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Sample records for chronic constipation due

  1. Chronic constipation in hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy.METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients' mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors,calcium antagonists, anticoagulants, antithrombotics,antidepressants, anti-epileptics.RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident.Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13),sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury.CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients.Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere,and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.

  2. [Surgical treatment of chronic idiopathic constipation].

    Science.gov (United States)

    Menguy, R; Chey, W

    We review current experience with surgical treatment of severe constipation due to primary inertia of the colon. Over the last 10 years, we have operated 18 patients (14 females and 4 males) with severe constipation. The surgical procedure was either nearly total colonectomy with ascending colon/rectum anastomosis (8 cases) or total colonectomy with ileorectal anastomosis (9 cases). In one patient, coloproctectomy was performed with an ileoanal anastomosi. Indications for surgery were based on results of barium emena and functional evaluation of defecation. Results were satisfactory in all patients. In several patients however, we noted that the motility of other levels of the digestive tract was also impaired. Colonectomy was introduced as a treatment for chronic constipation nearly a century ago and although very few indications have been retained in the recent this procedure has now become an acceptable surgical approach in a limited number of well-though-out cases. PMID:7729199

  3. Management of chronic constipation in the elderly.

    LENUS (Irish Health Repository)

    Gallagher, Paul F

    2012-02-03

    Constipation is a significant healthcare problem in the elderly. However, while undoubtedly common in the elderly, data on the prevalence of constipation in general and of its subtypes vary considerably, depending on the nature of the study population and their location. Furthermore, the complexity of the pathophysiology of constipation in this age group is little appreciated. Assumptions regarding \\'age-related changes in colorectal physiology\\' are, for the most part, not supported by scientific evidence and may serve to distract the clinician from uncovering the contributions of co-morbid diseases and the impact of iatrogenic factors. The evidence base from which one can develop recommendations on the management of constipation in the elderly is, for the most part, slim. This becomes most starkly apparent when one attempts to critically assess specific approaches to management. There is insufficient evidence to support the use of many commonly used laxatives both in the general population and in the elderly. Lifestyle interventions have value for some patients but data are lacking on the benefits of these interventions for patients with chronic constipation. Data in the elderly do not exist for most new pharmacological approaches to constipation. Pending the availability of good data, management of constipation in the elderly should be tailored to each individual\\'s needs and expectations, regardless of age or place of residence. In certain situations, constipation may be complicated by the development of impaction; preventive strategies are important in this context. We urge enrolment of many more elderly individuals with chronic constipation in clinical trials designed to address their particular needs.

  4. The intestinal ecosystem in chronic functional constipation.

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    Zoppi, G; Cinquetti, M; Luciano, A; Benini, A; Muner, A; Bertazzoni Minelli, E

    1998-08-01

    Chronic functional constipation is common in infants, and the bacterial composition of stools in this condition is not known. The study aims were to: (i) investigate the composition of the intestinal ecosystem in chronic functional constipation; (ii) establish whether the addition of the water-holding agent calcium polycarbophil to the diet induces an improvement in constipation; and (iii) determine the composition of the intestinal ecosystem after the use of this agent. In total, 42 children (20F, 22M; mean age: 8.6 +/- 2.9 y) were studied. Twenty-eight children with functional chronic constipation without anatomical disorders were treated double-blind in random sequence for 1 month with an oral preparation of calcium polycarbophil (0.62 g/twice daily) or placebo. Intestinal flora composition was evaluated by standard microbiological methods and biochemical assays on faecal samples collected before and after treatment. Fourteen healthy children were studied as controls. The results show that (i) the constipated children presented a significant increase in clostridia and bifidobacteria in faeces compared to healthy subjects--different species of clostridia and enterobacteriaceae were frequently isolated; no generalized overgrowth was observed; Clostridia outnumbered bacteroides and E. coli mean counts by 2-3log, while bacteroides and E. coli counts were similar (5-6 log10/g fresh faeces); these intestinal disturbances could be defined as a dysbiosis, i.e. a quantitative alteration in the relative proportions of certain intestinal bacterial species. (ii) Clinical resolution of constipation was achieved only in 43% of treated children and an improvement in 21% (one bowel movement every 2 d). (iii) Calcium polycarbophil treatment induced no significant changes in the composition of the intestinal ecosystem, nor in blood chemistry parameters.

  5. Chronic constipation causing obstructive nephropathy in a delayed toddler.

    LENUS (Irish Health Repository)

    Barrett, Michael Joseph

    2012-01-01

    Chronic constipation causing obstructive nephropathy is very rare in children. However, it can cause urinary tract obstruction with acute impairment of renal function with a need for emergent disimpaction. The authors discuss a 2 years 4 months old child who presented to our emergency department with acute renal failure due to faecal impaction.

  6. Biofeedback treatment of chronic constipation: myths and misconceptions.

    Science.gov (United States)

    Chiarioni, G

    2016-09-01

    Chronic constipation is a prevalent disorder with considerable impact on healthcare costs and quality of life. Most patients would respond to conservative measures in primary care. Patients with refractory constipation are commonly referred to dedicated centers for appropriate investigations and management. After testing, three main subtypes of constipation are commonly identified: normal colon transit, slow transit, and functional defecation disorders. The etiology of functional defecation disorders is consistent with maladaptive behavior, and biofeedback therapy has been considered a valuable treatment option. Being safe and only marginally invasive, retraining has been historically employed to manage all types of refractory constipation. There are a number of strongly held beliefs about biofeedback therapy that are not evidence-based. The aim of this review was to address these beliefs concerning protocols, efficacy, indications, and safety, with a special focus on the relevance of identifying patients with a functional defecation disorder who are ideal candidates for retraining. Randomized controlled trials support the effectiveness of biofeedback therapy for severe, refractory constipation due to functional defecation disorders. Limitations of the treatment are discussed, but biofeedback remains the safest option to successfully manage this hard-to-treat subtype of constipation. PMID:27450533

  7. Constipation due to Liver Disorder in Iranian Traditional Medicine`s Viewpoint

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    R Choopani

    2014-04-01

    Full Text Available Introduction: Constipation is one of the most common pediatric disorders.In many cases, there is no anatomic endocrineor metabolic cause in explanation of chronic constipation.More than 85% of them called functional or idiopathic.Constipation is one of the serious disease in Iranian Traditional Medicine. Besides the problem it causes, chronic constipation can be the origin of many disease. That is why, ithas been called Mother of disease.The purpose of this study is to investigate the Constipation in children and the role of other organs such as the liver by view of Iranian Traditional Medicine   Materials and Method: This study is a review through Iranian traditional medicine references. At first, all the main available traditional books were reviewed. All the data about therapies of vaginal discharge in ITM were collected then classified.   Results: In traditional medicine different reasons have been mentioned for constipation especially for childrenwhich most of them are similar to etiology in Modern Medicine.Constipation due to liver disorder is one of the causes of constipation.In Iranian Traditional medicine` viewpoint, one of the mechanism for excretion is existence of secreted bile in intestine.If by any reason,measure or quality of its which secreted in intestine through bile changes or if intestinal mucous secretion becomes barrier for absorbing the food,it will caused disorder in excretion and finally will lead to constipation.Well known Iranian Traditional Medicine scientists, has mentioned all reasons for liver disorders and changing quality& quantity of secreted bile .he has mentioned the solutions as well.   Conclusion: It is hoped that by paying attention to constipation and with advanced clinical research we will be able to explain idiopathic constipation and prepare new ways of treatments for constipation. New researches have approved the effectiveness of these foods and drugs for treating the constipation.   Keywords

  8. Intractable chronic constipation in children: Outcome after anorectal myectomy

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    Seyed Abdollah Mousavi

    2014-01-01

    Full Text Available Background: Many children with constipation fail to respond with conventional medical therapy. Surgery can produce a good result in dysfunction of the colon secondary to aganglionosis. However, its role in treating idiopathic constipation is more controversial. Patients and Methods: A consecutive series of 44 patients with chronic idiopathic intractable constipation were included in this study. All children were investigated by barium enema and anorectal manometry. Due to inadequate response to medical therapy, all of these patients were selected for internal sphincter myomectomy. Patients were followed-up from 3 to 12 months. Results: Short-term (3 months and long-term (6 months follow-up was available for all patients. The histology examinations showed normal ganglion cells in 32, hypoganglionosis in eight and aganglionosis in four patients. In short-term, regular bowel habits, without the need for laxatives or low dose drugs were recorded in 35 patients (79.5%. Overall there was an improvement in 68.2% of the children after 6 months follow-up. There was not any correlation between histopathological findings, duration of symptoms, age and sex of operation and response to myectomy. Conclusion: anorectal myectomy is an effective procedure in patients with intractable idiopathic constipation. It relieves symptoms in 68.2% of patients with chronic refractory constipation.

  9. Linaclotide: A Novel Therapy for Chronic Constipation and Constipation-Predominant Irritable Bowel Syndrome

    OpenAIRE

    Lacy, Brian E.; Levenick, John M.; Crowell, Michael D.

    2012-01-01

    Chronic constipation and irritable bowel syndrome (IBS) are functional gastrointestinal disorders that significantly affect patients’ quality of life. Chronic constipation and IBS are prevalent—1 2% of the US population meet the diagnostic criteria for IBS, and 1 5% meet the criteria for chronic constipation— and these conditions negatively impact the healthcare system from an economic perspective. Despite attempts at dietary modification, exercise, or use of over-the-counter medications, man...

  10. Recommendations on Chronic Constipation (Including Constipation Associated with Irritable Bowel Syndrome Treatment

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    Pierre Paré

    2007-01-01

    Full Text Available While chronic constipation (CC has a high prevalence in primary care, there are no existing treatment recommendations to guide health care professionals. To address this, a consensus group of 10 gastroenterologists was formed to develop treatment recommendations. Although constipation may occur as a result of organic disease, the present paper addresses only the management of primary CC or constipation associated with irritable bowel syndrome. The final consensus group was assembled and the recommendations were created following the exact process outlined by the Canadian Association of Gastroenterology for the following areas: epidemiology, quality of life and threshold for treatment; definitions and diagnostic criteria; lifestyle changes; bulking agents and stool softeners; osmotic agents; prokinetics; stimulant laxatives; suppositories; enemas; other drugs; biofeedback and behavioural approaches; surgery; and probiotics. A treatment algorithm was developed by the group for CC and constipation associated with irritable bowel syndrome. Where possible, an evidence-based approach and expert opinions were used to develop the statements in areas with insufficient evidence. The nature of the underlying pathophysiology for constipation is often unclear, and it can be tricky for physicians to decide on an appropriate treatment strategy for the individual patient. The myriad of treatment options available to Canadian physicians can be confusing; thus, the main aim of the recommendations and treatment algorithm is to optimize the approach in clinical care based on available evidence.

  11. Fecal Microbiota and Diet of Children with Chronic Constipation.

    Science.gov (United States)

    de Moraes, Joyce Gomes; Motta, Maria Eugênia Farias de Almeida; Beltrão, Monique Ferraz de Sá; Salviano, Taciana Lima; da Silva, Giselia Alves Pontes

    2016-01-01

    Many factors explain dysbiosis in chronic constipation (CC), such as a low-fiber diet. The objective of this study was to compare the fecal microbiota of constipated and nonconstipated children and their intake frequencies of food. Methods. This observational study included 79 children (M/F 43/36) aged six to 36 months divided into two groups: cases (39 constipated children) and controls (40 nonconstipated children). We used a structured form to collect demographic variables, conducted anthropometric assessment, and collected food intake frequency data. The fecal microbiota of the stool samples was analyzed by real-time polymerase chain reaction (PCR) using the fluorophore SYBR® Green. Results. Constipated children had a smaller concentration of Lactobacillus per milligram of stool (p = 0.015) than nonconstipated children, but the concentration of Bifidobacterium per milligram of stool (p = 0.323) and the intake of fruits, vegetables (p = 0.563), and junk food (p = 0.093) of the two groups did not differ. Constipated children consumed more dairy products (0.45 ± 0.8; p > 0.001), were more frequently delivered via caesarean section (69.2%), were weaned earlier (median: 120; 60Q1-240Q3), and had a family history of constipation (71.8%). Conclusions. Children with CC have a smaller concentration of Lactobacillus in their stools and consume more dairy products. PMID:27418934

  12. Potential oxidative stress in children with chronic constipation

    Institute of Scientific and Technical Information of China (English)

    Jun-Fu Zhou; Jian-Guo Lou; Sheng-Li Zhou; Ji-Yue Wang

    2005-01-01

    AIM: To investigate the potential oxidative stress in children with -chronic constipation and to explore its mechanisms.METHODS: Seventy children with chronic constipation and 70 age- and sex-matched healthy children were enrolled in a randomized controlled study. Plasma levels of vitamins C and E, activities of superoxide dismutase and catalase and lipoperoxide level in erythrocytes were determined by spectrophotometry.RESULTS: Compared with healthy children whose vitamin C,vitamin E, superoxide dismutase, catalase and lipoperoxide were 58.35±14.42 μmol/L, 27.15±6.55 μmol/L, 2 206±171U/(g· Hb), 327.3±82.2 K/(g·Hb) and 19.18±4.27 nmol/(g·Hb)respectively, the levels of vitamin C, vitamin E, the activity of superoxide dismutase, and catalase in the children with chronic constipation significantly decreased [46.59±11.51 μmol/L,20.65±4.80 μmol/L, 1943±147 U/(g·Hb) and 269.3±67.8 K/(g·Hb),respectively P<0.01], while the lipoperoxide significantly increased [25.22±5.01 nmol/(g·Hb), P<0.01]. With a prolonged course of disease, the levels of vitamin C, vitamin E, the activity of superoxide dismutase and catalase in the children with chronic constipation gradually decreased,while the level of lipoperoxide gradually increased.CONCLUSION: Chronic constipation can cause potential oxidative stress in children.

  13. THE COLONIC TRANSIT TEST IN THE ASSESSMENT OF CHRONIC CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    In order to assess colonic motility of chronic constipation, colonic transit test was carried out in 34 patients with chronic constipation and in 20 healthy subjects. 20 radiopaque markers are ingested at 8 am before the day test, and plain abdominal films were obtained at 24 h, 48 h and 72 h. The normal value of colonic transit test was 16(80%), or more markers passed after 72 h. By means of transit time study, 34 constipated patients were classified into 2 groups: 12 normal transit patients and 22 slow transit patients. There was no difference in colonic transit time between normal transit patients and controls (P>0.05). Patients with slow transit had more markers left in right colon, left colon and rectosigmoid colon at 48 h (P<0.01, respectively) and 72 h (P<0.01, respectively). According to the transit index, 22 slow transit patients were divided into 3 types: 10 cases colonic stasis, 8 cases outlet obstruction and 4 cases colorectal stasis. The study suggests that chronic constipated patients have abnormalbilities of colonic transit.

  14. Constipation

    Science.gov (United States)

    ... continue Symptoms of Constipation Different people have different bathroom habits, so someone who doesn't have a bowel ... a chance for a relaxed visit to the bathroom before school. Get into the habit of going. Maybe you don't want to ...

  15. Assessment of chronic constipation: colon transit time versus defecography

    Energy Technology Data Exchange (ETDEWEB)

    Prokesch, R.W. E-mail: rupert.prokesch@univie.ac.at; Breitenseher, M.J.; Kettenbach, J.; Herbst, F.; Maier, A.; Lechner, G.; Mahieu, P

    1999-12-01

    Objective: The aim of this study was to determine the value of radiological colon transit time (CTT) measurements in relation to defecography (DFG) in chronically constipated patients. Materials and methods: In 30 patients with chronic constipation, total and segmental CTT was determined using radiopaque markers. In all of these patients defecography (DFG) was obtained. The patients were divided into three groups: In group I, 11 patients were classified with idiopathic constipation based on low stool frequency, normal DFG, or absence of symptoms of abnormal defecation. In group II, ten patients with rectal intussusception were diagnosed by DFG. In group III, there were nine patients with rectal prolapse or spastic pelvic floor syndrome, based on results of DFG. Results: Group I, idiopathic constipation (n=11), showed increased total CTT (mean, 93 h) and segmental CTT (right colon, 33 h (36%), left colon, 31 h (33%), rectosigmoid, 29 h (31%)). In group II, intussusception (n=10), patients had normal mean total CTT (54 h) and a relative decrease in rectosigmoid CTT (mean, 13 h (24%)). In group III (n=9), rectal prolapse (n=5) or spastic pelvic floor syndrome (n=4), patients showed elevated total (mean, 167 h) and rectosigmoidal CTT (mean, 95 h (57%)). Mean total CTT was significantly different between groups I and II and between groups II and III, and mean rectosigmoidal CTT was significantly different between all three groups (P<0.05). Conclusion: The use of total and rectosigmoidal CTT helps to identify the underlying pathophysiology of chronic constipation. Furthermore CTT helps to identify patients, who may benefit from DFG.

  16. Efficacy and tolerability of Laxatan® Granulat in patients with chronic constipation

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    Joerg Gruenwald

    2009-09-01

    Full Text Available Joerg Gruenwald, Regina Busch, Christine BentleyAnalyze and Realize AG, Berlin, GermanyBackground: On average 12% of the population worldwide suffer from acute or chronic constipation. Pathological intestine alterations, an unhealthy diet with reduced liquid intake, and little exercise are potential reasons. Often the motility of the intestine is disturbed. Changing nutrition habits or lifestyle is not always successful. In such cases, laxatives containing macrogol and inulin are highly effective.Methodology: The efficacy and tolerability of Laxatan® Granulat, a laxative containing macrogol, inulin, and mineral salts, was assessed in a drug-monitoring study of 105 patients for four weeks.Results: At the end of this study, a highly significant reduction of the constipation symptoms in 98.1% of the patients was observed. No adverse events were reported during this drug-monitoring study. The overall efficacy was rated as being “very good” or “good” for 96% and the overall tolerability was rated as being “very good” or “good” for 99% of patients.Conclusion: The combination of macrogol, inulin, and mineral salts is highly effective in the treatment of chronic constipation. Due to its prebiotic activity, inulin probably leads to proliferation of lactic acid-producing bacteria. The lowered pH and increased water content probably increases the peristaltic action and therefore reduces constipation.Keywords: Laxatan®, macrogol, inulin, constipation

  17. Evaluation of Immunohistochemistry (IHC in Children with Chronic Constipation

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    Amir Masood Azizpoor

    2015-10-01

    Full Text Available Introduction Constipation is one of the most common causes of referral to pediatric gastroenterology clinics. The histopathology and Immunohistochemistry (IHC studies indicated that several neurons are currently detectable in motility of the gut. We aimed to evaluate calretinin in the children with chronic constipation. Materials and Methods In this cohort study, 40 children with chronic constipation, 28 boys (70% and 12 girls (30% referring to pediatric surgery ward in Shahid Mohammadi Hospital, Bandar Abbas-Iran, between January 2010 to February 2012, were recruited. Then, full rectal biopsy 1.5 cm above dentate line was performed for all children and calretinin immunoreactivity and pattern of staining for ganglion cells (nuclear and cytoplasmic and also nerve fibers in different layers of the bowel (lamina propria, muscularis mucosa, submucosa, and muscularis propria were measured. According to their pathologic results, the children were assigned in two groups for treatment: 1- Those with aganglionosis underwent pull- through operation, and 2- Patients with ganglion but abnormality in their immunohistochemistry received botulinum toxin. Results In this study, 9 (23.9% aganglionic patients with the mean age of 3.6±1.7 years compared with 31 (76.1% hypoganglionosis patients with the mean age of 3.2±1.2 years were examined. Pull- through operations were carried out for all patients in the aganglionic group, and for 6 (19.4% patients in the hypoganglionosis group. Postoperative manometry was significantly better in both groups, but monomeric change was not significant between the two groups. Conclusion Our results revealed that calretinin is absent in aganglionic children, moreover we indicated, calretinin IHC is a very useful and valuable technique for detecting aganglionosis in patients with chronic constipation.

  18. A Study of Anorectal Manometry in Patients with Chronic Idiopathic Constipation

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To study the changes of anorectal motility in patients with chronic idiopathic constipation, anorectal motility was investigated by water-perfused manometric system in 30 patients with chronic idiopathic constipation and 18 healthy subjects. Our results showed that there was no significant difference between the constipation group and the control group in anal sphincteric resting pressure and anal maximal squeezing pressure. The minimum relaxation volume, the rectal defecatory threshold, the rectal maximal tolerable volume and the rectal compliance in the patients were significantly higher than those in the controls (P< 0. 01 or P< 0. 05). It is concluded that patients with chronic idiopathic constipation have anorectal motility disturbances.

  19. Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation

    DEFF Research Database (Denmark)

    Neri, Luca; Conway, Paul Maurice; Basilisco, Guido

    2015-01-01

    BACKGROUND AND AIM: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychom......BACKGROUND AND AIM: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating...... the psychometric properties of PAC-SYM in patients with chronic constipation. METHODS: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion...... validity, responsiveness to clinical change, and its minimal clinically important difference. RESULTS: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated...

  20. A critical appraisal of lubiprostone in the treatment of chronic constipation in the elderly

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    Gras-Miralles B

    2013-02-01

    Full Text Available Beatriz Gras-Miralles,1 Filippo Cremonini1,21Gastroenterology Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 2Southern Nevada VA Healthcare System, Las Vegas, NV, USAAbstract: Chronic constipation is a common disorder in the general population, with higher prevalence in the elderly, and is associated with worse quality of life and with greater health care utilization. Lubiprostone is an intestinal type-2 chloride channel activator that increases intestinal fluid secretion, small intestinal transit, and stool passage. Lubiprostone is currently approved by the US Food and Drug Administration for the treatment of chronic idiopathic constipation and of irritable bowel syndrome with predominant constipation. This review outlines current approaches and limitations in the treatment of chronic constipation in the elderly and discusses the results, limitations, and applicability of randomized, controlled trials of lubiprostone that have been conducted in the general and elderly population, with additional focus on the use of lubiprostone in constipation in Parkinson's disease and in opioid-induced constipation, two clinical entities that can be comorbid in elderly patients.Keywords: irritable bowel syndrome, Parkinson's disease, opioid-induced constipation, chronic constipation

  1. Linaclotide-a novel secretagogue in the treatment of irritable bowel syndrome with constipation and chronic idiopathic constipation.

    Science.gov (United States)

    Sharma, Shivani; Sharma, Tina; Dhingra, Richa; Tomar, Prince; Singh, Sukhminder; Malhotra, Manav; Bhardwaj, T R

    2013-10-01

    Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are highly prevalent gastrointestinal disorders. Traditional symptoms based therapies had somewhat limited success and efficacy in addressing the disorders. Recently, linaclotide emerged as novel peptide capable of improving abdominal symptoms in patients suffering from IBS-C and CIC. Guanylate cyclase C (GC-C) receptor a multi domain protein, found to be molecular target for linaclotide which acts by activating GC-C receptor on the apical surface of intestinal epithelial cells. Binding of linaclotide to GC-C receptor triggers the elevation of second messenger cGMP that elicits fluid secretion into intestinal cells which play a critical role in maintaining homeostasis through cystic fibrosis transmembrane conductance regulator (CFTR). Data from Phase II and III clinical trials demonstrated that linaclotide seems to produce a statistically significant increase in stool frequency, improved straining, decreased abdominal pain and discomfort. PMID:24001336

  2. Risk factors for chronic constipation and a possible role of analgesics.

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    Chang, J Y; Locke, G Richard; Schleck, C D; Zinsmeister, A R; Talley, N J

    2007-11-01

    Constipation has an estimated prevalence of 15% in the general population. However, the etiopathogenesis of this condition remains relatively obscure. This study sought to identify potentially novel risk factors for chronic constipation. A valid self-report questionnaire was mailed to an age- and gender-stratified random sample of Olmsted County, Minnesota residents aged 30-64 years. A logistic regression model that adjusted for age, gender and somatic symptom score (SSC) was used to identify factors associated with chronic constipation. People reporting symptoms of irritable bowel syndrome (IBS) were excluded. Of the 892 eligible subjects, 653 (73%) returned the survey. Among the 523 subjects not reporting IBS symptoms, chronic constipation was reported by 93 (18%) of the respondents. Chronic constipation was significantly associated with use of acetaminophen [>or=7 tablets per week, OR = 2.7 (1.1-6.6)]; aspirin [OR = 1.7 (1.0-2.7)]; non-steroidal anti-inflammatory drugs [OR = 1.8 (1.1-3.0)]; and SSC. No association was detected for age, gender, body mass index, marital status, smoking, alcohol, coffee, education level, food allergy, exposure to pets, stress, emotional support, or water supply. Chronic constipation is associated with use of acetaminophen, aspirin and non-steroidal anti-inflammatory drugs. The explanation of these associations requires further investigation. PMID:17988275

  3. Prevalence and Self-recognition of Chronic Constipation: Results of an Internet Survey

    Science.gov (United States)

    Tamura, Akio; Tomita, Toshihiko; Oshima, Tadayuki; Toyoshima, Fumihiko; Yamasaki, Takahisa; Okugawa, Takuya; Kondo, Takashi; Kono, Tomoaki; Tozawa, Katsuyuki; Ikehara, Hisatomo; Ohda, Yoshio; Fukui, Hirokazu; Watari, Jiro; Miwa, Hiroto

    2016-01-01

    Background/Aims Although chronic constipation is a common symptom, to date no international consensus has been reached regarding its definition. The aims of this study were (1) to investigate defecation habits and (2) to examine the prevalence of constipation using the Japanese Society of Internal Medicine (JSIM) and the Rome III criteria using an online survey. Methods An online questionnaire composed of items on the frequency, interval, form of defecation, the management, and self-recognition of constipation (reference standard of constipation) was created. A total of 5155 valid responses were received. In addition, constipation symptoms were evaluated through a survey using the JSIM and the Rome III criteria. Results In the internet survey, 28.4% of the respondents considered themselves to be constipated. Stratified by sex, significantly more females (37.5%) than males (19.1%) considered themselves to be constipated (P < 0.001). The prevalence of constipation among the respondents was 28.0% using the Rome III, but only 10.1% using the JSIM. The diagnostic accuracy was 73.2% for the Rome III and 78.1% for the JSIM, while the diagnostic specificity was 81.1% for the Rome III and 97.5% for the JSIM. However, the diagnostic sensitivities for both measures were low, at 52.2% and 29.2% for the Rome III and the JSIM, respectively. Conclusions The online survey developed for this study was able to provide clarification regarding defecation patterns. The results also suggest a discrepancy between the self-recognized prevalence of constipation in Japan and prevalence of constipation based on the JSIM criteria. PMID:27426278

  4. The Clinical Experiences of Dr.CAI Gan in Treating Chronic Constipation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zheng-li; ZHU Mei-ping; LIU Qun; LEI Yun-xia

    2009-01-01

    @@ Prof.CAI Gan (蔡淦) is an academic leader in TCM treatment of the spleen and stomach disease.He insisted that liver depression, spleen deficiency and poor nourishment of the intestines are the core of pathogenesis for chronic constipation.Therefore he often treats the disease by strengthening the spleen,relieving the depressed liver, nourishing yin and moistening the intestines.Meanwhile he attaches great importance to syndrome differentiation and comprehensive regulation and treatment.As a result,good therapeutic effects are often achieved.The authors summarized his ways for treating chronic constipation with the following 10 methods, which are introduced below.

  5. Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation

    Directory of Open Access Journals (Sweden)

    Lee N

    2012-06-01

    Full Text Available Noel Lee, Arnold WaldDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USAAbstract: Both irritable bowel syndrome (IBS, characterized by chronic and recurrent abdominal pain and altered bowel habits, and functional constipation are highly prevalent gastrointestinal problems for which many patients seek medical advice. A diverse number of treatment approaches are currently recommended to treat persons with chronic constipation as well as patients with IBS in which constipation is the main gastrointestinal symptom (IBS-C. These approaches have had somewhat limited success, and many patients remain dissatisfied with available therapy. Recently, linaclotide, a novel intestinal secretagogue, which works by activating the guanylate cyclase C receptor on the luminal surface of the intestinal epithelium, has been demonstrated to be efficacious in patients with both chronic functional constipation and with IBS-C in a series of randomized, placebo-controlled studies in these populations. Evidence for this assertion is provided in this systematic review of the pharmacologic properties of this novel agent and the published pivotal studies which support the efficacy of this agent in targeted populations.Keywords: linaclotide, constipation, irritable bowel syndrome, safety, efficacy

  6. Patient considerations in the management of chronic constipation: focus on prucalopride

    Directory of Open Access Journals (Sweden)

    Shin A

    2016-07-01

    Full Text Available Andrea Shin Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA Abstract: Chronic constipation is a common condition that significantly impacts health care utilization, productivity, and quality of life. Laxatives are commonly used, although often insufficient in restoring normal bowel function or providing adequate relief. There remains a significant need for the development of novel agents to optimize treatment of this condition. This review provides an overview of the preclinical and clinical trial data, supporting the efficacy and safety of prucalopride, a highly selective 5-HT4 receptor agonist that has been approved by the European Medicine Agency for the treatment of chronic constipation in adults who have failed standard laxative therapy. Unlike older 5-HT4 agonists, prucalopride has not been associated with adverse cardiovascular side effects or QT prolongation owing to its high selectivity and affinity for the 5-HT4 receptor without clinically significant cross-reactivity at the human ether-à-go-go-related gene (hERG potassium channel or 5-HT receptor subtypes that have previously been implicated in adverse cardiovascular events and arrhythmias. Careful safety assessments have documented the relative safety and tolerability of this agent in various patient groups. Focus has also been placed on demonstrating efficacy with regard to bowel function, symptoms, and patient-reported outcomes such as the Patient Assessment of Constipation-Symptoms and the Patient Assessment of Constipation Quality of Life scores to support the use of prucalopride as a safe and effective therapeutic option for the management of chronic constipation. Keywords: prucalopride, chronic constipation, 5-HT4 agonist, safety, prokinetic, PAC-QOL

  7. Chronic constipation in late pregnancy: an alarming sign for sigmoid volvulus

    International Nuclear Information System (INIS)

    Sigmoid volvulus complicating pregnancy is an extremely rare condition, that need an emergency management. Intestinal obstruction in pregnancy it self is a rare entity but when associated with sigmoid volvulus and history of chronic constipation in late pregnancy need emergency attention. (author)

  8. May Chronic Childhood Constipation Cause Oxidative Stress and Potential Free Radical Damage to Children?

    Institute of Scientific and Technical Information of China (English)

    JI-YUE WANG; YE-LING WANG; SHENG-LI ZHOU; JUN-FU ZHOU

    2004-01-01

    To investigate whether chronic childhood constipation (CCC) may cause oxidative stress and potential free radical damage to children, and to explore the mechanisms by which CCC may cause oxidative stress and potential free radical damage to chronic constipation patients (CCPs). Methods Sixty CCPs and sixty healthy child volunteers (HCVs) whose ages, gender and others were matched for the CCPs were enrolled in a randomized controlled study, in which levels of vitamin C (VC) and vitamin E (VE) in plasma as well as activities of superoxide dismutase (SOD) and catalase (CAT) in erythrocytes were determined by spectrophotometric analytical methods. Results Compared with average values of the above biochemical parameters in the HCVs group, the average values of VC and VE in plasma as well as those of SOD and CAT in erythrocytes in the CCPs group were significantly decreased (P<0.0001). Linear regression and bivariate correlation analysis showed that with prolonged course of the CCPs, the levels of VC and VE in plasma as well as the activities of SOD and CAT in erythrocytes in the CCPs were decreased gradually (P<0.0001). Conclusion The findings in the present study suggest that chronic childhood constipation causes oxidative stress and potential free radical damage to children with chronic constipation.

