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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seven hundred and three Nigerian village children in their first six years of life were subjected to anthropometric measurements and physical examination in early 1988. The heights of 66.9% and weights of 60.5% of them fell below the third percentile of a Nigerian equivalent for international reference population standard. Mid upper arm circumference values indicated moderate to severe malnutrition in over 25% of all 1-5 year old children surveyed. Fever, cough, headache and diarrhoea were the commonest symptoms encountered in the children. Mild pallor of the conjunctival mucosa and physical signs of protein energy malnutrition were commonly seen. Fungal and septic skin lesions were present in 11.45 and 11.1% of the children respectively, whilst rhinorrhoea was seen in 4.7%, otitis media in 6% and pharyngotonsillitis in 3.3%. Thirty four (4.8%) of the children had haemic whereas five had pathological murmurs. Dental calculi were present in 15.8%, umbilical herniae in 18.2%, hepatomegaly in 48.2% and splenomegaly in 23% of the children. Seven (1%) had cerebral palsy. The implication is that malnutrition, sickle cell disease, malaria and other infections are the prevailing causes of morbidity in the preschool aged children surveyed. Desirable improvements include upgrading socio-economic and living conditions and instituting appropriate control measures.
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PMID:Anthropometric measurement in children aged 0-6 years in a Nigerian village. 758 49

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.
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PMID:Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni. 766 18

Schistosoma mansoni was introduced in the Richard Toll area (Senegal) around 1988, probably due to man-made ecological changes in the Senegal river basin. Since 1991, we investigate the community of Ndombo, close to Richard Toll. Four random population samples of approximately 400 subjects are surveyed, starting at 8 months intervals. Each cohort is examined parasitologically (Kato-Katz), clinically, serologically (circulating antigen and antibody profiles); treated with praziquantel 40 mg/kg; and followed up 6-12 weeks, 1 and 2 years after treatment. Water contact patterns and snail densities are longitudinally surveyed. In the first cohort, prevalence of infection was 91%, with 41% excreting over 1000 eggs per gram (epg); the mean egg count was 646 epg, individual counts up to 24,000 epg. Prevalences remained almost 100%, but egg counts declined strongly in adults, in spite of continued exposure and the supposed lack of acquired immunity. Antigen detection in serum and urine confirmed that the egg counts genuinely reflect variations of worm burdens. Serum circulating anodic antigen (CAA) provided intriguing epidemiological information on worm burdens, while circulating cathodic antigen (CCA) showed promise for non-invasive diagnosis and screening. So far, similar epidemiological results were found in subsequent cohorts, although some variations were observed, possibly due to seasonal transmission fluctuations. IgE levels increased with age, while IgG4 peaked in the age-group 10-19 years. IgE and IgG4-levels against adult worm antigen (AWA) and soluble egg antigen (SEA) increased between cohort 1 and cohort 3 in almost all age-groups. In all 3 cohorts examined so far a strong correlation between IgG4 and pre-treatment egg-load was observed. Further follow-up and analysis, and comparison with chronically infected populations will provide insight in the development of acquired immunity. Abdominal discomfort was reported by 61% and diarrhoea by 33% of the subjects in the first cohort; mild hepatomegaly was found in 16%, splenomegaly in 0.5%. There was no correlation between frequency of symptoms and egg counts. This low morbidity, in spite of intense infections, was confirmed by ultrasound, and may be due to the recent nature of the focus. In the first cohort, 82% of treated subjects still excreted eggs 12 weeks after treatment, though egg counts declined strongly. Antigen detection confirmed these results. Parasitological negativation rates in subsequent cohorts, followed up sooner after treatment, improved but remained remarkably low. The low drug efficacy may be due to very rapid reinfection (though further reinfection after one year was limited), and/or to the lack of immunity in the population. Reduced susceptibility of the local schistosome strain can not be excluded, however. Praziquantel treatment provoked impressive but transient side effects (colics, vomiting, urticaria, oedema), the frequency of which correlated with intensity of infection.
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PMID:Epidemiology, immunology and chemotherapy of Schistosoma mansoni infections in a recently exposed community in Senegal. 782 23

In a prospective study, we investigated whether human immunodeficiency virus (HIV) infection alters the clinical presentation in patients with tuberculous pleuritis. One hundred twelve of 118 patients who presented with pleural effusion suffered from tuberculosis (TB); 65 patients (58%) were HIV seropositive. Evidence of disseminated TB was found more often in HIV-positive than in HIV-negative patients (30.8% vs 10.6%, p < 0.02). Dyspnea, fever, night sweat, fatigue, and diarrhea, severe tachypnea, hepatomegaly, splenomegaly, and lymphadenopathy were significantly more common in HIV-infected than in HIV-negative patients with TB. The same applied to a negative Mantoux reaction, lower hemoglobin, higher beta 2-microglobulin values, and in pleural fluid, lower albumin and higher gamma-globulin levels. Among HIV-infected patients, PPD skin test anergy was significantly associated with relative low albumin and gamma-globulin levels of pleural fluid. However, the radiographic features did not differ with respect to HIV status; they were predominantly those of primary pleuritis (78% in each group). We conclude that coexisting HIV infection affects clinical and laboratory features, but not the radiographic presentation of patients with TB pleuritis in Tanzania.
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PMID:Clinical features of HIV-seropositive and HIV-seronegative patients with tuberculous pleural effusion in Dar es Salaam, Tanzania. 795 5

