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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 21 patients with liver cirrhosis, 35 normal subjects, 8 patients with chemical and 11 with manifest diabetes 0.5 g glucose/kg together with 14C-glucose were injected intravenously. 71% of the cirrhotics showed an impaired glucose tolerance. IRI response was exaggerated. The insulinogenic index was elevated in patients with liver cirrhosis and normal glucose tolerance and normal or subnormal in those with carbohydrate intolerance, as well as in diabetics. Decrease of the specific activity of glucose, expressing supply of non-labelled glucose to the body pool, was much more rapid in patients with carbohydrate intolerance, either hepatogenic or not, when compared at equal glucose concentrations. Moreover all groups with deteriorated glucose tolerance exhaled less 14CO2. Consequently, diabetes in chronic liver disease displays the same abnormalities as diabetes in obesity with respect to liver glucose supply and glucose oxidation. In both conditions diminished glucose assimilation is usually the result of reduced removal and increased supply. Therefore it is concluded that impaired hepatic uptake of glucose cannot be implicated as a single cause of hepatogenic diabetes.
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PMID:[Insulin resistance and blood glucose replacement rates in liver cirrhosis. Studies with 14C-glucose (author's transl)]. 90 3

The exact role of serum pseudocholinesterase (PSCE) is not known. Its main role probably consists in the degradation of butyril-choline, an intermediate of lipid metabolism. Decreased values have been described in liver cirrhosis as an index of diminished proteosynthetic function. An increased activity of this enzyme was reported in obesity, diabetes mellitus, nephrosis, hyperthyroidism and in hyperlipemic subjects without obesity. A significant correlation was found between serum cholesterol, triglycerides and PSCE, as an expression of lipid metabolism. In view of assessing the possible change of this enzyme during fattening, the authors investigated PSCE activity during fattening in pigs (the same breed). The results indicate a statistically significant increase of PSCE during fattening, from 30.4 +/- 1.7 to 43.6 +/- 1.7 (p less than 0.001). These results together with those reported in a previous paper concerning blood lipids and cholesterol, show a positive correlation between these parameters and PSCE during fattening in pigs, which might be due to an adaptative increase of the hepatic synthesis of this enzyme in response to the increased lipid metabolism.
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PMID:Serum pseudocholinesterase activity during experimental fattening. 94 98

Blood sugar, insulin and GH values were examined in two groups of cirrhosis of the liver patients, with and without ascites, after the administration of 100 g glucose per os. No significant differences between the two groups were observed. Insulin values were higher than those in the controls, with a pattern similar to that noted in subjects with chemical diabetes. GH values were higher than in normal subjects and secretion was not suppressed.
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PMID:[Plasma insulin and GH during oral glucose load in liver cirrhosis]. 95 Oct 48

The changes of blood glucose, serum insulin, serum free fatty acid and its fatty acid composition following oral glucose load were observed in twenty-nine cirrhotic patients. The insulin secretory response was significantly lower in the cirrhotic patients with overt diabetes than in those without overt diabetes. There were no definite relation between serum free fatty acid level or its composition and glucose intolerance. These results suggest that the diabetic state in most of the cirrhotic patients with overt diabetes is due to essential diabetes and that serum free fatty acid livel and its composition are not important factors contributory to the glucose intolerance in liver cirrhosis.
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PMID:Clinical investigation on abnormal glucose tolerance in liver cirrhosis. 97 84

Serum cholesterol, triglyceride, total lipids and the lipoprotein pattern were studied in 169 cases chronic liver disease confirmed by biopsy. On the ground of the immunological and morphological results the patients were classified into five groups. In chronic persistent hepatitis no significant abnormality was found. In chronic aggressive hepatitis and in cirrhosis of the liver the serum cholesterol level was significantly reduced. In fatty infiltration of the liver the serum cholesterol, triglyceride and total lipid concentrations were significantly increased, as compared with the normal values and with the figures obtained in the cases of chronic inflammatory liver disease. In the cases of cirrhosis with additional diabetes the lipid values were likewise increased. In chronic aggressive hepatitis and in cirrhosis of the liver the levels of pre-beta and alpha lipoprotein were decreased, in fatty infiltration of the liver those of beta and pre-beta lipoprotein were increased.
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PMID:Serum lipids and lipoproteins in chronic liver disease. 103 49

In a number of 3,554 clinically manifest diabetics who were admitted for the treatment of metabolism or other diseases from 1967 to 1974 12.1 per cent of hepatopathies were found. In men the incidence was 15.2 per cent, in women 10.7 per cent. Among these the fatty degeneration of the liver (28.8 per cent) and the cirrhosis (17.4 per cent) were most frequent. Referred to the entirety the result was an incidence of cirrhosis of 2.1 per cent. The confirmation of the diagnosis is performed by biopsy and endoscopy in 92 per cent. In 60 per cent of the examined persons the diagnosis was unknown before admission. There was no correlation to the duration of the diabetes. In the number of patients there appeared above all persons older than 50 to 60 years. The following concomitant diseases occurred: hypertension (33 per cent), coronary diseases (32 per cent), pyelonephritis (17 per cent) and adiposity (13 per cent).
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PMID:[Liver diseases in diabetes mellitus]. 119 48

