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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Percutaneous transhepatic portography with selective catheterization of the portal vein and its tributaries was performed on 120 patients, of whom 71% had cirrhosis of the liver. The technique was improved by ultrasonically guided puncture, and the procedure was successful in 96% of the examinations. Collateral veins were visualized in 81% and esophageal or gastric varices in 69% of the patients with portal hypertension. The procedure was performed with little risk and discomfort, and portograms of high quality were obtained. Other applications of percutaneous transhepatic catheterization of the portal vein system are discussed.
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PMID:Percutaneous transhepatic portography. I. Technique and application. 10 78

Complete loss of parietal peritoneal sensitivity observed in a patient with long-standing ascites secondary to cirrhosis of the liver prompted an investigation of peritoneal sensitivity in 22 patients with the same condition. In all of them a decrease of the peritoneal sensitivity to needle perforation was found. All perceived peritoneal perforation as less painful than perforation of the abdominal skin by the same needle. In 8 control patients perforation of the peritoneum caused more discomfort than the perforation of the skin. In 7 cirrhotic patients where a histologic examination of the parietal peritoneum was available a chronic fibrotic peritonitis was present. Peritoneal insensitivity may partly account for mild abdominal symptoms in cirrhotics developing bacterial peritonitis.
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PMID:[Diminished peritoneal pain perception in patients with liver cirrhosis and ascites]. 15 77

A modified method of catheterization of the umbilical vein differs from other methods, for at the dismissal of the patient from the hospital the peripheral end of the polyvinylchloride catheter filled with maiodil is sealed and inserted under the skin, which permits to keep the catheter in the umbilical vein for several years, taking out its end periodically from under the skin for introduction of necesary drugs in case of cancer and liver cirrhosis. The catheter does not cause any discomfort and prevents the umbilical vein and surrounding tissues against infection. The suggested method has been applied in 64 patients without any related complications.
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PMID:[Modified method for catheterization of the umbilical vein]. 71 35

An ultrasound-guided double pass biopsy technique using a large bore cutting needle via an anterior subcostal route (USAB) is described. The diagnostic adequacy of this biopsy procedure was evaluated in comparison with the traditional Menghini technique in 200 cases of suspected chronic liver disease randomly assigned to the two different procedures. Retrieval rate was better in the USAB group. The sample length was less than 15 mm in four cases in the USAB group and in 19 cases in the Menghini group. In three cases in the USAB group the second pass modified the diagnosis of the first specimen from chronic active hepatitis to active cirrhosis. In order to evaluate the safety and discomfort of the two procedures 340 patients assigned to the different techniques had liver ultrasound scans 6 and 24 h following percutaneous biopsy. USAB was associated with a reduced frequency of complications (one out of 170 patients vs. seven out of 170 patients who had the intercostal Menghini procedure). In our study, USAB seems to offer better sampling and size of individual samples, together with reduced frequency of major and minor complications.
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PMID:A randomized trial of ultrasound-guided anterior subcostal liver biopsy versus the conventional Menghini technique. 180 21

Grading of goitre size according to WHO or the palpatory estimation of thyroid volume does not allow a quantitative estimation of thyroid size or an objective follow-up during treatment with e.g. radioiodine. The present and other studies have demonstrated that the ultrasonic evaluation of thyroid volume is both accurate and precise. In addition, it is non-invasive, rapid, inexpensive and without discomfort to the patient. Using this technique it was demonstrated that thyroid volume increases with increasing age and body weight in both sexes, with weight having the most pronounced influence. The relationship between thyroid volume, body weight and age in non-goitrous healthy subjects can be described using a formula that allows the calculation of normal thyroid size for a population: Thyroid volume (ml) = 1.97 + 0.21 x bodyweight (kg) + 0.06 x age (years). Cigarette smoking is associated with an approximately 10-fold increase in goitre frequency probably due to a combination of an increased sympathetic stimulation of the thyroid and an iodine deficiency state caused by inhalation of thiocyanate. Although no seasonal alteration in serum TSH level could be demonstrated thyroid volume is 23% higher in the winter than in the summer. Cyclic alterations of thyroid volume possibly related to TSH alterations have been found with a 50% difference between minimum values in the first half and maximum values in the second half of the menstrual cycle. Nonthyroidal illnesses are associated with marked alterations in thyroid volume. Thus, chronic renal disease and acute hepatic disease demonstrate significant increases in thyroid volume although the precise mechanisms have not been clarified. Chronic hepatic disease per se and chronic nonrenal nonhepatic disease does not seem to influence thyroid volume. Chronic alcoholism, however, with or without liver cirrhosis is associated with a marked decrease in thyroid volume and an increase in the amount of fibrosis probably related to a direct toxic effect of alcohol on the thyroid. All these factors should be kept in mind when goitre frequency, goitrogenic action of drugs and goitre treatment effects are evaluated.
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PMID:Thyroid size determined by ultrasound. Influence of physiological factors and non-thyroidal disease. 219 37

