Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The neuropathology of 18 cardiac transplant recipients was reviewed with the clinical findings. Pathological changes were noted in the central nervous system (CNS) in 94% of the patients, the most frequent being cerebral vascular in origin (72%). Eight patients (44%) had multiple cerebral infarcts and morphologically, a large number of these antedated the transplantation. In addition 4 patients had acute focal ischemic changes which occurred after transplantation. Intracranial hemorrhage was noted in 5 patients (28%), including one case of fatal intracerebral hemorrhage following an acute hypertensive episode after the transplantation. While systemic infection was common (10 patients), there were only 5 cases of intracranial infection; including 3 cases of cytomegalovirus infection, one of candidiasis and one of aspergillosis. Post-transplant seizures, occurring in a third of the patients, were related to a variety of causative factors such as sepsis, intracranial hemorrhage, cerebral ischemia, metabolic encephalopathy and cyclosporin neurotoxicity. Of note in this series was the absence of CNS lymphoma or other systemic lymphoproliferative disorder.
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PMID:Neuropathology of heart transplantation. 254 97

Central nervous system (CNS) involvement is very frequently observed in pediatric AIDS. Clinical manifestations include encephalopathy, cognitive deficits, acquired microcephaly, neurological signs, myelopathy, and peripheral neuropathy. Neurological complications can be related to opportunistic viral infections such as encephalitis, atypical aseptic meningitis, progressive multifocal leukoencephalopathy, and myelitis. Nonviral syndromes include: toxoplasmosis, cryptococcal meningitis, candidiasis, Mycobacterium tuberculosis meningitis, and Mycobacterium avium subacute encephalitis. Bacterial infections, tumors, cerebrovascular complications, and peripheral neuropathies are not frequently observed in pediatric AIDS. The most severe complications of HIV infection is encephalopathy resulting from HIV infection of brain tissue. Direct HIV invasion of the CNS has been demonstrated. Clinical features of HIV encephalopathy are classified into three categories: (1) normal neurological findings; (2) static encephalopathy; and (3) progressive encephalopathy. AIDS dementia complex can be differentiated from the predominance of behavioral and cognitive disabilities.
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PMID:Acquired immune deficiency syndrome in childhood. Neurological aspects. 268 79

Therapy with synthetic ACTH (zinc tetracosactide) in children affected by epileptic encephalopathy is often associated with a large number of infectious complications. We studied the phagocytic activity of polymorphonuclear leucocytes (PMN) in 9 children with West or Lennox-Gastaut syndrome, measuring PMN superoxide anion production during the phagocytosis of particles of Zymosan and after phorbol myristate acetate (PMA) stimulation. The test was performed before, during and after therapy with zinc tetracosactide (0.02 mg/kg/day for 15 days). At the same time plasma immunoglobulins, C3, C4, C3 activator and cortisol were determined. During treatment PMN phagocytic function was significantly reduced but returned to normal levels after suspension of therapy. The other hematological parameters considered remained within the normal range. During the follow-up of the patients we observed 15 infectious episodes (3 mucocutaneous candidiasis, 2 enterocolitis, 4 urinary tract infections, 1 otitis media, 3 bronchiolitis, 2 pneumonia). One of the patients died of a bilateral pneumonia. Three children were treated with ACTH on alternating days. In these patients PMN phagocytic activity was less impaired and 2 infectious episodes rapidly resolved. Alternate day ACTH therapy seems to be preferable.
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PMID:Impairment of polymorphonuclear leucocyte function during therapy with synthetic ACTH in children affected by epileptic encephalopathies. 300 25

We studied infections in 101 consecutive patients who underwent liver transplantation between July 1984 and September 1985. The mean length of follow-up was 394 days. Eighty-three percent of population had 1 or more episodes of infection and 67% of the population had severe infections. The overall mortality was 26/101 (26%) and 23 of 26 deaths (88%) were associated with infection. Seventy percent of severe infections occurred in the first 2 months after transplantation. The most frequent severe infections were abdominal abscess, bacterial pneumonia, invasive candidiasis, Pneumocystis pneumonia, and symptomatic cytomegalovirus infection. Patients with more than 12 hours of cumulative surgical time had a higher rate of severe infections (P less than 0.001), particularly fungal (P less than 0.001) and bacterial (P less than 0.01) infections. Also, the use of choledocho-jejunostomy was associated with a higher rate of infection in patients who had more than 1 transplant operation (P less than 0.02). No increase in infection was found in patients who received azathioprine, or more than the median number of steroid boluses or "recycles"; but patients who received OKT3 therapy had a higher rate of protozoal infections (P less than 0.05). A result similar to that of our previous studies was a strong relation between the number of severe fungal infections and prolonged courses of antibiotics after transplant operation (P less than 0.001). Pretransplant manifestations of severe liver disease such as ascites, encephalopathy, and gastrointestinal bleeding were not associated with higher rates of infection after transplantation, but high serum levels of ALT were. Patients with lower ratios of T-helper to T-suppressor lymphocytes had more severe viral (P less than 0.02) and fungal (P less than 0.01) infections after transplantation.
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PMID:Infections after liver transplantation. An analysis of 101 consecutive cases. 328 Sep 44

