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)

This retrospective study was done to stress the particular features of perforation of the gastroduodenal ulcer in patients with cirrhosis. From 1979 to 1987, 135 patients were operated upon for perforation of the gastroduodenal ulcer: clinical, biologic and roentgenographic data of 22 patients with cirrhosis were compared with 112 patients without cirrhosis. In the 22 patients with cirrhosis, three gastrectomies and 19 simple closures with omental patch were performed. Clinical ascites was present in 16 of 22 patients with cirrhosis. Acute abdominal pain and leukocytosis were less frequent in patients with cirrhosis (p less than 0.05), whereas associated bleeding in the upper part of the gastrointestinal (GI) tract was more frequent (p less than 0.05). In patients with cirrhosis, abnormal plasma creatinine level and associated upper GI bleeding were more frequent in patients with ascites (p less than 0.05); on the other hand, acute abdominal pain and rebound tenderness were less frequent (p less than 0.05). The incidence of pneumoperitoneum was higher in patients with cirrhosis. Surgical treatment was significantly delayed in patients with cirrhosis and ascites. Ulcers were larger in patients with cirrhosis and ascites than without (p less than 0.001). Over-all morbidity and mortality rates in patients with cirrhosis were 77.3 and 50.0 per cent, respectively. Mortality and morbidity were significantly higher in patients with ascites than without (62.5 versus 16.6 and 100 versus zero per cent, respectively), in patients with prothrombin times of less than 50 per cent and with plasma creatinine levels more than 110 micromolars.
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PMID:Gastroduodenal ulcer perforation in the patient with cirrhosis. 155 8

The discovery and subsequent clinical application of somatostatine, a polypeptide neurohormone of 14 amino acids, and of its analogs, opens a novel chapter of neuroendocrinology that is still in full evolution and to a large extent unknown. The isolation of an octapeptide, a selective somatostatine analog, permits to prolong its action, in fact it has a halflife of about 140 min in old subjects and about 100 min. in the young. Thanks to its excellent tolerability, the synthetic hormone can be usefully applied in the treatment of acromegaly, gigantism and hypersomatotropinemic conditions in general, and even in other clinical branches, such as treatment of esophageal hemorrhage due to the rupture of varices in liver cirrhosis or to erosion of gastric blood vessels in patients suffering from peptic ulcer disease.
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PMID:[New prospects in the therapeutic use of somatostatin and its derivatives]. 167 25

Somatostatin, originally detected by Krulich and ultimately isolated by Brazeau, was initially described as a growth hormone release-inhibiting factor. Subsequent investigation into the use of native somatostatin and the development of long-acting somatostatin analogues, especially octreotide acetate, have fostered increasing uses of these compounds. Though the clinical and investigational uses of somatostatin and its analogues are varied, one central theme remains constant: the ability of these agents to suppress circulating peptide levels. This article, a review of the current non-endocrine applications of somatostatin and its analogues, covers a wide range of potential applications for somatostatin-like compounds. These include use in cirrhosis and variceal bleeding, peptic ulcer disease, pancreatic fistulas, acute and chronic pancreatitis, dumping syndrome, cancer therapy, small bowel fistulas, psoriasis, pain control, and autonomic hypotension. Somatostatin may also play a role in the development and potential treatment of neurologic disease and may have profound found influence on behavior.
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PMID:Non-endocrine applications of somatostatin and octreotide acetate: facts and flights of fancy. 168 32

Recurrent bleeding after stapled oesophageal transection was studied in 73 patients with cirrhosis transected for acute variceal bleeding. The most frequent source of bleeding was partial or total circumferential oesophageal erosion at the transection: staple-line erosion. This lesion occurred in 36 (49 per cent) patients and was the source of rebleeding in 29 (40 per cent) patients with 54 episodes. Rebleeding in 22 (30 per cent) patients was due to varices in nine (12 per cent), peptic ulcer in six (8 per cent), gastric erosions in two (3 per cent) and unknown sources in five (7 per cent), accounting for 33 episodes. The mean(s.e.m.) blood transfusion requirement for bleeding from staple-line erosions were 1.5 (0.25) units per bleed versus other sources, 6.5(1.0) units per bleed (P less than 0.001). Staple-line erosion was present at the first postoperative endoscopy in 11 (15 per cent) patients but the time to appearance varied widely. The lesion was more common in patients with Pugh's grade A liver disease at the time of transection, reflecting the increased survival rate of these patients. Staple-line erosion is a common source of minor recurrent bleeding following stapled oesophageal transection.
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PMID:Staple-line erosion: a common source of recurrent bleeding following stapled oesophageal transection. 164 94

