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15 recordsLinked to original sources
PubMed1987

Postmenopausal bleeding: etiology, evaluation, and management.

Postmenopausal bleeding can be an alarming symptom for both the patient and the physician because, although in a majority of these cases no pathology is present, the risk of malignancy must be considered. It is important for the physician to fully understand the pathophysiology, differential diagnosis, and the methods of evaluating and treating this disorder in order to ensure the health and comfort of the patient.

Diagnosis, Differential↗
PubMed1983

Foregut mucosal defects: an etiology of hyperamylasemia.

To evaluate a preliminary correlation of hyperamylasemia to upper gastrointestinal bleeding, total serum amylase and serum isoamylase profiles were determined in 50 patients with upper gastrointestinal bleeding. Etiologies of the bleeding were determined in 46 patients including gastritis or duodenitis in 25, gastric ulcers in 12, duodenal ulcers in 3, Mallory-Weiss tears in 3, gastric carcinoma in 2, and esophageal varices in 1. Gastritis or duodenitis was seen incidentally in 14 more patients. Hyperamylasemia was seen in 38 patients, most commonly being due to a rise of both nonpancreatic and pancreatic isoamylases (18 patients). In 13 patients it was due to an elevation of nonpancreatic amylase alone, and in 7 patients secondary to elevated pancreatic isoamylase alone. Acute pancreatitis raises only the pancreatic component and cannot explain the hyperamylasemia in most of these patients. Hyperamylasemia did not correlate to etiology of the bleeding; gastritis or duodenitis present in the majority of these patients appears to be the unifying factor. Since both nonpancreatic and pancreatic amylases are present in the duodenum and the stomach with pyloric reflux, reabsorption of intraluminal amylase across damaged mucosa is postulated as a mechanism to explain the observed isoamylase patterns. The possibility of decreased amylase clearance as an explanation is unlikely. An alternative central nervous system mechanism might be invoked. It is concluded that hyperamylasemia is a complex event which the use of isoamylase analysis is beginning to elucidate. The hyperamylasemia seen commonly in patients presenting with upper gastrointestinal bleeding does not imply the presence of acute pancreatitis.

Amylases↗
PubMed1976

Pathogenesis of massively bleeding colonic diverticulosis: new observations.

Colonic diverticulosis is a common cause of acute severe rectal hemorrhage. The precise site of bleeding, etiology, and pathogenesis have not been previously identified. Arteriographic, microangiographic, and detailed histologic observations in 10 cases of massively bleeding colonic diverticulosis demonstrated strikingly consistent changes related to the characteristic angioarchitecture of colonic diverticula. These changes included: (1) asymmetric rupture of the vas rectum toward the lumen of the diverticulum precisely at its dome or its antimesenteric margin; (2) conspicuous eccentric intimal thickening of the vas rectum, often with thinning of the media and duplication of the internal elastic lamina at and near the bleeding point; and (3) general absence of diverticulitis. Comparison with control colonic diverticula suggests that traumatic factors arising within the diverticular or colonic lumen induce asymmetric intimal proliferation and segmental weakening of the associated vas rectum, predisposing to rupture and massive bleeding.

Adult↗
PubMed1978

Protean manifestations of mycotic aneurysms.

Nine patients examined by arteriography were shown to have mycotic aneurysms involving the thoracic aorta, subclavian artery, renal artery, middle cerebral artery, hepatic artery, and splenic artery. Patients presented with sepsis, chest pain, mediastinal mass, headache, hypertension, and intraperitoneal bleeding. Etiologic factors included endocarditis, septicemia, drug abuse, and poorly controlled soft-tissue infection. Most mycotic aneurysms were virulent processes with rapid progression and only three of the nine patients (33%) survived. Since mycotic aneurysms may be associated with rapid progression and poor prognosis, early recognition is mandatory.

Adolescent↗
PubMedDate not supplied

[Prevalence of HIV antibody carriers in patients assisted in the recovery room].

A study has been performed on 200 patients at the Recovery Department of our hospital during 1987. This study was carried out in order to determine patients with human immunodeficiency virus (HIV) antibody. This group was randomized and consisted of 154 men and 46 women, with an average age of 35.6 +/- 3.9, a total weight of 68 +/- 6 kg and a height of 1.69 +/- 0.2 m. The day entered at the Recovery Department we assessed the following parameters: a) addiction to drugs by parenteral way; b) bleeding; c) invasive procedures; d) etiology, and e) blood samples were drawn for plasma antibody to HIV. We detected five patients (2.5%) with antibody anti-HIV and all of these patients were male and they were aged in 20-39 years old. We noticed a close relation between addiction to drugs and HIV (p less than 0.001), nevertheless no relation has been found between invasive procedures, bleeding, etiology and antibody to HIV. We conclude that the number of patients that we detected with antibody from the HIV is similar to those found by other studies that has been carried out in emergency situation, but greater than those found in the screening of the general population.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Epidemiology and etiology of acute digestive hemorrhage in France].

The epidemiology of gastrointestinal bleedings is poorly known in France. The principal source of bleeding comes from upper gastrointestinal tract. The most common etiology of upper gastrointestinal bleeding is peptic ulcer. Non steroidal anti-inflammatory drugs absorption is frequently associated with ulcer bleeding. The second most frequent etiology is variceal hemorrhage, complicating mostly alcoholic cirrhosis. The causes of lower gastrointestinal tract bleeding are more difficult to detect. The major causes are: colonic diverticula, angiodysplasias, traumatic ulcers of the rectum, colorectal carcinomas and colitis. In children, peptic ulcers and varices are the two main causes of upper gastrointestinal bleeding. Etiologies of lower gastrointestinal bleeding are varying according to the age: juvenile polyposis in children less than 6 years and Meckel's diverticulum after 6 years.

Acute Disease↗
PubMed1984

Inhibition of ovulation by intranasal nafarelin, a new superactive agonist of GnRH.

Thirty healthy female volunteers used a new superactive stimulatory analog of the hypothalamic gonadotropin-releasing hormone (GnRH) for inhibition of ovulation and contraception during 3 months. The potent GnRH agonist nafarelin (D-Nal(2)6-GnRH) was administered intranasally in a daily dose of 125 micrograms to 15 women and 250 micrograms to 15 women. The treatment inhibited ovulation in all women during the 89 months of therapy. No pregnancies occurred during 59 treatment months in which no additional contraceptives were used. The mean estradiol concentration decreased during the 3-month treatment within the normal range for the early to mid-follicular phase of the menstrual cycle. The results suggest that the GnRH agonist nafarelin has a potential for contraception by inhibition of ovulation in women.

Administration, Intranasal↗
PubMed1984

Vaginal bleeding in adolescents.

Abnormal vaginal bleeding in the teenage years usually has nonorganic causes; however, a careful elimination of organic causes is necessary before the diagnosis of dysfunctional uterine bleeding is made. The differential diagnosis in the case of such a complaint and a management plan are discussed.

Adolescent↗