Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020639 (hypoproteinemia)
 1,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 43-year-old man was admitted to our hospital because of legs edema and periorbital edema in Dec. 1983. Laboratory findings showed massive proteinuria (3.7 g/day), Bence Jones protein (BJP) in urine, and hypoproteinemia. Peripheral blood examinations were normal and a bone marrow aspiration showed hypocellularity with slight increase of monocytes and plasma cells. Serum immunoelectrophoresis showed two M-components (IgG kappa, IgA lambda). Serum IgG was 1,690 mg/dl, IgA 379 mg/dl and IgM 160 mg/dl. No remarkable findings were obtained in bone survey, Ga-scintigraphy and rectal biopsy, and a diagnosis of diclonal gammopathy with nephrotic syndrome was made. In Aug. 1986, serum IgA started to increase rapidly with concomitant decrease IgG. He died of pneumonia due to pancytopenia in Dec. 1986, when serum IgG was 450 mg/dl, IgA 1,014 mg/dl, and IgM less than 39 mg/dl. Immunoelectrophoresis showed two M-components (IgG kappa, IgA lambda) in serum and BEP (kappa, lambda), IgG (kappa) and IgA (lambda) in urine. An autopsy showed massive infiltration of myeloma cells which were positive for lambda light chain in bone marrow, suggesting a development of myeloma from a diclonal gammopathy in about 3 years.
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PMID:[Diclonal gammopathy (IgG kappa, IgA lambda) with nephrotic syndrome terminating into IgA lambda myeloma after three years--report of a case]. 210 4

In a 6.5 year period starting January 1982, 121 patients (74 male, 47 female; 1.6:1) with complicated gastroesophageal reflux referred to Alberta Children's Hospital, University of Calgary, required a Nissen fundoplication at a mean age of 35.5 months (range 3 weeks to 18 years). The median age of onset of symptoms was less than 1 month. Symptoms and indications for surgery included regurgitation (88%), failure to thrive (52%), reflux-associated pulmonary symptoms and aspiration (48%), biopsy evidence of esophagitis (35%) with heartburn (17%), dysphagia (18%), hematemesis (17%), anemia (13%), and hypoproteinemia (22%). Sixty-four percent of the patients had a syndrome or chromosomal abnormality, respiratory disease, or neuromuscular disorder. The barium contrast upper-gastrointestinal radiographic series, performed in all patients, identified structural [gastric outlet obstruction (2%), esophageal stricture (11%), erosive esophagitis (9%)], and functional abnormalities [gastroesophageal reflux (90%), barium aspiration (8%), esophageal hypoperistalsis (30%), delayed gastric emptying (4%)]. Barium contrast upper gastrointestinal radiographic series identified gastroesophageal reflux with a sensitivity of 90% (compared to history), was 50% sensitive and 92% specific for erosive esophagitis (compared to biopsy), was 59% sensitive and 74% specific for esophageal dysmotility (compared to esophageal manometry), and there was a significant (p less than 0.01) association between barium aspiration and prior evidence of aspiration pneumonitis. Esophageal manometry demonstrated a significantly (p less than 0.001) lower esophageal sphincter pressure in patients compared with controls, but no significant correlation with failure to thrive, aspiration pneumonia, biopsy evidence of esophagitis, or parameters of the 24-hour esophageal pH study. Twenty-four hour pH monitoring showed significantly (p less than 0.05) more reflux episodes than in asymptomatic controls and there was significant (p less than 0.05) correlation between the percentage of time pH was less than 4 and the presence of hypoalbuminemia, and biopsy-proven erosive esophagitis or Barrett's esophagus. Endoscopic appearance was 91% sensitive and 60% specific for esophagitis when compared to biopsy. Nissen fundoplication was completely effective at resolving gastroesophageal reflux in 83%, and associated with marked improvement in 15%. No patient died as a result of fundoplication. Major complications included: recurrence of symptoms requiring reoperation (2%), subsequent mechanical bowel obstruction (8%), wound infection or pneumonia (12%).
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PMID:Investigation and outcome of 121 infants and children requiring Nissen fundoplication for the management of gastroesophageal reflux. 227 17

