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)

Sexually transmitted diseases (STDs) are diagnosed in 10 million patients per year in the United States. The infected individuals come from all walks of life and all age groups. They may present with either genital or nongenital signs and symptoms. Most individuals are treated as outpatients, but more than a quarter of a million hospital admissions for STDs are necessary each year. These numbers will rise precipitously as the number of AIDS cases increases. More than 10,000 deaths per year are caused by STDs, primarily because of AIDS, cervical carcinoma, and hepatitis B induced cirrhosis and hepatoma. Physicians must become highly skilled in the diagnosis and treatment of the common STDs caused by herpes simplex virus, Neisseria gonorrhoeae, and Chlamydia trachomatis. Simple office microscopic skills are needed for the diagnosis of vaginitis, cervicitis, and urethritis, and all physicians should be encouraged to develop these skills. Physicians will need to keep abreast of the rapidly evolving changes in the diagnosis and treatment of STDs.
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PMID:The office approach to the sexually transmitted diseases: Part I. 362 20

The interrelationship between hepatitis B virus (HBV) infection, hepatic injury and clinical activity in chronic HBV infection is incompletely understood. We have scored histologic activity, the expression of hepatitis B core (HBcAg) and hepatitis B surface antigen (HBsAg) and assessed HBV replication to correlate HBV antigen expression with histologic disease. Forty-seven formalin-fixed, percutaneous liver biopsies from HBeAg carriers were studied. Twenty-nine were Black, 16 Caucasian and two Oriental. Fifty-nine percent had chronic active, 35% chronic persistent hepatitis and 14% cirrhosis. None were positive for antibodies to Human Immunodeficiency Virus (HIV). HBsAg and HBcAg in tissue were detected by immunochemical staining. Diffuse HBsAg staining was observed in 10/15 patients with CPH, but there was no correlation between histologic score and HBsAg expression. Intracytoplasmic HBcAg was observed in patients seroconverting to anti-HBe, but was also detected in patients with minimal hepatitis. An inverse correlation between histologic score and HBcAg expression was observed. HBcAg expression was more widespread in patients with CPH (mean 37%) than in CAH (mean 18%). A positive correlation was observed between serum aminotransferase concentrations and histologic score. Although no consistent pattern can be discerned, HBcAg expression and hepatic injury are frequently dissociated in patients with chronic HBV infection; complex host responses may determine the variable degree of disease activity and hepatic injury.
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PMID:Hepatitis B core and surface antigen expression in HBeAg and HBV DNA positive chronic hepatitis B: correlation with clinical and histological parameters. 368 95

A case of spontaneous bacterial peritonitis is reported. A methodical postmortem examination failed to disclose cirrhosis or other liver pathology; nor, was any anatomic alteration of the immune system noted. Acquired immunodeficiency syndrome was likewise discounted. A discussion ensues concerning recognition of this entity.
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PMID:Spontaneous bacterial peritonitis in the non-cirrhotic individual. 372 72

As a major tourist attraction for heterosexuals and homosexuals, Thailand stands to experience major increases in the rate of acquired immunodeficiency syndrome (AIDS). This article describes 2 AIDS cases in Thailand, including the 1st documented case. The 1st case involved a 28-year-old unmarried Thai male who travelled to the US in 1981 for postgraduate work and had contact with both female prostitutes and homosexual men. In 1982-83, the patient demonstrated fever, fatigue, meningitis, and finally Pneumocystis carinii. He was hospitalized in 1984 for fever, bilateral deafness, and diarrhea. Serologic analysis revealed antibodies to human T-cell lymphotropic virus type III (HTLV- III). Death occurred in January 1985. The 2nd patient was a 52-year- old single man who had moved from West Germany to Thailand 10 years previously to admission in 1985 for upper gastrointestinal bleeding. The patient, a homosexual, make frequent visits to Germany and was an alcoholic. The initial clinical diagnosis was ruptured esophageal varices with cirrhosis. The patient further had a history of herpes simplex genitalis. The subsequent course of the disease process included massive blood loss and interstitial pneumonitis. Serology revealed antibodies to HTLV-III. Death occurred in August 1985. Both of these patients belonged to groups at high risk of AIDS and had clinical, serologic, and immunologic indicators that enabled confirmation of the AIDS diagnosis.
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PMID:Acquired immune deficiency syndrome in Thailand. A report of two cases. 372 46

