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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Homologous blood transfusions carry risks--febrile reactions, isoimmunization incompatibility reactions and transmission of infectious diseases such as AIDS and hepatitis. Although autotransfusion techniques will reduce the need for banked homologous blood, autologous shed blood does contain various cellular fragments that may act directly as myocardial depressants. Accordingly, the myocardial muscle mechanical properties of isolated human right atrial trabeculae contracting in vitro were measured in a bath containing either blood collected in the Sorensen ATS Autotransfusion Receptal unit or arterial autologous blood. Muscles were tested randomly in each solution by measuring their isometric resting and developed forces and the mean rate of developed force at different stimulation rates (force-frequency relation). In addition, biochemical, hematologic and immunologic assays were performed on each blood specimen. Significant increases (p less than 0.05) in potassium and plasma-free hemoglobin indicated that cell disruption had occurred in blood collected in the autotransfusion apparatus; however, there was no statistically significant difference in mechanical performance between muscles contracting in either solution. From these results, the authors conclude that autotransfused blood does not directly affect human heart-muscle mechanics.
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PMID:Direct effects of autotransfused blood on myocardial muscle mechanics in man. 382 18

A highly sensitive fluorometric method for determination of prolylendopeptidase (PE) activity in human erythrocyte hemolysates in the presence of hemoglobin has been developed. The method is based on measurement of fluorescence of 4-methyl-7-aminocoumarine released in the course of enzymatic reaction from the substrate Z-glycyl-proline-4-methylcoumarine-7-amide. A correlation was introduced for the quenching of fluorescence by hemoglobin. The method is suitable for the determination of PE activity in human erythrocyte hemolysates in various pathological states. The dependence of PE activity on the incubation time, protein and substrate concentrations were studied using the 1,200-fold purified preparations of prolylendopeptidase II. The values of PE activity in erythrocyte hemolysates of healthy donors and in those of patients with odontogenic phlegmons of maxillary-facial area were virtually identical. PE activity in erythrocyte hemolysates of stored blood was 5 times lower than that in the cell hydrolysates of fresh blood. The PE activity was not observed in blood serum of fresh and stored blood of healthy persons and of patients with acute inflammatory processes of maxillary-facial area, as well as in blood serum of patients with hepatitis and glomerulopephritis.
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PMID:[Fluorometric method of determining prolylendopeptidase activity in human erythrocytes in normal and pathologic conditions]. 390 10

In a prospective study, 93 patients were observed up to nine months after open-heart surgery using hypothermia, hemodilution and cold cardioplegia. In the first two weeks frequent determinations were made of serum aminotransferase, alkaline phosphatases (ALP), lactic dehydrogenase isoenzymes, gamma glutamyltransferase (GT), total and free bilirubin and bile acids. Plasma hemoglobin was measured at the end of the operation. After the first period, aminotransferases, alkaline phosphatases and bilirubin were determined monthly. On the first postoperative day almost all of the patients showed abnormal aspartate aminotransferase (ASAT) activity and ASAT/ALAT (alanine aminotransferase) greater than 1, and about 25% had hyperbilirubinemia. The findings suggested early postoperative leakage of enzymes not only from the myocardium, but also from the liver. After two weeks the patients presented another pattern of liver dysfunction, with abnormal ALAT in 50%, ASAT/ALAT less than 1, and abnormal ALP and GT in 28 and 45%, respectively. Eight patients were judged to have post-transfusion hepatitis of non-A, non-B type. Six of them had abnormal aminotransferases for more than six months.
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PMID:Hepatic dysfunction after open-heart surgery. 615 78

