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)

Interferon alpha is the only available therapy for patients with chronic hepatitis B. With interferon alpha 3-15 MU thrice weekly or 5 MU daily during 3-6 months one-third of the patients achieve seroconversion of HBeAg and HBV-DNA together with normalization of aminotransferases and slight improvement of histology. Loss of HBsAg is reported in a minority of responders during treatment, but increases during follow-up. Patients with baseline alanine aminotransferase of at least twice the upper limit of normal and low HBV-DNA concentration achieve the best response rates. HIV-positive patients with low CD4 counts and Asians are poor responders. As side-effects influenza-like symptoms are experienced by almost all patients. Mild leukopenia, thrombocytopenia and decreased hairgrowth are frequently reported. Severe depression, depersonalization and psychosis are reported in a small number of patients but tend to be poorly recognized in some studies. The decision whether dose reduction is indicated seems strongly related to the opinion of the investigator. Although long-term effects on the occurrence of cirrhosis and the development of hepatocellular carcinoma are not available yet, the achieved results are promising.
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PMID:Current status of interferon alpha in the treatment of chronic hepatitis B. 143 94

A new Swedish population register, created by linking Census data to the Cause of Death Registry and covering over 99% of the population, has been used to study the relationship between occupational category, marital status and citizenship in 1970 and mortality in closely alcohol-related diseases during 1971-1980 for the ages 25-64 years. Age-standardized rate ratios (SRR) have been computed for mortality in alcoholism, alcohol intoxication and alcohol psychosis ("AAA") and in liver cirrhosis. SRR-values for both diagnose categories and both sexes were higher than average among not gainfully employed (SRR = 3.71 among males and SRR = 1.96 among females in 1976-80 for "AAA"), among employees in the service sector, engine-drivers and unskilled workers and increased in liver cirrhosis among artists and authors. Among females there were smaller variations in mortality for occupational groups than among males. The SRR-values showed a tendency to be higher in 1976-80 than in 1971-75, probably due to health-related selection to some extent. The alcohol-related mortality was also increased among divorced, widows (SRR = 1.37 for "AAA" and 2.81 for liver cirrhosis in 1976-80) and widowers and among never married males. SRR was much higher among Finnish citizens in Sweden (SRR for "AAA" = 3.85 among males and 2.35 among females in 1976-80) than among males and females living in Finland (SRR for "AAA" = 1.13 among males and 0.36 among females) and also higher than among immigrants from other countries, summed (SRR for "AAA" = 0.62 among males and 0.64 among females).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mortality in alcohol-related diseases in Sweden during 1971-80 in relation to occupation, marital status and citizenship in 1970. 148 49

Percutaneous endoscopic gastrostomy (PEG) has become the preferred method of nutritional support in virtually every patient in whom this procedure is technically feasible because of its apparent technical facility, cost containment, and bedside insertion. PEG can, however, be associated with serious complications and death. This is a report of three patients who developed life-threatening abdominal wall abscesses and four patients who died after PEG insertion. The patients ranged in age from 30 to 80 years, four female and three male. Complicating medical conditions included cirrhosis, diabetes, heart-lung transplantation, neurological dysfunction, and psychosis. The four patients who died were all noted to have had unsatisfactory adhesion between the gastric serosa and the anterior abdominal wall, resulting in large gastric defects where the PEG had been placed and intraperitoneal contamination with gastric contents and feedings. Three additional patients developed abdominal wall abscesses requiring operative debridement. The patient considered to be high risk for surgical gastrostomy may be a higher risk for PEG. Alternatives to PEG should be considered in patients with poor nutritional status or debilitating medical conditions, or in patients undergoing immunosuppressive therapy and steroid use. Psychosis and dementia should be considered relative contraindications to PEG because these patients may dislodge the gastrostomy tube, resulting in severe wound infection and, possibly, death.
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PMID:Fatal and disastrous complications following percutaneous endoscopic gastrostomy. 249 84

