Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum alpha-fetoprotein levels were measured by radioimmunoassay in 473 patients with biopsy-proved noneoplastic hepatic disorders; 22% had values greater than 40 ng/ml, whereas only 1 of 350 patients with nonhepatic benign diseases had a value greater than this. Levels exceeded 40 ng/ml in more than 30% of patients with various types of hepatitis, and in 0% to 15% with inactive postnecrotic cirrhosis, primary biliary cirrhosis, biliary tract obstruction, and alcoholic liver disease. Values greater than 500 mg/ml were observed solely in viral subacute hepatic necrois. Only one patient had a level exceeding 3,000 ng/ml, the concentration at which alpha-fetoprotein is detectable by agar-gel diffusion. Of 75 patients with hepatoma, serum alpha-fetoprotein levels exceeded 40 ng/ml in 69%, and exceeded 3,000 ng/ml in 48%. These studies indicate that serum alpha-fetoprotein levels are elevated in several nonneoplastic hepatic disorders when a sensitive assay is used; this phenomenon may reflect hepatic regeneration.
JAMA 1975 Jul 07
PMID:alpha-fetoprotein in noneoplastic hepatic disorders. 4 62

Previous studies demonstrated the effectiveness of diuretics in mobilizing fluid, but frequent complications occur with their use in treating ascites. To develop an effective but safe regimen for treatment of cirrhotic ascites, a two-part crossover study was done. Subjects with life-threatening complications of cirrhosis were excluded. In part one it was demonstrated that a six-day diuretic regimen with dietary sodium restriction of 10 mEq/day is safe and more effective than sodium restriction alone. In part two the duration of diuretic therapy was safely extended from six to nine days with mobilization of significantly more fluid. Careful selection of subjects, use of diuretics in modest dosages for brief periods of time, and daily monitoring of subjects were important for the success of this study.
JAMA 1977 Mar 07
PMID:An optimal diuretic regimen for cirrhotic ascites. A controlled trial evaluating safety and efficacy of spironolactone and furosemide. 31 63

30 consecutive patients with cirrhosis of the liver complicated by refractory ascites, hepatorenal syndrome, or both, received a LeVeen peritoneal-venous shunt. After surgery, these patients demonstrated a decreased abdominal girth (108 vs 93 cm, P less than .001), decreased body weight (80 vs 70 kg, P less than .001), and increased urinary flow (607 vs 4,254 ml, P less than .001). All patients had previously failed to show substantial benefit with 7 to 124 days of medical care. The mean BUN value was significantly decreased, from 39 to 23 mg/100 ml (P less than .005). Adosterone retention was reduced from a mean value of 32 to 12.8 ng/100 ml. The LeVeen continuous peritoneal-venous shunt is an important innovation that completely relieves refractory ascites in cirrhotic patients and reverses the pathophysiology of the hepatorenal syndrome.
JAMA 1977 Jan 10
PMID:LaVeen continuous peritoneal-jugular shunt. Improvement of renal function in ascitic patients. 57 50

Chronic arthritis was the only symptom that led to the detection of increased iron stores in four patients. In these persons, the serum iron was ordered at the time of initial examination, and ranged from 212 to 237 microgram/dl with a transferrin saturation of 83% to 100%. Liver biopsy specimens showed hepatocyte iron deposition in each person, with definite cirrhosis in only one patient. These cases illustrate that a chronic arthropathy may be the first clinical manifestation of iron overload, and can lead to discovery of the disease in patients and their family members. Treatment may then be initiated before extensive tissue damage has occurred.
JAMA 1977 Oct 24
PMID:Arthropathy as the major clinical indicator of occult iron storage disease. 57 39

Because of the unusual clinical course of a patient with hepatic cirrhosis, refractory ascites, and hepatorenal syndrome, we were able to examine the complex interrelationships between massive ascites, renin-aldosterone activity, and renal and hepatic function before and after placement of a peritoneojugular vein (LeVeen) shunt. Measurements indicated that when the shunt was functioning, renin-aldosterone production was suppressed, the hepatorenal syndrome was reversed, and ascites remitted. These data suggest that hyperreninemia, hyperaldosteronism, and functional renal abnormalities of this disorder are potentially reversible and arise primarily from the imbalance between formation and drainage of hepatosplanchnic lymph rather than from hepatocellular dysfunction, lowered plasma oncotic pressure, or portal hypertension.
JAMA 1978 Jan 02
PMID:Peritoneovenous (LeVeen) shunt. Control of renin-aldosterone system in cirrhotic ascites. 57 28

