A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Treatments
In traditional Chinese perpective
1. Traditional Chinese herbs
for nourishing the liver (Yanggan Lidan Granule (YGLDG))
In the study of Eighty guinea pigs randomly divided into four groups, which were normal control group, untreated group, nourishing-liver Chinese drug (NLCD) group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group, gallstones were induced in the guinea pigs of the latter 3 groups by the feed of diet inducing cholelithiasis with high cholesterol, while the corresponding medicines were used in NLCD group and UDCA group
for prevention and treatment for 7 weeks, showed that the [Ca(2+)]i in
gallbladder cells is the important factor for contractile function of
gallbladder and the information of gallstones. Traditional Chinese herbs
for nourishing the liver may significantly increase the [Ca(2+)]i in
gallbladder cells to facilitate contraction of the smooth muscle cells
of gallbladder and relieve the cholestatis(17).
Other study to explore the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese
herbal medicine for nourishing liver and improving choleresis, on the
rate of gallstone formation and content of plasma cholecystokinin in
guinea pigs with induced cholesterol gallstones. indicated that YGLDG can significantly decrease the rate of gallstone formation in
guinea pigs. It may be related to elevating the content of CCK in the
plasma(18).
2. Ingredients of Yanggan Lidan Granule (YGLDG)
a. Bai Shao tonifies liver Yin,
b. Chen Pi,
c. Gao Qi Zi tonifies liver Yin
d. He shou wu tonifies liver Yin
e. Gan Cao
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Sources
(17) http://www.ncbi.nlm.nih.gov/pubmed/17352876
(18) http://www.ncbi.nlm.nih.gov/pubmed/18405610
Tuesday, 3 December 2013
Gallstone Treatment In Herbal medicine perspective
A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Gallstone Treatment In conventional medicine perspective
A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Treatment
F.1. In conventional medicine perspective
1. Cholecystectomy
No treatment for people who have developed galldtones but with no system, otherwise, surgery to remove the gallbladder may be necessary. Cholecystectomy is the surgical removal of the symptomatic gallbladder. In the sugery, It is the most common method for treating symptomatic gallstones, other surgeries include the laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.
2. Others
a. Some researchers suggested for the treatment of gallstones in patients with normal stonefree bile ducts, new modalities have been developed besides the classical cholecystectomy and the oral litholysis. The interventional procedures (local litholysis, extracorporeal shockwave lithotripsy, combination of shockwave lithotripsy and local litholysis, cholecystostomy and extra- or intracorporeal lithotripsy) do not need a narcosis and can be applied even in high-risk patients. Because the gallbladder itself is not removed, the recurrence rate after all these interventions is rather high. The new operative procedures (laparoscopic cholecystectomy, mini-laparotomy cholecystectomy) are definitive solutions for stone disease, but must be performed mostly in narcosis(13).
b. Today, cholecystectomy was still the most frequent method of treatment for symptomatic cholecystolithiasis (n = 1369) with low morbidity (4.3%) and lethality (0.28%). Probably less than 20% of all cases fulfill the strict selection criteria for extracorporeal shock wave lithotripsy (ESWL). All alternative methods of treatment in which the gallbladder is preserved have an increased risk for gall stone recurrence. Only after the long-term follow-up results of ESWL are known, the recurrence rate can be assessed. In most cases, bile duct stones (n = 417) were removed by endoscopy, if necessary in combination with ESWL (n = 310, stone removal: 95%, lethality: 0.3%). However, in low risk patients with concurrent cholecystolithiasis surgery was still the method of choice (n = 107, stone removal: 96%, lethality: 0/107)(14).
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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/2028140
(14) http://www.ncbi.nlm.nih.gov/pubmed/2721300
(15) http://www.ncbi.nlm.nih.gov/pubmed/21756271
Treatment
F.1. In conventional medicine perspective
1. Cholecystectomy
No treatment for people who have developed galldtones but with no system, otherwise, surgery to remove the gallbladder may be necessary. Cholecystectomy is the surgical removal of the symptomatic gallbladder. In the sugery, It is the most common method for treating symptomatic gallstones, other surgeries include the laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.
