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King-wah Chiu - One of the best experts on this subject based on the ideXlab platform.
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Risk factors associated with fulminant amebic colitis.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996Co-Authors: Seng-kee Chuah, Chi-sin Changchien, King-wah Chiu, I-shyan Sheen, K D FanAbstract:Amebic colitis is associated with serious complications and a high fatality rate if it progresses to its fulminant form. The purpose of this retrospective study was to determine the risk factors associated with fulminant amebic colitis. From February 1978 to February 1993, 60 adults were diagnosed with intestinal amebiasis at Chang Gung Memorial Hospital. Sixteen patients with massive bloody diarrhea, persistent systemic toxicity or signs of peritonitis were classified as having fulminant colitis, five of whom progressed to fulminant colitis after admission to the hospital. Forty-four patients with good responses to Amebicides and without complications were classified as having moderate colitis. There was no amebiasis-related mortality among patients with moderate colitis. In contrast, five patients with fulminant colitis died. Early diagnosis and surgical treatment significantly decreased mortality when compared with conservative treatment. Significant factors associated with the development of fulminant intestinal amebiasis in univariate analyses were being male, age over 60 years, having an associated liver abscess, progressive abdominal pain, signs of peritonitis, leukocytosis, hyponatremia, hypokalemia and hypoalbuminemia. Only the factors of being over 60 years of age and hypokalemia were important in multivariate analyses. We conclude that early and extensive surgical treatment is mandatory for patients with typical presentations of fulminant amebic colitis on admission to the hospital, such as progression to peritonitis, persistent systemic toxemia and explosive bloody diarrhea. For other patients, especially the elderly and those with low serum potassium levels, close monitoring and observation for signs of fulminant colitis is important.
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The prognostic factors of severe amebic liver abscess: a retrospective study of 125 cases.
The American journal of tropical medicine and hygiene, 1992Co-Authors: Seng-kee Chuah, Chi-sin Changchien, I-shyen Sheen, Hsien-hong Lin, Shue-shian Chiou, Cheng-tang Chiu, Chung-huang Kuo, Jye-jou Chen, King-wah ChiuAbstract:Abstract One hundred twenty-five cases of amebic liver abscess were diagnosed at Chang Gung Memorial Hospital in Taiwan from January 1981 to December 1989. An analysis of possible prognostic factors for severe amebic liver abscess was done retrospectively. The majority of the patients came from the southern part of Taiwan. Severe amebic liver abscess was defined as the rupture of an abscess that was resistant to 72 hr of medical treatment, or complicated by secondary bacterial infection. The results showed significant differences between patients with severe liver abscess and those with more moderate forms of amebic liver abscess in indices such as jaundice, hemoglobin and serum bilirubin levels, and dyspnea, as well as in pulmonary changes (right diaphragm elevation, right pleural effusion) seen on chest radiographs. Those patients with diabetes mellitus also had greater evidence of severe liver abscess. Moderate cases that were treated with Amebicides showed excellent responses (no mortality). Severe cases required, in addition to Amebicide therapy, either percutaneous or surgical drainage of pus, especially in those patients with ruptured abscesses. Those patients with abscesses that ruptured into the thoracic cavity were treated by either thoracostomy or needle aspiration, and all were cured. Three patients died of abscess rupture into the abdominal cavity, associated with secondary bacterial infection. The overall mortality rate was 2.4%. These symptoms and signs of severe liver abscess are indicators of the need for intensive treatment such as aspiration or surgical drainage.
Fernando Antônio De ,medeiros - One of the best experts on this subject based on the ideXlab platform.