Two 2-year-old Salers cattle from different herds raised on pasture were evaluated for retarded growth and diarrhea. Increase of liver enzyme activities and prolonged sulfobromophothalein (BSP) half life (T1/2) indicated liver disease with impaired liver function. Histopathologic examination of liver biopsies revealed a micronodular cirrhosis with marked deposition of hemosiderin in hepatocytes, Kupffer cells, and arterioles. Transferrin saturation (TS) and liver iron content were markedly increased, consistent with a diagnosis of hemochromatosis. Both animals were euthanatized due to deterioration in their condition. Necropsy findings included hepatomegaly and hemosiderin accumulation in the liver, lymph nodes, pancreas, spleen, thyroid, kidney, brain and other glandular tissue. Continued surveillance of the second herd (serum iron, total iron binding capacity [TIBC], unsaturated iron binding capacity [UIBC], and TS), identified a heifer as a hemochromatosis suspect in a subsequent generation. Liver biopsies from that animal revealed the same histopathologic changes as the previous 2 animals, and similar increases in liver iron content (8,700 ppm, normal range 45 to 300 ppm). The 3 affected cattle were all products of line breeding programs and shared a common ancestor. The absence of dietary iron loading in conjunction with the histopathologic and metabolic findings were consistent with a diagnosis of primary hemochromatosis. The reported disease is similar to idiopathic hemochromatosis in human beings in which there is a hereditary defect in iron metabolism.
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PMID:Hemochromatosis in Salers cattle. 804 72

Microsporidia cause opportunistic infections in AIDS patients and commonly infect laboratory animals, as well. Euthymic C57B1/6 mice experimentally infected with intraperitoneal injections of 1 x 10(6) Encephalitozoon cuniculi Levaditi, Nicolau et Schoen, 1923, Encephalitozoon hellem Didier et al., 1991, or Nosema corneum Shadduck et al., 1990 displayed no clinical signs of disease. Athymic mice, however, developed ascites and died 8-16 days after inoculation with N. corneum, 21-25 days after inoculation with E. cuniculi, and 34-37 days after inoculation with E. hellem. All athymic mice displayed hepatomegaly, dilated intestine and accumulation of ascites fluid. Granulomatous lesions are primarily located in the liver, lung, pancreas, spleen, and on serosal surfaces of abdominal organs. The murine microsporidiosis model also was used to examine immune response that inhibit microsporidia growth in vitro. Recombinant murine interferon-gamma (mIFN-gamma, 100 mu/ml) alone or in combination with lipopolysaccharide (LPS; 10 ng/ml) could activate thioglycollate-induced peritoneal murine macrophages to destroy E. cuniculi. The production of the nitrogen intermediate, NO2-, correlated with parasite destruction. Inhibition of NO2- generation by addition of the L-arginine analogue, NG-monomethyl L-arginine (NMMA), inhibited microsporidia killing, as well. Since microsporidiosis is becoming an important opportunistic infection in AIDS patients, a microsporidiosis model is being developed using SIV/DeltaB670-infected rhesus macaque monkeys (Macaca mulatta). SIV-infected immunocompetent monkeys given E. cuniculi or E. hellem per os developed specific antibodies, and microsporidia could be detected sporadically by calcofluor or antibody fluorescence staining of stool and urine sediment smears. As immunodeficiency progressed, monkeys developed diarrhoea, cachexia, and anorexia, and organisms were detected in urine and stool with greater frequency. Immunodeficient SIV-infected monkeys died approximately 27 days after receiving E. hellem by intravenous inoculation, and approximately 110 days after receiving E. hellem per os. Lesions typical for SIV-infection were observed in both groups of monkeys and microsporidia were detected in kidney and liver of the intravenously-injected monkeys. The murine microsporidiosis model provides an efficient means for studying protective immune responses to microsporidiosis, and may prove useful for screening immunological and chemotherapeutic agents. The pathogenesis of Encephalitozoon microsporidiosis in SIV-infected monkeys appears to parallel encephalitozoonosis in AIDS patients, suggesting that simian microsporidiosis may provide a useful model for evaluating diagnostic methods and therapeutic strategies during various stages of progressing immunodeficiency.
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PMID:Experimental microsporidiosis in immunocompetent and immunodeficient mice and monkeys. 805 Jul 48

