Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

365 consecutive patient of portal hypertension [Cirrhosis 285, Non-cirrhotic portal fibrosis (NCPF) 50, Extrahepatic portal vein obstruction (EHPVO)-30] were evaluated prospectively over a period of 2 years. Of these, 33 patients underwent successful sclerotherapy with evaluation before and after the same. Portal hypertensive gastropathy (PHG) was found in 56.4% (mild 28.2%, Severe 28.2%) of total patients; while its incidence was 60.6% in cirrhosis, 54% in NCPF and 20% in EHPVO. Incidence of PHG was significantly higher in cirrhotics when compared with non-cirrhotics (60.7% vs 41.25%: p < 0.05). PHG is more common in patients with large esophageal varices as compared to those with small varices (64.1% vs 50.8%: p < 0.05). Overall incidence of gastric varices was 29.3% while its incidence in cirrhosis, NCPF and EHPVO was 22.1%, 44% and 73.3% respectively. Incidence of gastric varices was significantly higher in non-cirrhotics (NCPF + EHPVO) when compared with cirrhotic (p < 0.05) and in patients with large esophageal varices when compared with patients having small esophageal varices (p < 0.05). Peptic ulcer was found in 10.9% patients with portal hypertension. (More than 90% were cirrhotics, mainly alcoholics). 33 patients underwent successful sclerotherapy of which 11 had PHG (mild--6, severe--5) at the beginning of sclerotherapy. After successful sclerotherapy 26 patients had PHG (mild--14, severe--12) p < 0.001). There was no significant difference in incidence of gastric varices before and after sclerotherapy. Incidence of PHG was significantly higher in cirrhotics while gastric varices were seen more commonly in patients with non-cirrhotic portal hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Stomach in portal hypertension. 829 22

The aim of this paper was to assess diurnal periodicity in the time pattern of the time of onset of acute gastrointestinal bleeding related to portal hypertension manifested by hematemesis or melena in cirrhotic patients over a period of 24 h. The study was a prospective evaluation of separate and consecutive episodes of bleeding requiring admission to hospital following hematemesis or melena in cirrhotic patients with the use of cosinor statistical analysis to determine rhythmicity. A total 744 episodes of bleeding were studied during separate and consecutive hospital admissions over a 68-month period. The time of onset of manifestation of variceal bleeding (n = 608) in both alcoholic (n = 279) and non-alcoholic (n = 329) cirrhosis and bleeding from non-variceal sources excluding peptic ulcer (n = 136) showed a significant diurnal rhythm (P = 0.005 and P < 0.05, respectively), with two peaks at 08:00 h and 20:00 h. This pattern was not modified by sex, age, severity of liver disease, seasonal variations or initial presentation with hematemesis or melena on its own. This is the first study showing significant diurnal periodicity in the time of onset of bleeding in cirrhotic patients. It is also the first study to show periodicity of upper gastrointestinal bleeding from any source. The cause for the observed rhythmicity is not apparent but parallel changes in portal pressure and/or changes in hemostatic factors could explain this observation.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Diurnal pattern of variceal bleeding in cirrhotic patients. 789 Sep 13

Serum pancreatic stone protein (PSP) was determined in sera of pancreatic and nonpancreatic diseases using enzyme immunoassay specific to human PSP to study the diagnostic and pathophysiological significance of PSP. Serum PSP in acute pancreatitis (mean +/- SD = 1075.4 +/- 2849.1 ng/mL, n = 33) was significantly higher than that in controls (78.6 +/- 31.8 ng/mL, n = 37, p < 0.01), chronic pancreatitis (156.8 +/- 82.8 ng/mL, n = 32, p < 0.05), and pancreatic cancer (148.468.8 ng/mL, n = 26, p < 0.05). No significant difference was found between noncalcified and calcified chronic pancreatitis. Serum PSP levels were significantly higher in chronic renal failure under hemodialysis (1796.0 +/- 1492.9 ng/mL) than in other diseases such as peptic ulcer, liver cirrhosis, gallstone, and diabetes mellitus. Low but significant correlation was obtained between serum PSP and serum immunoreactive trypsin (r = 0.22, p < 0.05). Increased serum PSP levels in acute pancreatitis and chronic renal failure suggest that serum PSP levels reflect reflex from pancreatic secretion, release from damaged pancreatic acinar cells, or retention in circulation, and can be useful for diagnosis of acute pancreatitis, but not chronic calcified pancreatitis.
 ...
PMID:Serum pancreatic stone protein in pancreatic diseases. 850 56

