Abstract:
:Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis without adequate plasma volume expansion, transjugular intrahepatic portosystemic shunt (TIPS) insertion, peritoneovenous shunting and surgery. Cardiac failure is an important cause of mortality after liver transplantation, but improved liver function has also been shown to reverse the cardiac abnormalities. No specific treatment can be recommended, and cardiac failure should be treated as in non-cirrhotic patients with sodium restriction, diuretics, and oxygen therapy when necessary. Special care should be taken with the use of ACE inhibitors and angiotensin antagonists in these patients. The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Møller S,Henriksen JHdoi
10.1136/gut.2006.112177subject
Has Abstractpub_date
2009-01-01 00:00:00pages
44-54issue
999eissn
0032-5473issn
1469-0756pii
85/999/44journal_volume
85pub_type
杂志文章abstract::Thirty patients who had undergone major abdominal surgery were randomly assigned to a continuous infusion of either 0.45 mg meptazinol/kg/hr or 0.3 mg pethidine/kg/hr. Analgesia was assessed by rating scale, ranging from 0 (no pain) to 10 (unbearable pain), and by questionnaire. Respiration rate was closely monitored ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-01-01 00:00:00
abstract::The differing aspects of fibrocystic disease are presented. The various histological components making up the breast account for the variegated presentation of symptoms and findings. Pain, tenderness and nodularity represent the greatest problem with the former two prompting the patient to seek relief. The latter symp...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::A girl of 12 years old presented with acute small bowel obstruction nine weeks after an uncomplicated appendicectomy. The obstruction was found to be due to the development of sclerosing peritonitis. Previous reports of this rare condition have suggested that it is predominantly found in adolescent girls residing in s...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.719.841
更新日期:1985-09-01 00:00:00
abstract::Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly describe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.394
更新日期:1983-06-01 00:00:00
abstract::A child with the isolated anomaly of azygos continuation of the inferior vena cava is presented. The interest of this abnormality lies in its detection as a mediastinal mass on the chest radiograph. Computed tomography with intravenous contrast enhancement is the method of choice to diagnose this venous anomaly. Aware...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.762.253
更新日期:1989-04-01 00:00:00
abstract::Tourette's syndrome is a neuropsychiatric disorder characterised by motor and phonic tics. Although tics are common in children, only about 1% of those affected meet the criteria for Tourette's syndrome, and many are not disabled by it. Associated problems such as attention deficit hyperactivity disorder and obsessive...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2010.223685rep
更新日期:2011-02-01 00:00:00
abstract::Multiple lymphomatous polyposis is an uncommon but distinctive form of gastrointestinal lymphoma. Clinical symptoms may closely resemble those of colorectal carcinoma and diagnostic confusion may result. The condition has a characteristic pathological appearance and immunophenotype which is important in allowing disti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.811.401
更新日期:1993-05-01 00:00:00
abstract::Serum lysozyme (muramidase) estimation is a simple, convenient and useful laboratory investigation. A review of the literature shows that lysozyme has been implicated as an aetiological factor in various disorders, and credited with being a prognostic indicator in acute myeloid leukaemia, but these promises have not b...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.619.257
更新日期:1977-05-01 00:00:00
abstract::We report a 71 year old lady who presented with weight loss, rectal bleeding and bilateral foot drop having been previously fit and well. Clinical examination, laboratory investigation and postmortem examination confirmed the diagnosis of active Crohn's disease and acute peripheral neuropathy. The clinical course of t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.828.762
更新日期:1994-10-01 00:00:00
abstract::We report the use of nivazol in a patient with Nelson's syndrome. Nivazol was highly effective in reducing ACTH secretion but, contrary to reports of its use in other primates, in our patient nivazol did have systemic glucocorticoid effects. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.749.220
更新日期:1988-03-01 00:00:00
abstract::Although primary percutaneous coronary intervention (PCI) in clinical trials has lower rates of reinfarction, stroke and mortality than fibrinolytic therapy, because of system delays in routine practice, field triage and prehospital administration of fibrinolytic therapy may lead to similar clinical outcomes, especial...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/hrt.2007.137182
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Doctors in all specialties are involved in making "do not attempt resuscitation" (DNAR) decisions; this can be a difficult and challenging process. Guidelines exist to provide an ethical and legal framework for the process and documentation of these decisions. OBJECTIVE:To audit the documentation of resus...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2006.050260
更新日期:2007-02-01 00:00:00
abstract::Ruptured abdominal aortic aneurysm currently accounts for about 1 in 200 deaths and is a critical surgical emergency with an average hospital mortality of 50%. The combination of acute massive haemorrhage in an elderly patient with pre-existing medical disease is highly lethal and a major challenge for any health care...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.70.822.252
更新日期:1994-04-01 00:00:00
abstract::Although the relationship between group A streptococcal upper respiratory tract infection and the development of acute rheumatic fever has been known for many years, the pathogenetic mechanism(s) have never been defined. Thus, the mechanism of damage to the valves and to the myocardium in patients with rheumatic fever...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:Approximately 366 million people worldwide live with diabetes and this figure is expected to rise. Among the correct diagnosis, there will be errors in the diagnosis, classification and coding, resulting in adverse health and financial implications. AIM:To determine the prevalence and characteristics of d...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/postgradmedj-2013-132068
