Causas de mortalidad por enfermedades del aparato circulatorio en Jerez de los Caballeros (Badajoz) en el siglo XIX / Causes of death due to circulatory system diseases in horsemen of Jerez (Badajoz) in the 19th century

No disponible

Overview: Liver disease and transplantation.

Australia has had a proud and enviable record of seminal contributions to hepatology, with many contributors. Thus, any attempt to summarize these contributions ab initio in a brief review article is a significant challenge, primarily because it is so easy to overlook or underestimate particular aspects. In this article, I have confined my comments primarily to the areas where the contributions have had a significant global impact and have clearly been recognized internationally. This means that many worthwhile Australian additions will be omitted if there was less apparent international impact. The first significant interest in liver disease in Australia was from the Melbourne group at the Walter and Eliza Hall Institute (WEHI) and Royal Melbourne Hospital, leading to seminal contributions to the description, diagnosis, aetiopathogenesis and therapy of autoimmune hepatitis and primary biliary cirrhosis. Others from Royal Prince Alfred Hospital in Sydney contributed substantially to the effects of immunosuppression of autoimmune hepatitis and to early descriptions of primary sclerosing cholangitis. Other areas where Australians have contributed significantly include steatohepatitis, iron metabolism (and in particular hemochromatosis), viral hepatitis (both at the molecular and clinical level), portal hypertension, and transplant immunology. The remarkable contribution of Professor Dame Sheila Sherlock to Australian hepatology is also summarized.

[Tlaloc and ascites]. / Tláloc y la ascitis.

Ascites has been a common pathological sign among prehispanic Mexican people, as a result from hepatic and cardiac ailments. In this sense it represents a significant epidemiological problem. But it also is important because is related to Tlaloc and the rain gods and goddesses. The hidropic body is a symbolic water container and have a special function: serve as a Tlaloc and related gods vehicle to transport the precious liquid. In this paper we analyze the Tlaloc role as water and alimentary substances provider and his capital importance for people survival. We also describe five different plastic ways to represent water in the body, all of them with clear relationships to Tlaloc.

Chronic albumin infusions to achieve diuresis in patients with ascites who are not candidates for transjugular intrahepatic portosystemic shunt (TIPS).

While transjugular intrahepatic portosystemic shunt (TIPS) is a common therapy for cirrhotic patients with diuretic-resistant or diuretic-refractory ascites, some patients are unsuitable for the procedure for technical or medical reasons. We report our experience with the use of chronic intravenous albumin infusions to achieve diuresis in this difficult patient population and review the historic experience of chronic albumin infusions as a treatment for ascites. Nineteen patients with cirrhosis and diuretic-resistant or diuretic-refractory ascites who were deemed unsuitable for TIPS received outpatient intravenous albumin infusions (50 g) weekly for at least 4 weeks. The following endpoints were retrospectively recorded: serum sodium, serum creatinine, blood urea nitrogen, hematocrit, bilirubin, albumin, international normalized ratio, body weight, and Model for End-stage Liver Disease (MELD) score. The contraindications for TIPS included the following: portal vein thrombosis, two; advanced age, one; encephalopathy, nine; hyperbilirubinemia, five; and other, two. Compared to pretreatment, posttreatment weight decreased in 17 patients, remained unchanged in 0 patients, and increased in 2 patients. The overall mean change in body weight (before vs. after therapy) was 8 lb (P < 0.05). The only significant change in biochemistry was an increase in serum albumin from 2.5 g/dl before therapy to 3.5 g/dl after therapy (P < 0.05). We conclude that (1) recurrent intravenous weekly albumin infusions resulted in significant loss of edema and ascites as measured by loss of body weight, and (2) clinicians may want to consider chronic albumin infusions for selected patients with refractory ascites who are not candidates for TIPS.

Historia de las manifestaciones gastrointestinales del lupus eritematoso sistemico / History of the gastrointestinal manifestations in systemic lupus erythematosus

En este articulo revisamos la historia de las manifestaciones gastrointestinales en el Lupus Eritematoso Sistemico desde el siglo XIX hasta nuestros dias, recorriendo cada uno de los organos involucrados en este sistema y haciendo especial mencion de la gastropatia, enteritis, ileitis, sindrome de malabsorcion, vasculitis y vasculopatia intestinal, trombosis mesenterica, pancreatitis, ascitis, peritonitis, hepatitis autoinmune, entre otros

Meigs' syndrome: the history of the eponym.

Meigs' syndrome is defined as presence of ascites with hydrothorax in association with benign ovarian tumor. The syndrome is named after Joe Vincent Meigs (1892-1963), a Harvard Medical School Professor of Gynecology. However, it was described by several authors in the 19th and the beginning of 20th centuries. Meigs and Cass deserve the credit for awakening the medical profession to the importance of the syndrome in 1937. At the end, the syndrome was coined Meigs' syndrome by Rhodes and Terrell in 1937.

Historical aspects of treatment of patients with cirrhosis and ascites.

The most striking feature of the history of treatment of patients with cirrhosis and ascites is the recurring cycle of initial enthusiasm for a new modality based on uncontrolled observations, followed by reports of complications and failures and/or negative randomized control trials (RCTs). The RCTs tend to be performed rather late, after it is realized that there are problems with the new treatment. In 1975 Tom Chalmers made a plea for randomization of the first patient treated with a new modality. The appropriateness of performing RCTs very early in the evaluation of a new treatment cannot be overemphasized today. Carefully designed RCTs that focus on appropriate subsets of patients and evaluate clinically important endpoints (rather than easier-to-measure, but unimportant indirect endpoints) are the keys to "evidence-based medicine" that will lead to the best outcomes for our patients. If we do not remember that uncontrolled studies regularly lead us into years or even decades of "blind alleys" of investigation, we are destined to repeat the mistakes of the past.

[Origin and development of treatment of Guzhang syndrome (ascitis and abdominal distention) in TCM].

The theory and treatment of Guzhang syndrome was continuously developing as time went on. From Spring and Autumn, Warring States to the Han-Jin period, Neijin and Shang Han Lun laid down the foundation for the development of later ages. During the Tang-Song-Jin-Yuan periods, there were breakthrough and inventions in the recognition theory and treatment, particularly the contention between Gong (purgation) and Bu (reinforce) schools, thus further promoting the development of research on Guzhang syndrome. During Ming-Qing dynasties, based on summing up the experiences of forerunners, new implication or the causes, pathomechanism, diagnosis and treatment appeared with even greater progress. After inheriting and developing the available experiences, modern and contemporary doctors paid attention to combining TCM with modern medicine so that the theory and practice can be more perfected.