Protein-Losing Enteropathy Following Fontan Palliation

Publication date: December 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 12Author(s): Asim Al Balushi, Andrew S. MackieAbstractProtein-losing enteropathy (PLE) is a chronic condition involving multiple organ systems that may develop any time following Fontan completion. The pathogenesis of PLE is complex and multifactorial. Chronic venous hypertension, low cardiac output, and abnormal lymphatics may all play a role in the pathogenesis of PLE. Common signs and symptoms include chronic diarrhea, abdominal pain, and ascites. Diagnosis is based on the presence of signs and symptoms in addition to hypoalbuminemia and elevated stool alpha 1 antitrypsin. Early identification and a comprehensive approach to evaluation and treatment are important, as they may affect survival. The initial evaluation should include cardiac catheterization for hemodynamic assessment. Although an evidence base for treatment is lacking, various medical, interventional, and surgical approaches have been described with variable degrees of success. Commonly used therapies include nutritional support, diuretics, subcutaneous unfractionated heparin, budesonide, and sildenafil. Limited data exist for Fontan conversion or takedown. Assessment for heart transplantation should be considered. PLE mortality is high—approximately 50%—but may be mitigated by aggressive investigation and management. The evolving understanding of the role of lymphatics in the pathophysiology of PLE and the emer...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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Authors: Fournier E Abstract Carpal tunnel syndrome (CTS) is too common a condition not to daily interact with the practitioner, if only because of its entanglement to other pathologies, causal or chance association. The typical symptomatology, with hand paresthesia and morning pain upon waking, is related to a median nerve injury in the confined space of the carpal tunnel, more often by local inflammation and tenosynovitis of the finger flexors (repetitive activity of the hands). SCC may be secondary to situations (pregnancy) or conditions (edema, hypothyroidism…), which exaggerate the ordinary pathophysiol...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
Publication date: Available online 25 January 2020Source: Aquatic ToxicologyAuthor(s): Christine Dépatie, Magali Houde, Jonathan VerreaultAbstractLipids play important roles in growth, reproduction, locomotion, and migration of fish. Municipal effluents, which are complex mixtures of biological and chemical compounds including flame retardants, have been shown to alter lipid metabletabolism in environmentally and experimentally exposed fish. Down-regulation of several genes coding for fatty acid metabolism enzymes has previously been reported in male northern pike (Esox lucius) collected in the St. Lawrence River (Q...
Source: Aquatic Toxicology - Category: Toxicology Source Type: research
Authors: Pastor-Galán I, Hernández-Boluda JC, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Ayala R, Velez P, Pérez-Encinas M, Estrada N, García-Gutiérrez V, Fox ML, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Martínez-Valverde C, Arbelo E, Angona A, Magro E, Antelo ML, Somolinos N, Cervantes F, en representación del Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN) Abstract BACKGROUND AND OBJECTIVE MYELOFIBROSIS: is an infrequen...
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Scott J. Davidoff, M.D. - Main Line Spine Scott J. Davidoff, M.D. is a physician at Main Line Spine who specializes in physical medicine, pain medicine, and sports medicine. mainlinespine.com i'm posting the bio of this physician simply for illustrative purposes. this group for example has a bunch of the docs there who have done a fellowship at a number of non accredited places yet they are all saying they are board certified and this person is even the president of american board of pain? how can someone be the president of the board when doing a ...
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: Available online 25 January 2020Source: Social Science &MedicineAuthor(s): Katherine TierneyAbstractRacial disparities in outcomes of assisted reproductive technologies (ART) are well-documented, and evidence of racial disparities in other forms of fertility treatments has also been observed. To date, much of the research on these disparities has focused on individual-level causes. This paper contextualizes these disparities using the weathering hypothesis. Using the National Survey of Family Growth and exploratory analyses of the National Health and Nutrition Examination Survey, this study evaluates ...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research
ConclusionsHigher concentrations of triclosan, BP-3, and propyl, butyl, ethyl, and methyl parabens were associated with lower odds of diabetes. These findings warrant further investigation into the potential mechanism behind the observed associations and the temporal direction of the associations, given that we cannot rule out reverse causation. Future studies of these endocrine disruptors may improve the understanding of their relationship with diabetes.
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
AbstractTragedy is a founding theme in disability studies. Critical disability studies have, since their inception, argued that understandings of disability as tragedy obscure the political dimensions of disability and are a barrier facing disabled persons in society. In this paper, we propose an affirmative understanding of tragedy, employing the philosophical works of Nietzsche, Spinoza and Hasana Sharp. Tragedy is not, we argue, something to be opposed by disability politics; we can affirm life within it. To make our case, we look to an ongoing ethnography of two Canadian children ’s rehabilitation clinics. Lookin...
Source: Journal of Medical Humanities - Category: Medical Ethics Source Type: research
ConclusionErgonomic interventions focusing on modification of workstations, and promoting and delivering ongoing ergonomic education are very important to reduce the problem.
Source: Journal of Public Health - Category: Health Management Source Type: research
Publication date: Available online 25 January 2020Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Wen-Yi Liu, Jian-Hong Wang, Yuan Guo, Xin Wang, Xiao-Dong Wu, Chuan-Shen Xu, Yang Zhao, Yun-Jin ZangSummaryBackgroundAn objective and accurate evaluation of liver grafts is required to improve the prognosis of liver transplant recipients and to increase the number of available liver grafts.AimTo compare outcomes using FibroScan with that of pathology in liver grafts from brain-dead donors (DBD).MethodsLiver grafts from 52 DBD were examined using ultrasound (US), FibroScan before liver transplantation ...
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
ConclusionsPillar suture combined with tonsillectomy may reduce postoperative bleeding incidence despite increasing pillar edema in pediatric tonsillectomy. Postoperative pain-relief, palatal hematoma, palatal discomfort sensation, site infection, and velopharyngeal insufficiency were not significantly altered compared to tonsillectomy alone. However, further studies are needed to corroborate the results of this study.ResumoIntroduçãoDiversas técnicas cirúrgicas têm sido utilizadas na tonsilectomia no intuito de reduzir complicações.ObjetivosAvaliar os efeitos da sutura dos p...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
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