SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Gastrointestinal symptoms are common in patients with systemic lupus erythematosus (SLE) and can be due to primary gastrointestinal disorders, complications of therapy or SLE itself. In this case report, we describe three different presentations and causes of gastrointestinal complaints in patients with SLE. Diagnostic and management problems are discussed.
Surgical manipulations of the gastrointestinal system can have a major impact on the ingestive behavior of animals. Particularly well-documented are the feeding and drinking effects of JIB and vagotomy. These two surgical procedures are similar in that they reduce the food intake and body weight of obese animals more than that of lean animals, and of hypothalamic obese rats more than that of genetically obese rats. Intermediate effects are obtained with other obesity models. Given the multiple etiologies of human obesity, it is not surprising that gastrointestinal surgery has variable effects in obese humans. The effects of gastric surgery on the ingestive behavior of animals have received relatively little attention. This is unfortunate because gastric bypass is now one of the most widely used methods for surgical treatment of human obesity. In light of recent developments in gastric surgical techniques and new findings concerning the gastric modulation of food intake, the effects of gastric surgery on the feeding behavior of animals should be further investigated. Much remains to be learned about the physiologic and behavioral mechanisms by which gastrointestinal surgery influences ingestive behavior and body weight. Surgical manipulations of the gastrointestinal system may affect ingestive behavior by directly altering the neural and hormonal feedback signals to the brain from the stomach, intestines, and other organs (liver, pancreas), or they may indirectly alter these feedback signals by modifying the preabsorptive and/or postabsorptive flow of nutrients. Seen from a functional perspective, the gut sends to the brain different types of messages that modulate ingestive behavior. Most attention has focused on gut satiety signals, but the gut can also be the source of painful sensations that suppress ingestive behavior. The distinction between satiety and discomfort is not always clear-cut. For example, gut distention may be satiating when it is moderate, but painful when it is extreme. Nevertheless, the distinction is an important one, and the nature of the feeding-inhibitory effects obtained in animal studies must be carefully evaluated. Ideally, obesity surgery should produce minimal aversive consequences, although whether it is possible to reduce food intake and body weight without producing any discomfort remains to be established. In addition to being a source of feeding-inhibitory cues, the gastrointestinal system may also provide excitatory cues that stimulate feeding and modify food preferences. For example, intestinal infusions of carbohydrates increase subsequent food intake under certain conditions.(ABSTRACT TRUNCATED AT 400 WORDS)
OBJECTIVES: The aim of this study was to outline the parameters affecting the extent and type of surgery for metastatic tumors of the ovary. MATERIAL-METHOD: The data of 34 operated patients diagnosed with metastatic tumors of the ovary at the Istanbul University, Medical Faculty Gynecologic Oncology Department between 1991 and 1999 were evaluated retrospectively. The patients were divided into two study groups according to the origin of the tumor: 1. Metastatic tumors of the ovary originating from the organs apart from the gastrointestinal system (MT-NonGIS). 2. Metastatic tumors of the ovary originating from the gastrointestinal system (MT-GIS). Survival rates were calculated in months from the time of ovarian surgical intervention to the date of last known data of patient status. Mean survival rates for the noncensored data were calculated by the Kaplan-Meier method and resulting curves were compared by the log-rank procedure. Statistical significance was determined at the level of 0.05. RESULTS: The survival rate for all cases was 24.21 months: the same rate was calculated to be 45.36 months for the MT-nonGIS group while it was 15.8 months for the MT-GIS group. When both groups were compared in terms of survival rates, the difference was significant (p: 0.0025, log rank: 9.14). Overall cumulative survival rates for 9, 14, 24 and 50 months were 61.59%, 50.05%. 41.7% and 11.58%, respectively. It was also found that surgery performed on patients in the MT-GIS group did not alter the survival rate but if peritoneal metastasis was observed during surgery, life expectancy for these cases was significantly less. CONCLUSION: Although the number of patients included in our study was small, it is important because it gives us a clue about the type of surgery that should be performed in GIS-originating metastatic tumors of the ovary. Our study shows that aggressive surgery should be avoided in patients with peritoneal metastasis/spread.
The brain is capable of mediating complex regulatory functions in the cardiopulmonary and gastrointestinal systems. Increased intracranial pressure may have detrimental effects not only upon cerebral structure and function but also upon the cardiopulmonary and gastrointestinal systems. Although the manifestations of systemic dysfunction produced by cerebral disease have been defined, the precise role of the interaction and interrelationship of increased intracranial pressure and the nervous system pathways to specific organ systems in delineating the mechanisms of these manifestations continues to be a topic of inquiry.
