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971.
Haemodynamic parameters predicting variceal haemorrhage and survival in alcoholic cirrhosis 总被引:1,自引:0,他引:1
Stanley AJ; Robinson I; Forrest EH; Jones AL; Hayes PC 《QJM : monthly journal of the Association of Physicians》1998,91(1):19-25
The relationship between the various haemodynamic abnormalities observed in
cirrhosis and their prognostic value remains unclear. We report
haemodynamic measurements on 96 patients with alcoholic cirrhosis (mean
Childs-Pugh Score, CPS, 9.0 +/- 0.2, mean age 55.6 +/- 1.0 years) and
assess their value in predicting variceal bleeding and death during a mean
follow-up of 19.3 +/- 1.5 months. Baseline CPS correlated with hepatic
venous pressure gradient (HVPG) (p = 0.001), azygos blood flow (p <
0.05), cardiac index (p < 0.05), and inversely with mean arterial
pressure (p < 0.01) and systemic vascular resistance index (p <
0.05). Renal blood flow was not related to any haemodynamic parameter or
CPS. Thirty-eight patients died during follow-up, and 16 had a variceal
bleed. Death (p = 0.001) and variceal bleeding (p < 0.05) were more
likely in patients with HVPG > 16 mmHg than in those with HVPG < 16
mmHg, and variceal bleeding was more likely in patients with HVPG > 12
mmHg (vs. HVPG < 12 mmHg, p < 0.05). HVPG also predicted death and
variceal haemorrhage on univariate and multivariate analyses. No other
haemodynamic parameter predicted death or bleeding. In alcoholic cirrhosis,
severity of liver disease is related to HVPG, collateral blood flow and
degree of systemic circulatory abnormalities. HVPG is a useful predictor of
survival and variceal bleeding in these patients.
相似文献
972.
Specific antibodies to Trypanosoma cruzi among blood donors in Los Angeles, California 总被引:1,自引:0,他引:1
BACKGROUND: Trypanosoma cruzi, the cause of Chagas' disease, is often transmitted by transfusion in Latin America. Previous studies showed that at least 1 in 1000 eligible blood donors at the Los Angeles County+University of Southern California (LAC+USC) Medical Center Blood Bank had specific antibodies to T. cruzi. In June 1993, serologic screening of prospective allogeneic donors at epidemiologic risk for T. cruzi infection was begun voluntarily. STUDY DESIGN AND METHODS: The risk of T. cruzi infection in all eligible donors was assessed by questionnaire. At-risk donors were screened serologically for antibodies to T. cruzi with an enzyme immunoassay, and confirmatory testing was done with a radioimmunoprecipitation assay. RESULTS: During the 29-month study period 1311 (39.5%) of 3320 donors were judged to be at risk for T. cruzi infection. Seven donors (1/475) were reactive by an enzyme immunoassay, and six of these seven (1/ 553) were positive in a radioimmunoprecipitation assay. All radioimmunoprecipitation assay- positive donors had been born in countries in which Chagas' disease is endemic. One person in this group had received a transfusion in his homeland. CONCLUSION: These results demonstrate that a substantive proportion of eligible blood donors at our institution have antibodies specific for T. cruzi and that a commercially available assay can be used to detect these antibodies. Our data suggest that the risk of transmission of T. cruzi by transfusion could be eliminated by serologic testing limited to persons born in or transfused in countries in which Chagas' disease is endemic. 相似文献
973.
HLA antigens in Omani patients with vitiligo 总被引:7,自引:0,他引:7
M.N. VENKATARAM A.G. WHITE W.A. LEENY A.R.AL. SUWAID A.S. DAAR 《Clinical and experimental dermatology》1995,20(1):35-37
Fifty native Omanis with vitiligo were studied to compare the incidence of HLA ABC and DR antigens with a control population. HLA Bw6 was found in 82% of patients compared with 49% controls (Pc= 0.0009 RR = 4.56) and HLA DR7 occurred in 40% of patients and 9% in controls (Pc= 0.00075 RR = 6.17). HLA DR7 was significantly increased in those patients with acrofacial, compared to focal disease (57% vs. 24%P= 0.038). Sixty-six per cent of the patients in this study had parents who were consanguineous and a positive family history was only found in this group with an incidence of 32%. HLA Bw4 segregated 100% with patients with a positive family history compared with 48% in consanguineous patients without a positive family history (Pc= 0.011 RR = 23). Vitiligo appears to be associated with different HLA antigens in different ethnic groups. 相似文献
974.
Ian M. DeStefano Annie S. Wayne Sarah E. Cudney Elizabeth A. Rozanski 《Clinical Case Reports》2022,10(8)
A mixed breed dog was treated for severe hemolytic anemia secondary to Babesia canis infection. Within 14 hours of hospitalization, the dog developed respiratory distress and hypoxemia. The patient improved with lung‐protective mechanical ventilation and neuromuscular blockade. The dog survived to discharge and was reportedly healthy at three‐month follow‐up. 相似文献
975.