摘要:

Hepatomegaly and abnormalities of serum liver tests are common problems in patients with acquired immune deficiency syndrome. Opportunist infections (Mycobacterium avium-intracellulare and cytomegalovirus) and neoplasms (lymphoma, Kaposi’s sarcoma) are among the most prevalent hepatic lesions in AIDS. Although Kupffer cells and endothelial cells are potential sites of human immunodeficiency virus 1 (HIV-1) infection, current studies do not indicate that the liver is a major reservoir for this virus. Drug hepatotoxicity, multimicrobial infections of the biliary tree resembling sclerosing cholangitis and a variety of nonspecific hepatic changes should be considered in evaluating AIDS patients or HIV-1-infected patients with evidence of liver dysfunctio

ISSN:0257-2753    

DOI:10.1159/000171468

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Primary biliary cirrhosis is a chronic, usually progressive, cholestatic liver disease of presumed autoimmune etiology that affects predominantly young and middle-aged women. It is nearly always associated with an antibody directed against a component of the pyruvate dehydrogenase complex located on the inner wall of the mitochondria. The disease is associated with a number of other associated autoimmune disorders. No totally effective medical treatment has been established for the disease, although ursodeoxycholic acid appears promising. Complications of cholestasis such as fat malabsorption and fat-soluble vitamin deficiency should be excluded or corrected when found. Individual patient prognosis varies. Several models for estimating individual patient survival are available. Liver transplantation is recognized as a procedure to extend and improve the quality of life for patients with advanced disease.

ISSN:0257-2753    

DOI:10.1159/000171469

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In most individuals, only part of the imbibed alcohol reaches the systemic blood. With doses relevant to social drinking, this is due mainly to gastric first-pass metabolism of alcohol, which acts as a barrier against toxic alcohol blood levels. The activity of gastric alcohol dehydrogenase can account for a substantial fraction of this metabolism. Fasting, female gender, old age, dilution of alcoholic beverages, chronic alcohol consumption and still undetermined factors decrease the gastric metabolism of alcohol. Aspirin and some H2receptor antagonists also inhibit this gastric activity. In subjects with documented firstpass metabolism, these drugs increase blood alcohol levels, especially after repeated small drinks, and may result in unexpected impairment to perform complex tasks, such as driving. Thus, patients treated with these drugs should be warned of this possible side effect.

ISSN:0257-2753    

DOI:10.1159/000171470

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Placebo, defined as any therapeutic procedure, without any specific activity, given deliberately to have an effect on a patient, symptom, syndrome or disease, has a great impact in the evaluation of drug response. The possible pathways via which the possible effect brings about clinical and physiological changes remain unknown, but a humoral mechanism seems to be implicated in some placebo effects (e.g. placebo-induced analgesia). The placebo effect depends on many factors, including the type of patient, the personality of the physician, the doctor-patient relationship and the type and even the colour of the drug preparation. Placebo control is important particularly when the disease is characterized by frequent spontaneous periods of acute exacerbation and remission. Functional (such as dyspepsia and irritable bowel syndrome) and organic (such as peptic ulcer and inflammatory bowel disease) gastrointestinal diseases have got great benefit from placebo-controlled clinical trials. In such trials the more effective the placebo is, the more difficult it will be to demonstrate the efficacy of active drug in statistical terms. Nevertheless, provided the use of placebo be ethical for a given condition, placebo-controlled trials are the only objective way of assessing correctly drug response in patients.

ISSN:0257-2753    

DOI:10.1159/000171471

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171472

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171473

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171474

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171467

出版商:S. Karger AG    

年代:1994

数据来源: Karger