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Biomedical subjects

K R Reddy

Publications and source records attributed to K R Reddy.

At least 127 records · Page 7Linked to original sources
PubMed1989

Amoxicillin-clavulanate potassium-associated cholestasis.

Amoxicillin-clavulanate potassium, a semisynthetic penicillin-beta-lactamase inhibitor combination drug, is a widely used oral antibiotic. Since the marketing of this drug in 1984, more than nine million prescriptions have been dispensed. Several cases of jaundice and hepatic dysfunction have been observed and reported to the Food and Drug Administration and the pharmaceutical company (Beecham Laboratories). A review of 18 of these cases revealed a predominantly cholestatic syndrome in 7 cases, a mixed hepatocellular-cholestatic picture in 6 cases, a hepatocellular pattern in 4, and in 1 case the injury could not be clearly defined. No fatalities were observed, and all cases had reversal of hepatic dysfunction upon cessation of the drug. Fever was present in 2 patients and eosinophilia in 6 of 10 patients tested, suggesting a hypersensitivity phenomenon contributing to hepatic dysfunction in some of the cases. A percutaneous liver biopsy had been performed in 7 of 18 patients and four of these were reviewed by the authors. Prominent centrizonal cholestasis was seen in all four biopsies. Additionally, 1 patient had periportal and another had midzonal cholestasis. Although infrequent, recognition of an often benign cholestatic syndrome associated with amoxicillin-clavulanate potassium will help avoid unnecessary, invasive, and expensive diagnostic studies and also ameliorate symptoms upon withdrawal of the drug.

Adult↗
PubMed1989

Hepatic involvement as the primary manifestation of Kaposi's sarcoma in the acquired immune deficiency syndrome.

A 44-yr-old homosexual male with symptomatic human immune deficiency virus (HIV) infection presented with abdominal pain, hepatosplenomegaly, and rising serum alkaline phosphatase. Laparoscopy revealed multiple purplish nodules on the surface of the liver. Histopathology of the lesions was consistent with Kaposi's sarcoma. Six weeks later, cutaneous Kaposi's sarcoma became apparent on the head and neck. This case is unusual because, in all previously published cases, with the exception of one, intrahepatic Kaposi's sarcoma was found on autopsy. Moreover, all patients had evidence of extrahepatic Kaposi's sarcoma prior to the documentation of liver involvement.

Abdominal Pain↗
PubMed1989

Nyquil-associated liver injury.

Acetaminophen, a commonly used medication, is present in many over-the-counter remedies. In recent years, its potential to cause severe liver injury has been increasingly appreciated. Chronic abusers of alcohol may be particularly susceptible to hepatotoxicity from acetaminophen. We report two cases of unintentional liver injury associated with ingestion of Nyquil, a liquid cold remedy containing acetaminophen and 25% alcohol.

Acetaminophen↗
PubMed1989

Danazol-induced cholestasis.

A 39-yr-old female on high-dose Danazol presented with jaundice and pruritus. Danazol-induced cholestasis was suspected, and the drug was discontinued. A liver biopsy revealed panlobular cholestasis with portal and periportal inflammation. The cholestasis resolved completely in 8 wk. This is a rare case of Danazol-induced cholestasis and should be considered in the differential diagnosis of drug-induced liver injury.

Adult↗
PubMed1988

Malignant peritoneal mesothelioma. A clinical and laparoscopic study of ten cases.

A retrospective study of 10 cases of malignant peritoneal mesothelioma from two centers is reported. All cases were initially diagnosed between 1967 and 1986 utilizing laparoscopy and the histologic interpretation of laparoscopic biopsy samples. Subsequently, the original diagnosis was confirmed by two independent pathologists employing both histological and histochemical techniques. In five cases immunohistochemical studies were also performed. The clinical findings and course of the disease were similar to other reported series. Laparoscopic findings of mesothelioma were indistinguishable from metastatic peritoneal neoplasms. However, the presence of homogeneous spreading of nodules, plaques, or fleshy masses on both parietal and visceral peritoneum; the absence of direct or indirect signs of other abdominal neoplasms; and the absence of hepatic metastases or the possible presence of nodules or plaques on Glisson's capsule without any parenchymal involvement, when observed, allowed the laparoscopist to suspect the disease in four of 10 cases. Laparoscopy may be useful in detecting mesothelioma. The diagnosis is mainly morphological, but even morphology has its inherent limitations. Further studies are necessary to improve the diagnostic accuracy of this tumor.

Biopsy↗
PubMed1988

Combined surgical and radiologic approach to recurrent cholangitis and intrahepatic pigment stones.

