ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The frequent association of celiac sprue (CS) and insulin-dependent diabetes mellitus (DM) which may be the result of interplay between genetic, hormonal, and immunologic factors has obvious therapeutic implications. A gluten-free diet may improve the diarrhea in some patients with DM where the reason for diarrhea is underlying celiac sprue; the diet may also improve control of DM by normalizing the serum hormonal profile.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The relationship ofHelicobacter pyloriand gastroduodenal disorders should be compared in the developing (DG) and developed (DD) nations (Table 1) for a better understanding of the etiopathogenesis of these disorders. Although chronic gastritis is widespread in the DG nations, benign and malignant gastric ulcer (GU) are uncommon. Repeated reinfections and longer duration ofH. pyloriinfection in the fundus-body mucosa of patients with duodenal ulcer from the DG nations explain the lower values of maximal acid output reported. The lower prevalence of gastric metaplasia in patients with duodenal ulcer (DU) in the DG nations compared to patients in the DD nations suggests that DU in different populations results from varying mechanisms.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We compared, retrospectively, the effects of infection in jejunal mucosa with the protozoa cryptosporidia or microsporidia and with the human immunodeficiency virus (HIV) upon mucosal structure and absorptive function in 29 AIDS patients. The presence or absence of protozoal infection was confirmed by transmission electron microscopy. Villus blunting and crypt hyperplasia were seen mainly in the parasite-infected groups, although two patients without parasites also had shortened villi. Absorptive functions, including disaccharidase-specific activities and D-xylose absorption, closely paralleled the degree of small intestinal alteration. Evidence of HIV-infected cells in jejunal mucosa was examined by RNA in situ hybridization and by antigen-capture ELISA of mucosal homogenates. We found evidence of HIV in almost half the patients, which did not correlate with intestinal injury or diminished absorption.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We have reviewed the clinical records of 226 consecutive adult patients with celiac sprue diagnosed in our department from 1972 to 1989. The study period has been divided into three subperiods of 6 years each (1972–1977, 1978–1983, 1984–1989). From the first to the third subperiod a significant increase in the number of new diagnoses and of the proportion of patients recognized by minor symptoms has been observed. These patients represent 50% of our series in the last 3 years of the study and 70% in 1989. Diagnosing subclinical forms of celiac sprue has significantly lowered the mean age at diagnosis and, the female/male ratio. First-degree relatives of celiac patients; subjects who had a gluten-free diet for a period during childhood; patients with short stature, anemia, or amenorrhea of no obvious cause; or patients with unexplained immunological abnormalities are the groups in which most patients with subclinical celiac sprue have been found and in which potential patients should be sought. Helpful diagnostic tools include antigliadin antibody testing and the observation of absent or reduced Kerckring folds in the descending duodenum in the course of upper gastrointestinal endoscopy.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Malignant duodenocolic fistula is a seldom-seen complication of advanced right colon carcinoma. We describe four patients who illustrate the sometimes rewarding results of aggressive treatment. Because duodenocolic fistula is always associated with severe nutritional impairment, operation should be deferred until total parenteral nutrition (TPN) and blood transfusions have improved the clinical state. Whenever feasible, resection offers the best treatment; lesser techniques such as bypass and exclusion result only in minimal palliation. A direct approach and fistula disconnection are contraindicated. The benefit of exploration should almost always be offered, even in such secondary fistulas, as a better quality of life and long-term survival are realistic goals.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Fifty patients with idiopathic ulcerative colitis-25 with acute exacerbation of the disease (Group I) and 25 in quiescent phase (Group II)-were studied. None of the patients had a history of recent exposure to antimicrobial drugs or hospitalization. Evidence of infection with protozoal and bacterial agents and/or presence ofClostridium difficiletoxin was demonstrated in eight (32%) patients in group I and one (4%) patient in group II (group I vs. group II, p < 0.05; X2test with Yate's correction). In five of the six patients with demonstrableClostridium difficiletoxin in the stool, one patient with Entamoeba trophozoites, and another with Salmonella infection, the exacerbation responded clinically and endoscopically to specific antimicrobial therapy. Another two patients who hadEntamoeba histolyticacysts in the stool had no change in their clinical status with metronidazole. We conclude that infectious agents are responsible for some of the exacerbations in patients of ulcerative colitis in a tropical country like India, where careful microbiologic examination is in order in every acute exacerbation of this disease. This contrasts with the findings in developed countries.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We have seen two cases of a segmental ischemic colitis develop during nonsteroidal antiinflammatory drug (NSAID) treatment. No other possible etiologic factors were shown. The short-term clinical course and the follow-up were uneventful. NSAIDs have been reported to cause different lesions in the large bowel, either by worsening preexisting colonic diseases or by inducing a primary pathology. We suggest that ischemia should be considered a possible mechanism of NSAID-associated colitis. Such ischemic colitis, not triggered by severe cardiovascular disease or operation, may be related to NSAIDs more often than currently recognized.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We report two cases of ischemic hepatitis in patients with alcoholic cirrhosis. In both, hepatic ischemia was induced by hemorrhagic shock and severe sepsis. Despite control of the bleeding and restoration of normal hemodynamics, liver failure deteriorated to hepatic coma and death in both cases. Ischemic hepatitis occurred in 1.5% of 130 consecutive cases of cirrhosis admitted for hemorrhage on our medical intensive care unit. Although cirrhotic patients run an increased risk of ischemic hepatitis, our experience and our review of the literature indicate that this condition is rare in these patients.

ISSN:0192-0790    

出版商:OVID    

年代:1993

数据来源: OVID