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S Jarnum

Publications and source records attributed to S Jarnum.

At least 37 records · Page 2Linked to original sources
PubMed1989

Malignancy in ulcerative colitis.

All patients with ulcerative colitis referred to Rigshospitalet, Copenhagen, from 1 April 1964 to 1 January 1983 (18 years and 9 months) were studied from time of referral until death, proctocolectomy, or end of the study (1983). There were 759 patients, 423 females (56%) and 336 males (44%). None was lost to follow-up study. Median time from onset of disease until death, proctocolectomy, or end of the study was 11 years (range, 0-54 years). Median age at onset was 28 years (range, 0-83) among the males and 28 years (range, 4-83) among the females. Pancolitis was present in 312 patients (41%), left-sided colitis in 212 (28%), and haemorrhagic proctitis in 235 (31%). Surgical treatment was performed in 299 patients (39%): proctocolectomy in 197 (26%), colectomy with occluded rectal stump in 72 (9%), and colectomy with ileorectal anastomosis in 30 (4%). Altogether, 49 patients developed cancer, 20 being intestinal and 29 extraintestinal cancer. Compared with the general population matched for age, sex, and calendar time, there was an excessive number with intestinal cancer in both sexes (p less than 0.05). In females the number with extraintestinal cancer was higher than in the general population (p less than 0.01), a finding that has not been reported elsewhere. We found a similar, significantly increased incidence of extraintestinal cancer in females with Crohn's disease in a previous report. We found no increased risk of colorectal cancer in patients with early onset of ulcerative colitis. For all age classes we found that the age of appearance of colorectal cancer followed the equation: age at colorectal cancer = 14 + age at onset of ulcerative colitis. We found no higher potential for development of colorectal cancer in patients with pancolitis. In our series the incidence of colorectal cancer in pancolitis and left-sided colitis was equal. The incidence in patients with haemorrhagic proctitis was zero.

Adolescent↗
PubMed1988

Calcium-binding protein in human duodenal biopsies.

Intestinal calcium-binding protein (CaBP) (molecular weight 10,000) was measured by a specific enzyme-linked immunoadsorbent assay in duodenal biopsies of 94 patients (aged 20-89 years). The patients were examined for complaints of upper abdominal dyspepsia, but no significant pathology was found by gastroduodenoscopy. The median amount of CaBP in duodenal biopsies was 6.0 micrograms/mg of cytosolic protein with a coefficient of variation of 0.6. No change in the amount of CaBP per mg of cytosolic protein was observed with age. A significant correlation (P less than 0.001) was found between the concentration of CaBP and s-1,25-dihydroxyvitamin D (1,25(OH)2D). The amount of CaBP per mg of cytosolic protein did not correlate with immunoreactive parathyroid hormone in serum, and no relation between CaBP and the specific activity of alkaline phosphatase of the mucosal biopsies was found. The results of the present study show a wide variation in the amount of the 10 kDa CaBP in duodenal biopsies of humans and no change with age. Further, a correlation between s-1,25(OH)2D and CaBP was found.

Adult↗
PubMed1988

Measurement of the 10,000-molecular weight calcium-binding protein in small-intestinal biopsy specimens from patients with malabsorption syndromes.

Calcium-binding protein (CaBP) (molecular weight, 10,000) was measured in small-intestinal biopsy specimens from 36 patients with malabsorption syndromes: short-bowel syndrome (n = 13), untreated coeliac disease (n = 4), coeliac disease in remission (n = 7), patients with intestinal bypass owing to morbid obesity (n = 5), and in patients with chronic diarrhoea of unknown cause (n = 7). Twelve patients with no signs of malabsorption who had the irritable bowel syndrome were used as controls. Patients with small-bowel resections showed reduced concentrations of CaBP (p less than 0.01) and low intestinal calcium absorption (p less than 0.05). Small amounts of CaBP were found in intestinal specimens from patients with coeliac disease in remission (p less than 0.01), and CaBP was almost undetectable in patients with a newly diagnosed coeliac disease and avillous jejunal biopsy findings (p less than 0.001). Patients with chronic diarrhoea and patients with an intestinal bypass had CaBP concentrations comparable to those of the control group. A direct correlation was found between CaBP and the fractional calcium absorption in all patients (p less than 0.05). CaBP may therefore be considered an indicator of the efficiency of the small intestine to absorb calcium.