2. Others
a. Some researchers suggested for the treatment of gallstones in patients with normal stonefree bile ducts, new modalities have been developed besides the classical cholecystectomy and the oral litholysis. The interventional procedures (local litholysis, extracorporeal shockwave lithotripsy, combination of shockwave lithotripsy and local litholysis, cholecystostomy and extra- or intracorporeal lithotripsy) do not need a narcosis and can be applied even in high-risk patients. Because the gallbladder itself is not removed, the recurrence rate after all these interventions is rather high. The new operative procedures (laparoscopic cholecystectomy, mini-laparotomy cholecystectomy) are definitive solutions for stone disease, but must be performed mostly in narcosis(13).
b. Today, cholecystectomy was still the most frequent method of treatment for symptomatic cholecystolithiasis (n = 1369) with low morbidity (4.3%) and lethality (0.28%). Probably less than 20% of all cases fulfill the strict selection criteria for extracorporeal shock wave lithotripsy (ESWL). All alternative methods of treatment in which the gallbladder is preserved have an increased risk for gall stone recurrence. Only after the long-term follow-up results of ESWL are known, the recurrence rate can be assessed. In most cases, bile duct stones (n = 417) were removed by endoscopy, if necessary in combination with ESWL (n = 310, stone removal: 95%, lethality: 0.3%). However, in low risk patients with concurrent cholecystolithiasis surgery was still the method of choice (n = 107, stone removal: 96%, lethality: 0/107)(14).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/2028140
(14) http://www.ncbi.nlm.nih.gov/pubmed/2721300
(15) http://www.ncbi.nlm.nih.gov/pubmed/21756271
Gallstone Preventions - The Diet
A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Prevention
1. Vegetable
Vegetable protein may reduce the risk of cholelithiasis(19)
2. A low-fat, low-protein, high-carbohydrate or lowering of glycaemic index and the caloric reduction diet may reduce the risk of formation of gallstone formation(21)
3. Reduce intake of bad fat(23)
In the study of found that the type of dietary fat habitually consumed can influence bile composition in humans. In gallbladder, this influence was noted in the presence of more concentrated bile in the olive oil group. However, this was not translated into a modification of cholesterol saturation, which is likely due to the fact that cholesterol gallstones were present by the time the dietary intervention started(22).
4. Nuts
Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds According to the study by Dr, Ros E nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women(20).
5. Wheat bran
There is a study of 10 patients with probable cholesterol gallstones took bran supplements for 4-6 weeks, their gallbladder bile aspirated from the duodenum became less saturated with cholesterol(24).
6. Others
Some researchers suggested that intake of high energy, simple sugar and saturated fat favors gallstone formation. Fiber and moderate consumption of alcohol reduce the risk(25). Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(19) http://www.ncbi.nlm.nih.gov/pubmed/1503808
(20) http://www.ncbi.nlm.nih.gov/pubmed/22254047
(21) http://www.ncbi.nlm.nih.gov/pubmed/14619611
(22) http://www.ncbi.nlm.nih.gov/pubmed/15797676
(23) http://www.ncbi.nlm.nih.gov/pubmed/1398503
(24) http://www.ncbi.nlm.nih.gov/pubmed/941893
(25) http://www.ncbi.nlm.nih.gov/pubmed/15190042
Prevention
1. Vegetable
Vegetable protein may reduce the risk of cholelithiasis(19)
2. A low-fat, low-protein, high-carbohydrate or lowering of glycaemic index and the caloric reduction diet may reduce the risk of formation of gallstone formation(21)
3. Reduce intake of bad fat(23)
In the study of found that the type of dietary fat habitually consumed can influence bile composition in humans. In gallbladder, this influence was noted in the presence of more concentrated bile in the olive oil group. However, this was not translated into a modification of cholesterol saturation, which is likely due to the fact that cholesterol gallstones were present by the time the dietary intervention started(22).
4. Nuts
Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds According to the study by Dr, Ros E nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women(20).
5. Wheat bran
There is a study of 10 patients with probable cholesterol gallstones took bran supplements for 4-6 weeks, their gallbladder bile aspirated from the duodenum became less saturated with cholesterol(24).