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Estudo fitoquímico e biológico de espécies amazônicas: Pradosia huberi (Ducke) Ducke (Sapotaceae) e Licania macrophylla Bent. (Chrysobalanaceae)
Universidade Federal da Paraíba, 2008Co-Authors: Fernando Antônio De ,medeirosAbstract:O uso das plantas como recurso terapêutico tem ganhado destaque e tornado modismo no mundo. No Brasil não é diferente, e nos últimos anos alguns estados da federação vem implantando a fitoterapia como alternativa terapêutica para o sistema único de saúde. Porém algumas dificuldades são encontradas, entre elas a falta de informações científicas que subsidie o conhecimento tradicional de determinadas espécies. A espécie Licania macrophylla Benth pertence a família Chrysobalanaceae e é conhecida popularmente por anauera ou anuera . As cascas do caule dessa espécie é usada no estado do Amapá como antidiarréica e amebicida. A espécie Pradosiahuberi Ducke, pertence à família Sapotaceae, e é designada popularmente de casca doce ou pau doce , suas cascas do caule são usadas pelos povos amazônicos como auxiliar no tratamento de problemas gástricos e má digestão. No entanto o uso das cascas do caule dessas espécies na preparação de fitoterápico ou mesmo em preparações caseiras é uma prática predatória, pois a recuperação do dano causado pela retirada das cascas leva anos para sua reconstituição, quando não elimina o espécime. O objetivo deste trabalho foi realizar o estudo fitoquímico e biológico das espécies Licania macrophylla Benth e Pradosia huberi (Ducke) Ducke e comparar a composição química entre folhas e cascas do caule das duas espécies, de forma a sugerir se é possível substituir o uso das cascas do caule pelas folhas, e assim contribuir com a conservação das espécies em discussão. As espécies estudadas foram coletadas no município de Porto Grande Amapá Brasil e exsicatas estão depositadas no Herbário Amapaense HAMAB do IEPA. O estudo fitoquímico das cascas do caule da espécie L. macrophyla Benth (Chrysobalanaceae) levou ao isolamento de (-)- 4 -O-metil-epigalocatequina-3 -O-α-L-raminosídeo (Lm-1), (-)-4 -metil-epigalocatequina (Lm-2), enquanto das folhas foram isoladas feofitina A (Lm-3), 132-hidroxi-(132-S)- feofitinaA (Lm-4), feofitina B (Lm-5), β-sitosterol (Lm-6a), estigmasterol (Lm-6b), β-Oglicosídeo- sitosterol (Lm-7), álcool betulínco (Lm-8) e ácido oleanólico (Lm-9), sendo o primeiro não relatado na literatura. Da espécie Pradosiahuberi foi isolado 2,3- dihidromiricetina-3-α-L-O-raminosídeo (Ph-1) e das folhas éster graxo do eritrodiol (Ph- 2), éster graxo do ácido oleanólico (Ph-3), éster graxo do ácido betulínco (Ph-4) e espinasterol (Ph-5), todas identificadas através de técnicas de RMN de 1H e 13C uni e bidimensionais e comparações com a literatura. A avaliação da atividade antidiarréica do extrato metanólico das cascas do caule (EMC) de L. macrophylla mostrou que esse não interfere nos parâmetros intestinais: modulação da defecação normal; diarréia induzida por agente catártico e trânsito intestinal estimulado. Porém EMC apresentou-se ativo frente à Staphylococcus aureus ATCC 25928, Pseudomonas aeruginosa ATCC 25853 e Escherichia coli ATCC 10536, resultado semelhante ao obtido com Lm-1. O extrato metanólico das folhas (EMF) de L. macrophylla mostrou-se ativo frente as doze cepas bactérianas testadas, resultado semelhante ao observado com Lm-4 e Lm-9. No que se refere aos constituintes químicos isolados das cascas do caule e folhas nas duas espécies pode-se afirmar que não são semelhantes. Já em relação a atividade antimicrobiana do EMC e EMF esses apresentaram-se semelhantes, sugerindo que se a atividade antidiarréica fica comprovada que se deve apenas a ação antimicrobiana pode-se haver substituição do uso das cascas do caule pela folhas.The use of plants as a treatment method has gained prominence and became fashionable in the world. In Brazil is not different. In recent years some brazilian states has been implementing phytotherapy as an alternative therapy for the public health. However there are some drawbacks as the lack of scientific information that supporting