A 37-yr-old white woman from Australia presented with ascending cholangitis and jaundice and was found to have multiple brown, "earthy" pigment stones in the biliary tree, including the segmental ducts. Removal of these stones was accomplished via a subcutaneously placed afferent jejunal limb of a choledochojejunostomy using balloon dilators. The jejunal conduit also served as an access for periodic removal of newly formed stones. This combined surgical and radiologic approach is an effective way of removing recurring pigment stones. The afferent jejunal limb can also be used to perfuse dissolution agents, if necessary, via catheters placed in the biliary tree.

Adult↗
PubMed1988

Early recognition of recurrent hepatocellular carcinoma utilizing gallium-67 citrate scintigraphy.

Gallium-67 scintigraphy is a valuable test together with other screening tests such as alpha feto-protein (AFP) and other imaging modalities in following up recurrent hepatocellular carcinoma (HCC). Three patients were followed in our institution for intervals varying from 2-24 mo after successful resection of uninodular localized hepatomas. In the first patient, gallium scan showed abnormal localized activity while the computed tomography (CT) scan and the magnetic resonance imaging were negative. Liver function tests and AFP were also normal and the patient was operated upon only on the basis of the gallium scan. The second patient had a follow-up gallium scan 2 mo after the first operation that showed an area of increased activity along the inferior aspect of the right lobe. A CT scan done after that showed no evidence of recurrence, but subsequently became positive when repeated 4 mo later. The third patient had abnormal simultaneous gallium scan and CT scan demonstrating a recurrence in the left adrenal gland while both AFP and carcinoembryonic antigen were normal. This has led us to consider every patient a candidate for a baseline and follow-up gallium scan for evaluation for recurrence following HCC.

Adrenal Gland Neoplasms↗
PubMed1988

Spontaneous group B Salmonella enteritidis peritonitis in cirrhotic ascites and acquired immune deficiency syndrome.

Salmonella represents an infrequent cause of spontaneous bacterial peritonitis in cirrhotic ascites. A cirrhotic patient, an alcoholic and former intravenous drug abuser, developed spontaneous group B Salmonella enteritidis (undetermined serotype) bacterial peritonitis. The isolation of this pathogen, a common cause of bacteremia in acquired immune deficiency syndrome, led to the serological determination of infection with human immune deficiency virus (HIV).

Ascites↗
PubMed1987

Experience with diagnostic laparoscopy in a hepatology training program.

Laparoscopy is an underutilized endoscopic procedure in the United States even though it has proven to be an important diagnostic modality. Among factors that may account for the unpopularity of this procedure are lack of experience and proper training in many gastroenterology fellowship programs, a perceived notion that there is a relatively high complication rate, and the preference for radiologic imaging techniques for establishing a diagnosis. We reviewed, over an 11-month period, our experience with laparoscopy in a large teaching center to better assess its safety when performed by trainees. The major and minor complication rates were 0.9% and 2.9%, respectively, with no fatalities. These findings compare favorably with the general experience.

Adolescent↗
PubMed1987

Postoperative jaundice as a clue to unrecognized biliary tract obstruction.

Postoperative jaundice is often a complex clinical problem of multifactorial origin. If underlying liver disease is present preoperatively, there is a greater likelihood of jaundice after surgery. We describe two patients: one with intrabiliary hepatocellular carcinoma and the other with primary sclerosing cholangitis. The underlying processes were unmasked after the development of jaundice in the postoperative period. These cases point out the importance of considering previously undiagnosed biliary tract obstruction in the differential diagnosis of postoperative jaundice.

Aged↗
PubMed1987

Failure of Centers for Disease Control criteria to identify hepatitis B infection in a large municipal obstetrical population.

The Centers for Disease Control (CDC) has recommended screening pregnant women from high-risk populations for hepatitis B surface antigen (HBsAg). To assess the adequacy of the risk criteria, all women presenting for delivery to a large municipal hospital were screened. Sera from 5356 women were tested, and questionnaires designed to identify women at high risk were completed by 78% of these patients. Sixty-four women were found to be HBsAg seropositive (1.2%). If the CDC criteria had been applied for screening, 30 of the seropositive mothers (47%) would not have been identified. Women from some Latin American and Caribbean countries not recommended for screening were found to have a relatively high prevalence of hepatitis B infection. Reluctance to give a history of venereal disease or illicit drug use may be another factor in the failure of the CDC screening strategy. To achieve effective immunoprophylaxis of newborns, all pregnant women should be screened for HBsAg carriage.

Carrier State↗
PubMed1987

The initial presentation of fatty liver of pregnancy mimicking acute viral hepatitis.

Acute fatty liver of pregnancy, a disease of the 3rd trimester of pregnancy, may have varied presentations. An unusual initial presentation of acute fatty liver of pregnancy mimicking an acute viral hepatitis is reported herein. Osmium tetroxide preparation of pathological specimen for the diagnosis of acute fatty liver of pregnancy is also discussed.

Adult↗