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)

The risk of contracting hepatitis B: (HBV) by health workers is widely accepted. In 1989 our Hepatology Service started a voluntary anti-HBV vaccination program, employing recombinant vaccine (SKF) by intramuscular route with a 0-1-6 month schedule after screening with antibody against the anti-core HBV antigen (AntiHBc Elisa Abbott). Initially, it was planned to monitor antibody titers against superficial antigen (Anti-HBs) 30 days after the last dose. An epidemiological form listing personal data, working area, profession, seniority, written consent for blood extraction and tentative acceptance of vaccination, was completed by 357 hospital staff members. After serological screening, only 184 (51%) workers agreed to receive vaccination. Given the paucity of volunteers, an attempt was made to explain this degree of reluctance by a randomized blind voluntary survey, to which 349 hospital staff members and 40 medical students replied. Questions were related to knowledge concerning vaccination in general, hepatitis and particularly hepatitis B, and specific anti-HBV vaccination. An appraisal of data gathered disclosed a considerable lack of information not only on the risk of HBV infection and its complications, but also on the existence of a suitable vaccine. Non-existent adverse effects of vaccination were mentioned, including AIDS (Acquired Immuno-Deficiency Syndrome), hepatitis and cirrhosis, among others. To overcome this obstacle, we held a two-day workshop on hepatitis B prevention and prophylaxis intended for medical and ancillary staff. After the meeting, which were attended by 221 members, 48 individuals, comprising 25 physicians and 23 nurses, spontaneously requested to be vaccinated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Professional risk: hepatitis B. Vaccination strategies in a general hospital]. 129 85

To estimate the impact of intravenous drug use (IVDU) on mortality in the general population of young adults in Rome, Italy, the Population Attributable Risk (PAR) was calculated for the overall and cause-specific mortality in the 15-34 years age group. Relative risks were derived from a previous historical cohort study on mortality among 4200 intravenous drug users (IVDUs) in Rome, in which increased mortality from cardiovascular, respiratory, and gastrointestinal diseases as well as from violence, overdose and AIDS had been observed. The prevalence of the risk factor (i.e. the proportion of IVDUs) in the general population was estimated using the 'multiplier formula' and 'capture-recapture' methods. The proportion of all deaths attributable to IVDU in the 15-34 age group in the Roman population was 16% and 9% in males and females, respectively. The cause-specific attributable proportions were 66% for endocarditis and 37% for cirrhosis in males, and 36% for endocarditis and pneumonia in females. These findings further document the relevant health consequences of IVDU on the general population of a large metropolitan area.
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PMID:The impact of intravenous drug use on mortality of young adults in Rome, Italy. 149 77

Primary sclerosing cholangitis is a condition of unknown cause. It is recognized by liver dysfunction and its characteristic radiologic appearance, which is related to portal tract inflammation, bile duct proliferation, and periductal fibroses involving small intrahepatic and large extrahepatic ducts. The disease lasts about 10 years from the time of diagnosis. Primary sclerosing cholangitis is recognized by abnormal results on routine liver function tests or by the development of clinical jaundice. An autoimmune cause has been suggested because of its strong association with inflammatory bowel disease, certain antigens, AIDS, and immunoregulatory abnormalities. Results of medical management of sclerosing cholangitis have been disappointing. Immunosuppressive drugs, copper chelating agents, and antibiotics have failed to alter progression of the disease. Colectomy in patients with inflammatory bowel disease also has no influence. The judicious use of dilations of strictures, bypass procedures, or resection can palliate jaundice in patients with primary sclerosing cholangitis, but liver transplantation is the definitive treatment. Because palliative operations increase the hazards of liver transplantation, percutaneous dilations and stentings are preferred initially. Cirrhosis and portal hypertension are indications for transplantation. In the future, transplantation may be indicated earlier in the course of the disease.
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PMID:Primary sclerosing cholangitis. 158 51

