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

Acute fatty liver of pregnancy is a rare disease which may be letal if diagnosis is missed. The pathogenesis is not completely clear, but there is some evidence that some cases have been associated with a genetic deficiency of fatty acid beta-oxidation. Other predisposing factors include primiparity, multiple pregnancy, male fetal sex and pre-eclampsia. Clinical presentation and laboratory findings are often unspecific. Increasing serum aminotransferases are characteristic in the early stage of the disease. Liver biopsy establishes the diagnosis and typically shows microvesicular, centrilobular fatty changes of hepatocytes. Differential diagnosis includes the HELLP-Syndrome, cholestasis of pregnancy, pre-eclampsia and viral or drug induced hepatitis. Without adequate treatment liver failure with coagulopathy and encephalopathy may develop. Two cases of acute fatty liver in pregnancy in an early stage are presented. Clinical and histopathological findings as well as diagnostic and therapeutic procedures are discussed.
 ...
PMID:[Acute fatty liver in pregnancy: clinical and histopathological course. Case report]. 1188 62

A young woman with pre-eclampsia became unresponsive shortly after delivery. Examination revealed extensive brain stem dysfunction with absent pupillary light reflexes and decerebrate posturing. Computed tomography showed hypodensity throughout the brain stem, and it was initially thought that she had suffered catastrophic brain stem infarction. However, magnetic resonance diffusion imaging and apparent diffusion coefficient mapping showed that she had brain stem vasogenic oedema (posterior reversible encephalopathy syndrome, PRES), rather than cytotoxic oedema. With antihypertensive and supportive treatment, she recovered rapidly, and had no abnormalities on repeat imaging.
 ...
PMID:Don't throw in the towel! A case of reversible coma. 1208 57

Posterior reversible encephalopathy syndrome is a proposed cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, and other focal neurological signs, and a diagnostic magnetic resonance imaging picture. A variety of different etiologies have been reported like hypertension, pre-eclampsia/eclampsia, cyclosporin A or tacrolimus neurotoxicity, uraemia and porphyria. With early diagnosis and prompt treatment, the syndrome is usually fully reversible. We report a case of recurrent PRES of unknown aetiology following intensive care unit treatment and only moderately elevated blood pressure. Clinicians as well as radiologists must be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent deficits.
 ...
PMID:Recurrent posterior reversible encephalopathy syndrome (PRES). 1503 79

Oxidative stress usually occurs when the production of damaging free radicals (ROS) and other oxidative molecules exceeds the capacity of the body's antioxidant defenses. This process is supposed to begin after the delivery, but it can even affect the fetus when maternal pregnancy diseases (i.e.: pre-eclampsia, eclampsia, maternal infections) occur and in the case of preterm delivery. Most living organisms have developed well integrated antioxidant defenses to prevent the potential negative role of the ROS, in order to scavenge them and to control their concentration. These mechanisms are deficient in preterm newborn. Many illnesses in preterm infants, including bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), brain injury such as hypoxic/ischemic encephalopathy, and intraventricular hemorrhage (IVH) are thought to be related to the action of ROS. This presumably occurs due to the fact that the antioxidant system of preterm infants is at the same time highly stressed and incompletely developed. Unfortunately, the clinical trials which tried to prevent oxidative stress using antioxidant agents failed their objective and therefore they cannot be considered as an effective therapy. The objective of this review is to clarify the role of oxidative stress in the development of the previous severe diseases in preterm infants, and its possible correlation with hyperbilirubemia.
 ...
PMID:Role of oxidative stress as physiopathologic factor in the preterm infant. 1545 36

The critical states occurring during pregnancy, labor, and early puerperium were analyzed. Seventy puerperas treated at intensive care units (ICU) were examined. The patients were divided into 5 groups: 1) those with preeclampsia (n = 15); 2) eclampsia (n = 22); 3) massive blood loss (n = 17); 4) pyoseptic complications (n = 10); 5) acute respiratory failure (n = 6). The APACHE II scale severity was 22 +/- 5.3 scores. The mean age of puerperas is 29.2 +/- 7.2 years. Total mortality was 14.3%. Parametric and non-parametric statistic methods were used to analyze the reasons for referral of the patients to ICU, their age composition, the association of an outcome to the time of their referral to ICU, the duration of stay there and at hospital, mortality, the time of controlled ventilation, the incidence of multiorgan failure. The common reasons for referral of the puerperas from maternity homes to ICU were eclampsia, preeclampsia, and massive blood loss. Acute respiratory distress syndrome (52.9%), encephalopathy (44.3%), coma (47.1%), and intestinal insufficiency (38.6%) were predominant in the pattern of multiorgan failure in intensive care obstetric patients. When emergencies occurred in puerperas, earlier referral from maternal homes to ICU caused a reduction in mortality from 33.% at referral on day 3 after their occurrence to 23.5% at referral on day 2, and to 11.5 at referral on day 1.
 ...
PMID:[Postpartum emergencies: some aspects]. 1571 18

