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Biomedical subjects

S Fagiuoli

Publications and source records attributed to S Fagiuoli.

At least 55 records · Page 3Linked to original sources
PubMed1994

Rheumatoid arthritis: a complication of interferon therapy.

A case report of rheumatoid arthritis developing during alpha-interferon therapy of chronic hepatitis C is reported. The rheumatoid arthritis was severe, being non-responsive to the use of nonsteroidal anti-inflammatory drugs, and persisted despite discontinuation of the interferon therapy. The literature relative to this case suggesting an association between rheumatoid arthritis and interferon therapy is presented. This case suggests that interferon therapy may precipitate subclinical rheumatoid arthritis in an individual without pre-existing clinical arthritis.

Adult↗
PubMed1994

Parental and medical over-administration of acetaminophen causing lethal hepatotoxicity in a 10-year-old.

A 10-year-old girl with acute influenza B virus disease was given repetitive doses of acetaminophen by her mother to reduce the child's fever. When finally seen by trained medical personnel, the child was experiencing abdominal pain, nausea, and vomiting, which are classic signs of acetaminophen hepatotoxicity. Despite these findings, the child was given additional acetaminophen and experienced lethal hepatotoxicity.

Acetaminophen↗
PubMed1994

Upper gastrointestinal endoscopy: its clinical use and safety at a transplant center.

Upper gastrointestinal endoscopy is a widely practiced clinical procedure that has become routine in even the most remote medical environments. Its application at a liver transplant center represents the use of this particular technology at the opposite extreme of medical practice and its use in a unique and severely ill group of patients. The following is a description of the author's experience with upper gastrointestinal endoscopy at the University of Pittsburgh's liver transplant center. Despite the severity of illness of the patients seen at this center, documented by the high frequency of patients seen with abnormal prothrombin times and low platelet counts, upper gastrointestinal endoscopy performed either for diagnostic or therapeutic procedures has been found to be safe. The disease processes that affect transplant patients both before and after transplantation are not seen frequently in the general practice of gastroenterology. Thus the endoscopist at a transplant center has to be able to recognize, identify, and treat the unique problems seen in a transplant population.

Endoscopy, Gastrointestinal↗
PubMed1994

Gastrointestinal transit in cirrhotic patients: effect of hepatic encephalopathy and its treatment.

Chronic hepatic encephalopathy is highly responsive to changes in diet, to antibiotic therapy and to ingestion of nondigestible disaccharides. The precise pathophysiology of chronic hepatic encephalopathy in individual cases is highly variable, although ammonia toxicity and production of neurotransmitterlike substances in the gut have been proposed to contribute to the overall syndrome of chronic hepatic encephalopathy. The support for this hypothesis is based on the empiric observation that reduction in protein intake, a catharsis or both are effective treatments for chronic hepatic encephalopathy. This study was performed to evaluate the effect of mild subclinical and low-grade (grade 0 to 1) chronic hepatic encephalopathy on gastric emptying and oral-cecal transit times. Thirty patients were studied. Ten had no evidence of chronic hepatic encephalopathy, as determined with a battery of neuropsychiatric studies (group 1); 10 had subclinical hepatic encephalopathy, as judged on the basis of abnormal neuropsychiatric test performance but normal neurological examination (group 2); and 10 had grade 1 hepatic encephalopathy. Each underwent a liquid gastric emptying study and a lactulose oral-cecal transit time study. No significant differences between groups were evident in the results of the gastric emptying studies. In contrast, the time required for a lactulose load to reach the cecum was significantly greater in the patients with hepatic encephalopathy (p < 0.01) and increased as a function of the hepatic encephalopathy grade.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Preoperative evaluation of a patient for hepatic surgery.

An overview is given of current practice in deciding which patients can undergo a major abdominal operative procedure involving the hepatobiliary system. The criteria developed for individuals with normal and diseased livers are presented, and the unique circumstances of liver transplantation are also addressed.

Humans↗
PubMed1993

Types, causes, and therapies of hepatitis occurring in liver transplant recipients.

