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  1. Article: Aorto-duodenal fistula: a rare but serious complication of gastrointestinal hemorrhage. A case report.

    Šumskienė, Jolanta / Šveikauskaitė, Edita / Kondrackienė, Jūratė / Kupčinskas, Limas

    Acta medica Lituanica

    2017  Volume 23, Issue 3, Page(s) 165–168

    Abstract: A primary aortoduodenal fistula (PADF) is a rare cause of gastrointestinal bleeding that is difficult to diagnose (and sometimes not diagnosed until a laparotomy.) A PADF is associated with high mortality if undiagnosed and untreated (the mortality rate ... ...

    Abstract A primary aortoduodenal fistula (PADF) is a rare cause of gastrointestinal bleeding that is difficult to diagnose (and sometimes not diagnosed until a laparotomy.) A PADF is associated with high mortality if undiagnosed and untreated (the mortality rate of nearly 100% in the absence of a surgical intervention). While this condition is extremely rare with an incidence rate at autopsy of 0.04% to 0.07%, a secondary ADF occurs much more commonly (the post-operative incidence of 0.5% to 2.3%) and is due to prior aortic surgery and/or the placement of a synthetic aortic graft. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm or without it when no identifiable source of bleeding is found. We present an autopsy case of a 59-year-old man with no history of an abdominal aortic aneurysm who presented with intermittent massive gastrointestinal bleeding. The autopsy revealed a pinhole fistula. It was identified between an atherosclerotic abdominal aortic aneurysm and the lower horizontal part of the duodenum. Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. This case is unique in that the fistula formed as a result of a complex atherosclerotic abdominal aorta and a localized necrotizing granulomatous aortitis the etiology of which was not clear.
    Language English
    Publishing date 2017-03-08
    Publishing country Lithuania
    Document type Journal Article
    ZDB-ID 1291937-8
    ISSN 2029-4174 ; 1392-0138
    ISSN (online) 2029-4174
    ISSN 1392-0138
    DOI 10.6001/actamedica.v23i3.3380
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Sensitivity and Specificity of Biochemical Tests for Diagnosis of Intrahepatic Cholestasis of Pregnancy.

    Jurate, Kondrackiene / Rimantas, Zalinkevicius / Jolanta, Sumskiene / Vladas, Gintautas / Limas, Kupcinskas

    Annals of hepatology

    2017  Volume 16, Issue 4, Page(s) 569–573

    Abstract: Background and aim: Intrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory ... ...

    Abstract Background and aim: Intrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory tests used for diagnosis of intrahepatic cholestasis of pregnancy and determine more reliable cut-off values of transaminases.
    Material and methods: Sixty one symptomatic patients with ICP and 29 healthy pregnant women were included in the retrospective analysis.
    Results: ICP patients had higher total bile acids (TBA) levels than healthy women (32 vs. 6; P < 0.0001) due to increase in cholic acid (CA) and chenodeoxycholic acid (CDCA). CA/CDCA ratio was significantly higher in ICP patients compared to healthy pregnant women (1.13 vs. 0.68; P < 0.00002). TBA, CA, CDCA and CA/CDCA ratio demonstrate the following sensitivity (94%, 96%, 89%, 71.9%) and specificity (63%, 63%, 59%, 79.3%, respectively) for ICP diagnosis. Lowering cut-off values for ALT (31 U/L) and AST (30 U/L) resulted only in minimal increase of sensitivity to 92.2% vs. 90.1% for ALT and to 92.2%, vs. 90.6% for AST.
    Conclusion: The present study did not reveal any single specific and sensitive marker for reliable diagnosis of ICP. Establishment of lower cut-off values for transaminases activity might only minimally increase the accuracy of diagnosing ICP.
    MeSH term(s) Adult ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Bile Acids and Salts/blood ; Biomarkers/blood ; Chenodeoxycholic Acid/blood ; Cholestasis, Intrahepatic/blood ; Cholestasis, Intrahepatic/diagnosis ; Cholic Acid/blood ; Clinical Enzyme Tests ; Female ; Humans ; Liver Function Tests ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications/blood ; Pregnancy Complications/diagnosis ; Reproducibility of Results ; Retrospective Studies ; Young Adult
    Chemical Substances Bile Acids and Salts ; Biomarkers ; Chenodeoxycholic Acid (0GEI24LG0J) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2) ; Cholic Acid (G1JO7801AE)
    Language English
    Publishing date 2017-06-27
    Publishing country Mexico
    Document type Evaluation Study ; Journal Article
    ZDB-ID 2188733-0
    ISSN 1665-2681
    ISSN 1665-2681
    DOI 10.5604/01.3001.0010.0294
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: TM6SF2

    Basyte-Bacevice, Viktorija / Skieceviciene, Jurgita / Valantiene, Irena / Sumskiene, Jolanta / Petrenkiene, Vitalija / Kondrackiene, Jurate / Petrauskas, Dalius / Lammert, Frank / Kupcinskas, Juozas

    International journal of molecular sciences

    2019  Volume 20, Issue 6

    Abstract: Previous large-scale genetic studies identified single nucleotide polymorphisms (SNPs) of ... ...