A successful program to reduce the amount of blood required in cardiac surgical procedures should encompass all phases of surgical therapy: preoperative exclusion or treatment of coagulation disturbances, intraoperative hemodilution to a hematocrit of 20% and subsequent reinfusion of autologous blood, and postoperative reinfusion of shed mediastinal blood during the first 12 postoperative hours keeping the hematocrit at 28%. In 1977, the bank blood requirement for 527 cardiac surgical procedures (control group) averaged 2 units per patient. Twenty-seven percent could be operated on without bank blood. Intraoperative hemodilution was applied lowering the hematocrit to 23%. The postoperative limit for blood transfusion was a hemoglobin of 11 g/100 ml or a hematocrit of 32%. The reinfusion of shed mediastinal blood, introduced in 1978 (512 patients), has reduced the need for bank blood by 50% to one unit per patient (p less than 0.001). Fifty-three percent of the patients required no bank blood. Since mid-1980 (350 patients), postoperative hemodilution has reduced the need for bank blood to 0.3 units per patient (p less than 0.001). Eighty percent of the operations could be carried out without bank blood. The postoperative blood loss of 1.4 units per patient was identical in both the control and reinfusion groups. This reduction of homologous blood transfusions results in a decreased risk of hepatitis for the patient and in a financial advantage for the hospital.
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PMID:Reduction of bank blood requirements in cardiac surgery. 618 May 7

The author describes a case of virus hepatitis which was complicated at the 43d day of staying at hospital by the development of grave hemolytic anemia accompanied by hemoglobin fall down to 3.6 g% and red cell count decrease to l 250 000 per mm3. The author believes that the hemolytic crisis was of the autoimmune genesis. Multiple modality treatment including prednisolone (180 mg/day), transfusion of blood and erythrocyte mass provided good results. The patient was discharged in a satisfactory state at the 84th day of staying at hospital.
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PMID:[Viral hepatitis complicated by hemolytic anemia]. 652 64

We describe an end stage renal disease (ESRD) patient on maintenance hemodialysis who developed a spontaneous increase in erythropoiesis associated with an episode of viral hepatitis. Resolution of the hepatitis was accompanied by a reduction in erythropoiesis with the hemoglobin and hematocrit falling back toward the patient's low baseline levels. Plasma erythropoietin (Ep) titers were measured during the period of active erythropoiesis and were found to be low to low normal. The unusual phenomenon of increased erythropoiesis in ESRD following liver injury has been previously described and is thought to be mediated through increased hepatitic Ep production. The low Ep titers measured in our patient, however, suggest that the liver may be capable of stimulating erythropoiesis by another mechanism.
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PMID:Erythropoiesis associated with viral hepatitis in end stage renal disease. 670 89

Clinical sarcocystosis was studied in 37 goats after inoculation with graded doses of sporocysts of Sarcocystis capracanis. Eight uninoculated goats served as controls. Clinical response varied with the dose. Goats inoculated with 10-40 million sporocysts died between 11 and 13 days after inoculation (DAI), from interstitial pneumonia, vasculitis, and necrosis of mesenteric lymph nodes. All goats inoculated with 100,000 or 1 million sporocysts died between 19 and 23 DAI; clinical signs were anorexia, fever (40-41 C), anemia, and weight loss. Four of 4 goats inoculated with 50,000 sporocysts and 1 of 4 inoculated with 10,000 sporocysts died 24, 28, 39, 68, and 61 DAI, respectively. Goats inoculated with 1,000 sporocysts and uninoculated goats remained clinically normal. After day 18 and before day 68, packed cell volume and hemoglobin content decreased to as low as 11% and 3.6 g/dl, respectively. Alanine aminotransferase and lactic dehydrogenase activities were inconsistently increased. Blood urea nitrogen and bilirubin values were increased, reaching as high as 63 mg/dl and 10 mg/dl, respectively. Histologically, thymic atrophy, vasculitis, hepatitis, cholangitis, myocarditis, generalized myositis, and encephalomyelitis were the main microscopic findings. The cause of the anemia in goats that died after day 19 was not determined.
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PMID:Sarcocystosis in goats: clinical signs and pathologic and hematologic findings. 678 65