traditional knowledge of some species. The Licania macrophylla Benth species belongs to the Chrysobalanaceae family and is known popularly as "anauera" or "anuera." The stem bark of this species is used in the state of Amapá like Amebicide as antidiarrheal. The Pradosia huberi Ducke species belongs to the Sapotaceae family, and is popularly called "fresh bark" or "stick candy ' and its stem bark is used by Amazonian peoples to assist in the treatment of stomach problems and indigestion. However the use of the stem bark of these species in the preparation of herbal formulation or even home preparation is a predatory practice, because recovery of the damage caused by removal of the bark takes years to rebuild, if not eliminates the specimen. The aim of this work was the phytochemical and biological study of the Licania macrophylla Benth and Pradosia huberi (Ducke) Ducke species and compare the chemical composition of leaves and stem bark of both species, so as to suggest that you can replace the use of shells stem by the leaves, and thus contribute to the conservation of the species under discussion. The species studied were collected at Porto Grande - Amapá - Brazil and specimens are deposited in the Herbarium Amapaense HAMAB IEPA. The phytochemical study of the stem bark of the L. macrophyla Benth (Chrysobalanaceae) species led to the isolation of (-)-4'-O-methyl-epigallocatechin-3'-O-α- L-raminosídeo (LM-1), (-)-4'-methyl-epigallocatechin (Lm -2), while the leaves were isolated pheophytin A (Lm-3), 132-hydroxy-(132-S) pheophytin A (Lm-4), pheophytin B (Lm-5), β-sitosterol (Lm-6a ), stigmasterol (Lm-6b), β-sitosterol-O-glycoside (Lm-7), alcohol betulínco (Lm-8) and oleanolic acid (Lm-9), the first not reported in the literature. From species was isolated Pradosia huberi 2,3-dihidromiricetina-3-α-LO-raminosídeo (Ph-1) and leaves the fatty ester erythrodiol (Ph-2), ester of fatty oleanolic acid (Ph-3) fatty ester betulínco acid (Ph-4) and espinasterol (Ph-5), all identified by techniques 1H NMR and 13C single and two-dimensional and comparisons with published literature. Evaluation of antidiarrhoeal activity of the methanol extract of the stem bark (EMC) of L. macrophylla showed that this does not interfere with intestinal parameters: modulation of normal defecation, cathartic agent-induced diarrhea and intestinal transit stimulated. But EMC had to be active against Staphylococcus aureus ATCC 25928, Pseudomonas aeruginosa ATCC 25853 and Escherichia coli ATCC 10536, a result similar to that seen with Lm-1. The methanol extract of leaves (EMF) of L. macrophylla was active against the twelve bacterial strains tested, a result similar to that observed with Lm-4 and Lm-9. Regarding the chemical constituents isolated from the stem bark and leaves in two species can state that are not similar. Regarding the antimicrobial activity of EMC and EMF were similar, suggesting that the activity is antidiarrhoeal proven that one should only antimicrobial can be no substitution of the stem bark of the leaves
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Estudo fitoquímico e biológico de espécies amazônicas: Pradosia huberi (Ducke) Ducke (Sapotaceae) e Licania macrophylla Bent. (Chrysobalanaceae)
'Portal de Periodicos UFPB', 2008Co-Authors: Fernando Antônio De ,medeirosAbstract:The use of plants as a treatment method has gained prominence and became fashionable in the world. In Brazil is not different. In recent years some brazilian states has been implementing phytotherapy as an alternative therapy for the public health. However there are some drawbacks as the lack of scientific information that supporting traditional knowledge of some species. The Licania macrophylla Benth species belongs to the Chrysobalanaceae family and is known popularly as "anauera" or "anuera." The stem bark of this species is used in the state of Amapá like Amebicide as antidiarrheal. The Pradosia huberi Ducke species belongs to the Sapotaceae family, and is popularly called "fresh bark" or "stick candy ' and its stem bark is used by Amazonian peoples to assist in the treatment of stomach