RESUMO
The evidence saying that the rate of Systemic Inflammatory Response Syndrome [SIRS] is high in patients with advanced cirrhosis and portal hypertension, this could have negative outcome on patients prognosis. This prospective study included 109 cirrhotic patients who were admitted to Imam Khomeini Hospital, affiliated with Orumieh University of Medical Sciences, during 2011-2012. The presence of SIRS and the model for end stage liver disease [MELD] were assessed on admission and during the hospital stay. SIRS was considered positive if patients had two or more of the following: temperature of >38°C or <36°C; heart rate >90 beats/min; respiratory rate >20/min or PaCO2 <32 mmHg or the use of mechanical ventilation; WBC >12000/mm[3] or <4000/mm[3] or more than 10% immature neutrophil count. MELD was calculated as: MELD = 3.8 [Ln serum bilirubin [mg/dl]] +11.2 [Ln INR] +9.6 [Ln serum creatinine [mg/dl]] +6.4. Hospital outcome was defined as death or hospital discharge. A total of 109 cirrhotic patients between the ages of 14 to 84 [mean: 54.6 +/- 18.4] years were included. There were 65 [59%] male patients. Of the 109 patients, 76 [69.8%] were SIRS-negative and 33 [30.2%] were SIRS-positive. The mean calculated MELD score for all patients was 15.5. There was a cor-relation noted between SIRS and high serum creatinine levels [p=0.01] and between SIRS and a high MELD score [p=0.00]. During follow-up 19 [17.4%] patients died. SIRS was correlated with death [p<0.00] on multivariate analysis, SIRS was independently associated with hospital death. SIRS is a relatively frequent event in cirrhotic patients admitted to referral centers. It is closely related to the severity of liver disease as shown by the MELD score. SIRS independently and adversely affects the in-hospital outcome in patients with liver cirrhosis
RESUMO
The knowledge on Helicobacter pylori [H. pylori] contribution in the pathology of the liver and biliary tract diseases in human is very limited. The aim of this study was to assess the probable association between H. pylori seropositivity and hepatic encephalopathy. This is a case control study conducted through three groups, cirrhotics with hepatic encephalopathy [HE], cirrhotics without HE and healthy controls. All subjects were examined serologically for determination of IgG class antibodies to H. pylori based on ELISA technique. H. pylori seropositivity was present in 88% cirrhotic patients with hepatic encephalopathy, 86% cirrhotics without hepatic encephalopathy and 66% healthy controls. According to our results, H. pylori seropositivity rate in cirrhotic patients with or without hepatic encephalopathy was higher than healthy controls. But H. pylori seropositivity rate was not significantly different among cirrhotics with hepatic encephalopathy and those without it