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Metastatic infection secondary to genitourinary tract sepsis
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Metastatic infection Skeletal metastases Endocarditis
1976.
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An integrative survey is given of three disease processes, in which recent progress of a fundamental nature has been made, primarily affecting the liver, either coincident with or caused by the gravid state: (1) recurrent cholestasis of pregnancy (RCP), (2) viral hepatitis coincident with pregnancy, and (3) acute fatty liver of pregnancy (AFLP). In addition to an assessment of our present knowledge with respect to RCP and AFLP, new genetic hypotheses are proposed. In the latter, the proposal of an ornithine transcarbamylase deficiency, similar to that seen in Reye’s syndrome, has potential therapeutic implications that are explored. In light of the currently available information on the interaction between maternal viral hepatitis and the variant forms of vertical maternal-fetal transmission, tentative recommendations regarding management of the newborn are suggested.
Am J Med 61: 367-376,
Recurrent cholestasis of pregnancy Acute fatty liver of pregnancy Reye’s syndrome
Holzbach RT: Jaundice in pregancy-1976.
Hormonal hepatlc effects Maternal viral hepatitis
Metastatic infections arising from sepsis in the genitourinary tract are reviewed in 175 cases, including five in which we treated the patients. The skeleton was the most common site Of metastasis (59 per cent). The endocardium was next most frequently involved (28 per cent). Gram-negative organisms were implicated in less than two-thirds of the cases (59 per Cent). Impaired host defense mechanisms were noted in 25 per cent of the patients experiencing metastatic infections. The lower urinary tract was the source of metastasis in 75 per Cent Of the patients, particularly after urologic manipulation in men. Women were more likely to experience metastatic infection from the upper urinary tract. Anatomic and pathologic considerations explaining these sex differences are presented.
Siroky MB, Moylan RA, Austen G Jr, O&on CA: Metastatic infection secondary to genitourinary tract sepsis. Am J Med 61: 351-360, 1976.
Genitourinary tract sepsis Urologic manipulation
Progressive systemic sclerosis Nodal fibrosis Bundle branch block
lmmunodeflclency Xanthomas Bile acid a&rations
, Chronic obstructive liver disease and secondary hyperlipidemia developed in an immunodeficient boy. Sequential addition of cholestyramine and phenobarbital to his medical regimen, following an initial response to bile drainage, resulted in the disappearance of xanthomas and pruritus, and the restoration of normal serum concentrations of lipids and bile acids. This improvement may result from shifting the bile acid pool from the peripheral blood compartment to the enterohepatic circulation.
lsenberg JN, Hanson RF, Williams GC, Zavoral J, Page AR, Sharp HL: Immunodeficiency, xanthomas and obstructive liver disease. Am J Med 61: 393-400, 1976.
Obstructive liver disease Hyperlipldemia Prurltus
Progressive systemic sclerosis (PSS) may be associated with focal myocardial fibrosis. Electrocardiographic abnormalities including conduction block are common in PSS but whether they are due to direct destruction of the specialized conduction tissue Of the heart is uncertain. The conduction systems of 35 patients with progressive systemic sclerosis were studied. Morphologic abnormalities within the conduction system in our patients were difficult to attribute to PSS per se. Furthermore, although conduction abnormalities were more frequent in patients with myocardial disease, specific conduction system disease was not the cause in most patients. The conduction system appears to be relatively spared from the myocardial changes of PSS, and the high incidence of conduction disturbances in this condition may be a consequence, rather, of damage to working myocardium.
Ridolfi RL, Bulkley BH, Hutchins GM: The cardiac conduction system in progressive systemic sclerosis. Clinical and pathologic features of 35 patients. Am J Med 61: 361-366, 1976.
Cardiac conduction system Myocardial flbrosis
--
-
Metastatic infection Skeletal metastases Endocarditis
1976.
-
.-
An integrative survey is given of three disease processes, in which recent progress of a fundamental nature has been made, primarily affecting the liver, either coincident with or caused by the gravid state: (1) recurrent cholestasis of pregnancy (RCP), (2) viral hepatitis coincident with pregnancy, and (3) acute fatty liver of pregnancy (AFLP). In addition to an assessment of our present knowledge with respect to RCP and AFLP, new genetic hypotheses are proposed. In the latter, the proposal of an ornithine transcarbamylase deficiency, similar to that seen in Reye’s syndrome, has potential therapeutic implications that are explored. In light of the currently available information on the interaction between maternal viral hepatitis and the variant forms of vertical maternal-fetal transmission, tentative recommendations regarding management of the newborn are suggested.
Am J Med 61: 367-376,
Recurrent cholestasis of pregnancy Acute fatty liver of pregnancy Reye’s syndrome
Holzbach RT: Jaundice in pregancy-1976.
Hormonal hepatlc effects Maternal viral hepatitis
Metastatic infections arising from sepsis in the genitourinary tract are reviewed in 175 cases, including five in which we treated the patients. The skeleton was the most common site Of metastasis (59 per cent). The endocardium was next most frequently involved (28 per cent). Gram-negative organisms were implicated in less than two-thirds of the cases (59 per Cent). Impaired host defense mechanisms were noted in 25 per cent of the patients experiencing metastatic infections. The lower urinary tract was the source of metastasis in 75 per Cent Of the patients, particularly after urologic manipulation in men. Women were more likely to experience metastatic infection from the upper urinary tract. Anatomic and pathologic considerations explaining these sex differences are presented.
Siroky MB, Moylan RA, Austen G Jr, O&on CA: Metastatic infection secondary to genitourinary tract sepsis. Am J Med 61: 351-360, 1976.
Genitourinary tract sepsis Urologic manipulation
Progressive systemic sclerosis Nodal fibrosis Bundle branch block
lmmunodeflclency Xanthomas Bile acid a&rations
, Chronic obstructive liver disease and secondary hyperlipidemia developed in an immunodeficient boy. Sequential addition of cholestyramine and phenobarbital to his medical regimen, following an initial response to bile drainage, resulted in the disappearance of xanthomas and pruritus, and the restoration of normal serum concentrations of lipids and bile acids. This improvement may result from shifting the bile acid pool from the peripheral blood compartment to the enterohepatic circulation.
lsenberg JN, Hanson RF, Williams GC, Zavoral J, Page AR, Sharp HL: Immunodeficiency, xanthomas and obstructive liver disease. Am J Med 61: 393-400, 1976.
Obstructive liver disease Hyperlipldemia Prurltus
Progressive systemic sclerosis (PSS) may be associated with focal myocardial fibrosis. Electrocardiographic abnormalities including conduction block are common in PSS but whether they are due to direct destruction of the specialized conduction tissue Of the heart is uncertain. The conduction systems of 35 patients with progressive systemic sclerosis were studied. Morphologic abnormalities within the conduction system in our patients were difficult to attribute to PSS per se. Furthermore, although conduction abnormalities were more frequent in patients with myocardial disease, specific conduction system disease was not the cause in most patients. The conduction system appears to be relatively spared from the myocardial changes of PSS, and the high incidence of conduction disturbances in this condition may be a consequence, rather, of damage to working myocardium.
Ridolfi RL, Bulkley BH, Hutchins GM: The cardiac conduction system in progressive systemic sclerosis. Clinical and pathologic features of 35 patients. Am J Med 61: 361-366, 1976.
Cardiac conduction system Myocardial flbrosis