The Acquired Immunodeficiency Syndrome (AIDS) has involved the pediatric age group and is especially prevalent in babies born of mothers who are intravenous drug abusers or prostitutes. Approximately 30% of children born to mothers who are seropositive for the human immunodeficiency virus (HIV) will develop HIV infection. There are several important differences in children and adults with AIDS. The incubation period of the disease is shorter, and initial clinical manifestations occur earlier in children. In addition, certain infections are more common in children, and the different types of malignancy, especially Kaposi's sarcoma, are unusual in the pediatric age group. The altered immune system involves both T cells and humoral immunity and increases susceptibility to a variety of infections, particularly opportunistic organisms. In this publication the complications of pediatric AIDS involving the lungs, cardiovascular system, gastrointestinal tract, genitourinary system, and neurological system are described. The most common pulmonary complications in our experience are Pneumocystis carinii pneumonia and pulmonary lymphoid hyperplasia. The spectrum of cardiovascular involvement in pediatric AIDS includes myocarditis, pericarditis, and infectious endocarditis. Gastrointestinal tract involvement is usually due to opportunistic organisms that produce esophagitis, gastritis, and colitis. Abdominal lymphadenopathy is a common finding either due to disseminating Mycobacterium avium-intracellulare infection or nonspecific lymphadenopathy. Although cholangitis is more commonly seen in adults, it may occur in children with AIDS and, in most cases, is due to related opportunistic infections. Genitourinary infections may be the first evidence of HIV disease. Cystitis, pyelonephritis, renal abscesses, and nephropathy with renal insufficiency are complications of pediatric AIDS. A variety of neurological abnormalities may occur in pediatric AIDS. The most common cause of neurological dysfunction in children with AIDS is HIV neuropathy. We present the many complications of AIDS in children demonstrated by a variety of imaging modalities, emphasizing the importance of diagnostic imaging in children with this disease.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Occupational and working environment factors have always occupied an important place in studies on sickness absenteeism. The study performed during the years 1987-1988 in two electronic industry plants involved such elements of the working environment as the place of a worker in the production process and the occupation performed. Our analysis was aimed at indicating differences in the temporary work disability, in particular due to some groups of diseases, between occupations essential for the manufacturing process. The frequency of sickness absenteeism in general and due to main groups of diseases expressed in terms of percentage of sick persons with temporary work disability was analysed. The Chi 2 test was used to determine the relationship between individual groups. The analysis of sickness absenteeism in individual groups was performed according to sex and age. The analysis allowed to indicate groups of workers with increased risk of sickness absenteeism in the plants under study. They are mostly workers involved in the basic production and in chemical processes. Sickness absenteeism of those workers was higher than the average by 26% in Plant I and by 33% in Plant II. The highest sickness absenteeism rate for that group was due to diseases of the nervous system--71%; the gastrointestinal system--46%; and the musculo-skeletal system--81%. The relationship between the occurrence of sickness absenteeism and the type of activity was statistically significant (p < 0.05) in both Plants but in relation to selected groups of occupation it was significant only in Plant I.
Explore the source record for details and available documents.
In the recent years, functional electrical stimulation has been applied to restore impaired motility in the gastrointestinal tract. Unlike other methods of electrical stimulation of the gut, microprocessor-controlled, sequential electrical stimulation has been shown to induce peristalsis and enhance emptying in acute canine gastric and colonic models. This study aims at completing the development of a portable microprocessor-based functional stimulator system consisting of a microelectronic stimulator, patient-specific computer-based real-time software and a programming interfacing device. The ultimate goals of the design are to ensure that (1) the portable stimulator can be efficiently utilized in chronic animal experiments; and (2) the device can be further miniaturized into an implantable version. The designed portable stimulator generates four channel sequential bipolar rectangular pulse trains with programmable parameters within the stimulation requirements obtained from a previously developed computer model. Real-time simulation of colonic peristalsis and a case-specific stimulation model were implemented using patient-specific computer-based software. A chronic canine case study confirmed the feasibility of this microprocessor-controlled stimulation method for future clinical applications in humans.
Food hypersensitivities can be divided into toxic and nontoxic, and the latter can further be subdivided into immune and nonimmune hypersensitivities. Cow's milk allergy or intolerance occurs in 5-15% of infants, mostly during the first year of life, or occasionally later. The symptoms may involve different organ systems, especially the gastrointestinal system, skin, and respiratory system. For the diagnosis of cow's milk protein allergy/intolerance, double-blind, placebo-controlled food challenge has been used as a gold standard. Since the test suffers from some drawbacks, many reports have pointed to the need for novel and simpler diagnostic procedures and criteria. In our study, clinical symptoms and laboratory findings of patients with cow's milk protein allergy were compared to assess the possible correlation between particular laboratory findings, clinical picture, and the organ system predominantly involved. There were no significant differences in the levels of IgE, cow's milk protein specific IgE, eosinophilia, prick test results, rectal mucosa biopsy histology, and atopy incidence in patient families among the children with gastrointestinal, cutaneous, and combined gastrointestinal and cutaneous symptoms. Improvement in the symptoms with dietary therapy irrespective of clinical presentation and type of hypersensitivity underlying the symptoms in all these patients strongly suggests that clinical response should be a basic criterion for the diagnosis of cow's milk protein allergy.
