scholarly journals Relationship between portal HTN and cirrhosis as a cause for diabetes

2019 ◽  
Vol 7 (2) ◽  
pp. 79-83 ◽  
Author(s):  
Herbert Djiambou-Nganjeu
Keyword(s):  
Portal Hypertension ◽  
Liver Enzymes ◽  
Alcoholic Cirrhosis ◽  
Signs And Symptoms ◽  
Blood Platelet ◽  
International Normalized Ratio ◽  
Portal Flow ◽  
Prothrombin Index ◽  
Wbc Count ◽  
The Relationship

Abstract Our aim was to explore the relationship between liver cirrhosis (LC), portal hypertension (PH), and diabetes mellitus (DM). LC displayed hemodynamic alterations reflected by signs and symptoms of hypertension and hyperdynamic circulation. Portal hypertension also caused splenomegaly because of the blood flow into the spleen from the portal vessels and portal flow. The alcoholic cirrhosis displayed abnormal values (AST, ALT, AST/ALT, albumin, ammonia, bilirubin, blood platelet, erythrocytes, glucose, Hb, international normalized ratio (INR), PT, prothrombin index (PI), thymol test, white blood cell (WBC) count), which demonstrated the presence of portal hypertension, ascites, DM, infection, and coagulopathy. The evaluation of liver enzymes and other laboratories data helped to determine the severity of the condition and prognosis. Diabetes appeared to be less affecting the prognosis of patients with cirrhosis than LC itself, showing that hepatocellular failure was largely responsible for patients’ mortality rather than diabetes and its complications. Patients displayed a BMI correlating obesity, although affected by concomitant diseases that commonly cause a severe weight loss. The elevated BMI in this case was accentuated by the presence of ascitic fluid, which is responsible for the increase in weight and the inaccurate BMI evaluation. Ascites affect patients’ recovery from liver diseases. Obese patients with cirrhosis can be related to have a large amount of ascites and that physicians should be expecting to notice changes in their BMI pre- and postoperatively, subsequently making a prior classification as obese inappropriate. Disease severity could be assessed through the evaluation of PH stage, which was characterized by a significant depletion of WBC and as well as platelet counts.

Animal Model of Portal Hypertension with Observations Regarding the Relationship between Portal Flow and Pressure

1993 ◽  
Vol 28 (5) ◽  
pp. 442-445 ◽  
Author(s):  
ELIZABETH SCHENCK ◽  
JAMES A. NELSON ◽  
FRANK L. STARR ◽  
DOUGLAS CODWELL
Keyword(s):  
Animal Model ◽  
Portal Hypertension ◽  
Portal Flow ◽  
The Relationship

scholarly journals Determining the Relationship Between Fever of Without focus and Latent Pneumonia in Feverish Children in Bandar Abbas, Iran

2021 ◽  
Vol 10 (2) ◽  
pp. 47-50
Author(s):  
Mohammad Meidari ◽  
Mehran Ahmadi ◽  
Marjan Tari Verdi ◽  
Shahram Zare ◽  
Maryam Mohammadian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Pediatric Emergency ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Bandar Abbas ◽  
Wbc Count ◽  
The Relationship

Background: Fever is one of the most common causes of children’s referral to the emergency department, for which in 20% of cases no clear source is found. Latent pneumonia is not easily differentiable as one of the differential diagnoses of fever of unknown origin (FUO). This study aimed to determine the relationship between FUO and latent pneumonia in feverish children referring to pediatric emergency department. Materials and Methods: The present analytical research was carried out on 220 children with FUO aged 3-36 months referred to pediatric hospital of Bandar Abbas, Iran in 2019. To find the signs and symptoms, demographic information, history, and physical examination results were recorded by a physician using a predetermined checklist. Chest x-ray and blood sample were prepared for white blood cell (WBC) count, C-reactive protein (CRP), and absolute neutrophil count (ANC). Results: The mean age of the patients was 18.38±8.6 months. There was no significant difference between the mean fever, pulse rate, respiratory rate, WBC count, erythrocyte sedimentation rate (ESR), and ANC among the three groups differentiated by their diagnosis. The mean CRP in the bacterial pneumonia group was 68.17±24.13, while it was 35.00±20.43 in the viral infection group and 35.71±26.20 in the group of other diseases; the difference was statistically significant (P=0.004). Conclusion: Although there was no significant difference between WBC, ANC, and ESR and latent pneumonia, there was a significant difference between CRP and latent pneumonia, whose value was larger in these patients.

Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension

2015 ◽  
Vol 24 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Jiannan Yao ◽  
Li Zuo ◽  
Guangyu An ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Intrahepatic Portosystemic Shunt

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words:  –  –  – .

scholarly journals Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and Candida albicans in breastfeeding women

2021 ◽  
Vol 17 ◽  
pp. 174550652110314
Author(s):  
Pamela Douglas
Keyword(s):  
Candida Albicans ◽  
Human Milk ◽  
Signs And Symptoms ◽  
Breast Pain ◽  
Breastfeeding Support ◽  
Candida Spp ◽  
Healthy Human ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
The Relationship

Background: Breastfeeding mothers commonly experience nipple pain accompanied by radiating, stabbing or constant breast pain between feeds, sometimes associated with pink shiny nipple epithelium and white flakes of skin. Current guidelines diagnose these signs and symptoms as mammary candidiasis and stipulate antifungal medications. Aim: This study reviews existing research into the relationship between Candida albicans and nipple and breast pain in breastfeeding women who have been diagnosed with mammary candidiasis; whether fluconazole is an effective treatment; and the presence of C. albicans in the human milk microbiome. Method: The author conducted three searches to investigate (a) breastfeeding-related pain and C. albicans; (b) the efficacy of fluconazole in breastfeeding-related pain; and (c) composition of the human milk mycobiome. These findings are critiqued and integrated in a narrative review. Results: There is little evidence to support the hypothesis that Candida spp, including C. albicans, in maternal milk or on the nipple-areolar complex causes the signs and symptoms popularly diagnosed as mammary candidiasis. There is no evidence that antifungal treatments are any more effective than the passage of time in women with these symptoms. Candida spp including C. albicans are commonly identified in healthy human milk and nipple-areolar complex mycobiomes. Discussion: Clinical breastfeeding support remains a research frontier. The human milk microbiome, which includes a mycobiome, interacts with the microbiomes of the infant mouth and nipple-areolar complex, including their mycobiomes, to form protective ecosystems. Topical or oral antifungals may disrupt immunoprotective microbial homeostasis. Unnecessary use contributes to the serious global problem of antifungal resistance. Conclusion: Antifungal treatment is rarely indicated and prolonged courses cannot be justified in breastfeeding women experiencing breast and nipple pain. Multiple strategies for stabilizing microbiome feedback loops when nipple and breast pain emerge are required, in order to avoid overtreatment of breastfeeding mothers and their infants with antifungal medications.

scholarly journals Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center

2021 ◽  
pp. 112067212199104
Author(s):  
Giuseppe D’Amico Ricci ◽  
Claudia Del Turco ◽  
Elena Belcastro ◽  
Marco Palisi ◽  
Mario R Romano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Time Span ◽  
Nasopharyngeal Swab ◽  
Eye Disorders ◽  
Eye Examination ◽  
The Relationship ◽  
Acute Conjunctivitis ◽  
Piedmont Region

Purpose: Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. Methods: In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. Results: Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed −0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions ( p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9–12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. Conclusion: Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. Synopsis The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.

scholarly journals Assessment of the relationship of serum liver enzymes activity with general and abdominal obesity in an urban Bangladeshi population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nurshad Ali ◽  
Abu Hasan Sumon ◽  
Khandaker Atkia Fariha ◽  
Md Asaduzzaman ◽  
Rahanuma Raihanu Kathak ◽  
...  
Keyword(s):  
General Population ◽  
Abdominal Obesity ◽  
Liver Enzymes ◽  
Serum Levels ◽  
General Obesity ◽  
Enzymes Activity ◽  
Elevated Liver Enzymes ◽  
Bangladeshi Population ◽  
Relationship Of ◽  
The Relationship

AbstractObesity is a global health concern because of its increasing trend both in developed and developing countries. A limited number of studies have evaluated the association of liver enzymes with both general and abdominal obesity in the general population; data for the Bangladeshi population are not available yet. This study aimed to assess the relationship of serum liver enzymes activity with both general and abdominal obesity in Bangladeshi adults. In total, 540 blood samples were obtained from the participants (388 males and 152 females) and analyzed for serum levels of ALT, AST, GGT, and ALP using standard methods. General obesity was defined as body mass index (BMI) ≥ 27.5 kg/m2 and abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in males and ≥ 80 cm in females. The relationship between liver enzymes and obesity was evaluated by multivariate logistic regression models. Overall, 58% of participants in the general obesity group and 55% of the participants in the abdominal obesity group had at least one or more elevated levels of liver enzymes. The prevalence of elevated liver enzymes was significantly higher in the obesity group compared to the normal BMI and WC groups (p < 0.05 for all cases). The mean level of serum ALT, AST and GGT were significantly higher in the obesity group than the normal BMI group (p < 0.05). In the WC groups, mean AST and GGT were significantly higher in the obesity group compared to the normal group (p < 0.05). In regression analysis, serum levels of ALT showed an independent and significant association with general obesity, whereas, serum GGT showed a significant association with both general and abdominal obesity. In conclusion, a high prevalence of elevated liver enzymes was observed among participants included in the present study. Of the four enzymes, serum GGT was independently associated with both general and abdominal obesity. Further studies are required to understand the complex relationship between liver enzymes and obesity in the general population.

Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms

2017 ◽  
Vol 17 (6) ◽  
pp. 496-504 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K Moser ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Self Care ◽  
Signs And Symptoms ◽  
Comprehensive Understanding ◽  
Behavior Scale ◽  
Heart Failure Exacerbation ◽  
The Relationship ◽  
Different Levels ◽  
Care Behavior

Background: Although incomplete understanding of heart failure and its signs and symptoms appears to be a barrier to successful self-care, there are few studies examining the relationship between self-care and levels of comprehensive understanding of heart failure and its signs and symptoms. Aim: To determine whether incomplete understanding of heart failure and its signs and symptoms is associated with self-care in heart failure patients who were recently discharged from the hospital due to heart failure exacerbation. Methods: Patients completed the nine-item European Heart Failure Self-care Behavior scale and questionnaire to assess knowledge of heart failure and its signs and symptoms. Three groups were formed by their different levels of understanding of heart failure and its signs and symptoms. Multivariable linear regression was used to determine whether these three levels of understanding groups predicted self-care after controlling for demographic and clinical variables. Results: Of 571 patients 22.1%, 40.1% and 37.8% had poor, moderate, and complete understanding, respectively. Compared with patients in the poor understanding group, patients in complete and moderate understanding groups were more likely to have better adherence to self-care activities (standardized β = −0.14, 95% confidence interval −3.41, −0.47; standardized β = −0.19, 95% confidence interval −4.26, −1.23, respectively). Conclusions: Fewer than half of the patients had a comprehensive understanding of heart failure and its signs and symptoms, which was associated with poor self-care. Our study suggests that patient education should include contents to promote comprehensive understanding of heart failure and its symptoms, as well as the importance of self-care behaviors.

Is duodenal biopsy always necessary for the diagnosis of coeliac disease in adult patients with high anti-tissue transglutaminase (TTG) antibody titres?

2021 ◽  
pp. flgastro-2020-101728
Author(s):  
Junaid Beig ◽  
Kamran Rostami ◽  
David T S Hayman ◽  
Summer Hassan ◽  
Stephen Gerred ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Linear Models ◽  
Tissue Transglutaminase ◽  
Signs And Symptoms ◽  
Duodenal Biopsy ◽  
Adult Patients ◽  
Antibody Titres ◽  
Red Flag ◽  
The Relationship ◽  
Duodenal Biopsies

ObjectiveAvoiding duodenal biopsy in adults for coeliac disease (CD) diagnosis is controversial. Some retrospective and prospective studies have shown that CD can be reliably diagnosed in adults with serology rather than duodenal biopsies. This study aimed to check the accuracy of a cut-off value of ≥10 upper limit of normal of anti-tissue transglutaminase antibody (anti-TTG IgA) titres for CD diagnosis in adult patients.MethodWe retrospectively analysed adult patients (≥16 years) who underwent gastroscopy from 2013 to 2018 for positive coeliac serology. The relationship between titres and disease was determined by using linear models, whereas sensitivity and specificity were assessed by receiver operator curve.ResultsWe analysed 144 newly anti-TTG antibody-positive adult patients with a median age of 48.5 years (IQR 32–62); among them, 86 (60%) patients had CD (Marsh III: n=68 and Marsh II and I: n=18) with a higher prevalence in females (n=59 (69%)) and Europeans (n=60 (70%)). Fifty (58%) patients with CD had colonoscopy and five (6%) had imaging; only six patients were diagnosed with additional conditions. An anti-TTG IgA titre cut-off value of 150 U/L was 100% specific for CD in our dataset, with 70% (95% CI: 60% to 88%) sensitivity for this patient group.ConclusionCoeliac serology using anti-TTG IgA with titres ≥10× normal value is an excellent predictor of CD, irrespective of age, gender and ethnicity. Duodenal biopsy may not be necessary in selected adult patients with CD, especially younger than 50 years of age without additional gastrointestinal red-flag signs and symptoms.

scholarly journals Peculiarity of clinical course of postpericardiotomy syndrome in different methods of surgery and postoperative antithrombotic therapy

Kardiologiia ◽  
2021 ◽  
Vol 61 (4) ◽  
pp. 53-59
Author(s):  
T. A. Mangileva ◽  
O. A. Kazantseva ◽  
I. V. Karaseva
Keyword(s):  
Coronary Bypass ◽  
International Normalized Ratio ◽  
Antiplatelet Drugs ◽  
Heart Valve Disease ◽  
Nsaid Treatment ◽  
Postpericardiotomy Syndrome ◽  
Reactive Protein ◽  
Prothrombin Index ◽  
Thrombotic Complications ◽  
Anti Inflammatory