Famotidine is a potent histamine H2-receptor antagonist widely used in the treatment and prevention of peptic ulcer disease. After intravenous administration the plasma famotidine concentration-time profile exhibits a biexponential decay, with a distribution half-life of about 0.18 to 0.5h and an elimination half-life of about 2 to 4h. The volume of distribution of the drug at steady-state ranges from 1.0 to 1.3 L/kg; plasma protein binding is low (15 to 22%). Famotidine is 70% eliminated unchanged into urine after intravenous administration. The total body and renal clearances of famotidine correlate significantly with creatinine clearance. Because its renal clearance (15 L/h) far exceeds the glomerular filtration rate, famotidine is considered to be eliminated not only via glomerular filtration but also via renal tubular secretion. Since its clearance is reduced in patients with renal insufficiency and in elderly patients, the maintenance dosage should be reduced in these patient groups. Removal of famotidine by any of the currently employed blood purification procedures (haemodialysis, peritoneal dialysis and haemofiltration) does not occur to a clinically significant degree. Liver cirrhosis does not appear to affect the disposition of famotidine unless severe renal insufficiency coexists. After oral administration, peak plasma concentrations are attained within 2 to 4h; the oral bioavailability ranges from 40 to 50%, due mainly to incomplete absorption. The oral absorption of the drug is dose-independent within a range of 5 to 40 mg. There are 3 formulations available (tablet, capsule and suspension), which appear to be bioequivalent. Coadministration of potent antacids reduces the oral absorption of famotidine by 20 to 30%. On a weight-to-weight basis, the antisecretory effect of famotidine is about 20 and 7.5 times more potent than those of cimetidine and ranitidine, respectively. Plasma famotidine concentrations correlate with its antisecretory effect: values of about 13 and 20 micrograms/L produce a 50% reduction in the gastrin-stimulated gastric acid secretion and a fasting intragastric pH of greater than 4, respectively. Available data suggest that famotidine interacts neither with the hepatic oxidative drug metabolism nor with the tubular secretion of other commonly used therapeutic agents. However, further studies are required to evaluate a full spectrum of its drug interaction potential.
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PMID:Clinical pharmacokinetics of famotidine. 176 69

The purpose of this study was to investigate whether any specific causes of death were more frequent than expected in an Australian group of 305 gastric ulcer patients (131 men, 174 women) who had died in New South Wales between 1 January 1974 and 31 December 1983. The distribution of causes of death among the ulcer population deaths was compared with that among the New South Wales population deaths, after adjusting for sex, 5-year age group, and time period of death (1974-1978, 1979-1983). Causes of death were ascertained from death certificates. Deaths due to peptic ulcer, liver cirrhosis, and diffuse pulmonary disease were more frequent than expected (p less than 0.05). The associations found with these other diseases accord with those found in previous surveys on causes of death in gastric ulcer patients and in studies of living gastric ulcer populations. Overall, the combined evidence suggests that liver cirrhosis and diffuse pulmonary disease are associated with gastric ulcer.
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PMID:Causes of death amongst a population of gastric ulcer patients in New South Wales, Australia. 177 84

Toxic hepatitis developed but in one out of 127 peptic ulcer patients treated with cimetidine. In patients (n-142) treated with gastrozepine, no cases of toxic hepatitis were recorded. These anti-ulcer agents did not influence absorptive capacities of the liver or hepatic blood flow. Meanwhile microsomal exidase (antitoxic) function of hepatocytes noticeably declined as a result of cimetidine treatment in every 8th patient with peptic ulcer subjected to the continuous 5-week treatment with the drug and in every 5th patient given the treatment (maintenance included) for a longer time. In patients suffering from liver cirrhosis with secondary gastroduodenal ulcers or multiple erosions, the 5-week treatment either with almagel and platyphylline or gastrozepine provided approximately similar results and promoted ulcer and erosion healing in half the cases. Adjuvant 3-week therapy with sucralfate (venter) having cytoprotective properties led to the disappearance of gastroduodenal ulcers and erosions in 23 out of 26 patients, in whom the previous treatment was ineffective.
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PMID:[The effect of cimetidine and gastrozepin on liver function and the pharmacotherapy of "hepatogenous" gastroduodenal ulcers and erosions]. 179 25