6. Others
Some researchers suggested that intake of high energy, simple sugar and saturated fat favors gallstone formation. Fiber and moderate consumption of alcohol reduce the risk(25). Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(19) http://www.ncbi.nlm.nih.gov/pubmed/1503808
(20) http://www.ncbi.nlm.nih.gov/pubmed/22254047
(21) http://www.ncbi.nlm.nih.gov/pubmed/14619611
(22) http://www.ncbi.nlm.nih.gov/pubmed/15797676
(23) http://www.ncbi.nlm.nih.gov/pubmed/1398503
(24) http://www.ncbi.nlm.nih.gov/pubmed/941893
(25) http://www.ncbi.nlm.nih.gov/pubmed/15190042
Gallstone - The Complications and Diseases associated with gallstone
A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Complications and Diseases associated with gallstone
1. Spontaneous cholecystocutaneous fistula
Spontaneous perforation of gallbladder as a complication of biliary stones may lead to a cholecystocutaneous abscess or fistula. The pathophysiology of this condition has been associated with increased pressure in the gallbladder, secondary to biliary obstruction(9).
2. Jaundice
In the study to evaluate 56 patients with obstructive jaundice, the presence or absence of calculi in the gallbladder has been correlated with the cause of the obstruction. Seven of 23 patients with obstruction caused by stone had no calculi in the gallbladder. Twelve of 33 patients with obstruction due to tumor also had gallstones. It was concluded that the presence of calculi in the gallbladder is a poor indicator of the cause of obstructive jaundice(10).
3. Others diseases associated with gallstones
a. In Children
In the review of the risk factors, complications, and outcomes of gallstones at our institution, particularly in those patients who are asymptomatic at the time of initial diagnosis, researchers at the The Hospital for Sick Children, Toronto, showed that at diagnosis, 50.5% of children were asymptomatic; these patients were diagnosed at a mean age of 8.23 years. Compared with symptomatic patients, they were less likely to have a hemolytic anemia but more likely to have other risk factors, including cardiac surgery, leukemia and lymphoma, short bowel syndrome, or exposure to total parenteral nutrition or cephalosporins(11).
b. In Adult
Gallstones cause various problems besides simple biliary colic and choplecystitis. With chronicity of inflammation caused by gallstone obstruction of the cystic duct, the gallbladder may fuse to the extrahepatic biliary tree, causing Mirizzi syndrome, or fistulize into the intestinal tract, causing so-called gallstone ileus. Stones may pass out of the gallbladder and travel downstream through the common bile duct to obstruct the ampulla of Vater resulting in gallstone pancreatitis, or pass out of the gallbladder inadvertently during surgery, resulting in the syndromes associated with lost gallstones(12).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(9) http://www.ncbi.nlm.nih.gov/pubmed/22794521
(10) http://www.ncbi.nlm.nih.gov/pubmed/7434173
(11) http://www.ncbi.nlm.nih.gov/pubmed/20118803
(12) http://www.ncbi.nlm.nih.gov/pubmed/18992599
Complications and Diseases associated with gallstone
1. Spontaneous cholecystocutaneous fistula
Spontaneous perforation of gallbladder as a complication of biliary stones may lead to a cholecystocutaneous abscess or fistula. The pathophysiology of this condition has been associated with increased pressure in the gallbladder, secondary to biliary obstruction(9).
2. Jaundice
In the study to evaluate 56 patients with obstructive jaundice, the presence or absence of calculi in the gallbladder has been correlated with the cause of the obstruction. Seven of 23 patients with obstruction caused by stone had no calculi in the gallbladder. Twelve of 33 patients with obstruction due to tumor also had gallstones. It was concluded that the presence of calculi in the gallbladder is a poor indicator of the cause of obstructive jaundice(10).
3. Others diseases associated with gallstones
a. In Children
In the review of the risk factors, complications, and outcomes of gallstones at our institution, particularly in those patients who are asymptomatic at the time of initial diagnosis, researchers at the The Hospital for Sick Children, Toronto, showed that at diagnosis, 50.5% of children were asymptomatic; these patients were diagnosed at a mean age of 8.23 years. Compared with symptomatic patients, they were less likely to have a hemolytic anemia but more likely to have other risk factors, including cardiac surgery, leukemia and lymphoma, short bowel syndrome, or exposure to total parenteral nutrition or cephalosporins(11).
