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 paper describes the results of studying the immune status of 1,960 patients with stomach, pancreas, liver, gall bladder, small and large intestine disorders, who were treated in the Central Research Institute of Gastroenterology. The results of the study demonstrate that alimentary system diseases are concomitant with changes in the functional activity of the immune system and development of the systemic immune response aimed at the neutralization and elimination of pathogenic agents. Impaired regulatory and efferent lymphocyte capacities, increased synthesis of cytokines, immunoglobulins, heterologous (anti-viral, anti-bacterial or antigliadin), autologous (to parietal cells, microsome mitochondria, tissue transglutaminase) antibodies, formation of immune complexes, autoimmune reactions and secondary immunodeficiency are specific immune mechanisms of the pathological process development, its synchronization and progression in patients with alimentary system diseases. Changes in the immunological status indices are expressed in varying degree depending on the organ involved, etiological factor, clinical course and stage of the disease, as well as treatment used. The immunological status indices have maximal values in cases of chronic hepatitis, hepatic cirrhosis, peptic or duodenal ulcer, cholelithiasis, chronic pancreatitis, gluten-sensitive enteropathy and minimal values in cases of chronic gastritis, gastroesophageal disease, steatohepatitis and irritable bowel syndrome. These data are sufficient for developing an algorithm of immune diagnostics for a number of alimentary system diseases. The study of immune status indices is of great diagnostic and prognostic value as it defines the etiological factor, intensity of inflammatory, infectious and autoimmune processes as well as disease stage and activity, its forecast and the efficacy of treatment of alimentary system diseases.
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PMID:[Diagnostic and prognostic value of humoral immune status indices for alimentary system diseases]. 1753 52

The GI endoscopy can be divided into upper GI tract endoscopy (oesophago-, gastro-, entero-, fistulo- and cholangioscopy) and lower GI tract endoscopy (recto-, sigmo-, colonoscopy) from practical point of view and the characteristic of used equipment. A lot of therapeutic methods for GI tract is associated with each of these procedures. GI tract endoscopy doesn't play significant part in diagnosis of acute and chronic hepatitis. Significance of endoscopy procedures decidedly increases in the case of progressive liver fibrosis and liver cirrhosis, where changes in GI tract are observed to 87% patients. These changes can be divided into: 1) not associated with portal hypertension, 2) these ones caused by portal hypertension. The most observed changes not associated with portal hypertension involve: reflux esophagitis, esophageal candidiasis; different variants of gastritis, gastric and duodenal ulcer. To the changes connected with portal hypertension, which are possible for endoscopy assessment, belongs esophageal and gastric varices, portal gastro-, entero-, colopathy, and gastric antral vascular ectasiae (GAVE). However to-day endoscopy has got not only diagnostic significance but also enables therapy of acute GI bleeding in this group of patients., the primary and secondary prophylaxis of bleedings from GI varices (particulary endoscopy band ligation-EBL) as well as estimation of pharmaco- and surgical therapy efficiency.
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PMID:[Diagnosis and therapy of portal hypertension with special reference to endoscopic methods]. 1768 53

Proton pump inhibitors (PPI) are very effective in inhibiting acid secretion and are extensively used in many acid related diseases. They are also often used in patients with cirrhosis sometimes in the absence of a specific acid related disease, with the aim of preventing peptic complications in patients with variceal or hypertensive gastropathic bleeding receiving multidrug treatment. Contradicting reports support their use in cirrhosis and evidence of their efficacy in this condition is poor. Moreover there are convincing papers suggesting that acid secretion is reduced in patients with liver cirrhosis. With regard to Helicobacter pylori (H pylori) infection, its prevalence in patients with cirrhosis is largely variable among different studies, and it seems that H pylori eradication does not prevent gastro-duodenal ulcer formation and bleeding. With regard to the prevention and treatment of oesophageal complications after banding or sclerotherapy of oesophageal varices, there is little evidence for a protective role of PPI. Moreover, due to liver metabolism of PPI, the dose of most available PPIs should be reduced in cirrhotics. In conclusion, the use of this class of drugs seems more habit related than evidence-based eventually leading to an increase in health costs.
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PMID:Proton pump inhibitors in cirrhosis: tradition or evidence based practice? 1849 46