Liver transplantation (OLTx) has become a common life-saving procedure for individuals with chronic advanced liver disease. It is also used in the clinical treatment of patients with fulminant hepatic failure and those with primary neoplastic disease of the liver. Despite its overall success in restoring meaningful life to those who undergo the procedure, the posttransplant life of a liver allograft recipient is not without hazard. A common problem following liver transplantation is the finding of abnormal liver injury tests reflecting a "hepatitis" that can not be ascribed to allograft rejection. The majority of such cases are a consequence of either a technically flawed operation, drug-induced liver injury, or one or another form of viral hepatitis. Each of these problems is discussed in the following clinical review.

Chemical and Drug Induced Liver Injury↗
PubMed1993

Liver transplantation for subfulminant hepatitis.

The preceding discussion has characterized the various types of viral hepatitis, both common and unusual, that can lead to subfulminant hepatic failure. Whenever specific medical therapy exists, it is preferred. If the disease has progressed sufficiently to prohibit survival inspite of medical therapy, OLT is indicated under the umbrella of continuing specific medical therapy. Conversely, if no medical therapy exists, OLT is the only possible therapy but should be used only if extrahepatic disease processes do not prohibit survival. Hopefully, with better and more effective means of immunosuppression, immunosuppression monitoring and the development of additional medical therapies for viruses, OLT will be used less often in cases of subfulminant viral hepatitis in the future.

Hepatic Encephalopathy↗
PubMed1992

Prospective controlled trial with antiestrogen drug tamoxifen in patients with unresectable hepatocellular carcinoma.

Clinical and experimental evidence indicates that estrogens are involved in the control of hepatocyte proliferation both in normal and in neoplastic conditions. Thirty-two cirrhotic patients with unresectable or otherwise untreatable hepatocellular carcinoma were allocated to receive either tamoxifen (30 mg/day) or no treatment. The patients in the two groups were matched for age, male/female ratio, Child-Pugh class, approximate tumor volume (US and CT scan), and etiology of the underlying cirrhosis. Survival of the tamoxifen-treated patients (life-table, Wilcoxon-Breslow) was significantly prolonged (P = 0.0038), with 35% (vs 0%) survival at 12 months. No difference was observed between males and females or between alcoholic and nonalcoholic cirrhosis. In 40% of tamoxifen-treated patients, the levels of alpha-fetoprotein declined. In conclusion, the antiestrogen tamoxifen appears to be effective in the palliative treatment of hepatocellular carcinoma. An initial decline in alpha-fetoprotein levels may represent an early favorable prognostic sign.

Aged↗
PubMed1992

Anti-HCV positive hepatocellular carcinoma in cirrhosis. Prevalence, risk factors and clinical features.

Recent reports indicate that hepatitis C virus (HCV) may play a role in the pathogenesis of hepatocellular carcinoma in cirrhotics. Using an ELISA test, we evaluated the prevalence of anti-HCV antibodies in 97 patients with hepatocellular carcinoma (HCC) in cirrhosis and in a group of 223 patients, including: 49 patients with HBsAg-positive chronic liver disease (CLD), 42 with alcoholic CLD, 110 with cryptogenic CLD and 22 with post-transfusional HBsAg-negative CLD. All diagnoses were histologically confirmed. Overall, anti-HCV-positive HCC were 64% of the total, with no statistically significant difference with respect to CLD (60.9%). The prevalence of anti-HCV was higher in cryptogenic HCC (80%) than in HBsAg-positive (60%) or alcoholic HCC (42.8%) (p less than 0.005). When HCC and cirrhosis of similar putative etiology were considered, anti-HCV prevalence was significantly higher in HCC than in cirrhosis only in the groups of patients with alcoholic liver damage (60% in HCC vs. 38% in cirrhosis, p less than 0.005). In HBsAg-positive patients, anti-HCV prevalence was twice as high in HCC than in CLD, but the difference was not statistically significant. Overall, anti-HCV prevalence in HCC was significantly higher than in alcoholic or HBsAg-positive CLD (p less than 0.001 and p less than 0.01, respectively) but lower than in cryptogenic CLD (p less than 0.001). Association between anti-HCV and anti-HBc was significantly more prevalent in patients with CLD than in those with HCC.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