[Vegetarianism yesterday and tomorrow].
Explore the source record for details and available documents.
Diet Therapy↗
Biomedical subjects
A Hany
Publications and source records attributed to A Hany.
Diuretic use: a risk for subclinical thiamine deficiency in elderly patients.
Long term diuretic therapy represents one central pharmacologic therapy of heart insufficiency and hypertension. Diuretics lead not only to an increased urinary excretion of electrolytes but also of water soluble vitamins. In this prospective study we evaluated the effect of hospitalization on the overall biochemical vitamin status in subjects older than 50 years (n=149, mean +/- SD age 70 +/- 10 years). Vitamin nutriture and other parameters were assessed at admission and discharge (duration of the hospitalization 19 +/- 1 day). Only vitamin B1 nutriture worsened during the hospitalization and in a multivariate procedure the only significant predictor of the change in the vitamin B1 nutriture was the use of diuretics during the hospitalization (F=4.06, p < 0.001). The changes in the ETK (erythrocyte transketolase activity in whole blood) and a-ETK (ETK activity coefficient) during the hospital stay correlated with the cumulative dosage of furosemide adjusted for the duration of the therapy (r = 0.36, p < 0.001 and r = - 0.28, p > 0.03). Our data suggest that hospitalized elderly are at increased risk for vitamin B1 deficiency especially when on a diuretic treatment. It is possible that a low dose thiamine supplementation my help to prevent the development of a subclinical wet-beriberi in older subjects on diuretics.
Aged↗
[Familial giant hemangiomas of the liver. Study of a family and review of the literature].
In this report we present for the first time strong evidence for autosomal-dominant inheritance of grant liver hemangiomas. Furthermore, we review the current literature about incidence, pathogenesis, clinics, as well as diagnostic and therapeutic aspects of LH. A large family of Italian origin is described where three female patients in three successive generations suffered from large symptomatic LH. In addition, two other female relatives exhibited asymptomatic LH on sonographic scans. The restriction of the disease to the female gender could be explained by a sex-dependent difference in penetrance or expressivity of a presumable "liver-hemangioma" gene, or by known proliferative factors such as female sex hormones. We also observed an increased incidence of adenomas of the thyroidea among members with or without LH of the presented family. This uncommon familial association has also not yet been described and its genetic aspects are discussed.
Adenoma↗
Antibody response in six HACEK endocarditis cases under therapy.
The antibody response to bacteria of the so-called HACEK group, i.e. Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella kingae, was measured in sera of six patients with endocarditis. The corresponding isolates from their blood cultures were identified by conventional methods, including reactions for nitrate reduction and catalase as well as acid production from sugars. Crude antigens were prepared by glycine extraction and sonification of the blood culture isolates, and used to determine titers by complement fixation. A patient with Haemophilus parainfluenzae bacteremia received a short course of antibiotic therapy, and relapsed with spondylitis and endocarditis 5 months later. Titers of sera against his own isolate rose from 1:40 to 1:320 and fell to 1:40 after therapy within one year. A patient with C. hominis endocarditis had a similarly prolonged course. The complement fixation titer against his own isolate was already 1:240 before antibiotics were administered. Another patient with C. hominis endocarditis presented a titer of 1:320 2 weeks after the diagnosis. These three patients revealed C-reactive protein values over 50 mg/l in the first serum sample. Decrease of both antibody titers and C-reactive protein values correlated with clinical improvement. Two patients with prosthetic valve replacement 5 months earlier developed C. hominis and K. kingae endocarditis, respectively. At admission, C-reactive protein values were 64 and 82, respectively, and therapy was instituted immediately. The first sera were received 3 and 6 weeks, respectively, after isolation of the corresponding blood culture isolates and revealed already low titers, i. e. 1:80 and 1:60, respectively. A woman with A. actinomycetemcomitans endocarditis received immediate therapy and did not develop titers against her own isolate. CRP was 100 at admission and remained over 50 5 weeks later. We conclude that the complement fixation assay with individual antigen preparations was easy to perform and allowed monitoring of the antibody response in 5 of 6 HACEK endocarditis cases under therapy, but the usefulness of this method to find culture-negative HACEK endocarditis needs to be established.
Aged↗
Two brothers in a Malaysian family with X-linked lymphoproliferative disease--a case report.
We report the occurrence of X-linked lymphoproliferative disease (XLP) in two brothers in a Malaysian family. In this disorder, a primary Epstein-Barr virus (EBV) infection is followed by an abnormal proliferation of transformed B-cells that cannot be controlled by suppressor T-cells, leading to the development of deranged immune function. This results in fatal infectious mononucleosis, acquired hypogammaglobulinaemia, virus-infected haemophagocytic syndrome and non-Hodgkin's lymphoma. The diagnosis should be considered when there is a family history of any male having a fulminant course of infectious mononucleosis, an otherwise benign disease. Early diagnosis is important as bone marrow transplantation is the only curative option in this disorder.
Child, Preschool↗
Propionibacterium acnes as a cause of aggressive aortic valve endocarditis and importance of tissue grinding: case report and review.
