ABSTRACT
Millions of Americans regularly use herbal supplements, but many are unaware of the potential hidden dangers. Numerous supplements have been associated with hepatotoxicity and, indeed dietary/herbal supplements represent an increasingly common source of acute liver injury. We report a case of acute liver failure requiring liver transplantation associated with the use of Garcinia cambogia, a supplement widely promoted for weight loss. When patients present with acute hepatitis or liver failure from an unknown etiology, a careful history of supplement use should be performed.
Subject(s)
Anti-Obesity Agents/adverse effects , Garcinia cambogia/adverse effects , Liver Failure, Acute/chemically induced , Plant Preparations/adverse effects , Biopsy , Female , Humans , Liver Failure, Acute/diagnosis , Liver Failure, Acute/surgery , Liver Function Tests , Liver Transplantation , Middle Aged , Phytotherapy , Plants, Medicinal , Risk Assessment , Risk Factors , Treatment OutcomeABSTRACT
Hepatic abscesses can result from foreign body perforation of the gastrointestinal tract. Although uncommon, reported cases often involve solitary hepatic abscess with no obvious etiology. We describe the case of a 65-year- old female with multiple hepatic abscesses occurring secondary to chicken bone perforation of the sigmoid colon identified on colonoscopy. With prompt diagnosis, the patient was successfully treated with endoscopic removal of the foreign body and broad spectrum antibiotic treatment.
Subject(s)
Colon , Foreign Bodies/complications , Liver Abscess/etiology , Aged , Animals , Bone and Bones , Chickens , Female , Humans , Liver Abscess/pathologyABSTRACT
OBJECTIVE: To determine the prognostic value of exercise testing, valve area, and maximum transaortic pressure gradient in asymptomatic patients with aortic valve stenosis. SETTING: The outpatient service of a tertiary referral centre for cardiology. DESIGN: Prospective clinical study. PATIENTS: 66 consecutive patients with isolated severe aortic stenosis (aortic valve area /= 0.7 cm(2) (p = 0.0021). There was no relation between the end points and transaortic gradient (p = 0.6882). In multivariate analysis, a hazard ratio of 7.43 was calculated for patients with a positive versus a negative exercise stress test. Although asymptomatic in daily life, 6% of the patients (4/66) experienced sudden death; all these had a positive exercise test and an aortic valve area of
Subject(s)
Aortic Valve Stenosis/diagnosis , Exercise Test/methods , Adolescent , Adult , Aged , Aged, 80 and over , Aortic Valve Stenosis/pathology , Aortic Valve Stenosis/physiopathology , Blood Pressure , Cohort Studies , Contraindications , Decision Making , Disease-Free Survival , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Risk Assessment , Risk FactorsABSTRACT
Mycotic aneurysms of the celiac artery are extremely rare, and in our review of the literature we found that in only one case was it due to infective endocarditis. In our case a 19-year-old female patient with culture-negative infective endocarditis presented with pain in the epigastric area. A celiac artery aneurysm was diagnosed by ultrasonography and confirmed on CT scan and angiography, which also demonstrated an associated aneurysm of the superior mesenteric artery. Since excellent collateral circulation was present, simple ligation of the two aneurysms was performed. The patient presented no major complications in the postoperative course.