problems and indigestion. However the use of the stem bark of these species in the preparation of herbal formulation or even home preparation is a predatory practice, because recovery of the damage caused by removal of the bark takes years to rebuild, if not eliminates the specimen. The aim of this work was the phytochemical and biological study of the Licania macrophylla Benth and Pradosia huberi (Ducke) Ducke species and compare the chemical composition of leaves and stem bark of both species, so as to suggest that you can replace the use of shells stem by the leaves, and thus contribute to the conservation of the species under discussion. The species studied were collected at Porto Grande - Amapá - Brazil and specimens are deposited in the Herbarium Amapaense HAMAB IEPA. The phytochemical study of the stem bark of the L. macrophyla Benth (Chrysobalanaceae) species led to the isolation of (-)-4'-O-methyl-epigallocatechin-3'-O-α- L-raminosídeo (LM-1), (-)-4'-methyl-epigallocatechin (Lm -2), while the leaves were isolated pheophytin A (Lm-3), 132-hydroxy-(132-S) pheophytin A (Lm-4), pheophytin B (Lm-5), β-sitosterol (Lm-6a ), stigmasterol (Lm-6b), β-sitosterol-O-glycoside (Lm-7), alcohol betulínco (Lm-8) and oleanolic acid (Lm-9), the first not reported in the literature. From species was isolated Pradosia huberi 2,3-dihidromiricetina-3-α-LO-raminosídeo (Ph-1) and leaves the fatty ester erythrodiol (Ph-2), ester of fatty oleanolic acid (Ph-3) fatty ester betulínco acid (Ph-4) and espinasterol (Ph-5), all identified by techniques 1H NMR and 13C single and two-dimensional and comparisons with published literature. Evaluation of antidiarrhoeal activity of the methanol extract of the stem bark (EMC) of L. macrophylla showed that this does not interfere with intestinal parameters: modulation of normal defecation, cathartic agent-induced diarrhea and intestinal transit stimulated. But EMC had to be active against Staphylococcus aureus ATCC 25928, Pseudomonas aeruginosa ATCC 25853 and Escherichia coli ATCC 10536, a result similar to that seen with Lm-1. The methanol extract of leaves (EMF) of L. macrophylla was active against the twelve bacterial strains tested, a result similar to that observed with Lm-4 and Lm-9. Regarding the chemical constituents isolated from the stem bark and leaves in two species can state that are not similar. Regarding the antimicrobial activity of EMC and EMF were similar, suggesting that the activity is antidiarrhoeal proven that one should only antimicrobial can be no substitution of the stem bark of the leaves.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESO uso das plantas como recurso terapêutico tem ganhado destaque e tornado modismo no mundo. No Brasil não é diferente, e nos últimos anos alguns estados da federação vem implantando a fitoterapia como alternativa terapêutica para o sistema único de saúde. Porém algumas dificuldades são encontradas, entre elas a falta de informações científicas que subsidie o conhecimento tradicional de determinadas espécies. A espécie Licania macrophylla Benth pertence a família Chrysobalanaceae e é conhecida popularmente por anauera ou anuera . As cascas do caule dessa espécie é usada no estado do Amapá como antidiarréica e amebicida. A espécie Pradosiahuberi Ducke, pertence à família Sapotaceae, e é designada popularmente de casca doce ou pau doce , suas cascas do caule são usadas pelos povos amazônicos como auxiliar no tratamento de problemas gástricos e má digestão. No entanto o uso das cascas do caule dessas espécies na preparação de fitoterápico ou mesmo em preparações caseiras é uma prática predatória, pois a recuperação do dano causado pela retirada das cascas leva anos para sua reconstituição, quando não elimina o espécime. O objetivo deste trabalho foi realizar o estudo fitoquímico e biológico das espécies Licania macrophylla Benth e Pradosia huberi (Ducke) Ducke e comparar a composição química entre folhas e cascas do caule das duas espécies, de forma a sugerir se é possível substituir o uso das cascas do caule pelas folhas, e assim contribuir com a conservação das espécies em discussão. As