We reviewed 57 episodes of Pseudomonas aeruginosa bacteremia in 55 patients with hematologic disorders such as acute leukemia during a 16-year period, focusing especially on the prognosis. Survival at one week after onset was observed in only 39% of the episodes. Prognosis was significantly better in patients with unimicrobial bacteremia than in those with polymicrobial bacteremia (21/42 vs 1/15, p less than 0.01), in patients without shock than in those with shock (13/21 vs 9/36, p less than 0.02), in patients with granulocyte count at onset of at least 100/mm3 than in those with more marked granulocytopenia (10/13 vs 12/44, p less than 0.01), in patients with an increase in granulocyte count by at least 100/mm3 during their infection than in those without any subsequent increase (18/18 vs 4/13, p less than 0.001), and in patients with total serum protein level at onset of at least 6.0 g/dl than in those with hypoproteinemia (18/32 vs 4/25, p less than 0.01). Patients with bacteremia secondary to urogenital infection tended to have a higher one-week survival rate than those with pneumonia followed by bacteremia (4/8, 50% vs 2/9, 22%). With regard to the antibiotic treatment of unimicrobial bacteremia, 14 (70%) of 20 patients receiving therapy with one or two anti-pseudomonal beta-lactam antibiotics and an aminoglycoside in combination that were effective in vitro against the infecting organism survived, and so did only seven (32%) of 22 patients receiving therapy with either one in vitro effective beta-lactam or aminoglycoside or inadequate drugs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pseudomonas aeruginosa bacteremia associated with hematologic disorders [III]. Prognostic factors]. 250 88

To describe the epidemiologic and clinical features associated with invasive amebiasis in Bangladesh, 85 hospitalized diarrheal patients with hematophagous trophozoites of Entamoeba histolytica in their stools were compared to a control group of 84 hospitalized diarrheal patients without amebiasis. Postmortem examinations were carried out in 22 deaths due to amebiasis. For the patients with amebiasis, there was a bimodal age distribution with peaks at 2-3 years and greater than 40 years, whereas the control patients had a unimodal distribution with the peak at 0-1 year. The sex distribution was equal in childhood but young adults were predominantly female and older adults predominantly male. The clinical features significantly associated with amebiasis were prolonged dysentery, prior measles rash, malnutrition, hyponatremia, hypokalemia, and hypoproteinemia (all P less than 0.05). The case fatality rate in amebiasis was 29%, which was significantly higher than 11% for the controls (P less than 0.05). Postmortem findings included extensive colitis with deep ulcers and complications, including colonic perforation in 2 cases, peritonitis in 4 cases, pneumonia in 9 cases, and septicemia in 5 cases. These results indicate that invasive amebiasis in this population differs from other diarrheal diseases, affecting mainly children greater than 2 years and adults and causing severe and fatal illness characterized by extensive colitis with diverse systemic consequences.
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PMID:Epidemiologic and clinical features of invasive amebiasis in Bangladesh: a case-control comparison with other diarrheal diseases and postmortem findings. 289 90

Pulmonary edema is an important feature of many newborn lung diseases, including respiratory distress from severe perinatal asphyxia, heart failure, hyaline membrane disease, pneumonitis from group B beta-hemolytic streptococcus, and chronic lung disease (bronchopulmonary dysplasia). Neonatal pulmonary edema often results from increased filtration pressure in the microcirculation of the lungs. This occurs during sustained hypoxia, in left ventricular failure associated with congenital heart disease or myocardial dysfunction, following excessive intravascular infusions of blood, colloid, fat, or electrolyte solution, and in conditions that increase pulmonary blood flow. Low intravascular protein osmotic pressure from hypoproteinemia may predispose infants to pulmonary edema. Hypoproteinemia is common in infants who are born prematurely. Large intravascular infusions of protein-free fluid further decrease the concentration of protein in plasma and thereby facilitate edema formation. Lymphatic obstruction by air (pulmonary interstitial emphysema) or fibrosis (long-standing lung disease) also may contribute to the development of edema. Bacteremia, endotoxemia, and prolonged oxygen breathing injure the pulmonary microvascular endothelium and cause protein-rich fluid to accumulate in the lungs. The risk of neonatal pulmonary edema can be reduced by several therapeutic measures designed to lessen filtration pressure, increase plasma protein osmotic pressure, and prevent or reduce the severity of lung injury.
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PMID:Edema formation in the lungs and its relationship to neonatal respiratory distress. 657 79

