[1001 codes on prescription forms].
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Drug Prescriptions↗
Biomedical subjects
A Aly
Publications and source records attributed to A Aly.
[Steroids and NSAID: combination increases risk for stomach ulcer].
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Adrenal Cortex Hormones↗
[NSAID-induced ulcer and its complications].
The past two decades have seen a dramatic increase in the consumption of NSAIDs, despite their notorious association with serious gastrointestinal side effects. Of NSAID users, 20-50 per cent have an ulcer at some time; and 1-2 per cent of those on continuous NSAID treatment are hospitalised annually for ulcer complications, causing death in 10 per cent of cases, or total of 450 deaths annually in the Nordic countries. The risk factors are advanced age, a history of peptic ulcer or NSAID-induced gastrointestinal complications, high-dose NSAID treatment and concomitant cardiovascular disease. Ulcers can be healed with routine treatment, and Heliobacter pylori infection does not seem to be an aggravating factor. As ulcerous complications often appear without prodromal symptoms, prophylaxis should be considered for high-risk patients. Whereas histamine H2-antagonists prevent only duodenal ulcers, omeprazole seems to be effective against gastric and ulcers as well. The prostaglandin E1 analogue misoprostol protects against both gastric and duodenal ulcers, and reduces the risk of serious complications by 40 per cent. Newly developed NSAIDs, highly selective for cyclo-oxygenase 2 (COX-2), may exert potent anti-inflammatory effects without affecting COX-1 or the gastrointestinal mucosa.
Age Factors↗
Indicators of changes in weight and eating behaviour in severely obese patients treated in a nursing behavioural program.
To assess some possible reasons for the changes of weight and eating behaviour at a one year follow up in 33 severely obese subjects (mean BMI, 39.9 s.d. 5.2) treated in a nursing behavioural-treatment program, three instruments were used; the Self Motivation Inventory (SMI), the Sense of Coherence Scale (SOC) and the Karolinska Scales of Personality (KSP). The Three Factor Eating Questionnaire (EI) measuring restrained eating, disinhibition and hunger, was used to register the change of eating behaviour. The weight lost at the one year follow-up was significantly (P < .01) correlated to the restrained eating score at the time for the follow-up as well as to the difference value (P < .01) of the restraint score before and one year after treatment and to the number of participated booster sessions (P < .05). The SMI score, as measured before treatment, correlated significantly to all the EI subscales scores at the one-year follow-up (P < .05, P < .01, P < .01). Thus, the greater the self motivation, the more restraint and the less disinhibition and hunger. In turn, the SOC score correlated significantly (P < .01) to the SMI score. Thus, the stronger the sense of coherence, the more perceived self-motivation. Finally, there was a significant negative correlation between the KSP subscales Somatic Anxiety (P < .01), Muscular Tension (P < .05), Psychic Anxiety (P < .001), Psychasthenia (P < .01), Hostility (P < .001), and Inhibition of Aggression (P < .001) and a positive correlation between Socialization (P < .05) and the SOC score.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
A new endotracheal tube for carbon dioxide and KTP laser surgery of the aerodigestive tract.
We have tested the fire-resistance of a new endotracheal tube designed for use in laser surgery of the upper aerodigestive tract. This Teflon/metallic-wrapped silicone tube seems capable of withstanding occasional, accidental pulsed laser impact at power settings used clinically (1 to 10 watts) without fire. On rare occasions when continuous mode is used, the tube seems capable of withstanding at least several seconds of continuous irradiation at clinical power settings without igniting. When used with other recommended safety procedures, this tube should minimize the risk of endotracheal tube fire from accidental laser impact.
Digestive System Diseases↗
[The man and the woman behind the syndrome. A man and a woman behind the Cronkhite-Canada syndrome. A rare gastrointestinal polyposis with changes in the hair, skin and nails].
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Adult↗
Role of immersion refractometry for investigating laser-induced effects in cells.