Pharmacological properties of the anti-ulcer drug 3-[[[2-(3,4-dimethoxyphenyl)ethyl]carbamoyl] methyl]-amino-N-methylbenzamide (DQ-2511, CAS 104775-36-2) on the central and autonomic nervous systems, smooth muscle, gastrointestinal system, and other miscellaneous systems were investigated. 1. DQ-2511 showed little or no influence on general behavior, spontaneous motor activity, hexobarbital sleeping time (mouse), conditioned avoidance response (rat), body temperature (rabbit), EEG or spinal reflex (cat) after oral administration (300-1000 mg/kg) or intravenous injection (15, 50 mg/kg). It also had no anticonvulsant or analgesic activities (mouse). 2. DQ-2511 had no influence on pupil size (rabbit). It reduced or tended to reduce contractile responses of the nictitating membrane induced by electrical stimulation of pre- and post-ganglionic sympathetic nerve (cat) at the highest dose. The drug inhibited the pressor response to norepinephrine, but had little or no inhibitory effect on the depressor response to acetylcholine at the highest dose (dog). 3. DQ-2511 reduced contractile responses to nicotine, BaCl2, acetylcholine, histamine and serotonin (isolated guinea pig ileum), to acetylcholine and histamine (trachea), and to norepinephrine (vas deferens) at high concentrations. It also inhibited spontaneous and oxytocin-induced motility (isolated rat uterus). 4. DQ-2511 decreased gastric motility in a dose-related manner at intravenous doses of 5-50 mg/kg (dog). It also reduced gastric emptying rate at oral doses of 100-1000 mg/kg, and gastric secretion at intraperitoneal doses of 100-300 mg/kg (rat). On the other hand, it induced no definite changes in intestinal motility (dog) or gastrointestinal transit (mouse).(ABSTRACT TRUNCATED AT 250 WORDS)
BACKGROUND: Many studies have analyzed the metastatic patterns of breast carcinoma. However, very few studies have analyzed the differences in metastatic patterns of lobular versus ductal carcinoma. METHODS: By use of our tumor registry, the metastatic sites of all invasive lobular and invasive ductal breast carcinoma cases during an 18-year period (January 1973 to December 1990) were analyzed. RESULTS: There were 2605 cases of invasive lobular and invasive ductal breast carcinoma. Lobular carcinoma accounted for 359 (14%) and ductal carcinoma for 2246 (86%) of the cases. The percentage of patients with regional lymph node metastasis at diagnosis was not significantly different between the two groups. The rates of metastasis to all lymph nodes, liver, and central nervous system were not significantly different. However, the rates of metastasis to the gastrointestinal system (4.5% vs 0.2%), gynecologic organs (4.5% vs 0.8%), peritoneum-retroperitoneum (3.1% vs 0.6%), adrenal glands (0.6% vs 0%), bone-marrow (21.2% vs 14.4%), and lung-pleura (2.5% vs 10.2%) were significantly different (p < 0.05). CONCLUSIONS: The metastatic patterns of lobular and ductal carcinoma of the breast are different, with gastrointestinal system, gynecologic organ, and peritoneum-retroperitoneum metastases markedly more prevalent in lobular carcinoma. Physicians should be aware of these different metastatic patterns of lobular and ductal carcinoma of the breast.
Extrapulmonary infection with Pneumocystis carinii, although uncommon, is increasingly recognized. Use of aerosolized pentamidine versus a systemic medication is thought to be a contributing factor due to the low concentrations of drug that are incapable of suppressing systemic infection. Infection with P carinii has been reported in every organ system including the gastrointestinal system. A 28-year-old acquired immunodeficiency syndrome patient receiving prophylaxis with aerosolized pentamidine who presented with a solitary rectal ulcer is reported. Initial biopsy was characteristic of extrapulmonary P carinii infection, with numerous organisms present. Occasional cytomegalovirus inclusion bodies were noted which may have been a copathogen but which were not treated. Treatment with intravenous pentamidine resulted in documented eradication of P carinii and complete resolution of the ulcer. Although lower gastrointestinal pneumocystosis has been described without ulceration, this is the first description of rectal ulceration presenting as the initial manifestation of extrapulmonary pneumocystosis.
