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)

A significant increase in associated liver disease has been confirmed in duodenal ulcer cases, with various studies showing a 5-14% incidence of the ulcers in patients with cirrhosis. The present study was undertaken to discover the incidence of peptic ulcer in such patients, to investigate a series of epidemiological data in a group cirrhosis patients with ulcers and to establish an adequate protocol for the treatment of the ulcer in both its acute and post-healing stage. The incidence of peptic ulcers in cirrhosis patients was calculated in a retrospective study of 377 hospitalised patients in two consecutive years (1986, 1987). The epidemiological data are based on 99 of them. Acute ulcer treatment was given in 31, while 41 with healed ulcers were put on maintenance therapy. Ulcers were found in 16-17% of the cirrhosis patients; the cirrhosis was caused by alcohol abuse in 61.53% and was post-necrotic in 21.79%. Endoscopy revealed duodenal ulcers in 60.6%, gastric ulcers in 32.3%. In this sample, 39.39% were non-smokers, while 23.23% smoked over 20 cigarettes a day.
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PMID:[Peptic ulcer and liver cirrhosis. Clinico-epidemiologic considerations]. 232 Feb 79

The hospital prevalence rate for upper gastrointestinal ulcerative disease in 28,531 inpatients consecutively admitted in two teaching hospitals in the Comprehensive Hospital Drug Monitoring (CHDM) in Berne, from 1974 to 1985, was 2.2% (1.8% for gastric or duodenal ulcer, and 0.4% for erosive gastritis). This was based on the evaluation of 634 patients after exclusion of the subgroup of patients with hepatic cirrhosis or upper gastrointestinal neoplasia. After exclusion of patients on anticoagulant therapy (n = 73), 561 (= 100%) patients could be further studied. Of them, 33.3% (n = 187) were found to have been exposed to non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, within 21 days prior to confirmation of the diagnosis. The observed relative risk (RR) of developing a substantial acute upper gastrointestinal bleeding (Hb less than 10 g/100 ml for men, and less than 9 g/100 ml for women, or a decrease in Hb of more than 25%) was 1.61 when patients exposed to NSAIDs (n = 187) were compared to patients not exposed to those drugs (n = 374). Although there was no significant sex difference overall, the RR for gastrointestinal bleeding differed considerably in the various age-groups; it was elevated in men under 40 years (RR = 2.86) and in women over 60 years of age (RR = 1.89), as compared to the mean RR of 1.61.
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PMID:Risk of acute upper gastrointestinal bleeding in patients with ulcerative disease and treatment with non-steroidal anti-inflammatory drugs (NSAIDs). Results from the Comprehensive Hospital Drug Monitoring Berne (CHDM). 232 44

Upper gastrointestinal hemorrhage is one of the more important complications of cirrhosis and a major cause of death in such patients. The main sites of bleeding are esophageal varices, gastritis, and peptic ulcers. In order to determine the prevalence of either potential bleeding lesions or of other endoscopic findings in hemodynamically stable individuals with various etiologies of cirrhosis, 510 consecutive cirrhotic patients, evaluated for possible orthotopic liver transplantation (OLTx) underwent an upper gastrointestinal endoscopy for combined diagnostic and therapeutic purposes. The patients were divided into two main groups: 319 patients with parenchymal liver disease and 191 patients with cholestatic liver disease. Gastritis was found significantly more often in patients with parenchymal liver disease than in those with cholestatic liver disease (49.8% vs 30.9%; P less than 0.001). In contrast, the prevalence of esophagitis, esophageal and gastric varices, gastric ulcer, duodenal ulcer, and duodenitis was similar in both groups. Normal endoscopic findings were present in 5.0% of the parenchymal group and 11.5% of the cholestatic group (P less than 0.02). Ascites and encephalopathy were found significantly more often in subjects with parenchymal liver disease as compared to those with cholestatic liver disease. Portal hypertension and its degree, as assessed by the presence and size of esophageal varices, was similar in both groups, and in both groups there was a statistically significant qualitative trend of increasing prevalence of esophageal varices with increasing severity of disease as estimated using Pugh-Child's criteria.
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PMID:Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively. 234 4