A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy.
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PMID:Mortality of intravenous drug users in Rome: a cohort study. 192 19

We report on the treatment of invasive aspergillosis with the new triazole antimycotic agent itraconazole. All 11 patients suffered from pulmonary invasive aspergillosis. Two patients also had cerebral aspergillosis; in one of these patients the paranasal sinuses were also invaded. Underlying diseases were acute lymphoblastic leukaemia (n = 3), acute myeloid leukaemia (n = 4); one patient underwent allogeneic bone marrow transplantation before he developed aspergillosis; another was transplanted after successful aspergillosis treatment, liver cirrhosis (n = 1), lung infarction after pulmonary embolism (n = 1), chronic bronchitis after pulmonary tuberculosis (n = 1) and AIDS (n = 1). In five cases initial diagnosis was established by means of mycological methods and clinical signs. In six patients invasive pulmonary aspergillosis was initially diagnosed due to the clinical criteria presented in this paper. Secondary mycological confirmation after onset of therapy was achieved in five out of these six patients. All of the patients initially responded to therapy. One female patient experienced a relapse of aspergillosis and died of cerebral involvement and relapsing leukaemia. Two further patients died due to underlying diseases (pulmonary embolism, relapsing leukaemia). Nine patients (82%) were cured of the mycosis, including the patient with cerebral involvement; two underwent surgical resection of residual pulmonary lesions. Itraconazole is a very effective drug for treatment of invasive aspergillosis. Therapeutic efficacy can be optimized by early diagnosis using clinical criteria and prompt start of treatment.
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PMID:Therapy of invasive aspergillosis with itraconazole: improvement of therapeutic efficacy by early diagnosis. 166 78

The interferons (IFN) act too slowly to arrest acute viral infections, but interferon-alpha (IFN alpha) preparations have proved useful in some chronic infections and will clearly be used increasingly in these in the future. In the preparations derived from human leucocytes or cultured B lymphoblastoid cells, which are in routine clinical use, mixtures of a number of distinct subtypes of human IFN alpha have been identified. There are also 3 slightly different versions of the same single subtype, IFN alpha-2, made by recombinant DNA procedures in bacteria. IFN alpha preparations are injected intramuscularly or subcutaneously. Dose-related side effects are common but usually tolerable, but prolonged treatment may cause increasing fatigue and depression. Some patients form neutralising antibodies which block the effects of the IFN; these appear to be relatively more common after recombinant IFN alpha-2 than after IFN derived from human cells. Given intranasally, IFN alpha can prevent a subsequent experimental rhinovirus infection, or the spread of natural colds within a family. Repeated administration progressively damages the nasal mucosa, so that long term prophylaxis is not possible. IFN alpha has proved useful in patients with papillomavirus warts of the larynx, ano-genital region (condyloma acuminata) and skin (common warts). Treatment regimens remain to be optimised and are likely to include surgery or other treatments. IFN alpha and zidovudine (azidothymidine) synergistically inhibit the growth of HIV in vitro, and combination are on trial in patients with early AIDS. Very large doses of IFN alpha are effective against Kaposi's sarcoma in some AIDS patients. In chronic hepatitis B, continuing virus replication may lead to cirrhosis or primary liver cancer. Earlier clinical trials with IFN alpha gave inconclusive results, but recent large studies have confirmed that 25 to 40% of patients obtain benefit; this probably results from both the antiviral and the immunomodulatory effects of IFN alpha. In patients with chronic hepatitis C, the biochemical markers usually improve rapidly during IFN alpha administration, but relapse if treatment is stopped after only a few months; to increase the chances of sustained cure, the treatment period is now being prolonged.
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PMID:The use of interferon-alpha in virus infections. 172 72