b. In Adult
Gallstones cause various problems besides simple biliary colic and choplecystitis. With chronicity of inflammation caused by gallstone obstruction of the cystic duct, the gallbladder may fuse to the extrahepatic biliary tree, causing Mirizzi syndrome, or fistulize into the intestinal tract, causing so-called gallstone ileus. Stones may pass out of the gallbladder and travel downstream through the common bile duct to obstruct the ampulla of Vater resulting in gallstone pancreatitis, or pass out of the gallbladder inadvertently during surgery, resulting in the syndromes associated with lost gallstones(12).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(9) http://www.ncbi.nlm.nih.gov/pubmed/22794521
(10) http://www.ncbi.nlm.nih.gov/pubmed/7434173
(11) http://www.ncbi.nlm.nih.gov/pubmed/20118803
(12) http://www.ncbi.nlm.nih.gov/pubmed/18992599
Monday, 2 December 2013
Thyroid disease: Euthyroid sick syndrome as a result of Sepsis - Diseases associated to Sepsis
Euthyroid sick syndrome
Euthyroid sick syndrome is defined as a condition of low T3 low T4 syndrome. According ot the study by the Mayo Clinic, in other word this is the abnormalities of thyroid hormone concentrations seen commonly in a wide variety of nonthyroidal illnesses, resulting in low triiodothyronine, total thyroxine, and thyroid stimulating hormone concentrations(a). Decreased triiodothyronine (T3) levels are most common. Patients with more severe or prolonged illness also have decreased thyroxine (T4) levels. Serum reverse T3 (rT3) is increased. Patients are clinically euthyroid and do not have elevated thyroid-stimulating hormone (TSH) levels(b). Causes of euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, chronic renal failure, cirrhosis, and diabetic ketoacidosis and inflammatory bowel disease(c). Others, in the study of classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG suggested that in SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure(d).
Euthyroid sick syndrome as a result of Sepsis
Sepsis is defined as a condition caused by chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body as a result of severe infection(a)(b). according to the study by the University of Utah, sepsis is the commonest cause of admission to medical ICUs across the world. Mortality from sepsis continues to be high. Besides shock and multi-organ dysfunction occurring following the intense inflammatory reaction to sepsis, complications arising from sepsis-related immunoparalysis contribute to the morbidity and mortality from sepsis(c).
Diseases associated to Sepsis
1. Staphylococcal infections
Preterm infants are especially susceptible to late-onset sepsis that is often due to Gram-positive bacterial infections resulting in substantial morbidity and mortality(24).
2. Elevated central venous pressure
Elevated central venous pressure is associated with impairment of microcirculatory blood flow in sepsis(25).
3. Neonatal cellulitis
there is a report of a case of late onset neonatal invasive group A streptococcal disease characterized with rapidly progressing cellulitis and development of sepsis(26).
4. Methicillin-resistant Staphylococcus aureus
There is a report of the spectrum of community-acquired S. aureus infections and to compare the patients infected with methicillin-susceptible or methicillin-resistant strains among patients aged <20 years. Overall, 90 cases of community-acquired S. aureus were detected in an 11-year period(27).
5. Bladder infection
Bladder bacteria is common but unique cause for sepsis(28).
6. Urinary tract infection
In the study to evaluate the effectiveness of Lactobacillus GG supplementation in reducing the incidence of urinary tract infections (UTIs), bacterial sepsis and necrotizing enterocolitis (NEC) in preterm infants, found that seven days of Lactobacillus GG supplementation starting with the first feed is not effective in reducing the incidence of UTIs, NEC and sepsis in preterm infants. Further studies are required to confirm our results in lower birthweight populations(29).
7. Venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolus)
According to the study b ythe UC Davis School of Medicine, there was increased risk of AbVTE early (<90 days; hazard ratio [HR] 5.4 [confidence interval (CI), 2.3-12.5]), but not late (≥90 days; HR 1.5 [CI, 0.9-2.6]) after splenectomy. There was increased risk of VTE both early (HR 5.2 [CI, 3.2-8.5]) and late (HR 2.7 [CI, 1.9-3.8]) after splenectomy. The cumulative incidence of sepsis was 11.1% among the ITP patients who underwent splenectomy and 10.1% among the patients who did not. Splenectomy was associated with a higher adjusted risk of sepsis, both early (HR 3.3 [CI, 2.4-4.6]) and late (HR 1.6 or 3.1, depending on comorbidities). ITP patients post splenectomy are at increased risk for AbVTE, VTE, and sepsis(30).
8. Hydroureteronephrosis
Hydroureteronephrosis without vesicoureteral reflux or lower-urinary-tract obstruction is uncommon in infants. There has been considerable interest in and controversy over the cause and management of this entity. We have cared for three neonates with severe hydroureteronephrosis after acute urinary tract infections, who were treated without operation, according to Pais VM, and Retik AB(31).
