Metastatic pancreatic vipoma: a case report of clinical response following treatment with corticosteroids and actinomycin D.
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Biomedical subjects
Publications and source records attributed to J F Fielding.
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Forty-six of sixty-one drug abusers admitted for detoxification had liver biopsies. Nineteen biopsied patients had normal liver function tests. Of these, two had chronic active hepatitis; nine had chronic persistent hepatitis; six including three with fatty changes, had minor changes, and only two had normal liver histology. Chronic active hepatitis was found only in those with persistent HBS antigenaemia. Chronic persistent hepatitis was found in four patients who were negative HBS antigen and antibody, and in four patients who had cleared HBSAg. In parenteral drug abusers with normal liver function tests the absence of persistent HBS antigenaemia does not rule out chronic liver disease: liver biopsy is necessary for accurate assessment of liver status.
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The right iliac fossa squelch sign, not previously associated with the irritable bowel syndrome, is found in over one-third of patients at diagnosis. It is found in one-quarter of patients who have not improved at follow-up, but is virtually absent in those who have improved. It is also found in patients with active regional enteritis. Fluid feces passing through bowel of decreased pliability may be the factor which allows elicitation of the sign.
The overall effect of the beta-blocker timolol maleate was not significantly different from placebo in patients with the irritable bowel syndrome on a high fibre diet. However, all 3 symptom-free patients were on timolol maleate. If beta-blockers have a major role to play in the treatment of the irritable bowel syndrome it must be through a central rather than a peripheral effect.
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