Maternal morbidity and perinatal outcome in 108 pregnancies complicated by sickle cell anemia (hemoglobin SS disease), sickle cell-hemoglobin C disease (hemoglobin SC disease), or sickle cell-beta-thalassemia disease were analyzed. Women given prophylactic red cell transfusions (1973-1982) during pregnancy were matched with historic controls whose care was almost identical except that blood was not given unless indicated (1955 to 1972). In women with hemoglobin SS disease who received prophylactic red cell transfusions, there was a sevenfold reduction in perinatal mortality and negligible maternal morbidity. In pregnancies complicated by hemoglobin SC disease during which transfusions were given, there were no perinatal losses, whereas there were in 18% of women not given transfusions. Maternal morbidity in women given transfusions was negligible; however, half of those not transfused experienced morbidity and, importantly, pulmonary complications were common. Transfusion-related complications included hepatitis and alloimmunization. From these experiences the authors conclude that prophylactic red cell transfusions reduce maternal morbidity and perinatal mortality appreciably, although perinatal morbidity is not eliminated. Transfusion therapy is justifiably started early in pregnancy for women with hemoglobin SS disease; however, transfusions may be withheld until the end of the second trimester for women with hemoglobin SC or sickle cell-beta-thalassemia disease.
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PMID:Pregnancy and sickle cell hemoglobinopathies: results with and without prophylactic transfusions. 688 18

In this study a control group of 523 patients, who were operated on in 1977 using extracorporeal circulation and whose drained blood had been rejected postoperatively, was compared to a group of 523 patients, operated on in 1978, whose blood was retransfused. The blood lost through substernal suction drainage was readministered during the first 12 h by means of a self-made retransfusion system that reemployed parts of the heart-lung machine. Age, sex, or type of operation were distributed evenly among the two groups. The mean postoperative blood loss amounted to 700 ml in the control group and to 720 in the retransfusion group. Accordingly, the necessary postoperative blood substitution was identical in both groups (retransfusion 2 units per patient compared to 2 units in the controls, 1 unit corresponding to 540 ml). In the retransfusion group 50% of the total mediastinal drainage blood was transfused. Thus the demand for donor blood was reduced by 50% in the retransfusion group (retransfusion group: 1 unit, control group 2 units per patient; P < 0.001). The number of operations that could be performed without donor blood increased from 27% (control) to 53% (retransfusion). Hemolytic and clotting studies of the mediastinal blood showed that it was defibrinized and contained markedly more serum hemoglobin, platelets, and clotting factors than the conserved blood. The considerable dilutional effect due to the retransfusion, however, had no influence on coagulation status or kidney function. There were no complications. With this system retransfusion of drainage blood is a simple and safe procedure. The reduction of donor blood transfused diminishes the patient's risk of hepatitis and means a financial advantage for the hospital.
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PMID:[Autotransfusion of drainage blood after heart surgery (author's transl)]. 745 12

Implementation of the Safe Motherhood initiative in India calls for the institution of good prenatal care for all women. The first aspect of prenatal care is collecting the patient's history and reviewing the health history of her family. The physical examination should include inspection for reproductive tract diseases, a bimanual examination early in pregnancy to correlate the size of the uterus and the reported last menstrual period, and routine abdominal palpation. Ultrasonography should be performed at least once. Laboratory tests should include analysis of hemoglobin and hematocrit levels, urine analysis, blood grouping and Rh typing, serological tests for syphilis, antibody screening and screening for rubella and hepatitis antigen, and cervical cytology. Additional screening and genetic testing may be necessary in certain cases. Women with no complications should be seen once a month for 28-30 weeks, once every two weeks until 36 weeks, and once a week thereafter. High-risk patients should be seen more frequently. Infections detected during pregnancy must be properly treated with antibiotics, although, in general, women should avoid medications during pregnancy. In India, hematinics and vitamins should be given to all pregnant women. Drugs and substances to be avoided during pregnancy include tetracycline, chloramphenicol, streptomycin, cotrimoxazole, diuretics, alcohol, trimethadone, warfarin, lithium, quinine, sex hormones, anesthetics, tobacco, vitamin D, and all live vaccines except BCG. Common sense should dictate the safe level of activity for a pregnant woman.
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PMID:Role of antenatal care in safe motherhood. 765 37


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