RESUMEN
BACKGROUND AND AIM: Subclinical hepatic encephalopathy (HE) in cirrhotic patients is usually characterized by memory impairment and psychomotor slowing. Our aim was to investigate memory status in cirrhotic patients with and without clinically overt HE. MATERIAL AND METHODS: Thirty-two cirrhotic patients (10 female and 22 male) aged 49 +/- 17 years and 20 healthy subjects (six female and 14 male) aged 46 +/- 12 years were included in the study. Memory status was defined by Wechsler Memory Scale, verbal memory process and complex memory process tests. RESULTS: Grade-1 HE was detected in 7 (22%) patients with cirrhosis. We detected 36 to 92% decrement in various memory tests in cirrhotic patients without HE as compared to healthy subjects. The scores for all psychometric testing results were significantly lower in cirrhotic patients without HE as compared to healthy subjects. We detected 42.9 to 100% decrement in various memory tests in cirrhotic patients with HE than cirrhotic patients without HE. However, there was no statistical significant difference between cirrhotic patients with and without HE. There was no statistical significant difference in cirrhotic patients with Child-Pugh A, B, and C. CONCLUSION: In conclusion, memory status was influenced in which patients with cirrhosis yet has a normal mental and neurological status to routine clinical examination (subclinical HE). Occasionally, decreased memory performance may adversely affect the satisfaction and lifestyle of these patients. Therefore, subclinical HE is an important social problem.
Asunto(s)
Encefalopatía Hepática/etiología , Cirrosis Hepática/complicaciones , Trastornos de la Memoria/etiología , Anciano , Estudios de Casos y Controles , Femenino , Encefalopatía Hepática/fisiopatología , Humanos , Cirrosis Hepática/psicología , Masculino , Trastornos de la Memoria/fisiopatología , Persona de Mediana Edad , Psicometría , Trastornos Psicomotores , Factores de RiesgoAsunto(s)
Arteritis de Células Gigantes/diagnóstico , Arteritis de Takayasu/diagnóstico , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/patología , Sedimentación Sanguínea , Diagnóstico Diferencial , Arteritis de Células Gigantes/diagnóstico por imagen , Arteritis de Células Gigantes/patología , Humanos , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/patología , Masculino , Persona de Mediana Edad , Radiografía , Arteria Subclavia/diagnóstico por imagen , Arteria Subclavia/patología , Arteritis de Takayasu/diagnóstico por imagen , Arteritis de Takayasu/patologíaRESUMEN
Autosomal dominant polycystic kidney disease is a multisystem disorder characterized by multiple, bilateral renal cysts and is also associated with cysts in other organs, such as the liver, pancreas, and arachnoid membranes. Dermatomyositis is a disease which mainly involves the skin and muscles, although occasionally other organs are affected. In this report, a 56-year-old male patient with a four-year history of autosomal dominant polycystic kidney disease was presented. Renal failure was exacerbated by a coexisting dermato-polymyositis. Prednisone treatment with hemodialysis improved the situation. This is the first report renal failure in a patient with autosomal dominant polycystic kidney disease and dermato-polymyositis.
Asunto(s)
Dermatomiositis/complicaciones , Riñón Poliquístico Autosómico Dominante/complicaciones , Insuficiencia Renal/etiología , Dermatomiositis/epidemiología , Glucocorticoides/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Riñón Poliquístico Autosómico Dominante/epidemiología , Prednisona/uso terapéutico , Diálisis Renal , Insuficiencia Renal/epidemiología , Insuficiencia Renal/terapiaRESUMEN
PURPOSE: The aim of this study was to evaluate differences in gallbladder contractility by measuring gallbladder wall thickness, fasting and residual gallbladder volume, and gallbladder ejection fraction in patients with cirrhotic and malignant ascites. METHODS: Twenty-four patients (16 women and 8 men) with malignant ascites (2 cervical, 2 colon, 2 stomach, 6 pancreatic, and 12 ovarian carcinomas), aged 59 +/- 12 years, and 26 patients (14 women and 12 men) with cirrhotic ascites, aged 57 +/- 16 years, were included in the study. After patients fasted overnight for 8 hours, gallbladder wall thickness, fasting gallbladder volume, and gallbladder volume and ejection fraction were measured sonographically at 10, 20, 30, 40, 50, 60, 70, 80, and 90 minutes after ingestion of a standard liquid test meal. RESULTS: The mean gallbladder wall thickness was higher in patients with cirrhotic ascites than in those with malignant ascites (5.5 +/- 1.5 mm [standard deviation] versus 3.1 +/- 0.6 mm, respectively; p < 0.001). The mean fasting gallbladder volume was also higher in patients with cirrhotic ascites than in those with malignant ascites (27.3 +/- 11.5 cm(3) versus 17.6 +/- 8.9 cm(3); p < 0.05). Patients with cirrhotic ascites had significantly higher mean postprandial gallbladder volumes and ejection fractions than did those with malignant ascites at all times except 10 minutes after the meal (p < 0.05). CONCLUSIONS: Our findings suggest that gallbladder contractility is greater in patients with cirrhotic ascites than in patients with malignant ascites.