[Handling a digestive system hemorrhage].
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Emergency Treatment↗
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The Australian general practice morbidity and prescribing survey, 1969 to 1974. 5. Aspects of morbidity: diseases of the digestive system.
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Adult↗
General pharmacological properties of the human corticotropin-releasing hormone corticorelin (human).
General pharmacological effects of the human corticotropin-releasing hormone, corticorelin (human) (CAS 86784-80-7), on the central nervous system, somatic nervous system, autonomic nervous system and smooth muscle, respiratory and circulatory system, digestive system and miscellaneous organs were investigated. 1. The central nervous system: Corticorelin (human) had little effect on hexobarbital-induced sleeping-time, maximal electroshock-induced convulsion, acetic acid-induced writhing, rota-rod performance. Corticorelin (human) at doses of more than 10 micrograms/kg i.v. induced flush of skin and pilo-erection, at doses of more than 30 micrograms/kg i.v. decreased body temperature, delayed expression of perphenazine-induced catalepsy and indicated hunched posture, and at the dose of 100 micrograms/kg i.v. induced the rise of awake-level and decrease of the total power of EEG, and decreased the spontaneous motor activity. 2. The somatic nervous system: Corticorelin (human) did not cause muscle relaxation in mice and had little effect on neuromuscular transmission in rats. No local anesthetic activity of corticorelin (human) was exhibited through inhibition of the corneal reflex in guinea pigs. 3. The autonomic nervous system and smooth muscle: Corticorelin (human) had no effect on the contraction of isolated ileum of guinea pigs induced by histamine and acetylcholine, and on the contraction of isolated trachea of guinea pigs induced by histamine, and the pupil diameter of rabbits. Corticorelin (human) at doses more than 30 micrograms/kg i.v. decreased spontaneous motility and contractile force of uterus of non-pregnant rabbits. 4. The respiratory and circulatory system: Corticorelin (human) had no effect on the contraction of isolated aorta of rats induced by norepinephrine. Corticorelin (human) at doses of more than 3 micrograms/kg i.v. decreased the blood pressure, increased heart rates and slightly increased the number of respiration in dogs. However, corticorelin (human) had no effect on ECG and femoral blood flow in dogs. 5. The digestive system: Corticorelin (human) at doses of more than 0.3 microgram/kg i.v. increased duodenal motility and contractile force, at doses of more than 1 microgram/kg i.v. increased colonic contractile force transiently and increased antral motility. Corticorelin (human) at doses of more than 3 micrograms/kg i.v. caused diarrhea and at doses of more than 30 micrograms/kg i.v. inhibited small intestinal propulsion in mice. Corticorelin (human) at dose of 100 micrograms/kg i.v. showed an inhibition of the gastric juice secretion and decreased the excretion of Na+, Cl- and H+ in rats. Corticorelin (human) produced slight gastric damages only at the highest dose of 100 micrograms/kg i.v.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗
A case-control study of asbestos in drinking water and cancer risk.
The authors conducted a case-control, interview-based study of the risk of developing cancer from asbestos in drinking water. The Everett, Washington area was selected for the study because of the unusually high concentration of chrysotile asbestos in the drinking water it draws from the Sultan River (200 X 10(6) fibers/liter). Through a population-based tumor registry, the authors identified 382 individuals with cancer of the buccal cavity, pharynx, respiratory system, digestive system, bladder, or kidney, diagnosed between 1977 and 1980, and then interviewed them or their next-of-kin. The authors conducted similar interviews of a control group of 462 individuals. Finally, interviews were validated in several ways, including comparing the collected data with that from secondary sources. Estimates of exposure to asbestos in drinking water were based on residence and workplace history, and on individual water consumption. Four different measures of exposure were used. Cancer risk was estimated by logistic regression and other methods. The authors found no convincing evidence for cancer risk from imbibed asbestos. Exposure was similar between cases and controls. Confidence intervals for relative odds for almost all sites included unity. Out of 84 dependent estimates of risk by sex, site, and exposure measure, 63 indicated a protective effect and 21 indicated an increased risk. In instances where relative odds differed appreciably from unity for both males and females, the effect was protective. The relative odds of cancer for 20 years of exposure to Sultan River drinking water varied from 0.92 to 0.99 for females and 0.82 to 1.01 for males for all study sites grouped. For cancer of the digestive system, the corresponding range was 1.03 and 1.08 for females and 0.85 to 1.00 for males. There were six statistically significant associations (p less than 0.05). All involved male stomach (eight cases) and male pharynx (four cases), and indicate elevated risk. This number of significant associations is close to that expected (for the number of comparisons made). The female risks for these two sites indicate a protective effect, and it is concluded that the male results are probably due to chance.
