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)

Two hundred fifty pediatric (less than 18 years of age) patients underwent orthotopic liver transplantation because of end-stage liver disease and were given combination therapy with cyclosporine and prednisone. The most common indications for transplantation in decreasing order of frequency were biliary atresia, inborn errors of metabolism, and postnecrotic cirrhosis. The 5-year actuarial survival for the entire group was 69.2%. Age and diagnosis did not influence survival. Infections were the most common cause of death, followed by liver failure and cerebrovascular accident. The impact of retransplantation on survival depends on the indication. The survival is better when retransplantation is carried out after rejection than because of technical complications, and the latter has a better survival than does primary graft nonfunction. The difference in survival among these groups is statistically significant. The quality of life for 164 of 173 survivors is good to excellent; only nine children are currently experiencing medical problems. A persistent problem in pediatric transplantation is the scarcity of small donors.
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PMID:Indications for pediatric liver transplantation. 331 78

Chronic evolution after acute hepatitis B virus infection. During a 13 months period 1977-1978 a total of 129 cases of acute viral hepatitis type B occurred among patients who were admitted with hepatitis to Roslagstull, Hospital, Stockholm, Sweden. Less than 1% progressed to chronicity. Prevalence of Delta superinfection was studied among 60 patients with chronic hepatitis B. Nineteen (32%) were anti-delta positive. The majority of the positive patients were either non-European immigrants or addicts, both 9/19 (47%). Infections with the delta agent was found to have occurred in Stockholm already in the early 1970s. Rate of HBeAg clearance during chronic HBV was studied among 36 HBeAg positive patients. Seroconversion to anti-HBe was noted in 17 patients (47%), whereas HBeAg persisted in 19 during a mean follow-up period of 53 months. The spontaneous annual HBeAg seroconversion rate was 11%. HBeAg clearance occurred as frequently among homosexual men as among patients in other categories. However, 12/14 homosexual men were HBeAg positive after 2 years follow-up, compared with 1/13 drug addicts. Thus, homosexual men seemed to require a longer time for HBeAg seroconversion than i.v. drug addicts. HBV-DNA in serum, a strong indicator of viral particles and infectivity was analysed among patients with HBeAg seroconversion, initial HBeAg negativity and/or delta superinfection. HBV-DNA was found in 75-80% of our HBeAg positive patients. A correlation between chronic liver disease and presence of HBV-DNA in serum was also found. Thus, HBV DNA was found in 63% of patients with CAH or CAH/CI as compared with only 39% of patients with CPH. Delta infected patients had HBV-DNA more often than those without hepatitis D infection. Seven delta infected, anti-HBe positive, patients were still HBV-DNA positive five to eight years later. Therefore delta infected anti-HBe positive patients can be infectious for prolonged periods. Histological outcome. 63% (12/19) anti-delta positive patients were classified as CAH with or without cirrhosis as against 39% (16/41) of the anti-delta negative patients. Eleven of 15 homosexual men (73%) had histological findings classified as CAH or CAH/CI. None of them were superinfected with HDV. Thus homosexual men developed severe hepatic lesions without being delta infected. In contrast 78% (7/9) i.v. drug addicts with CAH were delta infected. A numerical scoring system was applied and compared with conventional morphological classification of liver histology to assess the histological outcome of 42 patients with repetitive liver biopsies.
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PMID:Chronic hepatitis B. Impact of hepatitis D virus superinfection and the hepatitis B e-system on histological outcome, and correlation of the hepatitis B e-system to HBV-DNA in serum. 346 8

The frequency of infection at the time of admission with upper gastrointestinal haemorrhage has been determined in 149 successive cirrhotic patients admitted to an intensive care unit. Infection status was investigated by clinical examination, chest X-ray, and blood, urine and ascitic fluid culture. At initial examination infection was present in 32 patients (22 per cent) and was often in the form of septicaemia or spontaneous peritonitis; the bacteria responsible were frequently digestive in origin. At endoscopy, acute lesions of gastroduodenal mucosa were more frequent among infected patients, whereas gastro-oesophageal varices and chronic gastroduodenal ulcers were more frequent among the non-infected patients. Acute mucosal lesions were observed in 70 per cent of infected patients and in 19 per cent of non-infected patients. The mortality rate was higher in infected patients. Infection and the frequency of acute mucosal lesions were related to the severity of the cirrhosis. It is suggested that these lesions could be due to stress secondary to infection.
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PMID:Frequency of infections in cirrhotic patients presenting with acute gastrointestinal haemorrhage. 348 99

