Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Methoxyflurane is utilized in obstetrics for analgesia during labor. It has been recognized as an unpredictable hepatotoxin. Although hepatitis has been seen after its use in anesthesia, only one case of hepatitis has been reported after its use for analgesia in labor. Two more cases of hepatitis following methoxyflurane analgesia are reported. Direct toxic effects of its metabolites and host idiosyncrasy may underlie the hepatic injury from methoxyflurane.
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PMID:Methoxyflurane hepatitis: two cases following obstetric analgesia. 613 1

The prevalence of hepatitis B viral markers is increased in some groups of medical workers who are exposed to blood from patients carrying the virus, but this has not been studied critically in physicians and others who administer anesthesia. Physician anesthesiologists (M.D.) and nurse anesthetists and anesthesia assistants (non-M.D.) at four university-affiliated hospitals were evaluated for hepatitis B markers as determined by seropositivity for hepatitis B surface antigen, antibody to the hepatitis B surface antigen, or antibody to the hepatitis B core antigen. In the 86 subjects (38 M.D., 48 non-M.D.) who represented 80.4% of possible participants, the overall prevalence of serologic markers of hepatitis B was 23.3%. The frequency did not differ between M.D. (23.7%) and non-M.D. (22.9%) groups or between men (20.3%) and women (26.9%). Of 81 subjects who had no clinical history of hepatitis, 16 (19.8%) had positive serologic markers. The frequency of seropositivity increased with time since graduation from medical school (M.D.) or nursing school or college (non-M.D.). The prevalence of serologic markers of hepatitis B virus in this study of anesthesia personnel is five to eight times that of the general population but is similar to that of other medical workers who frequently are exposed to blood.
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PMID:The prevalence of hepatitis B viral markers in anesthesia personnel. 614 Aug 88

This study was undertaken to determine the effects of two H2-receptor antagonists, cimetidine and ranitidine, on halothane metabolism and hepatotoxicity in the hypoxic Fisher 344 rat model for halothane hepatitis. In this model, liver injury is caused by toxic intermediates formed during metabolism of halothane by a reductive pathway. Administration of cimetidine (120 mg/kg ip) 20 min prior to anesthesia led to inhibition of the reductive pathway, as assessed by measurement of the exhaled metabolites, 2-chloro-1,1,1-trifluoroethane and 2-chloro-1,1-difluoroethylene, during anesthesia, and urinary fluoride excretion in the 22-hr postanesthesia period. Oxidative metabolism of halothane, assessed by serum bromide concentrations 22 hr postanesthesia, was unaffected. Cimetidine administration provided partial protection against the hepatotoxic effect of halothane, as indicated by serum alanine aminotransferase activities 22 hr postanesthesia. When ranitidine HCl (120 mg/kg ip) was administered prior to anesthesia, reductive metabolism of halothane was unaffected, but the oxidative pathway was slightly inhibited. Ranitidine did not provide protection against halothane-induced liver injury. These results provide additional evidence that halothane hepatotoxicity in the hypoxic rat model is due to toxic intermediates formed during the reductive metabolism of halothane.
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PMID:Effects of cimetidine and ranitidine on halothane metabolism and hepatotoxicity in an animal model. 614

Cryosurgery, from the Greek word "kyros" meaning icy cold, is 80 years old and has become firmly established in medicine as a modality for the destruction of superficial benign and malignant lesions. Its advantages include simplicity of use, few complications, use where radiotherapy would destroy tissue such as cartilaginous structures, little bleeding, only occasional need for anesthesia, and no need for hospitalization. Patients with pacemakers and elderly patients can be treated. A good cosmetic result is obtained and multiple lesions can be treated at one sitting. It is the treatment of choice for many basal cell epitheliomas on the eyelid, and in patients with multiple cancers, those allergic to local anesthesia, those on anticoagulants, and those patients with a history of hepatitis or other serologically transmitted diseases. Cryosurgery is not a panacea for the treatment of benign or malignant skin lesions. The physician must be knowledgeable about the clinical nature of the lesion being treated and must foster a degree of skill using cryosurgical techniques in order to avoid pitfalls and to obtain satisfactory results. There is no substitute for experience.
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PMID:The appropriate use of liquid nitrogen. 622 25