Clinical and pathological analysis of 66 cases of fibromatoses are presented. The age range in our series was 1 to 72 years. Superficial fibromatoses occurred predominantly in older patients with a peak incidence in the fifties while deep fibromatoses occurred predominantly in younger patients with a peak incidence in the twenties. Male to female ratio was 1.4 to 1. The abdominal fibromatosis occurred in female while our palmar fibromatosis occurred in male. There were 17 cases (26%) of multiple fibromatoses which occurred most frequently on both palms and had a tendency to symmetric distribution. The latent period between the two fibromatoses in a patient ranged from 1 year to 36 years. Clinical presentations included a palpable nodule or mass; flexure contracture of finger; penile hypertrophy, contracture, or discomfort on erection; and soreness, tenderness, or paresthesia over the tumor. Hydronephrosis may be complicated by intraabdominal fibromatosis. Size of the tumors ranged from 0.5 cm. To 30.0 cm. Three cases were associated with diabetes mellitus, 2 with alcoholics, 1 with liver cirrhosis, 2 with pulmonary tuberculosis, and 3 with hepatocellular carcinoma, cholangiocarcinoma, and mammary papillary carcinoma, respectively. Nine cases (14%) were associated with variable types of trauma, including being hurt by a stick, intramuscular injection in the gluteal region, tying penile shaft with a plastic band, breast massage and hot applying, and operation on abdomen. The superficial fibromatoses seldom recurred after excisional biopsy or fasciectomy while the deep fibromatoses often recurred. The recurrent rate of the deep fibromatoses was 21%. Malignant transformation or spontaneous regression was not found.
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PMID:[The fibromatoses. A clinicopathological study of 66 cases]. 281 66

To investigate the efficacy and the acceptability of different doses of lactitol in patients with subclinical hepatic encephalopathy, 28 patients with cirrhosis were enrolled in a controlled clinical trial comparing 5-month therapies with lactitol at two different doses: 0.3 and 0.5 g/kg bw per day. This period was followed by 1 month of recovery. Patients were monitored with venous blood ammonia determination, three psychometric tests, clinical evaluation of mental status and EEG. The porto-systemic encephalopathy index of Conn was determined periodically. Twenty-two patients completed the trial (11 for each dose of lactitol). Both doses of lactitol decreased plasma ammonia levels and improved the porto-systemic encephalopathy index. The higher dose was more effective in improving performance in the psychometric tests. After the period of recovery, both the porto-systemic encephalopathy index and the psychometric test scores returned to pretreatment values. Lactitol was tolerated well by patients. Three patients given the higher dose reported periodic intestinal discomfort, but did not stop taking lactitol or reduce the dosage; no side-effects were reported by the patients taking the lower dose. These results indicate that lactitol in doses ranging from 0.3 to 0.5 g/kg bw is a well-tolerated and effective treatment for subclinical encephalopathy.
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PMID:Effects of long-term administration of low-dose lactitol in patients with cirrhosis but without overt encephalopathy. 769 33

