ABSTRACT
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Subject(s)
Humans , Acute Disease , Peritoneum , Pancreatitis , Respiratory Distress Syndrome , PancreatitisABSTRACT
Usually, cytomegalovirus infection dosen't cause symptoms in immunocompetents patients although sometimes can. In alcoholic and cirrhotic subjects can cause several and fatal infections. We describe a case of disseminated cytomegalovirus infection in an alcoholic patient with excellent response to ganciclovir.
Subject(s)
Cytomegalovirus Infections , Immunocompetence , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
La infección por citomegalovirus en pacientes inmunocompetentes suele ser asintomática. Los pacientes inmunodeprimidos pueden presentar cuadros severos con mala respuesta al tratamiento. Presentamos el caso de un paciente alcohólico con infección diseminada por citomegalovirus con excelente respuesta al tratamiento con ganciclovir (AU)
Usually, cytomegalovirus infection dosent cause symtons in immunocompetents patients although sometimes can. In alcoholic and cirrhotic subjects can cause several and fatal infections. We describe a case of disseminated cytomegalovirus infection in an alcoholic patient with excellent response to ganciclovir (AU)
Subject(s)
Middle Aged , Male , Humans , Cytomegalovirus Infections , Immunocompetence , Severity of Illness IndexABSTRACT
OBJECTIVE: To test the hypothesis that the heterozygous state for HFE gene mutations involved in the pathogenesis of hemochromatosis, that may induce an increase of hepatic iron content, may aggravate the liver damage induced by prolonged and excessive use of ethanol. PATIENTS AND METHODS: C282Y and H63D mutations of HFE gene were identified through polymerase chain reaction (PCR) on leukocyte DNA, in 125 consecutive patients diagnosed of advanced alcoholic liver disease (109 men, mean age 54 years, SD 11) and 181 healthy controls. All subjects were white Spaniards. RESULTS (CASES/CONTROLS): 1. Genotype distribution: a) mutation C282Y: no homozygotes, 10/23 heterozygotes, 115/158 normal (p = 0.60); b) mutation H63D: 9/5 homozygotes, 46/52 heterozygotes, 70/124 normal (Chi square 6.51, p = 0.039). 2. Allele frequencies: a) mutation C282Y: 240/339 normal, 10/23 mutated (p = 0.21); b) mutation H63D: 186/300 normal, 64/62 mutated (odds ratio 1.66, 95% CI 1.10-2.52, p = 0.01). CONCLUSIONS: Our results suggest that H63D mutation of the HFE gene, but not the C282Y mutation, is associated to the risk of developing advanced liver alcoholic disease.
Subject(s)
HLA Antigens/genetics , Histocompatibility Antigens Class I/genetics , Liver Diseases, Alcoholic/genetics , Membrane Proteins , Mutation/genetics , Adult , Aged , DNA/genetics , Female , Gene Frequency , Hemochromatosis Protein , Humans , Liver Diseases, Alcoholic/epidemiology , Male , Middle Aged , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Objetivo: examinar la hipótesis de que el estado heterocigoto para las mutaciones del gen HFE involucradas en la patogenia de la hemocromatosis, que puede originar un incremento del contenido hepático de hierro, potencia el daño hepático inducido por el consumo excesivo y prolongado de etanol. Pacientes y métodos: se identificaron las mutaciones C282Y y H63D del gen HFE, mediante reacción en cadena de la polimerasa (PCR) sobre ADN genómico leucocitario, en 125 pacientes consecutivos diagnosticados de hepatopatía alcohólica avanzada (109 varones, edad media 54 años, DE 11) y en 181 controles sanos. Todos los sujetos eran de raza caucasoide y nacionalidad española. Resultados (casos/controles): 1. Distribución genotípica: a) mutación C282Y: ningún homocigoto, 10/23 heterocigotos, 115/158 normales (p = 0,60); b) mutación H63D: 9/5 homocigotos, 46/52 heterocigotos, 70/124 normales (Chi cuadrado 6,51, p=0,039). 2. Frecuencias alélicas: a) mutación C282Y: normales 240/339, mutados 10/23 (p=0,21); b) mutación H63D: normales 186/300, mutados 64/62 (odds ratio 1,66, 95 por ciento IC 1,10-2,52, p=0,011).Conclusiones: nuestros resultados sugieren que la mutación H63D, pero no la mutación C282Y, del gen HFE es un indicador de riesgo para el desarrollo de hepatopatía alcohólica avanzada (AU)
Subject(s)
Middle Aged , Adult , Aged , Male , Female , Humans , Membrane Proteins , Histocompatibility Antigens Class I , Mutation , Reverse Transcriptase Polymerase Chain Reaction , DNA , HLA Antigens , Liver Diseases, Alcoholic , Gene FrequencyABSTRACT
We report the case of a previously well 89-years-old-healthy man who presented at least four episodes of intermittent obstructive jaundice during the eight months prior to admission in our Hospital. Studies revealed a duodenal diverticulum arising near of the ampulla of Vater. We believed the diverticulum was responsible for the intermittent obstructive jaundice and we performed a choledochoduodenostomy. He had no postoperative complications and was discharged from the hospital asymptomatic. This case documents an uncommon presentation of this disease generally asymptomatic with intermittent obstructive jaundice episodes.