    Abstract Previous large-scale genetic studies identified single nucleotide polymorphisms (SNPs) of the
    MeSH term(s) Acyltransferases/genetics ; Adult ; Aged ; Fatty Liver, Alcoholic/genetics ; Female ; Genetic Predisposition to Disease ; Hepatitis C/complications ; Hepatitis C/genetics ; Humans ; Lipase/genetics ; Liver Cirrhosis/genetics ; Liver Cirrhosis/virology ; Male ; Membrane Proteins/genetics ; Middle Aged ; Polymorphism, Single Nucleotide
    Chemical Substances Membrane Proteins ; TM6SF2 protein, human ; Acyltransferases (EC 2.3.-) ; MBOAT7 protein, human (EC 2.3.-) ; Lipase (EC 3.1.1.3) ; adiponutrin, human (EC 3.1.1.3)
    Language English
    Publishing date 2019-03-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms20061277
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Aorto-duodenal fistula

    Jolanta Šumskienė / Edita Šveikauskaitė / Jūratė Kondrackienė / Limas Kupčinskas

    Acta Medica Lituanica, Vol 23, Iss

    a rare but serious complication of gastrointestinal hemorrhage. A case report

    2016  Volume 3

    Abstract: A primary aortoduodenal fistula (PADF) is a rare cause of gastrointestinal bleeding that is difficult to diagnose (and sometimes not diagnosed until a laparotomy.) A PADF is associated with high mortality if undiagnosed and untreated (the mortality rate ... ...

    Abstract A primary aortoduodenal fistula (PADF) is a rare cause of gastrointestinal bleeding that is difficult to diagnose (and sometimes not diagnosed until a laparotomy.) A PADF is associated with high mortality if undiagnosed and untreated (the mortality rate of nearly 100% in the absence of a surgical intervention). While this condition is extremely rare with an incidence rate at autopsy of 0.04% to 0.07%, a secondary ADF occurs much more commonly (the post-operative incidence of 0.5% to 2.3%) and is due to prior aortic surgery and/or the placement of a synthetic aortic graft. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm or without it when no identifiable source of bleeding is found. We present an autopsy case of a 59-year-old man with no history of an abdominal aortic aneurysm who presented with intermittent massive gastrointestinal bleeding. The autopsy revealed a pinhole fistula. It was identified between an atherosclerotic abdominal aortic aneurysm and the lower horizontal part of the duodenum. Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. This case is unique in that the fistula formed as a result of a complex atherosclerotic abdominal aorta and a localized necrotizing granulomatous aortitis the etiology of which was not clear.
    Keywords primary aortoduodenal fistula ; gastrointestinal bleeding ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2016-11-01T00:00:00Z
    Publisher Vilnius University Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Sensitivity and Specificity of Biochemical Tests for Diagnosis of Intrahepatic Cholestasis of Pregnancy

    Kondrackiene Jurate / Zalinkevicius Rimantas / Sumskiene Jolanta / Gintautas Vladas / Kupcinskas Limas

    Annals of Hepatology, Vol 16, Iss 4, Pp 569-

    2017  Volume 573

    Abstract: Background and aim: Intrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory ... ...

    Abstract Background and aim: Intrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory tests used for diagnosis of intrahepatic cholestasis of pregnancy and determine more reliable cut-off values of transaminases. Material and methods: Sixty one symptomatic patients with ICP and 29 healthy pregnant women were included in the retrospective analysis. Results: ICP patients had higher total bile acids (TBA) levels than healthy women (32 vs. 6; P < 0.0001) due to increase in cholic acid (CA) and chenodeoxycholic acid (CDCA). CA/CDCA ratio was significantly higher in ICP patients compared to healthy pregnant women (1.13 vs. 0.68; P < 0.00002). TBA, CA, CDCA and CA/CDCA ratio demonstrate the following sensitivity (94%, 96%, 89%, 71.9%) and specificity (63%, 63%, 59%, 79.3%, respectively) for ICP diagnosis. Lowering cut-off values for ALT (31 U/ L) and AST (30 U/L) resulted only in minimal increase of sensitivity to 92.2% vs. 90.1% for ALT and to 92.2%, vs. 90.6% for AST. Conclusion: The present study did not reveal any single specific and sensitive marker for reliable diagnosis of ICP. Establishment of lower cut-off values for transaminases activity might only minimally increase the accuracy of diagnosing ICP.
    Keywords Intrahepatic cholestasis ; Pregnancy ; Diagnostics ; Serum bile acids ; Transaminases ; Specialties of internal medicine ; RC581-951
    Subject code 610
    Language English
    Publishing date 2017-07-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