The broad background of scattered light observed in spectra of cell suspensions is reduced by factors of up to 20 by immersion refractometry allowing for improved spectroscopic determination of the absorption properties of cells in the 325-820 nm range. Refractive-index matched spectra of E. coli C1a exhibit a set of resonant features near 422, 561, and 582 nm. Exposure wavelengths are chosen based on this spectrum and cell viability is investigated in E. coli suspensions exposed to 350, 400, 422, 440, and 700 nm radiation delivered in nanosecond pulses with total doses from 500 millijoules to 60 Joules. We observe a loss in cell viability for doses greater than 1 Joule at 422 nm and for all doses at other wavelengths; exposures of less than 1 Joule at 422 nm enhance growth. Excluding exposures at wavelengths within the resonant feature, longer wavelengths are less effective at reducing the viability of E. coli C1a. This indicates the occurrence of at least two absorption processes.
Absorption↗
Aspects on the role of tachykinins and vasoactive intestinal polypeptide in control of secretion, motility and blood flow in the gut.
Both intrinsic and extrinsic neurons of the gut respond to mechanical and chemical stimuli by the release of neurotransmitters. We summarize here some of our recent work on the role of vasoactive intestinal polypeptide (VIP), substance P (SP) and neurokinin A (NKA) in the secretory, motor and vascular effects of hydrochloric acid stimulation in the isolated rat duodenal loop and electrical nerve stimulation and mechanical stimulation of the cat colon. Isolated duodenal loops of conscious rats were perfused with isotonic saline, and challenged at hourly intervals with brief exposures to increasing concentrations of HCL. The concentrations of bicarbonate and prostaglandin E2 (PGE2) released from the duodenal mucosa were significantly augmented already by pH 5.0 whereas VIP was significantly augmented at pH 3.0 and the tachykinins SP and NKA at pH 2.0. Continuous electric stimulation of the pelvic nerve in cats at 4 Hz during 1 s with 10 s rest produced a marked release of NKA-LI and SP-LI from the colon to blood. Reflex activation of the pelvic nervae by mechanical stimulation of the anus or rectal distension produced a less pronounced release of NKA-LI and SP-LI from the colon to blood. There was a simultaneous colonic contraction and vasodilation during each nerve stimulation. Close intraarterial infusions of NKA, neurokinin B, SP, neuropeptide K (NPK), eledoisin and physalemin at doses of 0.1-100 pmol/min induced dose-dependent proximal and distal colonic contractions and vasodilation, NKA being the most potent. The effects of the tachykinins were reduced after tetrodotoxin and atropine, but unchanged after treatment with hexamethonium.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Intraepithelial bodies in colorectal adenomas: Leuchtenberger bodies revisited.
The presence of intraepithelial inclusion bodies (Leuchtenberger bodies) was recorded in rectal or colonic specimens from 130 patients. Large to moderate number of intraepithelial bodies were recorded in 81.8 percent of 55 colorectal adenomas from patients with familial adenomatous polyposis (FAP). Conversely, none of the 55 non-FAP adenomas or of the 20 specimens with ulcerative colitis (10 with dysplasia) had similar amounts of intraepithelial granules. Feulgen studies demonstrated that the granules contain DNA and are probably nuclear fragments of destroyed lymphocytes. Although the pathogenesis of this phenomenon remains obscure, it appears that the presence of large to moderate number of intraepithelial bodies in colorectal adenomas should strongly raise the suspicion of FAP.
Adenoma↗
Electrosurgery-induced endotracheal tube ignition during tracheotomy.
