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Biomedical subjects

V G Levy

Publications and source records attributed to V G Levy.

At least 55 records · Page 3Linked to original sources
PubMed1984

Budd-Chiari syndrome with thrombosis of the inferior vena cava: long-term patency of meso-caval and cavoatrial prosthetic bypass.

Portacaval or mesocaval shunts may relieve ascites that is caused by chronic forms of primary Budd-Chiari syndrome. When inferior vena cava stenosis is severe or is the site of thrombosis, another procedure has to be used. Portoatrial or cavoatrial shunting has been suggested, and a few reports have been made after only a short follow-up period. The case of a young woman with long-standing ascites caused by primary occlusion of the hepatic veins illustrates the incomplete relief of ascites after mesocaval shunt, which was caused by severe stenosis of the inferior vena cava. At 2 1/2-year follow-up, thrombosis of the retrohepatic inferior vena cava was documented and the mesocaval shunt remained patent. Cavoatrial bypass performed with the use of a long Dacron graft was successful as noted at a 4 1/2-year postoperative follow-up, and there was angiographic proof of patency. Budd-Chiari syndrome with stenosis or thrombosis of the inferior vena cava may be cured by prosthetic bypasses to the right atrium. Combined mesocaval and cavoatrial shunt should be encouraged in this specific situation.

Adult↗
PubMed1983

[Immunoallergic complication induced by rifampicin with disseminated intravascular coagulation].

In a 48-years old woman, intermittent rifampicin treatment induced an immunoallergic reaction with digestive disorders, haemolysis, acute renal failure and prolonged prothrombin time. The reintroduction of rifampicin, 17 days later, resulted in a similar, though more severe, reaction associated with diffuse haemorrhages from disseminated intravascular coagulation, this association being exceptional. The responsibility of rifampicin was demonstrated by the chronological relationship between clinical symptoms and administration of the drug, and by the presence in the patient's serum of anti-rifampicin antibodies. The antigen-antibody reaction with complement activation and haemolysis probably explains the disseminated intravascular coagulation.

Acute Kidney Injury↗
PubMed1983

Comparison of six treatments of ascites in patients with liver cirrhosis. A clinical trial.

UNLABELLED: A national multicenter study (34 centers) compared six treatments in 328 patients with cirrhotic ascites. Excluded were patients with g.i. bleeding within the last six months, chronic encephalopathy, cancer, tuberculosis or the following complications persisting after three weeks: acute encephalopythy, fever greater than 38 degrees C, infected ascites or biochemical abnormalities: blood urea greater than 8 mmol/l, natremia less than 130 mmol/l, kaliemia less than 2.5 or greater than 5.5 mmol/l, WBC greater than 12000 mm3, total bilirubin greater than 85.5 mumol/l. In each center patients were randomized into two treatment groups, each center using 2 of 6 proposed treatments: (1) Spironolactone and 500 mg Na p.d (77 patients), (2) Spironolactone + furosemide or Moduretic (amiloride + hydrochlorothiazide) and 500 mg Na p.d (80 patients), (3) Spironolactone + Furosemide or Moduretic and unrestricted sodium diet (86 patients), (4) Concentrated ascites reinfusion and 500 mg Na p.d. (36 patients), (5) Unmodified ascites reinfusion and 500 mg Na p.d. (23 patients), (6) Slow ascites drainage and 500 mg Na p.d. (31 patients). Statistical analysis methods were X2, variance analysis and Spotvoll-Stoline and Dunn-Sidak tests. Before treatment, there was no significant difference between the 6 groups. RESULTS: After one month of treatment, no difference was found in the frequency of total or partial regression of ascites, complications of cirrhosis, mortality, acceptability of treatment. Mechanical treatments induced more rapid weight loss but more frequent recurrence; comparison of groups 2 and 3 did not confirm any benefit associated with unrestricted Na diet. Duration of treatment and hospitalization were shorter in group 4 than in groups 3 and 6.

Amiloride↗
PubMed1983

[Hemochromatotic cirrhosis complicating pyridoxine-sensitive hereditary sideroblastic anemia. Case report].

A further case of sporadic congenital sideroblastic anaemia is reported. Despite no contributing factors such as blood transfusion, oral ingestion of iron or alcoholic beverages, were present excessive iron stores occurred with consecutive tissue damage resulting in cirrhosis of the liver, portal hypertension and diabetes mellitus. HLA phenotype was A3 B7 as in primary hemochromatosis. Correction of anemia was obtained by vitamin B6 administration. Improvement of iron overload was achieved through the use of daily subcutaneous infusions of the iron chelating drug desferrioxamine with a portable infusion pump.

Adult↗
PubMed1982

[Treatment of cholesterol gallstones with ursodesoxycholic acid (author's transl)].

A double-blind clinical trial comparing ursodesoxycholic acid and chenodesoxycholic acid in patients with cholesterol stones in the gall-bladder showed that ursodesoxycholic acid was superior to the older drug not so much in percentage of biliary calculi dissolved but in dosage reduction (50%) and improved clinical and biological tolerance.

Chenodeoxycholic Acid↗
PubMed1981

[Liver damage following clomethacin treatment. 6 cases, including 2 deaths (author's transl)].

The authors report on 6 cases of severe liver damage following clomethacin treatment. Three patients developed prolonged hepatitis, lasting more than 3 months, with biochemical and histological signs of activity; one patient committed suicide by overdosage and died of subacute necrotizing hepatitis; one patient died of chronic cirrhotic hepatitis after prolonged clomethacin-alpha-methyldopa combined treatment, and there was one case of active hepatitis on latent cirrhosis. Drug toxicity was suggested by the presence of jaundice with occasional fever, urticaria or pruritus and eosinophilia, and by the lack of any other cause. It was confirmed in 3 cases by relapse of the condition after re-introduction of the drug, in one case by the circumstances surrounding death (attempted suicide) and in one case by the deterioration observed with increased dosage. In one patient the responsibility of clomethacin was shared with alpha-methyldopa, a potentially hepatotoxic drug.

Acute Disease↗
PubMed1979

[Selective distal spleno-renal shunt. A report of 14 patients (author's transl)].

Fourteen cirrhotic patients underwent distal splenorenal shunt to prevent recurrent hemorrhage from oesophageal varices. No post-operative mortality was observed. Transitory chylous ascites occured in 1 patient, portal thrombosis with concomitant early rebleeding in another one. Hypersplenism was improved post-operatively. Porto-caval encephalopathy was not observed. With a follow-up between 3 and 27 months, one single patient died from hepatic failure, variceal bleeding did not reccur in long term survivors.

Adult↗