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

The influence of alimentation on the digestive pathology is very important. In this report the authors review the principal results of epidemiologic studies and animals experimentations. According to this survey of the literature it can be stated that some presumptions exist for: -- the responsibility of diet without vegetal fibers in the frequency of constipation, colonic divercitular disease, piles and hiatal hernia. The comparison of the alimentary habits in the western Europe with rural Africa is very instructive on that matter; -- the responsibility of alcohol consumption, use of hypercaloric regimen and hyperlipidic ingestats as causative factors for chronic pancreatitis; -- the importance of an hypercaloric, hyperlipidic and low residue regimen as etiologic factors in biliary gallstones; -- the role of denutrition and alcoholism in liver steatosis and cirrhosis in developed country; -- more important, perhaps, is the suspicion of the role of nutrition in the development of digestive cancer: alcohol will facilitate oesophageal cancer, alimentary nitrites gastric cancer meanwhile fiberless regimen and biles salts will promote colonic cancer. Impairments of nutrition observed after digestive resections in case of inappropriate alimentation are also analyzed as well as the principal alimentary disturbances related to allergy or enzymatic deficiency.
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PMID:[Dietary behavior and digestive diseases]. 82

A 46-year-old man with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension.
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PMID:Thrombosed hemorrhoid mimicking rectal carcinoma at CT. 138 55

The relationship of stature with the prevalence of 18 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 63,859 individuals aged 20 or over randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the Italian population. Rate ratios (RR) were computed using multiple logistic regression, including terms for sex, age, geographical area, education and smoking. For 15 out of 18 diseases or groups of diseases the RR was below unity in the highest quartiles of height, and the inverse trends with stature were significant for 11 (diabetes, RR 0.90 for highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71; arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the diseases considered showed significant direct trends with height, but hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest quartile of height. The generalised inverse relationship between height and prevalence of chronic disease suggests that poorer nutrition in childhood and adolescence is an unfavourable indicator for the subsequent occurrence of several diseases. Major exceptions were hypertension and varices, two conditions highly dependent on the pattern of health care utilization, and cancer.
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PMID:Height and the prevalence of chronic disease. 160 29

A prospective study was performed to evaluate the prevalence of anorectal varices and their clinical significance as well as to study other proctosigmoidoscopic changes in 75 patients with portal hypertension of diverse etiology. Sixty-seven patients (89.3%) had lower gastrointestinal varices with no significant difference (p greater than 0.05) in prevalence between cirrhosis (92.1%), noncirrhotic portal fibrosis (87%), and extrahepatic portal venous obstruction (85.7%). The rectum was the most common site of lower gastrointestinal varices. External anal and sigmoid colonic varices almost always occurred in the presence of rectal and/or internal anal varices. There was no correlation between the presence of rectosigmoid varices and the severity of esophagogastric mucosal changes or portal hypertension. There was no suggestion that esophageal variceal sclerotherapy influenced the presence of anorectal varices. Seven patients (9.3%) had recent hematochezia, including three patients in whom it occurred in the absence of any upper gastrointestinal hemorrhage. Varices were the cause of bleeding in at least five patients. An abnormal mucosal vascular pattern in the form of telangiectasias or spiders was seen, irrespective of etiology of portal hypertension, in nine patients (12%). Hemorrhoids were present in 31 patients (41.3%) with an age-related difference (p less than 0.05) between patients with cirrhosis (55.3%) and extrahepatic portal venous obstruction (21.4%).
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PMID:Rectosigmoid varices and other mucosal changes in patients with portal hypertension. 188 98

The causes of gastrointestinal bleedings was assessed by fiber gastroscopy, rectoromanoscopy and fiber colonoscopy. The most frequent causes of bleedings from the upper gastrointestinal tract are gastric and duodenal ulcers, erosive hemorrhagic gastritis, gastric cancer, liver cirrhosis with bleeding from varicose veins, polyps, diverticuli, Mallory-Weiss syndrome, etc. The most frequent causes of bleedings from the lower gastrointestinal tract are hemorrhoids, anal fissures, colonic polyps, chronic ulcerohemorrhagic colitis, rectal carcinoma, etc. The diagnostic importance of urgent endoscopic examinations is pointed out.
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PMID:[Endoscopic assessment of hemorrhage from the gastrointestinal tract]. 189 7

Colonic disease is relatively uncommon in cirrhosis. To determine the prevalence of colonic lesions in cirrhosis of all types, cirrhotics evaluated for possible liver transplantation underwent combined pan upper endoscopy and colonoscopy. The patients were divided into two main groups, 248 with parenchymal liver disease (nonviral and viral) and 164 with cholestatic liver disease. The prevalence of the various colonic lesions identified was: polyps, 8.4%; nonspecific edema, 19.9%; inflammatory changes, 11.6%; hemorrhoids, 25.2%; and rectal varices, 3.6%. Normal findings were present in 42.4%. Except for an increased prevalence (P less than 0.05) of edema and a reduced prevalence (P less than 0.001) of inflammatory changes in the parenchymal liver disease group, the prevalence for all other lesions was similar in the two groups. Esophageal varices were present in most patients with hemorrhoids and in all with rectal varices. The degree of portal hypertension and/or disease severity was associated with hemorrhoids but not with rectal varices. The higher prevalence of inflammatory changes in the cholestatic group was because one fourth of this group had an inflammatory bowel disease.
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PMID:Colonic disease in cirrhosis. An endoscopic evaluation in 412 patients. 234 25