A case of prosthetic valve endocarditis with Propionibacterium acnes is described. The diagnosis was documented by histology and isolation of P. acnes from both blood and anulus tissue. Grinding of the tissue, which was first omitted to avoid contamination, was indispensable for cultivating the agent. The literature for P. acnes endocarditis is reviewed.
Aged↗
Isolation of Escherichia fergusonii from four different sites in a patient with pancreatic carcinoma and cholangiosepsis.
Escherichia fergusonii was isolated from a 69-year-old male with pancreatic carcinoma and cholangiosepsis from gallbladder fluid, three blood cultures, feces, and a superficial wound of the abdomen. Biochemical reactions, antimicrobial susceptibility patterns, susceptibility to polyvalent phage 0-1, and rRNA gene restriction analysis suggested that the four strains were of clonal origin. Our data indicate that E. fergusonii possesses a pathogenic potential in humans.
Aged↗
[Rheumatic fever. Its current status based on 4 cases].
We report on 4 patients with rheumatic fever hospitalized and investigated in our clinics within a 12 month period between 1990 and 1991. In each case a clinically non-severe sore throat preceded the outbreak of rheumatic fever. In three cases diagnosis was according to the revised Jones criteria. Polyarthritis was the only major symptom in these cases. One patient suffered from monarthritis. Minor symptoms were fever, arthralgia, elevated blood sedimentation rates and elevated values for CRP and for antistreptolysin O. The joint symptoms were treated with nonsteroidal drugs and subsided. One of the patients had a recurrence 9 months after the first attack even though correct secondary prophylaxis with a 4-weekly intramuscular regimen of 1.2 million units of benzathine penicillin was carried out. We discuss some epidemiological aspects and diagnostic difficulties resulting from a changing clinical pattern of the disease, and emphasize the need for streptococcal sore throat treatment and continuous secondary prophylaxis to prevent recurrences.
Adult↗
[Arrhythmia and swelling of all extremities].
A 54-year-old patient complained about palpitations secondary to ventricular arrhythmias over a period of several years and severe fatigue for months. Later on arthralgia of the left shoulder and diffuse swelling of both hands and feet appeared. An elevated B. burgdorferi antibody titer and later on in the course the characteristic cutaneous aspect of acrodermatitis chronica atrophicans supported the diagnosis of Lyme-Borreliosis with affection of multiple organs. Under intravenous antibiotic treatment with 2 g Ceftriaxone per day for two weeks the symptoms regressed completely. The clinical findings occurring in this patient are discussed.
Arrhythmias, Cardiac↗
[Paresthesias].
A 23-year-old patient suddenly experienced paresthesia in both legs which progressively ascended to the region of the umbilicus and finally also occurred in all fingers. The physical examination revealed a decreased sensation for touch, discrimination and vibration in all paresthetical regions and on the stem even up to dermatome C5. A mild elevation of the protein content, a mononuclear pleocytosis and oligoclonal bands were found in the cerebrospinal fluid. Magnetic resonance imaging of the cervical spinal cord showed a hyperintensive lesion in the region of the posterior tract at C6. With respect to these findings and after exclusion of other neurological affections, multiple sclerosis was diagnosed. The symptoms subsided spontaneously within five weeks, and the patient was discharged without any complaints. The diagnostic accuracy of the various findings is discussed.
Adult↗
[Acute fatal liver insufficiency due to valproic acid therapy].
Fatal hepatic failure associated with valproic acid therapy is a rare side effect occurring in 1:5000-10,000 of the patients exposed to this antiepileptic drug. Its relevance arises from its fatal outcome and the high number of patients who are treated with this drug (one million worldwide in 1988). 112 cases were published up to 1988. Most of the affected patients were young (less than 10 years old), male, and mentally retarded. Many were under antiepileptic polytherapy. The children of this age group constituted only 23% of the patients treated with valproic acid but 73% of all fatalities. 90% of the patients developed hepatic failure in the first 5 months of therapy. Low doses or therapeutic serum levels of valproic acid do not prevent this dramatic event. Specific therapy is not known. In addition to the case report we review the literature and make recommendations for monitoring therapy with valproic acid.
Adult↗
Valproic-acid-induced pancreatitis. Case report and review of the literature.
We report a case of pancreatitis with fatal liver failure, in a 21-year-old, mentally retarded patient, taking valproic acid (VPA) therapy, together with a review of the literature of this rare side effect. Until March 1991, only 24 cases of isolated pancreatitis and six cases (including ours) of pancreatitis with hepatic failure under VPA treatment have been published. Most of the patients were less than 20 years old, and injury to the pancreas developed during the first year of therapy in 72% of the patients, approaching a mortality of 21%. Pancreatitis associated with liver failure has a poor prognosis mainly because of the VPA hepatotoxicity. It seems that the pancreatic side effects fluctuate between two extremes: asymptomatic hyperamylasemia and fatal pancreatitis.
Adult↗
[Classical pseudomembranous diphtheria caused by Corynebacterium ulcerans].