    Jurate Kondrackiene, Limas Kupcinskas

    World Journal of Gastroenterology, Vol 14, Iss 38, Pp 5781-

    2008  Volume 5788

    Abstract: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden ... ...

    Abstract Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP.
    Keywords Cholestasis of pregnancy ; Canalicular ABC transporters ; Pruritus ; Fetal outcome ; Ursodeoxycholic acid ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Gastroenterology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 610
    Language English
    Publishing date 2008-10-01T00:00:00Z
    Publisher Baishideng Publishing Group Co. Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: SERPINA1 and HSD17B13 Gene Variants in Patients with Liver Fibrosis and Cirrhosis.

    Basyte-Bacevice, Viktorija / Skieceviciene, Jurgita / Valantiene, Irena / Sumskiene, Jolanta / Petrenkiene, Vitalija / Kondrackiene, Jurate / Petrauskas, Dalius / Lammert, Frank / Kupcinskas, Juozas

    Journal of gastrointestinal and liver diseases : JGLD

    2019  Volume 28, Issue 3, Page(s) 297–302

    Abstract: Background and aims: Two single nucleotide polymorphisms (SNPs) in SERPINA1 (Pi*Z rs28929474 and Pi*S rs17580) are risk factors for developing liver cirrhosis. A recent study identified a common SNP in HSD17B13 (rs72613567) that conferred protection ... ...

    Abstract Background and aims: Two single nucleotide polymorphisms (SNPs) in SERPINA1 (Pi*Z rs28929474 and Pi*S rs17580) are risk factors for developing liver cirrhosis. A recent study identified a common SNP in HSD17B13 (rs72613567) that conferred protection from chronic liver disease. The aim of the present study was to test these associations in a cohort of Lithuanian patients with liver fibrosis or cirrhosis.
    Methods: The study included 302 patients with cirrhosis, 127 patients with liver fibrosis (METAVIR stages I-III) and 548 controls, all from Lithuania. SNPs were genotyped by quantitative PCR, using TaqMan allelic discrimination assays. Adjusted p value of ≤ 0.016 was considered significant.
    Results: Genotype distributions of SERPINA1 and HSD17B13 SNPs were in Hardy-Weinberg equilibrium. SERPINA1 Pi*Z was not associated with liver fibrosis or cirrhosis. HSD17B13 rs10433937 (in high linkage disequilibrium with rs72613567; r 2 =0.96) also showed no overall association with liver disease, but the GG- genotype was associated with reduced risk of liver fibrosis (aOR 0.37, p=0.03). SERPINA1 Pi*S was associated with higher risk of developing hepatic fibrosis (aOR 3.42, p=0.001) and cirrhosis (aOR 2.59, p=0.02).
    Conclusions: We found that SERPINA1 Pi*S variant conferred an increased risk of developing liver fibrosis, while SERPINA1 Pi*Z and HSD17B13 rs10433937 were not associated with liver fibrosis or cirrhosis of different aetiology.
    MeSH term(s) 17-Hydroxysteroid Dehydrogenases/genetics ; Adult ; Aged ; Alleles ; Case-Control Studies ; Cohort Studies ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Liver Cirrhosis/etiology ; Liver Cirrhosis/genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Risk Factors ; alpha 1-Antitrypsin/genetics
    Chemical Substances SERPINA1 protein, human ; alpha 1-Antitrypsin ; 17-Hydroxysteroid Dehydrogenases (EC 1.1.-) ; HSD17B13 protein, human (EC 1.1.-.-)
    Language English
    Publishing date 2019-09-12
    Publishing country Romania
    Document type Journal Article
    ZDB-ID 2427021-0
    ISSN 1842-1121 ; 1841-8724
    ISSN (online) 1842-1121
    ISSN 1841-8724
    DOI 10.15403/jgld-168
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: TM6SF2 and MBOAT7 Gene Variants in Liver Fibrosis and Cirrhosis

    Viktorija Basyte-Bacevice / Jurgita Skieceviciene / Irena Valantiene / Jolanta Sumskiene / Vitalija Petrenkiene / Jurate Kondrackiene / Dalius Petrauskas / Frank Lammert / Juozas Kupcinskas

    International Journal of Molecular Sciences, Vol 20, Iss 6, p

    2019  Volume 1277

    Abstract: Previous large-scale genetic studies identified single nucleotide polymorphisms (SNPs) of the TM6SF2 and MBOAT7 genes as risk factors for alcoholic liver cirrhosis and non-alcoholic fatty liver disease. In this study, we tried to evaluate the association ...