Subject(s)
Cholestasis/etiology , Diverticulum/diagnosis , Duodenal Diseases/diagnosis , Aged , Aged, 80 and over , Cholangiography , Choledochostomy , Diverticulum/complications , Diverticulum/surgery , Duodenal Diseases/complications , Duodenal Diseases/surgery , Humans , Male , RecurrenceABSTRACT
Se presenta el caso de un varón de 89 años sin antecedentes de interés que presentó al menos cuatro episodios de ictericia obstructiva autolimitada consecutivos en el trascurso de ocho meses, requiriendo ingreso hospitalario en los dos últimos, objetivándose finalmente como causa de los mismos la presencia de un divertículo duodenal periampular por lo que fue intervenido quirúrgicamente, lo que resolvió de forma definitiva el cuadro. Se considera de interés esta forma inusual de presentación de esta patología generalmente asintomática, con episodios intermitentes de ictericia obstructiva (AU)
Subject(s)
Aged , Male , Aged, 80 and over , Humans , Cholangiography , Choledochostomy , Cholestasis , Diverticulum/complications , Duodenal Diseases/complications , Recurrence , Cholestasis/etiology , Diverticulum/diagnosis , Diverticulum/surgery , Duodenal Diseases/diagnosis , Duodenal Diseases/surgeryABSTRACT
We present a member of a family with glycogen deposit disease (GDD) type III (Forbes-Cori's disease) confirmed postmortem through enzymatic analysis of the hepatic and muscular tissues, coinciding with a Crohn's disease associated to ankylopoietic spondylitis, with final development of an extended secondary amiloidosis, all of these diagnosis established in life of the patient and verified in necropsy. We comment this rare finding, the absence of similar cases in the bibliography and the fortuitous nature of this association given the impossibility to suggest another relationship.
Subject(s)
Amyloidosis/etiology , Crohn Disease/complications , Glycogen Storage Disease Type III/complications , Spondylitis, Ankylosing/complications , Adult , Amyloidosis/genetics , Crohn Disease/genetics , Glycogen Storage Disease Type III/genetics , Glycogen Storage Disease Type III/pathology , Humans , Male , Pedigree , Spondylitis, Ankylosing/geneticsABSTRACT
The use of vasodilators to prevent the rupture of esophagic varices (EV) due to portal hypertension (PH) would reduce the portal pressure (PP) as the result of increased portocolateral flow. Rinsaterine, a 5-HT2 receptor blocker, reduces PP in experimental models of PH. This pilot study was designed to verify if ritanserine has a sustained and additive effect to propranolol on PP in cirrhotic patients with PH. Ten chronic patients with EV, under prophylactic therapy with propranolol and with a suprahepatic venous pressure gradient (SVPG) > 12 mm Hg, received ritanserine (0.11-0.14 mg/kg/day). One patients completed one month of treatment due to drug intolerance. Nine patients completed one month of treatment; SVPG did not show any significant variation in four patients and decreased 3 mm Hg in five patients, which were treated during 70 days more. After then, HVPG returned to its previous values except in one patient. The long-term association between ritanserine and propranolol does not improve the results of propranolol. However, the initial response observed in all of these patients supports the role of the serotoninergic system in the PH and states the need for further studies on 5-HT2 blocking for the prophylaxis of EV rupture.
Subject(s)
Hypertension, Portal/drug therapy , Propranolol/therapeutic use , Ritanserin/therapeutic use , Adult , Aged , Drug Therapy, Combination , Humans , Middle AgedSubject(s)
Ferritins/blood , Graves Disease/blood , Adult , Alkaline Phosphatase/blood , Female , Humans , Male , Middle AgedABSTRACT
A patient who had been successfully treated of Hodgkin's disease (nodular sclerotic type) with mediastinal radiotherapy and polychemotherapy, suffered an acute pericarditis immediately after radiotherapy and a complete atrial-ventricular block 14 years later. Five years later she presented refractory hemorrhagic peritonitis. Necropsy study showed a peritoneal mesothelioma (in non radiated area) and diffuse subpericardial fibrosis. Complete A-V block is a very rare late complication of mediastinal radiotherapy and mesotheliomas (almost exclusively in irradiated areas), also. We have not found any reports on other cases of peritoneal mesotheliomas not attributable to radiotherapy as second neoplasia in Hodgkin's disease.
