RESUMO
BACKGROUND/AIMS: In this study, ascitic fluid polymorphonuclear (PMN) response, short-term prognosis, and factors related to hospital mortality were investigated in 62 cases of spontaneous bacterial peritonitis occurring in cirrhotic patients treated with Ceftriaxone (1g every 12 hours). METHODOLOGY: The diagnostic criteria for (SBP) were ascitic fluid PMN count < 250 cells/mm3 and no evidence of secondary peritonitis. Analysis of ascitic fluid samples were obtained on admission, and on the 4th and 10th days of antibiotic therapy. RESULTS: The etiology of cirrhosis was alcohol in 63% of the cases, and 79.5% of patients belonged to Child-Pugh Class C. Ascitic fluid analysis showed positive cultures in 47% of the cases, and a marked decrease in PMN count during treatment (admission: 7762 +/- 2837; 4th day: 388 +/- 91; 10th day: 173 +/- 59 cells/mm3). Ascitic PMN was < 250 cells/mm3 within 4 days of treatment in 33% of the cases. The hospital mortality rate was 24%, and was related to gastrointestinal hemorrhage, hepatic encephalopathy, renal failure and 4th day ascitic fluid PMN count. CONCLUSION: Ceftriaxone is a safe and effective option for the treatment of SBP.
Assuntos
Infecções Bacterianas/tratamento farmacológico , Ceftriaxona/uso terapêutico , Cefalosporinas/uso terapêutico , Neutrófilos/efeitos dos fármacos , Peritonite/tratamento farmacológico , Líquido Ascítico/citologia , Infecções Bacterianas/complicações , Infecções Bacterianas/mortalidade , Contagem de Células , Feminino , Mortalidade Hospitalar , Humanos , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Peritonite/complicações , Peritonite/mortalidade , Prognóstico , Fatores de TempoRESUMO
In this study the hepatic lipoprotein lipase (LPL) activity was evaluated in adult female mice acclimatized at 5 degrees C and submitted to carbon tetrachloride (CCl4) or ethionine, in order to determine the possible role of this enzyme in the fatty liver. The results were compared with those obtained in mice kept at room temperature (27 degrees C) that received the same hepatoesteatosis inducing agent. In contrast to animals kept at room temperature, in cold acclimatized mice neither the enhancement of the LPL-liver activity by the action of CCl4 or ethionine occurred nor the development of fatty infiltration in the liver was observed. We conclude that the low temperature induced a protective effect against CCl4- or ethionine-induced fatty liver that was correlated with the no-increase of the hepatic LPL activity.