  9. Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

    Science.gov (United States)

    Shin, Jeong Eun; Jung, Hye-Kyung; Lee, Tae Hee; Jo, Yunju; Lee, Hyuk; Song, Kyung Ho; Hong, Sung Noh; Lim, Hyun Chul; Lee, Soon Jin; Chung, Soon Sup; Lee, Joon Seong; Rhee, Poong-Lyul; Lee, Kwang Jae; Choi, Suck Chei; Shin, Ein Soon

    2016-01-01

    The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods. PMID:27226437

  10. Irritable bowel syndrome and chronic constipation: Fact and fiction.

    Science.gov (United States)

    Bellini, Massimo; Gambaccini, Dario; Usai-Satta, Paolo; De Bortoli, Nicola; Bertani, Lorenzo; Marchi, Santino; Stasi, Cristina

    2015-10-28

    Irritable bowel syndrome (IBS) and functional constipation (FC) are the most common functional gastrointestinal disorders. According to the Rome III Criteria these two disorders should be theoretically separated mainly by the presence of abdominal pain or discomfort relieved by defecation (typical of IBS) and they should be mutually exclusive. However, many gastroenterologists have serious doubts as regards a clear separation. Both IBS-C and FC, often associated with many other functional digestive and non digestive disorders, are responsible for a low quality of life. The impact of the media on patients' perception of these topics is sometimes disruptive, often suggesting a distorted view of pathophysiology, diagnosis and therapy. These messages frequently overlap with previous subjective opinions and are further processed on the basis of the different culture and the previous experience of the constipated patients, often producing odd, useless or even dangerous behaviors. The aim of this review was to analyze the most common patients' beliefs about IBS-C and CC, helping physicians to understand where they should focus their attention when communicating with patients, detecting false opinions and misconceptions and correcting them on the basis of scientific evidence. PMID:26523103

  11. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    Tihomir Kekez; Goran Augustin; Irena Hrstic; Dubravko Smud; Mate Majerovic; Zeljko Jelincic; Emil Kinda

    2008-01-01

    Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Heal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Multislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised en-block. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.

  12. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    Directory of Open Access Journals (Sweden)

    Senay Akbay

    2014-06-01

    Full Text Available The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervosa. But severe bone marrow supression has rarely been reported. To our knowledge, there is not any publication in the literature about bone marrow supression due to constipation.We reported here a 17 years old girl diagnosed as anorexia nervosa who was not wasted yet, presented with constipation and developed fever and pancytopenia.

  13. Transcutaneous Neuromodulation at Posterior Tibial Nerve and ST36 for Chronic Constipation

    Directory of Open Access Journals (Sweden)

    Nina Zhang

    2014-01-01

    Full Text Available The aims of this study were to investigate the effects and possible mechanisms of transcutaneous neuromodulation (TN in patients with chronic constipation. Twelve patients were recruited. The treatment consisted of 2-week TN and 2-week sham-TN which was performed in a crossover design. Bowel habit diary, Patient Assessment of Constipation Symptom (PAC-SYM, Patient Assessment of Constipation Quality of Life (PAC-QOL, and anorectal motility were evaluated. Electrocardiogram was recorded for the assessment of autonomic function during acute TN therapy. It was found that (1 TN improved the frequency of spontaneous defecation. After 2-week TN therapy, 83% patients had more than 3 times bowel movements per week which was significantly different from sham-TN (P=0.01. (2 TN improved PAC-SYM and PAC-QOL scores (P<0.001, resp.. (3 TN significantly decreased the threshold volume to elicit RAIR (P<0.05, ameliorated rectal sensory threshold (P=0.04, and maximum tolerance (P=0.04. (4 TN, but not sham-TN, increased the vagal activity (P=0.01 versus baseline and decreased the sympathetic activity (P=0.01, versus baseline. It was concluded that needleless TN at posterior tibial nerve and ST36 using a watch-size stimulator is effective in chronic constipation, and the effect was possibly mediated via the autonomic mechanism.

  14. Prospective study of biofeedback retraining in patients with chronic idiopathic functional constipation

    Institute of Scientific and Technical Information of China (English)

    Jun Wang; Mao-Hong Luo; Qing-Hui Qi; Zuo-Liang Dong

    2003-01-01

    AIM: To determine the efficacy and long-term outcome of biofeedback treatment for chronic idiopathic constipation and to compare the efficacy of two modes of biofeedback (EMG-based and manometry-based biofeedback).METHODS: Fifty consecutive contactable patients included 8 cases of slow transit constipation, 36 cases of anorectic outlet obstruction and 6 cases of mixed constipation. Two modes of biofeedback were used for these 50 patients, 30 of whom had EMG-based biofeedback, and 20 had manometrybased biofeedback. Before treatment, a consultation and physical examination were done for all the patients, related information such as bowel function and gut transit time was documented, psychological test (symptom checkJist 90, SCL90)and anorectic physiological test and defecography were applied. After biofeedback management, all the patients were followed up. The Student′s t-test, chi-squared test and Logistic regression were used for statistical analysis.RESULTS: The period of following up ranged from 12 to 24months (Median 18 months). 70% of patients felt that biofeedback was helpful, and 62.5% of patients with constipation were improved. Clinical manifestations including straining, abdominal pain, bloating, were relieved, and less oral laxative was used. Spontaneous bowel frequency and psychological state were improved significantly after treatment. Patients with slow and normal transit, and those with and without paradoxical contraction of the anal sphincter on straining, benefited equally from the treatment. The psychological status rather than anorectal test could predict outcome. The efficacy of the two modes of biofeedback was similar without side effects.CONCLUSION: This study suggests that biofeedback has a long-term effect with no side effects, for the majority of patients with chronic idiopathic constipation unresponsive to traditional treatment. Pelvic floor abnormalities and transit time should not be the selection criteria for treatment.

  15. Prucalopride: the evidence for its use in the treatment of chronic constipation

    Directory of Open Access Journals (Sweden)

    Georges Coremans

    2008-12-01

    Full Text Available Georges CoremansDivision of Gastroenterology, University Hospital Gasthuisberg, University of Leuven, Leuven, BelgiumIntroduction: Chronic constipation is a common condition that is difficult to treat. Existing options for the treatment of patients with different subgroups of constipation are limited. A new efficacious and safe drug is needed to limit the frequently observed adverse effects induced by laxatives, to improve general wellbeing and quality of life, and to provide an alternative for enemas or even resectional surgery in patients in whom stimulant laxatives cause disabling adverse effects or fail to increase bowel movement frequency. Aims: The purpose of this article is to assess the current evidence supporting the use of the selective and high affinity serotonin-4 (5-HT4 receptor agonist prucalopride in the management of chronic constipation.Evidence review: There are now convincing data from phase II and multicenter phase III randomized, double-blind, placebo-controlled trials that prucalopride treatment results in a clinically meaningful increase in the number of spontaneous complete bowel movements, a reduction of perceived severity of symptoms and improved disease-related quality of life in a significant proportion of patients. There is a rapid onset of the effect and the improvement is maintained for at least 12 weeks. Prucalopride in a dose of up to 4 mg per day appeared generally well tolerated and devoid of serious cardiac events. Adverse events, most frequently headache and nausea, are usually mild or moderate and occur mainly during the first days of treatment. Prucalopride should be used with prudence and with careful assessment of the benefit-risk ratio until more clinical and electrophysiologic data become available, because relatively few patients have been exposed to the drug for long periods of time.Place in therapy: Prucalopride 1–2 mg once daily may be given to patients suffering from chronic constipation for whom

  16. Efficacy and tolerability of Laxatan® Granulat in patients with chronic constipation

    OpenAIRE

    Gruenwald, Joerg; Busch, Regina; Bentley, Christine

    2009-01-01

    Background: On average 12% of the population worldwide suffer from acute or chronic constipation. Pathological intestine alterations, an unhealthy diet with reduced liquid intake, and little exercise are potential reasons. Often the motility of the intestine is disturbed. Changing nutrition habits or lifestyle is not always successful. In such cases, laxatives containing macrogol and inulin are highly effective. Methodology: The efficacy and tolerability of Laxatan ® Granulat, a laxative cont...

  17. Pattern analysis of defecography in patients with chronic functional constipation: is it predictable for the responsiveness of biofeedback therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hye Rin; Kim, Ah Young; Hong, Seong Sook; Byun, Jae Ho; Myung Seung Jae; Ha, Hyun Kwon [University of Ulsan of Medicine, Seoul (Korea, Republic of)

    2005-08-15

    To determine of pattern analysis of defecography can predict the responsiveness of biofeedback therapy in patients with chronic functional constipation. Over a two-year period, 104 patients with chronic functional constipation underwent defecography and biofeedback therapy. Two blinded readers analyzed the defecographic findings and classified them into six types; I = normal defecation, II = hypertonic lower anal sphincter (poor anal opening due to a persistent contraction of the lower anal sphincter), III dyskinetic puborectal sling (inadequate laxity of the puborectal sling), IV spastic pelvic floor syndrome (persistent contraction of both the puborectal sling and the lower and sphincter), V unclassified (including paradoxical contraction of the anal sphincter), VI anatomical obstruction. In addition, the degree of rectal contraction during defecation was scored (grade 0 to 3). After biofeedback therapy, the differences in the defecography patterns or rectal contraction between the two groups, the responsive or non-responsive group, were analyzed. The defecograms revealed that the type IV of the spastic pelvic floor syndrome was most common (50 of 104 patients, 48%), followed by II (21/104, 20%), III (12/104, 11.5%), V (9/104, 9%) and VI (12/104, 11.5%). Biofeedback therapy showed a therapeutic response in 71 out of 104 patients (68%) but failed in 33 patients (32%). However, there were no significant differences in the defecographic pattern between the responsive and non-responsive groups ({rho} = 0.630). The defecograms revealed contractions in 78 patients (75%) and moderate to vigorous contractions (more than grade 2) in 66 patients. Most of the biofeedback-responsive group showed rectal contractions (66 of 71 patients, 93%, {rho} < 0.001). In patients with chronic functional constipation, there was no significant difference in the morphological patterns of the defecogram between the responsive and non-responsive biofeedback groups. However, the presence of

  18. Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part Ⅰ :Diagnosis)

    Institute of Scientific and Technical Information of China (English)

    Antonio Bove; Filippo Pucciani; Massimo Bellini; Edda Battaglia; Renato Bocchini; Donato Francesco Altomare; Giuseppe Dodi

    2012-01-01

    Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life,and this fact is consistent with the high rate at which health care is sought for this condition.The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation.The commission presents its results in a "Question-Answer" format,including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine.This section represents the consensus for the diagnosis.The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation.The presence of alarm symptoms and risk factors requires investigation.The physical examination should assess the presence of lesions in the anal and perianal region.The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation.Variousscoring systems are available to quantify the severity of constipation; the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable.The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life.No single test provides a pathophysiological basis for constipation.Colonic transit and anorectal manometry define the pathophysiologic subtypes.Balloon expulsion is a simple screening test for defecatory disorders,but it does not define the mechanisms.Defecography detects structural abnormalities and assesses functional parameters.Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports.All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between

  19. Linaclotide in Chronic Idiopathic Constipation Patients with Moderate to Severe Abdominal Bloating: A Randomized, Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Brian E Lacy

    Full Text Available Abdominal bloating is a common and bothersome symptom of chronic idiopathic constipation. The objective of this trial was to evaluate the efficacy and safety of linaclotide in patients with chronic idiopathic constipation and concomitant moderate-to-severe abdominal bloating.This Phase 3b, randomized, double-blind, placebo-controlled clinical trial randomized patients to oral linaclotide (145 or 290 μg or placebo once daily for 12 weeks. Eligible patients met Rome II criteria for chronic constipation upon entry with an average abdominal bloating score ≥5 (self-assessment: 0 10-point numerical rating scale during the 14-day baseline period. Patients reported abdominal symptoms (including bloating and bowel symptoms daily; adverse events were monitored. The primary responder endpoint required patients to have ≥3 complete spontaneous bowel movements/week with an increase of ≥1 from baseline, for ≥9 of 12 weeks. The primary endpoint compared linaclotide 145 μg vs. placebo.The intent-to-treat population included 483 patients (mean age=47.3 years, female=91.5%, white=67.7%. The primary endpoint was met by 15.7% of linaclotide 145 μg patients vs. 7.6% of placebo patients (P<0.05. Both linaclotide doses significantly improved abdominal bloating vs. placebo (P<0.05 for all secondary endpoints, controlling for multiplicity. Approximately one-third of linaclotide patients (each group had ≥50% mean decrease from baseline in abdominal bloating vs. 18% of placebo patients (P<0.01. Diarrhea was reported in 6% and 17% of linaclotide 145 and 290 μg patients, respectively, and 2% of placebo patients. AEs resulted in premature discontinuation of 5% and 9% of linaclotide 145 μg and 290 μg patients, respectively, and 6% of placebo patients.Once-daily linaclotide (145 and 290 μg significantly improved bowel and abdominal symptoms in chronic idiopathic constipation patients with moderate-to-severe baseline abdominal bloating; in particular

  20. RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION

    Directory of Open Access Journals (Sweden)

    Mehran PEYVASTEH

    2015-12-01

    Full Text Available Background and Objectives - The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods - Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA. Results - Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months. Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months. Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P <0.001. Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion - Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment.

  1. Carbon dioxide insufflation or warm-water infusion for unsedated colonoscopy: A randomized controlled trial in patients with chronic constipation in China

    OpenAIRE

    Xiaoling Xu; Haihang Zhu; Di Chen; Langui Fan; Ting Lu; Qin Shen; Chaowu Chen; Denghao Deng

    2016-01-01

    Aims: The effect of carbon dioxide (CO 2 ) insufflation and warm-water infusion during colonoscopy on patients with chronic constipation remains unknown. We evaluated CO 2 insufflation and warm-water irrigation versus air insufflation in unsedated patients with chronic constipation in China. Patients and Methods: This randomized, single-center, controlled trial enrolled 287 consecutive patients, from January 2014 to January 2015, who underwent colonoscopy for chronic constipation. Patients we...

  2. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

    OpenAIRE

    Shubov, Andrew; Taw, Lawrence

    2015-01-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptom...

  3. Usefulness of colon transit time and defecography in patients with chronic constipation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyoung Seuk; Chung, Jae Joon; Kim, Myung Hyun; Park, Su Mi; Yang, Hee Chul [NHIC Ilsan Hospital, Ilsan (Korea, Republic of)

    2006-05-15

    We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipations or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n = 8, 30.8%), outlet obstruction and colon inertia (n = 2, 7.7%), colon inertia (n = 2, 7.7%), and outlet obstruction and hindgut dysfunction (n = 1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n = 8, 30.7%), rectocele and perineal descent syndrome (PDS; n = 4, 15.4%), PDS and rectal intussusception (n = 3, 11.5%), spastic pelvic floor syndrome (SPFS; n = 3, 11.5%), rectocele and SPFS (n = 1, 3.8%), and rectal intussusception (n = 1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n = 4, 36.4%), SPFS (n = 1, 9.1%), rectocele and PDS (n = 1, 9.1%), and PDS and rectal intussusception (n = 1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function.

  4. An unpopular geriatric syndrome: Management of chronic constipation in some European countries. Denmark, Estonia, Italy and Luxembourg

    DEFF Research Database (Denmark)

    Curiale, V.; Kolk, H.; Pedersen, Hanne K.;

    2013-01-01

    , and care usually relies on patients by the use of over the counter laxatives or herbal remedies, with little or no physician control except for the most severe cases. This paper explores the epidemiology, screening, diagnosis and management of chronic constipation in old age in four very different European......The prevalence of self-reported chronic constipation is high in old age, affecting grossly one out of four older subjects, although solid consistent epidemiological data are lacking for many countries. It is more prevalent in frail elders and in those living in nursing homes, usually associated...... with a high burden of comorbid problems and the use of drugs that may cause this side effect. Constipation is a significant health problem that impairs function and quality of life. Faecal impaction is a feared complication that may require hospitalization. However, it is not a very popular geriatric syndrome...

  5. Efficacy and safety of prucalopride for chronic constipation: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Hui-jun TANG

    2014-08-01

    Full Text Available Objective To evaluate the efficacy and safety of prucalopride in the treatment of chronic constipation (CC. Methods Articles regarding treatment of constipation were retrieved from PubMed, EMBASE, Web of Science, The Cochrane Central Register of Controlled Trials, Chinese Journals Full-text Database (CNKI, China National Knowledge Infrastructure, Wan Fang Digital Journal Full-text Database, and Database for Chinese Technical Periodical (VIP to collect clinical randomized controlled trials for CC treated by prucalopride. Meta analysis was performed by using Review Manager 5.0. Results A total of eleven randomized controlled trials including 3278 patients met the inclusion criteria, and ten of them were analyzed to compare the effect of prucalopride with placebo, and another group of articles were analyzed to compare the effect or prucalopride with that of PEG 3350+electrolytes. Mete-analysis showed that the efficacy rate was significantly higher in prucalopride group (29.2% than in the placebo group (12.6%, RR=2.37, 95% CI 2.02-2.79, P0.05. Conclusion Prucalopride is effective in the treatment of CC, with relatively milder and lower incidence of adverse reaction, and it could be a new choice for the treatment of CC. DOI: 10.11855/j.issn.0577-7402.2014.06.10

  6. Use of Prucalopride for Chronic Constipation: A Systematic Review and Meta-analysis of Published Randomized, Controlled Trials.

    Science.gov (United States)

    Sajid, Muhammad S; Hebbar, Madhu; Baig, Mirza K; Li, Andy; Philipose, Zinu

    2016-07-30

    This article highlights the role of prucalopride in the management of chronic constipation based upon the principles of meta-analysis using data reported in the published randomized, controlled trials. Sixteen randomized, controlled trials on 3943 patients reported the effectiveness of prucalopride in patients with chronic constipation. Prucalopride successfully increased the frequency of spontaneous bowel movements per week in all variable doses of 1 mg (standardized mean difference [SMD], 0.42 [95% CI, 0.18-0.66; P = 0.006]), 2 mg (SMD, 0.34 [95% CI, 0.11-0.56; P = 0.003]), and 4 mg (SMD, 0.33 [95% CI, 0.22-0.44; P = 0.00001]). The risks of adverse events or side effects such as headache, abdominal cramps, excessive flatulence, dizziness, diarrhea, and rash were higher (odds ratio, 1.70 [95% CI, 1.27 to -2.27; P = 0.0004]) in prucalopride group. Prucalopride is clinically a beneficial pharmacotherapy for chronic constipation and its routine use may be considered in patients with chronic simple laxative-resistant constipation. PMID:27127190

  7. Evaluation of Constipation

    OpenAIRE

    Alame, Amer M.; Bahna, Heidi

    2012-01-01

    The evaluation of the chronically constipated patient is multifaceted and challenging. Many clinicians define constipation according to the latest Rome III diagnostic criteria for functional gastrointestinal disorders. Female sex, older age, low fiber diet, a sedentary life style, malnutrition, polypharmacy, and a lower socioeconomic status have all been identified as risk factors for functional constipation. In elderly patients, it is important to rule out a colonic malignancy as the cause o...

  8. Proteomic analysis of down-regulated proteins in colonic mucosa of chronic slow transit constipation rats

    Institute of Scientific and Technical Information of China (English)

    Wang Xingwei; Liu Haifeng; Xu Mei; Chen Gang; He Juntang; Wang Guoan; Teng Xiaochun; Fang Dianchun

    2009-01-01

    Objective: To investigate the alternations of proteins in the colonic mucosa of chronic slow transit constipation (STC) rats with a 2-DE-based proteomic method and analyze the function of these down-regulated proteins so as to provide theoretical basis for the pathogenesis of intestinal mucosa of chronic STC rats. Methods: STC model was established by feeding rats with 8 mg/(kg·d) diphenoxylate for 120 d. An experimental model of chronic STC rat was used for separation of proteomics from colonic mucosa using two-dimensional electrophoresis (2-DE). Proteins altered in expressional level were identified by Image Master 2DElite, mass spectrometry, and bibliometrics were applied to identify the differential protein expression and their clinical significance and function were analyzed. Results: Obvious differential protein expression was observed in the pathogenesis of STC, including mast cell protease (Al), non-specific dipeptidase (A2) and chondrosome succinate dehydrogenase precursor (A3). The expressions of Al, A2 and A3 were down-regulated in the gel graph of STC rats. Conclusion: The down-regulation of chondrosome succinate dehydrogenase, mast cell protease as well as non-specific dipeptidase in rat colon suggests the functional impairment of the oxidoreduction of mitochondrion is very important in the genesis and development of STC. The immunological reaction of STC rats is weakened, and the function of digesting and absorbing protein may be damaged to some extent.

  9. Approaches to managing chronic constipation in older people within the community setting.

    Science.gov (United States)

    Bardsley, Alison

    2015-09-01

    Constipation is a common presenting problem within the community setting, but its treatment is often unsatisfactory. It is important for nurses to remember that constipation is a symptom and not a disease. For older adults, constipation can have a gradual onset over a number of years, with many people 'self-medicating' with over-the-counter laxatives and herbal products, which then result in the need for daily laxatives. This article will consider best practice for the assessment, treatment, and prevention of constipation in adults within the community.

  10. Chronic constipation recognized as a sign of a SOX10 mutation in a patient with Waardenburg syndrome.

    Science.gov (United States)

    Arimoto, Yukiko; Namba, Kazunori; Nakano, Atsuko; Matsunaga, Tatsuo

    2014-05-01

    Waardenburg syndrome is characterized by hearing loss, pigmentation abnormalities, dysmorphologic features, and neurological phenotypes. Waardenburg syndrome consists of four distinct subtypes, and SOX10 mutations have been identified in type II and type IV. Type IV differs from type II owing to the presence of Hirschsprung disease. We identified a de novo nonsense mutation in SOX10 (p.G39X) in a female pediatric patient with Waardenburg syndrome with heterochromia iridis, profound bilateral sensorineural hearing loss, inner ear malformations, and overall hypopigmentation of the hair without dystopia canthorum. This patient has experienced chronic constipation since she was a neonate, but anorectal manometry showed a normal anorectal reflex. Chronic constipation in this patient was likely to be a consequence of a mild intestinal disorder owing to the SOX10 mutation, and this patient was considered to have a clinical phenotype intermediate between type II and type IV of the syndrome. Chronic constipation may be recognized as indicative of a SOX10 mutation in patients with Waardenburg syndrome. PMID:24582978

  11. Electroacupuncture Treatment for Constipation Due to Spasmodic Syndrome of the Pelvic Floor- A Report of 36 Cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows. Clinical Data There were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.

  12. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach.

    Science.gov (United States)

    Shubov, Andrew; Taw, Lawrence

    2015-07-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach. PMID:26331105

  13. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation

    Directory of Open Access Journals (Sweden)

    Amaral Karine M

    2010-04-01

    Full Text Available Abstract Background A phytotherapic compound containing Pimpinella anisum L., Foeniculum vulgare Miller, Sambucus nigra L., and Cassia augustifolia is largely used in Brazil for the treatment of constipation. However, the laxative efficacy of the compound has never been tested in a randomized clinical trial. The aim of this study was to evaluate the efficacy and safety of the product. Methods This randomized, crossover, placebo-controlled, single-blinded trial included 20 patients presenting with chronic constipation according to the criteria of the American Association of Gastroenterology. The order of treatments was counterbalanced across subjects: half of the subjects received the phytotherapic compound for a 5-day period, whereas the other half received placebo for the same period. Both treatment periods were separated by a 9-day washout period followed by the reverse treatment for another 5-day period. The primary endpoint was colonic transit time (CTT, measured radiologically. Secondary endpoints included number of evacuations per day, perception of bowel function, adverse effects, and quality of life. Results Mean CTT assessed by X ray was 15.7 hours (95%CI 11.1-20.2 in the active treatment period and 42.3 hours (95%CI 33.5-51.1 during the placebo treatment (p Conclusions The findings of this randomized controlled trial allow to conclude that the phytotherapic compound assessed has laxative efficacy and is a safe alternative option for the treatment of constipation. Trial registration ClinicalTrial.gov NCT00872430

  14. Effectiveness of inulin intake on indicators of chronic constipation; a meta-analysis of controlled randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Luis Collado Yurrita

    2014-08-01

    Full Text Available Background: Constipation is an intestinal dysfunction. Prebiotics, such as inulin, can improve bowel function by positively influencing intestinal biota. Aim: To analyze the scientific evidence for the role of inulin in improving bowel function in patients with chronic constipation. Methods: A meta-analysis of randomized controlled clinical trials was conducted, grounded on a literature search for the period 1995-2013 (descriptors: inulin & constipation on PubMed, ScieLo and Central Trials Register Cochrane databases. A total of 24 articles were found, 5 of them were selected for this meta-analysis, involving 252 subjects (experimental group: n = 144, control group: n = 108. The quality of the studies was assessed using the Jadad scale. Results: We found a significant overall effect of inulin on stool frequency (DEM = 0.69, 95%CI: 0.04, 1.34, stool consistency (Bristol scale (DEM = 1.07, 95% CI: 0.70, 1.45, transit time (DEM = -0.57, 95% CI: -0.99, -0.15 and hardness of stool (RR = 0.42, 95% CI: 0.26, 0.70. Pain and bloating do not improve with inulin intake. Conclusions: inulin intake has a positive effect on bowel function.

  15. Investigation and Analysis of Associated Factors of Chronic Constipation in Medical Staff in Shanghai%上海地区医务人员慢性便秘调查及其相关因素分析

    Institute of Scientific and Technical Information of China (English)

    袁春英; 袁蕙芸

    2015-01-01

    Background:With the increase in pace and pressure of modern life,the aging of population,the change in dietary pattern and the challenge of social psychological problems,the overall prevalence of chronic constipation is increasing in general population in recent decades. Aims:To investigate the prevalence and associated factors of chronic constipation in medical staff. Methods:A total of 1 000 medical staffs were enrolled at random in Shanghai Ren Ji Hospital for fulfilling a questionnaire on associated factors of chronic constipation. Diagnosis of chronic constipation met the Rome Ⅲ criteria. Chi-square test and Logistic regression model analysis were performed to screen the potential risk factors for chronic constipation. The statistically significant variables revealed by chi-square test were taken into the Logistic regression model. Results:Nine hundred and eighty-six medical staffs completed the questionnaire,of them 115 were diagnosed as chronic constipation with a prevalence of 11. 7% . Multivariate Logistic regression analysis revealed that reading/ playing cell phone when defecation,working pressure,anxiety,and depression were the risk factors,which might increase the prevalence of chronic constipation;while regular life style,regular diet,drinking water,and regular bowel movement were the protective factors,which might decrease the prevalence of chronic constipation. Conclusions:Chronic constipation is prevalent in medical staff in Shanghai. Psychological factors,dietary pattern and life style,etc. are considered to be implicated in the pathogenesis of chronic constipation. Favorable life style,dietary pattern,bowel habit and mental status are associated with the reduced risk of chronic constipation.

  16. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    Directory of Open Access Journals (Sweden)

    Nelson LM

    2014-09-01

    Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

  17. The Efficacy of Functional Electrical Stimulation of the Abdominal Muscles in the Treatment of Chronic Constipation in Patients with Multiple Sclerosis: A Pilot Study

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    Christine Singleton

    2016-01-01

    Full Text Available Chronic constipation in patients with multiple sclerosis (MS is common and the current methods of treatment are ineffective in some patients. Anecdotal observations suggest that functional electrical stimulation (FES of the abdominal muscles may be effective in the management of constipation in these patients. Patients and Methods. In this exploratory investigation we studied the effects of FES on the whole gut transit time (WGTT and the colonic transit time (CTT. In addition, we evaluated the treatment effect on the patients’ constipation-related quality of life and on the use of laxatives and the use of manual bowel evacuation. FES was given for 30 minutes twice a day for a period of six weeks. Four female patients were studied. Results. The WGTT and CTT and constipation-related quality of life improved in all patients. The patients’ use of laxatives was reduced. No adverse effects of FES treatment were reported. Conclusion. The findings of this pilot study suggest that FES applied to the abdominal muscles may be an effective treatment modality for severe chronic constipation in patients with MS.

  18. PREVALENCE OF CHRONIC CONSTIPATION AND ITS PSYCHOSOCIAL IMPACT ON CHILDREN AGED BETWEEN 4 TO 14 YEARS AND THEIR PARENTS : A HOSPITAL BASED CROSS - SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Madhu

    2015-08-01

    Full Text Available BACKGROUND: Gastrointestinal functional disorders especially constipation cause morbidity in otherwise healthy children with an estimated prevalence of 1% to 30%. It is perceived as a benign, easily treatable condition however left untreated, can lead to complication s ( F aecal impaction, incontinence and bowel perforations. Only a small proportion of patients seek medical advice; thus, the exact prevalence of the disorder is difficult to estimate. AIMS: To estimate the prevalence of chronic functional constipation in children aged 4 - 14 years and the degree of psychosocial impact on children and their parents. SETTINGS AND DESIGN: This cross - sectional study was carried out at K.R and Cheluvamba Hospital, MMC &RI, MYSORE from 1st FEB 2014 to 31ST MAY, 2014. METHODS AND MATERIAL: Constipation was defined using Rome III criteria. Children with organic causes of chronic constipation were excluded. Abdominal pain, fecal mass, anorexia, fecal soiling, withholding behavior were recorded. Psychosocial impact on children and par ents was assessed using Paediatric Quality Of Life Inventory (PQLI and modified PIP Questionnaires. Scoring done according to instructions given with respective questionnaires. STATISTICAL ANALYSIS: Prevalence was calculated using rates, ratios and percen tages. Tests of significance were performed wherever relevant. P value of less than 0.05 was considered significant. RESULTS: The prevalence of functional constipation was estimated to be 14.29% with higher prevalence in females as compared to males i.e. 1 6.19% vs. 13.42%. Perineal soiling was significantly associated with functional constipation i.e. 58.33%. Mean score of all children was 75.4 and 70.6 for physical and psychosocial impact. 88% children reported PQLI score <80(Mean 69.4. No difference betw een male and female child (p=.614. 83.33% parents reported score <80(Mean 69.3. No significant difference on psychosocial impact and quality of life according to PQLI

  19. Evidence for motor neuropathy and reduced filling of the rectum in chronic intractable constipation.

    Science.gov (United States)

    Waldron, D J; Kumar, D; Hallan, R I; Wingate, D L; Williams, N S

    1990-11-01

    Subtotal colectomy with ileorectal anastomosis is now frequently offered to patients with slow transit constipation who have severe symptoms and no response to more conventional medical treatment. If this operation is to be successful, the underlying problem should be delay in the progress of contents through the colon but no mechanical or functional obstruction in the small bowel or rectum. We have used a recently described technique of prolonged ambulant manometry and electromyography to investigate anorectal function in these patients. Pressure data were collected using a 2 mm diameter intrarectal probe carrying microtransducers, and external anal sphincter activity was assessed by a pair of silver-silver chloride surface electrodes. Fourteen control subjects and eight patients with colonic inertia were studied. Sampling reflexes, indicative of rectal filling, occurred at mean (SEM) rates of 7.4 (2.0)/hour in controls but were significantly reduced in patients (2.4 (0.3)/hour (p less than 0.01]. Recurrent rectal motor complexes were seen to occur in both groups at intervals of 76 (1.8) minutes in controls and 64.9 (7.2) minutes in patients (p less than 0.1), and with amplitudes of 42.4 (2.1) mmHg and 9.2 (0.7) mmHg (p less than 0.001), respectively. External sphincter electromyographic spike activity did not differ between groups. Our results support the concept of reduced transit of faeces to the rectum from the colon over a 24 hour period in slow transit constipation and suggest that a motor neuropathy may also be present in the rectum. PMID:2253913

  20. Safety and tolerability of tegaserod in patients with chronic constipation: pooled data from two phase III studies.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    BACKGROUND & AIMS: Studies show that tegaserod effectively relieves the symptoms of chronic constipation\\/idiopathic constipation (CC). This pooled analysis assessed the safety and tolerability of tegaserod in a large dataset of CC patients. METHODS: Adverse event (AE) data were pooled from 2 double-blind, placebo-controlled phase III trials of 12 weeks\\' duration. Post hoc analysis was conducted for the most frequent AEs (incidence, >or=3%). RESULTS: Eight hundred eighty-one, 861, and 861 patients received tegaserod 6 mg twice a day, 2 mg twice a day, or placebo, respectively. Most AEs were mild\\/moderately severe. AE incidence was similar for the tegaserod 6 mg and 2 mg twice a day (57.1% and 56.3%, respectively) and placebo groups (59.6%) and most frequent in the gastrointestinal system (tegaserod 6 mg twice a day, 25.8%; 2 mg twice a day, 22.5%; placebo, 24.6%). Headache, the most common AE, was slightly more frequent in the placebo group (tegaserod 6 mg twice a day, 11.0%; 2 mg twice a day, 10.1%; placebo, 13.2%). Diarrhea (generally transient and resolved with continued treatment) was the only AE with a statistically significant difference between groups (tegaserod 6 mg twice a day 6.6% vs placebo 3.0%, P=.0005). Serious AE incidence (1.4% overall) was comparable across treatment groups, although abdominal surgery was less common in the combined tegaserod (0.5%) than the placebo group (1.0%). Discontinuation as a result of AEs was slightly higher in tegaserod 6 mg twice a day patients (5.7%; 2 mg twice a day, 3.3%; placebo, 3.7%), mainly because of diarrhea. Laboratory and electrocardiogram parameters were comparable across groups. CONCLUSIONS: Tegaserod is well tolerated by patients with CC during 12 weeks of treatment.

