Résumé
BACKGROUND: Zinc is essential for various metabolic processes of the body. Since serum zinc levels are lowered in liver diseases, it has been postulated to be a precipitating factor for hepatic encephalopathy. METHODS: We prospectively studied serum zinc levels in consecutive patients with fulminant hepatic failure, subacute hepatic failure and chronic liver disease with encephalopathy. Serum zinc levels were correlated with various clinical and biochemical parameters and final outcome of patients. Serum zinc levels were estimated by atomic absorption spectrometry at admission and also 24 hours after recovery in survivors. RESULTS: Of the 55 patients (age 17-65 years, 35 men) studied, 30 had acute, 5 subacute and 20 chronic liver disease. Patients with hepatic encephalopathy had significantly lower serum zinc levels as compared to 20 age and sex matched controls. High serum bilirubin levels and prothrombin time showed inverse relationship with serum zinc levels. There was no relationship of serum zinc levels with age, sex, grade and duration of encephalopathy, liver size, ascites or splenomegaly. CONCLUSIONS: Hepatic encephalopathy is associated with low serum zinc levels. Recovery occurred in 17 patients despite persisting low serum zinc levels. Serum bilirubin > 23 mg/dL and prothrombin time prolongation > 12 seconds above control have inverse correlation with serum zinc level.
Sujets)
Adulte , Maladie chronique , Femelle , Encéphalopathie hépatique/sang , Humains , Maladies du foie/sang , Défaillance hépatique/sang , Mâle , Études prospectives , Spectrophotométrie atomique , Zinc/sangRésumé
Thirty-five cases of septic cavernous sinus thrombophlebitis seen over the past 5 years are reviewed. Of these 80% were secondary to infection of the medial 1/3rd of the face. In more than 2/3rds of the cases the infecting organism was Staphylococcus aureus. Even with appropriate antibiotic therapy the overall mortality was 34.3%.
Sujets)
Adolescent , Adulte , Sujet âgé , Sinus caverneux , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Inde/épidémiologie , Mâle , Adulte d'âge moyen , Études rétrospectives , Thromboses des sinus intracrâniens/diagnostic , Infections à staphylocoques , Staphylococcus aureus/isolement et purificationRésumé
Acute Renal Failure (ARF) secondary to rhabdomyolysis and myoglobinuria was seen in four patients. In three, this was secondary to trauma and the fourth patient had an inflammatory myositis. All 4 patients had total recovery of renal function.