espécies estudadas foram coletadas no município de Porto Grande Amapá Brasil e exsicatas estão depositadas no Herbário Amapaense HAMAB do IEPA. O estudo fitoquímico das cascas do caule da espécie L. macrophyla Benth (Chrysobalanaceae) levou ao isolamento de (-)- 4 -O-metil-epigalocatequina-3 -O-α-L-raminosídeo (Lm-1), (-)-4 -metil-epigalocatequina (Lm-2), enquanto das folhas foram isoladas feofitina A (Lm-3), 132-hidroxi-(132-S)- feofitinaA (Lm-4), feofitina B (Lm-5), β-sitosterol (Lm-6a), estigmasterol (Lm-6b), β-Oglicosídeo- sitosterol (Lm-7), álcool betulínco (Lm-8) e ácido oleanólico (Lm-9), sendo o primeiro não relatado na literatura. Da espécie Pradosiahuberi foi isolado 2,3- dihidromiricetina-3-α-L-O-raminosídeo (Ph-1) e das folhas éster graxo do eritrodiol (Ph- 2), éster graxo do ácido oleanólico (Ph-3), éster graxo do ácido betulínco (Ph-4) e espinasterol (Ph-5), todas identificadas através de técnicas de RMN de 1H e 13C uni e bidimensionais e comparações com a literatura. A avaliação da atividade antidiarréica do extrato metanólico das cascas do caule (EMC) de L. macrophylla mostrou que esse não interfere nos parâmetros intestinais: modulação da defecação normal; diarréia induzida por agente catártico e trânsito intestinal estimulado. Porém EMC apresentou-se ativo frente à Staphylococcus aureus ATCC 25928, Pseudomonas aeruginosa ATCC 25853 e Escherichia coli ATCC 10536, resultado semelhante ao obtido com Lm-1. O extrato metanólico das folhas (EMF) de L. macrophylla mostrou-se ativo frente as doze cepas bactérianas testadas, resultado semelhante ao observado com Lm-4 e Lm-9. No que se refere aos constituintes químicos isolados das cascas do caule e folhas nas duas espécies pode-se afirmar que não são semelhantes. Já em relação a atividade antimicrobiana do EMC e EMF esses apresentaram-se semelhantes, sugerindo que se a atividade antidiarréica fica comprovada que se deve apenas a ação antimicrobiana pode-se haver substituição do uso das cascas do caule pela folhas
Seng-kee Chuah - One of the best experts on this subject based on the ideXlab platform.
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Risk factors associated with fulminant amebic colitis.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996Co-Authors: Seng-kee Chuah, Chi-sin Changchien, King-wah Chiu, I-shyan Sheen, K D FanAbstract:Amebic colitis is associated with serious complications and a high fatality rate if it progresses to its fulminant form. The purpose of this retrospective study was to determine the risk factors associated with fulminant amebic colitis. From February 1978 to February 1993, 60 adults were diagnosed with intestinal amebiasis at Chang Gung Memorial Hospital. Sixteen patients with massive bloody diarrhea, persistent systemic toxicity or signs of peritonitis were classified as having fulminant colitis, five of whom progressed to fulminant colitis after admission to the hospital. Forty-four patients with good responses to Amebicides and without complications were classified as having moderate colitis. There was no amebiasis-related mortality among patients with moderate colitis. In contrast, five patients with fulminant colitis died. Early diagnosis and surgical treatment significantly decreased mortality when compared with conservative treatment. Significant factors associated with the development of fulminant intestinal amebiasis in univariate analyses were being male, age over 60 years, having an associated liver abscess, progressive abdominal pain, signs of peritonitis, leukocytosis, hyponatremia, hypokalemia and hypoalbuminemia. Only the factors of being over 60 years of age and hypokalemia were important in multivariate analyses. We conclude that early and extensive surgical treatment is mandatory for patients with typical presentations of fulminant amebic colitis on admission to the hospital, such as progression to peritonitis, persistent systemic toxemia and explosive bloody diarrhea. For other patients, especially the elderly and those with low serum potassium levels, close monitoring and observation for signs of fulminant colitis is important.