To investigate a possible protective role of HTLV-III neutralizing antibodies in individuals exposed to the virus, sera of children with acquired immunodeficiency syndrome or acquired immunodeficiency syndrome-related complex were analyzed for neutralizability of HTLV-IIIB infectivity. Twelve pediatric patients (nine acquired immunodeficiency syndrome, three acquired immunodeficiency syndrome-related complex) were clinically stable and had survived more than 2 yr postonset. Their predominant clinical problems included lymphocytic interstitial pneumonia, candidiasis, recurrent bacterial infections, failure to thrive, and lymphadenopathy. Twelve additional children (all acquired immunodeficiency syndrome) were classified as clinically poor; 10 of them had died. Their median length of survival was less than 2 yr, and their disease spectrum included progressive encephalopathy, thymic depletion or atrophy, and Pneumocystis carinii pneumonia in addition to many of the clinical features of the stable children. All (100%) of the stable patients possessed serum neutralizing antibody in contrast to only one of the 12 (8%) clinically poor patients. A simple decline in immunologic reactivity to HTLV-III antigens with disease progression did not account for this difference, since HTLV-III antibody titers of the clinically poor cases (1 X 10(2) to 1 X 10(7)) ranged as high as those of the stable cases (1 X 10(4) to 1 X 10(7)) when measured by the ELISA technique. Although stable cases possessed a higher geometric mean titer (2.8 X 10(5)) by ELISA than the poor cases (4 X 10(4)), this difference was not statistically significant. Serial serum samples from stable children exhibited continual neutralizing antibody activity while two of three clinically poor cases lacked neutralizing activity in serial specimens.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationship between HTLV-III neutralizing antibody and clinical status of pediatric acquired immunodeficiency syndrome (AIDS) and AIDS-related complex cases. 347 82

Patients with acute liver failure (ALF) have increased susceptibility to infections, principally as a result of impaired phagocytic function, reduced complement levels, and the need for invasive procedures. Bacteriologically proven infection is recorded in up to 80% of these patients and fungal infection (predominantly candidiasis) in 32%. Clinical signs such as high temperature and high WBC are absent in 30% of the cases. Pneumonia accounts for 50% of infective episodes, and bacteremia and urinary tract infection a further 20 to 25% each, at a median 5, 3, and 2 days, respectively, after the onset of ALF. Selective parenteral and enteral antisepsis regimens (SPEAR) were evaluated in prospective controlled studies, but early systemic antibiotics alone are as effective as SPEAR. With early antibiotics, the incidence of infective episodes is reduced to 20% and the overall mortality to 44%, with a reduction in progression to encephalopathy and an increased opportunity for transplantation.
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PMID:Bacterial and fungal infection in acute liver failure. 902 52

Malignancies may uncommonly present as fulminant hepatic failure and, due to the rarity of such an occurrence, they may easily be overlooked as one of its possible causes. An unusual case of Hodgkin's disease presenting as a fulminant hepatic failure is reported. A 34-year-old man presented with an acute onset of liver failure characterized by jaundice, ascites, encephalopathy and bleeding diathesis. Chemotherapy was initiated, resulting in a dramatic improvement not only in the patient's level of consciousness, but also in prothrombin time. Unfortunately, he succumbed shortly after to disseminated candidiasis. A post-mortem needle liver sample revealed massive hepatocellular necrosis, but no liver infiltration by the neoplastic disease. We conclude that in Hodgkin's disease, involvement of the liver can be manifested as a syndrome of paraneoplastic fulminant hepatic failure. In such cases, liver transplantation is an absolute contraindication but urgent chemotherapy under antifungal surveillance can be life saving.
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PMID:Fulminant hepatic failure as a presenting paraneoplastic manifestation of Hodgkin's disease. 1050 47

To assess the pattern of change in the causes of death among HIV/AIDS patients in Taiwan after the introduction of highly active antiretroviral therapy (HAART), national HIV/AIDS registry data were linked with cause of death and health insurance claims data from 1994 to 2002 for analysis. Although HIV/AIDS remained the leading underlying cause of death among HIV/AIDS patients during the study period (552/752 = 73.4%), an increased proportion of deaths was due to non-HIV/AIDS causes (other infectious diseases, cancers, liver diseases, etc.) after the introduction of HAART in 1997. Deaths from suicide increased threefold, from three (1.5% of total) in 1994-1996 to 14 (4.8%) in 2000-2002. Most AIDS-related conditions associated with death (cryptococcosis, cachexia/wasting, dementia/encephalopathy, etc.) decreased in frequency from 1998-2000 to 2001-2002. Nonetheless, some AIDS-related conditions associated with death remained stable or increased in frequency, such as candidiasis, tuberculosis, and non-Hodgkin's lymphoma. In conclusion, as the duration of survival increased, the likelihood of suicide also increased. More effort is required to address the mental health of HIV/AIDS patients as a part of therapy.
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PMID:Changes in causes of death and associated conditions among persons with HIV/AIDS after the introduction of highly active antiretroviral therapy in Taiwan. 1687 43

Fulminant hepatic failure is liver disease that causes encephalopathy within 8 weeks of onset of symptoms or within 2 weeks of onset of jaundice in a patient without prior evidence of liver disease. Autoimmune polyendocrine syndrome type-1 is an autoimmune autosomal-recessive condition causing parathyroid and adrenal insufficiency, alopecia, chronic mucocutaneous candidiasis, ectodermal dystrophy and, rarely, hepatitis. Although the liver can be affected as a consequence of the autoimmune process, the spectrum of disease activity is varied. Autoimmune hepatitis develops in 10-20% of patients and successful liver transplantation has been reported in pediatric patients who failed immunosuppressive treatment. We report fulminant hepatic failure in an adult patient with autoimmune polyendocrine syndrome type-1 who responded to medical treatment and did not require liver transplantation. We highlight the diagnostic scoring system for autoimmune hepatitis and the referral criteria for liver transplantation in fulminant hepatic failure.
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PMID:Fulminant hepatic failure in autoimmune polyendocrine syndrome type-1. 2618 30