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Biomedical subjects

E L Cattau

Publications and source records attributed to E L Cattau.

At least 37 records · Page 2Linked to original sources
PubMed1988

The effect of the Garren-Edwards Gastric Bubble on solid and liquid gastric emptying.

To determine the effect of the Garren-Edwards Gastric Bubble (GEGB) on gastric emptying, radionuclide solid and liquid gastric emptying in 12 obese patients prior to insertion of the GEGB was studied. Four were restudied at one and seven days and ten patients were restudied at twelve weeks with the GEGB in place. There were no significant differences in liquid gastric emptying at one and seven days nor in solid and liquid gastric emptying at twelve weeks. Solid gastric emptying was significantly decreased from a mean of 63% to 31% after one day (P less than 0.05) and returned to preplacement baseline by seven days. These results indicate that gastric emptying is not significantly changed after twelve weeks with the GEGB in place. Therefore, the mechanism of action for weight reduction with the GEGB is not likely to be mediated by an effect on gastric emptying. However, the solid food-induced dyspeptic symptoms commonly noted 1-3 days after placement of the GEGB, which resolve within seven days, are probably explained by transiently delayed solid gastric emptying.

Adolescent↗
PubMed1988

Pancreas divisum: thin-section CT.

Twelve patients with known pancreas divisum underwent thin-section computed tomography (CT) to determine the capability of CT to depict this pancreatic anomaly. Focal pancreatic enlargement was present in five patients. Two distinct pancreatic moieties separated by a fat cleft were noted in three patients; a fourth patient had focal atrophy in the distribution of the dorsal pancreas. The two pancreatic moieties were identified at the same craniocaudal level in all four of these patients. The dorsal duct was depicted in all 12 patients, while the short ventral duct was seen in only five of the 12 patients. Failure of the ventral and dorsal pancreatic ducts to fuse was identified in all five patients in whom both ducts were seen. CT may not enable specific diagnosis of pancreas divisum in the majority of patients. If, however, distinct pancreatic moieties or unfused ductal systems are evident, the diagnosis may be confidently suggested.

Adult↗
PubMed1987

A study of patient acceptance of double-contrast barium enema and colonoscopy. Which procedure is preferred by patients?

To our knowledge, no previous study has addressed the question of which method of evaluation of the lower gastrointestinal tract is preferred by patients, air-contrast barium enema or colonoscopy. Over a four-month period, we asked 189 consecutive patients who had undergone colonoscopy to express their preference for either air-contrast barium enema or colonoscopy. A clear preference for colonoscopy was expressed by our patients in terms of comfort and polyp detection despite higher cost. Time lost from work and post-procedure constipation were significantly less for colonoscopy than for barium enema. These factors should be considered in the evaluation of suspected lower gastrointestinal tract disease.

Adult↗
PubMed1987

Serum angiotensin converting enzyme activity in evaluation of patients with liver disease.

This study was undertaken to evaluate angiotensin converting enzyme activity in patients with liver disease, and to explore its relationship to thyroid function in patients with liver disease. Serum angiotensin converting enzyme activity and thyroid hormone levels, determined in 79 patients with intrahepatic-type liver disease and 18 patients with extrahepatic biliary obstruction, were compared with values in 129 euthyroid controls. Serum angiotensin converting enzyme activity was higher in intrahepatic disease than in extrahepatic obstruction, but statistically significant only for acute intrahepatic disease. In the patients studied, high serum angiotensin converting enzyme activity (22 units/ml or more) virtually excluded extrahepatic biliary obstruction, with a negative predictive value of 94 percent. Low serum angiotensin converting enzyme activity had a positive predictive value for extrahepatic obstruction of only 67 percent. Increased angiotensin converting enzyme activity could not be explained as a function of enhanced thyroid activity. Serum angiotensin converting enzyme activity may be useful in separating patients with intrahepatic liver disease from those with extrahepatic obstruction.

Cholestasis, Extrahepatic↗
PubMed1987

Esophageal acid sensitivity in Barrett's esophagus.

Esophageal acid sensitivity was evaluated in 15 patients with Barrett's esophagus and in 15 patients with reflux esophagitis uncomplicated by Barrett's. Patients with Barrett's esophagus had sensitivity to esophageal acid perfusion less frequently than those with uncomplicated reflux esophagitis (66 vs. 100%; p less than 0.05). Moreover, patients with Barrett's esophagus with acid sensitivity took longer to develop pain during acid perfusion (p less than 0.05), and overall, experienced less severe symptoms (p less than 0.01) than those with reflux esophagitis. Over a 2-week period, as judged by diary, the Barrett's group had less frequent (p less than 0.01) and less severe (p less than 0.01) heartburn symptoms than the other patients. These results indicate that patients with Barrett's esophagus have significantly reduced esophageal acid sensitivity and, as a consequence, have an impaired ability to recognize acid reflux.