A 24-year-old Chinese woman was admitted for cholestatic jaundice following a short history of fever associated with headache and diarrhoea. She had mild hepatomegaly. Initial laboratory investigations were non-contributory. A percutaneous liver biopsy revealed inflammatory changes more in keeping with a systemic infection than a primary hepatitic problem. Repeat blood and stool cultures finally grew salmonella typhi. Jaundice is a rare manifestation of typhoid fever; it occurs in less than one-third of patients with hepatomegaly. Such a presentation may mimic primary hepatic infections. Awareness of this rare occurrence in typhoid fever would help in early diagnosis and therapy.
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PMID:Uncommon presentation of typhoid fever: a case report. 812 63

In order to examine the character and phases of injury to the nervous system in HIV infection, 207 persons were observed. In 100, antibodies to the virus and to its separate proteins were discovered by immunofermentation analysis (IFA) reaction and by Western blot test. In 67, first phases of acute inflammation asymptomatic of persistent generalized lymphadenopathy were registered; and in 33, other ailments were found. In this group, which consisted of 74 men and 26 women aged 18-45, 91 were citizens of the Community of Independent States (15 of whom had served in the military) and 9 were citizens of other countries (4 had seen military duty). 75% of cases contracted the infection via sexual transmission. The control group comprised 65 seropositive people at the first screening confirmed by IFA but negative or doubtful by Western blot. Clinical laboratory and special psychological investigations were carried out using a 16-factor personality questionnaire and standard personality analysis methods. Generalized lymphadenopathy was found in 78%, hepatomegaly in 69%, chronic infection of the upper respiratory tract 67%, dermatological pathologies 33%, acute infections 32% (syphilis, hepatitis B), splenomegaly 20%, diarrhea and loss of more than 10% of body mass 11%. There was significant decrease of T-helper cells in 82.8%, in the correlation of the quality of T helper cells and T suppressor cells in 72.4%. In 67 persons who were in the second stage of HIV infection, there was a high frequency of pathological psychological symptoms. According to the personality scale, 60% had schizoid signs, 50% had depression, 40% had psychopathy, 30% had psychasthenia, and 20% had paranoia. When 33 persons in the second and third phase of the disease were measured, schizoid signs increased to 85.7%, depression to 78.6%, psychopathy to 57.1%, psychasthenia to 71.4%, and paranoia to 64.3%. In the first phases of the disease mainly hypochondria, depression, and hysteria predominated, and as the disease progressed, psychopathy, paranoia, psychasthenia, schizoid signs, and mania rose.
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PMID:[HIV infection: the clinical and expert diagnostic aspects]. 817 5

A study of morbidity due to Schistosoma mansoni infection was carried out in Ndombo, a recently established but intense focus in northern Senegal. A random population sample (n = 422) was examined by repeated egg counts, standardized interviews, and clinical examinations. Egg counts were positive in 91%, with more than 1,000 eggs per gram of feces in 41% of the subjects. Abdominal discomfort was reported by 60% of the subjects, diarrhea by 33%; 17% of the stools were liquid upon inspection. Hepatomegaly was mostly mild and found in 7% of the subjects, mainly in males less than 20 years of age. Splenomegaly was detected in only 0.5% of the people examined. There was no significant correlation between the frequency of complaints or symptoms and egg counts. The remarkably mild morbidity in spite of the intense level of many infections may be explained by the recent nature of the focus; more severe chronic morbidity may develop in the future.
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PMID:Morbidity due to heavy Schistosoma mansoni infections in a recently established focus in northern Senegal. 820 6

A review was made of the clinical characteristics and evolution of all patients over 14 years old with typhoid fever who were treated at the Albert Schweitzer Hospital in Haiti from January 1989 through July 1991. Two hundred and seventeen patients were studied. Their most common symptoms were fever (100%), diarrhea (64.1%), and abdominal pain (51.2%). Splenomegaly and hepatomegaly were rarely noted. Sixty-eight patients (31.3%) were lost to follow-up, 129 (59.4%) were cured, and 20 (9.2%) died. There was a tendency for patients who were ill longer before seeking medical assistance to experience higher mortality. The data also indicate that patients with central nervous system involvement had a less favorable prognosis than other patients. Overall, the high incidence of hospital-reported cases (74 cases per 100,000 inhabitants) shown by these and other data makes it clear that typhoid fever is a highly prevalent infection in rural Haiti. At present, it appears that the only hope for effectively controlling the disease is by educating the population at risk, not only to prevent the disease but also to seek early medical assistance after becoming infected. Typhoid fever patients with a long history of illness before consultation may have a less favorable prognosis than other patients and should be kept under close observation. In addition, any suspected typhoid fever patient with signs of central nervous system involvement should be treated promptly with high-dose steroids, besides receiving an adequate antibiotic regimen.
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PMID:Typhoid fever in rural Haiti. 831 61


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