[Physiopathology of cholesterol gallstone appearance and new methods for their dissolution].
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Biomedical subjects
Publications and source records attributed to R Enat.
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D-penicillamine is not generally considered to cause hepatic damage. Cholestatic jaundice developed in a patient with rheumatoid arthritis 4 weeks after penicillamine was added to his regimen, and he died in acute renal failure. The probability that penicillamine caused the cholestasis is discussed.
Two cases of severe hepatic parenchymal injury are presented. One case can be attributed to pyridinol carbamate with certainty, and this drug was probably the cause of hepatic injury in the second case. Pyridinol carbamate should be added to the list of drugs which are known to cause parenchymal liver damage.
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Hepatic damage due to Adelphan or to one of its two components (Rauwolfia alkaloids [Reserpin] and 1,4-dihydrazinophthalazine [Nepresol]) has not thus far been described. A patient is presented who repeatedly reacted to Adelphan with fever, chills and hepatic damage. Adelphan should therefore be added to the list of drugs which may cause hepatic damage.
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Electron microscopy study of a liver biopsy from a patient with the Dubin-Johnson syndrome revealed evidence of severe mitochondrial damage. The changes included membranous whorls, isolated intramitochondrial membranes, myelin figures and large cytoplasmic vacuoles, presumably representing degenerated micochondria. Mitochondrial damage should be looked for in future electron microscopy studies in patients with the Dubin-Johnson syndrome.
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The aim of this work was to compare the efficacy of the Cetacaine topical anesthetic spray preparation to placebo. Cetacaine and placebo, from coded but otherwise identically packaged and scented sprays, were administered to 150 consecutive patients. After endoscopy, patients and physicians completed questionnaires evaluating the difficulty of the endoscopy. No statistically significant differences were found between the full formula and placebo-treated patient responses to the amount of cough or gag, or the degree of difficulty of intubation of the endoscope. Analysis of physician responses showed that in the subgroup of patients being endoscoped for the first time, the gastroscope was introduced more easily (p less than 0.05) when the premedication had been full formula rather than placebo.
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