Adult↗
Histology of selected tissues of the leopard seal and implications for functional adaptations to an aquatic lifestyle.
The microscopic anatomy of the cardio-respiratory system, digestive system, kidney, lymphatic system and integument was investigated in the leopard seal, Hydrurga leptonyx, by examining histological sections of tissues collected from leopard seals in Antarctica and New South Wales, Australia. The majority of the tissues had similar histological features to those described in terrestrial mammals and other pinniped species, particularly phocid seals. Differences noted included readily identifiable Purkinje cells within the endocardium, muscular rather than cartilaginous reinforcement of the smaller airways, a single capillary layer within the alveolar septa, limited and variable keratinization of the oesophageal epithelium, few lymphoid follicles within the lamina propria of the gastrointestinal tract, and an absence of a sporta perimedullaris musculosa described in the kidney of cetaceans and some pinniped species. Adaptations of the lung, spleen and integument, similar to those described in other pinnipeds, including reinforcement of the pulmonary terminal airways, prominent pulmonary interlobular septa, ample smooth muscle in the capsule and trabeculae of the spleen, increased thickness of the epidermis, well-developed dermal sebaceous glands, and a thick blubber layer, appear to confer upon the leopard seal advantages related to its aquatic lifestyle.
Adaptation, Physiological↗
Mortality from birth to adult life: a longitudinal study of twins.
We have examined mortality from birth through adult life in a cohort of 2562 twins born in Birmingham, UK, between 1950 and 1954. Their birthweights and obstetric details had been recorded as part of a longitudinal study of births in Birmingham. There were a total of 151 perinatal deaths (perinatal mortality rate = 116 per 1000 births) and 227 infant deaths (infant mortality rate = 94 per 1000 live births). 70 deaths occurred after the age of one year. In comparison with national mortality rates in the UK, overall mortality in the twins was high (standard mortality rate, SMR = 259, 95% CI 221-300). Mortality was highest in the first year of life and, although it then declined progressively, it remained significantly higher that that of the general population until age 5 years. The excess mortality was largely due to conditions originating in the perinatal period but there were excess rates of congenital abnormalities, diseases of the respiratory system, digestive system and nervous and sensory organs. A Cox proportional Hazards analysis showed that the risk of death was related to low birthweight, prematurity and male sex. Death of the co-twin was highly predictive of mortality throughout the period of follow up. These studies not only underline the excess mortality associated with twin birth but show for the first time that this excess mortality extends into childhood.
Adolescent↗
Budd-Chiari syndrome caused by Behçet's disease: treatment by side-to-side portacaval shunt.
