RESUMO
BACKGROUND: Complications associated with liver cirrhosis are various and potentially fatal. The treatment options to counteract hepatic decompensation are limited. Therefore, the study aimed to explore the use of allopurinol in preventing the recurrence of liver cirrhosis-related complications. METHODS: One hundred patients with hepatic decompensation were randomized into 1:1 ratio to receive either allopurinol 300 mg or placebo tablets once daily for 6 months. The primary endpoint was the incidence of cirrhosis-related complications (overt ascites, spontaneous bacterial peritonitis, variceal bleeding, hepatorenal syndrome, and hepatic encephalopathy). RESULTS: Six months following treatment, allopurinol reduced the relative risk (RR) of any first complication experienced after enrollment by 56% (hazard ratio [HR] 0.44; 95% confidence interval [CI], 0.27-0.62); P Ë .001). Allopurinol decreased the RR of overt ascites by 67% (HR 0.33; 95% CI, 0.0098-0.94); P = .039] and reduced the RR of spontaneous bacterial peritonitis by about 75% (HR 0.25; 95% CI, 0.05-0.76; P = .01). Likewise, allopurinol was linked to an 80% reduction in the RR of developing hepatorenal syndrome (HR 0.2; 95% CI, 0.04-0.87; P = .033). CONCLUSION: Allopurinol significantly decreased the recurrence of overall liver cirrhosis-related complications. Therefore, allopurinol may constitute a promising agent for patients with hepatic decompensation. These positive outcomes could be a result of its ability to reduce bacterial translocation and inflammation. GOV IDENTIFIER: NCT005545670.
Assuntos
Varizes Esofágicas e Gástricas , Síndrome Hepatorrenal , Peritonite , Humanos , Alopurinol/uso terapêutico , Varizes Esofágicas e Gástricas/complicações , Ascite/etiologia , Ascite/prevenção & controle , Síndrome Hepatorrenal/tratamento farmacológico , Síndrome Hepatorrenal/etiologia , Síndrome Hepatorrenal/prevenção & controle , Hemorragia Gastrointestinal/etiologia , Cirrose Hepática/complicações , Peritonite/prevenção & controle , Peritonite/complicaçõesRESUMO
In summary the carbon tetrachloride/phenobarbital of cirrhosis in rats mimics human cirrhosis very closely, with development of ascites and SBP. This model shows us that bacterial overgrowth occurs as cirrhosis progresses and that bacterial translocation from the gut to extra-intestinal sites is part of the early pathogenesis of SBP. SID with norfloxacin dramatically reduced translocation and SBP at the expense of grampositive overgrowth and infection with gram-positives and colonization with strange gram negatives. SID with TMP-SMZ actually delayed development of ascites and prolonged survival.
Assuntos
Animais , Ratos , Ascite/microbiologia , Cirrose Hepática Experimental/complicações , Peritonite/microbiologia , Translocação Bacteriana/fisiologia , Ascite/prevenção & controle , Cirrose Hepática Experimental/induzido quimicamente , Cirrose Hepática Experimental/microbiologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Fenômenos Fisiológicos Bacterianos , Intoxicação por Tetracloreto de Carbono , Norfloxacino/uso terapêutico , Peritonite/prevenção & controle , Antibioticoprofilaxia , Translocação BacterianaRESUMO
O objetivo deste estudo foi estimar os coeficientes de herdabilidade para os escores visuais de coração e de fígado em uma linhagem macho de frangos de corte. As análises dos dados foram realizadas através do método da máxima verossimilhança restrita e do método R, utilizando-se informações de 6167 animais. Os escores visuais de coração e de fígado não pareceram ser capazes de apresentar resposta à seleção, tendo em vista as estimativas de herdabilidade obtidas através do método da máxima verossimilhança restrita, que foram de 0,05±0,02 para ambas as características. Possivelmente devido à pouca variabilidade dos dados dos escores visuais de coração e de fígado, as análises realizadas pelo método R não atingiram convergência.
The objective of this study was to estimate the heritability coefficients for heart and liver visual scores in a male broiler line. Dataset analysis was realized by restricted maximum likelihood and by R method. Data from 6167 individuals were used. Heart and liver visual scores did not seem to be able to respond to selection, since the heritability estimates obtained by restricted maximum likelihood were 0,05±0,02 for both traits. Possibly due to the low variability of visual scores data, the analyses by R method did not converge.
Assuntos
Ascite/prevenção & controle , Aves , Hereditariedade/genética , Melhoramento Genético/métodos , Moldes GenéticosRESUMO
Se evalúan 7 pacientes con cáncer de ovario recurrente que fueron tratadas con radioterapia. La toxicidad durante y posterior al tratamiento fue significativa (hematológica y digestiva). Sin embargo, la tolerancia y calidad de vida de las pacientes fue buena, particularmente por la menor incidencia de ascitis aun habiendo recurrencia de la enfermedad. La sobrevida media libre de enfermedad fue 8 meses