8 research outputs found
Angiogenesis and portal-systemic collaterals in portal hypertension
In patients with advanced liver disease with portal hypertension, portal-systemic collaterals contribute to circulatory disturbance, gastrointestinal hemorrhage, hepatic encephalopathy, ascites, hepatopulmonary syndrome and portopulmonary hypertension. Angiogenesis has a pivotal role in the formation of portal-systemic shunts. Recent research has defined many of the mediators and mechanisms involved in this angiogenic process, linking the central roles of hepatic stellate cells and endothelial cells. Studies of animal models have demonstrated the potential therapeutic impact of drugs to inhibit angiogenesis in cirrhosis. For example, inhibition of VEGF reduces portal pressure, hyperdynamic splanchnic circulation, portosystemic collateralization and liver fibrosis. An improved understanding of the role of other angiogenic factors provides hope for a novel targeted therapy for portal hypertension with a tolerable adverse effect profile
Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors
Background: Hemolytic-uremic syndrome (HUS) is characterized by acute
renal failure, microangiopathic hemolytic anemia and thrombocytopenia. Aim: To describe the
characteristics of patients with the diagnosis of HUS in Chile, and to identify the most reliable early
predictors of morbidity and mortality. Material and methods: The clinical records of patients with
HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals,
were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and
mortality were analyzed. Results: A cohort of 587 patients aged 2 to 8 years, 48% males, was
analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in
39% of the patients, hypertension in 45% and seizures in 17%. Forty two percent required renal
replacement therapy (RRT) and peritoneal dialysis was used in the majority of cases (78%). The most
frequently isolated etiological agent was Escherichia coli. Mortality rate was 2.9% in the acute phase
of the disease and there was a positive correlation between mortality and anuria, seizures, white
blood cell count (WCC) >20.000/mm3 and requirements of renal replacement therapy (p <0.05).
Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute
phase were the need for renal replacement therapy, anuria, WCC >20.000/mm3, seizures and
hypertension. Conclusions: The present study emphasizes important clinical and epidemiological
aspects of HUS in a Chilean pediatric population