Twenty-seven patients suffering from congenital coagulation defects of the prothrombin complex factors were investigated: six had haemophilia B; 14, factor VII defect; four, factor X defect; and three, factor II defect. Nineteen patients (70.3%) had previously received plasma and/or clotting factors concentrates. Among these, markers of hepatitis B infection (HBV) were present in five cases (26.3%) and hepatitis C (HCV) antibodies were found in seven cases (36.8%). The HIV1 prevalence was similarly high. In fact, five patients (26.3%), previously infused with factor IX or prothrombin complex factors concentrates, developed HIV1 infection. No patient with factor VII deficiency became HIV1 positive, despite the administration of unheated factor VII concentrates and the consequent HBV and HCV contamination. In the HIV1 positive group, three patients showed a false positivity for HIV2 antibodies. Five years after seroconversion, three patients developed AIDS (stage IV) and died, one had persistent generalized lymphadenopathy (stage III), and one with post-hepatitis liver cirrhosis was asymptomatic (stage II) for HIV infection. The significant decrease in total white cells, T4 lymphocytes and platelet counts and increase of beta 2-microglobulin and neopterin levels confirmed the prognostic value of these markers for the progression of HIV1 disease. Only one HIV1 negative transfused patient developed anti-HTLV-I p19 antibodies.
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PMID:Prevalence of HIV infection in a cohort of patients with congenital coagulation defects of the prothrombin complex factors. 178 37

We present a case of disseminated tuberculosis with peritoneal and intestinal involvement in a homosexual patient who presented micronodular fibrosis and was infected by HIV, with an AIDS diagnosis since he had previously presented an esophagitis caused by candida. Diagnosis was made from a sample obtained from an ulcerated lesion from rectum-sigmoid region by colonoscopy, and when stained with Ziehl-Nielsen revealed acid-alcohol resistant bacilli (AARB) identified as M. tuberculosis. The torpid evolution of the process, which was complicated by the uncompensation of the cirrhosis determined the patient's death inspite of treatment. The characteristics of intestinal tuberculosis in HIV infected patients is reviewed.
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PMID:[Intestinal tuberculosis in acquired immunodeficiency syndrome]. 178 2

Postmortem examination of 21 patients showed a vacuolar myelopathy resembling that associated with the acquired immunodeficiency syndrome. Underlying diseases included six cases of leukemia or lymphoma, five of carcinoma, three of systemic lupus erythematosus, two of chronic lung disease, and one each of cadaveric renal transplant, cirrhosis, diabetes, hemophagocytic syndrome, and viral encephalitis. Fourteen patients were on long-term steroid therapy and 10 of these also had immunosuppressive chemotherapy. No patient had the acquired immunodeficiency syndrome, although one received blood transfusions in 1978. Signs and symptoms consistent with myelopathy included paraparesis in seven patients, ataxia in one, and bilateral extensor plantar reflexes in one. Microscopic examination showed vacuolation in spinal cord white matter primarily located in posterior and lateral columns. Lipid-laden macrophages and axonal changes were proportional to the severity of the vacuolation, which was severe in five patients, moderate in 10, and mild in six. Eight patients had coexistent viral diseases elsewhere in the central nervous system, but viral-associated antigens or genomic material was not found in regions of vacuolated spinal cord white matter. Although the etiology of these myelopathies is unknown, their association with immune suppression and coexistent viral infection of the central nervous system suggests that an opportunistic viral infection may be important.
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PMID:Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients. 186 65

Three bacteremias of Campylobacter fetus were described. One was a male patient and two were females. Underlying illnesses were present in all of them (Hodgkin disease, AIDS and hepatic cirrhosis respectively). They were all admitted because of fever and no other symptoms of infectious focus were present. Physical findings were not relevant. The blood cultures became positive in days 6, 7 and 9 respectively. Antibiotic treatments were not standardised, so no conclusions can be drawn. The evolution was correct except for the patient infected by the human immunodeficiency virus who carried out a recurrent course. The authors comment on the increasing interest of this pathogen causing extraintestinal infection.
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PMID:[Bacteremia from Campylobacter fetus. Increasing interest and incidence]. 194 96


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