  1. [Pathogenetic approaches to treating constipations].

    Science.gov (United States)

    Luzina, E V

    2014-01-01

    Constipation affects 15-25% of people. Its mechanisms are various. There are constipations due to intestinal dyskinesia (functional constipation, irritated bowel syndrome), slow transit (colonic inertia), and muscular apparatus discoordination ensuring defecation (dyssynergic defecation). The treatment of different types of constipation uses prokinetics (type 4 serotonin receptor agonists, chlorine channels activators and guanylate cyclase C channel activators) or spasmolytics, among which pinaverium bromide (dicetel) has demonstrated its high efficacy. Biofeedback therapy or surgical techniques may be used. There is a need to prescribe laxatives in any type of constipation. A pathogenetic approach to treating constipation is most efficient. The paper characterizes stimulant, osmotic, volume, and emollient laxatives and agents stimulating the urge to defecate. It also gives the data of meta-analyses evaluating the efficacy of different drug groups. Particular emphasis is laid of the effect of lactulose and its first preparation--duphalac. PMID:25306754

  2. 潜艇艇员慢性便秘的心理因素研究%Research on the effect of psychological factors affecting chronic constipation in submariners

    Institute of Scientific and Technical Information of China (English)

    林坚; 熊波; 王舒莉

    2010-01-01

    Objective To investigate the relationship between functional constipation and psychological factors through psychological tests of the submariners with chronic constipation and to provide basis for the diagnosis and treatment of functional constipation. Methods Twenty - six patients with functional constipation conforming to Rome Ⅲ diagnostic criteria and 30 asymptomatic healthy controls were studied. Life event scale and symptom checklist were used for psychological tests and psychological status was also analyzed. Results In the assessment of life - event scale, the rate of psychological abnormalities for the functional constipation group was higher than that for the control group. In the symptom self - assessment, total score, total average score, number of positive items of the experimental group were significantly higher than those of the control group. In addition, somatization, compulsion, depression, anxiety and other factors of the experimental group were also higher than the control. Conclusions Psychological factors played a certain role in the development of constipation. For this reason, when drug treatment was made, it was necessary to give psychological tests and psychological treatment to the submariners with constipation.%目的 通过对潜艇艇员中便秘患者进行心理测试来研究功能性便秘与心理因素之间的关系,以期为便秘的诊断和治疗提供依据.方法 对26名符合罗马Ⅲ标准的功能性便秘患者(实验组)和30名健康者(对照组)进行对照研究,采用生活事件量表、症状自评量表进行心理测试,分析心理状况.结果 在生活事件量表评定中,在负性生活事件得分上,实验组高于对照组;在症状自评量表评定中,总分、总均分、阳性项目数,实验组均明显高于对照组;另外,躯体化、强迫、抑郁、焦虑等因子分实验组也都高于对照组.结论 精神心理因素在便秘的发病中起了一定作用,因此在对潜艇艇员便

  3. [Irritable colon and constipation].

    Science.gov (United States)

    Meyenberger, C

    1993-04-20

    Irritable bowel syndrome is a very common clinical problem with a broad spectrum of severity. The management includes a combination of positive diagnosis of typical symptoms with limited investigations to exclude underlying structural or biochemical disorders. Therapeutic trials focus on the relief of predominant symptoms. Identification and modification of factors exacerbating symptoms, behavioural techniques and pharmacologic agents directed to the presumed gastrointestinal motor dysfunction are required. Psychological support by the physician is the most important part of treatment. Chronic constipation may be the predominant symptom of irritable bowel syndrome. Underlying organic disorders must be excluded by clinical examination and endoscopy. Severe chronic constipation requires further investigation of colonic motility and defecation. High fibre diet, osmotic laxatives and procinetic agents may lead to an improvement. In rare cases surgery may be indicated. PMID:8488351

  4. Mesenteric tumor due to chronic anisakiasis

    Directory of Open Access Journals (Sweden)

    Pablo Menéndez

    2015-09-01

    Full Text Available Intestinal anisakiasis is a rare parasitic disease and difficult to diagnose due to symptoms are not specific, so it is considered an underdiagnosed disease. The clinical suspicion with a correct diagnosis of anisakiasis allows the establishment of a correct treatment; in most cases, the resolution is possible with conservative treatment, avoiding unnecessary surgery to the preoperative differential diagnosis of acute abdomen. We report the case of a patient who required urgent surgery secondary to an exacerbation of chronic anisakiasis.

  5. Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation

    Science.gov (United States)

    Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran

    2016-01-01

    Purpose To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (<8 years), 0.53±0.12 g/kg/d (8 to <12 years), and 0.36±0.05 g/kg/d (12 to 15 years). The dose of lactulose was 1.99±0.43 mL/kg/d (<8 years) or 1.26±0.25 mL/kg/d (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation.

  6. Carbon dioxide insufflation or warm-water infusion for unsedated colonoscopy: A randomized controlled trial in patients with chronic constipation in China

    Directory of Open Access Journals (Sweden)

    Xiaoling Xu

    2016-01-01

    Full Text Available Aims: The effect of carbon dioxide (CO 2 insufflation and warm-water infusion during colonoscopy on patients with chronic constipation remains unknown. We evaluated CO 2 insufflation and warm-water irrigation versus air insufflation in unsedated patients with chronic constipation in China. Patients and Methods: This randomized, single-center, controlled trial enrolled 287 consecutive patients, from January 2014 to January 2015, who underwent colonoscopy for chronic constipation. Patients were randomized to CO 2 insufflation, warm-water irrigation and air insufflation colonoscopy insertion phase groups. Pain scores were assessed by the visual analog scale (VAS. The primary outcome was real-time maximum insertion pain, recorded by an unblinded nurse assistant. At discharge, the recalled maximum insertion pain was recorded. Meanwhile, patients were requested to select the VAS at 0, 10, 30, and 60 min after the procedure. In addition, cecal intubation and withdrawal time, total procedure time, and adjunct measures were recorded. Results: A total of 287 patients were randomized. The correlation between real-time and recalled maximum insertion pain ((Pearson coefficient r = 0.929; P < 0.0001 confirmed internal validation of the primary outcome. The mean real-time maximum pain scores during insertion 2.9 ± 2.1 for CO 2 , 2.7 ± 1.9 for water achieved a significantly lower pain score compared with air (5.7 ± 2.5 group (air vs CO 2 P < 0.001; air vs water P < 0.001. However, no significant pain score differences were found between the patients in the CO 2 and water groups (CO 2 vs water, P = 0.0535. P values in painless colonoscopy and only discomfort colonoscopy (pain 1-2 were, respectively, 6 (6.4% and 8 (8.5% for air; 17 (17.7% and 29 (30.2% for CO 2 ; 16 (16.5% and 31 (31.9% for water. At 0, 10, 30, and 60 min postprocedure, pain scores showed in the CO 2 and water groups had significantly reduced than in air group. Insertion time was signi

  7. Evaluation for the efficacy of biofeedback therapy for chronic constipation%生物反馈治疗慢性便秘的疗效评价

    Institute of Scientific and Technical Information of China (English)

    刘芳宜; 方秀才; 王智凤

    2011-01-01

    Biofeedback therapy has a high efficacy and no adverse effects, and become one of the first-line treatments for chronic constipation, especially for functional defecation disorders. However, there are several factors that could interfere in assessing the efficacy of biofeedback therapy for chronic constipation in publications. In this review, we will discuss how to evaluate the efficacy according to the evidences.%生物反馈治疗以其高疗效、无副作用的特点,成为慢性便秘、特别是功能性排便障碍的一线治疗方案之一.许多因素可能影响对生物反馈治疗效果的判断.本文将就此进行综述,总结客观评价生物反馈疗效时需要注意的方面,为将生物反馈治疗更好地应用于临床提供参考.

  8. Constipation in Children

    Science.gov (United States)

    ... of Constipation in Children Constipation happens when stool stays too long in a child's colon. Causes of constipation in children may include ignoring the urge to have a bowel movement, a diet low in fiber, certain medicines or health problems.​ Diagnosis of Constipation in Children ​A doctor will ...

  9. Comparing Oral Route Paraffin Oil versus Rectal Route for Disimpaction in Children with Chronic Constipation; a Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Vajiheh Modarresi

    2010-09-01

    Full Text Available Objective:Functional constipation is a common and challenging problem in pediatrics. Fecal disimpaction prior to maintenance therapy is recommended to ensure successful treatment. The aim of this study was to compare the efficacy and patients compliance of the two methods of paraffin oil administration (oral and rectal route with the purpose of disimpaction in treatment of children with functional constipation. Methods:A total of 80 children (49 males and 31 females aged 1-12 years, with functional constipation according to Rome III criteria, whose rectal examination confirmed fecal impaction were divided into two groups randomly. Group I received 3 ml/kg/day paraffin oil orally and group II received 3ml/kg/day paraffin oil rectally during 3 consequent days. Successful treatment was defined as no detectable fecal impaction in rectal examination after at most 72 hours. Patient compliance and family satisfaction also was evaluated using a scored questionnaire. Findings:Response to the treatment in both groups was with 92.5% and 82.5% in group I and II, respectively. So, there was no significant difference between the two methods of therapy. Family satisfying and compliance were obviously more achieved in group 1 (87.5% vs 57.5% than in Group 2 (P<0.001. No parents in group I complained about type of treatment while 12.5% of parents in group II were unsatisfied with the mode of paraffin oil administration. The most common side effect of paraffin oil in both groups was anal oil seepage (27.5%. Nausea and abdominal pain were more common side effects in group 1 and 2 respectively. Conclusion:It seems that using paraffin oil per oral route in comparison with rectal route could be a preferred option for disimpaction in children causing less anxiety to the family.

  10. Living with constipation

    DEFF Research Database (Denmark)

    Munch, Lene; Tvistholm, Nina; Trosborg, Ingelise;

    2016-01-01

    as pronounced relief after bowel movements, Impact on well-being and social activities; being constipated negatively impacted their mood and limited social activities, Striving for bowel balance; the participants experienced an ongoing strive for balancing between constipation and diarrhea. Themes related...... to advise on the management of constipation....

  11. Duloxetine in the treatment of chronic pain due to fibromyalgia and diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Alan Wright

    2010-12-01

    Full Text Available Alan Wright, Kyle E Luedtke, Chad VanDenBergCenter for Clinical Research, Mercer University, Atlanta, Georgia, USAAbstract: Duloxetine is a serotonin-norepinephrine reuptake inhibitor approved by the US Food and Drug Administration for the treatment of fibromyalgia and painful diabetic neuropathy at doses of 60 mg daily. Duloxetine has been shown to significantly improve the symptoms of chronic pain associated with these disorders, as measured by the Fibromyalgia Impact Questionnaire, Brief Pain Inventory scores, the Clinical Global Impressions Scale, and other various outcome measures in several placebo-controlled, randomized, double-blind, multicenter studies. Symptom improvement generally began within the first few weeks, and continued for the duration of the study. In addition, the efficacy of duloxetine was found to be due to direct effects on pain symptoms rather than secondary to improvements in depression or anxiety. Adverse events including nausea, constipation, dry mouth, and insomnia, were mild and transient and occurred at relatively low rates. In conclusion, duloxetine, a selective inhibitor for the serotonin and norepinephrine transporters, is efficacious in the treatment of chronic pain associated with fibromyalgia or diabetic neuropathy, and has a predictable tolerability profile, with adverse events generally being mild to moderate.Keywords: duloxetine, chronic pain, neuropathic pain, fibromyalgia, efficacy, safety

  12. Metano no ar expirado de crianças com constipação crônica funcional Breath methane in children with chronic constipation

    Directory of Open Access Journals (Sweden)

    Ana Cristina Fontenele SOARES

    2002-03-01

    Full Text Available Racional - Metano é um gás intestinal que pode estar presente no ar expirado de cerca de 10% das crianças. Objetivo - Pesquisar a produção de metano em crianças com constipação crônica funcional e a concentração de metano no ar expirado antes e depois de evacuação induzida por enema retal. Material e Métodos - Foram estudadas 75 crianças com idades entre 3 e 13 anos com constipação crônica funcional. O metano foi determinado em amostras de ar coletado no final de expiração voluntária em cromatógrafo de gás Quintron (modelo 12i. Foram consideradas produtoras as crianças com metano em concentração maior ou igual a 3 partes por milhão (ppm. Resultados - Produção de metano foi caracterizada em 44 (86,3% dos 51 pacientes com constipação e escape fecal e em apenas 7 (29,2% dos 24 com constipação sem escape fecal. Na 6ª semana de tratamento, constatou-se redução de 65,2% no número de produtores de metano. A produção de metano foi avaliada também em 10 crianças com hábito intestinal normal e nenhuma delas era produtora de metano. No grupo de 20 crianças com fecaloma secundário à constipação crônica, foi avaliada a concentração de metano antes e depois da evacuação induzida por enema de fosfato hipertônico. Destes 20 pacientes, 12 eram produtores de metano. A mediana (percentis 25 e 75 entre parênteses de metano no ar expirado diminui de 21,5 (15,0-25,5 ppm antes, para 11,0 (4,0 e 12,5 ppm após a evacuação. Conclusão - A produção de metano associa-se com constipação com escape fecal e diminui com a redução da impacção fecal.Rational- Methane is an intestinal gas which may be excreted in the expired air of about 10% of children. Objective - The aims of this study were to investigate methane production by children with functional chronic constipation and methane concentration in the expired air before and after a bowel movement induced by a phosphate enema. Methods- Seventy-five patients

  13. Constipation in old age.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2009-01-01

    The prevalence of constipation increases with age. However, constipation is not a physiological consequence of normal ageing. Indeed, the aetiology of constipation in older people is often multifactorial with co-morbid diseases, impaired mobility, reduced dietary fibre intake and prescription medications contributing significantly to constipation in many instances. A detailed clinical history and physical examination including digital rectal examination is usually sufficient to uncover the causes of constipation in older people; more specialized tests of anorectal physiology and colonic transit are rarely required. The scientific evidence base from which to develop specific treatment recommendations for constipation in older people is, for the most part, slim. Constipation can be complicated by faecal impaction and incontinence, particularly in frail older people with reduced mobility and cognitive impairment; preventative strategies are important in those at risk.

  14. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  15. Extraperitoneal Fluid Collection due to Chronic Pancreatitis.

    Science.gov (United States)

    Yasuda, Takeo; Kamei, Keiko; Araki, Mariko; Nakata, Yasuyuki; Ishikawa, Hajime; Yamazaki, Mitsuo; Sakamoto, Hiroki; Kitano, Masayuki; Nakai, Takuya; Takeyama, Yoshifumi

    2013-01-01

    A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy) was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl) was found to exist in the extraperitoneal space (over the peritoneum), but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

  16. Extraperitoneal Fluid Collection due to Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Takeo Yasuda

    2013-08-01

    Full Text Available A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl was found to exist in the extraperitoneal space (over the peritoneum, but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

  17. Diagnostic value of pelvic floor ultrasound in constipation due to female pelvic floor dysfunction%盆底超声对女性盆底功能障碍所致便秘的诊断价值

    Institute of Scientific and Technical Information of China (English)

    徐辰一; 丁曙晴; 薛雅红; 丁义江

    2012-01-01

    Constipation caused by female pelvic floor dysfunction (FPFD) is closely related to pathological changes in the front, middle and back basins. Constipation caused by pathological changes in the back basin manifests itself as rectocele, internal rectal intussusception, enterocele, descending perineum, and pelvic floor dyssynergia. Constipation due to the pathological changes in the front and middle basins not only manifests the above symptoms but also exhibits the symptoms of uterine and bladder prolapse. Pelvic floor ultrasound allows observing pathological changes in the front, middle and back basins in patients with constipation caused by FPFD, analyzing the changes in structure and function of static and dynamic pelvic floors, and making a more systematic assessment of female pelvic floor lesions, which is conducive to guiding con- stipation treatment. Therefore, pelvic floor ultrasound has great value in constipation caused by FPFD. In this paper, we review the diagnostic value of pelvic floor ultrasound in constipation due to female pelvic floor dysfunction.%女性盆底功能障碍(female pelvic floor dysfunction,FPFD)所致便秘与前、中及后盆病变密切相关,后盆病变所致便秘常表现为直肠前突(rectocele,RC)、直肠内套叠(intemal rectal intussusception,IRI)、肠疝(enterocele,EC)、会阴下降(descending perineum,DP)及盆底失弛缓综合征(pelvic floor dyssynergia,PFD)等,而中、前盆病变所致便秘不仅会出现后盆的特征性改变,还会伴见子宫脱垂(uterine prolapse,UP)、膀胱脱垂(bladder prolapse,BP)等症状.使用盆底超声不仅可以观察FPFD所致便秘的前、中及后盆影像学的改变,分析盆底静动态结构及功能的变化,还能对女性盆底病变作出较为完整的系统评估,有利于指导便秘的后期治疗.故研究盆底超声对FPFD所致便秘有较大应用价值.本文就盆底超声对FPFD所致便秘的诊断价值进行阐述.

  18. Management of Constipation in Older Adults.

    Science.gov (United States)

    Mounsey, Anne; Raleigh, Meghan; Wilson, Anthony

    2015-09-15

    Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home residents. Primary constipation is also referred to as functional constipation. Secondary constipation is associated with chronic disease processes, medication use, and psychosocial issues. Fecal impaction should be treated with mineral oil or warm water enemas. Most patients are initially treated with lifestyle modifications, such as scheduled toileting after meals, increased fluid intake, and increased dietary fiber intake. Additional fiber intake in the form of polycarbophil, methylcellulose, or psyllium may improve symptoms. Fiber intake should be slowly increased over several weeks to decrease adverse effects. The next step in the treatment of constipation is the use of an osmotic laxative, such as polyethylene glycol, followed by a stool softener, such as docusate sodium, and then stimulant laxatives. Long-term use of magnesium-based laxatives should be avoided because of potential toxicity. If symptoms do not improve, a trial of linaclotide or lubiprostone may be appropriate, or the patient may be referred for further diagnostic evaluation. Peripherally acting mu-opioid antagonists are effective for opioid-induced constipation but are expensive.

  19. 推拿结合腹针治疗慢性功能性便秘42例%Massage Combined with Abdominal Acupuncture Treating 42 Cases of Chronic Functional Constipation

    Institute of Scientific and Technical Information of China (English)

    代生成; 柳正伟; 闫继红; 李国武; 罗建; 罗才贵

    2014-01-01

    目的:探讨推拿结合腹针治疗慢性功能性便秘的临床疗效。方法:42例慢性功能性便秘患者采用推拿结合腹针治疗,观察其治疗效果。结果:临床痊愈23例,显效15例,有效2例,无效2例,总有效率为95.2%。结论:推拿结合腹针治疗慢性功能性便秘有效,值得临床广泛推广。%Objective:To investigate the clinical effect of massage combined with abdominal acupuncture treating chronic functional constipation. Methods:42 cases of patients with chronic functional constipation were treated with massage combined with abdominal acupuncture, to observe the curative effect. Results: 23 cases were clinically cured, 15 cases markedly effective, 2 cases effective, 2 cases invalid, the total effective rate was 95.2%. Conclusion:Massage combined with abdominal acupuncture is effective in chronic functional constipation, being worthy of widely clinical promotion.

  20. A randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of tegaserod in patients from China with chronic constipation

    Institute of Scientific and Technical Information of China (English)

    San-Ren Lin; Mei-Yun Ke; Jin-Yan Luo; Yao-Zong Yuan; Ji-Yao Wang; Shelley diTommaso; Verena Walter; Jiaqing Huang

    2007-01-01

    AIM: To evaluate the efficacy and safety of tegaserod,6 mg twice daily (b.i.d.), in men and women with chronic constipation (CC) from China.METHODS: This was a multicenter, double-blind,placebo-controlled study. Following a 2-wk treatmentfree baseline period, patients were randomized to receive either tegaserod (6 mg b.i.d.) or placebo (b.i.d.) for 4 wk. An analysis of covariance with repeated measures was used to determine the overall effect of treatment for the primary efficacy variable; the change from baseline in the number of complete spontaneous bowel movements (CSBMs) during the 4-wk treatment period.Secondary efficacy endpoints included other measures of response in terms of CSBMs, and patients' daily and weekly assessment of bowel habits. Safety was also assessed, based on the incidence and severity of adverse events (AEs).RESULTS: A total of 607 patients were randomized to receive either tegaserod (n = 304) or placebo (n = 303).Tegaserod treatment resulted in a rapid and significant increase from baseline in the adjusted mean number of CSBMs per week over wk 1-4 compared with placebo(1.39 vs 0.91, P = 0.0002). A statistically significant difference in favor of tegaserod was also observed for a mean increase ≥ 1 CSBM/wk over wk 1-4 (47.7%vs 35.0%, tegaserod vs placebo, respectively, P =0.0018) and for the absolute number of ≥ 3 CSBMs/wkover wk 1-4 (25.0% vs 14.5%, tegaserod vs placebo,respectively, P = 0.0021). Improvements in other symptoms of CC were also seen in the tegaserod group,including improved stool form and reduced straining. In addition, more patients in the tegaserod group reported satisfactory relief from their constipation symptoms. The frequency and severity of AEs was comparable between tegaserod and placebo groups, with the exception of a greater incidence of diarrhea in patients receiving tegaserod (3.6%) compared with placebo (1.7%).CONCLUSION: Tegaserod treatment improved multiple symptoms of CC and was associated with a favorable

  1. Analysis of opioid-mediated analgesia in Phase III studies of methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain

    Directory of Open Access Journals (Sweden)

    Webster LR

    2015-10-01

    Full Text Available Lynn R Webster,1 Darren M Brenner,2 Andrew C Barrett,3 Craig Paterson,3 Enoch Bortey,3 William P Forbes3 1PRA Health Sciences, Salt Lake City, UT, 2Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 3Salix, a Division of Valeant Pharmaceuticals North America LLC, Bridgewater, NJ, USA Background: Subcutaneous methylnaltrexone is efficacious and well tolerated for opioid-induced constipation (OIC but may theoretically disrupt opioid-mediated analgesia. Methods: Opioid use, pain intensity, and opioid withdrawal (Objective Opioid Withdrawal Scale [OOWS] and Subjective Opiate Withdrawal Scale [SOWS] scores were reported in a randomized, double-blind trial with an open-label extension (RCT and an open-label trial (OLT evaluating safety in adults with chronic noncancer pain. In the RCT, patients taking ≥50 mg of oral morphine equivalents daily with <3 rescue-free bowel movements weekly received methylnaltrexone 12 mg once daily (n=150, every other day (n=148, or placebo (n=162 for 4 weeks, followed by open-label methylnaltrexone 12 mg (as needed [prn]; n=364 for 8 weeks. In the OLT, patients (n=1,034 on stable opioid doses with OIC received methylnaltrexone 12 mg prn for up to 48 weeks. Results: Minimal fluctuations of median morphine equivalent dose from baseline (BL were observed in the RCT double-blind period (BL, 154.8–161.0 mg/d; range, 137.1–168.0 mg/d, RCT open-label period (BL, 156.3–174.6; range, 144.0–180.0 and OLT (BL, 120 mg/d; range, 117.3–121.1 mg/d. No significant change from BL in pain intensity score occurred in any group at weeks 2 or 4 (both P≥0.1 of the RCT double-blind period, and scores remained stable during the open-label period and in the OLT (mean change, —0.2 to 0.1. Changes from BL in OOWS and SOWS scores during the double-blind period were not significantly impacted by methylnaltrexone exposure at weeks 2 or 4 (P>0.05 for all. Conclusion: Methylnaltrexone did not affect

  2. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available   Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  3. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  4. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma.

    Science.gov (United States)

    Fattahi, Asieh Sadat; Maddah, Godratollah; Motamedolshariati, Mohammad; Ghiasi-Moghadam, Taghi

    2014-03-01

    Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  5. Diagnosis of Constipation in Children

    Science.gov (United States)

    ... a physical exam, and may order tests. Medical history The medical history will include questions about the child’s constipation, such ... history of constipation Doctors primarily use a child’s medical history to diagnose functional constipation. The child’s history and ...

  6. Challenges and New Treatment in Childhood Constipation

    Directory of Open Access Journals (Sweden)

    M Sobhani Shahmirzadi

    2014-04-01

    Full Text Available Chronic Constipation is a debilitating condition that is often associated with different abdominal problem. It can cause distress for the child and family and can result in emotional disturbance and family problem. Based on the current algorhytm, the treatment of chronic constipation consists of 4 important phases, 1: education, 2: disimpaction, 3: prevention of re-accumulation of feces and 4: follow up. Challenges in treatment are related to many issues: a    Discussing the importance of problem for parents, b    Family concern about safety and side effects of drugs, c    Adherence to long term treatment, which is often crucial but unacceptable by family, d    Amelioration of withdrawal behavior in toddlers group which don’t understand the facts, e    Planning a appropriate diet for constipation which is again unacceptable by children, f     Cost of treatment g    Anismus Besides of known treatment consist of various drugs:   Biofeedback is one of the approaches that have proven benefits but with less emphasis and introduction, so application of this obsolete method needs further works. Tegaserod, a selective agonist that acts at 5-HT4 receptors and increases small bowel transit, stimulates intestinal secretion and inhibits visceral afferent responses has proven effective in the treatment of chronic constipation in adults.  In children with hard stools, 5-HT4 agonist might benefit children with constipation and tendency to form hard stools, and large rectal masses. The role of this promising new agent in pediatric constipation has to be established in future studies. Pre and Probiotics:  Non-digestible oligosaccharides consist mainly of fructooligosaccharides (FOS. FOS reduces fecal pH, increases the water, holding capacity of stool and fecal weight and decreases intestinal transit time. Furthermore, it has prebiotic effects by selectively stimulating the growth of probiotics bacteria, such as bifidobacteria. Surgery

  7. Therapeutic Efficacy of Lactulose Combined with Bacillus subtilis and Enterococcus faecium Preparation on Chronic Constipation%乳果糖联合枯草杆菌二联活菌治疗慢性便秘的疗效

    Institute of Scientific and Technical Information of China (English)

    吴小玲; 何义波; 吴瑜梅

    2016-01-01

    Background:The incidence of chronic constipation is increasing in recent years,which seriously affects the quality of life of patients. Aims:To investigate the therapeutic efficacy of lactulose combined with Bacillus subtilis and Enterococcus faecium preparation on chronic constipation. Methods:A total of 112 patients with chronic constipation from Jan. 2011 to Jan. 2014 at Emeishan Hospital of TCM were enrolled,and were randomly divided into observation group and control group. Patients in both groups accepted the guidance of diet. In addition,patients in control group were orally administrated with lactulose while patients in observation group were orally administrated with lactulose combined with Bacillus subtilis and Enterococcus faecium preparation. After 4 weeks of treatment,therapeutic efficacy in the two groups was compared,patient assessment of constipation quality of life scale(PAC-QOL)was used to evaluate the quality of life. Results:The overall therapeutic efficacy rate in observation group was significantly higher than that in control group (98. 2% vs. 72. 2% ;χ2 = 12. 399,P < 0. 05). Score of every factor and the total score of PAC-QOL were significantly lower after treatment than those before treatment in both groups(P < 0. 05),while physical discomfort score and the total score in observation group were significantly lower than those in control group( P < 0. 05). Conclusions:Lactulose combined with Bacillus subtilis and Enterococcus faecium preparation can effectively improve the symptoms of difficulty in defecation,hard stool,and improve the quality of life in patients with chronic constipation.%背景:近年慢性便秘发病率呈上升趋势,严重影响患者的生活质量。目的:探讨乳果糖联合枯草杆菌二联活菌肠溶胶囊治疗慢性便秘的临床疗效。方法:选择2011年1月—2014年1月峨眉山市中医院慢性便秘患者112例,随机分为观察组和对照组。两组患者均接受饮食指导,对

  8. Constipation and Fecal Soiling

    Science.gov (United States)

    ... such as peer conflicts, academic difficulties, and low self-esteem, all of which can contribute to constipation and soiling. Children respond well to a carefully planned, consistent system of rewards for appropriate behaviors. Parents can develop behavior modifications or reward systems that ...

  9. Chronic mycobacterial meningitis due to Mycobacterium chelonae: a case report.

    Science.gov (United States)

    Salmanzadeh, Shokrallah; Honarvar, Negin; Goodarzi, Hamed; Khosravi, Azar Dokht; Nashibi, Roohangiz; Serajian, Amir Arsalan; Hashemzadeh, Mohammad

    2014-10-01

    We report a case of chronic meningitis due to Mycobacterium chelonae. This organism is a rapidly growing Mycobacterium (RGM) and can be found worldwide in environmental sources such as soil, dust, and water. M. chelonae is an uncommon cause of meningitis; the majority of infections caused by this organism are localized cutaneous or soft tissue infections, and rarely lung infections. The organism is indistinguishable phenotypically, so we applied PCR based on the rpoB gene sequence followed by restriction fragment length polymorphism (RFLP) for molecular identification. The subsequent sequencing of RFLP products revealed 99.7% similarity with M. chelonae.

