ABSTRACT
During gastrointestinal bleeding associated with cirrhosis, the presence of blood within the lumen of the gut may cause or favorise the onset of hepatic coma. Digestive lavage by rapid intragastric infusion of an isotonic solution based upon mannitol may reduce the mortality due to hepatic coma. The value of this method was studied retrospectively by comparison of two series of haemorrhagic complications: Group I-1971-1976: 224 haemorrhagic complications treated in the usual manner; Group II-1976-1977: 127 haemorrhagic complications treated in accordance with a protocol which included digestive lavage. The results indicate the prognostic significance of certain clinical signs (ascites, jaundice, shock), and also made it possible to determine the cause of death and to demonstrate a reduction in mortality in the group treated by digestive lavage (p < 0.02), concerning only deaths as a result of hepatic coma (p < 0.01) above all in forms with a poor initial prognosis with shock or decompensation with jaundice and ascites.
Subject(s)
Gastrointestinal Hemorrhage/etiology , Liver Cirrhosis, Alcoholic/complications , Adult , Aged , Ascites/complications , Female , Gastric Lavage , Gastrointestinal Hemorrhage/mortality , Gastrointestinal Hemorrhage/therapy , Hepatic Encephalopathy/etiology , Hepatic Encephalopathy/mortality , Hepatic Encephalopathy/prevention & control , Humans , Jaundice/complications , Male , Middle Aged , Prognosis , Retrospective StudiesSubject(s)
Colitis/blood , Crohn Disease/blood , Endotoxins/blood , Acute Disease , Adolescent , Adult , Chronic Disease , Female , Humans , Limulus Test , Liver Diseases/etiology , Male , Thrombophlebitis/etiology , Toxemia/complicationsSubject(s)
Colitis/therapy , Parenteral Nutrition, Total , Parenteral Nutrition , Pregnancy Complications/therapy , Proctocolitis/therapy , Acute Disease , Adult , Female , Gastrointestinal Hemorrhage/therapy , Humans , Pregnancy , Pregnancy Complications, Cardiovascular/therapy , Pregnancy Trimester, Second , Pregnancy Trimester, ThirdSubject(s)
Colonic Neoplasms/diagnosis , Guaiac , Occult Blood , Rectal Neoplasms/diagnosis , Adult , Aged , Female , Humans , Male , Methods , Middle AgedSubject(s)
Kidney/physiology , Nervous System Diseases/physiopathology , Nervous System Physiological Phenomena , Animals , Autonomic Nervous System/physiopathology , Brain/physiology , Central Nervous System/physiology , Cerebral Cortex/physiology , Humans , Kidney/blood supply , Kidney/innervation , Kidney/physiopathology , Kidney Diseases/physiopathology , Spinal Cord/physiology , Vasomotor System/physiologyABSTRACT
The authors review the literature on the effects of the nervous system on the kidney in 3 stages: 1) Historical stage when the role of the renal nerve supply was overetimated by Claude Bernard. 2) Intermediate stage between the two wars with a clinical description of uremic encephalits or acute delirium. From the experimental point of view was demonstrated the inessential character of the nerve supply for the survival of the kidney. 3) Modern stage: from the clinical point of view one may distinguish functional nephropathies including those of nervous origin. The latter are due to metabolic or vascular mechanisms which are intricated to various degrees. Problems of regulation are raised in man by certain findings.
Subject(s)
Kidney Diseases/etiology , Kidney/innervation , Nervous System Diseases/complications , Brain Diseases/complications , Hematuria/etiology , Humans , Kidney/blood supply , Peripheral Nervous System Diseases/complications , Proteinuria/etiology , Uremia/etiology , Vascular Diseases/complicationsABSTRACT
UNLABELLED: We have compared, using non protein RQ method, energy expenditures of diarrheic patients with intraperitoneal or intraluminal suppuration and feed enterally (group II) or intravenously (group III). Five non suppurative diarrheic patients feed enterally were studied as control (group I). Carbohydrate, protein and fat intakes were not significantly different in the 3 groups of patients. Patients of group II metabolized significantly less of carbohydrate (p less than 0.01) and more of fat (P less than 0.01) than groups I and III patients. Carbohydrate and fat expenditures of patients of groups I and III were not significantly different. CONCLUSION: 1) There is a possible trouble of carbohydrate absorption in suppurative diarrheic patients. 2) Therefore caloric intake must be preferably parenteral in these patients.