The abuse by injection of heroin or other drugs has long been associated with liver disease caused by hepatitis B virus (HBV) and other viruses. Increasingly severe hepatic and virological complications of parenteral drug abuse have been reported due to infection with new viruses or concomitant alcohol abuse. The hepatitis delta virus (HDV) can replicate and cause liver infection only in the presence of HBV; such infection in HBV carriers may cause rapidly progressive and clinically significant liver disease. Liver cirrhosis is frequently detected in parenteral drug abusers who have chronic infection with both HBV and HDV or who also abuse alcohol. More than one quarter of those persons with acquired immunodeficiency syndrome (AIDS) in the United States of America are homosexual or heterosexual males who are parenteral drug abusers. Existing evidence implicates parenteral drug abusers in the spread of hepatitis viruses and the retrovirus associated with AIDS to the general population. To cope with these serious problems the authors suggest that more intensive international co-operation is needed, particularly with a view to promoting data collection, research and the exchange of knowledge and experience on measures that have been effective in dealing with parenteral drug abuse and its complications.
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PMID:Acquired immunodeficiency syndrome and infection with hepatitis viruses in individuals abusing drugs by injection. 377 78

To assess the spectrum of hepatic abnormalities in acquired immune deficiency syndrome (AIDS), we reviewed clinical, biochemical, and pathological material in 32 patients with AIDS. Eight-four percent of AIDS cases had a history of intravenous drug abuse. Ninety percent of AIDS patients has some liver biochemical abnormality at the first presentation of illness. During the course of AIDS, significant (p less than 0.05, paired Student's t test) rises in alkaline phosphatase and bilirubin occurred, without rises in aminotransferases. Mean abnormalities were mild, reflecting approximately 2-fold increases over baseline. Liver failure was not believed to contribute to the death of any AIDS patient. Pathological findings in AIDS included specific infectious diagnosis in 26%, granulomas in 16%, hemosiderosis in 26%, nonspecific abnormalities in 39%, cirrhosis in 23%, and chronic active hepatitis in 3%. AIDS cases were also compared to 10 selected age, sex, and epidemiologically similar non-AIDS patients. Although granulomas or infections were not seen in our comparison group, only the incidence of chronic active hepatitis was significantly different between the groups. If only those with intravenous drug abuse were studied, then none of 24 AIDS patients versus four of eight non-AIDS cases (p less than 0.005) had chronic active hepatitis. AIDS patients with specific hepatic infections tended to have a higher alkaline phosphatase and aspartate aminotransferase (p less than 0.05) than noninfected cases. However, substantial overlap existed, and no difference in hepatomegaly was noted. Ninety percent of AIDS patients were ingesting at least one potentially hepatotoxic drug. We conclude that AIDS patients have a high incidence of underlying hepatic abnormalities. However, clinical and biochemical abnormalities are similar in our selected liver biopsy patients with intravenous drug abuse with or without AIDS. As expected, AIDS patients have a higher incidence of hepatic granulomas and infections, but these patients were not clearly distinguishable from other AIDS cases. Histological examination showed a wide array of changes by light microscopy, but no specific lesion of AIDS was noted. The low incidence of chronic active hepatitis in this AIDS population may imply that the altered T lymphocyte function in AIDS could influence the course of liver disease in these patients.
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PMID:The liver in acquired immune deficiency syndrome: emphasis on patients with intravenous drug abuse. 382 29

The computed tomography (CT) scans of 27 patients with abdominal tuberculosis were reviewed retrospectively to determine the range of abdominal involvement. Most patients had been at increased risk because of intravenous drug abuse, alcoholism, acquired immunodeficiency syndrome (AIDS), cirrhosis, or steroid therapy. The etiologic agent was Mycobacterium tuberculosis in 23 patients and M. avium-intracellulare in four patients with AIDS. In five patients, tuberculosis was limited to the abdomen. CT findings included adenopathy, splenomegaly, hepatomegaly, ascites, bowel involvement, pleural effusion, intrasplenic masses, and intrahepatic masses. Characteristic features were a tendency for adenopathy to prominently involve peripancreatic and mesenteric compartments, low-density centers within enlarged nodes, complex nature of the ascites, and adenopathy adjacent to sites of gastrointestinal tract involvement. Recognition of these manifestations and maintenance of an index of suspicion, especially in patients at risk, should help optimize the correct diagnosis and management of intraabdominal tuberculosis.
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PMID:Abdominal tuberculosis: CT evaluation. 403 67