  10. Research of Curative Effect to Chronical Functional Constipation(CFC)with Different Processed Products of Plantain Seed%车前子不同炮制品对慢性功能性便秘的疗效

    Institute of Scientific and Technical Information of China (English)

    刘川玉; 周劲刚; 何洁; 唐建红

    2011-01-01

    Objective: It has been observed the curative effect to Chronical Functional Constipation (CFC)with the different processed products of Plantain Seed.Method: It had been chosen ninty examples of patients with the chronical functional constipation (CFC), they had been divided into three groups randomly.Then they had been treated with the stir-frying with salt-water of Plantain Seed, the simple stir-frying of Plantain Seed and the raw powder of Plantain Seed differently, and it had been compared and researched the curative effects and the recurrence rates.Result: The comparation of curative effects of these three groups of patients had significant difference (P < 0.05 ), and the curative effect in the group of the raw powder of Plantain Seed had been the most significant among the total, its effective power (96.67% ) and cure rate (90%) had been higher the other two groups, and its recurrence rate of patients' post-recovery had been the lowest (3.66%).Conclusion: The curative effect to the chronical functional constipation (CFC) with the raw powder of Plantain Seed has been certain and significant, and it has the low recurrence rate.So that the raw powder of Plantain Seed has the value of developing,extending and utilizing extremely.%目的:观察车前子不同炮制品对慢性功能性便秘的疗效.方法:选择慢性功能性便秘患者90例,随机分成3组,分别用盐制车前子、清炒车前子和车前子生粉进行治疗,对其疗效和复发率进行比较研究.结果:3组患者的疗效比较具有显著性差异(P<0.05),车前子生粉组的疗效最为显著,有效率(96.67%)和治愈率(90%)均高于其他两组,患者愈后复发率最低(3.66%).结论:车前子生粉对慢性功能性便秘疗效确切显著,复发率低,极具开发推广应用价值.

  11. 24式太极拳锻炼对功能性便秘患者的康复影响%About the convalescent influence of 24-Pattern Shadowboxing to the patients with chronic functional constipation

    Institute of Scientific and Technical Information of China (English)

    周勇; 梁磊; 李虹; 李靖

    2015-01-01

    目的:探讨24式太极拳锻炼对功能性便秘患者肠胃功能的康复影响。方法:在陕西省中医院、第四军医大学西京医院、陕西省人民医院随机抽选自愿参加实验的无运动禁忌的功能性便秘患者51例,进行为期3个月的实验研究;将51例患者随机分为A、B、C三组,A组为太极拳锻炼组,B组为药物治疗组,C组为对照组。结果:A、B组患者的肠胃功能在实验前后具有明显的改善(p0.05);实验后A组患者比B、C两组有显著改善(p<0.01)。结论:虽然药物治疗对功能性便秘患者的肠胃功能状态的改善有一定的效果,但相对于24式太极拳锻炼,其改善程度并不明显,表明24式太极拳锻炼对功能性便秘患者肠胃功能状态的改善具有积极的康复影响。%Aim:the article discusses the convalescent influence of 24-Pattern Shadowboxing to the patients with chronic functional constipation. Method: random selects 51 patients with chronic functional constipation from Chinese medicinehospitals, Xijing Hospital of Fourth Military Medical University and People Hospital of Shaanxi,and divides them into three groups(group A is shadowboxing group,group B is drug therapy group, group C is control group) to experimental survey for 3 months. Result: it has a very obvious improvement for gastrointestinal functions of group A and B before and after experiment,gastrointestinal functions of group C has little symptomatic improvement or exacerbation,and group has more obvious improvement than B and C after experiment. Conclusion:compared to 24-Pattern Shadowboxing,drug therapy has less improvement even though it has some effect for gastrointestinal functions of patients with chronic functional constipation which testifies 24-Pattern Shadowboxing has positive convalescent influence for the improvement of gastrointestinal functions of patients with chronic functional constipation.

  12. Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children

    OpenAIRE

    Chen, Si-Le; Cai, Shi-Rong; Deng, Liang; Zhang, Xin-hua; Luo, Te-Dong; Peng, Jian-Jun; Xu, Jian-bo; Wen-feng LI; Chen, Chuang-Qi; Ma, Jin-ping; He, Yu-Long

    2014-01-01

    Abstract Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amounts from the gastrointestinal tract and routinely used to treat chronic constipation in adults. Here, we report the results of a meta-analysis of PEG-based laxatives compared with lactulo...

  13. Normal aspects of colorectal motility and abnormalities in slow transit constipation

    Institute of Scientific and Technical Information of China (English)

    Gabrio Bassotti; Giuseppe de Roberto; Danilo Castellani; Luca Sediari; Antonio Morelli

    2005-01-01

    Human colonic motility is a relatively difficult topic to investigate. However, the refinement of manometric techniques in recent years enabled us to study both the proximal and distal segments of the viscus. The present paper reviews our knowledge about normal aspects of colorectal motility in man and the abnormalities found in slow transit constipation (STC), one of the most frequent and difficult to treat subtypes of constipation. An internetbased search strategy of the Medline and Science Citation Index was performed using the keywords colon, colonic,colorectal, constipation, slow transit, motility, recal, rectum in various combinations with the Boolean operators AND, OR and NOT. Only articles related to human studies were used, and manual cross-referencing was also performed.Most of colonic motor activity is represented by single nonpropagated contractions, rarely organized in bursts; this activity is maximal during the day, especially after waking and following meals. In addition, a specialized propagated activity with propulsive features is detectable, represented by high- and low-amplitude propagated contractions. In the severe form of constipation represented by the slow transit type, the above motor activity is completely deranged. In fact, both basal segmental activity (especially in response to meals) and propagated activity (especially that of high amplitude) are usually decreased, and this may represent a physiologic marker of this disorder. Human colonic motor activity is quite a complex issue, still only partly understood and investigated, due to anatomic and physiological difficulties. In recent years, however, some more data have been obtained, even in proximal segments. These data have helped in elucidating, althoughonly in part, some pathophysiological mechanisms of chronic constipation, and especially of the STC subtype.

  14. Constipation: A common problem in childhood

    Directory of Open Access Journals (Sweden)

    Bukarica Svetlana

    2005-01-01

    Full Text Available Introduction Constipation in children is defined as the infrequent and difficult passage of hard stool, not necessarily associated with infrequent stools. All healthy newborns have their first stool within the first 24 to 48 hours after birth. Intestinal transit time increases with age, therapy decreasing the frequency of stooling. Anatomy and Physiology of Anus and Rectum Acquisition of fecal continence requires: normal internal and external anal sphincters, puborectal muscle as well as intact sensory input from both the rectal vault and anal canal. Etiology and Differential Diagnosis During the first year of life, failure to have bowel movement every other day warrants evaluation. During infancy, constipation is usually due to dietary manipulations, malnutrition or some other functional abnormalities. Anatomic causes are found only in 5% of patients. Diagnosis and Therapy Diagnosis relies on history and physical examination. Digital rectal examination usually reveals a shorter anal canal with decreased sphincter tone. The rectal ampulla is dilated and filled with stool. Anorectal manometry is helpful in differentiating functional constipation from aganglionosis or other neurologic problems. Treatment varies depending on the underlying cause. Bowel retraining, aimed at establishing regular daily bowel movement, is of utmost importance in children. The response to treatment is usually dramatic. Conclusion Constipation in children causes anxiety in the family and successful treatment requires persistent reassurance and repeated reevaluation.

  15. Pulmonary cavity due to chronic eosinophilic pneumonia associated with arsenicosis.

    Science.gov (United States)

    Sengupta, A; Saha, K; Jash, D; Bandyopadhyay, A

    2012-01-01

    In developing country like India arsenic poisoning is a major public health problem. Association of chronic eosinophilic pneumonia and chronic diarrhea with arsenicosis is rare. Also pulmonary cavity formation in chronic eosinophilic pneumonia is very uncommon. A 44-year-old male patient, resident of an arsenic affected area was admitted for evaluation of chronic diarrhoea, persistent peripheral eosinophilia along with radiologically visible cavity in right upper zone. There were dermatological manifestations of arsenicosis along with presence of noncirrhotic portal fibrosis and peripheral eosinophilia. On bronchoalveolar lavage study, eosinophil comprised 40% of total cellularity making the diagnosis of chronic eosinophilic pneumonia. After ruling out all possible causes of diarrhoea and chronic eosinophilic pneumonia, we came to conclusion that arsenic could be implicated as causative agent.

  16. Pulmonary cavity due to chronic eosinophilic pneumonia associated with arsenicosis.

    Science.gov (United States)

    Sengupta, A; Saha, K; Jash, D; Bandyopadhyay, A

    2012-01-01

    In developing country like India arsenic poisoning is a major public health problem. Association of chronic eosinophilic pneumonia and chronic diarrhea with arsenicosis is rare. Also pulmonary cavity formation in chronic eosinophilic pneumonia is very uncommon. A 44-year-old male patient, resident of an arsenic affected area was admitted for evaluation of chronic diarrhoea, persistent peripheral eosinophilia along with radiologically visible cavity in right upper zone. There were dermatological manifestations of arsenicosis along with presence of noncirrhotic portal fibrosis and peripheral eosinophilia. On bronchoalveolar lavage study, eosinophil comprised 40% of total cellularity making the diagnosis of chronic eosinophilic pneumonia. After ruling out all possible causes of diarrhoea and chronic eosinophilic pneumonia, we came to conclusion that arsenic could be implicated as causative agent. PMID:23279770

  17. LECTURE ON ACUPUNCTURE Part I Clincal Acupuncture Lecture Thirty-one CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    于慧文; 王红玉; 董洪英

    2003-01-01

    Constipation refers to a condition of difficulty in defecation with discharge of dry and impacted stool. The patient may have no defecation for quite a few days. In view of the differences in its etiology and pathogenesis, constipation can be divided into four types: heat type,qi stagnation type,qi-blood deficiency type and cold type. Constipation is often seen in various acute and chronic diseases. Also, for the differentiation of syndromes and treatment, the simple habitual constipation may be referred to in this section.

  18. Clinical management of constipation.

    Science.gov (United States)

    Lennard-Jones, J E

    1993-10-01

    First, it is important to find out whether the patient is complaining of infrequent defaecation, excessive straining at defaecation, abdominal pain or bloating, a general sense of malaise attributed to constipation, soiling, or a combination of more than one symptom. Second, one must decide if there is a definable abnormality as a cause of the symptom(s). Is the colon apparently normal or is its lumen widened (megacolon)? Is the upper gut normal or is there evidence of neuropathy or myopathy? Is the ano-rectum normal or is there evidence of a weak pelvic floor, mucosal prolapse, major rectocele, an internal intussusception or solitary rectal ulcer? Is there any systemic component such as hypothyroidism, hypercalcaemia, neurological or psychiatric disorder or relevant drug therapy? Choice of treatment will depend on this clinical evaluation. The range of treatments available is: Reassurance and stop current treatment: Patients with a bowel obsession may take laxatives or rectal preparations regularly without need. Increase dietary fibre: Most cases of 'simple' constipation respond to increased dietary fibre, possibly with an added supplement of natural bran. Toilet training and altered routine of life: Young people particularly may need to recognise the call to stool and alter their daily routine to permit and encourage regular defaecation. Medicinal bulking agent: Ispaghula, methyl cellulose, concentrated wheat germ or bran, and similar preparations are useful when patients with a normal colon find it difficult to take adequate dietary fibre. These preparations increase the bulk of stool and soften its consistency. They may be useful for those patients with the constipated form of irritable bowel syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8234432

  19. Chronic manganese toxicity due to substance abuse in Turkish patients

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    Ayhan Koksal

    2012-01-01

    Full Text Available Background: Manganese toxicity may lead to a levodopa-resistant akinetic-rigid syndrome. Pathological changes occur mostly in the pallidium and stratium. Materials and Methods: We report seven patients with a new form of chronic manganese toxicity due to long-term intravenous use of a solution consisting of ephedrine, acetylsalicylic acid and potassium permanganate as a psycho-stimulant, popularly known as "Russian Cocktail". Results: The age of the patients ranged between 19 and 31 years, and the duration of substance abuse was between nine and 106 months. The onset of symptoms from first use ranged seven to 35 months. The initial symptom was impaired speech followed by gait disturbance and bradykinesia. In addition to these symptoms, choreic movements, ataxia presenting as backward falls and dystonia were also seen. Serum and urine samples revealed high levels of manganese. Hyperintense lesions on T1-weighted magnetic resonance imaging were seen in bilateral basal ganglia and brainstem, dentate nuclei, features consistent with manganese intoxication. Conclusion: Manganese toxicity, which may cause a distinctive irreversible neurodegenerative disorder, can be seen frequently with "Russian Cocktail" abuse, a substance which can be accessed very easily and at a low cost.

  20. Systematic Review of Stimulant and Nonstimulant Laxatives for the Treatment of Functional constipation

    Directory of Open Access Journals (Sweden)

    Pierre Paré

    2014-01-01

    Full Text Available BACKGROUND: Constipation is an uncomfortable and common condition that affects many, irrespective of age. Since 1500 BC and before, health care practitioners have provided treatments and prevention strategies to patients for chronic constipation despite the significant variation in both medical and personal perceptions of the condition.

  1. Secondary chronic cluster headache due to trigeminal nerve root compression.

    Science.gov (United States)

    Mjåset, Christer; Russell, M B; Russell, M Bjørn

    2010-12-01

    A 50-year-old woman had a gradual onset of chronic headache located in the right temporal region and a burning sensation in the root of the tongue which over a year evolved into chronic cluster headache with a milder chronic headache in-between the severe cluster headache attacks. A cerebral magnetic resonance imaging (MRI) showed vascular compression of the trigeminal nerve root on the pain side. Neurosurgery microvascular decompression relieved the patient's chronic cluster headache, the chronic intermittent headache and the burning tongue sensation. The effect was persistent at a 1 year follow-up. Patients with atypical symptoms of cluster headache should be examined with cerebral MRI angiography of arteries and veins to exclude symptomatic causes. PMID:20384588

  2. Chronic neck pain disability due to an acute whiplash injury

    NARCIS (Netherlands)

    Nederhand, Marc J.; Hermens, Hermie J.; IJzerman, Maarten J.; Turk, Dennis C.; Zilvold, Gerrit

    2003-01-01

    Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the

  3. Current status of chronic constipation, sleep disturbances and olfactory disorders in the elderly of Chinese residents%中国老年人慢性便秘睡眠障碍和嗅觉异常状况调查

    Institute of Scientific and Technical Information of China (English)

    王志会; 王临虹; 齐士格; 李镒冲; 王丽敏

    2013-01-01

    Objective To investigate the current status and distribution characteristics of chronic constipation,sleep disturbances and olfactory disorders in Chinese elderly.Methods In 2010,the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang Production & Construction Corps.42 668 Chinese aged over 60 years in 98 548 households were randomly selected from 162 National Disease Surveillance Points (DSPs) by a stratified multistage cluster sampling.All subjects received a set of standardized questionnaire and interview.After a complex weighing,the differences in the prevalence of constipation,sleep disturbances and olfactory disorders were investigated among the residents with different genders,ages,urban or rural areas and regions.Results In all subjects aged over 60 years,the general prevalence of self-reported constipation was 5.06 %,which increased with age.The general prevalence of self-reported constipation was higher in females than in males (5.80% vs.4.27%,x2 =21.78,P<0.05),higher in urban areas than in the rural areas (6.04% vs.4.58%,x2 =5.66,P<0.05),and there were no significant differences among residents in eastern,central,and western regions.The general prevalence of self-reported sleep disturbances was 14.19%,which increased with age.The general prevalence of self-reported sleep disturbances was higher in females than in males (17.27% vs.10.94%,x2 =165.53,P<0.05),and there were no significant differences among residents in urban and rural areas or in different regions.The general prevalence of self-reported olfactory disorders was 8.49%,which increased with age.The general prevalence of self-reported olfactory disorders was higher in females than in males (9.36% vs.7.58%,x2 =22.32,P<0.05).There were significant differences in the prevalence of self-reported olfactory disorders among residents in eastern,central and western regions (6.98%,8.28% and 11.00%,x2 =6

  4. Biofeedback therapy on enteric modulation in patients with chronic constipation%生物反馈治疗对慢传输型便秘患者肠功能调节作用的研究

    Institute of Scientific and Technical Information of China (English)

    郝玉霞; 王俊平; 李红霞; 刘俊; 张瑾

    2012-01-01

    目的 探讨生物反馈治疗慢传输型便秘的前景及机制.方法 使用Medtronic Synectics 公司的SYS Orin PC-12和U-Control TMEMG Home Trainer生物反馈训练系统为患者进行治疗,使患者学会识别自身正常和异常的电信号,教会患者进行正确的排便,并对治疗前后患者的症状变化及肛管静息压、最大收缩压、直肠容量感觉阈值、直肠肛门抑制性反射等进行自身对照研究.结果 慢传输型便秘生物反馈治疗后可使肛管平均静息压增大,最大收缩压减少,直肠容量感觉阈值减少,直肠肛门抑制性反射减少,肛管向量容积舒张期减少,收缩期增加.结论 生物反馈疗法可以明显改善便秘患者的排便困难、粪便太硬、便意减少等症状,并使患者学会正确的排便动作,为生物反馈治疗便秘的临床应用提供了依据.%Objective To explore the prospect and mechanism of biofeedback therapy. Methods Biofeedback therapy was conducted using SYS Orin PC-12 and U-Control TMEMG Home Trainer systems (Medtronic Synectics Co. Ltd.). Patients were trained as on how to identify normal or abnormal electrical signals and defecate properly. A self-contrast study was performed on the variation in symptoms, anal canal resting pressure, maximal contracting pressure, rectal volume-sensing threshold and anorectal inhibitory reflex. Results Increased mean anal canal resting pressure as well as reduced maximal contracting pressure, rectal volume-sensing threshold and anorectal inhibitory reflex were recorded in patients with chronic slow-transmission constipation treated by biofeedback system. Also the detection were shortened dilation phase and prolonged contracting period as revealed by vector analysis of anal canal. Conclusion Biofeedback system can markedly ameliorate difficulty in defecation, reduce solidity of feces, improve the de -sire to defecate and guide patients defecate properly, thus offering proofs for the clinical application

  5. Manometric assessment of idiopathic megarectum in constipated children

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Chiarioni; Giuseppe de Roberto; Alessandro Mazzocchi; Antonio Morelli; Gabrio Bassotti

    2005-01-01

    AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Italy.We studied anorectal manometric variables and sensation in a group of constipated children with megarectum defined by radiologic criteria. Data from this group were compared with those obtained in a similar group of children with recurrent abdominal pain.METHODS: Anorectal testing was carried out in both groups by standard manometric technique and rectal balloon expulsion test.RESULTS: Megarectum patients displayed discrete abnormalities of anorectal variables and sensation with respect to controls. In particular, the pelvic floor function appeared to be impaired in most patients.CONCLUSION: Constipated children with megarectum have abnormal anorectal function and sensation. These findings may be helpful for a better understanding of the pathophysiological basis of this condition.

  6. Chronic Paraspinal Pain due to Multiple Aortic Aneurysms.

    Science.gov (United States)

    Basu, Arindam; Biswas, Nirendra Mohan; Roy, Pinaki; Maity, Pranab Kumar; Mukhopadhyay, Mainak

    2015-05-01

    Aneurysms of the aorta are not uncommon, both of the thoracic aorta or the abdominal aorta and may be associated with congenital aortic valve diseases, cystic medial necrosis, Marfan's Syndrome or Ehlers-Danlos syndrome, or atherosclerosis. We report a case of a 46 year old smoker who had developed multiple aneurysms of the aorta in both the thoracic and abdominal parts and was incidentally diagnosed on work-up of a chronic back pain associated with venous prominence on left side of chest and left arm. PMID:26591150

  7. Prevalência de constipação intestinal crônica em crianças atendidas em unidade básica de saúde Prevalence of chronic constipation in children at a primary health care unit

    Directory of Open Access Journals (Sweden)

    Ieda Regina Lopes Del Ciampo

    2002-12-01

    Full Text Available Objetivos: estudar a prevalência de constipação intestinal crônica funcional na infância, em uma unidade básica de saúde, e observar as suas principais características clínicas nessa população. Casuística e métodos: 313 crianças, pacientes da unidade básica de saúde Centro de Saúde Escola de Vila Tibério, Ribeirão Preto (SP, com idades entre 1 a 10 anos incompletos, compuseram a amostra. Destas, foram selecionadas 84 constipadas por critérios instituídos pelos autores. O teste do qui-quadrado foi aplicado para a comparação entre os grupos de constipados e não constipados (nível de significância = 0,01. Resultados: a prevalência de constipação intestinal crônica funcional foi de 26,8%. Das crianças constipadas, 85,7% tinham fezes endurecidas, 25% volume fecal diminuído, 17,9% intervalos às evacuações maiores que 2 dias (todas as crianças que apresentavam intervalo maior que 2 dias eram constipadas, 14,3% escape fecal, e 21,4% sangramento às evacuações. Conclusões: a prevalência de constipação intestinal foi elevada, e o intervalo entre as evacuações foi um critério diagnóstico importante para a seleção das crianças constipadas.Objective: to study the frequency of chronic constipation in childhood at a Primary Health Care Unit and to observe its characteristics in this population. Methods: The sample consisted of 313 children aged between one and 10 years treated at the Centro de Saúde Escola, in the district of Tibério, in the town of Ribeirão Preto. Among these, 84 children with chronic constipation were selected. The chi-squared test was used to compare the groups of constipated and nonconstipated children (p = 0.01. Results: The prevalence of chronic constipation was 26.8%. In the group of chronic constipation, 85.7% of the children had hardened stools, 25% showed reduction in fecal mass, 17.9% had an interval between evacuations longer than 2 days (constipated children, 14.3% revealed fecal

  8. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    Science.gov (United States)

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

  9. Spontaneous urinary extravasation due to chronic ureteral obstruction

    OpenAIRE

    神波, 照夫; 荒井, 豊; 朴, 勺; 池田, 達夫; 竹内, 秀雄; 高山, 秀則; 友吉, 唯夫

    1985-01-01

    Spontaneous nontraumatic perirenal extravasation of urine is an unusual phenomenon, and the majority of the reported case were caused by acute obstruction with passage of a ureteric calculus. Extravasation due to obstruction of more gradual onset occurs less frequently. We report four cases, three caused by tumor obstruction of the ureter, and one thought to be obstructed by the stricture due to ureteral inflammation. We discuss the diagnosis and treatment of spontaneous urinary extravasation...

  10.  Fecal Incontinence and Constipation in Children: A Clinical Conundrum

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    Khalil Ahmad

    2011-09-01

    Full Text Available  Constipation is the infrequent passage of hard stools with pain and difficulty. It is one of the most common pediatric problems parents and healthcare providers face. A significant number of children, especially of the younger age group, are referred to specialists because of constipation. Fecal incontinence is almost always associated with constipation, which leads to marked loss of self esteem among children. The majority of cases of constipation and fecal incontinence are secondary to functional disorders, rather than organic causes and result in behavioral problems, which affect the social life of the child, as well as the family. Previously, it was believed that constipation and fecal incontinence were actually secondary to underlying psychological problems. Studies have failed to prove that psychological abnormalities are etiological factors for constipation among children; chronic constipation probably leads to behavioral abnormalities and also affects the family dynamics. The important causes of constipation and fecal incontinence, their impact on the child and the family, as well as various treatment modalities available are discussed in this article, which also emphasizes the importance of history and physical examination.

  11. 慢性便秘伴发肛门直肠疼痛的全国多中心分层调查研究%Multi-centered stratified study of chronic constipation with anorectal pain in China

    Institute of Scientific and Technical Information of China (English)

    辛海威; 方秀才; 高峻; 刘诗; 肖英莲; 张军; 朱丽明; 王智凤; 柯美云

    2011-01-01

    Objective To investigate the prevalence of anorectal pain in chronic constipation (CO patients. Methods With multi-centered stratified questionnaires investigation,the face to face questionnaires investigation was carried out on the symptoms of constipation and intensity,frequency and duration of anorectal pain in CC patients. CC and anorectal pain was diagnosed according to Rome Ⅲ criteria. Results Total 921 CC patients were investigated,and 909 questionnaires were valid. Of those,there were 258 male cases and 651 female cases,the mean age was(48. 9±18. 7)years. About 15. 1%(137/909)CC patients reported anorectal pain in last six months;of those 26 cases(2. 9%)with chronic proctalgia(CP),111 cases(12. 2%)with proctalgia fugax(PF). The percentage of pain occurred frequently or regularly in CP and PF patients was 88. 5%(23/26)and 73. 9%(82/111)respectively. The pain of PF patients was milder than that of CP patients. The detection rate of CP was higher in tertiary hospitals than in primary cares(3. 6% vs 0. 6%,P= 0. 04). There was no significant difference of PF detection rate between different hospitals(P= 0. 09). The occurrence of pain was associated with anorectal symptoms,sleeping and psychosocial condition. Conclusions CC patients are frequently with anorectal pain and more common in female,which should cause extensive concern by physicians.If necessary,the prevalence of anorectal pain in general population as well as the mechanism of the symptom need further investigation.%目的 调查慢性便秘患者伴发肛门直肠疼痛情况.方法 采用全国多中心分层问卷调查,纳入慢性便秘患者后就便秘症状、肛门直肠疼痛程度、频率及持续时间等进行面对面问卷调查.慢性便秘与肛门直肠疼痛的判断均参考罗马Ⅲ诊断标准.结果 共凋查921例慢性便秘患者,有效问卷909份,其中男性258例、女性651例,平均年龄(48.9±18.7)岁.15.1%(137/909)的慢性便秘患者最近6个月有肛门直肠

  12. 王坤根教授诊治慢性便秘规律的数据挖掘研究%Study on Professor Wang Kungen's Therapeutic Principles in Treating Chronic Constipation Based on Data Mining

    Institute of Scientific and Technical Information of China (English)

    张弘; 叶姝均; 沈淑华

    2016-01-01

    [目的]利用数据挖掘技术探讨王坤根教授对慢性便秘的证治规律。[方法]建立王坤根教授2008年5月至2015年8月慢性便秘的门诊医案数据库,对数据规范化处理后进行频数分析、关联规则分析等数据挖掘研究。[结果]符合纳入、排除标准医案共207则,主要证型依次是胃肠积热证、肝郁脾虚证、阴液不足证和中气不足证,主要方剂依次是六磨汤、逍遥散、脾约丸和补中益气汤,方证间六磨汤与胃肠积热证、逍遥散与肝郁脾虚证、脾约丸与阴液不足证、补中益气汤与中气不足证存在较强的关联性,药对间生白术与大力子、生白术与生白芍、火麻仁与广木香、苍术与茯苓、桃仁与丹皮、莱菔子与枳壳存在较强关联性。[结论]慢性便秘的证型较为单一,泻热存津法、疏肝和胃法、健脾润肠法、补气行气法是王坤根治疗慢性便秘的主要治法。%Objective] To study Professor Wang Kungen's therapeutic principles in treating chronic constipation by data mining therapy. [Method]First, establish Wang Kungen's medical records database; then do data standardization and data mining. [Result]There are totally 207 cases that meet the demand. The major patterns of syndrome of CC in Professor Wang Kungen's medical records are as follows: gastrointestinal heat syndrome, stagnation of liver qi and spleen deficiency, Yin deficiency syndrome, Qi deficiency. The major prescriptions are as follows: Liumo Decoction, Xiao Yao San, Pi Yue Pill, Buzhong Yiqi decoction. There is close correlation between prescriptions and patterns as follows: gastrointestinal heat syndrome and Liumo Decoction; stagnation of liver qi and spleen deficiency and Xiao Yao San; Yin deficiency syndrome and Pi Yue Pill; Qi deficiency and Buzhong Yiqi decoction. There is close correlation between herbs as follows: rhizoma atractylodis macrocephalae and fructus arctii; rhizoma atractylodis macrocephalae

  13. Selenium and functional constipation in children

    OpenAIRE

    Marlina Tanjung; Supriatmo Supriatmo; Melda Deliana; Ade Rachmat Yudiyanto; Atan Baas Sinuhaji

    2016-01-01

    Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.Objective To determine the effect of selenium on functional constipation in children.Methods We conducte...

  14. Manometria anorretal em crianças com constipação intestinal crônica funcional refratária a tratamento Anorectal manometry in children with chronic functional intestinal constipation refractory to treatment

    Directory of Open Access Journals (Sweden)

    Danielle Aleixo O. Cruz

    2010-12-01

    Full Text Available OBJETIVO: Descrever os resultados da manometria anorretal dos pacientes com constipação intestinal crônica funcional (CICF, refratária aos tratamentos habituais, quanto ao tônus esfincteriano, presença do reflexo inibitório retoanal (RIRA, capacidade de expulsão do balão intrarretal e comportamento durante manobra evacuatória. MÉTODOS: Estudo retrospectivo por meio de análise de prontuários médicos entre janeiro de 2003 e junho de 2007, avaliando-se 31 pacientes ambulatoriais com CICF refratária a tratamentos convencionais por manometria anorretal com cateter de quatro canais (processador MPX 816 e software Proctomaster 5.0, Dynamed. RESULTADOS: Dos 31 pacientes, 24 (77% eram do sexo masculino. A idade média foi 8,9±2,6 anos. A média de pressão máxima fisiológica do canal anal foi 82±38mmHg. Dos 31 pacientes, 15 (48% apresentaram esfíncter anal normotônico e 16 (52%, hipertônico. O RIRA esteve presente em todos os casos. A prova de expulsão do balão intrarretal foi positiva em 12/31pacientes, sendo 4/12 com esfíncter normotônico e 8/12 com esfíncter hipertônico (p=0,22. Anismo foi detectado em 6/15 pacientes com esfíncter normotônico (40% e em 4/16 com esfíncter hipertônico (25% (p=0,45. CONCLUSÕES: Houve predomínio de esfíncter anal normotônico nos casos de CICF refratária. Pouco mais de 1/3 dos pacientes conseguiram a expulsão do balão durante a prova evacuatória, independentemente da tonicidade do esfíncter anal e cerca de metade dos pacientes apresentavam anismo sem relação com a tonicidade do esfíncter anal. A manometria anorretal é apropriada para o estudo da fisiologia e dinâmica evacuatória e pode ser útil para orientar o tratamento.OBJECTIVE: To evaluate anorectal manometry results in children with chronic functional intestinal constipation refractory to conventional treatment regarding mean anal sphincter resting pressure, presence of recto-anal inhibitory reflex (RAIR, expulsion

  15. Consumo de fibra alimentar por crianças e adolescentes com constipação crônica: influência da mãe ou cuidadora e relação com excesso de peso Dietary fiber intake for children and adolescents with chronic constipation: influence of mother or caretaker and relationship with overweight

    Directory of Open Access Journals (Sweden)

    Carolina Santos Mello

    2010-06-01

    Full Text Available OBJETIVO: Avaliar a influência da mãe ou da cuidadora sobre o consumo de fibra alimentar por crianças e adolescentes com constipação crônica bem como sua relação com a ocorrência de excesso de peso. MÉTODOS: Estudo transversal com 38 crianças e adolescentes com constipação funcional e suas respectivas cuidadoras. Para análise do consumo de fibra alimentar, foi utilizado o registro alimentar de três dias. Peso e estatura foram aferidos para verificar o estado nutricional. A história familiar de constipação foi investigada. RESULTADOS: A maioria dos pacientes com constipação (89,5%; 34/38 apresentava consumo insuficiente de fibra (inferior à idade +5g. Das 38 cuidadoras, apenas uma (2,6% apresentou ingestão de fibra superior à recomendação mínima (20g/dia. Excesso de peso foi encontrado em 28,9% (11/38 dos pacientes e em 60,5% (23/38 das suas responsáveis. Associação entre excesso de peso e presença de constipação foi verificada entre as cuidadoras (p=0,046. As crianças e adolescentes do sexo feminino com excesso de peso apresentaram menor ingestão de fibra, comparadas às sem excesso de peso (p=0,011. Nos pacientes do sexo masculino, essa associação não foi observada. O consumo de fibra pelas cuidadoras com excesso de peso foi inferior ao das demais (p=0,027. Observou-se correlação entre consumo de fibra pelas crianças com constipação e suas cuidadoras, nos sexos masculino (r=+0,561; p=0,005 e feminino (r=+0,782; pOBJECTIVE: To evaluate the influence of the mother or caretaker on the consumption of dietary fiber by children and adolescents with chronic constipation and its relationship with the occurrence of overweight. METHODS: This cross-sectional study enrolled 38 children and adolescents with functional constipation and their respective caretakers. A three-day food register was used for the analysis of the dietary fiber consumption. Weight and height were measured to verify the nutritional status

  16. Gastrointestinal bleeding due to large bowel infiltration by chronic lymphocytic leukaemia.

    OpenAIRE

    Tucker, J.; Cachia, P. G.

