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Aftereffects of a tainted meal.

A 58-year-old man presented with profuse diarrhea, abdominal distention, flatulence, weakness, and a 15-lb weight loss. The initial symptoms of nausea and vomiting had begun a week earlier, within hours of eating chicken that had not been well wrapped when purchased. Two days after symptom onset, he received intravenous rehydration therapy at another hospital. With resolution of the nausea and vomiting, he felt slightly better and went home against medical advice. He had not had fever, chills, hematochezia, melena, hematemesis, or dysuria.

Animals↗

Necrotizing enterocolitis: a prospective multicenter investigation.

Several pre- and post-natal factors possibly important in determining which infants will develop necrotizing enterocolitis (NEC) and which of these infants will die with this disease were prospectively studied in 1976 in 11 infants with radiographic or pathologic evidence of the disease from 12 institutions in the United States and 111 weight-matched, institution-matched control infants. By multivariant discriminant analysis, the authors idenfitied 10 independent significant determinants of NEC and 10 determinants predictive of a fatal outcome among case infants. Determinants of NEC were: Apgar score deterioration; presence of a patent ductus arteriosus; maternal receipt of anesthesia during delivery; infant not treated with parenteral gentamicin before the onset of disease; infant receipt of 10% dextrose solution; treatment of mother with antibiotics during pregnancy; hyperalimentation or gavage feedings; premature rupture of membranes. Important morbid events among cases included red blood cell transfusions, gas in the portal system, premature rupture of membranes, abdominal distension, isolation of Klebsiella organisms from the blood, surgery, prolonged perinatal oxygen requirement, and lower Apgar 2 score. Attempts to modify preventable risk factors may decrease the incidence (2.4 cases per 1000 live births) and case fatality (41%) documented in this study.

Anesthesia, Obstetrical↗

Gastrointestinal pneumatosis after docetaxel chemotherapy.

Breast cancer is one of the most frequent neoplasms in women. New drugs, including taxanes, have improved survival in patients with metastatic disease. Quality of life and efficacy are important goals during treatment of these women. Herein, we report a 51 year-old woman with metastatic breast cancer who developed gastrointestinal pneumatosis (GIP) after the first cycle of treatment, which consisted of docetaxel and pamidronate. The symptoms disappeared after 7 days with supportive management, nasogastric intubation, parenteral fluids, and wide-spectrum antibiotics. Thereafter, weekly fractionated chemotherapy with an initial 50% dose reduction was administered. Because of adequate tolerance, the dose was increased by 25% after the second cycle, and full-dose docetaxel was administered after the third cycle. After 6 months of follow-up, the patient remained under treatment, with an Eastern Cooperative Oncology Group performance status of 1. Gastrointestinal pneumatosis has been reported in association with chemotherapy. In most patients, it is reported to be associated with neutropenia, which was not present in this patient.

Antineoplastic Agents, Phytogenic↗