Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article gives an overview, citing animal and clinical studies, of the effects of increased intra-abdominal pressure (IAP) in severe obesity. Animal studies demonstrate that increased IAP increases pleural pressure, cardiac filling pressures, femoral venous pressure, renal venous pressure, systemic blood pressure, and vascular resistance, renin and aldosterone levels, and intracranial pressure. Thus, the comorbidities presumed secondary to increased IAP in obese patients include congestive heart failure, hypoventilation, venous stasis ulcers, gastroesophageal reflux, urinary stress incontinence, incisional hernia, pseudotumor cerebri, proteinuria, and systemic hypertension.
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PMID:Effects of increased intra-abdominal pressure in severe obesity. 1158 45

An 82-year-old female underwent emergency surgery for right femoral incarcerated hernia under general anesthesia. Anesthesia was induced and maintained with remifentanil and propofol. Her laboratory data showed severe hypokalemia (1.83 mEq x l(-1)) and metabolic alkalosis (HCO3 36.9 mmol x l(-1)). We suspected that the causes of such abnormalities were due to an endocrinological abnormality, but we could not ascertain the actual cause. Drip infusion of sodium chloride and saline solution infusion, to avoid supplying lactate or acetate, the source of bicarbonate ions, were chosen for palliative treatment. No adverse event occurred during surgery. After surgery, endocrinological functions were examined. Primary aldosteronism was ruled out because serum aldosterone and rennin activity were within normal ranges. The patient had been taking a Kampo preparation, Shakuyaku-kanzo-to, for two years. Glycyrrhizin, the main component of Shakuyaku-kanzo-to, has been reported to be a cause of pseudoaldosteronism by inhibiting the enzyme converting cortisol to cortisone. With these findings we confirmed that severe hypokalemia was induced by pseudoaldosteronism by long-term administration of Shakuyaku-kanzo-to.
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PMID:[Case of severe hypokalemia during emergency surgery caused by long-term administration of Shakuyaku-kanzo-to]. 2138 69

Prosthetic reinforcements markedly reduce the risk of hernia recurrence. However, the implantation of meshes is related to an inflammatory foreign body reaction (FBR) with serious complications (i.e., persistent seroma, wound infection, mesh migration, entrapment, chronic pain). Adrenal hormones profoundly modify inflammatory response. Their effects on FBR however, remain ill defined. We therefore studied the FBR to polyvinylidenfluoride (PVDF) mesh material that was coated with four different substances: hydrocortisone (COR) or mifepristone (MIF), which respectively stimulate and block the glucocorticoid receptor, and aldosterone (ALD) or spironolactone (SPI), which respectively stimulate and block the mineralocorticoid receptor. The coated substances were released from the meshes within 24 h. Seven, 21, and 90 days after implantation, the specimen was evaluated for collagen formation, granuloma size, inflammatory activity, and angiogenesis. COR and SPI coating protected from inflammatory response, while ALD and MIF coating showed little difference to the control group. The COR and SPI groups showed smaller granuloma sizes at all time points, as well as a reduced number of inflammatory cells (p < 0.001) at day 90, and decreased collagen formation starting after 21 days (p < 0.05). There was a negative correlation for angiogenesis with inflammation around foreign body structures. In summary, these results suggest that early and temporary stimulation of the glucocorticoid receptor or blockade of the mineralocorticoid receptor have beneficial effects on FBR in the long term.
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PMID:Beneficial effects of hydrocortisone or spironolactone coating on foreign body response to mesh biomaterial in a mouse model. 2202 Nov 81