Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report reviews 164 cases derived from 2 Australian and 3 U.S. centres. There were 128 direct operations and 63 shunts. There were 16 deaths (10% mortality) but 3 were due to unrelated causes. Direct procedures; In the long term these appear of little value. 37 of 48 children having splenectomy subsequently rebled. Almost all children having ligation of varices and direct operations on the stomach rebled subsequently. Acute bleeding can almost always be controlled by conservative measures and direct operations would appear to offer no benefit over non-operative management except in the occasional case of catastrophic management that cannot be controlled conservatively. Shunts; A properly performed decompressive shunt offers the best hope of long term control for bleeding varices. Meso-caval shunts seem to give somewhat better results than splenorenal shunts. About two-thirds of the patients undergoing shunts remain free of any further bleeding. Non-operative management; 27 children have had no surgery performed and all are alive except for one child who subsequently died in a railroad accident. Bleeding episodes become less frequent after the age of 15 years and there are a number of reasons for this including the progressive development of natural shunts. We are not aware of any deaths or major complications from hypersplenism. Growth and development of all children in this series has been normal, although other have commented on a significant incidence of encephalopathy. Conclusions; 1. GIT bleeding becomes progressively less after the age of 15 years. 2. Direct operations have little place in treatment. 3. Decompressive shunts are the most effective method of controlling continuing bleeding but require a shunt of at least 1 cm diameter. 4. Splenomegaly and hypersplenism are not serious problems. 5. One can anticipate the progressive development of natural shunts. 6. Splenectomy should be avoided in this disease unless accompanied by a shunt.
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PMID:Extrahepatic portal hypertension--long-term results. 30 Dec 81

An intervention study was carried out in the department of paediatrics of Mymensingh Medical College Hospital, Mymensingh to compare the clinical efficacy of Azithromycin in the treatment of childhood typhoid fever with that of cefixime for a period of one year from January 2011 to December 2011. A total of 60 cases of typhoid fever were enrolled in to a randomized clinical trial and was divided into two groups. The inclusion criteria of the cases were: Documented fever for more than 4 days plus two or more of the following clinical features: toxic physical appearance, intestinal complaints, coated tongue, ceacal gurgling, hepatomegaly and splenomegaly, diarrhoea and constipation plus positive Widal test and/or blood culture positivity. Patients who had complication like GIT heamorrhage; intestinal perforaion and/or shock were excluded from the study. Data were collected in a structured questionnaire. Azithromycin was given at a dose of 10mg/kg/day for a period of 07 days Cefixime was given at a dose of 20mg/kg/day in two divided dose for 14 days. The mean time of defervesence was 4.05+1.14 days with azithromycin and 3.41+0.95 with cefixime respectively. The minimum defervesence time was 02 days and maximum defervesence time was 07 days. Clinical cure rate was 87% in azithromycin group and 93% in cefixime group. No serious adverse effect was noted related to azithromycin and cefixime therapy except nausea, vomiting, diarrhoea and jaundice. It was found that azithromycin is almost as effective as cefixime in the treatment of typhoid fever.
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PMID:Comparison between azithromycin and cefixime in the treatment of typhoid fever in children. 2517 94

In countries endemic for liver and GIT diseases, frequent emergency department (ED) patients contribute to a disproportionate number of visits consuming substantial amount of medical resources. One of the most frequent ED visits is patients who present with hypovolemic shock, abdominal pain, or confusion with or without signs of upper gastrointestinal bleeding (UGIB). The use of conventional two-dimensional ultrasound (2D-U/S) may provide immediate and useful information on the presence of esophageal varices, gastrointestinal tumors, and other GIT abnormalities.The current study investigated the feasibility of using (2D-U/S) to predict the source of UGIB in ED and to determine patients' priority for UGE.Between February 2003 and March 2013, we retrospectively reviewed the profiles of 38,551 Egyptian patients, aged 2 to 75 years old, who presented with a history of GI/liver diseases and no alcohol consumption. We assessed the value of 2D-U/S technology in predicting the source of UGIB.Of 38,551 patients presenting to ED, 900 patients (2.3%), 534 male (59.3%) and 366 female (40.7%) developed UGIB. Analyzing results obtained from U/S examinations by data mining for emergent UGE were patients with liver cirrhosis (LC), splenomegaly, and ascites (42.6% incidence of UGIB), followed by LC and splenomegaly (14.6%), LC only (9.4%), and was only 0.5% who had no morbidity finding by 2D-U/S.Ultrasonographic instrumentation increases the feasibility of predictive emergency medicine. The area has recently not only gained a fresh impulse, but also a new set of complex problems that needs to be addressed in the emergency medicine setting according to each priority.
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PMID:The Value of U/S to Determine Priority for Upper Gastrointestinal Endoscopy in Emergency Room. 3126 50