Pulmonary edema is an important cause of respiratory distress in newborn infants. It occurs with severe perinatal asphyxia, heart failure, hyaline membrane disease, persistent patency of the ductus arteriosus, pneumonitis from group B beta-hemolytic streptococcus, and chronic lung disease (bronchopulmonary dysplasia). Neonatal pulmonary edema often develops from increased pressure in the microcirculation of the lungs. This may occur in conjunction with sustained hypoxia; left ventricular failure associated with congenital heart disease or myocardial dysfunction; following excessive intravascular infusions of blood, colloid, fat, or electrolyte solution and in conditions that increase pulmonary blood flow. Low intravascular protein osmotic pressure from hypoproteinemia may predispose infants to pulmonary edema. Hypoproteinemia is common in infants who are born prematurely. Large intravascular infusions of protein-free fluid further decrease the concentration of protein in plasma and thereby facilitate edema formation. Lymphatic obstruction by air (pulmonary interstitial emphysema of fibrosis (chronic lung disease) also may contribute to the development of edema. Bacteremia, endotoxemia, and prolonged oxygen-breathing injure the pulmonary microvascular endothelium and cause protein-rich fluid to accumulate in the lungs. Epithelial protein leaks may develop when the transpulmonary pressure needed to inflate the lungs increases because of high surface tension at the air-liquid interface. Fibrin clots from in some of the air spaces, which in combination with atelectasis and edema constitute the pathologic features of hyaline membrane disease. The risk of neonatal pulmonary edema can be reduced by several therapeutic measures designed to lessen fluid filtration pressure, increase plasma protein osmotic pressure, and prevent or reduce the severity of lung injury.
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PMID:Edema formation in the newborn lung. 676 Oct 39

An intensive treatment of patients undergoing thoracic surgery is important, foremost because of the extensity of the surgical procedures and the generally poor condition of the patients. As a first stage of preoperative preparation an evaluation of the functional capacity of the vital organs (heart, lungs and kidneys) is performed, and the most important infection's focci of the oro-pharynx, tracheobronchial tree, urinary tract and skin have to be detected and treated. Respiratory physiotherapy before the surgery improves the ventilatory function, enabling the patient to breath regularly and effectively cough, wherewith a bronchial spasm is prevented and bronchopulmonary infection limited. Before surgery any hypovolaemia, anaemia, hypoproteinemia and dysproteinaemia should also be corrected; in such patients the parenteral alimentation (hyperalimentation) through the central venous catheter, is also important. Immediately following the operation a continuous supervision of vital functions (usually managed by well-experienced surgical nurses) is very essential. Isothermia, isovolemia, a correct oxygenation and analgesia should be maintained permanently. To loose sight of hypoventilation and hypoxia can likely induce respiratory insufficiency. Symptoms indicating tracheal intubation and mechanical ventilation should be watched for and treated at the right moment. Following the surgery, prevention of pulmonary atelectasis and pneumonia, providing an effective thoracic drainage, and respiratory physiotherapy is of utmost importance. The prophylaxis of postoperative pulmonary embolism in particularly jeopardized patients consists in the administration of heparin. Antibiotics in accordance with antibiogram (material: samples taken by a catheter or by bronchoscope from the lung directly).
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PMID:[Intensive care of thoracic surgery patients]. 688 May 35

