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Biomedical subjects

A Elewaut

Publications and source records attributed to A Elewaut.

88 records · Page 5Linked to original sources
PubMedDate not supplied

Severe bleeding following endoscopic variceal ligation: should EVL be avoided in Child C patients?

In the last decade there has been an evolution in the treatment of bleeding oesophageal varices. Endoscopic variceal ligation (EVL) is one of those new techniques that not only has shown to be more effective than sclerotherapy, but also causes less side effects, resulting in less episodes of rebleeding and improving survival. We describe severe bleeding in 3 patients after EVL, occurring between 5 and 10 days after the initial ligation. Two Child C patients could not be resuscitated and died shortly after this event. Severely impaired clotting function as a result of the liver disease and the greater size of the ulcers induced by EVL may contribute to this dramatic complication. Severe bleeding due to postligation ulceration may lead to death, which occurred in 2 of our Child C patients. Since more and more endoscopists are using EVL in the treatment of oesophageal variceal bleeding, they should be aware of the possible complications caused by this rather new technique.

Contraindications↗
PubMedDate not supplied

Prevalence of the Cys282Tyr and His63Asp mutation in Flemish patients with hereditary hemochromatosis.

UNLABELLED: Recently Feder et al. have identified the gene responsible for hereditary hemochromatosis; it is located 3 Mbp telomeric of the MHC region on chromosome 6p and is called the HFE gene. The majority of the patients with hemochromatosis harbour the same missense mutation, Cys282Tyr. A second missense mutation (His63Asp) of which the significance is less clear, has also been described. To our knowledge the percentage of these two missense mutations in Flemish hemochromatosis patients is not known. MATERIALS AND METHODS: Forty nine (49) unrelated patients with the clinical diagnosis of hemochromatosis were screened for the two missense mutations. The missense mutations were diagnosed with a PCR technique. RESULTS: Of the 49 patients, 46 patients were homozygous for the Cys282Tyr mutation (94%), 2 were heterozygous (4%) and 1 carried two normal alleles (2%). Of the 3 patients not homozygous for the Cys282Tyr mutation, 3 were heterozygous for the His63Asp mutation (2 patients were 'compound heterozygotes'). DISCUSSION: The percentage of homozygotes (Cys282Tyr) in a Flemish hemochromatotic population is comparable with the figures published in the literature. The second missense mutation (His63Asp) could be of importance in association with the Cys282Tyr missense mutation.

Amino Acid Substitution↗
PubMedDate not supplied

Postvagotomy dysphagia necessitating surgical relief.

A case of severe dysphagia following transthoracic truncal vagotomy is reported. Stenosis of the esophagus was due to a periesophageal fibrotic band. Surgical treatment was mandatory and relief was brought by resection of the stricture and restoration of the continuity by colonic interposition. A review of the literature on the subject is presented.

Adult↗
PubMedDate not supplied

The effect of cimetidine versus ranitidine on the gastric emptying rate of intensive care unit patients sustained on artificial respiration.

OBJECTIVE: To answer the question if their is a difference between cimetidine versus ranitidine on the gastric emptying rate. DESIGN: Prospective, blinded, randomised controlled study. SETTING: A mixed intensive care unit at the University Hospital. PATIENTS: Twenty-four patients sustained on artificial respiration. INTERVENTIONS: Blinded and randomised either cimetidine 200 mg or ranitidine 50 mg were administered IV, after administration of 500 ml of enteral nutrition. MAIN OUTCOME MEASURES: The gastric emptying rate (gastric filling index) was measured over 120 minutes by an ultrasonographic method. In both groups t/2 was very long, there was no statistical difference between the two groups concerning the mean gastric filling index values at successive measurements (time 0 to 120 minutes). Neither was there a difference between the young and the elderly, female and male patients. CONCLUSION: Following administration of either ranitidine or cimetidine in bolus, no difference in the gastric emptying of gastric liquid feeding could be observed in critically ill intubated, ventilated patients.

Adult↗
PubMedDate not supplied

Fundic gland polyps: three other case reports suggesting a possible association with acid suppressing therapy.

We describe three patients who developed fundic gland polyps after starting a treatment with acid suppressive agents. All three patients were treated for a long time with H2-blockers or proton pump inhibiting agents for reflux oesophagitis. In one patient the fundic gland polyps disappeared after discontinuation of the acid suppressing therapy. A possible causal role of these agents is suggested. A review of the literature about fundic gland polyps and their possible association with acid suppressive therapy and a short review about proton pump inhibiting agents and the appearance of gastric polyps in general is given.

Aged↗
PubMedDate not supplied

Treatment of pancreatic pseudocysts by percutaneous drainage. Review and personal experience.

Pseudocysts are serious complications of acute and chronic pancreatitis. Asymptomatic pseudocysts require no specific treatment. Symptomatic pseudocysts can be decompressed by surgical, ultrasonographically and endoscopically guided methods. In the absence of randomised prospective trials it can not be stated that one of these technique is superior to others. Ultrasonographic and endoscopic approaches should be confined to centres with particular expertise in these techniques.

Adolescent↗
PubMedDate not supplied

Multifocal fatty infiltration of the liver; an aspecific presentation form of hepatitis C infection.

We present the case report of a 60 year old man with multiple focal echogenic lesions on ultrasound. While CT and MRI suggested the diagnosis of focal fatty infiltration of the liver, histology and serology showed a chronic hepatitis C infection. This is to our knowledge the first case of a patient with hepatitis C infection in whom focal steatosis could be seen on different imaging techniques.

Biopsy, Needle↗