BACKGROUND: Behçet's disease is a chronic multisystem vasculitis of unknown etiology that involves skin, mucous membranes, eyes, blood vessels, joints, central nervous system, digestive system, and occasionally other organs. Budd-Chiari syndrome from occlusion of the major hepatic veins is a rare and serious complication of Behçet's disease. Although the mortality rate of Behçet's disease is only 3% to 4%, development of Budd-Chiari syndrome in patients with Behçet's disease has been associated with a mortality rate of 61%. This report presents the largest reported experience of Behçet's disease-related Budd-Chiari syndrome confined to the hepatic veins, and results of treatment by side-to-side portacaval shunt (SSPCS). These results are compared with those we have obtained in Budd-Chiari syndrome confined to the hepatic veins without Behçet's disease, and with results of treatment of Budd-Chiari syndrome in Behçet's disease reported in the literature. STUDY DESIGN: SSPCS was performed in 5 patients with Behcet's disease who had developed acute Budd-Chiari syndrome, and 27 patients with Budd-Chiari syndrome from other causes. In all patients, Budd-Chiari syndrome was confined to the hepatic veins without involvement of the inferior vena cava (IVC). Patients were studied prospectively and were followed up at regular intervals for from 1.5 to 26 years (mean 10.6 years, 81% more than 5 years). Followup was 100%. Patients were mainly young adults; mean age was 24.6 years in the patients with Behçet's disease and 30.0 years in those without Behçet's disease. All patients had massive ascites, abdominal pain, hepatosplenomegaly, and abnormal liver function. Diagnosis was based on angiographic demonstration of occlusion of the major hepatic veins, and liver biopsy findings of intense hepatic congestion and necrosis. SSPCS was performed within 4 months of the onset of Budd-Chiari syndrome in all but 3 patients. Every year or two in followup, patients underwent liver biopsy and evaluation of SSPCS by Doppler duplex ultrasonography and angiography with pressure measurements. Outcomes criteria included mortality rate, SSPCS patency, maintenance of portal decompression, liver function, presence of ascites, presence of portal-systemic encephalopathy (PSE), need for diuretics, quality of life, and return to work. Our results were compared with those reported in the literature in 42 patients who had Budd-Chiari syndrome with Behçet's disease. RESULTS: SSPCS permanently reduced the mean portal vein-IVC pressure gradient (mm saline) from 205 to 7 in the 5 patients with Behçet's disease, and from 250 to 4 in the 27 without Behçet's disease. There was only one operative death, a patient without Behcet's disease. One patient with Behçet's disease died 2 years postoperatively from diffuse vasculitis, a complication of Behçet's disease, and the other 4 (80%) remain alive. All 26 operative survivors in the group without Behçet's disease (96%) are alive. Only one patient developed occlusion of the SSPCS, a man without Behçet's disease, and he required liver transplantation as a result of hepatic decompensation, PSE, and recurrent ascites. All other patients with or without Behçet's disease remained free of ascites, required no diuretics, were free of PSE, and had reversal of hepatic dysfunction. Serial liver biopsies showed normal architecture in 60% of patients with Behçet's disease and 46% of those without Behçet's disease. Return to fulltime work or housekeeping occurred in 80% of patients with Behçet's disease and 96% without Behçet's disease. Comparison of outcomes of our patients with 42 cases of Behçet's disease with Budd-Chiari syndrome reported in the literature, 79% of whom were treated medically, showed striking differences with an overall mortality rate of 61% in generally shortterm followup. (ABSTRACT TRUNCATED)
Adult↗
General pharmacology of KP-102 (GHRP-2), a potent growth hormone-releasing peptide.
The general pharmacological effects of the hexapeptide KP-102 (D-alanyl-3-(2-naphthyl)-D-alanyl-L-alanyl-L-tryptophyl-D-phenylalanyl-L-lysinamide dihydrochloride, growth hormone-releasing peptide-2, GHRP-2, pralmorelin, CAS 158861-67-7), which potently promotes growth hormone (GH) release by acting at both hypothalamic and pituitary sites, were evaluated in various animal experimental models. The administration of KP-102 showed no obvious effect at a pharmacological dose on the central nervous system. KP-102 had no significant effect on the autonomic nervous system and smooth muscle except a slight and transient increase in spontaneous motility of isolated rabbit ileum and contraction of isolated guinea pig ileum at high doses. There was negligible effect on the respiratory and cardiovascular systems, digestive system, renal function and blood system after KP-102 treatment. These results suggest that KP-102 has no serious general pharmacological effects at dose levels showing GH-releasing activity in the experimental animals. Therefore, it is concluded that KP-102 will be a useful drug for the diagnosis of serious GH deficiency and for treatment of short stature.
Acetic Acid↗
Dermatologic signs of biotin deficiency leading to the diagnosis of multiple carboxylase deficiency.
