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Acute pancreatitis is an inflammatory condition with a variable clinical course. Diagnosis is based upon clinical presentation, laboratory indices and imaging studies, whilst illness severity can be assessed by clinical scoring systems, such as the Ranson, Glasgow or APACHE II criteria, or by radiological assessments such as the CT severity index. Most patients develop self-limiting disease. However,...
Infectious diarrhoea remains a major cause of morbidity and mortality world wide. Viruses, bacteria and protozoa are responsible for the majority of infections, which are transmitted most commonly by the faecal–oral route through water, food and person-to-person transmission. Clinical presentation of infectious diarrhoea conforms to three patterns: acute watery diarrhoea; dysentery; and persistent...
Urinary tract infection is one of the commonest infections to affect humans. Uncomplicated infections occur most commonly in otherwise healthy women when uropathogenic bacteria, usually Escherichia coli, ascend from the perineum into the bladder and overcome host innate immunity. Complicated infections occur in patients with an anatomical or functional abnormality of the urinary tract. The diagnosis...
The risk of variceal bleeding can be estimated by the size of varices, the presence of endoscopic red signs and the degree of liver dysfunction. All patients with large varices, and those with cirrhosis and severe liver disease, irrespective of the size of varices, should be given primary prophylaxis with non-selective β-blockers. Banding ligation is equivalent and is used if there are contraindications...
Hepatic encephalopathy (HE) is a neurocognitive disorder that is associated with both acute and chronic liver injury. It has grown to become a dynamic syndrome, spanning a spectrum of neuropsychological impairment from normal performance through to coma. In acute liver failure, the central role of ammonia in the development of brain oedema remains incontrovertible but over the past 10 years, hepatologists...
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