Alcohol sales in Stockholm County decreased by 18 per cent from 1976 to 1981. The socioeconomic status of inpatients treated for alcohol psychosis, alcoholism, alcohol intoxication, liver cirrhosis, and pancreatitis was studied by linking data from the National Housing and Population Censuses in 1975 and 1980 with the inpatient care registers for 1976 and 1981. In both years, all rates were highest for people outside the labor market and lowest among white collar employees. The employment rate for those aged 25-44 years and treated in 1981 for alcohol psychosis, alcoholism, and alcohol intoxication--already low in 1975--had drifted further downward by 1980. Total rates of inpatient treatment for alcohol-related diagnoses generally declined but the gap between blue collar workers and white collar workers widened. We conclude that the goal for national alcohol policy, suggested by the WHO--a reduction of per capita consumption--should be combined with additional measures that will reach all social groups.
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PMID:Changes in alcohol-related inpatient care in Stockholm County in relation to socioeconomic status during a period of decline in alcohol consumption. 276 19

On the basis of the clinical, experimental-psychological and electroencephalographic examinations of 173 patients with portal hypertension (intrahepatic--110 and extrahepatic--63) the authors elucidated the regularities of the formation of mental disorders, their clinical characteristics and the course following surgical treatment. The asthenic syndrome with marked vegetative disturbances was the most prominent feature in the clinical picture. Patients with hepatic cirrhosis were characterized by a more severe asthenia and greater intensity of vegetative symptomatology as compared to patients with an extrahepatic form of portal hypertension. Characteristic of psychotic disorders in liver cirrhosis was severity of the psychoorganic syndrome. Personality shifts with the predominance of explosiveness, epilepsy- and paranoia-like tendencies grow with disease progression. Surgical treatment by constructing vascular anastomoses occasionally leads to intensification of the psychoorganic syndrome in cirrhosis patients and to its appearance in patients with extrahepatic portal hypertension, which calls for the development of more clear-cut indications for such surgery.
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PMID:[Dynamics and mental disorders in patients with portal hypertension after surgical treatment]. 371 7

Whole-field pattern-reversal VEPs (VEP) were examined in fifteen patients screened for hepatic cirrhosis. Twelve age- and sex-matched normal individuals and twenty-four psychotic patients on maintenance neuroleptic medication served as controls. There were no differences in latency or amplitude of the major positive component VEP (P100) to binocularly or monocularly presented reversing patterns between hepatic and control groups. Pre-exposure to flicker (the "photostress test") caused no abnormalities of VEP. Only in one patient with hepatic cirrhosis did monocular stimulation in the photostress condition cause a marked delay of P100. It is possible that this was an idiosyncratic response and that visual abnormalities detectable with the VEP technique can be attributed to other factors such as poor attention or accompanying disorders of the visual system.
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PMID:Pattern-reversal visual evoked potentials in hepatic cirrhosis. 375 4

Mortality and morbidity from ischaemic heart disease (IHD) was studied in 5404 Finnish males aged 35-64 years who had been hospitalised for alcohol-related disease in 1972 without any admissions for IHD during that same period. By record-linkage, morbidity and mortality were followed up to the end of 1975. The mortality of patients with alcohol-related diseases was compared to 1120 patients with acute appendicitis by calculating indirectly age-standardised mortality ratios (SMR). The mortality and morbidity of 5963 patients with acute myocardial infarction or angina pectoris was also studied. The following SMRs for IHD mortality, non-fatal-IHD-hospitalisation and for mortality from all causes respectively, were found: acute myocardial infarction 11.6, 7.2 and 7.2; alcohol intoxication 6.0, 4.5 and 4.5; angina pectoris 5.2, 10.5 and 3.4; liver cirrhosis 2.2, 2.5 and 11.8; alcoholism 1.9, 1.9 and 3.6; pancreatitis 1.8, 1.2 and 4.4; alcohol psychosis 1.7, 2.5 and 4.2. IHD mortality and morbidity appeared to be more prevalent in patients hospitalised with alcohol intoxication than in patients with other alcohol-related diseases. This suggests that rapid drinking predisposes both to serious intoxication and to fatal disturbances of cardiac rhythm.
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PMID:Alcohol-related diseases associated with ischaemic heart disease: a three-year follow-up of middle-aged male hospital patients. 376 98