In 1984 we started a prospective controlled trial comparing endoscopic sclerotherapy (ES) with the distal splenorenal shunt (DSRS) in the elective treatment of variceal hemorrhage in cirrhotic patients. The study population included 40 patients with cirrhosis and portal hypertension referred to our department from October 1984 to March 1988. These patients were drawn from a pool of 173 patients who underwent either elective surgery or endoscopic sclerotherapy during this time. Patients were assigned to one of the two groups according to a random-number table: 20 to DSRS and 20 to ES. During the postoperative period, no DSRS patient died, while one ES patient died of uncontrolled hemorrhage. One DSRS patient had mild recurrent variceal hemorrhage despite an angiographically patent DSRS. Four ES patients suffered at least one episode of gastrointestinal bleeding: two from varices and two from esophageal ulcerations. Five ES patients developed transitory dysphagia. Long-term follow-up was complete in all patients. Two-year survival rates for shunt (95%) and ES (90%) groups were similar. One DSRS patient rebled from duodenal ulcer, while three ES patients had recurrent bleeding from esophagogastric sources (two from varices and one from hypertensive gastropathy). One DSRS and two ES patients have evolved a mild chronic encephalopathy; four DSRS and two ES patients suffered at least one episode of acute encephalopathy. Two ES patients had esophageal stenoses, which were successfully dilated. Preliminary data from this trial seem to indicate that DSRS, in a subgroup of patients with good liver function and a correct portal-azygos disconnection, more effectively prevents variceal rebleeding than ES. However no significant difference in the survival of the two treatment groups was noted.
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PMID:Distal splenorenal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. First stage of a randomized, controlled trial. 240 92

The late complications in 25 patients more than 3 years after successful Kasai's operation for biliary atresia were presented. Nine (36%) of these 25 patients had episodes of variceal hemorrhage with portal hypertension, and biliary reobstruction in 3 (12%), bleeding from duodenal ulcer in 2, bleeding from gastric erosion in one, and diffuse pulmonary arterio-venous shunt in one were observed. Recently esophageal varices have been well controlled by endoscopic sclerotherapy, and the surgical treatment may be indicated in older children complicated with severe hypersplenism and marked splenomegaly, which are resistant for sclerotherapy. As a surgical procedure, splenectomy with periesophago-gastric devascularization (Hassab's operation) seems to be very useful for portal hypertension by biliary cirrhosis. The reoperation, hepaticoenterostomy, was performed in 3 patients with biliary reobstruction. All three patients are alive and well, and two of them are at 19 years (university student) and 24 years (married life) of age. Hepatic Rehepaticoenterostomy is well indicated rather than liver transplantation, if biliary reobstruction is incurable with conservative therapy. Many of the patients with complications were able to carry on an almost normal life, if suitable treatments for complications were taken.
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PMID:[Late complications after successful Kasai's operation for biliary atresia]. 258 18

In order to investigate whether the previously found excess mortality in surgically-treated patients with peptic ulcer might be due partly to the resections employed, a survival analysis was undertaken in 824 patients 8-13 years after different types of vagotomy. These patients had been submitted to selective gastric vagotomy with drainage, selective gastric vagotomy with antrectomy or parietal cell vagotomy with or without drainage for duodenal ulcer, pyloric ulcer, prepyloric ulcer, or combined ulceration during the period from 1972 to 1977. A statistically significant excessive mortality was found for both sexes in the total material compared to the background population. Analysis of the material, subdivided according to the operative methods employed, revealed a significant excess mortality in men treated with selective gastric vagotomy and antrectomy, whereas the mortality rates were slightly and insignificantly raised in the nonantrectomy groups. No significant difference in the mortality could be demonstrated in relation to the site of the ulcers. Analysis of the cause-specific mortality revealed a significantly raised mortality from gastrointestinal diseases, including a significant excessive mortality in the subgroups of benign peptic ulcer and cirrhosis of the liver. Likewise, the death rate from accidents including the subgroup of suicide was significantly increased. The overall mortality from malignancies was insignificantly raised among patients, whereas cancer in the stomach was significantly increased. An increased mortality from cancer in the lungs and pancreas did not reach statistical significance. These findings are in reasonable accordance with other studies. A significantly increased mortality from gastric cancer has been usual, although not a constant finding after gastric resection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Survival after vagotomy: results of the Aarhus County Vagotomy Trial. 262 88

Upper gastrointestinal hemorrhage is one of the more important complications of cirrhosis. Most of the available data regarding the prevalence of upper and lower gastrointestinal sites of bleeding in cirrhotic patients have been obtained in individuals with alcoholic cirrhosis evaluated in the course of an acute gastrointestinal bleeding episode. Few data exist, however, as to the prevalence of either potential bleeding sites or of normal endoscopic findings in hemodynamically stable individuals with cirrhosis of any etiology. Five hundred ten cirrhotic subjects, who were evaluated for possible liver transplantation (OLTx) between January 1985 and June 1987, were included in this study. Seventy-five had alcoholic cirrhosis and 435 had nonalcoholic cirrhosis of various etiologies. Of these 510 patients, 412 underwent combined upper and lower gastrointestinal endoscopy and 98 underwent upper gastrointestinal endoscopy alone. Gastritis, gastric and duodenal ulcer disease were found significantly (each at least p less than 0.025) more often in patients with alcoholic liver disease than in those with nonalcoholic liver disease. The prevalence of the various lower gastrointestinal lesions in both groups was similar. Of particular interest is the fact that in alcoholic cirrhotics, the prevalence of gastritis, gastric ulcer and duodenal ulcer disease was unrelated to the degree of portal hypertension, whereas in the nonalcoholic cirrhotics the prevalence of gastritis and duodenal ulcer disease but not gastric ulcer disease was associated significantly with the degree of portal hypertension as assessed by the presence or absence of large esophageal varices, ascites, and hepatic encephalopathy.
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PMID:Combined upper and lower gastrointestinal endoscopy: a prospective study in alcoholic and nonalcoholic cirrhosis. 269 Jun 64