The biotin-responsive, multiple carboxylase deficiencies are autosomal recessively inherited disorders of metabolism in which biotin-dependent carboxylases show diminished activity. This results in an accumulation of organic acids in the urine. The clinical picture involves the nervous system, skin, respiratory system, digestive system, and immune system. The disorder has a good prognosis if biotin therapy is introduced early. If not, it can result in irreversible damage to the central nervous system and early death from metabolic acidosis. We report a 4-year-old girl with unexplained seizures that did not respond well to anticonvulsants. The development of skin problems, which histologically could match the diagnosis of a nutritional dermatitis, together with the fact that the child was constantly eating without gaining weight, led us to the diagnosis of a metabolic disorder. The accumulation of organic acids in the urine suggested the possibility of a biotin deficiency. With biotin therapy the skin problems resolved completely. The seizures also diminished. This case shows that in young children with unexplained seizures that do not respond well to classic anticonvulsant therapy, the possibility of biotin deficiency should always be considered. This article also includes a thorough review of the skin manifestations and other problems caused by biotin deficiency.
Biotin↗
Community health profile of Windsor, Ontario, Canada: anatomy of a Great Lakes area of concern.
The rates of mortality, morbidity as hospitalizations, and congenital anomalies in the Windsor Area of Concern ranked among the highest of the 17 Areas of Concern on the Canadian side of the Great Lakes for selected end points that might be related to pollution in this relatively highly industrialized city. Mortality and morbidity rates from all causes were higher than in the rest of the province. Anomalously high rates of diseases included various cancers; endocrine, nutritional, metabolic, and immunity disorders; diseases of the blood and blood-forming organs, nervous system and sense organs, circulatory and respiratory systems, digestive system, genitourinary system, skin and subcutaneous tissue, musculoskeletal system and connective tissues; congenital anomalies, and infant mortality. Of particular concern was the early onset of the elevated rates of many of these diseases and conditions. Comparison of these incident rates with those in Hamilton, another industrial municipality in southern Ontario, suggested that in addition to a variety of local sources of industrial pollution from automobile manufacturing and use, transboundary air and water pollution from Detroit, Michigan, should be investigated as potentially important causes of these health outcomes in the Windsor Area of Concern. Some of the institutional and political trends of the past decade may need to be reversed before effective remedial programs are implemented for cleaning up contaminated sediments and for containment of leaking hazardous waste sites. This pilot project would seem to be a useful preliminary method of integrating human health concerns and of priority setting for the administration of the Great Lakes Water Quality Agreement and the Canada-United States Air Quality Agreement.
Adolescent↗
Cancer risk from asbestos in drinking water: summary of a case-control study in western Washington.
We conducted a case-control, interview-based study of the risk of developing cancer from asbestos in drinking water. An area that included Everett, Washington, was selected for the study because of the unusually high concentration of chrysotile asbestos in drinking water from the Sultan River. Through a population-based tumor registry, 382 individuals with cancer of the buccal cavity, pharynx, respiratory system, digestive system, bladder, or kidneys, diagnosed between 1977 and 1980, were identified, and they or their next of kin were interviewed. We conducted validation checks of our interviews, including a comparison with secondary sources. Data on asbestos exposure were collected based on residence and workplace history, and on individual water consumption. Logistic regression was used to estimate cancer risk. We found no convincing evidence for increased cancer risk from imbibed asbestos. Confidence intervals for relative risks for almost all sites included unity. There were significantly elevated risks only for male stomach and male pharyngeal cancer, but these sex-inconsistent results, based on small numbers of cases, are probably due to other factors.
Adult↗
[What do we know today about diaminodiphenylsulfone?].