The relationship between selected aspects of medical history and the risk of colorectal cancer was analysed using data from a case-control study of 673 cases of colon cancer, 405 of rectal cancer and 1501 controls in hospital for acute, non-neoplastic, non-digestive tract conditions, unrelated to known or suspected risk factor for large bowel cancer. Significantly elevated risks (RR) were observed for history of cholelithiasis (RR = 1.5 [95% confidence interval (CI) 1.1-2.1] for colon; 1.6 [1.2-6.4] for rectum) and diabetes (1.6 [1.1-2.3] for colon; 1.3 [0.8-2.0] for rectum), and a significant protection emerged for history of drug allergy (0.6 [0.4-0.9] for colon; 0.6 [0.5-1.0] for rectum). No significant association was found with thyroid disease, gastroduodenal ulcer, liver cirrhosis, hepatitis, pancreatitis, gastrectomy, appendicectomy, treatment with cimetidine/ranitidine, treatment with chenodesoxycholic acid or with blood transfusions. The associations with cholelithiasis, diabetes and drug allergy were not materially modified by allowance for major identified potential confounding factors, and were not restricted to the diseases diagnosed within 5 or 10 years before large bowel cancer diagnosis. Thus, the analysis of this large dataset offered further quantitative evidence suggesting a possible, however moderate, association between gallbladder disease and colorectal cancer risk, which may be related to enhanced or continuous secretion of secondary bile acids. The associations with diabetes and drug allergy were unexpected, and probably indirect, lacking previous epidemiological support or any obvious biological interpretation. Thus, they should be simply regarded as working hypotheses worthy of further consideration.
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PMID:History of selected diseases and the risk of colorectal cancer. 182 66

Peptic ulcer has been reported with increased frequency in patients with liver cirrhosis, its prevalence ranging form 5% to 20%. The aim of the present study is twofold: 1) to define the frequency of peptic ulcer in chronic liver disease in a large sample of cirrhotic patients, 2) to investigate the epidemiological and clinical features of a group of subjects affected by both peptic ulcer and liver cirrhosis. Two years of admission have been retrospectively investigated to define the frequency of peptic ulcer in chronic liver disease. In 237 subjects affected by both cirrhosis and peptic ulcer, epidemiological and clinical data were collected. Peptic ulcer was present in 16% of cirrhotic patients. There were no differences between ulcer subjects who drank and those did not. A linear positive correlation between smoking habit and frequency of ulcer disease has been found in the words. A positive history for peptic ulcer was described in a little subgroup of the studied sample, suggesting a low importance of the genetic factor in the pathophysiological pattern of ulcer disease in chronic hepatitis.
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PMID:[Ulcer and hepatic cirrhosis. Epidemiologic and clinical correlations]. 200 36

During its development, family practice in Taiwan has been housed at the university/college hospitals, and different settings have served as the main bases for service and teaching. To demonstrate the progress made in the family medicine clinic at the Chung Shan Medical College Hospital and to evaluate the appropriateness of this kind of family practice setting, our patient population of 616 was investigated. There were 5177 patient encounters during the period from September 1987 to August 1989. Of 616 patients, 52.3% were male, the average age was 38.5 years, 85.1% lived in Taichung, where the hospital is located, and 60.1% were insured. A total of 117 families, containing 310 members, made up 50.3% of the patient population. Most patients (64.0%) visited us after introductions by their relatives or friends. There was an average of 4.2 visits per patient per year, and only 6.3% of patients were lost to follow-up after their first visits. The three leading causes for visits to the Family Medicine Clinic were general medical examination (14.5%), acute upper respiratory tract infection (13.6%), and peptic ulcer diseases (8.0%): these comprised 36.1% of all patients' problems. The average referral rate among the 5177 patient encounters was 2.9%. Patient education about treatment of disease, immunization against hepatitis B, and screening for liver cirrhosis/hepatoma in hepatitis B antigen carriers were the most common preventative encounters in our clinic. In conclusion, university/college hospitals are certainly not the best site for service and teaching of family practice, since they are not based on ambulatory care.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Demonstrating the characteristics of family practice through the family medicine clinic located at a college hospital. 204 75


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