Adult↗
PubMed1988

Chronic intestinal pseudo-obstruction in patients with extensive bowel resection for Crohn's disease.

We report three cases of severe chronic intestinal pseudo-obstruction after extensive bowel resection for Crohn's disease. The patients retained less than or equal to 150 cm jejunum in continuity with the left half of the colon and had no evidence of inflammatory activity in the remaining bowel. Total parenteral nutrition was required, since even very small meals caused abdominal distention, pain, and vomiting. Two patients had a sigmoidostomy constructed, which alleviated the symptoms and enabled a normal oral intake, but only temporarily in one of the patients. Even with a sigmoidostomy the patients needed supplementary parenteral nutrition because of severe malabsorption with high stomal output.

Adult↗
PubMed1987

Faecal osmolality and electrolyte concentrations in chronic diarrhoea: do they provide diagnostic clues?

Osmolality, pH, and electrolyte concentrations in faecal fluid were measured in 23 patients referred to our department because of diarrhoeal disorders. The aim of the study was to ascertain whether such measurements could provide valuable diagnostic information in patients with diarrhoea. The patients were studied on a fat-restricted diet (70 g fat/day) and during fasting. Osmolality, pH, and concentrations of electrolytes in faecal water showed wide variations but were within normal ranges in most of the patients. The patients were grouped into secretory and osmotic diarrhoea on the basis of: 1) current assumptions on the pathogenesis of diarrhoea in different disorders; 2) persistence versus resolution of diarrhoea during fasting (resolution = decrease of stool mass to less than 200 g/24 h); and 3) an osmotic gap (measured osmolality -2 X (Na + K]. The accordance between these three ways of grouping was very incomplete. It is concluded that measurements of faecal fluid osmolality and electrolyte concentrations are of little value as diagnostic procedures in chronic diarrhoea. Determination of the osmotic gap and/or of the decrease of stool mass during fasting may help to elucidate the pathogenesis of diarrhoea in different disorders but does not seem diagnostically useful. Three patients turned out to be laxative abusers, and laxative ingestion should always be considered in chronic unsettled diarrhoea.

Adult↗
PubMed1986

Excretion, deconjugation, and absorption of bile acids after colectomy for ulcerative colitis. Comparative studies in patients with conventional ileostomy and patients with Kock's reservoir.

Bile acid metabolism was studied in 26 patients with a continent ileostomy (Kock's reservoir) and 32 patients with conventional ileostomy. All had been colectomized for ulcerative colitis. In patients with a continent ileostomy the 14C-glycocholic acid breath test showed increased pulmonary 14CO2 excretion as evidence of abnormal bacterial deconjugation of bile acids and increased faecal 14C excretion as evidence of bile acid malabsorption. Faecal bile acid excretion, determined chemically, and, by inference, bile acid synthesis were only moderately increased (median, 1.8 mmol/day). The disturbance of bile acid metabolism was similar to that found in 32 patients with conventional ileostomy, but more pronounced with higher faecal 14C. A significant difference was that no abnormal bacterial deconjugation took place in patients with conventional ileostomy, since their pulmonary 14CO2 excretion was subnormal. Stool mass was almost identical in the two groups, with median values of 665 and 663 g/day, respectively. Faecal fat excretion was normal in most in both groups. Thus bile acid metabolism is slightly more disturbed in patients with a continent ileostomy than in patients with conventional ileostomy. The resulting malabsorption was modest in both groups.

Adolescent↗
PubMed1986

Effects of cimetidine on jejunostomy effluents in patients with severe short-bowel syndrome.