    1986-01-01

    A 66 year old woman with a 9 year history of chronic lymphocytic leukaemia developed intermittent rectal bleeding for 9 months; sigmoidoscopic biopsy proved that this was due to large bowel infiltration by leukaemia. This is a very rare occurrence.

  17. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose.

    Science.gov (United States)

    Compain, F; Bruneval, P; Jarraud, S; Perrot, S; Aubert, S; Napoly, V; Ramahefasolo, A; Mainardi, J-L; Podglajen, I

    2015-11-01

    Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist. PMID:26693025

  18. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose

    Science.gov (United States)

    Compain, F.; Bruneval, P.; Jarraud, S.; Perrot, S.; Aubert, S.; Napoly, V.; Ramahefasolo, A.; Mainardi, J.-L.; Podglajen, I.

    2015-01-01

    Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist. PMID:26693025

  19. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose

    Directory of Open Access Journals (Sweden)

    F. Compain

    2015-11-01

    Full Text Available Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist.

  20. Therapeutic Efficacy Observation on Acupoint Sticking for Edema Due to Chronic Cardiac Failure

    Institute of Scientific and Technical Information of China (English)

    Xu Jia-li

    2014-01-01

    Objective: To evaluate the therapeutic effect of acupoint sticking with Chinese herbs for edema due to chronic cardiac failure. Methods: One hundred and seventy patients in conformity with the diagnostic criteria of edema due to chronic cardiac failure were randomly divided into two groups, 85 cases in each group. The observation group was treated by oral administration of diuretics plus acupoint sticking with Chinese herbs. The control group was treated just by oral administration of diuretics same as the observation group. The therapeutic effects were evaluated after continuous intervention for 14 d. Results: The total effective rate was 90.6% in the observation group, remarkably higher than 67.1% in the control group. The difference of overall therapeutic effect between the two groups was statistically significant (P Conclusion: The therapeutic effect of acupoint sticking with Chinese herbs plus oral administration of diuretics is better than simple oral administration of diuretics in treatment of edema due to chronic cardiac failure.

  1. Refractory chronic cough due to gastroesophageal reflux: Definition, mechanism and management

    Science.gov (United States)

    Lv, Han-Jing; Qiu, Zhong-Min

    2015-01-01

    Refractory chronic cough due to gastroesophageal reflux is a troublesome condition unresponsive to the standard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management. PMID:26413488

  2. Pathophysiology of constipation in the older adult

    Institute of Scientific and Technical Information of China (English)

    G Lindsay McCrea; Christine Miaskowski; Nancy A Stotts; Liz Macera; Madhulika G Varma

    2008-01-01

    This review provides information on the definition of constipation,normal continence and defecation and a description of the pathophysiologic mechanisms of constipation.In addition,changes in the anatomy and physiology of the lower gastrointestinal tract associated with aging that may contribute to constipation are described.MEDLINE (1966-2007) and CINAHL (1980-2007) were searched.The following MeSH terms were used:constipation/etiology OR constipation/physiology OR constipation/physiopathology) AND (age factors OR aged OR older OR 80 and over OR middle age).Constipation is not well defined in the literature.While self-reported constipation increases with age,findings from a limited number of clinical studies that utilized objective measures do not support this association.Dysmotility and pelvic floor dysfunction are important mechanisms associated with constipation.Changes in GI function associated with aging appear to be relatively subtle based on a limited amount of conflicting data.Additional research is warranted on the effects of aging on GI function,as well as on the timing of these changes.

  3. Efecto de la ingesta de un preparado lácteo con fibra dietética sobre el estreñimiento crónico primario idiopático The effect of a fibre enriched dietary milk product in chronic primary idiopatic constipation

    Directory of Open Access Journals (Sweden)

    J. López Román

    2008-02-01

    Full Text Available Objetivo: Determinar si la administración de un preparado lácteo enriquecido con un suplemento de fibra soluble (Naturfibra®[inulina y maltodextrina resistente a la digestión (Fibersol 2®], afecta a la sintomatología en el estreñimiento crónico primario idiopático. Ámbito: Sujetos de ambos sexos con estreñimiento según los criterios de Roma II. Sujetos: Se trata de un ensayo clínico doble ciego aleatorizado de intervención dietética realizado en 32 individuos con estreñimiento de ambos sexos (hombres 4; mujeres 28 y con una edad media de 47 ± 15 años. Los 32 individuos que formaban la muestra, se dividieron al azar en dos grupos homogéneos. Intervenciones: A cada grupo se le asignó un tipo de leche (A o B, una de ellas era leche semidesnatada enriquecida con fibra (A y la otra leche semidesnatada (B. Los sujetos tomaron medio litro de leche diario durante 20 días, lo que supone que aquellos que tomaron la leche enriquecida ingirieron 20 gramos de fibra al día. Resultados: Los individuos que presentaban esfuerzo deposicional (p Background: fibre is effective in some types of constipation. Our objective was to determine if the administration of an enriched dairy preparation with a supplement of soluble fibre (Naturfibra® [inulin and digestion resistant maltodextrin (Fibersol 2®], improves primary chronic constipation. Methods: Prospective, randomized, double blind clinical trial randomized with dietary intervention in 32 subjects with constipation according to the Rome II criteria. Thirty two subjects (men 4; women 28 with an average age of 47 ± 15 years were randomly divided in two homogeneous groups. A type of milk (A or B was assigned to each group. Group A received fibre enriched semi-skimmed milk; Group B received semi skimmed milk. The subjects drank half a litre of milk per day during 20 days, meaning that those who drank the enriched milk ingested 20 grams of fibre a day. Result: The subjects that presented

  4. [Chronic bone pain due to raised FGF23 production? The importance of determining phosphate levels

    NARCIS (Netherlands)

    Jongh, R.T. de; Vervloet, M.G.; Bravenboer, N.; Heijboer, A.C.; Heijer, M. den; Lips, P.

    2013-01-01

    Hypophosphatemia is an important finding in the evaluation of patients with chronic bone pain. Fibroblast-growth factor 23 (FGF23) plays a role in the differential diagnosis of hypophosphatemia. A 34-year-old man had progressive pain in both shoulders and hips due to hypophosphatemic osteomalacia. H

  5. [Risk of acute hepatic insufficiency in children due to chronic accidental overdose of paracetamol (acetaminophen)

    NARCIS (Netherlands)

    Hameleers-Snijders, P.; Hogeveen, M.; Smeitink, J.A.M.; Kramers, C.; Draaisma, J.M.T.

    2007-01-01

    Two girls aged 4 and 3 years, respectively, experienced acute liver failure due to accidental ingestion of supratherapeutic doses of paracetamol (90 mg/kg/day or more). Recognition of chronic paracetamol intoxication as a cause of acute hepatic failure is often delayed. It is important to consider t

  6. Constipation and risk of Parkinson's disease

    DEFF Research Database (Denmark)

    Svensson, Elisabeth; Henderson, Victor W; Borghammer, Per;

    2016-01-01

    OBJECTIVES: To examine long-term associations between constipation and Parkinson's disease (PD) in men and women, we conducted a population-based cohort study using prospectively collected registry data on hospital contacts for constipation and PD, stratified by follow-up time and sex. METHODS: We...

  7. 慢性便秘患者生物反馈疗法的疗效预测因素分析%Predictors of efficacy of biofeedback therapy in patients with chronic constipation

    Institute of Scientific and Technical Information of China (English)

    李苗苗; 叶必星; 汤玉蓉; 王美峰; 田园; 张红杰; 李学良; 林琳

    2014-01-01

    目的 探讨慢性便秘(CC)患者生物反馈(BF)疗法的疗效预测因素.方法 对70例CC患者进行BF治疗,治疗前应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量汉化版简明健康调查量表(SF-36)及生活方式量表进行问卷调查,同时对患者进行肛门直肠测压.治疗前后通过症状积分量表评定患者5项主要症状,以治疗前后症状积分变化作为BF疗效判断指标,对治疗前采集的可能影响BF疗效的因素进行单因素、多因素分析,得出BF疗效的独立预测因素.结果 单因素分析结果显示,BF疗效与生活质量中的“生理职能”维度呈正相关(r=0.256,P=0.031),与SDS评分(r=-0.315,P=0.007)、初始感觉阈值(r=-0.278,P=0.020)呈负相关.多因素分析结果显示,SDS评分(β=-0.263,P=0.033)、初始感觉阈值(β=-0.281,P=0.013)是BF疗效的独立预测因素.结论 存在抑郁倾向、直肠低敏感的CC患者BF疗效较差,采用相应的治疗措施有助于优化BF疗效.%Objective To explore the anorectal physiology,psychological state,quality of life,lifestyle of patients with chronic constipation (CC) and evaluate the factors which potentially predict the efficacy of biofeedback therapy(BF).Methods Seventy CC patients receiving BF training were enrolled in this study.Anorectal physiology,Zung's Self-Rating Depression Scale (SDS),Zung's Self-Rating Anxiety Scale (SAS) and Chinese version of the MOS 36-item short form healthy survey(SF-36),lifestyle scale were recorded before BF training.A bowel symptom measurement including five major symptoms was recorded before and after BF training.The improvement in the symptom score was considered as criteria of clinical efficacy of BF therapy.Thirty-two possible influencing factors of efficacy of BF therapy were selected.Univariate analysis and multivariate analysis were conducted to assess the independent predictors.Results The results of univariate analysis showed that efficacy of BF therapy was

  8. 老年特发性便秘患者直肠肛门动力学变化及心理评价%CHANGES IN ANORECTAL DYNAMICS AND PSYCHOLOGICAL EVALUATION IN ELDERLY PATIENTS WITH CHRONIC IDIOPATHIC CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    高利利; 吴本俨; 邵勇; 李园

    2001-01-01

    To investigate what anorectal dynamic abnormality and psychological factors exits in elderly patients with chronic idiopathic constipation (CIC), study was performed in 59 elderly patients with CIC and 36 elderly healthy subjects(EHS).Anorectal pressure was measured with Medtronic PcPolygraf,which was a water perfused catheter system.All subjests completed a self-rated inventory assessing psychological distress including depression(SDS) and anxiety(SAS). Maximal squeezing pressure and the changes in anal pressure during defecation in elderly patients(EP) with CIC were lower than those in EHS(P<0.05).The rectal lowest volume of sensory threshold(RLSTV),the rectal threshold volume for desire to defecate and the rectal maximal volume of tolerance were higher in EP than those in EHS(P<0.05). There were 28(47.5%) of EP who had increasing anal pressure when defecation was stimulated.The scores of SDS and SAS were higher in EP than those in EHS(P<0.05). It suggested that elderly patients with CIC may be associated with lower sensitivity,higher tolerance and discoordination of annorectum during defecation.Both depression and anxiety were associated with abnormal dynamics in EP with CIC.%探讨老年慢性特发性便秘(CIC)患者直肠肛门运动功能变化及其与心理因素的关系。采用瑞典Medtronic公司生产的8通道水灌注式消化道压力检测系统、Zung抑郁自评量表(SDS)及焦虑自评量表(SAS)对59例患者及36例老年对照者进行直肠肛门压力测定及心理状况分析。结果发现,老年CIC患者最大缩榨压、模拟排便时肛管压力变化低于老年对照组(P<0.05),直肠初始感觉阈值、排便阈值和最大耐受容量均高于老年对照组(P<0.05),并有28例(47.5%)CIC患者模拟排便时出现肛管压力异常升高。老年CIC患者SDS、SAS标准总分均明显高于老年对照组(P<0.05)。说明老年CIC患者与直肠低敏感、高耐受及排便

  9. Constipation

    Science.gov (United States)

    ... the Lower GI Tract Diverticular Disease​ Hirschsprung Disease​​ Intestinal Pseudo-obstruction Irritable Bowel Syndrome Additional Languages This content is also available in: Spanish​​ Related Research See more about digestive diseases research at NIDDK​ . ...

  10. Constipation

    Science.gov (United States)

    ... and pinto beans) Dried fruits (such as prunes, apricots, and figs) Fresh fruits and vegetables (eat at ... other treatments, your doctor may also recommend: Prescription medicine, such as lubiprostone, to help relieve your symptoms ...

  11. Scintigraphic measurement of colonic transit in patients with idiopathic constipation

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, K. H.; Kim, C. K. [College of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    1999-07-01

    To evaluate usefulness of scintigraphic measurement of total and regional colonic transit in patients with idiopathic constipation. 25 patients who were complained chronic constipation underwent scintigraphic measurement of the total and regional colon transit. Of them 10 patients were diagnosed as idiopathic constipation, none of whom had evidence of abnormal function of the pelvic floor. Ten healthy volunteers were also studied. 67 Gallium-labelled Amberlite resin particles were ingested in a coated capsule with methacrylate that dispersed in the ileocecal region. Images were obtained using a gamma camera at regular intervals for the 2, 4, 8, 24, and 48 hours after the initial counting of the radioactivity in the cecum. We determined the geometric center in four regions of interest in the colon (ascending, transverse, descending, and rectosigmoid). Ten patients with colonic inertia showed significant retention of solid residue in the ascending and transverse colon over a 48-hour period. The median values for the healthy subjects at 2, 4, 8, and 24, and 48 hours were 1.44{+-}0.2 (midway through ascending), 1.71{+-}0.45 (midway through transverse), 2.64{+-}0.95 (midway through descending), 3.94{+-}0.89 (midway through rectosigmoid), and 4.52{+-}0.76 (midway through the stool compartment). On the contrary, the values of ten patients with colonic inertia were 1.0{+-}0.0 (midway through ascending), 1.0{+-}0.0 (midway through ascending). 1.02 {+-}0.06 (midway through ascending), 1.70{+-}0.36 (midway through transverse), and 2.33{+-}0.31(midway through descending) at the same time (p<0.001). In patients with idiopathic constipation is characterized by exaggerated reservoir factions of the ascending and transverse colons. Scintigraphy using 67 Gallium-labelled pellets seems to be a useful tool to demonstrate the delayed colonic transit in patients with colonic inertia.

  12. Methylnaltrexone: the evidence for its use in the management of opioid-induced constipation

    Directory of Open Access Journals (Sweden)

    Peter Deibert

    2009-12-01

    : Methylnaltrexone applied subcutaneously every other day may be given to patients suffering from chronic constipation due to opioid therapy for whom laxatives do not provide adequate relief of their symptoms.Keywords: constipation, methylnaltrexone, opioid-induced bowel dysfunction, opioid analgesics, chronic severe pain

  13. Nonpharmacologic Treatments for Childhood Constipation : Systematic Review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. ME

  14. Nonpharmacologic treatments for childhood constipation: systematic review

    NARCIS (Netherlands)

    M.M. Tabbers; N. Boluyt; M.Y. Berger; M.A. Benninga

    2011-01-01

    To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. We systematic

  15. Factor analysis identifies subgroups of constipation

    Institute of Scientific and Technical Information of China (English)

    Philip G Dinning; Mike Jones; Linda Hunt; Sergio E Fuentealba; Jamshid Kalanter; Denis W King; David Z Lubowski; Nicholas J Talley; Ian J Cook

    2011-01-01

    AIM: To determine whether distinct symptom groupings exist in a constipated population and whether such grouping might correlate with quantifiable pathophysiological measures of colonic dysfunction. METHODS: One hundred and ninety-one patients presenting to a Gastroenterology clinic with constipation and 32 constipated patients responding to a newspaper advertisement completed a 53-item, wide-ranging selfreport questionnaire. One hundred of these patients had colonic transit measured scintigraphically. Factor analysis determined whether constipation-related symptoms grouped into distinct aspects of symptomatology. Cluster analysis was used to determine whether individual patients naturally group into distinct subtypes. RESULTS: Cluster analysis yielded a 4 cluster solution with the presence or absence of pain and laxative unresponsiveness providing the main descriptors. Amongst all clusters there was a considerable proportion of patients with demonstrable delayed colon transit, irritable bowel syndrome positive criteria and regular stool frequency. The majority of patients with these characteristics also reported regular laxative use. CONCLUSION: Factor analysis identified four constipation subgroups, based on severity and laxative unresponsiveness, in a constipated population. However, clear stratification into clinically identifiable groups remains imprecise.

  16. Hirschsprungs Disease: a Clinical and Pathologic Study in Iranian Constipated Children

    Directory of Open Access Journals (Sweden)

    Mehrzad Mehdizadeh

    2011-09-01

    Full Text Available Objective:Hirschsprung's disease (HD is a complex disorder resulting from absence of ganglion cells in the bowel wall leading to functional obstruction and bowel dilatation proximal to the affected segment. The aim of our study was to evaluate rectal biopsies from constipated children in different age groups to see in which age it is more likely to encounter HD to avoid unnecessary rectal biopsy. Methods: Records of all children with chronic constipation undergoing a rectal biopsy to exclude HD were obtained from the files of Childrens Medical Center in Tehran, Iran. A detailed retrospective demographic review, including age of beginning of signs and symptoms was made of all cases. Findings: Totally, 172 biopsies were taken from 168 children in a five year period, of which 127 cases (75% had HD. The mean age of constipated patients at biopsy was 39 months and the mean age of patients with proven HD was 18 months. Males were affected more than females. Congenital anomalies associated with HD were found in 9.6%. In 85 (91% cases constipation had begun in neonatal period. Conclusion:Our data supports previous studies that if constipation begins after the neonatal period, the child is unlikely to have HD. In neonates delay in meconium passage is the most important clinical sign of HD.

  17. Metacognitions Are Associated with Subjective Memory Problems in Individuals on Sick Leave due to Chronic Fatigue

    Science.gov (United States)

    Jacobsen, Henrik B.; Aasvik, Julie K.; Borchgrevink, Petter C.; Landrø, Nils I.; Stiles, Tore C.

    2016-01-01

    Background: Subjective cognitive impairments are frequent, but poorly understood in patients with chronic fatigue. We hypothesized that maladaptive metacognitive beliefs at baseline were associated with baseline subjective cognitive impairments, that they predict subjective cognitive impairments at treatment termination, and that a reduction in maladaptive metacognitive beliefs was associated with less subjective cognitive impairments at treatment termination, independent of changes in fatigue, pain, insomnia, depression, and anxiety. Methods: In this non-controlled study, patients (n = 137) on sick leave due to chronic fatigue received a 3.5-week inpatient RTW rehabilitation program. Of these patients 69 (50.4%) was referred with a ICPC-2 diagnosis of chronic fatigue. Patients completed questionnaires about metacognitive beliefs, somatic complaints, psychological complaints, and cognitive impairments before and after treatment. To test the hypotheses we performed paired t-tests of change, as well as seven hierarchical linear regressions. Results: Results showed that baseline maladaptive metacognitive beliefs were significantly associated with subjective cognitive impairments at baseline, controlling for symptoms. Score on baseline metacognitive beliefs did not predict impairments post-treatment. Testing specific maladaptive beliefs, pre-treatment scores on cognitive confidence were associated with subjective cognitive impairments both pre and post-treatment, controlling for symptoms. Post-treatment metacognitive beliefs and post-treatment cognitive confidence were associated with post-treatment subjective cognitive impairments, controlling for pre-treatment impairments and pre-treatment metacognitive beliefs, as well as pre and post-scores on symptom measures. Conclusion: This study reports associations between maladaptive metacognitive beliefs and subjective cognitive impairments in patients with chronic fatigue. Targeting metacognitive beliefs could prove an

  18. [Calcium polycarbophil in clinical practice. The therapy of constipation].

    Science.gov (United States)

    Pallotta, N; Rubinetto, M P; Zaccaro, C; Gizzi, G; Villani, V; Barbara, L

    1993-12-01

    The clinical efficacy of polycarbophil calcium was assessed in 57 patients of both sexes aged between 18 and 77 years old affected by chronic non-organic constipation. The multicentre study was performed using a single blind and cross-over protocol for 8 weeks, 4 with placebo and 4 with the drug (2 c.p.s 3 t.i.d). Thirteen patients failed to complete the study, 8 of them for reasons not related to the drug. In comparison to placebo, the drug caused a significant reduction in the consistency of stool and evacuatory force during the first week of stool therapy. Medical judgement was that efficacy was "very good" in 73% and "good" in 18%, whereas the drug was thought to be "non efficacious" in 9% of cases. The statistical analysis of data confirmed the efficacy of the drug. The hematochemical parameters evaluated before, during and after treatment only showed a slight increase in calcemia and calciuria which did not reach statistical significance. The therapeutic efficacy and lack of undesired effects confirm the value of polycarbophyl calcium in the treatment of chronic constipation.

  19. Case study to evaluate a standing table for managing constipation.

    Science.gov (United States)

    Hoenig, H; Murphy, T; Galbraith, J; Zolkewitz, M

    2001-01-01

    Standing devices have been advocated as a potentially beneficial treatment for constipation in persons with spinal cord injury (SCI); however, definitive data are lacking. A case of a patient who requested a standing table to treat chronic constipation is presented as an illustration of a method to address this problem on an individual patient level. The patient was a 62-year-old male with T12-L1 ASIA B paraplegia who was injured in 1965. The patient was on chronic narcotics for severe, nonoperable shoulder pain. His bowel program had been inadequate to prevent impactions. A systematic approach was used to measure the effects of a standing table on frequency of bowel movements (BMs) and on length of bowel care episodes. There was a significant (p < 0.05) increase in frequency of BMs and a decrease in bowel care time with the use of the standing table 5 times/week versus baseline. For this patient, the use of the standing table was a clinically useful addition to his bowel care program. PMID:12035465

  20. Efficacy of Lactic Acid Bacteria (LAB supplement in management of constipation among nursing home residents

    Directory of Open Access Journals (Sweden)

    Kim Jung

    2010-02-01

    Full Text Available Abstract Background Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management of nursing home residents. Methods Nineteen subjects (8M, 11F; mean age 77.1 ± 10.1 suffering with chronic constipation were assigned to receive LAB (3.0 × 1011 CFU/g twice (to be taken 30 minutes after breakfast and dinner a day for 2 weeks in November 2008. Subjects draw up a questionnaire on defecation habits (frequency of defecation, amount and state of stool, and we collected fecal samples from the subjects both before entering and after ending the trial, to investigate LAB levels and inhibition of harmful enzyme activities. Results were tested with SAS and Student's t-test. Results Analysis of questionnaire showed that there was an increase in the frequency of defecation and amount of stool excreted in defecation habit after LAB treatment, but there were no significant changes. And it also affects the intestinal environment, through significantly increase (p p Conclusion LAB, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased defecation habit such as frequency of defecation, amount and state of stool. So, it may be used as functional probiotics to improve human health by helping to prevent constipation.

  1. Efficacy and complications of polyethylene glycols for treatment of constipation in children: a meta-analysis.

    Science.gov (United States)

    Chen, Si-Le; Cai, Shi-Rong; Deng, Liang; Zhang, Xin-Hua; Luo, Te-Dong; Peng, Jian-Jun; Xu, Jian-Bo; Li, Wen-Feng; Chen, Chuang-Qi; Ma, Jin-Ping; He, Yu-Long

    2014-10-01

    Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amounts from the gastrointestinal tract and routinely used to treat chronic constipation in adults. Here, we report the results of a meta-analysis of PEG-based laxatives compared with lactulose, milk of magnesia (magnesium hydroxide), oral liquid paraffin (mineral oil), or acacia fiber, psyllium fiber, and fructose in children. This meta-analysis was conducted in accordance with PRISMA guidelines and involved searches of MEDLINE, Cochrane, EMBASE, and Google Scholar databases up to February 10, 2014, using the keywords (Constipation OR Functional Constipation OR Fecal Impaction) AND (Children) AND (Polyethylene Glycol OR Laxative). Primary efficacy outcomes included a number of stool passages/wk and percentage of patients who reported satisfactory stool consistency. Secondary safety outcomes included diarrhea, abdominal pain, nausea or vomiting, pain or straining at defecation, bloating or flatulence, hard stool consistency, poor palatability, and rectal bleeding. We identified 231 articles, 27 of which were suitable for full-text review and 10 of which were used in the meta-analysis. Patients who were treated with PEG experienced more successful disimpaction compared with those treated with non-PEG laxatives. Treatment-related adverse events were acceptable and generally well tolerated. PEG-based laxatives are effective and safe for chronic constipation and for resolving fecal impaction in children. Children's acceptance of PEG-based laxatives appears to be better than non-PEG laxatives. Optimal dosages, routes of administration, and PEG regimens should be determined in future randomized controlled studies and meta-analyses. PMID:25310742

  2. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  3. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jia Wang

    2016-01-01

    Full Text Available No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR due to spinal cord injury (SCI. The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR urine volume (MD −109.44, 95% CI −156.53 to −62.35. Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38. No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.

  4. Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

    Science.gov (United States)

    Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

    2014-01-01

    The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

  5. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    Science.gov (United States)

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid. PMID:25415793

  6. A Case Report of Stercoraceous Perforation of the Cecum due to Scybalum

    Directory of Open Access Journals (Sweden)

    HR Khorshidi

    2006-10-01

    Introduction & Objective: Non-traumatic colon perforations are usually caused by malignancy, diverticulum and colitis. Stercoraceous perforation of the colon has rarely been reported in the literature. This lesion is assumed to be produced by the pressure from a hard scybalum resulting in a perforated ulcer with necrotic edges. We report a case of stercoraceous perforation of the cecum due to scybalum. Case: We report a 50-year-old man who had a severe abdominal pain from 3 days ago and had peritonitis in physical exam. He was admitted in Mars, 2005 at Mobasher Kashani Hospital in Hamadan and he was parapelegic from 8 months ago due to trauma in his medical history and then he had severe and chronic constipation that necessitated the use of cathartic drugs. We operated him with diagnosis of peritonitis, and perforation of cecum due to scybalum was seen and right hemicolectomy and colostomy and ileostomy was done. Conclusion: The most common site of colon perforation due to scybalum is rectosigmoid area and cecal perforation is a rare area in the literature. It is presented with peritonitis in old patients that have chronic constipation. It is difficult to diagnose this lesion preoperatively. This lesion was only 11% correctly diagnosed before operation and should be always suspected when a patient with chronic constipation suffers from sudden abdominal pain. Resection and colostomy is the treatment of choice in most situations.

  7. Generalised osteitis fibrosa cystica due to secondary hyperparathyroidism in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Sundar K Shrestha

    2014-01-01

    Full Text Available Secondary hyperparathyroidism is a frequent complication of patients with chronic kidney disease and is characterized by excessive serum parathyroid hormone levels and an imbalance in calcium and phosphorus metabolism. Secondary hyperparathyroidism is the leading cause of renal osteodystrophy and bone disease. Osteitis fibrosa cystica, the classic and former most common osteodystrophy, is mainly caused by high bone turnover secondary to high levels of circulating PTH. Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. This condition has a high impact on the mortality and morbidity of dialysis patients Hyperparathyroidism develops early in the course of CKD and becomes more prominent as kidney function declines. However recently, with the technical development of imaging and laboratory screening methods, hypercalcemia due to primary or secondary hyperparathyroidism can often be detected early; as a result the frequency of osteitis fibrosa cystica has declined. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 60-66 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9676

  8. Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.

    Science.gov (United States)

    Altintas, Nejat

    2016-01-01

    Long-term non-invasive positive pressure ventilation (NPPV) has widely been accepted to treat chronic hypercapnic respiratory failure arising from different etiologies. Although the survival benefits provided by long-term NPPV in individuals with restrictive thoracic disorders or stable, slowly-progressing neuromuscular disorders are overwhelming, the benefits provided by long-term NPPV in patients with chronic obstructive pulmonary disease (COPD) remain under question, due to a lack of convincing evidence in the literature. In addition, long-term NPPV reportedly failed in the classic trials to improve important physiological parameters such as arterial blood gases, which might serve as an explanation as to why long-term NPPV has not been shown to substantially impact on survival. However, high intensity NPPV (HI-NPPV) using controlled NPPV with the highest possible inspiratory pressures tolerated by the patient has recently been described as a new and promising approach that is well-tolerated and is also capable of improving important physiological parameters such as arterial blood gases and lung function. This clearly contrasts with the conventional approach of low-intensity NPPV (LI-NPPV) that uses considerably lower inspiratory pressures with assisted forms of NPPV. Importantly, HI-NPPV was very recently shown to be superior to LI-NPPV in terms of improved overnight blood gases, and was also better tolerated than LI-NPPV. Furthermore, HI-NPPV, but not LI-NPPV, improved dyspnea, lung function and disease-specific aspects of health-related quality of life. A recent study showed that long-term treatment with NPPV with increased ventilatory pressures that reduced hypercapnia was associated with significant and sustained improvements in overall mortality. Thus, long-term NPPV seems to offer important benefits in this patient group, but the treatment success might be dependent on effective ventilatory strategies. PMID:26418151

  9. Burden of physical inactivity and hospitalization costs due to chronic diseases

    Directory of Open Access Journals (Sweden)

    Renata Moraes Bielemann

    2015-01-01

    Full Text Available OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases.METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio(Brazil's National Household Sample Survey. The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to.RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%, whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions. Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity.CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.

