Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0235108 (tense)
 2,176 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 3-day-old Quarter Horse colt was examined because of signs of severe depression, discomfort, and abdominal straining. The foal seemed disoriented, and the abdomen was tense and distended ventrally. The differential diagnoses included ruptured urinary bladder, retained meconium, septicemia/bacteremia, and neonatal maladjustment syndrome. Serum biochemical analysis revealed marked hyponatremia, hypochloremia, and moderate hyperkalemia, as well as mildly high urea, creatinine, and phosphorus concentrations. The primary differential diagnosis at this time was ruptured urinary bladder. Abdominocentesis was performed to confirm this diagnosis. Microscopic examination of abdominal fluid revealed calcium carbonate crystals, which originated from the urine of the foal. Biochemical analysis also confirmed the diagnosis of ruptured urinary bladder, because the ratio of peritoneal fluid creatinine to serum creatinine was 2.8:1. The foal died before surgical correction could be attempted.
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PMID:Diagnosis of ruptured urinary bladder in a foal by the identification of calcium carbonate crystals in the peritoneal fluid. 161 90

An 8-year-old sexually intact male llama was euthanatized because of obstruction of the penile portion of the urethra and rupture of the urinary bladder. Clinical signs of obstruction included anorexia, lethargy, teeth grinding, straining to defecate, inability to urinate, and tense abdomen. Laboratory findings included anemia, leukocytosis with left shift, high serum urea nitrogen, creatinine, and phosphorus concentrations, and low serum chloride concentration. Necropsy revealed ruptured urinary bladder and acute fibrinous peritonitis. A firm, gray, nonmineralized urethral plug occluded the penile portion of the urethra for a distance of 14 cm in the midpenile region, distal to the sigmoid flexure of the penis. The urinary bladder mucosa and the urethra had microscopic evidence of chronic inflammation. Escherichia coli, Klebsiella sp, and alpha-streptococci were isolated from the urethral plug.
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PMID:Urethral obstruction in a male llama. 259 47

In patients with portal hypertension and tense ascites, large-volume paracentesis improves patient comfort and may improve systemic hemodynamics. However, it has been avoided in nonedematous patients because of concern for complications, including intravascular volume depletion. In this study, 12 nonedematous patients with chronic liver disease, portal hypertension and tense ascites underwent 14 large-volume (5-liter) paracenteses for the relief of discomfort and/or respiratory distress. Plasma volume was measured directly by a dilution method with 125I-labeled human serum albumin prior to and at 24 or 48 hr after 13 of the paracenteses. All patients felt better postparacentesis. No dizziness, hypotension, tachycardia, encephalopathy or change in mean serum sodium, creatinine or blood urea nitrogen occurred. Two patients experienced a decrease in hematocrit, which was not explained by blood loss or increase in plasma volume. Mean plasma volume was 3,713 +/- 129 ml (55.1 +/- 1.5 ml per kg ideal body weight) preparacentesis and 3,684 +/- 136 ml postparacentesis, the difference being -0.78% (p = 0.48, NS). Our results suggest that 5-liter paracentesis in nonedematous patients with tense portal hypertension-related ascites improves patient comfort and is not associated with a decrease in measured plasma volume.
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PMID:Large-volume paracentesis in nonedematous patients with tense ascites: its effect on intravascular volume. 335

It has recently been shown that repeated large-volume paracentesis associated with intravenous albumin infusion is a rapid, effective, and safe therapy of ascites in cirrhosis. To investigate whether intravenous albumin infusion is necessary in the treatment of cirrhotics with large-volume paracentesis, 105 patients with tense ascites were randomly allocated into two groups. Fifty-two patients (group 1) were treated with paracentesis (4-6 L/day until disappearance of ascites) plus intravenous albumin infusion (40 g after each tap), and 53 (group 2) with paracentesis without albumin infusion. After disappearance of ascites, patients were discharged from the hospital with diuretics. Patients developing tense ascites during follow-up were treated according to their initial schedule. Paracentesis was effective in eliminating the ascites in 50 patients from group 1 and in 48 from group 2, with the duration of the hospital stay being approximately 11 days in both groups. Paracentesis plus intravenous albumin did not induce significant changes in standard renal function tests, plasma renin activity, and plasma aldosterone. In contrast, paracentesis without albumin was associated with a significant increase in blood urea nitrogen, a marked elevation in plasma renin activity and plasma aldosterone concentration, and a significant reduction in serum sodium concentration. One patient from group 1 and 11 from group 2 developed renal impairment or severe hyponatremia after treatment, or both (chi 2 = 9.19; p less than 0.01). The development of these complications could not be predicted by clinical and laboratory data before treatment. Although the probability of survival after entry into the study was similar in patients from both groups, a multivariate analysis identified the development of hyponatremia or renal impairment, or both, following the first paracentesis treatment and the occurrence of other complications during the first hospitalization (encephalopathy, gastrointestinal bleeding, and severe infection) as being the only independent predictors of mortality. These results indicate that intravenous albumin infusion is important in avoiding renal and electrolyte complications and activation of endogenous vasoactive systems in cirrhotics with ascites who are treated with repeated large-volume paracentesis. The development of such complications may impair survival in these patients.
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PMID:Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis. 336 Feb 70