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The prognostic factors of severe amebic liver abscess: a retrospective study of 125 cases.
The American journal of tropical medicine and hygiene, 1992Co-Authors: Seng-kee Chuah, Chi-sin Changchien, I-shyen Sheen, Hsien-hong Lin, Shue-shian Chiou, Cheng-tang Chiu, Chung-huang Kuo, Jye-jou Chen, King-wah ChiuAbstract:Abstract One hundred twenty-five cases of amebic liver abscess were diagnosed at Chang Gung Memorial Hospital in Taiwan from January 1981 to December 1989. An analysis of possible prognostic factors for severe amebic liver abscess was done retrospectively. The majority of the patients came from the southern part of Taiwan. Severe amebic liver abscess was defined as the rupture of an abscess that was resistant to 72 hr of medical treatment, or complicated by secondary bacterial infection. The results showed significant differences between patients with severe liver abscess and those with more moderate forms of amebic liver abscess in indices such as jaundice, hemoglobin and serum bilirubin levels, and dyspnea, as well as in pulmonary changes (right diaphragm elevation, right pleural effusion) seen on chest radiographs. Those patients with diabetes mellitus also had greater evidence of severe liver abscess. Moderate cases that were treated with Amebicides showed excellent responses (no mortality). Severe cases required, in addition to Amebicide therapy, either percutaneous or surgical drainage of pus, especially in those patients with ruptured abscesses. Those patients with abscesses that ruptured into the thoracic cavity were treated by either thoracostomy or needle aspiration, and all were cured. Three patients died of abscess rupture into the abdominal cavity, associated with secondary bacterial infection. The overall mortality rate was 2.4%. These symptoms and signs of severe liver abscess are indicators of the need for intensive treatment such as aspiration or surgical drainage.
P W Ralls - One of the best experts on this subject based on the ideXlab platform.
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Hepatic abscess
World Journal of Surgery, 1991Co-Authors: A J Donovan, A E Yellin, P W RallsAbstract:El absceso hepático—amibiano o piogénico—puede ser diagnositicado con gran precisión mediante la ultrasonografía (US) o la tomografía computadorizada (TC). La ultrasonografía es la modalidad de escogencia; détecta casí el 100% de los abscesos. La confirmación del diagnóstico de absceso amibiano del hígado se hace por la prueba de hemaglutinación indirecta, la cual debe resultar positiva en prácticamente el 100% de los casos. Cultivos del pus y de la sangre deben ser realizados en los pacientes con abscesos piógenos. Se logran cultivos positivos del pus del absceso en 90% de los casos. Se utiliza la guía ultrasonográfica o de tomografía computadorizada para la aspiración del absceso. El metronidazol es el agente amebicida de preferencia en el tratamiento del absceso amibiano del hígado. El drenaje abierto está contraindicado. En los casos en que falla la terapia con amibicidos, se realiza el drenaje cerrado guiado por US o por TC. La infección secundaria de un absceso amibiano del hígado es un fenómeno extraordinariamente raro. La identificatión y determinatión de la sensibilidad antibiótica de los microorganismos responsables del absceso piógeno representa un paso crucial en su manejo. A menos que se haga necesario realizar una laparotomía para la correción del algún proceso intraabdominal o porque el absceso es excesivamente grande, el tratamiento inicial del absceso piógeno es un ciclo de antibióticos propiados de 2 semanas, seguidos de tratamiento con antibióticos orales por un mes. La mayoría de los abscesos piógenos del hígado responde a este tipo de tratamiento. Si se requiere drenaje de un absceso piógeno, la técnica de preferencia es la punción percutánea por medio de un catéter guiado por US o TC. El drenaje quirúrgico abierto debe reservarse para aquellos casos en que la laparatomía es necesaria por razones diferentes o en que hay falla en la respuesta a un ciclo de terapia antibiótica