In a prospective study of 100 consecutive patients with cirrhosis, 44% had anorectal varices. The prevalence of anorectal varices rose with progression of portal hypertension; it was 19% in cirrhotic patients without portal hypertension compared with 59% in those who had bled from oesophageal varices. There was no evidence that endoscopic sclerotherapy directly increased the prevalence of anorectal varices. Haemorrhoids occurred independently of anorectal varices and their presence was unrelated to the degree of portal hypertension. These data provide further evidence that haemorrhoids and anorectal varices are separate and distinct entities. However, both can bleed and careful examination is essential to prevent misdiagnosis and inappropriate treatment.
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PMID:Anorectal varices, haemorrhoids, and portal hypertension. 256 7

The relation between body mass index and prevalence of 17 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 72,284 individuals aged 15 or over randomly selected within strata of geographical area, size of place of residence and of household in order to be representative of the whole Italian population. The prevalence of diabetes was directly and strongly related to body weight (age-adjusted relative risk estimates being 1.5 for overweight and 2.7 for obese men compared with normal weight individuals; 1.6 and 2.4 for overweight and obese women). Other conditions directly related to self-reported measures of body weight were hypertension (relative risk = 1.7 for obese men and 1.9 for women), myocardial infarction (relative risk = 1.5 for obese men, 1.6 for women), other heart diseases (relative risk = 1.7 for obese men, 1.5 for women), haemorrhoids or varices (relative risk = 1.2 for obese men, 1.5 for women), cholelithiasis (relative risk = 1.2 for obese men, 1.4 for women), urolithiasis and arthritis. Chronic respiratory disorders showed a U-shaped relation to measures of body weight, since their prevalence was elevated in both under- and over-weight individuals. Anaemias and gastroduodenal ulcer showed an inverse relation to body weight, whereas no association was apparent with allergy, liver cirrhosis, and psychiatric or neurological disorders. Allowance for the two major identified covariates (education and smoking) failed to explain the observed variations between measures of body weight and disease, while separate inspection of various strata of age indicated that for most diseases the elevated risks of obesity were higher in younger and decrease steadily with advancing age. Thus, the results of this national survey indicate that overweight has a widespread and substantial impact not only on mortality but also on morbidity from different chronic conditions.
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PMID:Body weight and the prevalence of chronic diseases. 341 82

The relation between education, prevalence of 17 chronic diseases or groups of diseases, and pattern of health care utilisation was evaluated from data from the 1983 Italian National Health Survey, based on 58 462 individuals aged 25 or over randomly selected within strata of geographical area, size of place of residence, and size of household, in order to be representative of the whole Italian population. Most of the diseases considered, including diabetes, hypertension, myocardial infarction and other heart disease, haemorrhoids or varices, chronic respiratory disease, anaemias, gastroduodenal ulcer, cholelithiasis and liver cirrhosis, kidney and urological diseases, arthritis, and psychiatric and neurological disturbances, were consistently less prevalent among more educated individuals. The age and sex adjusted risk estimates for individuals educated in high school or university compared with those with only a primary school education or less ranged between 0.21 for liver cirrhosis and 0.80 for anaemias. The sole exception was allergy, which was more prevalent among the more educated individuals (relative risk = 1.42). General practitioner visits and hospital admissions were reported less frequently by the more educated individuals, but specialist consultations of potential preventive value were less frequent among the less well educated. The results were similar when occupation was utilised as an indicator of social class. Thus, the findings of this national survey provide confirmation and quantitative assessment of considerable differences in health and health service utilisation according to indicators of social class.
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PMID:Education, prevalence of disease, and frequency of health care utilisation. The 1983 Italian National Health Survey. 365 37

A personal case series triggers an examination of surgical risk in patients with uncomplicated cirrhosis of the liver. After a general introduction the conditions that increase surgical risk in cirrhotic patients are analysed. These include generally poor resistance, altered haemostasis, a tendency towards cholestasis, water retention and hepatic encephalopathy. The conditions most often requiring surgical treatment are then considered. They include associated pathologies (cholelithiasis, hernias, tooth extractions, bleeding haemorrhoids etc) and complications of cirrhosis variceal bleeding, intractable ascites, splenomegaly, hepatocytoma).
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PMID:[Internal medicine evaluation of the surgical risk in cirrhosis patients]. 382 13


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