In a 63-year-old patient presenting with signs of classical diphtheria including membranous pharyngotracheobronchitis and myocarditis, Corynebacterium ulcerans was isolated in pure culture from the membranes. The strain produced a toxin specific for C. ulcerans but no diphtheria toxin. The patient was discharged after a complicated hospital course including respiratory and cardiac failure. Besides Corynebacterium diphtheriae, which has very rarely been isolated in Switzerland in recent years, Corynebacterium ulcerans should be considered as a cause of classical diphtheria.
Bacterial Toxins↗
[Risk of malignancies in celiac disease--a retrospective study].
A review of 52 patients with celiac disease showed the development of malignant tumors in eight cases (15%). The following malignomas were diagnosed: one malignant lymphoma, one multiple myeloma, one rhabdomyosarcoma, one carcinoma of the uterus, one carcinoma of the sigmoid colon and three adenocarcinomas of the small bowel. Patients with tumors showed significantly lower hemoglobin, lower serum albumin, and higher sedimentation rates than patients without tumors. The possibility of underlying malignoma must always be considered in all patients with newly diagnosed coeliac disease and in patients where symptoms of a known celiac disease change without alteration of the prescribed diet.
Aged↗
[Sepsis caused by Fusobacterium necrophorum: the re-discovered postangina sepsis Lemierre syndrome and other manifestations].
Among 5 patients with bacteremia due to Fusobacterium necrophorum, 3 young adults had post-anginal sepsis (Lemierre syndrome), including one with the classical secondary metastatic complications of pulmonary abscesses, pleural empyema, arthritis and hepatobiliary disturbances. The primary focus was a cholangiogenic abscess in an 81-year-old woman, and fetid otitis following a radical operation for cholesteomatous chronic otitis media in a 29-year-old male. Septicemia due to Fusobacterium necrophorum, and in particular Lemierre syndrome, are presented in the light of the literature.
Adult↗
[Adenocarcinoma of the small intestine in celiac disease. Case report and literature review].
We describe three patients with celiac disease complicated by adenocarcinoma of the small intestine, and summarize the 36 cases of this association that have been reported. Retrospectively we found an increased risk (relative risk 25-250) of developing adenocarcinoma of the small intestine in patients with celiac disease in the region of Winterthur (north-east Switzerland). We therefore suggest that celiac disease be considered a premalignant condition not only for malignant lymphoma and gastrointestinal tumors, but also for adenocarcinoma of the small intestine. Synchronous or metachronous development of carcinoma in one of our patients and in two cases reported in the literature offer further evidence that celiac disease is a premalignant condition for adenocarcinoma of the small bowel. In several patients celiac disease was diagnosed only after diagnosis of the carcinoma. With regard to asymptomatic or subclinical celiac disease, it seems justifiable to search for possible underlying celiac disease in all patients with established diagnosis of adenocarcinoma of the small intestine.
Adenocarcinoma↗
[Segmental hemorrhagic colitis following amoxicillin therapy].
We report on three young females complaining of bloody diarrhea of acute onset due to hemorrhagic colitis associated with oral amoxicillin therapy. The bloody diarrhea with abdominal cramps began 4 to 6 days after starting the treatment. Right colon was involved in two patients, and the descending and sigmoid colon in the other. Stool cultures and search for Cl. difficile toxins were repeatedly negative. Biopsy revealed marked mucosal hemorrhage (2/3), erosions (2/3) and thrombosed vessels (2/6). Symptoms rapidly resolved after 2 to 6 days. Extensive allergic evaluation in one patient did not reveal a hypersensitivity reaction. A literature review reveals another 31 patients with this characteristic form of colitis associated with ampicillin or amoxicillin therapy.
Adult↗
[Replacement of aluminum-containing phosphate binders by calcium and magnesium carbonates in long-term hemodialysis].
Aluminium-containing phosphate binders were replaced by a calcium and magnesium carbonate-containing antacid in 20 patients on long-term haemodialysis, over a three-month period in all of them, for 12 months in ten. After two months the serum aluminium level fell (mean +/- SD) from 3.0 +/- 1.6 to 1.4 +/- 0.5 mumol/l (P less than 0.001). After three months the serum phosphate level had fallen from 1.8 +/- 0.4 to 1.5 +/- 0.4 mumol/l (P less than 0.05), while during the same period parathormone (PTH-NH2) fell from 1.4 +/- 1.4 to 0.8 +/- 0.7 ng/ml (P less than 0.05). Serum total calcium concentration rose after two months from 2.2 +/- 0.2 to 2.4 +/- 0.2 mmol/l (P less than 0.001). In a third of patients the uraemic acidosis was corrected, standard bicarbonate rising from 18 +/- 2 to 21 +/- 3 mmol/l (P less than 0.05). Serum pH, potassium, sodium, magnesium and alkaline phosphatase did not change significantly. Hypercalcaemia was an expected disadvantage: repeated symptom-free episodes of hypercalcaemia occurred in six of 20 patients during the first three months and in a further two up to 12 months. These episodes were successfully controlled by a reduction of CaCO3/MgCO3 dosage and readministration of Al(OH)3. Extraosseous calcifications were not observed.
Adolescent↗