scholarly journals Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

2003 ◽  
Vol 40 (3) ◽  
pp. 166-172 ◽  
Author(s):  
Eduardo Balzano Maulaz ◽  
Angelo Alves de Mattos ◽  
Júlio Pereira-Lima ◽  
Judite Dietz
Keyword(s):  
Liver Disease ◽  
Staphylococcus Epidermidis ◽  
Clinical Evidence ◽  
Group A Streptococcus ◽  
Coagulase Negative Staphylococcus ◽  
Endoscopic Variceal Ligation ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Staphylococcus Hominis

BACKGROUND: Endoscopic procedures can develop bacteremia. Patients with chronic liver disease are more predisposed to undergo bacteremia and infections because they are immunocompromised. AIMS: The purpose of this study was to determine the incidence of bacteremia in cirrhotics submitted to endoscopic variceal ligation. METHODS: Three groups of 40 patients each were studied. One group was made up of patients with cirrhosis who were submitted to ligation, a second group was composed of cirrhotics who underwent esophagogastroduodenoscopy only, and a third group was composed of patients without liver disease who underwent esophagogastroduodenoscopy. Blood was sampled from all patients for culture, both in aerobic and in anaerobic mediums, immediately before endoscopy and at 5 and 30 minutes after its completion. RESULTS: Blood culture was positive in 6 samples. In 4 of these, the bacteria (Staphylococcus hominis hominis, Staphylococcus auricularis, Acinetobacter lwoffii, and coagulase-negative staphylococcus) were isolated before the endoscopic procedure and thus were considered as contamination. In the ligation group, a streptococcus of the viridans group was isolated 5 minutes after the procedure, and in the cirrhosis without ligation group, a Staphylococcus epidermidis was isolated at 30 minutes. None of the patients showed clinical evidence of infection. CONCLUSIONS: The bacteremia incidence in cirrhotic patients submitted to variceal ligation was 2.5%, showing no difference from the control groups.

scholarly journals Assessment of Malnutrition in Cirrhotic Patients

2016 ◽  
Vol 15 (2) ◽  
pp. 189-194 ◽  
Author(s):  
Mushtaque Ahmad Rana ◽  
Mohammad Abu Faisal ◽  
Mohammad Enamul Karim ◽  
Abu Raihan Siddique ◽  
Dewan Saifuddin Ahmed ◽  
...  
Keyword(s):  
Liver Disease ◽  
Nutritional Status ◽  
Medical Science ◽  
Assessment Tools ◽  
Severe Malnutrition ◽  
Group A ◽  
Malnourished Patient ◽  
Study Population ◽  
Cirrhotic Patients ◽  
Anthropometric Assessment

Malnutrition is a common but frequently overlooked problem among patients with cirrhosis of liver. Malnourished cirrhotic patients have a higher rate of complications and an overall increased mortality. Identifying these patients is of great clinical importance. This study was carried out to assess nutritional status of cirrhotic patients to identify those who are malnourished and to see the relationship between severity of liver disease and malnutrition. 105 patients were selected by purposive type sampling. Nutritional status was assessed by 3 anthropometric assessment tools- body mass index (BMI), mid upper arm muscle circumference (MAMC) and triceps skin fold thickness (TST). Severity of liver disease was assessed by Child-Pugh (CP) score. Severe malnutrition was defined as MAMC and TST <5th percentile, calculated from standard tables, and as BMI <16. Among 105 patients 18, 49 and 38 were of Child-Pugh group (CP group) A, B and C respectively. Anthropometric assessment revealed that, when assessed by MAMC 63% of the study population were severely malnourished. Based on MAMC, severe malnutrition was present in 39%, 63% and 73% patients in CP group A, B and C, respectively (P<0.05). So, percentage of severely malnourished patient increased with the increase in severity of liver disease. Based on TST, 28%, 34% and 50% patients were severely malnourished in CP-A, CP-B and in CP-C (p>0.05) respectively which showed a trend similar to that by MAMC. Whereas, based on BMI, 0%, 8% and 2% patients were severely malnourished respectively (p>0.05). It showed a decrease in the percentage of severely malnourished patient in CP group C than in CP group B. In this study, nutritional assessment by TST and MAMC revealed that severe malnutrition was common in our study population and assessment by MAMC showed a statistically significant association of severity of liver disease with severe malnutrition.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.189-194

scholarly journals Association of Adverse Effects of Red Meat Consumption with Liver Cirrhosis