adecuada y el drenaje percutáneo no es factible. La mortalidad en el manejo del absceso amibiano del hígado debe ser nula, y para el absceso piógeno de menos de 10%. Hepatic abscess—amebic or pyogenic—can be diagnosed with great accuracy by either ultrasonography or computed tomographic (CT) scanning. Ultrasound is the modality of choice and will detect almost 100% of abscesses. Confirmation of a diagnosis of amebic liver abscess is made by the indirect hemagglutination test that should be positive in almost 100% of cases. Cultures of pus from the abscess and from the blood must be obtained in cases of pyogenic liver abscess. A positive culture of pus from the abscess has been achieved in 90% of cases. Ultrasound or CT guidance is utilized in aspiration of a hepatic abscess . In the treatment of an amebic liver abscess, metronidazole is the Amebicide of choice. Open drainage is contraindicated. For cases that fail to respond to therapy with Amebicides, closed drainage guided by CT or ultrasound is performed. Secondary bacterial infection of an amebic liver abscess is an extremely rare event . The identification and determination of the antibiotic sensitivity of organisms responsible for pyogenic liver abscess is a crucially important step. Unless a celiotomy is necessary to correct an intraabdominal process or the abscess is extremely large, the initial treatment of pyogenic liver abscess is a 2 week course of appropriate antibiotics followed by a 1 month course of oral antibiotics. The majority of pyogenic liver abscesses will respond to such treatment. If drainage of a pyogenic abscess is required, the preferable technique is with a percutaneous CT- or ultrasound-directed catheter. Open surgical drainage should be reserved for those cases in which a celiotomy is required for other purposes or for the patient who has failed a course of appropriate antibiotic therapy and closed percutaneous drainage is not feasible . The mortality for treatment of amebic liver abscess should be approximately zero and for pyogenic liver abscess should be less than 10% . L'abcès hépatique amibien ou à pyogènes peut être diagnostiqué avec une grande précision soit par l'échographie, soit par la tomodensitométrie. L'échographie est la méthode de choix et détecte presque 100% des abcès. On obtient la confirmation du diagnostic d'abcès amibien par le test d'hémagglutination indirecte qui est positive dans presque 100% des cas. On doit faire des cultures de pus provenan′ de l'abcès et des hémocultures en cas d'abcès à pyogènes du foie. Ces cultures ont été positives dans 90% des cas. L'échographie et la tomodensitométrie aident à guider le drainage de abcès. Dans le traitement de l'abcès amibien du foie, le métronidazole est l'amibicide de choix. Le drainage à ciel ouvert est contreindiqué. Pour les cas qui ne répondent pas aux amibicides, un drainage percutané guidé par la tomodensitométrie ou l'échographie est indiqué. La surinfection d'un abcès amibien du foie est extrêmement rare. L'identification et la détermination de la sensibilité aux antibiotiques des organismes responsables de l'abcès à pyogènes est une étape extrêmement importante. A moins qu'une laparotomie soit nécessaire pour traiter une infection intraabdominale associée ou que le volume de l'abcès soit extrêmement important, le traitement initial d'un abcès à pyogènes comprend 2 semaines d'antibiotiques adaptés par voie générale suivies d'un mois d'antibiotiques par voie orale. La plupart des abcès à pyogènes répondront bien à ce traitement. Si le drainage d'un abcès à pyogènes s'avère nécessaire, la meilleure technique est percutanée avec un cathéter inséré sous contrôle tomodensitométrique ou échographique. On réservera le drainage chirurgical à ciel ouvert aux cas où une laparotomie est nécessaire pour d'autres raisons et où le malade n'a pas répondu à l'antibiothérapie adaptée et chez qui le drainage percutané est impossible à faire. La mortalité de l'abcès amibien traité devrait approcher 0% et atteindre pour l'abcès à pyogènes moins de 10%.
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Hepatic abscess.