INTRODUCTION: Diaminodiphenylsulfone or dapsone is a chemical analogue of sulfapyridine, synthesized in 1908. Dapsone is a bacteriostatic agent that proved to be efficient in treating leprosy and malaria, but today it is used in treating dermatologic noninfectious inflammatory diseases. PHARMACOLOGY: Dapsone is orally used in a dose of 50-400 mg per day in treatment of dermatologic diseases, and also in a dose of 50-100 mg per day in leprosy treatment. Dapsone is mainly eliminated from the body by urine and smaller part by faeces. Pharmacological interaction was reported when it is used with rifampicin and probenecid. MECHANISM OF ACTION: The bacteriostatic effect of dapsone is well known. It involves inhibition of folic acid synthesis in susceptible organisms. The anti-inflammatory effect of dapsone, which proves to be efficient in treating noninfectious inflammatory diseases, has not been explained completely yet. There are some pieces of evidence that anti-inflammatory action is not connected with its antibacteriological action. CLINICAL USE: Based on previous studies about therapy efficiency of dapsone in treating some diseases, there are two groups of diseases: the group responding well to dapsone (leprosy, malaria, DH, linear IgA-dermatosis, erythema elevatum diutinum, bullous systemic lupus erythematosus) and a group responding with average good response to dapsone (pyoderma gangrenosum, bullous and cicatricial pemphigoid, acne conglobata, discoid cutaneous lupus erythematosus, subcorneal pustulosis dermatosis, granuloma faciale, rheumatoid arthritis, polychondritis, leucocytoclastic vasculitis). ADVERSE EFFECTS: Adverse effects depend on the dose and they rarely occur at doses less than 100 mg per day. They are mainly shown on skin, nervous system, digestive system, hepatobiliary system, and kidney and hematologic system. The most important adverse effects are hemolytic anaemia and methemoglobinemia. Hemolysis usually occurs at doses of 200 mg and more per day. In patients with glucose-6-phosphate dehydrogenase deficiency, hemolysis may be provoked by a dose less than 50 mg per day. For prevention, before using dapsone in therapy, clinical examination with history, blood parameters, liver and renal parameters and determination of glucose-6-phosphate dehydrogenase level are recommended. CONCLUSION: The use of dapsone is absolutely indicated in DH treatment and erythema elevatum diutinum. Because of anti-inflammatory effects, dapsone can also be used in treating other inflammatory noninfectious dermatoses when one should take care about "therapy efficiency/adverse effect" balance using the correct dose, monitoring relevant clinical and laboratory parameters and educating patients.
Anti-Infective Agents↗
[WHO classification of breast tumors and tumors of the female genital organs: pathology and genetics].
Under the supervision of P. Kleihues and L. H. Sobin, the "World Health Organisation Classification of Tumours" with its numerous volumes is currently being re-edited. Following the first three volumes on "Central Nervous System", "Digestive System" and "Haematopoetic System", the volume on "Tumours of the Breast and Female Genital Organs" will be published this autumn. This volume will be edited by F. Tavassoli and P. Devilee. The new WHO books serve a double function of text books and atlases of tumour pathology. The first part of the new volume includes the genetics and pathology of the entire spectrum of malignant tumours and their precursor lesions. The following part is devoted to benign proliferative lesions.
Breast Neoplasms↗
Long-term disability among aviators in Japan Air Self-Defense Force: analysis of 260 cases.
BACKGROUND: As part of a study of the risks associated with aviator incapacitation, we identified the diseases that caused long-term disability (LTD) among aviators in the Japan Air Self-Defense Force (JASDF), and then assessed the magnitude of the problem that each group of diseases represented with regard to the safety of flight. METHODS: Case-notes for JASDF aviators who stopped work for more than 3 mo during 1980-2002 were identified from all files kept at the Medical Evaluation Section of the Aeromedical Laboratory. The case-notes were divided into four age groups and analyzed by diagnostic category or injury. RESULTS: We identified 260 aviators with LTD, including 217 active-duty pilots and 43 navigators with flying status. Of those, 59 cases (22.7%) had permanent disability for flight. About 75% of LTD cases could be attributed to five diagnostic categories: neoplasms, nervous system and sense organs, circulatory system, digestive system, and musculoskeletal system. Peaks in LTD were found in the 20-29 and 40-49 age-groups. In the younger group, 78.2% of the patients were students, of whom 23 were found to have a disability associated with a preexisting medical condition which was not detected in the initial screening process for pilots. In the 20-29 yr age-group, the most common reason for LTD was the nervous system and sense organs, while in the 40-49 yr age-group it was the circulatory system. CONCLUSION: Reduction in the frequency of LTD might be accomplished by improving the medical screening process for applicants and emphasizing the prevention of circulatory diseases during a pilot's career.