Large volume paracentesis, while effectively relieving symptoms in patients with tense ascites, has been generally avoided due to reports of complications attributed to an acute reduction in intravascular volume. Measurements of plasma volume in these subjects have been by indirect methods and have not uniformly confirmed hypovolemia. We have prospectively evaluated 18 patients (20 paracenteses) with tense ascites and peripheral edema due to chronic liver disease undergoing 5 liter paracentesis for relief of symptoms. Plasma volume pre- and postparacentesis was assessed by a 125I-labeled human serum albumin dilution technique as well as by the change in hematocrit and postural blood pressure difference. No significant change in serum sodium, urea nitrogen, hematocrit or postural systolic blood pressure difference was noted at 24 or 48 hr after paracentesis. Serum creatinine at 24 hr after paracentesis was unchanged but a small but statistically significant increase in serum creatinine (+0.1 +/- 0.3 mg per dl, p less than 0.01) was noted at 48 hr postparacentesis. Plasma volume changed -2.7% (n = 6, not statistically significant) during the first 24 hr and -2.8% (n = 12, not statistically significant) during the 0- to 48-hr period. No complications from paracentesis were noted. These results suggest that 5 liter paracentesis for relief of symptoms is safe in patients with tense ascites and peripheral edema from chronic liver disease.
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PMID:The effect of large volume paracentesis on plasma volume--a cause of hypovolemia? 388 8

In 2 separate series of dogs a segment of ureter was isolated from both bladder and kidney and left in situ with an intact blood supply. Tense cysts formed in these sequestered segments regardless of whether the ends were occluded or the segments were split longitudinally and left open. The formation of these cysts can be prevented by the removal of the urothelium. The cyst contents were found consistently to have a sodium concentration below that of the simultaneously obtained serum concentration and urea concentration higher than the simultaneously obtained serum urea. Osmolalities and protein levels within the cysts were virtually identical to the serum levels.
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PMID:Sequestration of ureteric segments in dogs. 723 40

Total paracentesis is widely used in the treatment of patients with cirrhosis and tense ascites. However, very little information is available regarding its consequences on splanchnic circulation, and its effects on portocollateral blood flow have not been investigated. Ten cirrhotic patients admitted because of tense ascites had measurements of hepatic and systemic hemodynamics, renal function and endogenous vasoactive neurohumoral systems at baseline, just after total paracentesis and 1 hr later. Total paracentesis caused a significant increase in cardiac output (+11%; 95% confidence interval, +4% to +19%) and a rapid fall in portal pressure, as shown by significant decreases in both the wedged hepatic venous pressure (-27% +/- 8%; p < 0.005) and the hepatic venous pressure gradient (-10%; 95% confidence interval, -3% to -18%). This was accompanied by a marked decrease in azygos blood flow (-28%; 95% confidence interval, -13% to -43%). These favorable hemodynamic effects were associated with a fall of the elevated levels of plasma renin activity (-47% +/- 9%; p < 0.05), plasma aldosterone (-31% +/- 21%; p < 0.05) and plasma norepinephrine and by a decrease in levels of serum creatinine (-24% +/- 15%; p < 0.05) and blood urea nitrogen (-4% +/- 3%; p < 0.05). These changes were maintained 1 hr later. This study indicates that in patients with cirrhosis and tense ascites total paracentesis favorably influences the systemic hemodynamics, portocollateral blood flow and portal pressure.
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PMID:Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites. 802 Sep 1