1. Acute galactosamine (Gal) hepatitis was induced in rats drinking ad libitum either sodic bicarbonated water of Vichy Grande Grille (GG) or ordinary tap water (OH2). Two series of experiments were performed. 2. In the first series, Gal-induced hepatitis was moderate. Twenty four hours after IP Gal injection, GG treated rats had relative to OH2 treated rats a decrease of bile flow and BSP excretion, and an increase of serum transaminase and bilirubin. Seven days after Gal the liver had returned to normal except for an increase in biliary bilirubin and liver total lipids. 3. In the second series, Gal-induced hepatitis was severe. Twenty four hours after galactosamine administration, an increase in mortality after anesthesia was found in Gal/GG rats. An increase of liver size and total hepatic lipids was also observed, while bile secretion, BSP excretion, cyt P 450 and ARN decreased in Gal/GG rats. Steatosis and inflammatory reactions were more important in Gal/GG than in Gal/OH2 rats. Most parameters came back to their normal levels in two days in Gal/OH2 rats, while 7 days were generally necessary in Gal/GG treated animals. Hepatic DNA kept increasing in Gal/GG animals and was still higher after 7 days, maybe due to a greater inflammatory reaction in the liver, maybe following a stimulated hepatocyte regenerative response. 4. These results indicate that GG water is not an inoffensive salt solution.
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PMID:[Aggravation of acute galactosamine hepatitis by a sodic bicarbonated water in rats (author's transl)]. 626 Oct 45

There is no longer any doubt that liver dysfunction following surgery and anaesthesia may sometimes be attributable to the inhalational anaesthetic agent halothane. Much controversy still surrounds the entity of halothane hepatitis, which continues to vex the practising anaesthesiologist. The incidence, causation, pathogenesis and diagnosis of halothane hepatitis are presented, and the safety and practicality of halothane administration in the presence of liver dysfunction are discussed.
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PMID:Halothane hepatitis and the anaesthesiologist. 636 93

Nitroglycerin was utilized in combination with general anesthesia in order to reduce mean arterial blood pressure with the objective of reducing operative blood loss in 26 consecutive patients undergoing radical hysterectomy and pelvic lymphadenectomy. This deliberate hypotensive technique added no morbidity and compared to a control group decreased the blood loss by 70%, shortened operating time by 29.5%, and decreased the percentage of patients requiring blood transfusions from 81% to 11.5%. The indications for controlled hypotension are still controversial and somewhat dependent upon the expertise of the anesthesia and surgery teams, availability of blood, and the risk of transfusion hepatitis. Cerebrovascular disease, myocardial ischemia, peripheral vascular disease, severe renal or hepatic disease, and hypovolemia are relative contraindications to deliberate hypotension.
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PMID:A deliberate hypotensive technique for decreasing blood loss during radical hysterectomy and pelvic lymphadenectomy. 641 54

The methods of gathering information to determine the safety of anesthesia and to establish the risk of mortality and morbidity include anecdotal tales, in-hospital audit and peer review, reports to medical protective societies, retrospective studies, reviews of specific problems and prospective studies. All these methods have limitations and, in particular, do not readily differentiate the anesthetic from the surgical contributions. However, it appears that over the past 30 years the risk of death directly attributable to anesthesia has decreased from 1 in 2680 to about 1 in 10 000. The main causes of death are faulty anesthetic techniques due to human error, drug overdose, coexistent disease and failure of immediate postoperative care. Equipment failure, poor preoperative assessment, halothane-associated hepatitis and malignant hyperthermia, although often cited in the literature, are rarely the cause of problems associated with anesthesia.
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PMID:Anesthesia in 1984: how safe is it? 646 15

The pharmacokinetics of thiopentone were compared in nine control patients and 10 patients with chronic alcoholism (without signs of cirrhosis or hepatitis) undergoing orthopaedic or abdominal surgery under general anaesthesia. The mean (+/- SD) alcohol intake was 92 +/- 14 litre of ethanol per year in the alcoholic patients and less than 10 litre yr-1 in the controls. Thiopentone plasma concentrations were measured by high pressure liquid chromatography after the administration of a single bolus dose (5-9 mg kg-1). The plasma clearance of thiopentone was significantly increased from 3.7 +/- 0.9 ml min-1 kg-1 in the controls to 5.4 +/- 2.2 ml min-1 kg-1 in the patients with chronic alcoholism. The volume of the central compartment and the total apparent volume of distribution were similar in both groups. The terminal elimination half-life was of 684 +/- 168 min in the alcoholics and did not differ significantly from the value found in the controls (750 +/- 212 min).
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PMID:Thiopentone pharmacokinetics in patients with chronic alcoholism. 649 49

Recent advances of pediatric endoscopy were discussed. Progresses of technique and improvements of instrument have made it possible to scope safely resulting in the increase of pediatric endoscopies. Gastric endoscopy has become useful to find the peptic ulcer of the stomach in the newborn babies who showed hematemesis. ERCP has been done successfully in the newborn babies making it possible to differentiate congenital biliary atresia from infantile hepatitis. Colonofiberscopy has become reliable and useful procedure to search the source of rectal bleeding but still had some problems to be resolved. General anesthesia has been widely used at the performance of pediatric endoscopy. In some institutes, local anesthesia has been recommended in the patients over 8 years old. In 1983, 1161 pediatric endoscopies were performed in 24 institutes, which were twofold of those performed in 1978. Number of these cases is not enough for the training of pediatric endoscopist. Urgent theme is to establish the system for the education of "true" pediatric endoscopist.
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PMID:[Progress and focal points discussed at the Japanese Committee on Pediatric Endoscopy]. 650 83


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