Since 1982, we have performed 384 courses of CHOP chemotherapy for 89 patients with malignancy including 70 with non-Hodgkin's lymphoma, adhering to the original regimen as strictly as possible. As severe acute reactions, myelosuppression, fever, arrhythmia, hemorrhagic cystitis, and perforation of duodenal ulcer were seen. Rates of fever had no tendency to increase with advancing age. Three patients only with diabetes mellitus had no severe side effects. Three patients with liver cirrhosis showed severe myelosuppression and fever. One patient both with liver cirrhosis and diabetes mellitus died from the infection due to CHOP chemotherapy, however the other febrile patients did not have life threatening infection. Thirty three percent (11/33 courses) of the patients with obesity experienced severe myelosuppression (WBC less than 1,000), while 55% (33/60 courses) of the patients without obesity. However satisfactory treatment results were not obtained in the patients with obesity. We consider that CHOP chemotherapy is excellent in feasibility even for the aged patients or the patients with diabetes mellitus. However, we suggest that the dose of CHOP chemotherapy should be reduced for the patients with liver cirrhosis.
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PMID:[Feasibility of CHOP chemotherapy--with special reference to age, diabetes mellitus, liver cirrhosis and obesity]. 273 36

In the present paper the following non-endocrine internal diseases are discussed: liver cirrhosis, diabetes, chronic renal failure and morbus Crohn. In alcoholic liver patients under fifty, hypospermia and oligozoospermia can be observed. The hormone assays showed moderately increased FSH- and LH-values in the serum; prolactin, testosterone and estradiol remained normal. An increased binding of testosterone to SHBG is supposed, and the androgen deficiency symptoms are considered to be due to the elevated binding of testosterone to SHBG. The other non-endocrine internal diseases and drug-groups (cytostatics, steroids, neuroleptics, antihypertensives, antiarrhythmics, nitrofurans, levamisole, fungicides and salazosulfapyridine) are reviewed on the basis of literature. After the administration of 1 g per day of cimetidine for four weeks in patients under fifty with duodenal ulcer, notable andrological side effects were not revealed by neither clinical nor hormone examinations.
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PMID:[Andrological abnormalities in internal diseases and following drug therapy]. 311 48

This is a report of six patients with cirrhosis of the liver in whom primary hyperparathyroidism occurred due to a solitary parathyroid adenoma 3 months to 9 years after undergoing emergency portacaval shunt for hemorrhage from esophageal varices. The presenting symptoms in all six patients were weakness and bone pain. Three patients had a bone fracture after insignificant trauma, one and probably two passed kidney stones, and a duodenal ulcer developed in two. Bone x-ray films showed generalized osteoporosis in all patients. Renal function and arterial blood pH were within normal limits in every patient. The diagnosis of primary hyperparathyroidism in each patient was based on repeated demonstrations of hypercalcemia, hypophosphatemia, and markedly elevated serum immunoreactive parathyroid hormone concentrations. In all six patients, removal of the parathyroid adenoma resulted in disappearance of symptoms; normalization of serum calcium, phosphorus, and immunoreactive parathyroid hormone levels; and in four of the six, improvement in radiographic evidence of osteoporosis during follow-up of from 1 to 6 years. The association of cirrhosis, portacaval shunt, and primary hyperparathyroidism has not been documented previously. Our six patients with primary hyperparathyroidism constitute 3.4 percent of 174 survivors of emergency portacaval shunt in a series of 264 unselected, consecutive patients with cirrhosis and bleeding esophageal varices. Hepatic osteodystrophy is known to have occurred in only 11 of these 174 survivors. Primary hyperparathyroidism may be a more common cause of hepatic osteodystrophy than has been previously recognized, and should be considered in patients with cirrhosis in whom weakness, bone pain, and bone demineralization develop, particularly if they have a portacaval anastomosis.
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PMID:Hyperparathyroidism, cirrhosis, and portacaval shunt. A new clinical syndrome. 325 57


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