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Biomedical subjects

E Strauss

Publications and source records attributed to E Strauss.

193 records · Page 11Linked to original sources
PubMedDate not supplied

Cryptogenic cirrhosis: clinico-biochemical comparison with alcoholic and viral etiologies.

Cryptogenic cirrhosis defines a group of undetermined etiology that would either be caused by factors as alcohol, virus and others or be due to still unknown etiological factors. To test these hypotheses we have looked for similarities or differences in clinico-biochemical presentation of 196 cases of alcoholic, viral and cryptogenic cirrhosis. Age, jaundice, spiders, palmar erythema and factor V showed a statistically significant difference of the cryptogenic cirrhosis when compared with both alcoholic and viral etiologies. On clinico-biochemical grounds it could be suggested that cryptogenic cirrhosis would constitute a discrete group, based on the following parameters: predominance of females, a more advanced age, less marked peripheral signs of chronic hepatic failure (jaundice, spiders and palmar erythema) besides milder alterations of laboratory liver function tests.

Adult↗
PubMedDate not supplied

[Nutritional evaluation in cirrhotic patients].

Great importance has been given to nutritional evaluation concerning either diagnosis or prognosis, and also involving nutritional support as therapeutic approach. Nutritional evaluation of 32 cirrhotic patients was performed using anthropometric measures as triceps skinfold and arm muscular circumference, and laboratory data: creatinine/height index, serum albumin transferrin; and lymphocyte number in peripheral blood. Non-caloric stores, evaluated by triceps skinfold were extremely low in 81% of the cases studied, while muscular stores, evaluated by arm muscular circumference and creatinine/height index were depleted in respectively 37.5% and 43.7%. Visceral stores evaluated by serum levels of albumin and transferrin, as well as immunological state, measured by peripheral lymphocytes counts, showed severe depletion in 10 to 15% of the patients. The increasing importance of nutrition in hepatic cirrhosis is stressed and interpretation of the different methods used for nutritional evaluation in chronic liver disease is discussed.

Adult↗
PubMedDate not supplied

[Results of spleno-renal anastomosis in the treatment of portal hypertension due to mansoni schistosomiasis. Apropos of a review of the literature].

1001 cases of spleno-renal shunts taken from 26 publications were selected after a literature review. The great majority of these were retrospective and had a very poor follow-up. The operative mortality levels were acceptable (4,5%) and the portal pressure decreased considerably. Nevertheless it has been shown that in 30,3% of the cases, thrombosis of the anastomosis developed. Recurrence of bleeding occurred in 16% of a population in which permeability of the anastomosis had not been controlled and it could be estimated that it goes up to 52% for the group with thrombosis of their anastomosis. Portal systemic encephalopathy varies with age, being 17% for people below 38,5% above 44 years of age.

Blood Pressure↗
PubMedDate not supplied

[Hepatic changes in patients with nonspecific ulcerative colitis].

The presence of hepatic changes in ulcerative colitis ranges from 4.7% to 90% and the mechanisms are not clear. This study had the purpose to verify their frequency, observe the relation between clinical forms and hepatic lesions and identify the possible histological changes in the liver. We studied 21 patients with ulcerative colitis (Group 1, subdivided in Group 1A non-alcoholic and 1B alcoholic) and compared with 10 patients with irritable bowel syndrome (Group 2). The study involved clinical evaluation, ultrasonography liver function tests and needle biopsy of the liver, performed by laparoscopy, when necessary. Clinical alterations were present in three patients. The ultra-sonographic study was altered in 14.3% in Group 1A and in 57.1% in Group 1B. The albumin and cholinesterase levels were the most frequent abnormality in ulcerative colitis. In irritable bowel syndrome (Group 2), these exams were normal. Liver biopsy was performed in 15 patients and variable degrees of histologic changes were present in all.

Adolescent↗
PubMedDate not supplied

The importance of bacterial infections as precipating factors of chronic hepatic encephalopathy in cirrhosis.

BACKGROUND/AIMS: It is generally accepted that chronic hepatic encephalopathy (HE) is a stable form of neuropsychiatric disorder, usually related to porto-systemic shunts and with no exogenous precipitating factors. Bacterial infections are frequent causes of morbidity in cirrhosis, including the development of HE in its acute form, but there are no reports of its role in chronic forms of HE. METHODOLOGY: We studied 168 episodes of hepatic encephalopathy in 111 patients with cirrhosis who were admitted to hospital during the last four years. Clinical staging was used for the diagnosis of acute and chronic HE, complemented by number connection tests and EEG. In chronic HE the diagnostic criteria were intolerance to animal proteins and a continuous need for medications and/or special diets. Alcohol was the etiology of cirrhosis in 81.1% of patients, hepatitis B or C virus in 12.6% and various factors in 6.3%. The male/female ratio was 3:1 and mean age was 53 years. RESULTS: Twenty patients (18%) were characterized as having chronic HE, whereas ninety-one (82%) presented acute HE. Precipitating factors could be detected in 43 out of 57 (75.4%) of chronic forms and in 108 of 111 (97.3%) episodes of acute HE. Bacterial infections were associated with HE in 15 of 43 cases (34.8%) of chronic HE and in 37 of 108 (34.7%) cases of acute HE (p < 0.05). Spontaneous bacterial peritonitis was the most prevalent infection in acute HE, whereas urinary tract infection was most frequent in chronic HE. Mortality was higher in acute than in chronic HE (p < 0.001), associated with Child C prognostic classification, grades III and IV of HE and more severe precipitating factors. CONCLUSIONS: The diagnosis and control of precipitating factors, especially bacterial infection, should also be considered during the treatment of chronic hepatic encephalopathy.

Acute Disease↗