9. Osteomyelitis
Sepsis and osteomyelitis about the ankle joint present a challenging clinical problem. Osteomyelitis usually follows open fracture of the distal tibia, often with a pilon fracture component. Treatment of subsequent osteomyelitis and sepsis, including the authors' experiences, is discussed. Septic ankle arthritis can occur hematogenously. In some patients, the optimal treatment for concomitant osteomyelitis and sepsis is a below knee amputation(32).
10. Necrotizing fasciitis
There is a report of a case of necrotizing fasciitis and sepsis caused by Aeromonas hydrophila after crush injury of the lower extremity(33).
11. Phlebitis
There is a report of a case of Septic pulmonary emboli secondary to internal jugular vein phlebitis (postanginal sepsis) caused by Eikenella corrodens(34).
12. Lymphedema
There is a report of a patient with congenital penoscrotal lymphedema complicated by cellulitis, lymphangitis, and severe sepsis associated with a streptococcal infection. This case represents the importance of obtaining a detailed clinical history and physical findings(35).
13. Vancomycin-Resistant Enterococci (VRE)
The prevalence of the VRE that caused bacteraemia increased from 2003 to 2010. This increase might be attributed to the clonal spread of VREfm belonging to ST18 and ST414. The all-cause 14 day mortality rate was lower in patients with bacteraemia due to VREfm isolates that belonged to ST414(36).
Chinese Secrets To Fatty Liver And Obesity Reversal
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Sources
(a) http://en.wikipedia.org/wiki/Sepsis
(b) http://www.mayoclinic.com/health/sepsis/DS01004
(c) http://www.ncbi.nlm.nih.gov/pubmed/24082613
(24) http://www.ncbi.nlm.nih.gov/pubmed/23935651
(25) http://www.ncbi.nlm.nih.gov/pubmed/23919272
(26) http://www.ncbi.nlm.nih.gov/pubmed/20807361
(27) http://www.ncbi.nlm.nih.gov/pubmed/24055391
(28) http://www.ncbi.nlm.nih.gov/pubmed/5564785
(29) http://www.ncbi.nlm.nih.gov/pubmed/12169832
(30) http://www.ncbi.nlm.nih.gov/pubmed/23637127
(31) http://www.ncbi.nlm.nih.gov/pubmed/1089891
(32) http://www.ncbi.nlm.nih.gov/pubmed/11232476
(33) http://www.ncbi.nlm.nih.gov/pubmed/18687029
(34) http://www.ncbi.nlm.nih.gov/pubmed/6383158
(35) http://www.ncbi.nlm.nih.gov/pubmed/11138888
(36) http://www.ncbi.nlm.nih.gov/pubmed/22618861
Euthyroid sick syndrome is defined as a condition of low T3 low T4 syndrome. According ot the study by the Mayo Clinic, in other word this is the abnormalities of thyroid hormone concentrations seen commonly in a wide variety of nonthyroidal illnesses, resulting in low triiodothyronine, total thyroxine, and thyroid stimulating hormone concentrations(a). Decreased triiodothyronine (T3) levels are most common. Patients with more severe or prolonged illness also have decreased thyroxine (T4) levels. Serum reverse T3 (rT3) is increased. Patients are clinically euthyroid and do not have elevated thyroid-stimulating hormone (TSH) levels(b). Causes of euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, chronic renal failure, cirrhosis, and diabetic ketoacidosis and inflammatory bowel disease(c). Others, in the study of classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG suggested that in SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure(d).
Euthyroid sick syndrome as a result of Sepsis
Sepsis is defined as a condition caused by chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body as a result of severe infection(a)(b). according to the study by the University of Utah, sepsis is the commonest cause of admission to medical ICUs across the world. Mortality from sepsis continues to be high. Besides shock and multi-organ dysfunction occurring following the intense inflammatory reaction to sepsis, complications arising from sepsis-related immunoparalysis contribute to the morbidity and mortality from sepsis(c).
Diseases associated to Sepsis
1. Staphylococcal infections
Preterm infants are especially susceptible to late-onset sepsis that is often due to Gram-positive bacterial infections resulting in substantial morbidity and mortality(24).
2. Elevated central venous pressure
Elevated central venous pressure is associated with impairment of microcirculatory blood flow in sepsis(25).
3. Neonatal cellulitis
there is a report of a case of late onset neonatal invasive group A streptococcal disease characterized with rapidly progressing cellulitis and development of sepsis(26).