Bacterial meningitis remains a relatively common disease worldwide (40,000 cases per year in the United States) and the mortality rate has not improved in over 30 years. Certain host factors increase the risk of acquiring meningitis and include: age (increased at extremes of life), male sex, low socioeconomic status (crowding), black race, recent nasopharyngeal carriage of a virulent strain, absence of specific bactericidal antibody, maternal factors at birth (neonatal disease), various immunologic defects (neonates, antibody or terminal complement component deficiency, splenectomy, and immunosuppression including the acquired immune deficiency syndrome), and certain chronic diseases (such as alcoholism, cirrhosis, and diabetes mellitus). Bacterial meningitis represents an infection in an area of impaired host resistance. The blood-brain barrier is a major protective mechanism for the central nervous system against circulating bacteria. However, once bacteria gain entry into the subarachnoid space, host defenses are inadequate. Polymorphonuclear leukocytes are at a disadvantage in the fluid medium of the cerebrospinal fluid and surface phagocytosis is inefficient. In addition, antibody and complement concentrations are low (or absent) in purulent cerebrospinal fluid early in the disease course. Functional opsonic and bactericidal activity is lacking; therefore, efficient phagocytosis of encapsulated meningeal pathogens is limited. The result is huge population densities (often 10(7) to 10(8) cfu per milliliter) of bacteria in cerebrospinal fluid. This finding suggests that bactericidal antibiotics with cerebrospinal fluid concentrations much greater than the minimal bacterial concentration of the pathogen are optimal for therapy of meningitis; this principle has been shown in experimental animal models and supported by therapeutic studies in human subjects.
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PMID:Bacterial meningitis in the patient at risk: intrinsic risk factors and host defense mechanisms. 637 70

So far little was known on the epidemiology of hepatitis A, B, C and of AIDS in Cambodia and especially not in the rural area of Takeo. Therefore serological markers for past or ongoing infections with the disease causing viruses were measured in 559 healthy individuals (305 adults, 200 children and 54 mothers of children with liver disorders) and in 185 individuals (103 adults and 82 children) with liver or kidney diseases. In none of the 744 samples tested was anti-HIV detected. 10-37% of the children and 73% of the adults showed HBV-markers, HBsAg being detectable in 2-14% of the children and in 8% of the adults. The prevalence for anti-HCV was 6.5% in the adults with a predilection in males (9%). No markers for HCV infections were found in children. Growing, age related proportions of children (27-97%) and 100% of the adults were anti-HAV IgG positive. HBsAg was detected in 46% of the adults with acute hepatitis, in 45% of those with chronic hepatitis/liver cirrhosis and in 90% of patients with hepato-cellular carcinoma (HCC). In children the corresponding figures were 18% for acute hepatitis and 18% for chronic hepatitis. Patients with acute hepatitis or HCC had a similar prevalence of anti-HCV as healthy individuals. However, 34% of the adult patients with chronic hepatitis/cirrhosis showed signs of a HCV-infection. When the data were analysed with respect to modes of viral transmission, crowding, transmission by unsafe sexual practice or contaminated injection material, and to a lesser extent vertical transmission, seem to be relevant for HBV. The main mode of acquiring HCV infection is probably through medical injections of all sorts, a habit which is very popular in Takeo. Prophylactic measures should concentrate on the prevention of HBV and HCV infections by hygienic means. HBV mass vaccination should be considered in the future.
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PMID:Prevalence of markers of hepatitis viruses A, B, C and of HIV in healthy individuals and patients of a Cambodian province. 750 85

Rhinocerebral phycomycosis is an uncommon opportunistic infection with ubiquitous fungi of the class Phycomycetes, starting in the nose and extending to the paranasal sinuses and then intracranially. The condition is often characterized by poor prognosis because of occlusion of the internal carotid artery. This disease is commonly associated with predispositions such as uncontrolled diabetes mellitus, which is the most common, immunosuppressive states and metabolic bankruptcy including leukemia, lymphoma, myeloma, malnutrition, uremic or diarrheal acidosis, severe burns, anemia, carcinoma, radiotherapy, liver cirrhosis, hemochromatosis, tuberculosis, septicemia, long-term medication of steroid, antibiotics and antimetabolite, drug addiction, cytotoxic drug administration and AIDS. Cases with unknown predisposition, however, have been infrequently reported in the literature. The authors report a case of rhinocerebral phycomycosis in which concurrence of Candida species instead of the above-mentioned common predispositions was considered a potential predisposition. To our knowledge, only 1 report in which Candida species are referred to as a potential predisposition for this disease has been previously issued. A 85-year-old man was admitted to our hospital on March 2, 1994 because of generalized convulsion. He had received a total extirpation of an ascending colon cancer in July 1993. On admission, physical inspection showed no abnormalities and neurological examination revealed obtunded consciousness without other abnormalities. He had no diabetes mellitus. Hematological and blood chemistry values were normal except for CA19-9 of 45 U/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of rhinocerebral phycomycosis]. 760 36


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