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)

A 53-year-old woman developed symptoms of slow speech, mild dementia, increased deep tendon reflex, ataxic gait, flapping tremor, and dystonic posture during two years. She had liver cirrhosis and hyperammonemia, which suggested a diagnosis of portal-systemic encephalopathy. MR T1-weighted images showed increased signal intensity in globus pallidus, internal capsule, substantia innominata, and a part of hypothalamus. T2-weighted images revealed abnormal findings as follows: high intense area in middle cerebellar peduncle, and low signal intensity of corpus callosum and pontine base. This is the first report about MRI abnormalities in substantia innominata, corpus callosum, and pontine base in a patient with portal-systemic encephalopathy.
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PMID:[A case of portal-systemic encephalopathy presenting characteristic MR images in globus pallidus, hypothalamus, corpus callosum, pontine base, and middle cerebellar peduncle]. 161 82

Neuropsychological deficits including dementia in some alcoholics may potentially result from progressive, submicroscopic loss of synaptic receptors in the absence of morphological lesions. The densities of two types of synaptic receptors were determined in autopsy brain homogenates from several brain regions of not grossly demented alcoholics and non-alcoholic controls. In alcoholics, muscarinic cholinergic receptors were decreased by 40% in frontal cortex, temporal cortex and putamen and by 30% in hippocampus. Benzodiazepine receptors were decreased by 30% in hippocampus and by 25% in frontal cortex but not in temporal cortex or putamen. These changes occurred in histologically normal brains in the absence of Wernicke's encephalopathy, coma, liver cirrhosis and cholinergic or benzodiazepine medications. A computer data base matched for differences in death-autopsy time intervals, age and hypoxia. We conclude that chronic exposure to alcohol results in a loss of synaptic receptors with their synapses. To what extent such receptor losses could result in impairment of cognitive function is currently unknown but will depend on other factors such as the availability of spare receptors and what subtypes of receptors are involved. A rationale may emerge for using in alcoholics the cholinergic treatments currently being developed for the cognitive deficits of Alzheimer's disease.
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PMID:Loss of synaptic receptors can precede morphologic changes induced by alcoholism. 166 10

The clinical background relating to edema in elderly inpatients was investigated, in terms of various items in elderly (aged greater than or equal to 65) cases with edema (n = 96) and without edema (controls, n = 95). Both groups were matched for sex, age, and underlying diseases. As compared with the control patients, the patients with edema had longer hospital stays with more disabled status, and showed less activity of daily living (ADL). The rates of bed-restricted patients, dementia patients, and patients with decubitus, muscle atrophy, or incontinence were found to be significantly higher in the patients with edema. The measurement of biochemical parameters revealed that the patients with edema had significantly lower levels of serum albumin, Na, Cl, creatinine, and uric acid, in contrast to higher levels of C-reactive protein. According to the classification of the assumed causes of edema, we divided the patients with edema into five groups; group 1 (n = 33): edema associated with immobilization, group 2 (n = 18): edema due to heart failure, group 3 (n = 15): edema on paretic limbs, group 4 (n = 6): edema due to hypoproteinemia, group 5 (n = 5): edema associated with liver cirrhosis. Both group 1 and group 4 patients had lower levels of hemoglobin and albumin, whereas group 3 patients had higher scores of ADL, higher blood pressure, and higher levels of hemoglobin and albumin. These results suggest that immobilization and restriction in bed, as well as malnutrition, were important factors in causing edema in elderly inpatients.
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PMID:[A controlled study on edema in elderly inpatients]. 238 89

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

In the last years, considerable advances have been made in the study of the proteins and polypeptides of the cytoskeleton, and its three main components: microfilaments (MF), intermediate filaments (IMF) and microtubules (MT). The principal properties of these elements and those of many associated proteins are recalled. The actin MF are mainly involved in cell contractility, the IMF in cell shape, while the MT and their associated proteins are involved in intracellular transport. Some pathological modifications of the cytoskeleton will be considered. In the liver, accumulations of keratin result in the formation of Mallory's hyalin, found in several types of cirrhosis and hepatomas. In muscle, accumulations of desmin are observed in various myopathies. An accumulation of alpha-actinin at the Z bands characterizes nemalin myopathy. In several forms of hemolytic anemias, alterations of the membranous cytoskeletal components of the red blood cells--spectrin, ankyrin, actin--may explain their abnormal shape and excessive fragility. In the nervous system, many pathological conditions are related to abnormal cytoskeletal components. In Parkinson's disease, Lewy bodies are an accumulation of neurofilaments (IMF). In Alzheimer's disease, and some related conditions, the intraneuronal tangles are associated with modifications of MT and neurofilaments. The role of MT and in particular of the MT-associated protein tau, as demonstrated recently, confirms the involvement of the MT. The observed disturbances of MT-related axonal flow may explain some of the known functional changes in these forms of dementia.
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PMID:[Pathology of the cytoskeleton]. 329 78