Adult↗
[A study on the health status of residents affected by flood disasters].
OBJECTIVE: To study the immediate and long-term effects of disasters caused by floods on residents health status. METHODS: Stratified sampling by ranks of flood disaster occurred in 1996 and 1998, flood disaster areas and control areas were carried out. A retrospective study was also carried out to study all diseases involved during 1996 - 1999. RESULTS: The incident rates of acute infectious disease in flooding areas in 1996 and 1998 were both higher than those of non-flooding areas (863.181/100 000 and 736.591/100 000, respectively). But there was no different between the incident rate of the first years in flooding areas and that of non-flooding areas. The prevalence rates of 8 kinds of chronic diseases related to circulatory system, nervous system, digestive system, injury and poisonous diseases in flooding areas were also higher than that in the non-flooding areas. The highest incidence rates of most diseases were in the mountainous flooding areas, followed by areas collapsed by flooding, and the lowest were seen in soakedareas by floods. The incidence rates of intestinal infectious diseases and respiratory infectious diseases were lower in areas where prevention and control measures were weak. CONCLUSION: Flood could lead to the increase of incidence rates both on acute infectious diseases and non-infectious diseases. Interventions on non-infectious diseases should also be enforced to stop the epidemics when preventing and controlling acute infectious disease.
Acute Disease↗
[Study progress of adverse effects of arsenic on health].
Adverse effects on health of high arsenic in drinking water and contaminated environment are currently of great concern. This review focuses on metabolism of arsenic and it's impairments to skin, blood circle system, nervous system, reproductive-and-urinary system, digestive system, respiratory system and immune system.
Animals↗
Non-antisecretory activities of H2 antagonists.
Besides the main effect of the H2 antagonists--that is, the inhibition of gastric acid secretion--these drugs possess several other pharmacological activities, which in most cases may be evident only for doses higher than those required to produce the H2 blockade. The non-secretory activities of the H2 antagonists may be classified into true side effects--that is, those independent of the primary action, which may or may not depend on the primary action. They concern the central and autonomic nervous systems, cardiovascular and endocrine systems, digestive system (gut, liver, pancreas), immune system, and so forth. It is obvious that when the actions of the different H2 blockers are completely at variance with regard to the same factor (cimetidine increase the TSH response to TRH, whereas ranitidine decreases it; ranitidine stimulates gastrointestinal motility, whereas oxmetidine inhibits it; ranitidine increases the exocrine pancreatic response to cholecystokinin, whereas oxmetidine decreases it; metiamide and cimetidine increase the activity of histamine methyltransferase, whereas burimamide decreases it), this is a clear demonstration that we are dealing with non-specific effects rather than with H2-receptor blockade. All these effects may be of interest because sometimes they may be useful in potentiating the primary action, and sometimes they may represent adverse reactions. In any case, they characterize pharmacologically the individual molecules of the family.
Autonomic Nervous System↗
[Morbidity in rural environment. A comparative study of 2 methods of obtaining data].
BACKGROUND: The great amount of information required to have the possibility of carrying out an opportune correct health planning has been the cause of an increased interest in the Information Systems about morbidity and it is primary level where the obtention of data becomes more difficult. The source of data is one of the problems to be solved; health surveys and consultation registers have been the most frequently used. Both show differences in their results, mainly due to the differences between the perceived morbidity and the treated morbidity, respectively established by each one of them. The objective of our study is to compare perceived morbidity with treated morbidity in the rural environment of Salamanca Province. METHODS: Data on morbidity obtained by the system of register in primary health care of the Community of Castilla y León in five base health areas of Salamanca Province, are compared with data obtained by interview survey in those areas during the same period of time. RESULTS: The three first causes of morbidity were: Diseases of Respiratory System, Digestive System and Circulatory System according to the home survey and Infectious and Parasite Diseases, Supplementary Classification and Signs, Symptoms and improperly Defined Morbid Status, according to registers. CONCLUSIONS: Taking into account the results obtained, the differences between both sources were statistically significative and the greatest differences were found in the group of Signs and improperly defined Morbid Status, Infections Diseases and the Supplementary Classification.
Adolescent↗