Management of tense ascites in cirrhotic patients on chronic hemodialysis is still a matter of speculation. A considerable problem with these patients is the frequent occurrence of hypotension during ultrafiltration. We describe a patient in whom ascitic fluid was reinfused on the arterial line and ultrafiltrated during standard treatment by using a single dialysis monitor, standard dialysis (SD) lines, and a standard hollow-fiber dialyzer. After 30 to 60 minutes of dialysis, with the patient lying on his left side, a gauge #16 IV catheter was introduced into the left lower abdomen and connected to the reinfusion line. The ascitic fluid was pumped from the abdomen to the arterious inlet of the coil at 500 to 2,000 mL/hr and ultrafiltered. In an individual patient, 13 sessions of ascites reinfusion-ultrafiltration dialysis (ARD) were performed over 3 months and compared with 18 SD sessions performed during the same period. In all procedures, the same SD equipment was used. During ARD, the average weight loss was 2.9 (SD 1.0) kg compared with a weight loss of 0.3 (0.04) kg during SD (P < 0.01). Baseline mean blood pressure was similar in both procedures; after starting dialysis, mean arterial pressure (MAP) dropped by an average of 15 mm Hg at 30 and 60 minutes. Subsequently, during ARD, MAP increased progressively by an average of 20 mm Hg at 180 minutes, whereas MAP did not change significantly during SD. Comparison between procedures by nonparametric one-way analysis of variance showed that body weight became significantly different at 120, 150, and 180 minutes (P < 0.01) and MAP at 150 and 180 minutes (P < 0.02 and P < 0.01, respectively). No major complications occurred. During ARD, on average urea reduction rate was 67%. ARD may represent an effective and safe combination between hemodialysis and the palliative treatment of tense ascites in cirrhotic uremic patients.
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PMID:Reinfusion and concentration of ascitic fluid during hemodialysis in a cirrhotic uremic patient. 966 39

We report a case of a nine-year old boy with vomiting, abdominal pain and fever, who underwent surgery with a diagnosis of appendicitis in Mendoza and from whom a Shiga toxin-producing Escherichia coli (STEC) O127:H21 strain was recovered. Forty-eight hours after surgery he presented bilious vomiting and two episodes of intestinal bleeding. Laboratory findings included: hematocrit, 35%; blood urea nitrogen, 0.22 g/L. The urinary output was normal. The following day physical examination showed an alert mildly hydrated child, without fever but with distended and painful abdomen. The patient was again submitted to surgery with a diagnosis of intestinal occlusion. Bleeding and multiple adhesions in jejunum and ileum were found. The patient still had tense and painful abdomen and presented two bowel movements with blood; hematocrit fell to 29% and blood urea nitrogen rose to 0.32 g/L. STEC O127:H21 eae(-)/Stx2/Stx2vh-b(+)/E-Hly(+) was isolated from a stool sample. He was discharged after 10 days of hospitalization and no long-term complications such as HUS or TTP were observed. This is the first report, to our knowledge, on the isolation of E. coli O127:H21, carrying the virulence factors that characterize STEC strains, associated to an enterohemorrhagic colitis case. This serotype was previously characterized as a non-classic enteropathogenic E. coli (EPEC). STEC infections can mimic infectious or noninfectious pathologies. Therefore an important aspect of clinical management is making the diagnosis using different criteria thereby avoiding misdiagnoses which have occasionally led to invasive diagnostic and therapeutic procedures or the inappropriate use of antibiotics.
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PMID:Intestinal bleeding and occlusion associated with Shiga toxin-producing Escherichia coli O127:H21. 1096 19

A 59-year-old woman undergoing narrowband UVB phototherapy for treatment of psoriasis presented suddenly with tense blisters on both hips. The blisters were asymptomatic and disappeared within 24 hours. Histopathology together with a negative porphyrin screen made the diagnosis of pseudoporphyria. Blood tests including a full blood count, urea and electrolytes, liver function tests and antinuclear autoantibodies were normal. The patient was otherwise healthy; there was no history of extensive sun exposure, sunbeds or medication with non-steroidal anti-inflammatory drugs. This presentation of pseudoporphyria secondary to narrowband UVB radiation is unusual, as UVB radiation is not known to be associated with pseudoporphyria.
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PMID:Pseudoporphyria secondary to narrowband UVB phototherapy for psoriasis. 1663 12


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