Analysis of mortality data based on underlying cause of death in epileptic patients is of limited value in view of the low case-fatality ratio of epilepsy. Recently the National Center for Health Statistics has made available all conditions mentioned on each death certificate for the entire US population. Using a case-control study design, we have analyzed all the associated conditions at the time of death in patients with epilepsy for the year 1978. Association between epilepsy and the following conditions reached statistical significance: mental retardation, cerebral palsy, cerebrovascular disease, myocardial ischemia, dementia, foreign body in pharynx and larynx, pneumonia, alcoholism and cirrhosis of liver. Early recognition and proper management of some of these factors could significantly reduce the mortality and morbidity in epileptic patients.
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PMID:Case-control study of associated conditions at the time of death in patients with epilepsy. 340 63

Optimum health management indicates the suspicion of dementia in every elderly person with altered environmental-social interactional skills, multiple physical complaints in the absence of objective disease, or vague and unclear history. A high level of suspicion is justified in light of the high prevalence of the syndrome. Despite the large numbers of mentally and physically impaired elderly people, detailed mental state examinations and assessment of functional capacity are rarely incorporated in health records, which suggests that physicians are probably aware of only the most obvious deficits. Such practice habits are inculcated in medical school and graduate training where these issues are rarely comprehensively addressed. The diagnosis of Alzheimer's disease during life can be made only after careful evaluation of neurobehavioral and physiologic parameters. Like cryptogenic cirrhosis and idiopathic cardiomyopathy, Alzheimer's disease has no known etiology or definitive treatment. Therapeutic energies must be directed at long-term management rather than cure. Such care includes management of behavioral and psychological symptoms, treatment of intercurrent illnesses, and maximization of functional ability. Knowledge of brain-behavior correlates is essential in the management of any cognitively impaired person. Care for people with Alzheimer's disease also includes evaluation and ameliorization of difficulties experienced by caregivers.
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PMID:Diagnosis and treatment of Alzheimer's disease. 636 32

Thirty-two cases with chronic subdural hematoma in adults were analyzed from two standpoints; one is the characteristics of pre- and post-operative psychiatric symptoms, the other is the common factors in patients with post-operative psychiatric symptoms. The average age of subjects was 55.4 years, and psychiatric symptoms were noticed in 18 cases (56%). Main pre-operative psychiatric symptoms were disorders of intellectual capacity including memory and orientation disturbance and were able to be classified into amnestic syndrome and dementia according to DSM-3. Outcome in amnestic group was good in contrast to that in dementia group mostly complicated by post-operative psychiatric symptoms. Post-operative psychiatric symptoms were seen in 6 cases. The average age of these cases was 68.2 years which was higher than that of asymptomatic group. And these were classified as dementia according to DSM-3. Common factors in these 6 cases were as follows: Accompanied by marked pre-operative psychiatric symptoms. High age. Complicated by post-operative subdural fluid collection with certain mass effects. Long period from head injury to operation. Accompanied by other complications such as cirrhosis of liver and hypertension. Subdural fluid collection following surgery is a problem under discussion. We obtained favorable results by subdural-peritoneal shunt.
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PMID:[Psychiatric symptoms of patients with chronic subdural hematoma]. 646 34

Idiopathic hemochromatosis (IHC) is a genetically determined impairment in control of iron absorption that results in excessive parenchymal iron deposition, particularly in the liver. Of patients with IHC, 50% have little or no chemical evidence of liver dysfunction. Cirrhosis may be clinically occult, but still cause a syndrome of chronic hepatocerebral degeneration. Two patients are reported with IHC and a syndrome of ataxia, rigidity, myoclonic jerks, and dementia. Other associated symptoms may include diminished libido, decreased hearing, peripheral neuropathy, and large joint disease. Because symptoms of IHC can be reversed by phlebotomy, appropriate laboratory studies should be considered to exclude IHC in any patient with unexplained dementia, encephalopathy, and gait ataxia.
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PMID:Idiopathic hemochromatosis (IHC): dementia and ataxia as presenting signs. 668 41

Alcohol and drug abuse are the two main addictions in the elderly subject. Prevalence of alcohol dependency is 14% in those over 65 years of age and 17% in elderly psychiatric patients. The distribution of alcoholism between the sexes becomes equal with age. After 65 years of age, the sex-ratio is 1 female to 1.3 male subjects. The elderly alcoholic population consists of both subjects having become alcoholics at a young age and those in whom alcoholic behaviour appeared at a late age. In one third of elderly alcoholics such dependency appeared after 60 years of age. The main risk factors for alcoholism in the elderly subject are lonliness, death of the spouse and the presence of an invalid or bedridden spouse. In the elderly, tolerance to and dependence on alcohol are rare and appear late. Somatic complications are particularly severe (cirrhosis, liver cancer, gastritis, acute pancreatitis and myocardial involvement). Psychiatric complications include anxiety, depression and especially suicide. Alcoholism is the third most frequent cause of organic cerebral dementia, following Alzheimer disease and vascular dementia. Drug dependency is very often linked to alcoholism and consists of tranquillizers and less often of antalgics.
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PMID:[Addictive behavior in the elderly]. 793 9


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