The effect of the H2-receptor blocking agent cimetidine on jejunal effluent was examined in eight short-bowel patients with high-output jejunostomies. Stool mass and faecal excretion of sodium and potassium were significantly reduced by intravenous injection of 400 mg cimetidine four times a day. The amount of calcium, magnesium, phosphate, zinc, and fat in jejunostomy effluent did not change significantly. Cimetidine may be considered an antidiarrhoeal drug in extensively small-bowel-resected patients with a jejunostomy and may reduce the need for parenteral saline supply in these patients.

Adult↗
PubMed1986

Catheter-related septicaemia in patients receiving home parenteral nutrition.

Forty-three patients received home parenteral nutrition (HPN) for 4 to 13 months (median, 30 months) with a total treatment period of 153 patient-years. All patients had central venous catheters; 71 PVC subclavian catheters, 138 Broviac catheters, and 16 other catheters were used. Broviac catheters were introduced into the central veins via a tunnel on the chest (94 catheters) or on the thigh (44 catheters). Eighty-two episodes of catheter septicaemia occurred in 28 (65%) of the patients, corresponding to an incidence of catheter septicaemia of 1 in 1.9 patient-years. The commonest microorganisms grown from the blood were coagulase-negative staphylococci, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Candida species. Septicaemia incidence was 1 in 2.6 catheter-years with the Broviac catheter on the chest and 1 in 1.6 catheter-years with the Broviac catheter on the thigh. In 49 cases the patient was treated with both antibiotics and change of the catheters, in 26 cases with antibiotics alone, and in 5 cases with change of the catheter alone. The antibiotic therapy was given for 3 to 15 days (median, 7 days). No patient died of catheter septicaemia. The relapse rate was low (less than 10%) and did not differ significantly between the three treatment groups. It is concluded that catheter septicaemia is a common complication of HPN. In most cases it runs a mild course. Bacteriaemia can often be eradicated by a brief antibiotic therapy without catheter exchange.

Adolescent↗
PubMed1986

Malignancy in Crohn's disease.

The incidence of cancer in Crohn's disease has been evaluated in 473 patients admitted to Rigshospitalet during the period 1 April 1964 to 1 January 1983. The patients' condition at the end of the survey, their survival, and the number and location of cancers were registered. During the survey period 23 cancers (4.9%) were found. Five were intestinal (1.1%) and were split evenly among the two sexes, whereas among 18 patients with extraintestinal cancers there was only 1 man. There was no increased risk of developing cancer inside the gastrointestinal tract compared with a background population matched for age, sex, and calendar time. Extraintestinal cancer in women was, however, significantly in excess.

Adolescent↗
PubMed1985

Effect of enterocoated cholestyramine on bowel habit after ileal resection: a double blind crossover study.

Ileal resection causes malabsorption of bile acid; the increased load of bile acids in the colon induces increased secretion of salt and water and hence diarrhoea. A study was carried out to test the effect of an enterocoated cholestyramine tablet designed to disintegrate in the colon and sequester the bile acids there, thereby minimising diarrhoea induced by bile acids while having no effect on malabsorption of bile acid and jejunal fat absorption. The study comprised 14 patients who had undergone ileal resection of 40-150 cm for Crohn's disease. A double blind crossover trial was performed with placebo and cholestyramine enterocoated with cellulose acetate phthalate. During treatment with cholestyramine the daily faecal output decreased, the number of defecations each week decreased, and the intestinal transit time increased. Acceptability of the tablets was high, in contrast with general clinical experience with cholestyramine powder. No change was observed in the total faecal output of bile acids or fat. Cholestyramine tablets caused a reduction in diarrhoea without noticeably interfering with the metabolism of fat or bile acid.

Adult↗
PubMed1985

Non-tropical sprue. Malignant diseases and mortality rate.

The complications of non-tropical sprue were registered in 100 patients seen during an 18-year period. The patients had a significantly higher mortality than the age- and sex-matched general population. They had an increased incidence of malignancies, predominantly malignant lymphomas and carcinomas of the gastrointestinal tract. The disease must be considered a premalignant condition.

Adolescent↗