Electrosurgery was the most common source of ignition for operating room fires prior to the advent of lasers. When combined with volatile anesthetic mixtures, electrosurgery has caused ignition of plastic, rubber, paper, enteric gases, and combustible preparation solutions. We report on an intubated patient whose polyvinyl chloride endotracheal tube ignited during a tracheotomy performed with an electrosurgical unit. The oxygen-rich environment, the polyvinyl chloride tube, and the heat generated by the electrosurgical unit combined to produce a fire. Since otolaryngologists are called upon often to perform tracheotomies on intubated patients, it is imperative that they understand the factors involved in the development of such a fire. This case is presented with an explanation of why this type of fire occurs. A brief review of the literature is included. Different kinds of electrosurgical units, precautions as to their use, and the management of electrosurgery-induced endotracheal tube fires are also discussed.
Child, Preschool↗
Occurrence of autoantibodies against intrinsic factor, H,K-ATPase, and pepsinogen in atrophic gastritis and rheumatoid arthritis.
The occurrence of autoantibodies against intrinsic factor, H,K-ATPase, and pepsinogen was analysed by means of enzyme-linked immunosorbent assay in three groups of sera. Group 1 comprised sera from 14 rheumatoid arthritis patients with normal acid secretion; group 2, sera from 18 rheumatoid arthritis patients with reduced acid secretion; and group 3, sera from 11 patients with pernicious anaemia or achylia. Groups 1 and 2 were rheumatoid factor-positive, and group 3 was negative. Intrinsic factor autoantibodies were low in groups 1 and 2. In group 3, 9 of the 11 sera (82%) scored positive. The highest titres of H,K-ATPase and pepsinogen autoantibodies were found in groups 2 and 3. Only one serum in group 1 scored positive against H,K-ATPase, and two against pepsinogen, whereas corresponding values were 11 (61%) and 7 (39%) in group 2, and 10 (91%) and 6 (55%) in group 3. Autoantibodies against H,K-ATPase from a pool of patient sera recognized both the alpha- and beta-subunits of the enzyme. The present results support the hypothesis of an autoimmune disease overlap between non-organ-specific rheumatoid arthritis and organ-specific pernicious anaemia.
Adenosine Triphosphatases↗
Cisapride stimulates small intestinal motility and relieves constipation in myelopathy due to cervical spinal stenosis: case report.
A patient with progressive spinal stenosis, paraplegia, chronic pain syndrome and simultaneous severe chronic constipation is described. Treatment with cisapride 10 mg, 4 times daily improved her condition, and this was associated with improved small intestinal motility during a 12-hour examination using a computer aided system.
Cisapride↗
Role of VIP in local control of secretion.
Vasoactive intestinal peptide (VIP) is a potent stimulant of duodenal HCO3- secretion and may, like prostaglandins, have a stimulatory role in the local duodenal HCO3- response to luminal HCl. Using a proximal duodenal loop in conscious rats, we examined the local luminal release of HCO3-, VIP and prostaglandin (PG) E2 in response to increasing concentrations of HCl (0.01-150 mmol l-1), perfused for 5 min at 60-min intervals. HCO3- and PGE2 were detected in all basal saline perfusate effluents, and were increased in a concentration-dependent manner by all acid concentrations tested. VIP was increased in a concentration dependent manner from pH 3. Exogenous VIP did not affect the basal luminal output of PGE2, or vice versa. Inhibition of prostaglandin synthesis by indomethacin augmented the HCl-stimulated luminal release of VIP, as well as the HCO3- response to exogenous VIP. The results are in agreement with previous studies, demonstrating that PGE2 is an important regulator of the duodenal HCO3- response to HCl in the rat. In addition, prostaglandins may negatively modulate the release of VIP from local VIPergic neurones, as well as the HCO3- secretagogue effect of VIP. Released VIP may contribute to the HCO3- response at pH less than or equal to 3.
Acid-Base Equilibrium↗
Cholinergic mechanisms involved in release and effect of prostaglandin E2 in HCl-stimulated duodenal HCO-3 secretion in the conscious rat.
