The Boston Marathon: Brave and beyond
Brave. It’s the word inscribed on the simple band Mary Tremper wears on her left wrist. The band is a reminder from her son Shane that she possesses the strength and courage to bravely face the future. When Mary, a Boston Children’s Hospital Miles for Miracles runner, found the band in the hospital gift shop she knew it was from Shane. And as Mary has shared her son’s story with her teammates and listened to theirs, they have redefined brave, together. A few of their stories, including the Tremper’s, follow. Brave: Remembering Shane Shane in the Boston Children’s NICU. “I run for Shane. I run because he can’t. I run because I can. I run for Shane.” This is Mary Tremper’s mantra. Shane, born May 6, 2016, was the Tremper’s second beautiful baby boy. The day after his birth Mary and her husband Jamie learned Shane had a large mass in his brain. Two days later, a team of specialists told the Trempers their son would not recover. Mary and Jamie vowed to make the most of Shane’s life however long or short it would be. Mary nursed Shane, Jamie snuggled him. They invited friends and family into the NICU. After Boston Children’s staff supported their decision to take Shane home, Mary, Jamie and big brother Owen tackled a family fun bucket list — the beach, the zoo, a barbecue. Several weeks later, they returned to Boston Children’s for Shane’s final moments. At times, Mary was crushed by grief. &...
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
CONCLUSIONS: A stepwise approach is recommended, in which full liver function is checked and the underlying cause of jaundice is investigated only after confirming cholestasis. PMID: 29807952 [PubMed - as supplied by publisher]
In this report, we present a 19-year-old patient presented with nausea, fatigue and jaundice. Her physical examination and laboratory tests revealed the diagnosis as acute hepatitis due to EBV with cross-reacting antibodies to cytomegalovirus.
Authors: Yinon Y, Farine D, Yudin MH Abstract OBJECTIVES: To review the principles of prenatal diagnosis of congenital cytomegalovirus (CMV) infection and to describe the outcomes of the affected pregnancies. OUTCOMES: Effective management of fetal infection following primary and secondary maternal CMV infection during pregnancy. Neonatal signs include intrauterine growth restriction (IUGR), microcephaly, hepatosplenomegaly, petechiae, jaundice, chorioretinitis, thrombocytopenia and anemia, and long-term sequelae consist of sensorineural hearing loss, mental retardation, delay of psychomotor development, and vi...
CONCLUSION: In children with CMV hepatitis, fever was the most common symptom at presentation, and jaundice was the most common clinical feature of hepatic CMV infection in infants younger than 3 months of age. Hepatic CMV infection in immunocompetent children is often a self-limited illness that does not require antiviral therapy, as most patients in this study had favorable outcomes. PMID: 29042868 [PubMed]
ConclusionsDespite recent reports that outcome of LapPE for BA may be unfavorable compared with the conventional open portoenterostomy, our results would suggest that JLapPE can be performed successfully, because it is performed exactingly according to a standard protocol. JLapPE will continue to be our procedure of choice for treating BA.
This study aimed to analyze the impact of etiologic heterogeneity and operation age on prognosis of infants with biliary atresia (BA) who received Kasai operation prior to 60 days of age. From 2004 to 2010, 158 infants received Kasai operation before turning 60 days old. According to Davenport 2012 classifications, 4 groups of BA were defined: cystic BA, syndrome BA, and associated malformation, cytomegalovirus (CMV)-associated BA, and isolated BA. Native (autologous) liver survival rates and incidence of cholangitis 2 years after operation, as well as jaundice clearance rates 3 months after operation, were recorded. Alt...
Question: A 59-year-old man presented to the clinic with 5 days of right upper quadrant abdominal pain, pruritus, and scleral icterus. The pain was constant, dull, nonradiating, and not associated with fever or rigors. His medical history pertinent for a diagnosis of AIDS 7 months before presentation. The patient subsequently had developed cytomegalovirus retinitis and disseminated Mycobacterium avium complex (MAC) infection. Physical examination was remarkable for scleral icterus and mild tenderness to deep palpation in the right upper quadrant without any rebound or guarding.
CONCLUSION: A high proportion of patients with acute CMV and EBV developed hepatitis and jaundice, most of those patients have good prognosis. Patients with CMV hepatitis were more often immunosuppressed, required hospitalization or were pregnant in comparison with patients with EBV hepatitis. PMID: 28446048 [PubMed - as supplied by publisher]
Conclusions:It is important to suspect HAV infection when the patient with encephalitis or myelitis have abnormal liver function.Disclosure: Dr. Jo has nothing to disclose. Dr. Baek has nothing to disclose. Dr. Jeon has nothing to disclose. Dr. Lee has nothing to disclose.
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