  10. Multicenter clinical study on Fuzhenghuayu capsule against liver fibrosis due to chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    Ping Liu; Mo-Bin Wan; Xiong Cai; Zhi-Qing Zhang; Jun Ye; Ren-Xing Zhou; Jia He; Bao-Zhang Tang; Yi-Yang Hu; Cheng Liu; Lie-Ming Xu; Cheng-Hai Liu; Ke-Wei Sun; De-Chang Hu; You-Kuan Yin; Xia-Qiu Zhou

    2005-01-01

    AIM: To study the efficacy and safety of Fuzhenghuayu capsule (FZHY capsule, a capsule for strengthening body resistance to remove blood stasis) against liver fibrosis due to chronic hepatitis B. METHODS: Multicenter, randomized, double blinded and parallel control experiment was conducted in patients (aged from 18 to 65 years) with liver fibrosis due to chronic hepatitis B. Hepatic histologic changes and HBV markers were examined at wk 0 and 24 during treatment. Serologic parameters (HA, LM, P-Ⅲ-P, Ⅳ-C) were determined and B ultrasound examination of the spleen and liver was performed at wk 0, 12 and 24. Liver function (liver function and serologic parameters for liver fibrosis) was observedat wk 0, 6, 12, 18 and 24. Blood and urine routine test, renal function and ECG were examined before and after treatment. RESULTS: There was no significant difference between experimental group (110 cases) and control group (106 cases) in demographic features, vital signs, course of illness, history for drug anaphylaxis and previous therapy, liver function, serologic parameters for liver fibrosis, liver histologic examination (99 cases in experimental group, 96 cases in control group), HBV markers, and renal function. According to the criteria for liver fibrosis staging, meanscore of fibrotic stage(s) in experimental group after treatment (1.80) decreased significantly compared to the previous treatment (2.33, P<0.05), but there was no significant difference in mean score of fibrotic stage(s) (2.11 and 2.14 respectively). There was a significant difference in reverse rate between experimental group (52%) and control group (23.3%) in liver biopsy. With marked effect on decreasing the mean value of inflammatory activity and score of inflammation (P<0.05), Fuzhenghuayu capsule had rather good effects on inhibiting inflammatory activity and was superior to that of Heluoshugan capsule. Compared to that of pretreatment, there was a significant decrease in HA, LM, P-Ⅲ-P and

  11. Managing constipation in older people in hospital.

    Science.gov (United States)

    Wessel-Cessieux, Elizabeth

    Constipation is a distressing disorder that is common among older patients in hospital. It is often underdiagnosed and undertreated, and can lead to increased morbidity and prolonged hospital stays. In most cases this common problem can be treated successfully if the correct management plan is adopted. This article reviews the prevention and management strategies available to address the issue.

  12. Chronic suppurative joint effusion due to burkholderia pseudomallei: A case report

    Directory of Open Access Journals (Sweden)

    Madhavi Deshmukh

    2013-01-01

    Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. pseudomallei in the clinical laboratory is very difficult, owing to low awareness of physicians to the nonspecific clinical manifestations, lack of responsiveness among microbiologists outside endemic areas, identification systems in the average sentinel laboratory, and the biosafety conditions necessary to process these organisms. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography (CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Culture was confirmed as Burkholderia pseudomallei on Vitek2C, which was sensitive to ceftazidime and trimethoprim/sulfmethoxazole. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia. This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized.

  13. Lymph node enlargement in pulmonary arterial hypertension due to chronic thromboembolism

    International Nuclear Information System (INIS)

    The aim of this study was to determine the prevalence and location of enlarged mediastinal and hilar lymph nodes in patients with pulmonary arterial hypertension (PAH) due to chronic pulmonary thromboembolism (CPTE) and to identify possible causes. Thoracic CT images of 85 patients(43 men and 42 women, aged 18-80 years) with PAH in whom CPTE was confirmed at surgery (n = 75) or angiography and angioscopy (n = 10) were evaluated by two thoracic radiologists to determine the presence, size and location of lymph nodes more than 1 cm in the short axis. The presence of pleural and pericardial effusions and parenchymal abnormalities were also noted. Enlarged lymph nodes were identified in 38 patients (44.7%), including 11 with possible causes of lymphadenopathy other than CPTE. In the 27 patients with CPTE alone, 67 enlarged lymph nodes were detected (average 2.5 per patient). Nine patients had three or more enlarged lymph nodes. The most common sites of lymph node enlargement were American Thoracic Society locations 7 (n = 13), 6 (n = 10), 11L (n = 9), 10R (n = 7) and 4R (n = 7). Pleural and pericardial effusions were more common in patients with CPTE who also had lymphadenopathy than in the group with no lymphadenopathy (P < 0.05). Lymph node enlargement is common in patients with PAH caused by CPTE. The frequent association of lymphadenopathy with pleural and pericardial effusions suggest a possible pathophysiological mechanism of increased lymphatic flow caused by right heart failure.

  14. Paediatric and adult colonic manometry: A tool to help unravel the pathophysiology of constipation

    Institute of Scientific and Technical Information of China (English)

    Philip; G; Dinning; Marc; A; Benninga; Bridget; R; Southwell; S; Mark; Scott

    2010-01-01

    Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Co-lonic motor dysfunction remains the leading hypothesis to explain symptom generation in chronic constipation, a heterogeneous condition which is extremely prevalent in the general population, and has huge socioeconomic impact and individual suffering. Physiological testing plays a crucial role in patient management, as it is now accepted that symptom-based assessment, although im-portant, is unsat...

  15. Effect of interferon therapy on radionuclide imaging in chronic liver diseases due to HCV infection

    Energy Technology Data Exchange (ETDEWEB)

    Ghaffar, Y.; Dorgham, L.; Lotfy, N. [Ain Shams Univ., Imbaba, Giza (Egypt)]|[Menofia Unif., Shebin El Kom (Egypt)] [and others

    1995-09-01

    Interferon (alpha-IFN) exerts a modulating effect on the immune system. Kupffer cells of the liver play an important immunological role by their uptake of various agents and particles, including colloids. We sought to discover if alpha-IFN could enhance the colloid uptake function of the Kupffer cells. The effect of alpha-IFN therapy on radioisotope scans of the liver was studied in 20 patients with chronic liver disease due to hepatitic C virus (HCV) infection who received therapy at a dose of 3 million IU for 6 mo, in another patients who received the same therapy for 12 mo and in matched control groups (10 patients with HCV infection for each study group) who did not received alpha-IFN. A {sup 99m}Tc-sulfur colloid scan of the liver was obtained for each group before and after therapy and, for control subjects, at the start and end of the study periods. The liver-to-spleen geometric mean ratio of colloid uptake was assessed. In the first study group, the mean rate of improvement in the liver-to-spleen ratio was 48% in 70% of the patients, compared to 8% in 20% of controls (p<0.05). In the second study group, mean liver-to-spleen ratio was 88% in 85% of patients, compared to 12% in 40% of controls (p<0.001). Alpha-IFN therapy appears to enhance the colloidal uptake function of Kupffer cells, which adds a new dimension to the immunomodulatory effect of interferon. 13 refs., 2 tabs.

  16. 睡眠障碍和相关焦虑、抑郁对126例慢性便秘患者的影响%Impact of sleep disorders and related anxiety and depression on 126 patients with chronic constipation

    Institute of Scientific and Technical Information of China (English)

    姜亚; 汤玉蓉; 谢忱; 俞汀; 林琳

    2016-01-01

    P <0.05);而躯体症状、心理社会症状、满意度与 PAC-QOL 总分,两组比较差异均无统计学意义(P 均>0.05),睡眠障碍组 SF-36的7个维度得分均低于睡眠正常组(Z =-2.551、-2.959,t=-5.038,Z =-3.700、-3.328、-2.193、-3.475;P 均<0.05)。患者便秘症状(CSS)、便秘严重程度(PAC-SYM)、便秘相关生命质量(PAC-QOL)均与 GAD-7、PHQ-9评分呈正相关(P 均<0.05),健康相关生命质量(SF-36)与 GAD-7、PHQ-9评分呈负相关(P 均<0.05)。结论睡眠障碍和相关的焦虑、抑郁可能加重慢性便秘患者临床症状,并影响患者的疾病、健康相关生命质量。%Objective To investigate the impact of sleep disorders and related anxiety and depression on the somatic symptoms and quality of life (QOL)in patients with chronic constipation (CC). Methods From January 2014 to June 2015 ,adult outpatients with CC were enrolled.A questionnaire survey was conducted among them, including demographic information,constipation symptom, constipation scoring system (CSS),patient assessment of constipation symptom (PAC-SYM),Pittsburgh sleep quality index (PSQI),generalized anxiety disorder-7(GAD-7),patient health questionnaire-9 (PHQ-9),patient assessment of constipation quality of life (PAC-QOL)and 36-item short form of health survery (SF-36).According to PSQI scores,patients were divided into sleep-disorder group and normal-sleep group.The impact of sleep disorders on common symptoms,somatic symptoms,psychological condition and disease/health-related QOL was analyzed. Chi-square test, t test, nonparametric statistical comparison test and Spearman correlation analysis were used for statistical comparison between the two groups.Results In 126 CC patients,59 patients were in sleep-disorder group,67 patients were in normal-sleep group.The incidences of incomplete defection and feeling of anus blocking of sleep

  17. Impact on behavioral changes due to chronic use of sertraline in Wistar albino rats

    OpenAIRE

    Shatavisa Mukherjee; Sukanta Sen; Arunava Biswas; Tapan Kumar Barman; Santanu Kumar Tripathi

    2015-01-01

    Aim: Despite having better tolerability and a wide range of clinical applications over other antidepressants, selective serotonin reuptake inhibitors (SSRIs) are also known to be associated with serious adverse effects like suicidal ideation on chronic use. The present study had explored the impact of the chronic use of sertraline, an SSRI, on the behavioral changes in Wistar albino rats. Materials and Methods: The study was conducted on 30 Wistar albino rats of either sex; divided into f...

  18. Follow-up in Childhood Functional Constipation

    DEFF Research Database (Denmark)

    Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard;

    2015-01-01

    OBJECTIVES: Guidelines recommend close follow-up during treatment of childhood functional constipation. Only sparse evidence exists on how follow-up is best implemented. Our aim was to evaluate if follow-up by phone or self-management through web-based information improved treatment outcomes....... METHODS: In this randomized, controlled trial, conducted in secondary care, 235 children, aged 2-16 years, who fulfilled the Rome III criteria of childhood constipation, were assigned to one of three follow-up regimens: (I) control group (no scheduled contact), (II) phone group (2 scheduled phone contacts......) and (III) web group (access to web-based information). PRIMARY OUTCOME: number of successfully treated children after 3, 6, and 12 months. SECONDARY OUTCOMES: phone contacts, relapse, fecal incontinence, and laxative use. RESULTS: After 3 and 6 months, significantly more children in the web group (79...

  19. Colectomy for idiopathic slow transit constipation

    Institute of Scientific and Technical Information of China (English)

    童卫东; 刘宝华; 张胜本; 张连阳; 黄显凯

    2003-01-01

    Objective: To evaluate the intervention of colectomy on a group of patients with idiopathic slow transit constipation (STC).Methods: Thirty-four patients with STC, underwent colectomy during recent 10 years in our department, were subjected and followed for a mean length of 34 months, and their colon transits, defecograms, colonoscopic examination, sex hormone detection, and immunohistochemical studies were retrospectively reviewed.Results: The colonic transit time ranged from 96 to 240 h, with a mean time of 136 h.Eighty-five percent of patients (29/34) accompanied with outlet obstructed constipation, and 50% (17/34) showed abnormal sex hormone levels.Colectomy obtained satisfactory results in most patients, except one case of recurrence.Moreover, more neurons positive to nitric oxide synthase (NOS) and lesser to vasoactive intestinal polypeptide (VIP) were seen in the colonic myenteric plexus.Conclusion: Colectomy produces a satisfactory functional outcome in the majority of patients undergoing surgery for slow transit constipation, but accompanied pelvic dysfunction must be corrected simultaneously.

  20. Impact on behavioral changes due to chronic use of sertraline in Wistar albino rats

    Directory of Open Access Journals (Sweden)

    Shatavisa Mukherjee

    2015-01-01

    Full Text Available Aim: Despite having better tolerability and a wide range of clinical applications over other antidepressants, selective serotonin reuptake inhibitors (SSRIs are also known to be associated with serious adverse effects like suicidal ideation on chronic use. The present study had explored the impact of the chronic use of sertraline, an SSRI, on the behavioral changes in Wistar albino rats. Materials and Methods: The study was conducted on 30 Wistar albino rats of either sex; divided into five groups. Four groups were subjected to chronic mild stress induced by using various stressors randomly scheduled in a week and continued for a period of 3 weeks. The stressed rodents were subjected to sertraline treatment for 9 weeks in different human therapeutic doses extrapolated to animal doses. Behavioral changes were monitored, assessed, and evaluated throughout the treatment phase with the help of tests such as locomotor activity test, forced swim test, tail suspension test, antianxiety test, and sucrose preference test (SPT. Results: All tests except SPT, demonstrated significant (P < 0.05 reduction in depressive-like activity in the stressed rodents by the mid-treatment phase, followed by an abrupt onset of the depressive state by the end of the treatment phase. SPT showed a significant (P < 0.05 increase in sucrose consumption throughout the treatment phase. Conclusion: Behavioral changes following chronic sertraline administration conferred gradual remission of depression state on initial treatment phase, followed by a reversal of effect on chronic use.

  1. Chronic Foot Pain due to Pachyonychia Congenita in a Pediatric Patient: A Successful Management Strategy.

    Science.gov (United States)

    Tariq, Sarah; Schmitz, Michael L; Kanjia, Megha Karkera

    2016-05-15

    We report the case of an 11-year-old girl who presented to our multidisciplinary pain center with the chief complaint of chronic bilateral foot pain because of a rare congenital keratin disorder. This patient had been diagnosed with pachyonychia congenita, an extremely rare genetic disorder primarily affecting the skin and nails. The child had bilateral foot pain for years because of the characteristic blisters and calluses on the soles of her feet. Chronic pain was negatively impacting her quality of life; she was severely limited in her activities of daily living secondary to pain. Furthermore, she reported absenteeism from school, lack of social activities, and frequent nighttime awakenings. We discuss the successful management of her chronic foot pain using a multimodal, multidisciplinary approach. PMID:27182712

  2. Observation of Xuanyou decoction combined with Zengye decoction on exogenous - caused chronic functional constipation with YIN - deficiency type%宣幽汤合增液汤治疗外感引起阴虚型慢性功能性便秘临床观察

    Institute of Scientific and Technical Information of China (English)

    盛冬梅; 高长远; 程艳丽

    2012-01-01

    Objective To observe the effect of Xuanyou decoction combined with Zengye decoction on exogenous — caused chronic functional constipation ( CFC) with YIN — deficiency type, and effect of exogenous pathogenic factor on CFC. Methods 160 cases of CFC with YIN - deficiency type were randomly divided into two groups. Control group ( n = 78) received oral Zengye decoction. Treatment group received Xuanyou decoction combined with Zengye decoction. Quantify integral change of the main symptoms, export symptoms, obstructive symptoms, and systemic symptoms were compared before and after treatment in two groups after two courses. Results The total effective rate was 95. 1% in treatment group and 71. 8% in control group. There was significant difference between two groups (P <0. 05). There was significant difference between before and after treatment on quantify integral change of the main symptoms, export symptoms, obstructive symptoms, and systemic symptoms in two groups ( P < 0. 01 ). There was significant difference between two groups on quantify integral change of the main symptoms, export symptoms, obstructive symptoms, and systemic symptoms after treatment (P <0.05). Conclusion Xuanyou decoction combined with Zengye decoction has definite effect on exogenous — caused chronic functional constipation with YIN — deficiency type, has more significantly improvement in particular the main symptoms and export symptoms. Starting from the exogenous factors defibering exterior eil plays an important role on the treatment of CFC with YIN - deficiency type.%目的 观察宣幽汤合增液汤治疗外感引起阴虚型慢性功能性便秘(CFC)的临床疗效,并探讨外感因素对阴虚型CFC的影响.方法 将160例阴虚型CFC患者随机分为2组.对照组78例采用增液汤口服治疗;治疗组82例采用宣幽汤合增液汤口服治疗.均治疗2个疗程,比较2组治疗前后主症、出口症状、梗阻症状及全身症状的量化积分变化,

  3. Epidemiology of constipation in Europe and Oceania: a systematic review

    Directory of Open Access Journals (Sweden)

    Mourtzoukou Eleni

    2008-02-01

    Full Text Available Abstract Background We aimed to review the literature regarding the epidemiology of constipation in Europe and Oceania and the associated prevalence/risk factors. Methods Two reviewers performed PubMed searches and a hand search of references. A study was considered eligible for inclusion if it reported data about the prevalence of constipation in any population, free of other gastrointestinal disorders, in Europe and Oceania. Studies were evaluated for quality. Data regarding the setting, type of study, definition of constipation, study population, prevalence of constipation, factors associated with increased odds for constipation, and the female to male ratio, were collected. Results The 21 reviewed studies depict prevalence rates in 34 different population groups ranging widely from a low 0.7% to a high 81%. In the general population of Europe the mean value of the reported constipation rates is 17,1 % and the median value 16.6%. Among the studies conducted in Oceania, the mean value of constipation prevalence was 15.3%. Female gender, age and socioeconomic and educational class seem to have major effect on constipation prevalence. A number of various other risk factors are, less clearly, associated with constipation. Conclusion This systematic review depicts the high prevalence and related risk factors of a disorder that decreases the health-related quality of life and has major economic consequences.

  4. Does the chronic inflammatory demyelinating polyradiculoneuropathy due to secondary cause differ from primary?

    OpenAIRE

    Vaibhav Wadwekar; Jayantee Kalita; Usha Kant Misra

    2011-01-01

    Background: The clinical presentation, neurophysiological findings, and outcome may vary between primary and secondary chronic inflammatory demyelinating polyradiculopathy (CIDP). Objective: To compare clinical and electrodiagnostic features of primary and secondary CIDP. Setting: Tertiary care teaching referral hospital. Materials and Methods: The CIDP patients who were diagnosed as per European Federation of Neurological Societies/Peripheral Nerve Society criteria were included and subjecte...

  5. Clinical utility of naloxegol in the treatment of opioid-induced constipation

    Science.gov (United States)

    Bruner, Heather C; Atayee, Rabia S; Edmonds, Kyle P; Buckholz, Gary T

    2015-01-01

    Opioids are a class of medications frequently used for the treatment of acute and chronic pain, exerting their desired effects at central opioid receptors. Agonism at peripherally located opioid receptors, however, leads to opioid-induced constipation (OIC), one of the most frequent and debilitating side effects of prolonged opioid use. Insufficient relief of OIC with lifestyle modification and traditional laxative treatments may lead to decreased compliance with opioid regimens and undertreated pain. Peripherally acting mu-opioid receptor antagonists (PAMORAs) offer the reversal of OIC without loss of central pain relief. Until recently, PAMORAs were restricted to subcutaneous route or to narrow patient populations. Naloxegol is the first orally dosed PAMORA indicated for the treatment of OIC in noncancer patients. Studies have suggested its efficacy in patients failing traditional constipation treatments; however, insufficient evidence exists to establish its role in primary prevention of OIC at this time. PMID:26109876

  6. Atypical femoral fracture due to chronic use of bisphosphonates: case report☆

    Science.gov (United States)

    Temponi, Eduardo Frois; de Carvalho Junior, Lúcio Honório; Costa, Lincoln Paiva

    2015-01-01

    The causal relationship between chronic use of bisphosphonates and occurrences of atypical femoral fractures has not yet been established. Nonetheless, it is known that their chronic use is more related to fractures with a pattern differing from that of classical osteoporotic fractures. Atypical fractures are still rare events and the benefit from using bisphosphonates remains greater for prevention and treatment of osteoporosis. There are few studies guiding the diagnosis and management of these fractures, thus making it difficult to achieve better results. In this report, we present the case of an elderly patient with an atypical femoral fracture that was managed in accordance with guidance from the American Society for Bone and Mineral Research. PMID:26401508

  7. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    Science.gov (United States)

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation.

  8. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    Science.gov (United States)

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation. PMID:25362226

  9. Ambient carbon monoxide and the risk of hospitalization due to chronic obstructive pulmonary disease

    OpenAIRE

    Tian, L.; Ho, KF; Wang, T.; Qiu, H.; Pun, VC; Chan, CS; Louie, PKK; Yu, ITS

    2014-01-01

    Data from recent experimental and clinical studies have indicated that lower concentrations of inhaled carbon monoxide might have beneficial antiinflammatory effects. Inhaled carbon monoxide has the potential to be a therapeutic agent for chronic obstructive pulmonary diseases (COPD). However, population-based epidemiologic studies of environmentally relevant carbon monoxide exposure have generated mixed findings. We conducted a time-series study in Hong Kong to estimate the association of sh...

  10. Chronic intestinal pseudo-obstruction due to lymphocytic intestinal leiomyositis: Case report and literature review

    OpenAIRE

    Uchida, Keiichi; Otake, Kohei; Inoue, Mikihiro; Koike, Yuhki; Matsushita, Kohei; Araki, Toshimitsu; Okita, Yoshiki; Tanaka, Koji; UCHIDA, KATSUNORI; Yodoya, Noriko; Iwamoto, Shotaro; Arai, Katsuhiro; Kusunoki, Masato

    2012-01-01

    Lymphocytic intestinal leiomyositis is a rare entity, which causes chronic intestinal pseudo-obstruction (CIPO) in children. We present the first case of a boy who had pure red cell anemia 1 year before onset. Prolonged ileus developed after gastroenteritis and the patient was diagnosed using a biopsy of the intestinal wall. Findings from the present case indicate that there are three important factors for accurate diagnosis: history of enteritis, positive serum smooth muscle antibody, and ly...

  11. Generalised osteitis fibrosa cystica due to secondary hyperparathyroidism in chronic kidney disease

    OpenAIRE

    Sundar K Shrestha; A Tayal

    2014-01-01

    Secondary hyperparathyroidism is a frequent complication of patients with chronic kidney disease and is characterized by excessive serum parathyroid hormone levels and an imbalance in calcium and phosphorus metabolism. Secondary hyperparathyroidism is the leading cause of renal osteodystrophy and bone disease. Osteitis fibrosa cystica, the classic and former most common osteodystrophy, is mainly caused by high bone turnover secondary to high levels of circulating PTH. Its pathophysiology is m...

  12. Hematobiochemical and pathological alterations due to chronic chlorpyrifos intoxication in indigenous chicken

    Directory of Open Access Journals (Sweden)

    Shameem Ara Begum

    2015-01-01

    Results: A significant (P < 0.01 increase of Hb, TEC, TLC, and heterophil percent and decrease of lymphocyte percent was observed. Serum ALP, AST, ALT, and uric acid increased significantly and CHE values decreased significantly in CPF treated birds. The protein level remained similar. Uric acid level was found to be increased significantly in the treated group. The results indicate that chronic CPF intoxication produces hematological, biochemical, and pathological changes in treated birds.

  13. Renal Bleeding Due to Extramedullary Hematopoiesis in a Patient With Chronic Myelogenous Leukemia

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    Stephanie Zettner

    2014-11-01

    Full Text Available Chronic myelogenous leukemia (CML is a myeloproliferative disorder that normally presents in middle-aged adults. Renal infiltration and extramedullary hematopoiesis in renal tissue has been rarely reported. This case report presents a patient with CML and renal insufficiency who developed gross hematuria. Efforts at controlling the hematuria led to a cascade of events propelled by the underlying disorder that ultimately led to a radical nephrectomy, multiorgan failure, and prolonged hospitalization. We suggest that management of gross hematuria in clinically stable patients with CML, suspected of having extramedullary hematopoiesis, should prioritize treatment of the myeloproliferative disorder over efforts to control bleeding.

  14. How to Treat Pain in the Hepatic Region Due to Chronic Hepatitis?

    Institute of Scientific and Technical Information of China (English)

    林宗广

    2004-01-01

    @@ Chronic viral hepatitis type B and C both have the symptoms of pain in the hepatic region, asthenia, poor appetite, abdominal fullness, among which pain in the hepatic region is the most commonly seen. According to the author's clinical experience, treatment based on accurate TCM differentiation can not only eliminate pain in the hepatic region but also restore the hepatic function at the same time. Differentiation includes analysis of the nature of the hepatic pain and the accompanying symptoms, and the treatment is aimed at the differentiated symptoms. The following are methods of treatment.

  15. Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma

    Science.gov (United States)

    Weledji, Elroy P.; Elong, Adolphe; Verla, Vincent

    2014-01-01

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the underlying complexity of obstetric injury. As prevention is not always possible, immediate recognition and adequate primary treatment is of importance. PMID:24876506

  16. The Identification of Constipation Problem in Healthy Young Individuals

    Directory of Open Access Journals (Sweden)

    Nurcan Uysal

    2010-04-01

    Full Text Available AIM: This study was descriptively prepared to determine the rate of constipation in healthy young individuals according to Roma II criteria. METHOD: The study population consisted of students (n=284 who studied at Ege University, School of Nursing in the 2006-2007 academic year. Constipation Questionnaire and Bowel Habit Form-The Visual Scale Analog Questionnaire (VSAQ were used in order to collect data. According to the findings of VSAQ form that includes Roma II criteria for the diagnosis of constipation, students fulfilling any two of the criteria, was accepted as being constipated. Chi-Square test, Pearson Correlation and T-Test were used to analyze the data. RESULTS: In the study results, it was determined that 56.7% of all students accepted themselves as being constipated, 87.7% of them fulfilled at least two of the Roma II criteria, the prevalence of constipation was higher in students who stayed in dormitories and ate less fibrous foods (p0.05. The mean scores of straining, not being completely empty, sense of fullness and pain obtained from the VSAQ and the mean score of negative effect on daily life were found to be statistically different between students, who accepted themselves as being constipated and who did not (p<0.05. CONCLUSION: Higher rate of students fulfilling at least two of the criteria, the determination of the negative effect of the constipation on daily life, and the drug use for the treatment was considered that constipation is a problem which excessive emphasis should be put on. To relieve constipation, firstly high fibrous food and plentiful fluid consumption are suggested to the students. [TAF Prev Med Bull 2010; 9(2.000: 127-132

  17. Antineutrophil Cytoplasmic Antibody Induction due to Infection: A Patient with Infective Endocarditis and Chronic Hepatitis C.

    Science.gov (United States)

    Kamar, Fareed B; Hawkins, T Lee-Ann

    2016-01-01

    While antineutrophil cytoplasmic antibody (ANCA) is often used as a diagnostic marker for certain vasculitides, ANCA induction in the setting of infection is much less common. In the case of infective endocarditis, patients may present with multisystem disturbances resembling an autoimmune process, cases that may be rendered even trickier to diagnose in the face of a positive ANCA. Though not always straightforward, distinguishing an infective from an inflammatory process is pivotal in order to guide appropriate therapy. We describe an encounter with a 43-year-old male with chronically untreated hepatitis C virus infection who featured ANCA positivity while hospitalized with acute bacterial endocarditis. His case serves as a reminder of two of the few infections known to uncommonly generate ANCA positivity. We also summarize previously reported cases of ANCA positivity in the context of endocarditis and hepatitis C infections. PMID:27366166

  18. Cerebral blood flow and liver function in patients with encephalopathy due to acute and chronic liver diseases

    DEFF Research Database (Denmark)

    Almdal, T; Schroeder, T; Ranek, L

    1989-01-01

    The purpose of the present investigation was to study changes in cerebral blood flow (CBF) in hepatic encephalopathy, to ascertain whether this was related to the changes in liver function and whether these changes gave any prognostic information. CBF, determined by the intravenous xenon-133 method......, and liver functions, assessed by the prothrombin index, bilirubin concentration, and the galactose elimination capacity, were studied in patients with acute fulminant liver failure and in patients with encephalopathy due to chronic liver diseases--that is, cirrhosis of various etiologies. The CBF range...... any differences between patients with acute or chronic liver diseases or the different degrees of hepatic encephalopathy. In conclusion, a marked reduction of the CBF was seen in hepatic encephalopathy, irrespective of the etiology of the disease....

  19. Evaluation of chronic arsenic poisoning due to consumption of contaminated ground water in West Bengal, India

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    Asutosh Ghosh

    2013-01-01

    Full Text Available Background: Chronic arsenic poisoning is an important public health problem and most notable in West Bengal and Bangladesh. In this study different systemic manifestations in chronic arsenic poisoning were evaluated. Methods: A nonrandomized, controlled, cross-sectional, observational study was carried out in Arsenic Clinic, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, over a period of 1 year 4 months. Seventy-three cases diagnosed clinically, consuming water containing arsenic ≥50 μg/L and having hair and nail arsenic level >0.6 μg/L, were included. Special investigations included routine parameters and organ-specific tests. Arsenic levels in the drinking water, hair, and nail were measured in all. Twenty-five nonsmoker healthy controls were evaluated. Results: Murshidabad and districts adjacent to Kolkata, West Bengal, were mostly affected. Middle-aged males were the common sufferers. Skin involvement was the commonest manifestation (100%, followed by hepatomegaly [23 (31.5%] with or without transaminitis [7 (9.58%]/portal hypertension [9 (12.33%]. Restrictive abnormality in spirometry [11 (15.06%], bronchiectasis [4 (5.47%], interstitial fibrosis [2 (2.73%], bronchogenic carcinoma [2 (2.73%], oromucosal plaque [7 (9.58%], nail hypertrophy [10 (13.69%], alopecia [8 (10.95%], neuropathy [5 (6.84%], and Electrocardiography abnormalities [5 (6.84%] were also observed. Conclusions: Mucocutaneous and nail lesions, hepatomegaly, and restrictive change in spirometry were the common and significant findings. Other manifestations were characteristic but insignificant.

  20. Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis

    Institute of Scientific and Technical Information of China (English)

    Lei Shen; Ji-Qiang Li; Min-De Zeng; Lun-Gen Lu; Si-Tao Fan; Han Bao

    2006-01-01

    AIM: To evaluate the validity of ultrasonographic and pathologic diagnosis of liver fibrosis in patients with chronic viral hepatitis.METHODS: The liver fibrosis status in 324 patients was evaluated by both needle biopsy and ultrasonography.Liver fibrosis was divided into S0 -S4 stages. S4 stage was designated as definite cirrhosis. The ultrasonographic examination included qualitative variables, description of liver surface and parenchyma, and quantitative parameters, such as diameter of vessels, blood flow velocity and spleen size.RESULTS: Ultrasonographic qualitative description of liver surface and parenchyma was related with the severity of fibrosis. Among the quantitative ultrasonographic parameters, cut-off value of spleen length (12.1 cm) had a sensitivity of 0.600 and a specificity of 0.753 for diagnosis of liver cirrhosis. The diameters of spleen (8 mm) and portal vein (12 mm) had a diagnostic sensitivity of 0.600and 0.767, and a diagnostic specificity of 0.781 and 0.446,respectively. The diagnostic accuracy for liver cirrhosis was moderately satisfactory, and the negative predictive values of these parameters reached near 0.95.CONCLUSION: Ultrasonography can predict the degree of liver fibrosis or cirrhosis. A single ultrasonographic parameter is limited in sensitivity and specificity for the diagnosis of early cirrhosis. The presence or absence of liver cirrhosis in patients with chronic virus hepatitis can be detected using 2 or 3 quantitative and qualitative parameters, especially the length of spleen, the diameter of spleen vein and echo pattern of liver surface.