A 34-year-old woman with eclampsia and the hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome developed encephalopathy, cardiomyopathy, pulmonary edema, liver failure, and disseminated intravascular coagulation (DIC), all of which resolved. She also had retinal hemorrhages in both eyes and a hemorrhagic infarct in the left occipital lobe that resulted in a permanent right homonymous hemianopia and a persistently depressed acuity of 20/100 OS. This case is unusual in demonstrating permanent visual deficits. In nearly all cases of preeclampsia or eclampsia, visual deficits are reversible. The superimposition of the HELLP syndrome may create more neurologic damage. Clinicians should be alert to patients at risk for HELLP syndrome and manage them aggressively.
 ...
PMID:Permanent visual deficits secondary to the HELLP syndrome. 1593 36

Establishing consistency between cerebral palsy registries in reporting of new cases enables more effective collaboration in terms of researching predisposing factors. To identify antenatal and intrapartum risk factors for cerebral palsy in the Estonian population, we undertook a matched case-control study of 153 children with cerebral palsy, ascertained from a population-based survey. One hundred two maternal, antenatal, and intrapartum variables were initially retrieved from medical records. Main outcome measures were the odds ratio estimates of relative risk of cerebral palsy. As a result of the study, and considering the whole spectrum of severity, the relevant risk factors during pregnancy were bleeding after 20 weeks, anemia in the second half of pregnancy, pregnancy-induced hypertension in the second half of pregnancy, and preeclampsia. The most important intrapartum factors were premature birth, placental abruption, an acute hypoxic event during delivery, and any fetal presentation other than vertex. Predisposing factors related to neonatal condition were an Apgar score < or = 7 at the first and fifth minutes of life, hypoxic-ischemic encephalopathy, and assisted ventilation. Our findings suggest that intrapartum factors, including those hypothetically realized through hypoxic-ischemic pathways, are not of low importance in the etiology of cerebral palsy.
 ...
PMID:Ante- and perinatal factors for cerebral palsy: case-control study in Estonia. 1622 10

We have conducted a case-control retrospective study to determine the risk of Intra Uterine Growth Retardation (IUGR) in pregnant women with preeclampsia. We have found that IUGR is one of the most prominent features of preeclampsia and occurs in 27% of cases (Odds Ratio 1.20). IUGR occurs during fetal-placental insufficiency (ultrasound structural changes of placenta such as aging and calcifications take place in 67.8% of cases, oligohydramnia in 42.8% of cases, changes of hemodynamics in maternal -- fetal placental unit -- in 82.3% of cases; deviation from the norm of resistance index and pulse index was 1.5-2 times higher). IUGR was accompanied with the poor functional state of the fetus (85.7% according to the cardiotocographic monitoring); morphological investigation of placenta showed dystrophic and destructive changes, which finally leads to the high rate of morbidity during neonatal period (hypoxic-ischemic encephalopathy -- 66%, respiratory distress syndrome -- 36%, pneumonia and atelectasis --14%) and fetal functional immaturity confirmed by EEG.
 ...
PMID:[Risk of iugr syndrome development during preeclampsia of the pregnant]. 1636 54

On the back of sheep experiments showing that uterine hypoxia induces a rapid and sustained elevation of fetal activin A levels, we undertook two prospective studies to explore whether this novel observation could be exploited clinically. The first was a prospective labour ward study investigating whether umbilical arterial activin A levels at delivery correlated with either neonatal hypoxic ischaemic encephalopathy or pH. Unfortunately, we were unable to demonstrate a link with either, but found that levels were significantly depressed among those who had an emergency Caesarean section, suggesting a possible role in active labour. Second, we investigated the link between activin A and intrauterine growth restriction (IUGR), a condition of fetoplacental hypoxia, by measuring levels in women presenting for antenatal ultrasound biometry with clinical suspicion of a small baby. We found that, compared to pregnancies with a baby that was small for gestational age (SGA) but otherwise healthy, levels were 2.4 and 8 times higher, respectively, in pregnancies complicated by IUGR, and those complicated by both IUGR and preeclampsia. However, a single blood sample of activin A was unable to distinguish between IUGR and SGA pregnancies with sufficient sensitivity to be clinically useful. Our studies were unable to demonstrate clinical utility for the experimental observation linking activin A and hypoxia.
 ...
PMID:Activin A, hypoxia and the prediction of obstetric outcomes. 1663 38

The spontaneous liver rupture associated with preeclampsia is a potential life threatening condition that requires a multidisciplinary team approach. There are near 200 cases reported in the world literature. This paper presents four cases of liver rupture associated with preeclampsia, three of which were consecutive with only two days apart, describing the clinical features and the therapeutic approaches. We also discussed about the mortality, which occurred in one of our cases, and perinatal mortality that affected one newborn and another one had neonatal encephalopathy secuelae. Three of the cases were managed in a surgical manner, one of them also with selective hepatic artery embolization meanwhile another one received conservative management. It is important to suspect this pathology in the preeclamptic patient, especially if she develops HELLP syndrome, in order to establish opportune diagnosis and treatment with a team including the intensive care, surgery and obstetrical staff.
 ...
PMID:[Spontaneous hepatic rupture of pregnancy. A report of four cases and medical literature review]. 1688 70


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>