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  1. 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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  2. 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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  3. 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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  4. 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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  5. 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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  6. Article ; Online: Association of HFE gene C282Y and H63D mutations with liver cirrhosis in the Lithuanian population

    Simonas Juzėnas / Juozas Kupčinskas / Irena Valantienė / Jolanta Šumskienė / Vitalija Petrenkienė / Jūrate Kondrackienė / Laimutis Kučinskas / Gediminas Kiudelis / Jurgita Skiecevičienė / Limas Kupčinskas

    Medicina, Vol 52, Iss 5, Pp 269-

    2016  Volume 275

    Abstract: Background and objective: Liver cirrhosis is the end-stage disease of chronic liver injury. Due to differences in the natural course of chronic liver diseases, identification of genetic factors that influence individual outcomes is warranted. HFE-linked ... ...

    Abstract Background and objective: Liver cirrhosis is the end-stage disease of chronic liver injury. Due to differences in the natural course of chronic liver diseases, identification of genetic factors that influence individual outcomes is warranted. HFE-linked hereditary hemochromatosis (HH) predisposes disease progression to cirrhosis; however, the role of heterozygous C282Y or H63D mutations in the development of cirrhosis in the presence of other etiological factors is still debated. The aim of this study was to determine the association between heterozygous C282Y and H63D mutations and non-HH liver cirrhosis in Lithuanian population. Materials and methods: The patient cohort consisted of 209 individuals. Diagnosis of cirrhosis was confirmed by clinical, laboratory parameters, liver biopsy, and radiological imaging. Control samples were obtained from 1005 randomly selected unrelated healthy individuals. HFE gene mutations were determined using the PCR-RFLP method. Results: The most common causes of cirrhosis were hepatitis C (33.9%), hepatitis B (13.6%), and alcohol (25.8%). C282Y allele was associated with the presence of cirrhosis (OR = 2.07; P = 0.005); this was also observed under recessive model for C282Y (OR = 2.06, P = 0.008). The prevalence of C282Y allele was higher in cirrhotic men than in controls (7.0% vs. 2.8%, P = 0.002). The carriage of H63D risk allele (OR = 1.54; P = 0.02), heterozygous C282Y/wt and homozygous H63D/H63D genotypes were associated with liver cirrhosis in males (OR = 2.48, P = 0.008, and OR = 4.13, P = 0.005, respectively). Conclusions: Heterozygous C282Y mutation of the HFE gene was associated with liver cirrhosis in the Lithuanian population. In gender-related analysis, heterozygous C282Y and homozygous H63D mutations were linked to liver cirrhosis in men, not in women.
    Keywords HFE ; C282Y ; H63D ; Liver cirrhosis ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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