Using a proximal duodenal loop in conscious rats, we investigated interactions between prostaglandin E2 and nicotinic and muscarinic receptor mechanisms previously found to be involved in the duodenal HCO3- response to HCl. In previous studies using the same model, a 5-min perfusion of the duodenal loop with 150 mmol l-1 HCl produced a marked and sustained HCO3- response. In the present study, the identical challenge produced a rapid 20-fold increase in the luminal output of prostaglandin E2 during acid exposure, followed by a sustained more than twofold elevation above the basal level during the 45 min monitored. The prostaglandin synthesis inhibitor indomethacin (4 mg kg-1 i.p.) suppressed the output of prostaglandin E2 during the HCl challenge from 131 +/- 84 to 15.4 +/- 10.0 pmol cm-1 h-1, and in the post-stimulatory period from 17.3 +/- 9.1 to 4.4 +/- 2.2 pmol cm-1 h-1. The nicotinic receptor antagonist hexamethonium (20 mg kg-1 i.v.) had no effect on the output of prostaglandin E2. The muscarinic receptor antagonist atropine (0.5 mg kg-1 s.c.) had no effect on the output of prostaglandin E2 during HCl challenge, but reduced the post-stimulatory output to 7.7 +/- 4.1 pmol cm-1 h-1. Perfusion of the duodenal loop with 0.1 mmol l-1 prostaglandin E2 produced a HCO3- response that was abolished by hexamethonium (20 mg kg-1 i.v.), but not affected by atropine (0.5 mg kg-1 s.c.).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Common skin lesions of the elderly.
The elderly patient can present with a variety of skin lesions of the head and neck. This article is designed to acquaint the otolaryngologist-head and neck surgeon with normal skin morphology and with the changes that occur with aging and sun exposure. Common benign and malignant skin lesions of the aging patient are discussed.
Head and Neck Neoplasms↗
Evaluation and treatment of complications of thyroid and parathyroid surgery.
The major complications of thyroid and parathyroid surgery include hemorrhage, respiratory obstruction, hyperthyroid storm, hypoparathyroidism, and laryngeal nerve injury. In this article, the incidence, diagnosis, and treatment of various complications are reviewed, with emphasis on hypoparathyroidism and vocal cord paralysis, either bilateral or unilateral. Thyroplastic phonosurgery and carbon dioxide laser arytenoidectomy, two recent surgical additions to the rehabilitation of vocal cord paralysis, are described in depth.
Aluminum Hydroxide↗
The effect of arachidonic acid and its metabolites on acid production in isolated human parietal cells.
The effect of arachidonic acid and its metabolites on the histamine-stimulated acid production in human isolated parietal cells provenient from endoscopic biopsies was examined. 14C-aminopyrine (14C-AP) accumulation in the parietal cells was used for evaluation of acid production. Histamine dose-dependently increased AP uptake. Histamine stimulation (taken as 100% at 10(-5) M) was significantly inhibited by prostaglandin (PG) E2 to 66 +/- 7% at 10(-8) M, 42 +/- 8% at 10(-6) M, and 13 +/- 10% at 10(-4) M (mean +/- SEM, n = 10). PGF2 alpha, PGD2, and PGI2 showed significant inhibitory effects only at very high concentrations (10(-5)-10(-4) M). Leukotriene (LT) B4 and LTC4 were without effect. The basal acid production (taken as 0%) was lowered significantly by 10(-6) M arachidonic acid to -20 +/- 7.4% (p less than 0.02, n = 10), and the histamine-stimulated (10(-6) M) acid production from 100% to 64 +/- 7.2% (p less than 0.001, n = 10). Aspirin (10(-3) M) increased basal (45 +/- 9.6%, p less than 0.001, n = 10) and histamine-stimulated (10(-6) M) acid production (164 +/- 16.3%, p less than 0.001). It is concluded that PGE2, the major product from arachidonic acid metabolism in the human gastric mucosa, is a significant inhibitor of the histamine-stimulated human parietal cell and may, in humans, play a role as a local physiologic inhibitor of acid secretion.
Adult↗