We describe the case of a 46-year-old man admitted for upper gastrointestinal bleeding in the context of cirrhosis. A deep bleeding duodenal ulcer was treated by sclerotherapy. Abdominal pain and fever lead us to perform an abdominal computed tomography, which demonstrated emphysematous cholecystitis. An emergency cholecystectomy was performed and antimicrobial therapy initiated. The patient recovered uneventfully. Links between ulcers and emphysematous cholecystitis are discussed.
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PMID:Upper gastrointestinal bleeding related to emphysematous cholecystitis due to Clostridium perfringens. 1966 Sep 73

A 48-year-old Indian male with alcoholic liver cirrhosis was admitted after being found unresponsive. He was hypotensive and had hematochezia. Esophagogastroduodenoscopy (EGD) showed small esophageal varices and a clean-based duodenal ulcer. He continued to have hematochezia and anemia despite blood transfusions. Colonoscopy was normal. Repeat EGD did not reveal any source of recent bleed. Twelve days after admission, his hematochezia ceased. He refused further investigation and was discharged two days later. He presented one week after discharge with hematochezia. EGD showed non-bleeding Grade 1 esophageal varices and a clean-based duodenal ulcer. Colonoscopy was normal. Abdominal computed tomography (CT) showed liver cirrhosis with mild ascites, paraumbilical varices, and splenomegaly. He had multiple episodes of hematochezia, requiring repeated blood transfusions. Capsule endoscopy identified the bleeding site in the jejunum. Concurrently, CT angiography showed paraumbilical varices inseparable from a loop of small bowel, which had herniated through an umbilical hernia. The lumen of this loop of small bowel opacified in the delayed phase, which suggested variceal bleeding into the small bowel. Portal vein thrombosis was present. As he had severe coagulopathy and extensive paraumbilical varices, surgery was of high risk. He was not suitable for transjugular intrahepatic porto-systemic shunt as he had portal vein thrombosis. Percutaneous paraumbilical embolization via caput medusa was performed on day 9 of hospitalization. Following the embolization, the hematochezia stopped. However, he defaulted subsequent follow-up.
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PMID:Percutaneous paraumbilical embolization as an unconventional and successful treatment for bleeding jejunal varices. 1967 28

Helicobacter pylori (H. pylori) is a major etiological factor of peptic ulcer disease (PUD). It is supposed to be a risk factor for the more frequently encountered PUD in patients with liver cirrhosis. Several investigators have evaluated the effect of H. pylori on liver cirrhosis, portal hypertensive gastropathy (PHG) and encephalopathy with controversial results. Some reports have shown a higher seroprevalence and suggested a synergistic effect of H. pylori on liver cirrhosis and PHG. However, this increased prevalence is associated with a negative histology and is not influenced by the cause of cirrhosis, PHG, Child class or gender. Most studies have not found any correlation between H. pylori and PHG. In contrast, other studies have reported a markedly lower prevalence of H. pylori in cirrhotics with duodenal ulcer compared to controls. The aim of this article is to review the relationship between H. pylori infection and portal hypertensive gastropathy and the role of H. pylori eradication in cirrhotic patients.
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PMID:Does Helicobacter pylori affect portal hypertensive gastropathy? 1985 22