更新日期:2014-01-01 00:00:00
abstract::Evidence is now accumulating on both clinical and experimental grounds that the retina is an a priori source of inflammatory activity. Reactive inflammation in the retina may produce many of the clinical signs previously ascribed to uveal inflammation. Autoimmune mechanisms are probably responsible for the majority of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.753.488
更新日期:1988-07-01 00:00:00
abstract::During one year, out of 1829 faecal specimens examined at the Chelmsford Public Health Laboratory, campylobacters were isolated from 109 (6%), 21 of the positive cultures were from hospital in-patients and 3 were from hospital staff. The remaining 85 isolates were from specimens sent in by general practitioners. The a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.80
更新日期:1980-02-01 00:00:00
abstract:AIMS:To review the clinical and pathological factors associated with fulminant amoebic colitis (FAC) requiring colonic resection and its outcome. METHODS:We retrospectively identified adult patients admitted to our centre between June 2007 and December 2011 with FAC who underwent colonic resection and were diagnosed w...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132597
更新日期:2015-04-01 00:00:00
abstract::Quantitative lipoprotein level data was obtained from healthy subjects and patients with ischaemic heart disease or peripheral vascular disease in four European communities. Hypertriglyceridaemia, due mainly to an increase in VLDL triglyceride, was commoner in London and Uppsala than in Naples and Geneva. In three com...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Diuretics are used extensively in hospitals and in community medical practice for the management of cardiovascular diseases. They are used frequently as the first line treatment for mild to moderate hypertension and are an integral part of the management of symptomatic heart failure. Although diuretics have been used ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2003.010835
更新日期:2004-04-01 00:00:00
abstract::Recurrence of adrenal cortical carcinoma 22 years after first presentation is reported in a 54-year-old woman with Cushing's syndrome. This tumour is normally associated with poor prognosis and prolonged survival is rare. Although the patient had remained well with apparent 'cure' in the intervening years, it is sugge...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.648.765
更新日期:1979-10-01 00:00:00
abstract::A case of Meckel's diverticulum in a middle-aged man presenting acutely with haematemesis and melaena is reported. Such a presentation has not to our knowledge been previously reported in this age group. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.698.786
更新日期:1983-12-01 00:00:00
abstract::This review examines the appropriate timing of intervention in acute pancreatitis. In gallstone pancreatitis, it is now clear that cholecystectomy during the primary admission carries no greater risk of complications than delayed cholecystectomy and enables earlier recovery to normal activity. This course of action pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.69.813.509
更新日期:1993-07-01 00:00:00
abstract::A 58 year old man presented with an anterior myocardial infarction requiring repeated resuscitation. He had impaired glucose tolerance. He died five weeks later and post-mortem examination revealed a myocardial abscess and sternal osteomyelitis due to Staphylococcus aureus. These had not been apparent clinically. The ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.766.589
更新日期:1989-08-01 00:00:00
abstract::Heatstroke following vigorous exercise is reported in a young male. Severe hepatic and renal failure resulted but the patient completely recovered following treatment by active measures to reduce his core temperature. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.748.157
更新日期:1988-02-01 00:00:00
abstract::Both the quality and the quantity of food ingested are relevant to the genesis of risk factors for coronary heart disease and the two are inseparable. Nevertheless they have a major common pathway through hypertension, which may well be the most important consequence of a high-protein, high-carbohydrate, high-fat, hig...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.629.171
更新日期:1978-03-01 00:00:00
abstract::Hospital referral is indicated as an emergency for breast infections not settling with oral antibiotics. Referrals to a breast clinic over a period of 6 months were assessed for prior antibiotic prescription. A total of 1078 patients were seen during this period. 91 (8%) patients had been prescribed antibiotics, 71% o...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2006.049296
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Colonoscopy is the best way of imaging the colon with concurrent biopsy and treatment. However it is expensive, requires full bowel preparation, and carries a risk of complications. Flexible sigmoidoscopy is an alternative way to investigate symptoms that raise the suspicion of a lesion of the rectum or left...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.2003.008540
更新日期:2004-02-01 00:00:00
abstract::Eight patients with endobronchial tuberculosis diagnosed on bronchoscopy were treated with antituberculosis drugs and a course of prednisone. The progress of the endobronchial lesions was assessed on repeated examinations. The course of the disease was variable and the endobronchial narrowing improved in two patients ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.66.780.822
更新日期:1990-10-01 00:00:00
abstract::The aortic root links the left ventricle and ascending aorta and functions as a support structure for the aortic valve. It can be affected by a variety of congenital and acquired conditions, some of which are potentially life threatening. Echocardiography and cardiac magnetic resonance imaging are established non-inva...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2008.075531
更新日期:2009-07-01 00:00:00