The significance of megamitochondria in the alcoholic liver injury of humans was investigated as part of a large Veterans Administration cooperative study of the natural history of alcoholic hepatitis. Two hundred twenty patients were clinically stratified into the following three groups according to disease severity using serum bilirubin and prothrombin time as indicators: Group 1 (mild disease), serum bilirubin levels less than 5 mg/dl and prothrombin time prolonged for less than 4 s; group 2 (moderate disease), serum bilirubin levels greater than 5 mg/dl but prothrombin time prolonged for less than 4 s; and group 3 (severe disease), serum bilirubin levels greater than 5 mg/dl and prothrombin time prolonged for greater than 4 s. Megamitochondria were observed in 20% of the patients (45 of 220). Of these, 43 patients were in groups 1 and 2 of severity and only 1 patient belonged in group 3. The association of megamitochondria with cirrhosis was infrequent (33%, 15 of 45 patients). The differences in severity correlated with the differences in mortality: in patients with megamitochondria, only 1 had died at 6 mo compared with 40 deaths in patients without megamitochondria. By 12 mo, there were two deaths in patients with megamitochondria versus 51 deaths in those patients without. No complications were present in 72% of patients with megamitochondria versus 39% for those without. Infection, gastrointestinal bleeding, pancreatitis, hyperglycemia, azotemia, delirium tremens, seizures, and hepatic encephalopathy were all more common in patients without megamitochondria. The patients with megamitochondria appear to represent a subcategory of alcoholic hepatitis with a milder degree of clinical severity, lower incidence of cirrhosis, fewer complications, and good long-term survival.
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PMID:Significance of megamitochondria in alcoholic liver disease. 369 4

In a five-year retrospective study, there were 57 episodes of bacteremia among 1623 admissions (3.5%) of patients suffering from cirrhosis. Gram-positive bacteria were found in 70% of the episodes, gram-negative bacteria in 30%. All of the gram-positive bacteria found were fully sensitive to methicillin and to gentamicin. The gram-negative bacteria found were all sensitive to gentamicin, but only 50% were sensitive to ampicillin. The distribution between gram-positive and gram-negative bacteria was the same, irrespective of whether the patients acquired the infection inside or outside the hospital. More than 50% of the patients suffered from one or more of the following complications of cirrhosis: ascites, encephalopathy and haematemesis. Twenty-one patients died within seven days after the bacteremia was diagnosed. Bacteremia is a serious complication of advanced cirrhosis, and it is recommended that adequate antibiotic treatment is started when septicemia is suspected.
Infection
PMID:Bacteremia in patients suffering from cirrhosis. 371 May 95

The majority of staghorn calculi (branched calculi)--25 per cent bilateral--is mainly composed of calcium phosphates, in about 2/3 with varying fractions of Struvite. Pure Struvite stones are rare. Large fractions of Struvite form a soft concrement. Infection with urea splitting bacteria arises ascending, therefore predominantly in female kidneys, except for the first decennium. Staghorn calculi without Struvite (1/3 of our cases), show extremely large growth and sterile urine. Some Struvite stones have sterile urine or Struvite without urea splitting bacteria. The shape of branched calculi depends on the form of hilus renalis and the aggressiveness of the alkaline urine and the infection. Renal cirrhosis--almost always present--follows bacterial or abacterial obstruction, depending on the degree of vascular obliteration by reactive fibrosis of the intima, with or without pyonephrotic, xanthomatous necrosis, similar to renal tuberculosis. The so-called "large stone kidney" is obstructive, aseptic and lipomatous special form of staghorn calculus and cirrhosis. Stone formation and grade of cirrhosis may be determined by tomography.
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PMID:[Classification of staghorn calculus disease of the kidney based on 105 personal cases and a review of the literature]. 371 38