Psychotropic drug use was investigated using a sample of 209 psychiatric in-patients at Harare Central Hospital, (92 patients) and Parirenyatwa Central Hospital, (117 patients). The patients' ages ranged from 10-80 years, 67pc of whom were males. Psychiatric diagnosis interacted in its effect with the number of psychotropic drugs. Schizophrenia or effective disorders were prescribed the most drugs per patient, i.e. 2.6 drugs. Antipsychotics were the most commonly used psychotropic drugs, accounting for 59.3pc of the total (51.4pc being schizophrenics), followed by antiparkinson drugs, (23.8pc), tricyclic antidepressants, (8.6pc), lithium, (4.9pc), benzodiazepines, (0.6pc) and anticonvulsants (0.7pc). The prevalence of psychotic illness was 69.3pc; affective disorders, 21.2pc; behavioural disorders, 4.2pc; alcohol and related disorders (confusion and cirrhosis), 3.3pc and mental retardation. Traditional medicine was often sort before any other or after other therapies had failed or to complement orthodox medication.
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PMID:Drug utilisation in psychiatric units at Parirenyatwa and Harare Central Hospitals (Zimbabwe). 802 75

This study describes mortality rates and predictors of mortality among late-middle-aged and older (55+) substance abuse inpatients (n = 21,139) in Department of Veterans Affairs (VA) Medical Centers in the 4 years after an index episode of care. A total of 24% of the patients died; this mortality rate was 2.64 times higher than expected. Predictors of earlier mortality included older age and nonmarried status, alcohol psychosis and organic brain disorder diagnoses, and several medical diagnoses, including neoplasms, liver cirrhosis, respiratory, endocrine and metabolic, and blood system disorders. Three proxy indicators of illness severity also predicted mortality: more prior inpatient and outpatient medical care and an index episode in an extended care unit. In contrast, more prior outpatient mental health care and remitted status predicted lower mortality. These diagnostic and treatment indicators can be used to identify patients at heightened risk for premature mortality. Moreover, they show that intensive mental health aftercare and remission of substance abuse may delay mortality, even among older patients who have longstanding substance abuse problems.
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PMID:Mortality rates and predictors of mortality among late-middle-aged and older substance abuse patients. 819 19

Medical records of the 15,924 twin-pairs in the National Academy of Sciences-National Research Council (NAS-NRC) twin registry were collected for an additional 16 years through 1994 when the surviving twins were aged 67 to 77 years. Compared with earlier analyses (Hrubec, Z, and Omenn, G. S., Alcohol. Clin. Exp. Res., 5:207-215, 1981), when subjects were aged 51 to 61, there were 23% more diagnoses of alcoholism (34.4 per 1,000 prevalence), 32% more diagnoses of alcoholic psychosis (5.4 per 1,000), and 25% more twins with liver cirrhosis (17.7 per 1,000). Overall, 5.3% of the cohort had at least one of the diagnoses related to alcoholism. Probandwise concordance rates (%) were: alcoholism-26.7 monozygotic (MZ), 12.2 dizygotic (DZ) (p < 0.0001); alcoholic psychosis-17.3 MZ, 4.8 DZ (p < 0.05); and cirrhosis-16.9 MZ, 5.3 DZ (p < 0.001). Concordance for any diagnosis related to alcoholism was 30.2 MZ, 13.9 DZ (p < 0.0001). Maximum-likelihood modeling indicated that approximately 50% of the overall variance was due to additive genetic effects; in all diagnosis categories, a totally environmental model gave a significantly poorer fit to the data. Bivariate and trivariate genetic analyses indicated most of the genetic liability for the organ-specific endpoints of psychosis and cirrhosis was due to the shared genetic liability for alcoholism. Once the shared variance with alcoholism was considered, there was no further shared genetic liability for psychosis and cirrhosis. Our results confirm Hrubec and Omenn's conclusion that there was significantly greater concordance in MZ twins-pairs for alcoholic psychosis and cirrhosis in the NAS-NRC twins, and concordance rates remained similar to those reported 16 years earlier. In contrast, we found most of the genetic liability to organ-specific complications of alcoholism was shared with the genetic liability for alcoholism per se; only a small portion of the genetic variance of the individual complications was independent of the genetic predisposition for alcoholism.
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PMID:Genetic predisposition to organ-specific endpoints of alcoholism. 898 99


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