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Biomedical subjects

A Thomson

Publications and source records attributed to A Thomson.

246 records · Page 14Linked to original sources
PubMedDate not supplied

Endoscopic diagnosis of pyriform fossa lymphoma.

Many endoscopists do not inspect the gastrointestinal tract superior to the cricopharyngeus, despite the fact that gastrointestinal symptoms (dysphagia, odynophagia and chest pain) can be produced by glottic and supraglottic lesions. A case of incoordinate swallowing secondary to a right-sided pyriform fossa lymphoma diagnosed at gastroscopy is presented.

Aged↗
PubMedDate not supplied

Oxidative stress and antioxidants in intestinal disease.

Oxidative injury caused by free radicals is an important cause of tissue injury now recognized to occur in inflammation, ischemia and by the action of xenobiotics. It is also recognized to induce gene mutation and promote carcinogenesis. In this review the general concept of nett free radical injury counterbalanced by antioxidants is discussed as oxidative stress. The role of oxidative stress in intestinal ischemia, radiation enteritis, inflammatory bowel disease and the promotion of gastric and colorectal cancer is discussed. The data for the role of oxidative stress in the pathogenesis of ischemic, inflammatory and radiation induced disease are strong, but interventional studies with antioxidants have shown only weak beneficial effects in the above diseases. Therefore the role of antioxidants in the therapy of gastrointestinal diseases remains controversial and should be the subject of controlled trials.

Antioxidants↗
PubMedDate not supplied

Congenital myotonic dystrophy.

We describe a case of severe congenital myotonic dystrophy (CDM). A 38-year-old primigravida, who was known to suffer from mild myotonic dystrophy (DM), conceived spontaneously and booked for confinement at 11 weeks in our unit. The couple had been fully counseled about the risks of transmission of this condition to their offspring before embarking on this pregnancy. Despite being fully aware of the risks, they declined prenatal diagnosis. The pregnancy was monitored by serial ultrasound scans. The diagnosis of CDM was suspected by ultrasound markers of borderline ventriculomegaly, polyhydramnios, and reduced fetal movements. The pregnancy ended prematurely at 33 weeks in an emergency caesarean section because of severe fetal compromise. The neonate died almost immediately after birth. The genetic analysis of cord blood confirmed severe DM. This case highlights the importance of ultrasound markers for the diagnosis of CDM in the absence of definitive prenatal diagnosis.

Adult↗
PubMedDate not supplied

[Neuropsychological findings in patients with middle temporal lobe epilepsy].

INTRODUCTION: Cognitive dysfunction in mesial temporal lobe epilepsy (MTLE) is still a controversial subject. Since refractory MTLE is considered a surgically remediable syndrome, the neuropsychological assessment to establish the presence of cognitive impairment in the surgical candidate became an important issue, given its possible relevance in predicting outcome after surgery. OBJECTIVE: Our aim was to study the cognitive profile of MTLE patients and to correlate the cognitive status with the presence or absence of hippocampal sclerosis. PATIENTS AND METHODS: Fifty patients with MTLE and 20 control subjects were matched by age and educational level. All subjects were studied with EEG, MRI scan, SPECT, and a comprehensive neuropsychological battery that included measures of language (naming and verbal fluency), visuospatial function (Block Design Test), memory (Signoret Battery), attention (Digit Span and Trail Making Test A) and executive abilities (Trail Making Test B and Wisconsin Card Sorting Test). RESULTS: MTLE patients, particularly those with hippocampal sclerosis, were found to have a considerable lower performance in learning (p < 0.01), naming (p < 0.05), attention (p < 0.05) and executive functions (p < 0.001). Among the MTLE patients a considerable number of subjects showed results within the normal range (n = 27) while others evidenced laterality specific cognitive impairments (n = 13). Material specific memory effects were seen in some patients but not all. CONCLUSIONS: Our results showed the neuropsychological heterogeneity of temporal lobe epilepsy, thus ruling out the existence of a single specific cognitive pattern of impairment in all MTLE patients, and suggesting the need of a thorough pre-surgical neuropsychological evaluation to be used with post-surgical prognosis purposes.

Adult↗
PubMedDate not supplied

Child-Pugh class, nutritional indicators and early liver transplant outcomes.

BACKGROUND/AIMS: Patients with chronic liver disease undergoing liver transplantation have reduced body fat and muscle mass. The extent to which nutritional indicators and Child-Pugh class are predictive of postoperative outcome in adults is unclear. The aims of this study were to determine in adult patients undergoing transplant 1) the influence of preoperative Child-Pugh class and nutritional indicators on early transplant outcomes and one-year survival, 2) the relationship between nutritional indicators and Child-Pugh class and disease type. This study included 80 patients (1990-1994). METHODOLOGY: The nutritional indicators utilized were grip strength, triceps skinfold thickness and uncorrected mid-arm muscle area. Measured outcomes were ventilator time, intensive care stay, postoperative hospital stay and one-year survival. RESULTS: Early morbidity was determined in survivors. Child-Pugh class C patients required longer ventilation and spent more time in the intensive care unit than Child-Pugh classes A and B. No significant relationships were found for length of hospital stay. Relationships between the nutritional indicators (when controlled for Child-Pugh class) and early morbidity could not be determined due to insufficient data. No relationship was established between one-year survival and Child-Pugh class or the nutritional indicators. Grip strength and mid-arm muscle area were lower in the patients in Child-Pugh classes B and C. Parenchymal liver disease was associated with lower grip strength and mid-arm muscle area when compared to cholestatic disease. CONCLUSIONS: Child-Pugh class C is associated with greater early postoperative morbidity. Advanced Child-Pugh class is also associated with diminished muscle status and parenchymal disease.

Adolescent↗