Adult↗
PubMed1987

Patient preference in upper gastrointestinal studies: roentgenography versus endoscopy.

We prospectively compared roentgenography and endoscopy of the upper gastrointestinal tract in terms of patient acceptance and tolerance. Endoscopy was significantly better tolerated and easier overall for patients. Patients found no difference between endoscopy and radiography with respect to pain or life-style interruption. Patients stated that they would prefer endoscopy to roentgenography if repeat evaluation were needed. We conclude that UGI endoscopy is better tolerated and more acceptable to patients than UGI roentgenography.

Adult↗
PubMed1987

"Nutcracker" esophagus: diagnosis with radionuclide esophageal scintigraphy versus manometry.

"Nutcracker" esophagus is a syndrome consisting of chest pain and/or dysphagia with elevation of the mean distal esophageal contractile pressure amplitude (MDA) (greater than 120 mm Hg). Its existence as a disorder of esophageal function and the proper manometric diagnostic criteria have been debated. A correlative study of radionuclide esophageal scintigraphy (RES) and manometry was performed in 31 patients with this manometric diagnosis. RES results were abnormal in 13 of 16 (81%) patients with an MDA above 150 mm Hg, and in only three of 15 (20%) patients with an MDA below this level. There was a significant difference in RES parameters (mean transit time and percentage emptying) between these two groups. Repeat manometric and RES studies showed considerable variability, but only RES showed a significant correlation between baseline and repeat studies. RES confirms a functional disorder in a subgroup of patients with the manometric diagnosis of nutcracker esophagus and supports a change in the manometric criteria for diagnosis of this disorder to an MDA above 150 mm Hg.

Chest Pain↗
PubMed1987

Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment.

A middle-aged man presented with diarrhea, fever, and leukocytosis 7 days after discontinuation of clindamycin therapy for a urinary tract infection. Proctosigmoidoscopy showed adherent, raised plaques studding the bowel wall consistent with antibiotic-associated pseudomembranous colitis. Vancomycin therapy was begun, but progressive abdominal distension, nausea, vomiting, and loss of bowel sounds occurred. Serial abdominal radiographs demonstrated colonic wall edema without dilatation. Subtotal colectomy was performed and resulted in complete resolution of symptoms.

Clindamycin↗
PubMed1987

Metoclopramide response in patients with progressive systemic sclerosis. Effect on esophageal and gastric motility abnormalities.

Twelve patients with progressive systemic sclerosis (four with CREST [calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia] variant) underwent systematic evaluation to assess the esophagogastric effects of metoclopramide hydrochloride in this patient population. Esophageal manometry, esophageal radionuclide scintigraphy, solid-phase gastric emptying, and 24-hour esophageal pH monitoring were performed in all patients with and without metoclopramide. Metoclopramide improved lower esophageal sphincter pressure and reduced the gastric emptying delay and gastroesophageal reflux in most patients but had a less consistent effect improving esophageal transit or esophageal body pressures. Metoclopramide should be strongly considered in the pharmacologic approach to the gastroesophageal reflux-related complications of this disease.

Adult↗
PubMed1987

Effects of nasopharyngeal cocaine or pharyngeal benzocaine on esophageal motility.

The esophageal effect of topical anesthetics applied to the nasopharynx was evaluated. Eight healthy volunteers underwent an esophageal motility study after each of the following: no anesthesia, 5% cocaine solution applied to the nasopharynx, and 20% benzocaine spray applied to the pharynx. Upper esophageal sphincter relaxation was prolonged after use of the 5% cocaine solution. No other significant effects on esophageal motility or pressures were noted.

Administration, Intranasal↗
PubMed1986

Chlorzoxazone hepatotoxic reactions. An analysis of 21 identified or presumed cases.

A drug rechallenge proved chlorzoxazone to be hepatotoxic in a patient who had been treated with a combination of it and acetaminophen (Parafon Forte) for several months. Failure to demonstrate a toxic response to acetaminophen coupled with a dramatic response to a single dose of chlorzoxazone implicated chlorzoxazone as the hepatotoxic agent. A review of US Food and Drug Administration records and cases reported in the medical literature disclosed 23 cases of chlorzoxazone-associated hepatotoxic reactions occurring since 1970. These cases were examined in terms of age, duration of therapy, other confounding etiologic factors, and ultimate outcome. There were two deaths involving hepatic failure. Reports of adverse reactions among six commonly used analgesic-muscle relaxants in Sweden have indicated a low, but comparatively greater, incidence of hepatotoxic reactions associated with a chlorzoxazone-containing compound.

Acetaminophen↗