Macroscopic intrahepatic portosystemic shunts are extremely rare and may be due to liver injury, congenital vascular malformations or pathologic collaterals secondary to portal hypertension. Forty-eight cases have been reported in the literature up to 1994 with 50-60% presenting cerebral manifestations and 40% being associated with cirrhosis. The case of a patient without cirrhosis who was admitted for upper digestive hemorrhage secondary to gastroduodenal ulcer is described. At 48 hours the patient had an episode of hepatic encephalopathy coinciding with bleeding reactivation. Abdominal echography suggested communication between the right portal and suprahepatic veins and posterior angiography confirmed the diagnosis. Color Doppler echography determined shunt and portal vein blood flow. No case of intrahepatic portosystemic venous shunt as a cause of encephalopathy was found to have been reported in the Spanish literature.
 ...
PMID:[Congenital intrahepatic venous shunt as a cause of hepatic encephalopathy]. 852 Dec 22

A peroral sugar-reducing preparation gliquidone (glurenorm) was tried in treatment of 66 patients with digestive diseases (peptic ulcer, chronic pancreatitis, cirrhosis of the liver), presenting with diabetes mellitus. The results of the studies made showed glurenorm to be a highly effective preparation in term of both its sugar-reducing effect and its capability to improve energy processes in gastric and duodenal mucosa, pancreacytes, hepatocytes, besides which, it appear to dispel metabolic disturbances and stimulate reparative processes in body organs, improves protein-synthetic processes in the liver, pancreas, mucosa of the gastroduodenal region.
 ...
PMID:[The use of the hypoglycemic preparation gliquidone in patients with digestive organ diseases combined with diabetes mellitus]. 884 83

We investigated the association of non-insulin-dependent (Type 2) diabetes mellitus and depression symptoms in a representative community-dwelling elderly population independently of other conditions such as gender, age, status, disability, cognitive impairment and a number of chronic medical conditions such as chronic obstructive lung disease, degenerative joint disease, heart disease, cirrhosis of the liver, cholelithiasis, peptic ulcer and kidney stones. A total of 1339 elderly subjects living in southern Italy were randomly selected from electoral rolls and evaluated. All subjects were tested by the Geriatric Depression Scale to detect depression, the Mini-Mental State Examination to study cognitive function and the Activity Daily Living Index to evaluate disability. Non-insulin-dependent diabetes mellitus affected 14.7% of our sample. Depression was more prevalent in women over 75 years of age than in younger women (15.9 vs 8.1%, p < 0.001). In multiple linear regression analysis, diabetes mellitus was found to be significantly associated with depression independently of age, gender, loneliness, cognitive impairment, chronic obstructive lung disease, degenerative joint disease, heart diseases, cancer, kidney disease, cirrhosis of the liver and cholelithiasis. It is concluded that non-insulin-dependent diabetes mellitus is significantly associated with depression in the elderly, which may have clinical implications for the achievement of sufficient blood glucose control.
 ...
PMID:Non-insulin-dependent diabetes mellitus is associated with a greater prevalence of depression in the elderly. The Osservatorio Geriatrico of Campania Region Group. 889 92

We prospectively evaluated 139 consecutive children presenting to the Sanjay Gandhi Postgraduate Institute of Medical Sciences (Lucknow, India) with gastrointestinal (GI) bleeding from January 1991 to November 1994. Our aims were to find out whether the causes of GI bleeding in a developing country differed from developed countries and how the application of newer diagnostic techniques would help in the diagnosis of GI bleeding. Barium studies, endoscopy, technetium-99m-labelled (erythrocytes and pertechnetate) scans, selective abdominal angiography using a digital subtraction technique and rectal endoscopic ultrasonography were performed. Upper GI bleeding (n = 75) was variceal in 71 (95%) children (extrahepatic portal venous obstruction in 65, cirrhosis in six) and non-variceal in four (5%) cases (Henoch-Schonlein purpura, idiopathic thrombocytopenic purpura, drug-induced gastric erosions and pseudoaneurysm of the gastroduodenal artery due to idiopathic chronic calcific pancreatitis). Causes of lower GI bleeding (n = 64) were colitis (27 cases; 42%), colorectal polyps (26 cases; 41%), enteric fever (n = 3), solitary rectal ulcer (n = 3), portal hypertensive colopathy (n = 2), colonic arteriovenous malformation (n = 1) and internal haemorrhoids (n = 1). One patient remained undiagnosed. Angiography performed in four children was diagnostic in two. In one child with massive lower GI bleeding from portal colopathy, the bleeding site (caecum) was localized by intra-operative colonoscopy, while in the other child with portal colopathy, rectal endoscopic ultrasonography was performed to substantiate the diagnosis. We conclude that the causes of upper GI bleeding in children in developing countries are different from those in developed countries (variceal bleeding due to extrahepatic portal venous obstruction is the most common cause, while peptic ulcer is rare). However, the spectrum of lower GI bleeding is similar to that of developed countries. Application of newer diagnostic techniques is helpful and safe in the identification of the cause of GI bleeding in children.
 ...
PMID:Gastrointestinal bleeding in children. 891 24