  1. A review and additional post-hoc analyses of the incidence and impact of constipation observed in darifenacin clinical trials

    Directory of Open Access Journals (Sweden)

    Tack J

    2012-09-01

    Full Text Available Jan Tack,1 Jean-Jacques Wyndaele,2 Greg Ligozio,3 Mathias Egermark41University of Leuven, Gastroenterology Section, Leuven, 2University of Antwerp, Department of Urology, Antwerp, Belgium; 3Novartis Pharmaceuticals Corporation, NJ, USA; 4Roche Diagnostics Scandinavia AB, Bromma, Sweden and formerly of Novartis Pharma AG, Basel, SwitzerlandBackground: Constipation is a common side effect of antimuscarinic treatment for overactive bladder (OAB. This review evaluates the incidence and impact of constipation on the lives of patients with OAB being treated with darifenacin.Methods: Constipation data from published Phase III and Phase IIIb/IV darifenacin studies were reviewed and analyzed. Over 4000 patients with OAB (aged 18–89 years; ≥80% female enrolled in nine studies (three Phase III [data from these fixed-dose studies were pooled and provide the primary focus for this review], three Phase IIIb, and three Phase IV. The impact of constipation was assessed by discontinuations, use of concomitant laxatives, patient-reported perception of treatment, and a bowel habit questionnaire.Results: In the pooled Phase III trials, 14.8% (50/337 of patients on darifenacin 7.5 mg/day and 21.3% (71/334 on 15 mg/day experienced constipation compared with 12.6% (28/223 and 6.2% (24/388 with tolterodine and placebo, respectively. In addition, a few patients discontinued treatment due to constipation (0.6% [2/337], 1.2% [4/334], 1.8% [4/223], and 0.3% [1/388] in the darifenacin 7.5 mg/day or 15 mg/day, tolterodine, and placebo groups, respectively, or required concomitant laxatives (3.3% [11/337], 6.6% [22/334], 7.2% [16/223], and 1.5% [6/388] in the darifenacin 7.5 mg/day or 15 mg/day, tolterodine, and placebo groups, respectively. Patient-reported perception of treatment quality was observed to be similar between patients who experienced constipation and those who did not. During the long-term extension study, a bowel habit questionnaire showed only small

  2. Histopathologic alterations associated with global gene expression due to chronic dietary TCDD exposure in juvenile zebrafish.

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    Qing Liu

    Full Text Available The goal of this project was to investigate the effects and possible developmental disease implication of chronic dietary TCDD exposure on global gene expression anchored to histopathologic analysis in juvenile zebrafish by functional genomic, histopathologic and analytic chemistry methods. Specifically, juvenile zebrafish were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb, and fish were sampled following 0, 7, 14, 28 and 42 d after initiation of the exposure. TCDD accumulated in a dose- and time-dependent manner and 100 ppb TCDD caused TCDD accumulation in female (15.49 ppb and male (18.04 ppb fish at 28 d post exposure. Dietary TCDD caused multiple lesions in liver, kidney, intestine and ovary of zebrafish and functional dysregulation such as depletion of glycogen in liver, retrobulbar edema, degeneration of nasal neurosensory epithelium, underdevelopment of intestine, and diminution in the fraction of ovarian follicles containing vitellogenic oocytes. Importantly, lesions in nasal epithelium and evidence of endocrine disruption based on alternatively spliced vasa transcripts are two novel and significant results of this study. Microarray gene expression analysis comparing vehicle control to dietary TCDD revealed dysregulated genes involved in pathways associated with cardiac necrosis/cell death, cardiac fibrosis, renal necrosis/cell death and liver necrosis/cell death. These baseline toxicological effects provide evidence for the potential mechanisms of developmental dysfunctions induced by TCDD and vasa as a biomarker for ovarian developmental disruption.

  3. Functional constipation in children: does maternal personality matter?

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    Khodjastejafari Saeedeh

    2009-08-01

    Full Text Available Abstract Aim To identify personality dimensions of mothers with a constipated child and compare it with those mothers of children without defecation problems. Methods We compared mothers of 150 children with functional constipation to mothers of 150 children with no such a problem attending to pediatric hospital of Tabriz University of medical sciences. Personality dimensions were evaluated by NEO five factor inventory after excluding any psychiatric disorders by an interview. Results Mean age (SD was 28.8(18.6 months in constipated children and 20.0(19.3 months in controls, 54.6% of constipated children and 56.7% of controls were male. Mean age (SD was 30.9(7.1 years in mothers of children with functional constipation and 30.1(7.6 years in controls. Mothers of children with functional constipation scored lower in neuroticism and scored higher in extraversion, conscientiousness and agreeableness. Conscientiousness was the dominant dimension of personality in both groups. Conclusion Our results suggest the maternal personality as a factor to directly influence toileting behavior of their children resulting in functional constipation.

  4. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult.

    Science.gov (United States)

    Mearin, Fermín; Ciriza, Constanza; Mínguez, Miguel; Rey, Enrique; Mascort, Juan José; Peña, Enrique; Cañones, Pedro; Júdez, Javier

    2016-06-01

    In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback

  5. Biomarkers to distinguish functional constipation from irritable bowel syndrome with constipation.

    Science.gov (United States)

    Whitehead, W E; Palsson, O S; Simrén, M

    2016-06-01

    Treatments for functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) differ, but symptom criteria do not reliably distinguish between them; some regard FC and IBS-C as parts of a single constipation spectrum. Our goal was to review studies comparing FC and IBS-C to identify possible biomarkers that separate them. A systematic review identified 15 studies that compared physiologic tests in FC vs IBS-C. Pain thresholds were lower in IBS-C than FC for 3/5 studies and not different in 2/5. Colonic motility was decreased more in FC than IBS-C for 3/3 studies, and whole gut transit was delayed more in FC than IBS-C in 3/8 studies and not different in 5/8. Pelvic floor dyssynergia was unrelated to diagnosis. Sympathetic arousal, measured in only one study, was greater in IBS-C than FC. The most reliable separation of FC from IBS-C was shown by a novel new magnetic resonance imaging technique described in this issue of the journal. These authors showed that drinking one liter of polyethylene glycol laxative significantly increased water content in the small intestine, volume of contents in the ascending colon, and time to first evacuation in FC vs IBS-C; and resulted in less colon motility and delayed whole gut transit in FC compared to IBS-C. Although replication is needed, this well-tolerated, non-invasive test promises to become a new standard for differential diagnosis of FC vs IBS-C. These data suggest that FC and IBS-C are different disorders rather than points on a constipation spectrum. PMID:27214096

  6. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult.

    Science.gov (United States)

    Mearin, Fermín; Ciriza, Constanza; Mínguez, Miguel; Rey, Enrique; Mascort, Juan José; Peña, Enrique; Cañones, Pedro; Júdez, Javier

    2016-06-01

    In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback

  7. Chronic somatic comorbidity and excess mortality due to natural causes in persons with schizophrenia or bipolar affective disorder.

    Directory of Open Access Journals (Sweden)

    Thomas Munk Laursen

    Full Text Available BACKGROUND: Suicide and death by accidents in persons with schizophrenia and bipolar disorder are common, but excess mortality from natural death accounts for even more years of life lost. The impact of somatic comorbidity, however, often is not duly considered in analyses and explanations of excess mortality in patients with psychotic disorders. OBJECTIVE/METHODS: This study investigates and evaluates the impact of 19 severe chronic diseases on excess mortality due to diseases and medical conditions (natural death in individuals with psychotic disorders compared with the general population using a population-based cohort study in Denmark. Incidence/mortality rate ratios of admission/mortality were calculated using survival analysis. RESULTS: Cohort members with psychotic disorders had higher incidence rates of hospital contacts for almost all of the 19 disorders than the general population. The mortality rate ratio (MRR of natural death was 7.10 (95% CI 6.45, 7.81 for schizophrenic men, decreasing to 4.64 (95% CI 4.21, 5.10 after adjustment for the somatic disorders. The same pattern existed in women and in both genders with bipolar disorder. Highest MRRs were observed for psychotic patients without hospital admissions with the investigated somatic disorders. CONCLUSION: Chronic somatic diseases accounted for half of the excess mortality in patients with schizophrenia or bipolar disorder. Chronic disorders investigated in this paper seem to be under-treated or under-detected among such patients.

  8. Characteristics of Children Admitted to Hospital for Constipation

    Directory of Open Access Journals (Sweden)

    Sevim Savaşer

    2011-12-01

    Full Text Available Introduction: The aim of this study was to determine the sociodemographic characteristics of children with constipation, the causes of constipations in these children and the common practices of the parents to solve the problem of constipation.Materials and Methods: The population of the study was comprised of children aged 1 to 16 years followed with the diagnosis of functional constipation in the outpatient clinics of pediatric surgery at a university hospital in Istanbul between 1 June 2009-1 June 2010. A total of 146 children and their parents who agreed to participate in the study were included. The data of this descriptive cross-sectional study were obtained by using a questionnaire which was evaluated by appropriate statistical analysis.Results: About half of the children in the study were between 1-3 years old and females. We detected that in approximately half of the children constipation problem began during transition period from solid foods before age 1. The majority of children experienced abdominal pain, bloating, stool retention, fear and anxiety during bowel movements, hard/painful defecation, increased stool volume and fecal mass; and that though it varied according to age groups, most of the children drank olive oil and fruit juice to overcome constipation. Families of children in all age groups affected in similar proportions by constipation problem and this problem did not affect sibling relations.Discussion: Risk factors for constipation were found to be under 4 years of age, starting additional/solid foods before 6 months, starting school, having family members with constipation, feeling fear and anxiety during defecation and having symptoms arising from stool retention such as abdominal pain, abdominal bloating, and hard and painful defecation. (Journal of Current Pediatrics 2011; 9: 103-9

  9. Does the chronic inflammatory demyelinating polyradiculoneuropathy due to secondary cause differ from primary?

    Directory of Open Access Journals (Sweden)

    Vaibhav Wadwekar

    2011-01-01

    Full Text Available Background: The clinical presentation, neurophysiological findings, and outcome may vary between primary and secondary chronic inflammatory demyelinating polyradiculopathy (CIDP. Objective: To compare clinical and electrodiagnostic features of primary and secondary CIDP. Setting: Tertiary care teaching referral hospital. Materials and Methods: The CIDP patients who were diagnosed as per European Federation of Neurological Societies/Peripheral Nerve Society criteria were included and subjected to detailed history and examinations. The clinical disability was graded on a 0-10 scale. Neurophysiology included motor and sensory nerve conductions and F wave studies of all four limbs. Based on investigations for underlying diseases, the patients were categorized into primary or secondary CIDP. Prednisolone was prescribed in all and azathioprine added in resistant cases. The secondary CIDP group received specific treatment in addition. The outcome was assessed at 3 months, 6 months, and last follow-up. Results: A total of 65 patients aged 17 to 72 years were included and 20 were females. Twenty-five patients had secondary CIDP and include diabetes mellitus (16, POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (4, monoclonal gammopathy of undetermined significance (2, myeloma (1, lymphoma (1, and malignancy (1. The secondary CIDP patients were older (48.35 vs 41.0 years, had less relapsing remitting (0 vs 6 and more frequent dysautonomia (7 vs 1. The demyelinating features were more marked in primary CIDP group and had better outcome compared with secondary CIDP. Conclusions: Of the total patients with CIDP, 38.5% of patients had secondary CIDP which was associated with progressive course, less demyelinating features, and worse prognosis.

  10. Recurrent Chronic Ambulatory Peritoneal Dialysis-Associated Infection due to Rothia dentocariosa

    Directory of Open Access Journals (Sweden)

    Shaun K Morris

    2004-01-01

    Full Text Available Rothia dentocariosa is a commensal organism of the human oropharynx. Clinical infection due to this organism is rare. A case of recurrent peritoneal dialysis-related peritonitis caused by R dentocariosa and a review of the literature is reported. Isolation of R dentocariosa from dialysate fluid should not be dismissed as a contaminant. Although there are no interpretive criteria for antimicrobial susceptibility testing, R dentocariosa appears to be susceptible to a variety of antibiotics including beta-lactams, vancomycin and aminoglycosides. Optimal therapy of peritoneal dialysis peritonitis caused by this organism may also require removal of the catheter.

  11. Gene expression and pathologic alterations in juvenile rainbow trout due to chronic dietary TCDD exposure

    International Nuclear Information System (INIS)

    Highlights: •First report of the effects of dietary TCDD in juvenile trout smaller than 20 g. •TCDD uptake was estimated using published models and confirmed by GC. •First report of dietary TCDD-induced lesions in nasal epithelium in any species. •Several useful biomarkers are identified from microarray-based transcriptomics analysis. -- Abstract: The goal of this project was to use functional genomic methods to identify molecular biomarkers as indicators of the impact of TCDD exposure in rainbow trout. Specifically, we investigated the effects of chronic dietary TCDD exposure on whole juvenile rainbow trout global gene expression associated with histopathological analysis. Juvenile rainbow trout were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb (ng TCDD/g food), and fish were sampled from each group at 7, 14, 28 and 42 days after initiation of feeding. 100 ppb TCDD caused 100% mortality at 39 days. Fish fed with 100 ppb TCDD food had TCDD accumulation of 47.37 ppb (ng TCDD/g fish) in whole fish at 28 days. Histological analysis from TCDD-treated trout sampled from 28 and 42 days revealed that obvious lesions were found in skin, oropharynx, liver, gas bladder, intestine, pancreas, nose and kidney. In addition, TCDD caused anemia in peripheral blood, decreases in abdominal fat, increases of remodeling of fin rays, edema in pericardium and retrobulbar hemorrhage in the 100 ppb TCDD-treated rainbow trout compared to the control group at 28 days. Dose- and time-dependent global gene expression analyses were performed using the cGRASP 16,000 (16K) cDNA microarray. TCDD-responsive whole body transcripts identified in the microarray experiments have putative functions involved in various biological processes including growth, cell proliferation, metabolic process, and immune system processes. Nine microarray-identified genes were selected for QPCR validation. CYP1A3 and CYP1A1 were common up-regulated genes and HBB1 was a common down

  12. Gene expression and pathologic alterations in juvenile rainbow trout due to chronic dietary TCDD exposure

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Qing [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); School of Freshwater Sciences, University of Wisconsin-Milwaukee, 600 E Greenfield Ave, Milwaukee, WI 53204 (United States); Rise, Matthew L. [Ocean Sciences Centre, Memorial University of Newfoundland, 1 Marine Lab Road, St. John' s, NL, A1C 5S7 (Canada); Spitsbergen, Jan M. [Department of Microbiology, Oregon State University, 220 Nash Hall, Corvallis, OR 97331 (United States); Hori, Tiago S. [Ocean Sciences Centre, Memorial University of Newfoundland, 1 Marine Lab Road, St. John' s, NL, A1C 5S7 (Canada); Mieritz, Mark; Geis, Steven [Wisconsin State Laboratory of Hygiene, 465 Henry Mall, Madison, WI 53706 (United States); McGraw, Joseph E. [School of Pharmacy, Concordia University Wisconsin, 12800 North Lake Shore Drive, Mequon, WI 53097 (United States); Goetz, Giles [School of Aquatic and Fishery Sciences, University of Washington, 1122 Northeast Boat Street, Seattle, WA 98195 (United States); Larson, Jeremy; Hutz, Reinhold J. [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); Carvan, Michael J., E-mail: carvanmj@uwm.edu [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); School of Freshwater Sciences, University of Wisconsin-Milwaukee, 600 E Greenfield Ave, Milwaukee, WI 53204 (United States)

    2013-09-15

    Highlights: •First report of the effects of dietary TCDD in juvenile trout smaller than 20 g. •TCDD uptake was estimated using published models and confirmed by GC. •First report of dietary TCDD-induced lesions in nasal epithelium in any species. •Several useful biomarkers are identified from microarray-based transcriptomics analysis. -- Abstract: The goal of this project was to use functional genomic methods to identify molecular biomarkers as indicators of the impact of TCDD exposure in rainbow trout. Specifically, we investigated the effects of chronic dietary TCDD exposure on whole juvenile rainbow trout global gene expression associated with histopathological analysis. Juvenile rainbow trout were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb (ng TCDD/g food), and fish were sampled from each group at 7, 14, 28 and 42 days after initiation of feeding. 100 ppb TCDD caused 100% mortality at 39 days. Fish fed with 100 ppb TCDD food had TCDD accumulation of 47.37 ppb (ng TCDD/g fish) in whole fish at 28 days. Histological analysis from TCDD-treated trout sampled from 28 and 42 days revealed that obvious lesions were found in skin, oropharynx, liver, gas bladder, intestine, pancreas, nose and kidney. In addition, TCDD caused anemia in peripheral blood, decreases in abdominal fat, increases of remodeling of fin rays, edema in pericardium and retrobulbar hemorrhage in the 100 ppb TCDD-treated rainbow trout compared to the control group at 28 days. Dose- and time-dependent global gene expression analyses were performed using the cGRASP 16,000 (16K) cDNA microarray. TCDD-responsive whole body transcripts identified in the microarray experiments have putative functions involved in various biological processes including growth, cell proliferation, metabolic process, and immune system processes. Nine microarray-identified genes were selected for QPCR validation. CYP1A3 and CYP1A1 were common up-regulated genes and HBB1 was a common down

  13. Biofeedback treatment in chronically constipated patients with dyssynergic defecation

    Directory of Open Access Journals (Sweden)

    Miguel A. Simón

    2011-01-01

    Full Text Available El objetivo de este estudio fue evaluar los efectos del entrenamiento en biofeedback-EMG en pacientes con estreñimiento crónico debido a defecación disinérgica. Con este propósito, 10 pacientes (4 varones, 6 mujeres con defecación disinérgica que no respondían a correcciones dietéticas y suplementos de fibra, fueron seleccionados e incluidos en el estudio sobre la base de cumplir los criterios Roma III para el diagnóstico de este trastorno funcional gastrointestinal. El estudio se llevó a cabo a lo largo de una serie de fases definidas: evaluación psicofisiológica y clínica previa al tratamiento (4 semanas, tratamiento por medio de biofeedback-EMG (8 sesiones, a razón de dos sesiones semanales y seguimiento (4 semanas un mes más tarde. En todas las fases, cuatro variables clínicas fueron evaluadas a través de autorregistro (frecuencia de defecaciones semanales, sensación de evacuación incompleta, nivel de dificultad de la evacuación y dolor perianal en la defecación; además, se obtuvieron medidas psicofisiológicas a través de electromiografía (EMG del esfínter anal externo. Los resultados muestran mejoras significativas en las medidas psicofisiológicas (actividad-EMG durante el esfuerzo para defecar e índice de anismus, así como en las variables clínicas. Los beneficios del biofeedback se mantuvieron en el período de seguimiento.

  14. Multi-scale predictions of massive conifer mortality due to chronic temperature rise

    Science.gov (United States)

    McDowell, Nathan G.; Williams, A.P.; Xu, C.; Pockman, W. T.; Dickman, L. T.; Sevanto, S.; Pangle, R.; Limousin, J.; Plaut, J.J.; Mackay, D.S.; Ogee, J.; Domec, Jean-Christophe; Allen, Craig D.; Fisher, Rosie A.; Jiang, X.; Muss, J.D.; Breshears, D.D.; Rauscher, Sara A.; Koven, C.

    2015-01-01

    Global temperature rise and extremes accompanying drought threaten forests and their associated climatic feedbacks. Our ability to accurately simulate drought-induced forest impacts remains highly uncertain in part owing to our failure to integrate physiological measurements, regional-scale models, and dynamic global vegetation models (DGVMs). Here we show consistent predictions of widespread mortality of needleleaf evergreen trees (NET) within Southwest USA by 2100 using state-of-the-art models evaluated against empirical data sets. Experimentally, dominant Southwest USA NET species died when they fell below predawn water potential (Ψpd) thresholds (April–August mean) beyond which photosynthesis, hydraulic and stomatal conductance, and carbohydrate availability approached zero. The evaluated regional models accurately predicted NET Ψpd, and 91% of predictions (10 out of 11) exceeded mortality thresholds within the twenty-first century due to temperature rise. The independent DGVMs predicted ≥50% loss of Northern Hemisphere NET by 2100, consistent with the NET findings for Southwest USA. Notably, the global models underestimated future mortality within Southwest USA, highlighting that predictions of future mortality within global models may be underestimates. Taken together, the validated regional predictions and the global simulations predict widespread conifer loss in coming decades under projected global warming.

  15. Tuina Intervention and Sleep and Emotional Disorders due to Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    戴德纯; 房敏; 严隽陶; 姜淑云; 刘鲲鹏

    2009-01-01

    目的:探讨慢性疲劳综合征患者的睡眠障碍和情绪特征及推拿的调节作用.方法:将30例慢性疲劳综合征患者作为治疗组,给予推拿治疗,手法以一指禅推法、滚法和按揉法为主;部位以督脉、膀胱经、阳明经为主,主穴取风府、腰阳关、心俞、脾俞、肝俞、合谷、太溪;隔日治疗1次,共治疗10次.30例正常人为对照组,不予任何处理.借助匹兹堡睡眠质量指数(PSQI)、Hamilton焦虑量表(HAMA)、Hamilton抑郁量表(17项)(HAMD)测量工具评估两组患者的睡眠质量和精神状态,并观察推拿治疗前、后治疗组患者相应量表的积分变化.结果:治疗组治疗前PSQI总分、睡眠质量、入睡时间、睡眠效率、睡眠障碍和日间功能障碍以及HAMD和HAMA积分均显著高于对照组,差异有统计学显著性意义(P<0.01);10次推拿治疗后,治疗组PSQI总分、入睡时间、睡眠障碍和日间功能障碍4项评分及HAMD、HAMA积分有显著变化,与治疗前比较,差异有统计学意义(P<0.05).结论:慢性疲劳综合征患者存在睡眠障碍及精神心理异常;中医推拿可提高慢性疲劳综合征患者睡眠质量,调整异常精神心理状态.%Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes

  16. A Case of Recurrent Hemorrhages due to a Chronic Expanding Encapsulated Intracranial Hematoma

    Directory of Open Access Journals (Sweden)

    Akiko Marutani

    2015-09-01

    Full Text Available Few case reports of encapsulated intracranial hematoma (EIH exist, and the mechanisms underlying the onset and enlargement of EIH remain unclear. Here, we report on a 39-year-old woman with an EIH that repeatedly hemorrhaged and swelled and was ultimately surgically removed. In June 2012, the patient visited her local doctor, complaining of headaches. A magnetic resonance imaging (MRI scan identified a small hemorrhage of approximately 7 mm in her right basal ganglia, and a wait-and-see approach was adopted. Six months later, her headaches recurred. She was admitted to our department after MRI showed tumor lesions accompanying the intermittent hemorrhaging in the right basal ganglia. After admission, hemorrhaging was again observed, with symptoms progressing to left-sided hemiplegia and fluctuating consciousness; thus, a craniotomy was performed. No obvious abnormal blood vessels were observed on the preoperative cerebral angiography. We accessed the lesion using a transcortical approach via a right frontotemporal craniotomy and removed the subacute hematoma by extracting the encapsulated tumor as a single mass. Subsequent pathological examinations showed that the hematoma exhibited abnormal internal vascularization and was covered with a capsule formed from growing capillaries and accumulating collagen fibers, suggesting that it was an EIH. No lingering neurological symptoms were noted upon postoperative follow-up. This type of hematoma expands slowly and is asymptomatic, with reported cases consisting of patients that already have neurological deficits due to progressive hematoma growth. Our report is one of a few to provide a clinical picture of the initial stages that occur prior to hematoma encapsulation.

  17. Ovarian strumal carcinoid presenting as severe progressive constipation

    OpenAIRE

    Kachhawa, G; Kumar, S.; Singh, G; Mathur, S; Kumar, L.; J Sharma

    2011-01-01

    Strumal carcinoid develops in a germ cell tumor characterized by an intimate mixture of thyroid and carcinoid. Unlike other carcinoid tumors, most patients with strumal carcinoid have no symptoms of carcinoid syndrome; few are reported to cause severe constipation. We report a case of a 60-year-old female patient presenting with severe progressive constipation and painful defecation for last few years. A right ovarian tumor was discovered during clinical examination. CT scan revealed a large ...

  18. Factors with to intestinal constipation in the rural area elderly

    OpenAIRE

    Sara Franco Diniz Heitor; Leiner Resende Rodrigues; Flávia Aparecida Dias; Nayara Paula Fernandes Martins; Darlene Mara dos Santos Tavares

    2013-01-01

    The objective of this study was to identify the prevalence of intestinal constipation in the rural area elderly and verify the factors associated. This is a home survey performed with 850 elderly residents of the rural area of Uberaba, Minas Gerais state. A structured instrument was used; information regarding their eating habits was obtained using an adapted questionnaire for food consumption frequency, and intestinal constipation was self-reported. Descriptive analysis, chi-square test and ...

  19. Decreased colonic mucus in rats with loperamide-induced constipation.

    Science.gov (United States)

    Shimotoyodome, A; Meguro, S; Hase, T; Tokimitsu, I; Sakata, T

    2000-06-01

    Constipation is a risk factor of colorectal cancer. Mucin is a major component of lumenal mucus, which protects the colorectal mucosa against mechanical and chemical damage. The aim of this study was to evaluate mucus production and to quantitate lumen mucus in a rat model of spastic constipation. We induced constipation with loperamide (1.5 mg/kg), and histochemically evaluated mucus production and the thickness of the mucus layer at the fecal surface. We quantitated the mucus attached to the mucosal surface using colonic perfusion with N-acetylcysteine. While more feces remained in the colon, there was less fecal excretion and lower fecal water content in loperamide-administered rats than in control rats. Crypt epithelial cells contained less mucus in constipated rats than in control rats. The mucus layer at the fecal surface was thinner and less mucus was recovered from the mucosal surface in constipated rats than in control rats. Mucus production of crypt epithelial cells and mucus at the fecal and mucosal surface were reduced by loperamide-induced constipation.

  20. Efficacy of polyethylene glycol 4000 on constipation of posttraumatic bedridden patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lian-yang; YAO Yuan-zhang; WANG Tao; FEI Jun; SHEN Yue; CHEN Yong-hua; ZONG Zhao-wen

    2010-01-01

    Objective:To investigate the efficacy and safety of polyethylene glycol 4000 (Forlax(R)) on adult patients with functional constipation due to posttraumatic confinement to bed.Methods: A total of 201 posttraumatic bedridden patients were studied in this prospective,open-labeled, singlegroup study. Polyethylene glycol 4000 was administered orally for 14 days and the dosage was adjusted according to the Bristol stool types. Demographic characteristics, disease status, treatment period and factors affecting clinical outcome, especially the concomitant medications, were recorded.Results:After administration of polyethylene glycol 4000, 194 cases (96.52%) showed remission of constipation,including 153 (76.12%)persistent remission. The average defecation frequency increased significantly after treatment and the percentage of patients with stools of normal types (Bristol types 3-5) increased as well. Genders, ages and concomitant medications showed no significant influence on the persistent remission rate. After consecutive treatment for two weeks, patients with slight movement showed a significantly higher remission rate than those without movement (95% vs 80%). At the end of treatment, most accompanying symptoms were relieved obviously. Patients with a medical history of constipation or ever taking laxatives showed a lower remission rate. Sixty cases (29.85%) developed diarrhea during the observational period, among whom 6 (10%) withdrew from the clinical observation voluntarily at the first onset of diarrhea. Two cases suffered from abdominal pain.Conclusions:Polyethylene glycol 4000 (Forlax(R)) has efficacy on functional constipation in posttraumatic bedridden patients. Furthermore, patients with milder symptoms,more movement in bed, and longer duration of treatment but without accompanying symptoms can achieve a higher remission rate.

  1. A case report of secondary Budd-Chiari syndrome due to chronic empyema diagnosed by NMR-CT

    International Nuclear Information System (INIS)

    A 34-year-old male patient complained of general fatigue, ascites, and edema of the lower extremities. A chest x-ray film showed atelectasis of the right lung and pleural effusion of the right side. Liver ultrasonography revealed stenosis of the middle and right hepatic veins. Venacavography revealed stenosis of the inferior vena cava and collateral circulation. Finally, abdominal NMR-CT clearly visualized lunate stenosis and antero-lateral deviation of the inferior vena cava. He was diagnosed as having secondary Budd-Chiari syndrome resulting from the deviation and stenosis of the inferior vena cava due to distortion of the surrounding tissues by the thickened pleura which was caused by chronic empyema. (Namekawa, K.)

  2. An Unpredicted Side Effect of Bisphosphonates in a Patient with Chronic Renal Failure Due to Multiple Myeloma: Reversible Parkinsonism

    Directory of Open Access Journals (Sweden)

    Barış İşak

    2010-09-01

    Full Text Available In this report, we present a unique case in which the chemotherapeutic agent, i.e., zoledronic acid, deepened the hypocalcemia on the basis of chronic renal failure secondary to multiple myeloma and caused parkinsonism episodes. An 80-year-old female patient, who had been diagnosed as multiple myeloma and had been administered bisphosphonate therapy monthly for six months, was ad¬mitted to our emergency room with two parkinsonism episodes. Low serum calcium levels accompanied parkinsonism symptoms, which subsided with calcium replacement therapy in both episodes. Imaging did not reveal any pathology in the basal ganglia. The fact that the patient was cured both times with calcium replacement suggests that hypocalcemia was the actual cause. This can be interpreted as a unique case, reflecting the reversible functional impairment due to metabolic side effects of a chemotherapeutic agent rather than destructive changes in the basal ganglia.

  3. 益生菌联合益生元治疗老年慢性功能性便秘临床分析%Chinical analysis of probiotics combined with prebiotics in the treatment of elderly patients with chronic func-tional constipation

    Institute of Scientific and Technical Information of China (English)

    王晓光; 石振东; 王国江

    2014-01-01

    Objective To explore the efficacy and safety of probiotics (bifidobacterium tetravaccine tablets ) combined with prebiotics ( lactulose oral liquid ) in the treatment of elderly patients with chronic functional constipation (CFC).Methods Two hundred and sixteen elderly patients with CFC were randomly divided into two groups .One hundred and ten patients in group A were given probiotics combined with prebiotics , One hundred and six patients in group B were given prebiotics ,the treatment course lasted for 4 weeks.The clincal efficacy and safety of the two groups were compared.Results In group A,marked effect was found in 83 patients, effective in 25 patients,ineffective in 2 patients.In group B,marked effect in 69 patients,effective in 21 patients ,ineffective in 16 patients.The clinical effi-cacy in group A were better than those in group B ( P<0.05 ) .During 12 weeks the recurrence rate in group A was 7.4%and that in group B was 21.1%( P<0.05 ) ,and the incidence of adverse reaction in group A was 8.2%and that in group B was 14.2%( P<0.05 ) .Conclusion The effect of probiotics combined with prebiotics is better than prebiotics alone in the treatment of elderly patients with CFC with less adverse drug reaction .%目的:探讨益生菌(双歧杆菌四联活菌片)联合益生元(乳果糖口服溶液)治疗老年慢性功能性便秘( CFC)的有效性和安全性。方法将216例老年CFC患者半随机分为两组,A组110例给予益生菌联合益生元治疗,B组106例单用益生元治疗,疗程均为4周。对比两组的临床疗效和安全性。结果 A组显效83例,有效25例,无效2例。 B组显效69例,有效21例,无效16例。 A组疗效明显优于B组( P<0.05)。A、B两组12周复发率分别为7.4%和21.1%,不良反应发生率分别为8.2%和14.2%。结论益生菌联合益生元治疗老年CFC疗效优于单用益生元,并且不良反应较少。

  4. 益生菌联合益生元治疗老年慢性功能性便秘临床分析%Chinical analysis of probiotics combined with prebiotics in the treatment of elderly patients with chronic func-tional constipation

    Institute of Scientific and Technical Information of China (English)

    王晓光; 石振东; 王国江

    2014-01-01

    目的:探讨益生菌(双歧杆菌四联活菌片)联合益生元(乳果糖口服溶液)治疗老年慢性功能性便秘( CFC)的有效性和安全性。方法将216例老年CFC患者半随机分为两组,A组110例给予益生菌联合益生元治疗,B组106例单用益生元治疗,疗程均为4周。对比两组的临床疗效和安全性。结果 A组显效83例,有效25例,无效2例。 B组显效69例,有效21例,无效16例。 A组疗效明显优于B组( P<0.05)。A、B两组12周复发率分别为7.4%和21.1%,不良反应发生率分别为8.2%和14.2%。结论益生菌联合益生元治疗老年CFC疗效优于单用益生元,并且不良反应较少。%Objective To explore the efficacy and safety of probiotics (bifidobacterium tetravaccine tablets ) combined with prebiotics ( lactulose oral liquid ) in the treatment of elderly patients with chronic functional constipation (CFC).Methods Two hundred and sixteen elderly patients with CFC were randomly divided into two groups .One hundred and ten patients in group A were given probiotics combined with prebiotics , One hundred and six patients in group B were given prebiotics ,the treatment course lasted for 4 weeks.The clincal efficacy and safety of the two groups were compared.Results In group A,marked effect was found in 83 patients, effective in 25 patients,ineffective in 2 patients.In group B,marked effect in 69 patients,effective in 21 patients ,ineffective in 16 patients.The clinical effi-cacy in group A were better than those in group B ( P<0.05 ) .During 12 weeks the recurrence rate in group A was 7.4%and that in group B was 21.1%( P<0.05 ) ,and the incidence of adverse reaction in group A was 8.2%and that in group B was 14.2%( P<0.05 ) .Conclusion The effect of probiotics combined with prebiotics is better than prebiotics alone in the treatment of elderly patients with CFC with less adverse drug reaction .

