showed a statistically significant difference compared to LC treated patients (using a cohorts match with propensity score). Only a small number of patients with acute cholecystitis was operated according guidelines within 72 hours. CONCLUSIONS: The analysis of aggregate administrative data is a powerful tool to support regional health management, improve the quality of medical care, and assess the appropriateness of therapeutic or diagnostic approaches. It is important to stress a short hospital stay for laparoscopic cholecystectomy patients (50% less than open surgery): this shorter hospital stay leads to a significant economic advantage. Moreover, mortality is significantly higher in open surgery for acute cholecystitis. Interestingly, the same finding was confirmed after 30 days and 1 year, probably due to comorbidities that are more evident in open surgery. KEY WORDS: Cholecystitis, Cholelithiasis, Delivery of health care, Disease management, Surgical.


Assuntos
Colecistectomia/estatística & dados numéricos , Adulto , Idoso , Colecistectomia/tendências , Colecistectomia Laparoscópica/estatística & dados numéricos , Colecistectomia Laparoscópica/tendências , Colecistite/epidemiologia , Colecistite/cirurgia , Colelitíase/epidemiologia , Colelitíase/cirurgia , Comorbidade , Bases de Dados Factuais , Feminino , Mortalidade Hospitalar , Humanos , Itália , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
20.
Can Vet J ; 58(9): 971-973, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28878422

RESUMO

A retrospective study of intrahepatic cholelithiasis (IC) in 9 dogs and 2 cats was conducted. Only 1 dog showed clinical signs related to hepatobiliary disease before referral and during the follow-up period. Intrahepatic cholelithiasis might be a subclinical finding in both dogs and cats.


Assuntos
Doenças do Gato/epidemiologia , Colelitíase/veterinária , Doenças do Cão/epidemiologia , Animais , Doenças do Gato/diagnóstico , Gatos , Colelitíase/diagnóstico , Colelitíase/epidemiologia , Doenças do Cão/diagnóstico , Cães , Feminino , Masculino , Estudos Retrospectivos
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