World journal of surgery, 1991Co-Authors: A J Donovan, A E Yellin, P W RallsAbstract:Hepatic abscess--amebic or pyogenic--can be diagnosed with great accuracy by either ultrasonography or computed tomographic (CT) scanning. Ultrasound is the modality of choice and will detect almost 100% of abscesses. Confirmation of a diagnosis of amebic liver abscess is made by the indirect hemagglutination test that should be positive in almost 100% of cases. Cultures of pus from the abscess and from the blood must be obtained in cases of pyogenic liver abscess. A positive culture of pus from the abscess has been achieved in 90% of cases. Ultrasound or CT guidance is utilized in aspiration of a hepatic abscess. In the treatment of an amebic liver abscess, metronidazole is the Amebicide of choice. Open drainage is contraindicated. For cases that fail to respond to therapy with Amebicides, closed drainage guided by CT or ultrasound is performed. Secondary bacterial infection of an amebic liver abscess is an extremely rare event. The identification and determination of the antibiotic sensitivity of organisms responsible for pyogenic liver abscess is a crucially important step. Unless a celiotomy is necessary to correct an intraabdominal process or the abscess is extremely large, the initial treatment of pyogenic liver abscess is a 2 week course of appropriate antibiotics followed by a 1 month course of oral antibiotics. The majority of pyogenic liver abscesses will respond to such treatment. If drainage of a pyogenic abscess is required, the preferable technique is with a percutaneous CT- or ultrasound-directed catheter.(ABSTRACT TRUNCATED AT 250 WORDS)
A. Astier - One of the best experts on this subject based on the ideXlab platform.
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[Organoarsenicals derived from 2-phenyl-[1,3,2]dithiarsolan-4-yl)-methanol (AsIII) with antileukaemic properties: from trypanosomicides to anticancer drugs]
Annales Pharmaceutiques Françaises, 2007Co-Authors: Stéphane Gibaud, A. AstierAbstract:For several decades, organometallic and organometalloid compounds have played an important part in anticancer chemotherapies, in particular those derived from platinum. Trivalent arsenic, in the form of arsenic trioxide (As2O3; Trisenox(R)) is currently used in the treatment of refractory leukemias, but at the cost of major adverse effects. Moreover, recent studies showed that the trypanocide melarsoprol, could be more effective than arsenic trioxide on myelogenous leukaemias. We have synthesized a series of derivatives from 2-phenyl-[1,3,2]dithiarsolan-4-yl)-methanol (AsIII). Our work shows that the substitution of the aromatic ring by an iodine atom in the ortho position or by an amino-dimethoxytriazin group in the para position increases very significantly the antileukemic activity and improves the therapeutic index (IT=LD50/IC50) of these melarsoprol-derivatives molecules, as compared to arsenic trioxide. However, one of the most promising compounds seems to be arsthinol, an old drug used in the past as an Amebicide. Nanoparticle carriers of melarsoprol were also prepared for the purpose of modifying its tissue distribution reduce its brain toxicity.
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Organoarséniés dérivés du 2-phényl- [1,3,2]dithiarsolane-4-yl)-méthanol (AsIII) à propriétés antileucémiques : des trypanosomicides aux anticancéreux
Annales pharmaceutiques francaises, 2007Co-Authors: Stéphane Gibaud, A. AstierAbstract:For several decades, organometallic and organometalloid compounds have played an important part in anticancer chemotherapies, in particular those derived from platinum. Trivalent arsenic, in the form of arsenic trioxide (As2O3; Trisenox(R)) is currently used in the treatment of refractory leukemias, but at the cost of major adverse effects. Moreover, recent studies showed that the trypanocide melarsoprol, could be more effective than arsenic trioxide on myelogenous leukaemias. We have synthesized a series of derivatives from 2-phenyl-[1,3,2]dithiarsolan-4-yl)-methanol (AsIII). Our work shows that the substitution of the aromatic ring by an iodine atom in the ortho position or by an amino-dimethoxytriazin group in the para position increases very significantly the antileukemic activity and improves the therapeutic index (IT=LD50/IC50) of these melarsoprol-derivatives molecules, as compared to arsenic trioxide. However, one of the most promising compounds seems to be arsthinol, an old drug used in the past as an Amebicide. Nanoparticle carriers of melarsoprol were also prepared for the purpose of modifying its tissue distribution reduce its brain toxicity.
