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)

The fundamental initiating factor in portal hypertension is an increase in resistance to portal venous flow. Portal venous pressure rises as a consequence, and collateral channels open to decompress the portal venous system. A number of secondary haemodynamic phenomena occur in animals and humans with portal hypertension. Systemic vascular resistance and mean arterial blood pressure fall and both cardiac output and splanchnic blood flow increase. Current theories suggest that increased vascular production of nitric oxide may have a principal role in the pathogenesis of these secondary haemodynamic changes. The most common causes of variceal bleeding are cirrhosis, schistosomiasis and extrahepatic portal venous obstruction. Varices develop in 90% of cirrhotic patients if follow-up is long enough. Bleeding from varices occurs in approximately 30% of patients followed up for 2-4 years, with mortality rates of 25% to 50% in those who bled. Prognosis is better in conditions where liver function is preserved, e.g. portal venous obstruction, schistosomiasis, etc.
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PMID:Pathophysiology and prognosis of oesophageal varices. 770 Dec 60

Histological features of chronic active and chronic persistent hepatitis were observed in mice, rabbits and non-human primates infected with either Schistosoma mansoni and Schistosoma japonicum. In early infection hepatitis appeared as a reactive change due to liver damage caused by the deposition of schistosome eggs, but portal and septal cellular infiltrations tended to remain long after parasite aggression had diminished or disappeared, either spontaneously with time or after chemotherapy. In rabbits, and to a lesser degree in monkeys, a picture of chronic active hepatitis was present, with evolution to cirrhosis in the former. The experimental findings indicate that schistosomiasis has the potential to induce chronic hepatitis and suggest that the current assumption that chronic hepatitis seen in humans with schistosomiasis is always due to concomitant viral infection should be reviewed.
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PMID:Chronic hepatitis in experimental schistosomiasis. 770 27

The thickness of the wall of the portal vein trunk (PVT) was determined with B-mode ultrasonography in 82 patients of schistosomiasis, with hepatic fibrosis, 35 cases of schistosomiasis without hepatic fibrosis, 30 cases of post-hepatitis cirrhosis and 32 healthy subjects. It was shown that the wall thickness of PVT increased in all the patients with schistosomiasis. The thickness in patients of schistosomiasis with hepatic fibrosis was markedly increased as compared with the other three groups (P < 0.01 in all). The magnitude of increase of the wall thickness correlated well with the severity of the pathological change of hepatic fibrosis. It was also noted that change of wall thickness of PVT was not only accompanied by change in hyaluronate and hydroxyproline estimation, but also closely correlated with the international criteria of ultrasound parameters for assessment of pathological changes of schistosomiasis (rs = 0.839, rs = 0.748). Measurement of the wall thickness of PVT is, therefore, a valuable clinical method for diagnosing schistosomiasis with hepatic fibrosis and determining the severity of its pathological change.
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PMID:[Determination of the thickness of the wall of portal vein trunk in patients of schistosomiasis japonica with hepatic fibrosis and its clinical significance]. 776 38

The pharmacokinetics and therapeutic efficacy of praziquantel (Distocide; Epico, El-Asher-Men-Ramadan City, Egypt) were studied in 40 patients with schistosomiasis mansoni and various degrees of hepatic dysfunction. The patients were allocated into four groups: the first included 10 patients with simple active schistosomiasis while the other three were made up of patients with schistosomiasis associated with liver cirrhosis and splenomegaly according to Child's classification of hepatocellular function. Every patient was treated with 40 mg/kg of praziquantel as a single oral dose. The efficacy of the drug was evaluated after two months by rectal snip examination. The pharmacokinetic parameters did not differ significantly between patients with simple active schistosomiasis (group 1) and those with hepatosplenomegaly with liver involvement but without ascites and jaundice (group 2). However, as liver cell dysfunction became more evident (groups 3 and 4), pharmacokinetic parameters of praziquantel such as the half-life of elimination, the half-life of absorption, the maximum concentration, the time to maximum concentration, and the area under the concentration-time curve increased proportional to the degree of hepatic insufficiency. Linear correlations were found between each of the these parameters on the one hand and hepatic function test results (total bilirubin, direct bilirubin, and serum albumin) on the other. In spite of these pharmacokinetic differences, the cure rates were 70%, 80%, 90%, and 90% in the four groups, respectively. Although the incidence of side effects was high (53%), such effects were transient and mild.
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PMID:Clinical and pharmacokinetic study of praziquantel in Egyptian schistosomiasis patients with and without liver cell failure. 781 Aug 16

The finding of epithelioid cell granulomas within liver biopsies is a not uncommon occurrence. We undertook this study to investigate the underlying conditions responsible for a diagnosis of granulomatous hepatitis in Northern Ireland during the thirteen year period 1980-1992. One hundred and sixty-three patients with hepatic granulomas were identified, accounting for 4% of all liver biopsies undertaken during the period of the study. In 145 cases (89%) a definite clinical diagnosis was established. The most common clinical diagnoses were primary biliary cirrhosis which accounted for 90 cases (55%) and sarcoidosis which accounted for 30 cases (18%). Other less common conditions associated with hepatic granulomas included tuberculosis (3 cases), Crohn's disease (3 cases), chronic active hepatitis (2 cases), drug hypersensitivity (2 cases) and extra-hepatic biliary obstruction (2 cases). Six patients were identified with a clinical diagnosis of psoriasis. Other miscellaneous conditions accounting for single examples of granulomatous inflammation were schistosomiasis, gout, Hodgkin's disease, secondary adenocarcinoma, collapse and necrosis of tumour following radiotherapy and chemotherapy, granulomatous inflammation within the wall of an abscess cavity and idiopathic cirrhosis. Only eighteen cases (11%) remained idiopathic with no definite diagnosis established after detailed investigation. The findings confirm the wide range of clinical conditions which can result in hepatic epithelioid cell granulomas. This has been emphasised in several previous major studies which are reviewed in this paper.
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PMID:Hepatic granulomas in Northern Ireland: a thirteen year review. 782 89

