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Psychological therapies for sickle cell disease and pain | Cochrane

Sickle cell disease is a group of blood disorders. It can cause anaemia, which if severe can reduce mobility. It may also allow small blood vessels to become blocked causing pain in muscle and bone and it can damage major organs such as the spleen, liver, kidneys, and lungs. People with sickle cell disease are more vulnerable to severe infections. Treatment is usually in response to symptoms and designed to ease pain. Psychological treatment to help people cope with sickle cell disease might complement current medical treatment. There are four types of treatment: patient education; cognitive therapy (to do with thoughts and feelings); behavioural therapy (to do with actions); psychodynamic psychotherapy (talking to relieve emotional pain). We searched for randomised or quasi-randomised controlled trials which compared psychological treatments to each other or to no treatment in sickle cell disease. We included seven studies in the review, of which five, with 260 people, had data we could enter into the review. One study showed that cognitive behaviour therapy reduced the affective part of pain (feelings about pain), but not the sensory part (pain intensity). Another study of this therapy had inconclusive results for coping strategies and showed no difference on how different groups used the health service. A study using cognitive behavioural therapy with teenagers and their families at home did not show any difference when compared with education about sickle cell disease. One education study did not show a reduction in depression. Furthermore, one study in patient education helped improve attitudes to healthcare workers and medication use in adolescents and young adults. The authors believe that some patient education seems relevant for children, adolescents and young adults, while methods to improve the ability to cope in both children and adults are important. Nonetheless, these results may not apply to across all ages, clinical severity, types of pain (acute or chronic) that people with sickle cell disease have, or which country they live in. More research needs to be done in this area.  
cochrane.org
over 5 years ago
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Endoscopic injection of cyanoacrylate glue versus other endoscopic procedures for acute bleeding gastric varices in people with portal hypertension | Cochrane

Acute bleeding from ruptured gastric varices (enlarged veins), the most severe consequence of portal hypertension (that is increased pressure in the veins leading to the liver), is associated with high death rates. The most promising treatment for this condition is considered to be endoscopic sclerotherapy (passing a flexible tube with a camera at the end down the oesophagus (swallowing tube) allowing direct visualisation and treatment of bleeding varices) with N-butyl-2-cyanoacrylate (cyanoacrylate), which is a glue that causes blood clots to form and stops the bleeding. However, incidence of re-bleeding and complications have opened a debate on when this glue should be used compared with other endoscopic procedures.  
cochrane.org
over 5 years ago
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19

Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases | Cochrane

Review question We reviewed vitamin K for upper gastrointestinal bleeding in people with acute liver disease (that is, loss of normal liver functions which occurs in days or weeks; most often, people do not have a pre-existing liver disease) or chronic liver disease (that is, progressive destruction of normal liver functions, usually associated with fibrotic regeneration of the liver tissue).  
cochrane.org
over 5 years ago
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3

Hospitals urge Muslims to donate organs - BBC News

Hospitals in the West Midlands are urging Muslims to consider donating their organs for patients waiting for a new kidney or liver.  
bbc.co.uk
over 5 years ago
Www.bmj
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A dose of humility

Paracetamol has come in for a bit of a kicking in recent months (doi:10.1136/bmj.h1186). So we asked James Dear and colleagues to comment (doi:10.1136/bmj.h3705). They confirm that important questions about this most commonly used drug remain unanswered. The evidence of effectiveness is patchy and depends on the condition: it’s good for postoperative dental pain; okay for headache, though not as good as other analgesics; of small and probably clinically irrelevant benefit for hip and knee pain; no better than placebo for back pain; and without enough evidence of benefit for the common cold. As for its safety, nearly 60 years of widespread use are reassuring. But there are simmering concerns about subclinical liver and cardiovascular effects and questions about whether or not to intervene in cases of small therapeutic overdose.  
feeds.bmj.com
about 5 years ago
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Cell transplant 'regenerates' liver - BBC News

Transplanting cells into livers has the potential to regenerate them, say scientists.  
bbc.co.uk
about 5 years ago
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Lab Case 66 – Interpretation

1.ALP and GGT elevated > ALT, elevated bilirubin suggesting obstructive liver enzyme picture with mild biochemical jaundice and transaminitis  
emergucate.com
about 5 years ago
Www.bmj
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An elderly woman with postprandial abdominal pain