Chitosan, a natural polymer obtained by alkaline deacetylation of chitin, is non-toxic, biocompatible, and biodegradable. These properties make chitosan a good candidate for the development of conventional and novel gastrointestinal (GI) drug and gene delivery systems. The objective of this review is to summarize the recent applications of chitosan in oral and/or buccal delivery, stomach-specific drug delivery, intestinal delivery, and colon-specific drug delivery. The use of chitosan for targeting of drugs to each of these sites in the GI tract is illustrated by examples supported by in vivo studies. Chitosan appears to be a promising material for GI drug and gene delivery applications as many derivatives and formulations are being examined.
BACKGROUND: Effects of coffee on the gastrointestinal system have been suggested by patients and the lay press, while doctors tend to discourage its consumption in some diseases. METHODS: The literature on the effects of coffee and caffeine on the gastrointestinal system is reviewed with emphasis on gastrointestinal function. RESULTS: Although often mentioned as a cause of dyspeptic symptoms, no association between coffee and dyspepsia is found. Heartburn is the most frequently reported symptom after coffee drinking. It is demonstrated that coffee promotes gastro-oesophageal reflux. Coffee stimulates gastrin release and gastric acid secretion, but studies on the effect on lower oesophageal sphincter pressure yield conflicting results. Coffee also prolongs the adaptive relaxation of the proximal stomach, suggesting that it might slow gastric emptying. However, other studies indicate that coffee does not affect gastric emptying or small bowel transit. Coffee induces cholecystokinin release and gallbladder contraction, which may explain why patients with symptomatic gallstones often avoid drinking coffee. Coffee increases rectosigmoid motor activity within 4 min after ingestion in some people. Its effects on the colon are found to be comparable to those of a 1000 kCal meal. Since coffee contains no calories, and its effects on the gastrointestinal tract cannot be ascribed to its volume load, acidity or osmolality, it must have pharmacological effects. Caffeine cannot solely account for these gastrointestinal effects. CONCLUSIONS: Coffee promotes gastro-oesophageal reflux, but is not associated with dyspepsia. Coffee stimulates gallbladder contraction and colonic motor activity.
PURPOSE: The original Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity and the more recent Portsmouth predictor equation for mortality scoring systems were developed to provide risk-adjusted mortality rates in general surgery. The aim of this study was to compare crude and risk-adjusted operative mortality rates among four surgeons using the above scoring systems and assess their applicability for patients scored retrospectively. METHODS: A total of 505 consecutive patients undergoing major gastrointestinal surgery were analyzed; 65 percent underwent colorectal, 27.5 percent underwent upper gastrointestinal, and 7.5 percent underwent small-bowel surgery. The observed:predicted mortality ratios using the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity and Portsmouth predictor equation for mortality scoring systems were calculated for each surgeon. RESULTS: The actual overall operative mortality rate was 11.1 percent (elective was 3.9 percent, and emergency was 25.1 percent). The Portsmouth predictor equation for mortality equation predicted a mortality rate of 11.3 percent (P = 0.51). However, the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity scoring system was found to overpredict death by a factor of two: 21.5 percent (P < 0.001). Mortality rates among the four surgeons varied from 7.6 to 14.7 percent but depended on the proportion of elective vs. emergency surgery. The observed:predicted ratio for Portsmouth predictor equation for mortality was close to unity (0.905-1.067) for all surgeons, but it was 0.45 to 0.56 for Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity. CONCLUSION: The Portsmouth predictor equation for mortality equation seems to be a more accurate predictor of mortality in gastrointestinal surgery. It would seem to provide the best choice for analyzing operative mortality rates for individual surgeons, taking into account variation in case mix and fitness of patients even when scored retrospectively. This has important implications for the future assessment of surgeons' clinical standards and the assessment of quality of surgical care.
Findings in 153 abnormal fetuses diagnosed by antenatal ultrasound and subsequently examined by a pediatric pathologist were reviewed. The primary diagnoses in the 153 cases were 67 nervous system anomalies, 19 gastrointestinal system anomalies, 18 genitourinary system anomalies, 13 chromosomal abnormalities, 10 skeletal system anomalies, and 26 other abnormalities. Forty-six percent of the total number had multiple abnormalities. In 67 cases (44%), autopsy showed further anomalies or altered the ultrasonographic diagnosis. However, in only 36 (25%) were there autopsy findings that altered management. Errors in ultrasound diagnosis were most commonly associated with the presence of multiple anomalies and oligohydramnios. Expert pathological examination remains an essential tool in the management of fetal anomaly.