    Abstract Previous large-scale genetic studies identified single nucleotide polymorphisms (SNPs) of the TM6SF2 and MBOAT7 genes as risk factors for alcoholic liver cirrhosis and non-alcoholic fatty liver disease. In this study, we tried to evaluate the association between TM6SF2 variant rs58542926 and MBOAT7 variant rs641738 and the risk of hepatic fibrosis or liver cirrhosis of different etiology. In parallel, we also aimed to evaluate whether these two SNPs modify the effects of the PNPLA3 rs738409 risk variant for the development of hepatic fibrosis and liver cirrhosis. The study was conducted at the Department of Gastroenterology, Lithuanian University of Health Sciences Hospital, and included 334 patients with liver cirrhosis, 128 patients with liver fibrosis, and 550 controls. SNPs were genotyped by quantitative PCR, using TaqMan allelic discrimination assays. Overall, TM6SF2 rs58542926 as well as MBOAT7 rs641738 were not linked to hepatic fibrosis, alcohol or hepatitis C virus induced liver cirrhosis in an Eastern European population. These genetic variations also did not mediate the effect of PNPLA3 rs738409 SNP for liver developing liver fibrosis or liver cirrhosis.
    Keywords hepatic fibrosis ; liver cirrhosis ; MBOAT7 ; TM6SF2 ; PNPLA3 ; gene polymorphism ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2019-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems.

    Kondrackiene, Jurate / Kupcinskas, Limas

    World journal of gastroenterology

    2008  Volume 14, Issue 38, Page(s) 5781–5788

    Abstract: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden ... ...

    Abstract Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP.
    MeSH term(s) Cholestasis, Intrahepatic/diagnosis ; Cholestasis, Intrahepatic/epidemiology ; Cholestasis, Intrahepatic/etiology ; Cholestasis, Intrahepatic/therapy ; Diagnosis, Differential ; Female ; Humans ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/epidemiology ; Pregnancy Complications/etiology ; Pregnancy Complications/therapy ; Pregnancy Outcome ; Risk Factors ; Treatment Outcome
    Language English
    Publishing date 2008-10-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.14.5781
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Zieve’s syndrome presenting with coagulopathy, skin and subcutaneous haemorrhage

    Jūratė Kondrackienė / Inga Beinaravičienė / Sigita Gelman / Limas Kupčinskas

    Acta Medica Lituanica, Vol 19, Iss

    2013  Volume 4

    Abstract: Zieve syndrome is characterized by hepatic dysfunction, jaundice, hyperlipidaemia, and reversible hemolytic anaemia after alcohol abuse. We report a rare case of this syndrome presenting with coagulopathy and subcutaneous haemorrhage. Laboratory tests ... ...

    Abstract Zieve syndrome is characterized by hepatic dysfunction, jaundice, hyperlipidaemia, and reversible hemolytic anaemia after alcohol abuse. We report a rare case of this syndrome presenting with coagulopathy and subcutaneous haemorrhage. Laboratory tests showed macrocytic anaemia, hyperbilirubinemia, increased activity of aminotransferases, hyperlipidemia, coagulopathy, signs of haemolysis: reduced concentration of haptoglobin, free hemoglobin. These abnormalities improved during 20 days. Ultrasonography revealed subcutaneous haemorrhagias, liver biopsy was consistent with steatohepatitis. There are a small number of reported cases of Zieve syndrome, and the reason could be the lack of pathognomonic symptoms, rapid decrease of hyperlipidaemic serum levels after alcohol withdrawal, patients denial of drinking. There is no specific treatment, therapy is similar to that for acute alcoholic hepatitis. The Zieve syndrome must be allways considered in the differential diagnosis of uncertain origin liver injury, hemolysis or coagulopathy.
    Keywords Zieve syndrome ; subcutaneous haemorrhage ; hyperlipidaemia ; hemolytic anaemia ; Medicine ; R
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Vilnius University Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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