The urinary excretions of L-xylulose, xylitol and D-glucarate after the oral administration of glucuronolactone (5 g) were measured in normal healthy persons, patients with diabetes mellitus, acute hepatitis in recovery stage, chronic hepatitis and liver cirrhosis. In normal subjects, the mean value of L-xylulose excretion was 14.6 +/- 1.4 mumol/2 h with a range from 6.5 to 21.8. Marked increase of L-xylulose excretion was observed in cirrhotic patients, the mean value was 97.1 +/- 19.8 with a range from 22.0 to 236.6. Though some cases of acute and chronic hepatitis showed higher values than the normal range, no case exceeded 50 mumol/2 h. The urinary excretion of xylitol in cirrhotic patients was also higher than normal no increase was observed in D-glucarate excretion. The values of L-xylulose excretion in cirrhosis were correlated with the values of serum total bilirubin, albumin, albumin/globulin ratio, lactate dehydrogenase and prothrombin time. These findings indicate that the measurement of L-xylulose in urine after the oral glucuronolactone loading provides a useful tool for evaluation of the severity of liver cirrhosis.
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PMID:Increased urinary excretion of L-xylulose in patients with liver cirrhosis. 124 50

In 28 out of 40 patients with idiopathic haemochromatosis manifest diabetes mellitus could be demonstrated 19 patients required insulin. Treatment of diabetes with or without insulin was problem-free. In only two patients there was an insulin resistance which required high doses of insulin some of the time. There was a family history of diabetes in eleven patients. Minimal diabetic retinopathy in two patients was the only typical complication specific to diabetes. Severe forms of microangiopathy are seldom seen in haemochromatosis diabetes. This form of diabetes is probably mainly of genetic origin. Liver cirrhosis and fibrosis and possibly pancreatic siderosis are additional factors to be considered. A sufficiently long and intensive venesection treatment leads to clinical improvement in the diabetes in only a small fraction of the haemochromatosis patients.
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PMID:[Diabetes mellitus in idiopathic haemochromatosis (author's transl)]. 127 43

As part of an infection control program in ICU, we studied prospectively 1500 consecutive patients admitted to a medical and surgical ICU from January 1988 to July 1990. Over this period of time, 69 patients developed septic shock, and 38 of them died (55.1%). Primary source of infection was the lower respiratory tract or intraabdominal in more than 50% of cases, and were related to a high mortality rate, however SS arising from a biliary tract infection is associated with a mortality rate below 20%. In the univariate analysis, nosocomial origin (p = 0.0001), creatinine serum level > 175 mumol/l (p = 0.005), multiple organ failure in the first 24 hours after shock started (p = 0.02), underlying cancer disease (p = 0.02) or liver cirrhosis (p = 0.03) were associated with a statistically significant higher risk for dying. No differences were found regarding age, sex, admission date, coma, recent surgery, prior cardiac arrest, diabetes, organ transplantation, corticosteroid therapy, cancer chemotherapy, absence of fever, bacteriology of the infection and appropriate antibiotic therapy. The multivariate analysis further identified that creatinine serum level > 175 mumol/l (p = 0.004), underlying cancer disease (p = 0.005), liver cirrhosis (p = 0.02) and nosocomial-acquired infection (p = 0.02) were independently associated to a higher risk for dying. These data allows the identification of factors related to a worst outcome. The high mortality rates recorded for septic shock still recommends the rapid transfer of the patient to an ICU as well as the use of aggressive therapy in all cases.
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PMID:[Septic shock: epidemiology and prognosis]. 129 99

A 57-year-old man had suffered from poorly controlled diabetes mellitus and liver cirrhosis due to alcohol and hepatitis C for about 10 years. He developed fever and swelling of the right cheek and neck due to periodontal infection. The symptoms worsened in spite of antibiotic therapy and were accompanied by dyspnea. He was therefore referred to our hospital. Chest radiographs and computed tomographs revealed widening of the superior mediastinum, pulmonary infiltrates and right pleural effusion. He was diagnosed as having mediastinitis, right pyothorax and pneumonia caused by periodontal infection. Tracheotomy and mechanical ventilation were performed. Antibiotic therapy resulted in improvement of the mediastinitis and pyothorax. However, renal and liver dysfunction developed and the patient died of multiorgan failure after 35 days of hospitalization. Death due to periodontal infection is rare. We give a review of the literature.
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PMID:[A fatal case of acute mediastinitis caused by periodontal infection]. 146 87


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