Using the enzyme-linked immunosorbent assay (ELISA), the prevalence rates for hepatitis B virus surface antigen (HBsAg), antibody to core antigen (anti-HBc), and antibody to surface antigen (anti-HBs) were studied among 325 school children and those seeking treatment for minor ailments in Gizan City, Saudi Arabia. Tests for hepatitis B virus e antigen (HBeAg), antibody to HBeAg (anti-HBe), IgM antibody to HBV core antigen (IgM anti-HBc) and antibody to delta-virus were made in HBsAg carriers. There was a serological evidence of HBV infection in 91 (28%) Saudis of which 11.1% were HBsAg carriers, 9.5% positive for anti-HBs and 7.4% positive only for anti-HBc. There was no intersex difference for positivity for HBsAg, anti-HBs and anti-HBc. The evidence of existing or earlier infection was higher in females. Among HBsAg carriers, none of the 24 was positive for IgM anti-HBc, 12% were positive for HBeAg or anti-HBe. Anti-delta antibody was present in one of the nine carriers tested. HBV infection in Gizan City is acquired fairly early during childhood with little clinical evidence suggestive of an acute hepatitis. Immunization against HBV should be considered in the neonatal period to prevent the long term sequelae of HBV, like cirrhosis and primary hepatocellular carcinoma.
Infection
PMID:Hepatitis B virus among Saudi children in Gizan, Saudi Arabia. 379 37

Hepatitis B virus (HBV) infections occur world-wide and more than 200 million people have been estimated to be chronic carriers of HB surface antigen (HBsAg). Long-term chronic carriage of HBsAg has been associated with an increased risk of chronic active hepatitis (CAH), cirrhosis and hepatocellular carcinoma (HCC). In Western countries, the prevalence of HBV infection is low in the general population. Only particular subgroups, for the most part adults, are at risk of such infections: health care workers, haemodialysis patients, transfusion patients, drug abusers and homosexuals. In Asia and tropical Africa, however, the prevalence of HBV infection is relatively high. Transmission occurs mainly during the perinatal period and infancy. Infection at a young age often results in the chronic carrier state. A hepatitis B vaccine has been developed in France and has been demonstrated to be safe, immunogenic, and effective in preventing HBV infection. Extensive experience from clinical trials now makes it possible to recommend vaccination strategies in terms of target populations and of optimal schedules. This paper reports the results of hepatitis B vaccination and, in particular, presents an overview of the vaccination experience in newborns and children.
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PMID:Hepatitis B vaccine: clinical experience. 624 47

Of 209 patients with liver disease attending the Al Qassimi Hospital, Sharjah, 172 were suffering from acute hepatitis. The proportion harbouring the hepatitis B surface antigen was unknown. Of the remainder, 10 were suffering from chronic active hepatitis, five from primary hepatoma and six from cirrhosis. Infection with hepatitis virus B was regarded as of aetiological significance in three cases of chronic active hepatitis, four of primary hepatoma and two of cirrhosis.
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PMID:The spectrum of liver disease in the United Arab Emirates. 627 80

The prevalence, epidemiology and consequences of delta infection were analysed in 60 patients attending the Roslagstull Hospital for Infectious Diseases, Stockholm, Sweden, between 1972 and 1982. All of the patients had biopsy-documented chronic hepatitis B. Using radioimmunoassay techniques, sera from all patients were tested for antibodies to hepatitis A virus, for hepatitis B surface antigen and the corresponding antibody, for antibodies to hepatitis B core antigen, for hepatitis B e antigen and the corresponding antibody and for antibodies to delta antigen. All 60 patients underwent a liver biopsy which was repeated in 28 patients. 32% of the patients (19/60) were found to be anti-delta positive. The majority of the anti-delta positive patients were either immigrants from non-European countries or addicts (both 9/19 or 47%). Infections with delta agent were found to have already occurred in the Stockholm region in the early 1970s. During the study period, four of the patients developed clinical and laboratory signs of acute hepatitis in association with a delta infection. Among the anti-delta positive patients, 63% (12/19) were classified as having chronic active hepatitis, with or without cirrhosis, as against 39% (16/41) of the anti-delta negative patients. Histological progression to cirrhosis was observed in two of the four anti-delta positive patients with initial chronic active or chronic persistent hepatitis.
Infection
PMID:Delta infection among patients with chronic hepatitis B in the Stockholm region. 670 9


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