2021 ◽  
Vol 15 (5) ◽  
pp. 1768-1770
Author(s):  
Gulshad Wagan ◽  
Abdullah Khilji ◽  
Kaleem Sheikh ◽  
Syed Sohail Abbas Naqvi ◽  
Imtiaz Wagan ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Meat Consumption ◽  
Red Meat ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
Group A ◽  
Cirrhotic Patients ◽  
Group B

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis and red meat consumption. Study Design: Cross-sectional Place and Duration: Medicine Department of Liaquat University Medical Hospital Jamshoro and Civil Hospital Khairpur Mir's for six months duration from December 2019 to November 2020. Methodology: Total 120 patients of both genders with chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (red meat consumption >60 gm/day) and group B (red meat consumption <60gm/day). Outcomes in term of mortality between both groups were examined. All the data was analyzed by SPSS 27.0. Results: There were 36 (60%) males and 24 (40%) were females with mean age 48.14±7.58 years in group A while in group B 39 (65%) and 21 (35%) patients were males and females with mean age 49.08±8.33 years. Cirrhotic patients with red meat consumption >60 gm/day had high mortality rate as compared to patients with red meat consumption <60 gm/day (10% Vs 3.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients and red meat consumption. Keywords: Chronic Liver Disease, Red Meat Consumption, Mortality

scholarly journals Staphylococcus epidermidis Antimicrobial δ-Toxin (Phenol-Soluble Modulin-γ) Cooperates with Host Antimicrobial Peptides to Kill Group A Streptococcus

PLoS ONE ◽  
2010 ◽  
Vol 5 (1) ◽  
pp. e8557 ◽  
Author(s):  
Anna L. Cogen ◽  
Kenshi Yamasaki ◽  
Jun Muto ◽  
Katheryn M. Sanchez ◽  
Laura Crotty Alexander ◽  
...  
Keyword(s):  
Antimicrobial Peptides ◽  
Staphylococcus Epidermidis ◽  
Group A Streptococcus ◽  
Group A

POSSIBLE ROLE OF HYPERAMMONAEMIA AND/OR OF PORTOSYSTEMIC SHUNTS ON THE VARIABILITY OF THE TSH RESPONSE TO TRH IN CIRRHOTIC PATIENTS

1978 ◽  
Vol 89 (2) ◽  
pp. 284-295 ◽  
Author(s):  
J. L. Schlienger ◽  
M. Hasselmann ◽  
M. Imler
Keyword(s):  
Liver Disease ◽  
Disease Group ◽  
Portosystemic Shunts ◽  
Advanced Cirrhosis ◽  
Free Thyroxine Index ◽  
Group A ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Group B

ABSTRACT Serum concentrations of thyroid hormones (T3, T4) and the TSH response to TRH administered iv were measured by radioimmunoassay in 21 patients with advanced cirrhosis and compared to 20 control patients without liver disease (group A). While the mean T4 values (8.6±0.3 μg/100 ml) were similar for the two groups, the mean T3 values were significantly lower in patients with liver disease (123 ± 12 vs. 156 ± 10 ng/100 ml). The mean baseline TSH levels and the magnitude of the peak were normal but very scattered in these patients. The TSH response to TRH appeared independant of nutritional status, T4 and T3, anaemia, hypoalbuminaemia, transaminasaemia and bilirubinaemia. The TSH release after TRH injection seemed however to be markedly elevated in cirrhotic patients with hyperammonaemia. Therefore, patients with liver disease were separated into two groups according to the absence (group B; n = 11) or the presence (group C; n = 10) of hyperammonaemia. Mean T4 values and the free thyroxine index were lower in group C (7.2 ± 0.6 vs. 9 ± 0.6 μg/100 ml and 1.87 ± 0.16 vs. 2.49 ± 0.15) but mean T3 and basal TSH values did not differ in group B and C. The TSH response was slightly dispersed in B and lower than that observed in A or in C (P < 0.01). A hyperresponsiveness in 4 patients and a hyperresponsiveness in 2 other patients was noted in group C without any correlation with the basal TSH value or T3 or T4 Since hyperammonaemia has been considered as a biological parameter of hepatic encephalopathy, it is suggested that the THS release which is neuraminergic controlled may be altered by this situation resulting in a cerebral aminergic mediators depletion.