The patient was a 62-year-old woman with a personal history of chronic alcoholism and a medical history of duodenal ulcer, congestive heart failure, atrial fibrillation, dilated cardiomyopathy, and recurring urinary tract infections. She had osteoporosis, cirrhosis of the liver and portal hypertension. She had undergone surgery for multiple arm fractures after an accidental fall in the previous year and had received NSAIDs without concomitant gastric protection. On the fourth day of hospitalization she had an episode of haematemesis. The patient continued to take NSAIDs as required, as well as habitual medication of propranolol 40 mg/day, spironolactone 25 mg/day, furosemide 40 mg/day, pantoprazole 40 mg/day and strontium 2 g/day. Upper digestive endoscopy (UDE) revealed level I/II (Baveno) oesophageal varicose veins with no signs of haemorrhage and portal hypertensive gastropathy. The duodenal bulbous was deformed by an extensive ulcer with blood clots and one vessel was visible along the antero-superior portion (Forrest IIa classification). Numerous superficial ulcers with haemosiderin pigment at D2 were observed. Endoscopic haemostasis was achieved with epinephrine and bipolar probe. Food was suspended and the patient received continuous intravenous treatment with pantoprazole 8 mg/h. UDE repeated after 48 hours showed no signs of haemorrhaging from the ulcer. After 72 hours, the pantoprazole dose was changed to 40 mg every 12 hours and food was allowed. After 12 days with no recurrence of the haemorrhagic incident, the patient was prescribed oral pantoprazole 40 mg once daily and released from hospital.
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PMID:Recurrent duodenal ulcer due to nonsteroidal anti-inflammatories following the suspension of antiulcer medication. 1993 84

Our patient was a 70-year-old man with hepatocellular carcinoma (HCC) and liver cirrhosis (Child-Pugh B). He had a history of distal gastrectomy with Billroth II reconstruction for duodenal ulcer and hepatectomy for HCC. One month after percutaneous radiofrequency ablation (RFA) for recurrent HCC, biliocutaneous fistula was observed. The cholangiogram demonstrated leakage of contrast material from an intrahepatic duct into the fistula, and a nasobiliary catheter was placed. Subsequently, the discharge of bile steadily decreased and stopped. Follow-up cholangiogram revealed no evidence of bile leakage. Biliocutaneous fistula is an extremely rare complication after percutaneous RFA, and the present case report suggests that endoscopic drainage is the first-line therapy for bile leaks after RFA.
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PMID:Endoscopic management of biliocutaneous fistula after percutaneous radiofrequency ablation therapy for hepatocellular carcinoma. 2007 66

It has been clearly established that Helicobacter pylori (H. pylori) infection plays a pivotal role in the pathogenesis of chronic gastritis, peptic ulcer, gastric adenocarcinoma, and gastric lymphoma MALT (mucosa-associated lymphoid tissue) in the general population, but data regarding the prevalence and the role of H. pylori infection in liver cirrhosis are conflicting. Most serological studies estimated a high prevalence of H. pylori infection in patients with liver cirrhosis; however, when other methods (urea breath test, histology, culture, rapid urease test) were used, the overall H. pylori prevalence was similar to that in controls. Although the prevalence of both gastric ulcer (GU) and duodenal ulcer (DU) is higher in cirrhotic patients than in general population, the relationship between H. pylori infection and peptic ulcer in cirrhosis remains controversial. Our data regarding peptic ulcer prevalence in cirrhotic patients are in agreement with previous studies that suggest an increased prevalence of both GU and DU. The incidence of bleeding peptic ulcer is high in cirrhotic patients and carries an increased risk of complications or death in these patients and therefore eradication of H. pylori infection might be as effective in preventing ulcer relapse and bleeding as it is in noncirrhotic ulcer patients. Hepatic encephalopathy is a frecquent complication of liver cirrhosis, and it is widely accepted that ammonia plays a major role in its pathogenesis. The ammonia production by H. pylori urease does not increase blood ammonia levels during cirrhosis, and eradication of H. pylori infection does not affect hepatic encephalopathy status.
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PMID:[Prevalence and role of Helicobacter pylori infection in some gastroduodenal and hepatic complications in cirrhotic patients]. 2020 58

On the basis of working materials of the Novosibirsk regional consultative and diagnostic center, the prognostic significance of functional diagnosis methods and consultative care was demonstrated. It was found that methods of echocardiography are important in forecasting the prevalence of ischemic heart disease, arterial hypertension, congenital and acquired valvular disease. The consultative care acquires significance in detecting diseases of the thyroid gland, bronchial asthma, hypertonic disease, urolithic disease, duodenal ulcer, chronic hepatitis and cirrhosis of the liver, allergic rhinitis.
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PMID:[The functional methods of examination and consultative care at diagnostic centers]. 2049 95


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