Hepatorenal syndrome — A defined entity with a standard treatment?

2008 ◽  
pp. 280-290
Author(s):  
A. L. Gerbes
Keyword(s):  
Hepatorenal Syndrome ◽  
Standard Treatment

Renal replacement therapy as bridging-to-recovery in refractory hepatorenal syndrome

2021 ◽  
Vol 59 (04) ◽  
pp. 331-335
Author(s):  
Christoph Luedemann ◽  
Jessica Plota ◽  
Jacob Nattermann ◽  
Christian P. Strassburg ◽  
Philipp Lutz ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Hepatorenal Syndrome ◽  
Standard Treatment ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Hepatic Hydrothorax ◽  
Bridging Therapy ◽  
Good Clinical Condition ◽  
Abstinence From Alcohol

AbstractA 50-year-old female patient with cirrhosis due to alcoholic steatohepatitis was referred to our department because of recurrent hepatorenal syndrome (HRS) and hepatic hydrothorax. Clinically, severe anasarca was the leading problem. In contrast to previous episodes, HRS did not respond to standard treatment including terlipressin.Given the severe, refractory hyperhydration, we finally initiated renal replacement therapy (RRT). Subsequently, RRT was performed without severe side effects for more than 100 days. In the meantime, liver function remarkably improved, most probably due to the prolonged abstinence from alcohol. Finally, RRT could be stopped. Since then, our patient has remained in good clinical condition for more than 6 months, with well-compensated Child-Pugh stage A cirrhosis and only mild chronic kidney disease stage III.In conclusion, this case highlights that RRT may be considered in individual cases as bridging therapy in refractory HRS until the liver regenerates due to the absence of damaging mechanisms.

Treatment of Delayed Union and Septic Osteomyelitis of Metacarpus III/IV in a Calf Using Gentamicin-impregnated Collagen Sponges and Minimal External Coaptation

1998 ◽  
Vol 11 (01) ◽  
pp. 19-22 ◽  
Author(s):  
A. Steiner ◽  
Gaby Hirsbrunner
Keyword(s):  
Standard Treatment ◽  
Delayed Union ◽  
Surgical Debridement ◽  
Rigid Fixation ◽  
Skin Defect ◽  
Long Time ◽  
Metaphyseal Fracture ◽  
External Stabilization ◽  
Long Acting ◽  
Local Antibiotic

SummaryA newborn calf was admitted for evaluation of a primarily closed comminuted metaphyseal fracture of metacarpus III/IV. Closed reduction and application of transfixation pins and a fibreglass cast were performed. Ten days after pin removal, radiographs revealed that the initially healed fracture had collapsed, and osteomyelitis was diagnosed. Bacteriological culture from the deep draining tract yielded Actinomyces pyogenes and Staphylococcus aureus. Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation, and long-time administration of antibiotics. In this case, we used surgical debridement, administration of a new long-acting local antibiotic (gentamicin- impregnated collagen sponges), and minimal external stabilization. At day 27 after initiation of this treatment, the skin defect had healed, and the fracture was stable on manual palpation.Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation and prolonged administration of antibiotics. In the case described, we used surgical debridement, administration of a long-acting local antibiotic (gentamicin-impregnated collagen sponges), and minimal external stabilization. The promising outcome of this case and the good results in human surgery warrant further investigation in the use of gentamicin-impregnated collagen sponges in veterinary orthopaedics.

NICOLAU SYNDROME DUE TO INTRAMUSCULAR DICLOFENAC SODIUM INJECTION

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Harris I Shaafie ◽  
Soumya Agarwal ◽  
Swosti Mohanty ◽  
Chandni Jain
Keyword(s):  
Standard Treatment ◽  
Rare Complication ◽  
Diclofenac Sodium ◽  
Tissue Necrosis ◽  
Cytotoxic Effects ◽  
Direct Damage ◽  
Nicolau Syndrome ◽  
Syndrome Diagnosis ◽  
Embolia Cutis Medicamentosa ◽  
Pigmentary Pattern

Nicolau syndrome (NS) is a rare complication characterized by tissue necrosis that occurs after parenteral injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery, acute vasospasm and cytotoxic effects of the drug. Severe pain in the immediate post injection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Herein, we present a rare case of NS due to Diclofenac Sodium (Voltaren®) injection in an 80-year-old female suffering from Lower Respiratory Tract Infection (LRTI) who was managed conservatively. Keywords: Nicolau Syndrome, Embolia cutis medicamentosa, Voltaren, Diclofenac sodium

Соматические дисфункции у детей с задержкой речи

2017 ◽  
pp. 61-65
Author(s):  
E. L. Kuznetsova ◽  
L. A. Dultsev ◽  
E. V. Safin
Keyword(s):  
Standard Treatment ◽  
Control Group ◽  
Complex Therapy ◽  
Osteopathic Treatment ◽  
Positive Effect ◽  
Experimental Group

Goal of research - the study aims to examine the osteopathic profi le of children with dysarthria and to develop recommendations for osteopathic correction of somatic dysfunctions in 2-3 year old children presenting this pathology.Materials and methods. 30 2-3 year old children with the symptoms of dysarthria took part in the research. All the children were divided into 2 groups: the control group of 15 children received standard treatment, and the experimental group of 15 children received both standard and osteopathic treatment. The dysarthria severity and the osteopathic profi le were evaluated with account of the number of somatic dysfunctions at global, regional, and local levels.Results. The osteopathic correction was shown to have a positive effect on dysarthria severity. The study established a correlation between the dysarthria severity in children and the number of somatic dysfunctions at the local level.Conclusion. The study suggests using osteopathic correction of somatic dysfunctions in the complex therapy of dysarthria in children.

Clinical, morphological and biochemical signs of polymycotoxicosis in highly productive cows

2020 ◽  
pp. 14-17
Author(s):  
Irina A. Shkuratova ◽  
◽  
Lyudmila I. Drozdova ◽  
Aleksander I. Belousov ◽  
Keyword(s):  
Metabolic Disorders ◽  
Hepatorenal Syndrome ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
The Body ◽  
Feed Mixture ◽  
Milk Productivity ◽  
Structural Disorders ◽  
Increased Sensitivity ◽  
Penicillium Spp

Mycotoxicological monitoring of forages shows that the problem of mycotoxicosis has been relevant for several decades. Minimal doses of mycotoxins in feed lead to a decrease in milk productivity, increased sensitivity to infectious and non-infectious diseases. When several mycotoxins enter the body simultaneously, a synergistic effect develops, causing a significant increase in toxicity. Feed contaminated with several types of fungi and their toxins is dangerous for dairy cattle. It was found that the feed mixture contained the types of associations of Aspergillus spp. fungi + Fusarium; Aspergillus spp. + Penicillium spp. + Mucor spp; Fusarium + Penicillium; Mucor spp. + Fusarium + Ustilaginales. Pathogenetic features of metabolic and morphological changes in highly productive cows with polymycotoxicosis were studied. Feeding food contaminated with various metabolites of mold fungi leads to the development of signs of chronic toxemia in animals. Clinical manifestations are the development of diarrhea and dehydration, with a decrease in milk productivity. Metabolic disorders feature the development of an inflammatory process, metabolic acidosis, hyperfermentonemia, with an increase in the amount of creatinine and urea in the blood serum. Metabolic signs indicate the development of hepatorenal syndrome due to structural disorders of the liver and kidneys. Histological signs of polymicotoxicosis are intracapillary and hemorrhagic glomerulonephritis, hepatocyte micronecrosis, and proliferation of connective tissue stroma cells, which leads to the development of atrophic cirrhosis in the interstitial and circular phases.

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