Chorioangioma is the most common tumor of the placenta. However, a large one complicated with hydrops fetalis is rare. We report a patient who had hydrops fetalis associated with placental chorioangioma. The clinical manifestations included generalized edema, coagulopathy, thrombocytopenia, anemia, hypoproteinemia and hepatosplenomegaly. The hospital course was complicated with acute renal failure and repeated pneumonia. The patient died on the 54th day of life due to persistent lung atelectasis and hypovolemic shock. The pathophysiology and management of the complications of hydrops fetalis with chorioangioma are discussed.
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PMID:Hydrops fetalis due to placental chorioangioma: report of one case. 915 71

We followed 126 patients with senile dementia of Alzheimer type (SDAT), and 129 over age 65 with vascular dementia (VD) who were diagnosed at the Center for Elderly Dementia in our institution between February 1990 and February 1993. At 5-year follow-up, 62 patients with SDAT and 71 patients with VD had died. These patients were assessed prospectively to investigate the neuropsychiatric and somatic factors related to the prognosis of SDAT and VD. There were no significant differences in the average age at onset and time of diagnosis of dementia between the SDAT and VD groups. Mean age at death, mean duration of dementia and 75% survival duration from dementia onset were shorter in patients with VD than in those with SDAT. Pneumonia was the most common cause of death in patients with either SDAT or VD, followed by geromarasmus in the SDAT group, and cerebrovascular and cardiovascular diseases in the VD group. In patients with SDAT, a poor prognosis was correlated with severe dementia, impaired intellectual function and degree of cortical atrophy. In patients with VD, physical complications, impaired motor function and hypoproteinemia enhanced the probability of death. This study confirmed that a progressive neurodegenerative course and physical conditions such as motor dysfunction or malnutrition are closely associated with the prognosis of patients with SDAT and VD, respectively.
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PMID:[A follow-up study on the outcome and relevant factors in senile dementia of Alzheimer type and vascular dementia]. 1046 54

BACKGROUND: Comparing primary vertical banded gastroplasty (VBG) and distal gastric bypass (DGBP) patients might assist decision-making based on patient profiles and desired outcomes. METHODS: A prospective study of 81 vertical banded gastroplasty and 60 distal gastric bypass patients. Technical aspects, complications, weight loss, post-op compliance and satisfaction are reported. Length of follow-up is 48 months (VBG) and 36 (DGBP). Lost-to-follow-up 41% (VBG) and 22% (DGBP). Ten per cent of VBGs were revised, with 1% takedown. Three percent DGBPs were converted to proximal GBPs. Demographics are comparable. RESULTS: Operative time was 40 min VBG and 88 DGBP; blood loss 187 cc vs 335 cc; and hospital stay 3 versus 4 days. Exclusive VBG complications include: 1% staple-line leak, 4% intra-abdominal abscess, 1% respiratory failure, 5% pneumonia, 1% intra-abdominal bleed, 1% small bowel obstruction, 2% infected incision, 2% fistula, 2% stenotic or obstructed obstructed stoma, and 1% bezoar. Exclusive DGBP complications include: 2% GI bleed, 12% marginal ulcer, 5% reflux esophagitis, 13% hypocalcemia, 23% hypovitaminosis A and D (12% requiring B12 therapy). Shared complications include hypoproteinemia 6% VBG versus 40% DGBP; excess vomiting (>6 months post-op), 7% versus 10%, excess diarrhea 2% versus 20%, dehydration 1% versus 8%, re-hospitalization 4% versus 15% (hyperalimentation), post-op cholecystectomy 1% versus 5%, weight regain 48% versus 1%. VBG experienced an average of 64% excess weight loss at 36 months versus DGBP 89% excess weight loss. VBG follow-up compliance is generally poor but good for DGBP. Compliance with diet and supplements is equivalent (50%). Satisfaction is 85% and 93% respectively. CONCLUSION: The DGBP provides better long-term weight loss, but nutritional deficiencies occur more often and require close follow-up. The surgery is more complex, but as a primary procedure there are few major complications.
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PMID:Vertical Banded Gastroplasty and Distal Gastric Bypass as Primary Procedures: A Comparison. 1072 88


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