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PubMed1980

[Osteomalacia due to vitamin D deficiency. Part two: Aetiology (author's transl)].

The mechanisms of vitamin D deficiency already described are triggered off by a variety of causes. Confinement indoors leads to defective photosynthesis and dietary restrictions to insufficient intake. Malabsorption results from digestive tract diseases: mainly adult coeliac disease, but also sequelae of gastrectomy, exocrine pancreatic insufficiency, chronic biliary obstruction and all other causes of steatorrhoea. Practically, osteomalacia of digestive origin usually results from multifactorial hypovitaminosis D. The same applies to primary or nutritional biliary cirrhosis, which frequently entails low vitamin D blood levels despite subnormal 25-hydroxylation. Osteomalacia is also found in renal osteodystrophy, where it is partly due to inhibition of 1,25-hydroxylase and subsequent deficiency of 1,25-dihydrocholecalciferol, though other, non vitaminic substances may also be involved. Two misleading forms of the disease must be borne in mind: one with renal tubular lsions, the other associated with functional pseudo-hypoparathyroidism. The aetiology of most cases of osteomalacia due to vitamin D deficiency can be elucidated by a few simple tests.

Adult↗
PubMed1995

[Surgical treatment of diseases of operated stomach].

Surgical treatment of 293 patients with diseases of an operated on stomach is analysed. Relapse of peptic ulcer after closure of a perforation was encountered in 170 patients, the dumping syndrome in 54, peptic ulcer of the anastomosis in 60, the afferent loop syndrome in 6, and a rare type of diseases of an operated on stomach in 3 patients. Classification of diseases of an operated on stomach according to the syndromes and differential diagnosis of functional syndromes are presented. Indications for surgical correction depending on the type and severity of the pathological condition were developed. The late-term results were studied in 266 patients. The results were good in 72%, satisfactory in 21%, and poor in 7% of cases. The late-term results in surgical correction of functional syndromes were good in 29%, satisfactory in 51.6%, and poor in 13.5% of patients. Mortality after all repeated operation was 1.3%.

Afferent Loop Syndrome↗
PubMed1977

[Differential diagnosis of malabsorption syndrome].

On the basis of two cases the development of a severe postoperative malabsorption syndrome after resection of the stomach with predisposition to a gastroenterostomia ileoterminalis. The fatal course in one of the patients is made the occasion to discuss the causes of the operatively conditioned failures and to demonstrate the symptomatology of a gastrointestinal anastomosis with a lower ileum loop. The duration of the disease can be retarded by insufficient examination technique. In postoperative distrubances of the passage as soon as possible the radiological control of the condition of the anastomosis including the whole samll intestine should be carried out.

Adult↗
PubMed1977

Post-operative medical problems of the stomach (author's transl).

Short survey of late or long-term consequences of gastric operations (recurrent ulceration, postprandial discomfort, disturbances of motility, syndrome of malassimilation). The possible importance of the recently discovered gastro-intestinal hormones Motilin, Gastric Inhibitory Polypeptide (GIP) and Vaso-active Intestinal Peptide (VIP) is discussed.

Anemia, Pernicious↗
PubMedDate not supplied

Serum erythropoietin and erythroid activity in vitamin B12 deficiency.

We studied erythropoiesis in 31 patients with vitamin B12 deficiency by measuring serum erythropoietin (s-Epo), serum transferrin receptor (s-TfR, taken as an index of total erythroid activity), reticulocyte count, and the reticulocyte maturation index (RMI). s-Epo and s-TfR were measured with commercial immunoassays, whereas reticulocyte count and RMI were determined by flow cytometry. s-Epo (123 +/- 196 U/L) and s-TfR (4.1 +/- 2 mg/L) levels were increased in patients with vitamin B12 deficiency. The absolute reticulocyte counts were decreased (29 +/- 18 x 10(9)/L) with a relative increase in the most immature fractions (RMI: 29.6 +/- 18%). A significant negative relationship was found between s-Epo and Hb level (r = -0.65, p < 0.0001). On the average, however, s-Epo was inappropriately low for the degree of anemia, since the observed/predicted (O/P) s-Epo ratio was 0.80 +/- 0.28 in vitamin B12 deficiency vs 1.00 +/- 0.16 in a group of patients with iron deficiency anemia. It is concluded that at least a portion of patients with vitamin B12 deficiency have serum erythropoietin levels that are inappropriately low for the degree of anemia.

Adolescent↗
PubMed1994

Evaluation of patients with postsurgical syndromes.

The evaluation of patients with postgastrectomy or other postsurgical syndromes must be thorough. A proper medical or surgical treatment plan should be based on a thoughtful physiologic examination, not just an anatomic evaluation. Procedures such as vagotomy testing and intestinal transit studies may identify or exclude causes (e.g., acid hypersecretion, poor gastric emptying) of postsurgical syndromes and should address the cause of the problem, not the effect.

Humans↗