The therapeutic effect of most immunosuppressive agents is unspecific and therefore often limited by an increased risk of infection by viral, bacterial or fungal organisms as well as by an increased incidence of malignant neoplasms. This short review includes the most commonly used immunosuppressants such as corticosteroids, azathioprine, methotrexate, cyclophosphamide and cyclosporine. The most common risks of long-term corticosteroid treatment are Cushing-like changes, decreased glucose tolerance and the usually benign steroid diabetes. Also clinically important is osteoporosis, since it can be prevented by physical training, calcium supplementation and treatment with vitamin D if necessary. Although there is still no proof of a significantly increased risk of peptic ulcer during steroid therapy, patients may develop gastrointestinal hemorrhage and even perforation without producing pain while being treated with corticosteroids. Mineralocorticoid effects, such as salt and water retention, are seen only with hydrocortisone and prednisone, whereas with synthetic steroids such as dexamethasone, sodium retention is absent despite their strong antiphlogistic activity. The most important side effect of the cytotoxic agents azathioprine, methotrexate and cyclophosphamide is marrow suppression. Due to the high turnover of neutrophils, patients most frequently suffer neutropenia rather than thrombocytopenia or anemia. Neutropenia, as well as impaired humoral and cellular immune mechanisms, are responsible for increased susceptibility to bacterial, viral or parasitic diseases during immunosuppressive therapy. Hepatotoxicity has been reported among patients receiving azathioprine (cholestatic hepatitis) and methotrexate (elevated AST levels and, rarely, liver fibrosis or cirrhosis). Cyclophosphamide causes hemorrhagic cystitis in a substantial proportion of patients, as well as an increased incidence of urothelial neoplasms. Both these side effects may be prevented by Mesna. The most important side effects of cyclosporine are acute and chronic nephrotoxicity usually associated with significantly elevated plasma levels of the drug. It must be borne in mind that severe nephrotoxicity may occur in patients receiving cyclosporine and ketoconazole together, since the latter may inappropriately increase the plasma cyclosporine level.
 ...
PMID:[Immunosuppression--a tightrope walk between iatrogenic harm and therapy]. 892 65

Many patients with liver cirrhosis have dyspeptic complaints. Peptic ulcer, gallstones and oesophagitis are the most common causes of dyspepsia. Functional dyspepsia is infrequently investigated in liver cirrhosis. Sixty-two patients with liver cirrhosis and dyspepsia were submitted to endoscopic and sonographic investigation. In 28 of them no organic finding was detected. These cases were considered as having functional dyspepsia. 36% were of dysmotility-like type, 28% were ulcer- and reflux-like, each, and 7% were of idiopathic type. Aerophagia could not be taken in consideration as functional dyspepsia, due to portal hypertension. In comparison with a group of 30 patients with functional dyspepsia without liver cirrhosis, functional dyspepsia in liver cirrhosis is more frequent in men than in women and occurs about a decade later. In 12 subjects the gastric emptying of a semifluid meal estimated by sonography was normal. Functional dyspepsia is a reality in liver cirrhosis. Gastric emptying seems not to have a major role in the etiopathogenesis of such complaints.
 ...
PMID:[Functional dyspepsia in liver cirrhosis]. 896 53

There is a higher prevalence of peptic ulcer disease in cirrhotic patients than in the general population. Whether Helicobacter pylori is a risk factor for peptic ulcer in cirrhosis remains controversial. The aim of this study was to determine whether there is a significant correlation between H.pylori infection and peptic ulcer in liver cirrhosis. In a cross-sectional study, 49 cirrhotic patients underwent upper gastrointestinal endoscopy and 75 controls (health examinees) without liver disease were also examined by endoscopy. The presence of H. pylori was assessed by culture, histologic findings and rapid urease test of gastric antrum biopsy specimens. Thirty of the 49 (61%) cirrhotic patients had peptic ulcers as compared to 24 of the 75 (32%) controls. The frequency of H. pylori in the antrum in the cirrhotic group was significantly lower than in the control group (39% vs 69%). The presence of H. pylori was more frequent in control patients with gastric (75%) and duodenal ulcers (95%) than nonulcer control patients (59%) whereas the difference between patients with peptic ulcer and nonulcer (40% vs 37%) was not significant in cirrhotic patients. H. pylori was identified in 40% of the cirrhotic patients with duodenal ulcers compared with 95% of controls with duodenal ulcers (p < 0.05). Nevertheless, this difference was not significant among patients with a gastric ulcer between the two groups (40% vs 75%). There was no significant difference in the frequency of H. pylori infection among nonulcer patients between the cirrhotic and control groups (37% vs 59%). In conclusion, we found no evidence to substantiate an etiologic role of H. pylori in the development of a duodenal ulcer in cirrhotic patients.
 ...
PMID:Helicobacter pylori infection and risk of peptic ulcer among cirrhotic patients. 903 84


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>