Hepatorenal Syndrome

1992 ◽  
Vol 3 (3) ◽  
pp. 614-632
Author(s):  
Christine Mudge ◽  
Laurie Carlson

The exact physiologic mechanism of the hepatorenal syndrome remains unclear; however, it always develops in the presence of liver failure. A number of theories have been postulated to explain the syndrome, which are discussed in this review. None of the proposed theories is able to explain the syndrome completely, and continued research is necessary. Management of hepatorenal syndrome is directed at supporting the patient and maintaining/ restoring hepatic function to prevent further renal damage. Liver transplantation has been considered an effective method of treatment for this patient population. Nursing care is supportive and focuses on maintaining the patients’ internal environment and psychologic well-being

2017 ◽  
Vol 21 (3) ◽  
Author(s):  
Bruno da Silva Lourenço ◽  
Maria Angélica de Almeida Peres ◽  
Isaura Setenta Porto ◽  
Rosane Mara Pontes de Oliveira ◽  
Virginia Faria Damásio Dutra

Abstract This study is an integrative review with the aim to identify and describe the scientific evidence of the practical effect of physical activity in people with mental disorders. For the selection of articles, the databases CINAHL, MEDLINE, LILACS, SciELO, Cochrane and Scopus were used. The sample of this review consisted of eight articles. Their analysis resulted in the categories: obesity and metabolic syndrome, specialized nursing, sedentary and healthy lifestyles, support and social network, incentive to the practice of physical activity, and anxiety and physical activity. The benefits to physical health were partially elucidated by the sample. The implications for nursing care arise from the therapeutic efficacy of physical activity by people with mental disorders, adding individual and collective benefits that provide socialization and promotion of well-being.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuji Suzuki ◽  
Keisuke Kakisaka ◽  
Takuro Sato ◽  
Ryouichi Mikami ◽  
Hiroaki Abe ◽  
...  

AbstractPatients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.


2021 ◽  
Vol 11 (01) ◽  
pp. e145-e147
Author(s):  
Nida Mirza ◽  
Ravi Bharadwaj ◽  
Smita Malhotra ◽  
Anupam Sibal

AbstractWilson disease (WD) is a disorder of copper metabolism resulting in accumulation of copper in vital organs of the human body, predominantly in the liver and the brain. Acute liver failure in WD has a bad prognosis, especially with a score ≥11 in the revised WD prognostic index; emergency liver transplantation is considered the only life-saving option in this scenario. Here, we reported a girl patient with WD-induced liver failure and poor prognostic score who was rescued by plasmapheresis. She also manifested severe Coombs negative hemolytic anemia and acute kidney injury. This case report highlights the utility of an adjunctive modality besides liver transplantation for the management of fulminant liver failure caused by WD.


Author(s):  
S. T. Binoj ◽  
Johns Shaji Mathew ◽  
M. Abdul Razak ◽  
Krishnanunni Nair ◽  
Shweta Mallick ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document