Aim    To compare features of the disease course and the effectiveness of nonsteroidal anti-inflammatory drug (NSAID) treatment of postpericardiotomy syndrome (PPS) in patients after coronary bypass (CB) surgery who were treated with antiplatelet drugs and in patients after surgical correction of heart valve disease (CHVD) who received the anticoagulant warfarin for prevention of thrombotic complications. Material and methods    This study included 89 patients of whom 53 patients had underwent CB and 36 patients had underwent CHVD. At 15 [13; 15] days after surgery, the severity of inflammatory response, the state of coagulation hemostasis, and hematocrit were studied. At 5 days after the first test, blood count and measurement of C-reactive protein were repeated. Echocardiography was used to determine the presence and volume of pleural effusion. For prevention of thrombotic complications, antiplatelet drugs were administered after CB and warfarin was administered after CHVD. PPS was detected in 35 (66 %) patients after CB and 18 (50 %) patients after CHVD. The ibuprofen treatment (600 mg twice a day) was administered to all patients with PPS. If positive changes in inflammatory markers were absent during the NSAID treatment, ibuprofen was replaced with prednisolone 0.5 mg/kg body weight with subsequent laboratory and instrumental monitoring. Results    Patients after CHVD treated with warfarin had higher values of international normalized ratio (INR) and activated partial thromboplastin time (aPPT) and lower values of prothrombin index (PTI), fibrinogen (p<0.001 for all), hemoglobin (p=0.0016), and hematocrit (p=0,0032) than patients after CB treated with antiplatelet drugs. 21 (40 %) patients with PPS required changing the anti-inflammatory therapy from ibuprofen to prednisolone. These patients displayed hypocoagulation, which was evident as reduced PTI (p=0.0023) and fibrinogen (p=0.0209), increased INR (p=0.0291) and aPPT (p=0.0416), and a higher incidence of pericardial effusion (p=0.0080). The insufficient effectivity of NSAIDs that required administration of prednisolone was more frequently observed in patients after CHVD (61 % vs. 29 %, р=0.037).Conclusion    Hypocoagulation observed in patients after CHVD due to the anticoagulant treatment with warfarin was associated with more severe course of PPS and lower effectiveness of the NSAID treatment compared to patients after CB. This results in more frequent replacement of NSAIDs with glucocorticoids in the treatment of patients after CHVD.

scholarly journals Study of haematological, biochemical profile and clinical presentation in dengue positive patients: 82 cases

2018 ◽  
Vol 6 (6) ◽  
pp. 2099
Author(s):  
Mubin I. Patel ◽  
Abhishek Patel ◽  
Avani Patel ◽  
Sharmistha Patel ◽  
Suresh Padsala
Keyword(s):  
Dengue Fever ◽  
Clinical Presentation ◽  
Liver Enzymes ◽  
Neglected Tropical Diseases ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Biochemical Profile ◽  
Igg Antibody ◽  
Aedes Mosquitoes ◽  
Clinical Signs And Symptoms

Background: Dengue Fever (DF) is a self-limiting disease caused by arbovirus and transmitted by Aedes mosquitoes (Aedes aegypti and Aedes albopictus). It is one of the 17 neglected tropical diseases by WHO. Diagnosis of dengue depends mainly on the detection of IgM and IgG antibody, and NS1 antigen.Methods: The study was carried out in Department of Pathology, affiliated with a government hospital. It includes 82 dengue patients, admitted from August 2015 to August 2016. Haematological, biochemical profile, clinical signs and symptoms were recorded. The Tourniquet test was performed in all the patients on admission. Grading of dengue: DF/DHFI/DHFII/DHFIII/DHFIV. Grade III and IV were collectively called as Dengue Shock Syndrome.Results: Total 82 Dengue positive cases were studied, 52 (63%) were males and 30 (37%) were females. 24 (29%) patients were recorded in September 22 (27%) in October 19 (23%) in August. 12 (14.60%) had positive tourniquet test. Thrombocytopenia was present in 86.5 % patients. Majority cases were of classical dengue fever 51 (62.20%), 14 (17.07%) were of DHF I, 12 (14.63%) were of DHF II, 3 (3.66%) were of DHF III and 2 (2.44%) were of DHF IV.Conclusions: It is very important to correlate clinical examination with haematological and biochemical profile in dengue patients. Hematocrit value, leucopenia, thrombocytopenia, raised liver enzymes is very important to monitor dengue cases in their initial stages and thus facilitate early treatment. This would minimize morbidity and mortality arising out of serious complications of dengue fever.

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