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2021 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2020 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

scholarly journals Incidence of Bacteremia After Endoscopic Variceal Ligation of Oesophageal Varices in Cirrhotic Patients

2013 ◽  
Vol 24 (1) ◽  
pp. 20-22
Author(s):  
Md Shahinul Alam ◽  
Thupten K Lama ◽  
AKM Khorshed Alam
Keyword(s):  
Systemic Infection ◽  
Oesophageal Varices ◽  
Coagulase Negative Staphylococcus ◽  
Endoscopic Variceal Ligation ◽  
Grade Ii ◽  
Agar Media ◽  
Cirrhotic Patients ◽  
Medicine Today ◽  
The One ◽  
Culture Positive

Bacteremia and infectious sequelea are frequent  complications after sclerotherapy. As cirrhotic patients are  immune deficient, bacteremia occurring as a consequence  of endoscopic variceal ligation (EVL) may develop systemic  infection. The aim of the study was to see the incidence of  bacteremia in cirrhotic patients after EVL.  In this study 91 cirrhotic patients with grade II-III  oesophageal varices were enrolled and 100 EVL sessions  were done. Patients receiving antibiotics, having evidence  of infection were excluded. After the completion of EVL,  blood samples for culture and sensitivity were collected at  5minute and after 30minute and subculture done in Blood  Agar and MacConkey Agar media. We followed the patients  for a week.  Of the one hundred cases there were 30 subjects in Child A,  48 in Child B and 13 in Child C class. Four patients (4%)  had positive blood culture after EVL, three of Child A class  and one of Child B class and non in Child C class. All three  patients of Child A had culture positive in their 30minute  sample and not in 5 minute sample. The Child B patient had  culture positive in his 5minute sample and not in 30minute  sample. The bacterium isolated was Coagulase negative  Staphylococcus, which we considered it as contaminant.  None of these patients developed any infectious sequelea.  The incidence of bacteremia after EVL is yet to be  ascertained. Post EVL antibiotic prophylaxis is not  recommended. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14109 Medicine TODAY Vol.24(1) 2012 pp.20-22

Etiology, clinical presentation, laboratory diagnostics, pathogenesis of impetigo and treatment methods

2020 ◽  
pp. 64-70
Author(s):  
Anastasiya Laknitskaya
Keyword(s):  
Streptococcus Pyogenes ◽  
Skin Diseases ◽  
Group A Streptococcus ◽  
Antibiotic Sensitivity ◽  
Antioxidant Defense System ◽  
Laboratory Diagnostics ◽  
Treatment Methods ◽  
Group A ◽  
The Individual

Currently, one of the priority medical and social problems is the optimization of treatment methods for pyoderma associated with Streptococcus pyogenes — group A streptococcus (GAS). To date, the proportion of pyoderma, the etiological factor of which is Streptococcus pyogenes, is about 6 % of all skin diseases and is in the range from 17.9 to 43.9 % of all dermatoses. Role of the bacterial factor in the development of streptococcal pyoderma is obvious. Traditional treatment complex includes antibacterial drugs selected individually, taking into account the antibiotic sensitivity of pathognomonic bacteria, and it is not always effective. Currently implemented immunocorrection methods often do not take into account specific immunological features of the disease, the individual, and the fact that the skin performs the function of not only a mechanical barrier, but it is also an immunocompetent organ. Such an approach makes it necessary to conduct additional studies clarifying the role of factors of innate and adaptive immunity, intercellular mediators and antioxidant defense system, that allow to optimize the treatment of this pathology.

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