4. Methicillin-resistant Staphylococcus aureus
There is a report of the spectrum of community-acquired S. aureus infections and to compare the patients infected with methicillin-susceptible or methicillin-resistant strains among patients aged <20 years. Overall, 90 cases of community-acquired S. aureus were detected in an 11-year period(27).
5. Bladder infection
Bladder bacteria is common but unique cause for sepsis(28).
6. Urinary tract infection
In the study to evaluate the effectiveness of Lactobacillus GG supplementation in reducing the incidence of urinary tract infections (UTIs), bacterial sepsis and necrotizing enterocolitis (NEC) in preterm infants, found that seven days of Lactobacillus GG supplementation starting with the first feed is not effective in reducing the incidence of UTIs, NEC and sepsis in preterm infants. Further studies are required to confirm our results in lower birthweight populations(29).
7. Venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolus)
According to the study b ythe UC Davis School of Medicine, there was increased risk of AbVTE early (<90 days; hazard ratio [HR] 5.4 [confidence interval (CI), 2.3-12.5]), but not late (≥90 days; HR 1.5 [CI, 0.9-2.6]) after splenectomy. There was increased risk of VTE both early (HR 5.2 [CI, 3.2-8.5]) and late (HR 2.7 [CI, 1.9-3.8]) after splenectomy. The cumulative incidence of sepsis was 11.1% among the ITP patients who underwent splenectomy and 10.1% among the patients who did not. Splenectomy was associated with a higher adjusted risk of sepsis, both early (HR 3.3 [CI, 2.4-4.6]) and late (HR 1.6 or 3.1, depending on comorbidities). ITP patients post splenectomy are at increased risk for AbVTE, VTE, and sepsis(30).
8. Hydroureteronephrosis
Hydroureteronephrosis without vesicoureteral reflux or lower-urinary-tract obstruction is uncommon in infants. There has been considerable interest in and controversy over the cause and management of this entity. We have cared for three neonates with severe hydroureteronephrosis after acute urinary tract infections, who were treated without operation, according to Pais VM, and Retik AB(31).
9. Osteomyelitis
Sepsis and osteomyelitis about the ankle joint present a challenging clinical problem. Osteomyelitis usually follows open fracture of the distal tibia, often with a pilon fracture component. Treatment of subsequent osteomyelitis and sepsis, including the authors' experiences, is discussed. Septic ankle arthritis can occur hematogenously. In some patients, the optimal treatment for concomitant osteomyelitis and sepsis is a below knee amputation(32).
10. Necrotizing fasciitis
There is a report of a case of necrotizing fasciitis and sepsis caused by Aeromonas hydrophila after crush injury of the lower extremity(33).
11. Phlebitis
There is a report of a case of Septic pulmonary emboli secondary to internal jugular vein phlebitis (postanginal sepsis) caused by Eikenella corrodens(34).
12. Lymphedema
There is a report of a patient with congenital penoscrotal lymphedema complicated by cellulitis, lymphangitis, and severe sepsis associated with a streptococcal infection. This case represents the importance of obtaining a detailed clinical history and physical findings(35).
13. Vancomycin-Resistant Enterococci (VRE)
The prevalence of the VRE that caused bacteraemia increased from 2003 to 2010. This increase might be attributed to the clonal spread of VREfm belonging to ST18 and ST414. The all-cause 14 day mortality rate was lower in patients with bacteraemia due to VREfm isolates that belonged to ST414(36).
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Sources
(a) http://en.wikipedia.org/wiki/Sepsis
(b) http://www.mayoclinic.com/health/sepsis/DS01004
(c) http://www.ncbi.nlm.nih.gov/pubmed/24082613
(24) http://www.ncbi.nlm.nih.gov/pubmed/23935651
(25) http://www.ncbi.nlm.nih.gov/pubmed/23919272
(26) http://www.ncbi.nlm.nih.gov/pubmed/20807361
(27) http://www.ncbi.nlm.nih.gov/pubmed/24055391
(28) http://www.ncbi.nlm.nih.gov/pubmed/5564785
(29) http://www.ncbi.nlm.nih.gov/pubmed/12169832
(30) http://www.ncbi.nlm.nih.gov/pubmed/23637127
(31) http://www.ncbi.nlm.nih.gov/pubmed/1089891
(32) http://www.ncbi.nlm.nih.gov/pubmed/11232476
(33) http://www.ncbi.nlm.nih.gov/pubmed/18687029
(34) http://www.ncbi.nlm.nih.gov/pubmed/6383158
(35) http://www.ncbi.nlm.nih.gov/pubmed/11138888
(36) http://www.ncbi.nlm.nih.gov/pubmed/22618861
Gallstone - The Causes and Risk Factors
A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
B. Causes and Risk factors
B.1. Causes
High cholesterol or bilirubin in the bile
Gallstones are precipitations of oversaturated bile fluid. They can develop in the gallbladder and in the efferent bile ducts; they are very often correlated with diseases of the gallbladder, bile ducts and neighboring organs(5).