No doubt chronic liver diseases due to schistosomiasis and other causes as virus hepatitis are not uncommon among Egyptian patients. Besides, neoplastic changes in such patients are always seen. So, the aim of this work was to evaluate the estimation of hepatocytes DNA in chronic liver diseases as a diagnostic feature for early preneoplastic changes in different groups of patients. These groups included (a) chronic persistent hepatitis, (b) chronic active hepatitis, (c) liver cirrhosis due to schistosomiasis and other causes & (d) hepatocellular carcinoma. The results were evaluated histochemically and histopathologically. It was concluded that the cytophotometic evidence of hepatocytes DNA in chronic liver diseases is a promising mean in detecting early preneoplastic changes.
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PMID:Cytophotometric estimation of hepatocytes DNA in chronic liver diseases including schistosomiasis for detection of early preneoplastic changes. 784 29

Cross-sectional imaging is playing an increasing role in diagnosis of diffuse liver diseases because it clarifies, in many cases, the overlap in clinical and laboratory manifestations often present in diffuse hepatic processes and thus may eliminate the need for a biopsy. Advances in cross-sectional imaging, particularly in magnetic resonance (MR) imaging, enable further characterization of hepatic parenchymal and architectural changes, allowing closer correlation with underlying pathologic changes. Advanced imaging techniques can be used to characterize a variety of metabolic, vascular, toxic, infectious, and neoplastic diffuse liver diseases. These include more common entities such as cirrhosis, Budd-Chiari syndrome, hemochromatosis, Wilson disease, fatty change, and diffuse neoplastic disease (hepatocellular carcinoma, metastasis, and lymphoma) and uncommon entities such as schistosomiasis, sarcoidosis, and amyloidosis. Correlation of computed tomographic and MR imaging findings with underlying pathologic features is helpful in understanding the gamut of diffuse diseases of the liver.
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PMID:Diffuse disease of the liver: radiologic-pathologic correlation. 785 42

Although beta-adrenoceptor antagonists improve morbidity and mortality in patients with portal hypertension associated with cirrhosis, this has not been demonstrated in non-cirrhotic patients. In the present, double-blind, 24-month, prospective study of patients with endoscopically-proven varices and ultrasonographically-confirmed hepatic fibrosis, the effects of propranolol 160 mg LA and placebo on the incidence of rebleeding and mortality were compared in 82 patients with portal hypertension secondary to schistosomiasis. The results, analysed on intention-to-treat basis, indicated a reduction in rebleeding (median time to rebleeding 589 days for propanol v. 252 days for placebo; P < 0.02) and increased survival in the propranolol-treated patients (three deaths v. seven deaths on placebo; P < 0.02). Fifteen patients withdrew from the propranolol group and 18 from the placebo group. A positive prognostic indicator was a large portal vein diameter whereas a small liver size indicated a negative outcome.
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PMID:Propranolol reduces mortality in patients with portal hypertension secondary to schistosomiasis. 797 39

The most common causes of variceal bleeding are cirrhosis, schistosomiasis, and extrahepatic portal venous obstruction. The prognosis for an individual patient depends on the severity of the bleeding episode and the underlying liver function. Liver function is determined to a large extent by the underlying liver pathology. Patients with noncirrhotic portal hypertension or cirrhosis with good liver function have good short- and long-term prognoses. In patients with established cirrhosis, the presence of alcoholic hepatitis, hepatocellular carcinoma, or portal venous thrombosis may adversely affect prognosis. In addition to affecting prognosis, the underlying pathology may also influence choice of treatment. This point is particularly true for treatments such as shunt surgery, liver transplantation, or transjugular intrahepatic shunts.
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PMID:Relation between liver pathology and prognosis in patients with portal hypertension. 804 20

Schistosomiasis and hepatitis B virus (HBV) infection are very common in Brazil but the interrelationships between the two infections are poorly understood. We have undertaken a detailed serological study of the prevalence of HBV markers in 189 Brazilian patients with chronic schistosomiasis mansoni, 46 with hepatointestinal (HIS) and 143 with hepatosplenic (HSS) schistosomiasis, 12 of the latter having decompensated liver disease (HSSD), and in 50 control patients. Sera were tested for HBsAg, anti-e, anti-HBc, anti-HBs and HBV-DNA. Eighty-three (44%) of the 189 schistosoma patients had at least one marker of HBV infection, 18 of whom (10%) were seropositive for HBsAg. All the controls were HBsAg negative, but ten (20%) had anti-HBc and anti-HBs. There was no significant difference in the frequency of these markers between HIS (14/46, 30.4%), HSSC (43/131, 34.5%), and the controls. Among the HBsAg-positive patients, one had HIS (HBV-DNA negative), seven had HSSC (one HBV-DNA positive) and ten had HSSD (six HBV-DNA positive), a significant association of HBV carriage with HSSD (P << 0.001). Mean (+/- SD) ALT values were significantly (P < 0.001) higher in HBsAg-positive HSSD patients (70.7 +/- 18 IU/liter) than in those with HSSC (29.5 +/- 15 IU/liter). Liver biopsies were performed in 12 HBsAg-positive patients (one with HIS, three with HSSC, and eight with HSSD) and in 50 HBsAg-negative HSSC patients. Seven of the eight HSSD patients had chronic active hepatitis with cirrhosis, and one had inactive cirrhosis. All three patients with HSSC and the one with HIS had chronic persistent hepatitis, with periportal fibrosis in three.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hepatitis B virus infection in schistosomiasis mansoni. 815 15


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