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Biomedical subjects

K R Reddy

Publications and source records attributed to K R Reddy.

At least 145 records · Page 8Linked to original sources
PubMed1986

The spectrum of liver disease in the acquired immunodeficiency syndrome.

Abnormal liver chemistries, unexplained fevers, or hepatomegaly prompted 36 liver biopsies on 34 patients with the acquired immunodeficiency syndrome. The most common finding was the presence of hepatic granulomas, seen in 13 of the biopsy specimens. Eight of these granulomas were ill-defined, and 5 were more clearly associated with mycobacterial disease. Portal fibrosis and fatty infiltration were common, but a paucity of significant inflammatory activity was seen despite elevated aspartate aminotransferase levels, perhaps related to the underlying immunoincompetent status. Other noteworthy histopathologic findings included 1 patient each with peliosis hepatis and cryptococcal hepatitis. Electron-microscopic evidence of cytoplasmic tubular structures or viral particles were seen within the hepatocytes of 2 patients. It is concluded that a broad spectrum of hepatic histopathology may be seen in the acquired immunodeficiency syndrome, and that liver biopsy may be diagnostically valuable in the clinical investigation of such patients.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Resection of metachronous hepatocellular carcinomas.

We have described the rare case of a woman with no recognized predisposing factors for hepatocellular carcinoma in whom a second hepatic neoplasm was successfully resected nine years after a presumed "curative" partial hepatectomy. The importance of long-term measurements of available tumor markers as well as aggressive surgical management is emphasized.

Adult↗
PubMed1986

Percutaneous transjejunal biliary dilatation: alternate management for benign strictures.

Since 1980, 23 patients with diffuse benign biliary strictures underwent percutaneous retrograde biliary dilatation through a surgically created jejunal access route. Bile ducts of 15 patients with sclerosing cholangitis, five with traumatic strictures, and three with strictures of diverse etiology were dilated with 25-atm balloons during 88 separate sessions. Individual dilatation intervals ranged between 2 and 36 months. Three patients with sclerosing cholangitis died. One uncomplicated bile duct rupture occurred in the trauma group because of balloon oversizing. Our 5-year experience indicates that bile duct patency can be safely maintained by repeated retrograde dilatations without the need for biliary catheters or stents.

Adolescent↗
PubMed1986

Misdiagnosis of echinococcal cyst disease of the liver.

Echinococcosis is a disease which is commonly seen in certain parts of the world and uncommonly seen in the United States. Recognition of this disease is important for appropriate surgical management with the least amount of morbidity and mortality. Proper history taking and awareness of this disease will decrease the chance of misdiagnosis. Two cases are presented here, and the salient features of this disease are reviewed, in order to reacquaint the physician.

Adult↗
PubMed1984

Cimetidine usage for unlabeled conditions in an ambulatory care service.

With the intent of cost containment, we conducted a survey of cimetidine usage in the Ambulatory Care Service of our Veterans Administration Medical Center. During a period of six months, this drug was prescribed for 132 patients. Only about 20% received cimetidine for FDA approved conditions. Treated conditions not approved by the FDA (unlabeled) included undiagnosed abdominal pain, past peptic ulcer disease, reflux esophagitis, and a variety of other conditions. Fourteen percent of the patients had demanded the drug. Irrespective of whether a confirmed diagnosis was present or not, most patients taking cimetidine had symptomatic relief. It is unclear whether more regulations or improved physician education would be the better method to control improper and unnecessary use of a drug that is generally safe but has potentially serious side effects.

Cimetidine↗
PubMed1984

Prolonged intrahepatic cholestasis secondary to acute hepatitis A.

Viral hepatitis characterized by prolonged cholestasis has not been associated with a specific serologic marker. We report the cases of six patients presenting with a clinical syndrome typical of cholestatic hepatitis who were subsequently found to have acute hepatitis A. Usual features include pruritus, fever, diarrhea, and weight loss with serum bilirubin levels greater than 10 mg/dL, and a clinical course lasting at least 12 weeks. All patients recovered completely without sequelae. Knowledge of this unusual manifestation of hepatitis A may help avoid potentially invasive procedures involved in the evaluation of suspected obstructive jaundice and facilitate appropriate immunoprophylactic measures.

Acute Disease↗
PubMed1984

Bilateral nipple necrosis after intravenous vasopressin therapy.

Bilateral nipple necrosis developed in two patients after intravenous vasopressin therapy for bleeding esophageal varices. When vasopressin therapy was promptly tapered and discontinued, recovery of skin changes occurred gradually. The role and some of the reported complications of vasopressin therapy in bleeding esophageal varices are discussed herein.

Adult↗
PubMed1984

Pyogenic liver abscess complicating common bile duct stenosis secondary to chronic calcific pancreatitis. A rare presentation.

Pyogenic liver abscess is a rare presentation of common bile duct stenosis secondary to chronic calcific pancreatitis. Two cases are described in this report; in both cases, biliary obstruction was present in the absence of jaundice. Successful therapy of the abscesses was accomplished with antibiotics alone and without continuous percutaneous drainage or surgical intervention. Definitive therapy should include eventual surgical correction of the biliary obstruction.

Adult↗
PubMed1983

Penicillin induced human platelet dysfunction and its reversal by epinephrine.

Antibiotics administered orally can impair platelet function and cause a bleeding diathesis. Platelet function impairment induced by antibiotics such as penicillin, carbenicillin and tetracycline could be corrected by exposing the refractory platelets to epinephrine first and then challenging with other agonists. Penicillin used in this study inhibited the platelet aggregation response and release reaction without blocking the ability of these platelets to convert arachidonic acid to thromboxane. The thromboxane generated in the presence of penicillin could not activate the platelets when threshold concentrations of arachidonate was used as stimulus. Epinephrine stimulation restored the platelet membrane sensitivity and normalized the platelet response to the action of agonists. These studies demonstrate that both by in vitro as well as in vivo routes penicillin induced temporary impairment of platelet function. The refractoriness was not due to the interference of membrane receptors for various agonists or due to the depletion of serotonin, adenine nucleotides or inhibition of cyclooxygenase activity. Penicillin inhibits some essential mechanism involved in platelet activation by agonists and this process may be calcium dependent. Epinephrine through alpha adrenergic stimulation restores the mechanism by which agonists initiate platelet activation.

Adult↗
PubMed1983

Strongyloidiasis. When to suspect the wily nematode.

Strongyloidiasis is a tenacious soil-transmitted nematode infestation endemic in the south-eastern United States. Thirty-three cases were diagnosed in a series of 1,290 stool examinations in 971 patients at Veterans Administration Medical Center, Mountain Home, Tennessee. Most patients had a concurrent major illness, such as chronic lung disease, serious bacterial infection, or cancer. A minority presented with gastrointestinal symptoms alone. Skin rash was uncommon. Eosinophilia, IgE elevation, and skin anergy were common. Atypical presentations included severe proctitis, colitis, and exacerbation of inflammatory bowel disease. In a patient with the hyperinfection syndrome, the diagnosis was made only at autopsy. Since strongyloidiasis seems to present like an opportunistic illness, all physicians, not just those in endemic areas, should consider its presence in the appropriate setting.

Adult↗