Twelve patients with liver cirrhosis complaining of painful muscle cramps were treated with Niuche-Shen-Qi-Wan (TJ-107). Three patients were at the decompensated state. Muscle cramps disappeared in 4 weeks on the average after oral administration of TJ-107 in all 12 patients. During the period of TJ-107 administration, there was no significant improvement of hepatic function. One patient complained of mild epigastric discomfort after taking TJ-107, but there were no other adverse effects. Our results indicate that TJ-107 is useful for treatment of painful muscle cramps in cirrhotic patients.
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PMID:Effect of niuche-shen-qi-wan on painful muscle cramps in patients with liver cirrhosis: a preliminary report. 916 2

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for the treatment of many conditions including rheumatoid arthritis, osteoarthritis, gouty arthritis, the joint and muscle discomfort associated with systemic lupus erythematosus, and other musculoskeletal disorders. Yet, their benefits, which are believed to be a result of their ability to inhibit cyclooxygenase-2 (COX-2), are accompanied by considerable toxicity. NSAIDs' untoward effects are attributed to their inhibition of the constitutively expressed enzyme cyclooxygenase-1 (COX-1), with attendant suppression of the synthesis of prostanoids, substances that mediate key homeostatic functions. Side effects include suppression of hemostasis through inhibition of platelet aggregation, adverse effects in patients with heart failure and cirrhosis, and those with certain renal diseases, as well as complicating antihypertensive therapies involving diuretics or beta-adrenoceptor blockade. Perhaps most importantly, NSAIDs disrupt the gastrointestinal mucosal-protective and acid-limiting properties of prostaglandins, frequently leading to upper gastrointestinal erosions and ulceration, with possible subsequent hemorrhage and perforation. These complications can be reduced through identification of patients at risk, with circumspect use of NSAIDs, careful functional monitoring, and, in the case of gastrointestinal toxicity, co-administration of such agents as misoprostol or omeprazole. However, these strategies introduce complexity into the treatment paradigm. Moreover, side effects and adverse events may be significantly reduced through the use of COX-2-specific inhibitors, new agents that alleviate pain and inflammation without the liability for adverse events caused by COX-1 inhibition.
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PMID:Gastrointestinal effects of nonsteroidal anti-inflammatory therapy. 1039 Jan 23

Mangafodipir trisodium (Mn-DPDP, Teslascan) is a well-tolerated liver contrast agent. Although the enhancement characteristics of the cirrhotic liver after Mangafodipir trisodium administration have been studied, at present there is no published data on the impact that cirrhosis might have on the safety and efficacy profiles of this agent. Our objective is to evaluate by means of a retrospective comparison the safety and efficacy of Mangafodipir trisodium in patients with underlying cirrhosis who were examined for suspicion of focal liver lesions. A total of 923 patients received Mangafodipir trisodium (5 micromol/kg) in 11 prospective randomized European clinical trials. Adverse events and discomfort were recorded and graded in all patients. The efficacy analyses were performed on the subsets consisting of 617 patients with independent lesion counts (detection), and on the subset with 399 patients with independent and onsite final lesion diagnosis (characterization). Of the 399 patients, 149 had histologic confirmation. One hundred eighty of 923 patients (19.5%) had cirrhosis. There were no main differences between cirrhotic and non-cirrhotic patients. Adverse events were observed in 64 patients (6.9%), 6.7% in the cirrhotic group and 7.0% in the non-cirrhotic group, a non-significant difference. Adverse events in most patients were mild or moderate. The presence and intensity of the events did not differ between groups. Discomfort was recorded in 79 patients (8.6%), equally distributed in cirrhotic (6.1%) and non-cirrhotic (9.2%) patients. Regarding lesion count, significantly more lesions were found in the post- than in the precontrast images in both the cirrhotic and non-cirrhotic groups ( p<0.0001). This increase was not influenced by the presence of liver cirrhosis ( p=0.94). Lesion characterization was significantly improved in cirrhotic patients after administration of Mangafodipir trisodium ( p=0.002) but not in non-cirrhotic patients ( p=0.13). Mangafodipir trisodium is a safe and well-tolerated useful contrast agent in patients with cirrhosis.
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PMID:Safety and efficacy of Mangafodipir trisodium in patients with liver lesions and cirrhosis. 1283 86


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