B.2. Risk factors
1. hypertriglyceridemia, overweight and insulin resistant
Patients with hypertriglyceridemia (HTG) - often overweight and insulin resistant - are at risk for gallstone disease(6).
2. Pregnancy and gender
Pregnant women(6b) and Elder are at higher risk to develop (specially, pigment stones in elder) gallstones(6a)
3. Haemoglobin E beta thalassaemia
in the study to determine whether this has a genetic basis we compared the bilirubin levels and frequency of gallstones in patients with different alleles of the UGT*1 gene, showed that the UGT*1 genotpe is of importance in the genesis of gallstones in this population of patients(7).
4. Obesity and weight loss
In the study to investigate the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues, showed that during weight loss, particularly among the obese, an increased risk exists for symptomatic gallstone formation. This acute risk offers the opportunity to investigate the cause of gallstones and possibly to prevent them(8).
5. Diet
Diet with high in saturated fat and low in fiber increase the risk of gallstones as a result of increased cholesterol in the bile.
6. Ethnicity
Certain races may be at the increased of the development of gallstone such as American Indians, Mexican have a genetic predisposition to secrete high levels of cholesterol in bile.
7. Hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease(8a).
Chinese Secrets To Fatty Liver And Obesity Reversal
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Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
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Sources
(5) http://www.ncbi.nlm.nih.gov/pubmed/423995
(6) http://www.ncbi.nlm.nih.gov/pubmed/20699090
(6a) http://www.ncbi.nlm.nih.gov/pubmed/7771432
(6b) http://www.ncbi.nlm.nih.gov/pubmed/17103289
(7) http://www.ncbi.nlm.nih.gov/pubmed/11425418
(8) http://www.ncbi.nlm.nih.gov/pubmed/8214980
(8a) http://www.ncbi.nlm.nih.gov/pubmed/17103289
B. Causes and Risk factors
B.1. Causes
High cholesterol or bilirubin in the bile
Gallstones are precipitations of oversaturated bile fluid. They can develop in the gallbladder and in the efferent bile ducts; they are very often correlated with diseases of the gallbladder, bile ducts and neighboring organs(5).
B.2. Risk factors
1. hypertriglyceridemia, overweight and insulin resistant
Patients with hypertriglyceridemia (HTG) - often overweight and insulin resistant - are at risk for gallstone disease(6).
2. Pregnancy and gender
Pregnant women(6b) and Elder are at higher risk to develop (specially, pigment stones in elder) gallstones(6a)
3. Haemoglobin E beta thalassaemia
in the study to determine whether this has a genetic basis we compared the bilirubin levels and frequency of gallstones in patients with different alleles of the UGT*1 gene, showed that the UGT*1 genotpe is of importance in the genesis of gallstones in this population of patients(7).
4. Obesity and weight loss
In the study to investigate the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues, showed that during weight loss, particularly among the obese, an increased risk exists for symptomatic gallstone formation. This acute risk offers the opportunity to investigate the cause of gallstones and possibly to prevent them(8).
5. Diet
Diet with high in saturated fat and low in fiber increase the risk of gallstones as a result of increased cholesterol in the bile.
6. Ethnicity
Certain races may be at the increased of the development of gallstone such as American Indians, Mexican have a genetic predisposition to secrete high levels of cholesterol in bile.
7. Hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease(8a).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(5) http://www.ncbi.nlm.nih.gov/pubmed/423995
(6) http://www.ncbi.nlm.nih.gov/pubmed/20699090
(6a) http://www.ncbi.nlm.nih.gov/pubmed/7771432
(6b) http://www.ncbi.nlm.nih.gov/pubmed/17103289
(7) http://www.ncbi.nlm.nih.gov/pubmed/11425418
(8) http://www.ncbi.nlm.nih.gov/pubmed/8214980
(8a) http://www.ncbi.nlm.nih.gov/pubmed/17103289
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