An elderly man with long-standing pulmonary emphysema was seen with recent onset of steatorrhea and ascites. He had very low levels of serum alpha1-antitrypsin, hepatic cirrhosis, and intestinal mucosal atrophy. We believe this this combination of findings did not occur by chance.
JAMA 1975 Jan 20
PMID:Alpha-1-antitrypsin deficiency, emphysema, cirrhosis, and intestinal mucosal atrophy. 107 83

Malnutrition is common among alcoholics because alcohol displaces protein-, vitamin-, and mineral-containing foods in the diet, and chronic alcohol consumption results in maldigestion and malabsorption of essential nutrients. In addition, alcohol exerts direct toxic effects on both the liver and gut, resulting in structural alterations in the intestine and the development of fatty liver, alcoholic hepatitis, and cirrhosis. Liver injury is preceded by an adaptive phase characterized by accelerated metabolism of drugs (including ethanol), and hyperlipemia, secondary to hypertrophy and hyperactivity of the smooth endoplasmic reticulum. Side effects include enhanced hepatotoxicity of CCI4 and possibly energy wastage. Alcoholics should not be led to beleive that correction or prevention of nutritional deficiency will prevent liver damage in the face of continued alcohol abuse.
JAMA 1975 Sep 08
PMID:Alcohol and malnutrition in the pathogenesis of liver disease.. 117 54

Hispanics are the fastest growing minority in the United States. Typically, they are divided into five subgroups: Mexican American, Puerto Rican, Cuban American, Central or South American, and "other" Hispanics. Risk factors for morbidity and mortality vary among these subgroups. Use of health care services is affected by perceived health care needs, insurance status, income, culture, and language. Compared with whites, Hispanics are more likely to live in poverty, be unemployed or underemployed, and have little education and no private insurance. Hispanics are at an increased risk for certain medical conditions, including diabetes, hypertension, tuberculosis, human immunodeficiency virus infection, alcoholism, cirrhosis, specific cancers, and violent deaths. Proportionate to their representation in the population, there are few Hispanic health providers, emphasizing the need for all medical personnel to be knowledgeable about Hispanic health care needs.
JAMA 1991 Jan 09
PMID:Hispanic health in the United States. Council on Scientific Affairs. 198 56

A case-control design was used to investigate the effects of preexisting chronic conditions on in-hospital mortality in adult trauma patients. Cases consisted of all trauma deaths (n = 3074) that occurred in 1983 in any of the 331 acute care hospitals in California. Three to four control patients (injured survivors) were matched to each case patient on the basis of injury severity, age, and individual hospital (n = 9869). The data source consisted of hospital discharge abstract data uniformly collected on all admissions to acute care hospitals in the state. Conditional logistic regression techniques were used to estimate the relative odds of dying for patients with and without one or more of 11 preexisting chronic conditions identified as potentially detrimental to outcome. The presence of cirrhosis (relative odds = 4.5), congenital coagulopathy (relative odds = 3.2), ischemic heart disease (relative odds = 1.8), chronic obstructive pulmonary disease (relative odds = 1.8), and diabetes (relative odds = 1.2) all significantly increased the risk of dying. These data provide statistical evidence to support the recommendation of the American College of Surgeons that the presence of underlying disease be considered in decisions to triage and transfer patients to trauma centers. They also underscore the importance of underlying disease in the case-mix adjustment of case-fatality rates and the identification of unexpected deaths for quality assurance review.
JAMA 1990 Apr 11
PMID:The effect of preexisting conditions on mortality in trauma patients. 231 71

Published studies encompassing more than 50,000 autopsies were assessed to determine the sensitivity and specificity of clinical diagnostics (the diagnostic process) in persons dying of 1 of 11 specific diseases during the period 1930 through 1977. The accuracy of clinical diagnostics, as reflected in these two determinations, appeared to improve over this period with respect to some of the diseases studied (rheumatic heart disease and leukemia), while for others it worsened (pulmonary tuberculosis, peritonitis, carcinoma of the lung, gastric carcinoma, and carcinoma of the liver and extrahepatic biliary tract) and for a significant number diagnostic accuracy seemed refractory to sustained change (pulmonary embolism, primary cirrhosis of the liver, gastric/peptic ulcer, and acute coronary thrombosis/myocardial infarction). The findings suggest a new way in which the autopsy can be used to monitor clinical diagnostics to identify possible sources of systematic weaknesses and provide data that can be used to approach the difficult subject of necessary fallibility.
JAMA 1989 Mar 17
PMID:The sensitivity and specificity of clinical diagnostics during five decades. Toward an understanding of necessary fallibility. 273 31


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