An 84 year old woman presented with a five month history of central, recurrent, severe epigastric pain, which occurred about 20 minutes after eating. This was associated with nausea, occasional diarrhoea, and vomiting. She had experienced early satiety and weight loss over the last few months. Her medical history included myocardial infarction two years earlier. She also had a 40 pack year history of smoking. On examination, she was cachectic, but physical examination and digital rectal examination were otherwise unremarkable. Blood tests—including full blood count, liver functions tests, amylase, and renal function—were normal. Chest and abdominal radiographs, abdominal ultrasound, and computed tomography of the abdomen were unremarkable. Computed tomography angiography was performed (fig 1⇓).  
feeds.bmj.com
about 5 years ago
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Von Meyenburg complex | Radiology Case | Radiopaedia.org

Innumerable tiny T2W hyperintense cystic lesions noted in the both lobes of liver with no obvious communication with the biliary tract suggestive of biliary hamartomas or von Meyenburg complex.  
radiopaedia.org
about 5 years ago
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24

Interventions for dialysis patients with hepatitis C virus (HCV) infection | Cochrane

Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV) which spreads from person to person through blood contact which is a result of sharing drug needles, and other items contaminated with blood. This virus remains in the body for a long time and can affect the liver causing its slow destruction or cirrhosis and liver cancer. Infected people may have weakness, nausea, jaundice and lose weight. On blood tests they may have increase in liver enzymes and bilirubin.  
cochrane.org
about 5 years ago
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Is surgery or observation better for people who have a severe blunt injury to the liver? | Cochrane

The liver is the most commonly affected organ when a person is injured in the abdomen. Abdominal injury is usually caused by motor vehicle crashes, falling, being punched in the stomach, or from other causes. When a person is badly injured in the abdomen, they have a 10% to 15% chance of death. According to previous research, the chance of death following a liver injury has not reduced over the past 30 years.  
cochrane.org
about 5 years ago
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Liver in cardiopulmonary disease - Best Practice & Research Clinical Gastroenterology

To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect.  
bpgastro.com
about 5 years ago
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Surefire Precision Chemoembolization Infusion System Keeps Drugs Within Liver Tumors |

Surefire Medical (Westminster, CO) landed FDA clearance for its Surefire Precision system for delivering drugs directly into tumors. It's designed to focus  
medgadget.com
about 5 years ago
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Critical Care

In a recent article in Critical Care, Tapia and colleagues evaluated the relationship between exogenous lactate clearance and liver perfusion in a short-term model of endotoxemic shock [1]. The authors concluded that the very low portal-hepatic vein lactate gradient was indicative of the inability of the liver to metabolize the increased lactate load. Although we believe that the authors addressed an important issue, we have some concerns regarding their methodology.  
ccforum.com
about 5 years ago
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2

Vitamin D Deficiency in Patients Listed for Liver Transplant

This article provides insight into the efficacy of current practice for the management of vitamin D deficiency in patients awaiting liver transplantation.  
medscape.com
about 5 years ago
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Branched-chain amino acids improve symptoms of hepatic encephalopathy | Cochrane

Hepatic encephalopathy is a brain dysfunction associated with liver disease. Cirrhosis, which is a condition where scar tissue (fibrosis) replaces the normal liver tissue, is the most common cause of hepatic encephalopathy. The severity of the symptoms range from minor signs to coma. The minor changes are known as minimal hepatic encephalopathy. Overt hepatic encephalopathy refers to the more severe stages with clinically apparent manifestations such as changes in the level of consciousness or neuropsychiatric abnormalities. Many people with cirrhosis lack amino acids, which are building blocks of proteins. The amino acids with a side-chain (a branch) are known as branched-chain amino acids (BCAA). The BCAA play an important part of the generation muscles and of the signalling chemicals in the brain. These effects may benefit people with hepatic encephalopathy.  
cochrane.org
about 5 years ago
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CT abdomen showing hepatocellular carcinoma LIVER TUMOR in a 2 year old child

Prepare for USMLE,UK,CANADIAN,AUSTRALIAN, NURSING & OTHER MEDICAL BOARD examinations around the globe with us.Understand the basics, concepts and how to answ...  
youtube.com
about 5 years ago
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CT abdomen showing carcinoma of liver

Prepare for USMLE,UK,CANADIAN,AUSTRALIAN, NURSING & OTHER MEDICAL BOARD examinations around the globe with us.Understand the basics, concepts and how to answ...  
youtube.com
about 5 years ago
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Cyst in the liver in a CT abdomen

Prepare for USMLE,UK,CANADIAN,AUSTRALIAN, NURSING & OTHER MEDICAL BOARD examinations around the globe with us.Understand the basics, concepts and how to answ...  
youtube.com
about 5 years ago
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Pregnancies After Liver Transplant Are High-Risk But Can Be Successful

Pregnancies after liver transplant are successful in many cases but still must be considered high risk, according to researchers who reviewed outcomes at one large center.  
medscape.com
almost 5 years ago