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  • 1
    ISSN: 1432-1440
    Keywords: Torasemide ; furosemide ; Spironolactone ; Cirrhosis ; Ascites
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of long-term therapy (70 days) with torasemide (20 mg/day), a new loop diuretic, were compared with those of furosemide (50 mg/day) in a randomized double-blind trial. Both drugs were administered in association with spironolactone (200 mg/day) in 28 nonazotemic cirrhotic patients with controlled ascites. The treatments did not modify creatinine clearance and exhibited a similar effect on body weight, urinary volume, and fractional excretion of uric acid, sodium, and chloride. The effect of torasemide on fractional potassium excretion was lower than that of furosemide. Torasemide showed higher sparing effect than furosemide on calcium, inorganic phosphate, and magnesium excretion and stronger action on free water clearance. No changes in serum parameters were induced by either treatment. Two episodes of hepatic encephalopathy occurred in the torasemide group. In view of its effects on sodium and water excretion and on other urinary parameters, torasemide can represent an alternative tool for the long-term treatment of ascites.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Liver cirrhosis ; Variceal bleeding ; Octreotide ; Terlypressin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty patients with endoscopically confirmed active variceal bleeding entered a randomized controlled clinical trial aimed at comparing the efficacy of octreotide vs. terlypressin in the control of acute variceal hemorrhage (period I, 24 h) and in the prevention of early rebleeding (period II, 6 days). Of the sixty 30 received octreotide (period I, 100 μg bolus followed by continuous intravenous infusion at 25 μg/h; period IT, 100 μg t.i.d. subcutaneously), and 30 received terlypressin (period I, 2 mg intravenous bolus every 4 h; period II, 2nd day, 2 mg every 6 h; from 3th to 7th days, 1 mg every 6 h). Control of bleeding was achieved in 23 (76.6%) patients receiving octreotide and in 16 (53%) treated with terlypressin (NS); none of these patients suffered rebleeding during treatment. No significant difference in mortality was observed between the two groups during the hospitalization period. Complications due to therapy were lower with octreotide than with terlypressin (P 〈 0.01). Under the same effectiveness conditions the cost/benefit ratio must be taken into account.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das HBeAg/anti-HBe System wurde bei 460 Hämodialysepatienten im Hinblick auf seine Wertigkeit als Marker für Infektiosität und Entwicklung einer chronisch progredienten Lebererkrankung untersucht. Die Bedeutung von HBeAg als Parameter für Infektioistät wurde durch das gleichzeitige Vorkommen von spezifischer DNS Polymerase (31 Patienten) und von diffus verbreiteten Core-Partikeln in Hepatozytenkernen (bei sechs Patienten bioptisch nachgewiesen) bestätigt. Hingegen bestand keine klinisch verwertbare Beziehung zwischen HBeAg und einem progressiven Verlauf der Leberekrankung, der bei allen Fällen durch biochemische und histologische Untersuchung ausgeschlossen wurde.
    Notes: Summary The HBeAg/anti-HBe system was studied as a marker of infectivity and chronic progressive liver disease in 460 hemodialysis patients. The importance of HBeAg as an index of infectivity was confirmed in that it was present simultaneously with specific DNA polymerase (31 patients) and by the presence of widely diffuse core particles in the hepatocyte nuclei (revealed by biopsy in six patients). In contrast, HBeAg showed no useful correlation with progressive liver disease, the absence of which was confirmed in all cases by biochemical and histological studies.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Expression von Markern des Hepatitis Delta Virus (HDV) wurde in Seren von 310 Patienten mit akuter Hepatitis, 63 chronischen Trägern des Hepatitis B Virus-Oberflächenantigen (HBSAg), und 76 Drogenabhängigen mit mindestens einem serologischen Marker für eine Hepatitis B Virus-(HBV-)Infektion untersucht. Bei 17,1% der Patienten mit akuter Hepatitis trat eine akute HDV-Infektion auf. Unter 40 Fällen von HBV-HDV-Koinfektion kam es zehnmal zu einer schweren und dreimal zu einer fulminanten Hepatitis. Bei 13 Fällen von Superinfektion trat nur zweimal eine schwere Hepatitis auf; der Übergang in eine chronische Hepatitis ein Jahr nach der HDV-Infektion war jedoch häufig (78% der Fälle). Auch in unserer Region stellt der parenterale Drogenabusus den Hauptrisikofaktor für die HDV-Infektion dar, und die hohe Prävalenz von HDV-Infektionen unterstreicht die Notwendigkeit eines serologischen Screening auf HDV-Marker bei Patienten mit akuter und chronischer Hepatitis.
    Notes: Summary Expression of hepatitis delta virus (HDV) markers was investigated in sera from 310 patients with acute hepatitis, 63 chronic hepatitis B surface antigen (HBsAg) carriers and 76 drug addicts positive for at least one serological hepatitis B virus (HBV) marker. Acute HDV infection occurred in 17.1% of the patients with acute hepatitis. Among 40 cases of coinfection, hepatitis was severe in ten and fulminant in three. Only two of the 13 superinfected patients showed a severe hepatitis, but a high percentage (78%) of them developed chronic hepatitis one year after HDV infection. Also in our area parenteral drug addiction represents the main factor of risk for HDV infection. The high prevalence of HDV infection in our area points to the necessity for serological screening for HDV markers in patients with acute and chronic hepatitis.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 36 (1991), S. 801-808 
    ISSN: 1573-2568
    Keywords: fulminant hepatic failure ; pancreatic hormones ; neutral amino acids ; hepatic regeneration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The behavior of insulin and glucagon and related metabolic substrates was assayed in plasma of patients with fulminant hepatic failure. All 12 subjects were provided the same nutritional support. High levels of insulin and glucagon were present at all times and no difference was observed between surviving patients (four) and those who died (8). Elevated values for branched-chain and aromatic amino acids as well as alanine were present. Statistically significant lower levels of aromatic amino acids and consequently a greater branched chain-aromatic amino acid ratio was found in surviving vs nonsurviving patients. A significantly greater level of alpha-fetoprotein was found in patients who survived as compared to those who died.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1573-2568
    Keywords: transjugular intrahepatic portosystemic shunt ; hepatic encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty-seven consecutive patients were prospectively evaluated to study the incidence of hepatic encephalopathy as well as modifications in the PSE index after TIPS. Various clinical, laboratory, and angiographic parameters were also recorded to identify risk factors for the development of post-TIPS hepatic encephalopathy (HE). Mean follow-up was 17±7 months. During follow-up, six patients died and one underwent transplantation. All other patients were followed for at least a year. Fifteen patients (32%) experienced 20 acute episodes of precipitated HE (hospitalization was necessary in 10 instances), and five patients (11%) presented a continuous alteration in mental status with frequent spontaneous exacerbation during follow-up. Both precipitated and spontaneous HE occurred more frequently during the first three months of follow-up. Moreover the PSE index was significantly worse than basal values one month after TIPS, thereafter returning to near basal values. HE was successfully treated in all patients but one who required a reduction in the stent/shunt diameter. Increasing age (〉65 years) and low portacaval gradient (〈10 mm Hg) were predictors of HE after TIPS. A gradual dilation of the stent/shunt should be performed to obtain a portacaval gradient 〉10 mm Hg to avoid an unacceptable rate of HE after TIPS.
    Type of Medium: Electronic Resource
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