  5. Epidemiology and Risk Factors of Functional Constipation in Pregnant Women.

    Directory of Open Access Journals (Sweden)

    Wenjun Shi

    Full Text Available To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors.We searched hospital databases for women who were 37-41 weeks pregnant (1698 cases from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software.Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history.The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population.

  6. Factors with to intestinal constipation in the rural area elderly

    Directory of Open Access Journals (Sweden)

    Sara Franco Diniz Heitor

    2013-12-01

    Full Text Available The objective of this study was to identify the prevalence of intestinal constipation in the rural area elderly and verify the factors associated. This is a home survey performed with 850 elderly residents of the rural area of Uberaba, Minas Gerais state. A structured instrument was used; information regarding their eating habits was obtained using an adapted questionnaire for food consumption frequency, and intestinal constipation was self-reported. Descriptive analysis, chi-square test and multiple logistic regression (p<0.05 were performed. The prevalence of intestinal constipation was 13.2%. The factors associated with intestinal constipation were: female gender (p<0.001, 80 years of age or older (p=0.035, living with another person (p=0.004, having no income (p=0.033, inadequate consumption of fruits (p=0.005 and vegetable (p=0.002. It is considered that client-centered nutritional education can help remove the factors associated with the outcome. Descriptors: Constipation; Aged; Gastrointestinal Motility; Rural Population; Geriatric Nursing.

  7. Systematic assessment of constipation on plain abdominal radiographs in children

    International Nuclear Information System (INIS)

    Constipation in childhood is common and its clinical assessment is often difficult. Plain abdominal radiography is simple and used to quantify constipation. Three scoring systems, those of Barr et al., Leech et al. and Blethyn et al., have been developed to quantify fecal loading on the abdominal radiograph. In order to determine which method is the most useful in clinical practice, we assessed the reproducibility of the three scoring systems. Plain abdominal radiographs from 40 clinically constipated children were retrospectively reviewed by two paediatric radiologists on two separate occasions. The radiographs were scored according to three different systems developed by Barr et al., Leech et al., Blethyn et al. Intraobserver variability and interobserver reproducibility were determined for each system. Kappa coefficients were calculated as indicators of inter- and intraobserver agreement for categorical outcome variables. The Leech score showed the highest reproducibility: the intraobserver agreement was high for both observers (κ values of 0.88 and 1.00, respectively, P<0.05). Furthermore, the interobserver agreement was also high: κ 0.91 in the first round and 0.84 in the second. The Leech score proved to be a highly reproducible tool for assessment of childhood constipation and is of value in clinical practice for systematic assessment of constipation on plain abdominal radiographs in children. (orig.)

  8. Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

    DEFF Research Database (Denmark)

    Noiesen, Eline; Trosborg, Ingelise; Bager, Louise;

    2014-01-01

    To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

  9. DEVELOPMENT ON CLINICAL TREATMENT OF CONSTIPATION WITH ACUPUNCTURE AND MOXIBUSTION

    Institute of Scientific and Technical Information of China (English)

    YAN Xing-ke; CHUI Jian-mei; YANG Yong-qing

    2005-01-01

    In the present paper, the authors review recent development of clinical treatment of constipation with acupuncture and moxibustion from ① body acupuncture therapy including special needling manipulations, as Ziwu Daojiu Needling, etc. and acupoint combination, ② electroacupuncture therapy, ③ scalp-acupuncture therapy, ④ auricular acupuncture therapy, ⑤ needle-embedding and acupoint-catgut-embedding therapies, ⑥ acupoint-application therapy, ⑦ combined acupuncture and medication therapy, ⑧ other therapies such as cupping therapy and holo-therapy, and ⑨ considerations about the action of acupuncture in the treatment of constipation and its prospect. Up to now, researches on the effect of acupuncture in treating constipation are seldom seen, thus, much attention should be paid about this by clinical and experimental researchers.

  10. The enteric microbiota in the pathogenesis and management of constipation.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2011-02-01

    For centuries, fiber has been recommended on an empirical basis for the management of constipation; it has only been in recent decades that the mechanisms whereby fiber and related products may influence colonic function have begun to be elucidated. The interaction between fiber and the microbiota of the human colon appears to play a major role in generating the beneficial effects of fiber. The microbiota is also the target for the other therapeutic interventions discussed in this chapter: prebiotics and probiotics. While a scientific basis for a role for these approaches in the management of constipation continues to develop, evidence from high-quality clinical trials to support their use in daily practice continues to lag far behind. While benefits for fiber and, perhaps, for certain prebiotic and probiotic preparations in constipation appear to be extant there is a real need for large well-conducted clinical trials in this important area of human medicine.

  11. Dry needling in patients with chronic heel pain due to plantar fasciitis: A single-blinded randomized clinical trial

    Science.gov (United States)

    Eftekharsadat, Bina; Babaei-Ghazani, Arash; Zeinolabedinzadeh, Vahideh

    2016-01-01

    Background: This study examined the effects of dry needling on chronic heel pain due to plantar fasciitis. Methods: During this single-blinded clinical trial, 20 eligible patients were randomized into two groups: A case group treated with dry needling and a control group. Patients’ plantar pain severity, (using modified visual analog scale [VAS] scoring system), range of motion of ankle joint in dorsiflexion [ROMDF] and plantar extension[ROMPE] and foot function index (using standard questionnaires of SEM5 and MDC7) were assessed at baseline, four weeks after intervention and four weeks after withdrawing treatment. Independent sample t-test, Mann-Whitney U test, paired t-test, Wilcoxon signed rank tests, and chi square test were used for data analysis. Results: The mean VAS scores in the case group was significantly lower than the control group after four weeks of intervention (pdry needling, by improving the severity of heel pain, can be used as a good alternative option before proceeding to more invasive therapies of plantar fasciitis. PMID:27683642

  12. Efficacy of Manual Therapy versus Conventional Physical Therapy in Chronic Low Back Pain Due to Lumbar Spondylosis. A Pilot Study

    Directory of Open Access Journals (Sweden)

    Arti Sharma

    2015-06-01

    Full Text Available Objectives: The objective of this work was to compare the efficacy of Maitland mobilization and conventional physical therapy on pain response, range of motion (ROM and functional ability in patients with chronic low back pain due to lumbar spondylosis. Methods: A total sample of 30 subjects (40–70 years of age with complaints of slow insidious onset of low back pain (LBP, with or without radiation not less than three months duration and decrease ROM were randomly assigned to: group-I, Maitland mobilization and lumbar stabilization exercises; group-II conventional physical therapy (traction, strengthening, stretching exercises. and outcomes were assessed for dependent variables. Results: There is statically a significant difference between pre and post measurement readings with time (p = 0.00 and between groups (p < 0.05 with respect to pain and function, but, with respect to ROM readings, showed statistical significance with time (p = 0.00 and no significance between groups (p > 0.05, indicating manual therapy group-I is improving faster and better than conventional physical therapy group-II. Conclusion: Our results showed that manual therapy interventions are more effective in managing low back pain, and function and range of motion of the lumbar spine than conventional physical therapy treatment.

  13. Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

    OpenAIRE

    Chan, Annie OO; Cheng, Cecilia; Hui, Wai Mo; Hu, Wayne HC; Wong, Nina YH; Lam, KF; Wong, Wai Man; Lai, Kam Chuen; Lam, Shiu Kum; Wong, Benjamin CY

    2005-01-01

    Aim: To investigate coping mechanisms, constipation symptoms and anorectal physiology in 80 constipated subjects and 18 controls. Methods: Constipation was diagnosed by Rome II criteria. Coping ability and anxiety/depression were assessed by validated questionnaires. Transit time and balloon distension test were performed. Results: 34.5% patients were classified as slow transit type of constipation. The total colonic transit time (56 h vs 10 h, P

  14. Constipation and LUTS: how do they affect each other?

    Directory of Open Access Journals (Sweden)

    Marcio A. Averbeck

    2011-02-01

    Full Text Available CONTEXT: Urinary bladder and rectum share a common embryological origin. Their autonomic and somatic innervations have close similarities. Moreover, the close proximity of these two organ systems could suggest that dysfunction in one may influence, also mechanically, the function of the other. Therefore, it is not surprising that defecation problems and lower urinary tract symptoms (LUTS occur together, as reported in the literature. OBJECTIVE: To study the relationship between constipation and LUTS focusing on what is evidence-based. EVIDENCE ACQUISITION: We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE database in February 2010 to retrieve English language studies (from 1997 to 2009 and the 2005, 2006 and 2007 abstract volumes of the European Association of Urology (EAU, American Urological Association (AUA and International Continence Society (ICS. EVIDENCE SYNTHESIS: We present the findings according to the studied population in four groups: (a children, (b middle-aged women, (c elderly and (d neuropathic patients. Most published studies that correlated rectal and bladder dysfunction were carried out in children or in young women. On the other hand, there are few studies regarding the association between constipation and LUTS in the elderly and in neuropathic patients. CONCLUSIONS: Several studies in children documented that constipation is linked to urinary tract problems, including infections, enuresis, vesicoureteral reflux and upper renal tract dilatation. The underlying pathophysiology of these findings has not yet been clearly defined. Studies in middle-aged women also support a high prevalence of constipation among patients suffering from urinary tract dysfunction. Furthermore, an association between constipation and urinary incontinence, as well as between constipation and pelvic organ prolapse, has been suggested. The only prospective study in constipated elderly with concomitant LUTS demonstrates

  15. Interactions of Constipation, Dysfunctional Elimination Syndrome, and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Walid A. Farhat

    2008-06-01

    Full Text Available Vesicoureteral reflux (VUR is simply described as incompetence of the unidirectional valve at the ureterovesical junction (UVJ, leading to backflow of urine to the kidney. Today, it is clear that VUR is not only related to the UVJ function but also to a combination of processes including immunity, bladder and pelvic floor function, dysfunctional voiding, and constipation. Although our surgical aims directed towards improving the valve coaptation at the UVJ, we understand today the importance of the diagnosis and treatment of constipation and dysfunctional voiding adjunctively.

  16. Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010

    Institute of Scientific and Technical Information of China (English)

    Hua Cui; Dong-Mei Miao; Zhi-Min Wei; Jian-Fang Cai; Yi Li; Ai-Min Liu; Fan Li

    2012-01-01

    Objectives To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD),and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period.Methods Medical records in the PLA General Hospital,Beijing Union Medical College Hospital,and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed.A total of 4960 patients with COPD were reviewed in the study (3570 males,mean age,72.2 ± 10.5 years; 1390 females,mean age,72.0 ± 10.4 years).Results The prevalence of CVD in COPD patients was 51.7%.The three most prevalent CVDs were ischemic heart disease (28.9%),heart failure (19.6%),and arrhythmia (12.6%).During the 10-year study period,the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age.There was higher morbidity due to ischemic heart disease (P < 0.01) in male COPD patients than in the female counterparts.However,heart failure (P < 0.01)and hypertension (P < 0.01) occurred less frequently in male COPD patients than in female COPD patients.Furthermore,the prevalence of ischemic heart disease decreased year by year.In addition to heart failure,various types of CVD complications in COPD patients tended to occur in younger subjects.The prevalence of all major types of CVD in women tended to increase year by year.Conclusions The prevalence of CVD in patients hospitalized for COPD in Beijing was high.Age,sex and CVD trends,as well as life style changes,should be considered when prevention and control strategies are formulated.

  17. Medium-Term Outcome of Sacral Nerve Modulation for Constipation

    DEFF Research Database (Denmark)

    Govaert, Bastiaan; Maeda, Yasuko; Alberga, Job;

    2012-01-01

    : Patients were eligible if they had had symptoms of constipation persisting for at least 1 year, if conservative treatment (dietary modification, laxatives and biofeedback therapy) had failed, and if predefined excluded conditions were not present. INTERVENTION: The first phase of the treatment process...

  18. [Relationship Pattern of Mothers with Functional Constipated Infants].

    Science.gov (United States)

    Steger, Lisa; Höllwarth, Maria; Rumpold, Gerhard; Juen, Barbara

    2014-01-01

    Relationship Pattern of Mothers with Functional Constipated Infants The present article investigates whether or not mothers of infants with functional constipation have a specific relationship pattern. This question is addressed by analyzing the data collected at the day care clinic for infant regulation disorders with appropriate methods like the questionnaire for the assessment of adjustment of mothers with children in infancy (EMKK, Engfer u. Codreanu, 1984) described here. The evaluation of data was performed in two ways: first with regard to the clinical study group of mothers with infants (age range from one to five years) suffering from functional constipation, and then compared to a clinical control group of mothers with infants who are coping with regulation disorders (by definition per Papouŝek, Schieche, Wurmser, 2010). With this comparison differences between the two groups are made visible and clinical interventions can be deduced accordingly. If the groups do not differ in their pattern described by the EMKK, the possible interventions can be adopted from the well-studied area of regulation disorders. The focus on analyzing the data of mothers with functional constipated infants serves as an important starting point for providing the best possible alignment of clinical intervention. PMID:25478715

  19. Methylnaltrexone in the treatment of opioid-induced constipation

    Directory of Open Access Journals (Sweden)

    Beverley Greenwood-Van Meerveld

    2008-12-01

    Full Text Available Beverley Greenwood-Van Meerveld1, Kelly M Standifer21Veterans Affairs Medical Center, Oklahoma Center for Neuroscience, Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 2Department of Pharmaceutical Sciences, Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: Constipation is a significant problem related to opioid medications used to manage pain. This review attempts to outline the latest findings related to the therapeutic usefulness of a μ opioid receptor antagonist, methylnaltrexone in the treatment of opioid-induced constipation. The review highlights methylnaltrexone bromide (RelistorTM; Progenics/Wyeth a quaternary derivative of naltrexone, which was recently approved in the United States, Europe and Canada. The Food and Drug Administration in the United States approved a subcutaneous injection for the treatment of opioid bowel dysfunction in patients with advanced illness who are receiving palliative care and when laxative therapy has been insufficient. Methylnaltrexone is a peripherally restricted, μ opioid receptor antagonist that accelerates oral–cecal transit in patients with opioidinduced constipation without reversing the analgesic effects of morphine or inducing symptoms of opioid withdrawal. An analysis of the mechanism of action and the potential benefits of using methylnaltrexone is based on data from published basic research and recent clinical studies.Keywords: methylnaltrexone, constipation, opioid

  20. Unusual Case of Voiding Symptoms and Constipation: Retrorectal Cystic Hamartoma.

    Science.gov (United States)

    Garrido-Abad, Pablo; Sinués-Ojas, Bryan A; Fernández-Arjona, Manuel

    2016-05-01

    Retrorectal cystic hamartoma (tailgut cyst) is a rare congenital lesion. This study is one of the few reports of this rare clinical entity causing irritative voiding symptoms and constipation in a male patient. Although most cases are asymptomatic, patients may present with symptoms resulting from local mass effect or complication. PMID:26902834

  1. Sacral Nerve Stimulation for Constipation: Suboptimal Outcome and Adverse Events

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Lundby, Lilli; Buntzen, Steen;

    2010-01-01

    Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events....

  2. Celiac disease is overrepresented in patients with constipation

    NARCIS (Netherlands)

    Pelleboer, Rolf A. A.; Janssen, Rob L. H.; Deckers-Kocken, Judith M.; Wouters, Edward; Nissen, Annemieke C.; Bolz, Werner E. A.; Ten, Walther E. Tjon A.; van der Feen, Cathelijne; Oosterhuis, Koen J.; Rovekamp, Mechelien H.; Nikkels, Peter G. J.; Houwen, Roderick H. J.

    2012-01-01

    Objective: It is suggested that patients with constipation should be screened for celiac disease. Similarly, it is recommended to investigate these patients for hypothyroidism and hypercalcemia. However, no evidence for these recommendations is available so far. We therefore set out to determine the

  3. Brain glucose metabolic changes associated with chronic spontaneous Pain due to brachial plexus avulsion:a preliminary positron emission tomography study

    Institute of Scientific and Technical Information of China (English)

    CHEN Fu-yong; TAO Wei; CHENG Xin; WANG Hong-yan; HU Yong-sheng; ZHANG Xiao-hua; LI Yong-jie

    2008-01-01

    Background Previous brain imaging studies suggested that the brain activity underlying the perception of chronic pain maV differ from that underlying acute pain.To investigate the brain regions involved in chronic spontaneous pain due to brachial plexus avulsion(BPA),fluorine-18fluorodeoxygIucose (19F-FDG) positron emission tomography (PET) scanning was applied to determine the glucose metabolic changes in patients with pain due to BPA.Methods Six right-handed patients with chronic spontaneous pain due to left-BPA and twelve right-handed age-and sex-matched healthy control subjects participated in the 18F-FDG PET study.The patients were rated by visual analog scale (VAS) during scanning and Hamilton depression scale and Hamilton anxiety scale after scanning.Statistical parametric mapping 2 (SPM2) was applied for data analysis.Results Compared with healthy subjects,the patients had significant glucose metabolism decreases in the right thalamus and S I(P<0.001,uncorrected),and significant glucose metabolism increases in the right orbitofrontaI cortex (OFC) (BA11),left rostral insula cortex and left dorsolateral prefrontal codex (DLPFC) (BA10/46) (P<0.001,uncorrected).Conclusion These findings suggest that the brain areas involved in emotion.aRention and internal modulation of pain may be related to the chronic spontaneous pain due to BPA.

  4. Expectations about recovery from acute non-specific low back pain predict absence from usual work due to chronic low back pain : a systematic review

    NARCIS (Netherlands)

    Hallegraeff, J.M.; Krijnen, W.P.; van der Schans, C.P.; de Greef, M.H.G.

    2012-01-01

    Question: Do negative expectations in patients after the onset of acute low back pain increase the odds of absence from usual work due to progression to chronic low back pain? Design: Systematic review with meta-analysis of prospective inception cohort studies. Participants: Adults with acute or sub

  5. Yacon-Based Product in the Modulation of Intestinal Constipation.

    Science.gov (United States)

    de Souza Lima Sant'Anna, Mônica; Rodrigues, Vivian Carolina; Araújo, Tatiane Ferreira; de Oliveira, Tânia Toledo; do Carmo Gouveia Peluzio, Maria; de Luces Fortes Ferreira, Célia Lúcia

    2015-09-01

    This study aimed to assess the effects of a yacon-based product (YBP) on constipation in adults, including the elderly. Forty-eight individuals were recruited and divided into equal intervention groups named the test and control groups. The YBP (test) and the control (maltodextrin) were dissolved in commercial orange juice. The volunteers for the YBP/test group consumed, on a daily basis, orange juice containing 10 g fructooligosaccharide (FOS)/inulin per day. The control group consumed, on a daily basis, orange juice containing 25 g of maltodextrin. The study had a span of 30 days. We evaluated the participants' frequency of evacuation, consistency of the feces, constipation score, abdominal symptoms (flatulence, pain, and abdominal strain), and effects upon the microbiota, pH, lactate, and short-chain fatty acids (SCFAs) of the feces. The study showed an increased number of evacuations after the consumption of the YBP as well as an improvement in the consistency of the feces and a reduction in the constipation score. After 30 days of intervention, the group that consumed the YBP showed higher counts of Bifidobacterium, lower Clostridium and enterobacteria counts, and lower fecal pH. In relation to SCFAs, no significant change was found after the intervention. However, the lactate concentration was higher in the test group when compared to the post-treatment control group. The YBP was effective in improving constipation symptoms; not only was its functional characteristic in reducing constipation symptoms evident but it also demonstrated usefulness as a potential therapy. PMID:25692980

  6. [Constipation in Patients with Incurable Cancer - Recommendations of the German S3 Guideline 'Palliative Medicine'].

    Science.gov (United States)

    Wirz, Stefan; Simon, Steffen; Frieling, Thomas; Bausewein, Claudia; Voltz, Raymond; Pralong, Anne; Mönig, Stefan; Follmann, Markus; Holtmann, Martin; Becker, Gerhild

    2016-08-01

    According to the German S3-guideline 'Palliative Medicine' which has been supported by the German Guideline Program in Oncology, constipation in palliative patients requires a consistent prophylaxis and therapy. Constipation is caused by immobilisation, poor health, exsiccosis, a low-fiber diet or a preexisting functional constipation. Further important causes are substances with constipating side effects, such as opioids or anticholinergic drugs. Pragmatically, constipation should be assessed by subjective parameters such as the feeling of incomplete evacuation, straining, or other complaints. Objective parameters are hard stool or reduced number of bowel movements. For the early detection of constipation the amount of the stool mass and the stool frequency are applicable. If constipation occurs, a standardized escalating protocol applying adequate fluid intake, a high fibre diet, and laxatives is recommended. New prokinetic agents, secretagogues, or opioid antagonists may be used as reserve drugs. PMID:27509350

  7. What Do We Know about Dietary Fiber Intake in Children and Health? The Effects of Fiber Intake on Constipation, Obesity, and Diabetes in Children1

    OpenAIRE

    Kranz, Sibylle; Brauchla, Mary; Slavin, Joanne L; Miller, Kevin B

    2012-01-01

    The effect of dietary fiber intake on chronic diseases has been explored in adults but is largely unknown in children. This paper summarizes the currently existing evidence on the implications of dietary fiber intake on constipation, obesity, and diabetes in children. Current intake studies suggest that all efforts to increase children’s dietary fiber consumption should be encouraged. Available data, predominantly from adult studies, indicate significantly lower risks for obesity, diabetes, a...

  8. Glove and PICO: a novel technique for treatment of chronic wound due to osteomyelitis of the hand.

    Science.gov (United States)

    Narayan, Nitisha; Edwards, Daren; Ragoowansi, Raj H

    2014-06-02

    Chronic wounds on the dorsum of the hand are often challenging to treat. Vacuum-assisted closure has enjoyed widespread use in recent years for many difficult chronic wounds as an alternative to surgery. Unfortunately, owing to the unique anatomy of the hand, it is usually very difficult to get a seal without significantly immobilising the hand. We report a case of a chronic wound on the dorsum of the hand as a result of osteomyelitis in a 37-year-old man, which was treated with Single Use Negative Pressure Wound Therapy, 'PICO' (Smith and Nephew Co, UK). We combined the PICO dressing with a rubber glove to get a good seal enabling appropriate suction without immobilising the hand. Once the wound bed was ready, the defect was covered with a reverse forearm flap.

  9. Non-reproducible results in genetic association studies in chronic hepatitis B due to the inadequate controls

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-hua

    2010-01-01

    @@ Infection of hepatitis B virus (HBV) is ubiquitous although the prevalence of hepatitis B surface antigen (HBsAg) varies considerably worldwide. Persistent HBV infection may lead to severe sequelae such as cirrhosis and hepatocellular carcinoma. Thus, clarification of the mechanism of susceptibility to persistent HBV infection would be valuable for the prevention and treatment of chronic hepatitis B.

  10. [Application of the Gompertz mortality law to the prognosis of lifespan shortening due to chronic internal irradiation].

    Science.gov (United States)

    Panteleev, L I; Shvedov, V L

    1984-01-01

    In experiments on albino rats received strontium 90 in daily doses of 1.85 to 185 kBq/day the regularities of death were studied. It was shown that death of animals exposed to chronic internal radiation followed the Gomperz B. mortality law.

  11. Recurrent severe gastrointestinal bleeding and malabsorption due to extensive habitual megacolon

    Institute of Scientific and Technical Information of China (English)

    Ingo Mecklenburg; Markus Leibig; Christof Weber; Stefan Schmidbauer; Christian Folwaczny

    2005-01-01

    Dilatation of the colon and the rectum, which is not attributable to aganglionosis, is a rare finding and can be the result of intractable chronic constipation. We report a rare case of a 29-year-old male patient with impressive megacolon, in whom Hirschsprung's or Chagas disease was ruled out. In the present case, dilatation of the colon was most likely due to a behavioral disorder with habitual failure of defecation. Chronic stool retention led to a bizarre bulging of the large bowel with displacement of the other abdominal organs and severe occult blood loss. Because of two episodes of life-threatening gastrointestinal bleeding despite conventional treatment of constipation, a surgical approach for bowel restoration was necessary. Temporary loop ileostomy had to be performed for depressurization of the large bowel and the subsequent possibility for effective antegrade colonic lavage to remove impacted stools. Shortly after the operation, the patient was healthy and could easily manage the handling of the ileostomy. However, the course of the megacolon in this young adult cannot be predicted and the follow-up will have to reveal if regression of this extreme colonic distension with reestablishment of regular rectal perception will occur.

  12. Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Shirazi, Ayala; Stubbs, Brendon; Gomez, Lucia; Moore, Susan; Gaughran, Fiona; Flanagan, Robert J.; MacCabe, James H.; Lally, John

    2016-01-01

    Constipation is a frequently overlooked side effect of clozapine treatment that can prove fatal. We conducted a systematic review and meta-analysis to estimate the prevalence and risk factors for clozapine-associated constipation. Two authors performed a systematic search of major electronic databases from January 1990 to March 2016 for articles reporting the prevalence of constipation in adults treated with clozapine. A random effects meta-analysis was conducted. A total of 32 studies were meta-analyzed, establishing a pooled prevalence of clozapine-associated constipation of 31.2% (95% CI: 25.6–37.4) (n = 2013). People taking clozapine were significantly more likely to be constipated versus other antipsychotics (OR 3.02 (CI: 1.91–4.77), p < 0.001, n = 11 studies). Meta-regression identified two significant study-level factors associated with constipation prevalence: significantly higher (p = 0.02) rates of constipation were observed for those treated in inpatient versus outpatient or mixed settings and for those studies in which constipation was a primary or secondary outcome measure (36.9%) compared to studies in which constipation was not a specified outcome measure (24.8%, p = 0.048). Clozapine-associated constipation is common and approximately three times more likely than with other antipsychotics. Screening and preventative strategies should be established and appropriate symptomatic treatment applied when required. PMID:27271593

  13. Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Ayala Shirazi

    2016-06-01

    Full Text Available Constipation is a frequently overlooked side effect of clozapine treatment that can prove fatal. We conducted a systematic review and meta-analysis to estimate the prevalence and risk factors for clozapine-associated constipation. Two authors performed a systematic search of major electronic databases from January 1990 to March 2016 for articles reporting the prevalence of constipation in adults treated with clozapine. A random effects meta-analysis was conducted. A total of 32 studies were meta-analyzed, establishing a pooled prevalence of clozapine-associated constipation of 31.2% (95% CI: 25.6–37.4 (n = 2013. People taking clozapine were significantly more likely to be constipated versus other antipsychotics (OR 3.02 (CI: 1.91–4.77, p < 0.001, n = 11 studies. Meta-regression identified two significant study-level factors associated with constipation prevalence: significantly higher (p = 0.02 rates of constipation were observed for those treated in inpatient versus outpatient or mixed settings and for those studies in which constipation was a primary or secondary outcome measure (36.9% compared to studies in which constipation was not a specified outcome measure (24.8%, p = 0.048. Clozapine-associated constipation is common and approximately three times more likely than with other antipsychotics. Screening and preventative strategies should be established and appropriate symptomatic treatment applied when required.

  14. Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success.

    OpenAIRE

    Ambrosino, N; Foglio, K; Rubini, F.; Clini, E.; Nava, S.; M. Vitacca

    1995-01-01

    BACKGROUND--Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique. METHODS--Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one as successful (78%) or unsuccessful (22%) according t...

  15. Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010

    OpenAIRE

    Cui, Hua; Miao, Dong-Mei; Wei, Zhi-Min; Cai, Jian-Fang; Li, Yi; Liu, Ai-min; Li, Fan

    2012-01-01

    Objectives To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD), and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period. Methods Medical records in the PLA General Hospital, Beijing Union Medical College Hospital, and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed. A total of 4960 patients with COPD were reviewed in ...

  16. Methylnaltrexone in the treatment of opioid-induced constipation

    OpenAIRE

    Beverley Greenwood-Van Meerveld; Standifer, Kelly M

    2008-01-01

    Beverley Greenwood-Van Meerveld1, Kelly M Standifer21Veterans Affairs Medical Center, Oklahoma Center for Neuroscience, Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 2Department of Pharmaceutical Sciences, Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: Constipation is a significant problem related to opioid medications used to manage pain. This review attempts to outline the la...

  17. [Constipation. Proposal for a new classification and therapy].

    Science.gov (United States)

    Nicastro, Attilio; Stella, Luigi Persico; Nicolai, Alessia Pia

    2006-01-01

    The Authors propose a new classification for constipation according to which 84 patients were selected (63 females, 21 males) for a functional rehabilitation programme. Patients were subjected to a diagnostic protocol involving the performance of a number of instrumental tests. Degree and symptomatology of constipation were established by taking the clinical history of the patient. The rehabilitation protocol involved the simultaneous performance of physiokinesitherapy, electrostimulation and biofeedback of the pelvic floor. Patients underwent 3 weekly sessions, each lasting 60 minutes, over a series of 15 consecutive sessions, followed by a series of 6 consecutive sessions every three months. One-year results showed that 77 patients (92%) reported achieving regular intestinal activity with at least one evacuation a day and at intervals of no more than 3 days, and with a modification of faecal consistency and discontinuation of laxatives and/or cathartics. The other 7 patients (8%) continued using laxatives at a minimal dosage but had an improved evacuation rate and faecal consistency. The results show that many patients with constipations can undergo rehabilitation procedures with encouraging and remarkable therapeutic success.

  18. Female outlet obstruction constipation: assessment with MR defecography

    International Nuclear Information System (INIS)

    Objective: Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of' anterior and mid pelvic. Methods: One hundred and seven female patients, aged 20 to 84 years (average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool. Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results: In all the 107 cases, 70 (65.4%) presented rectocele on dynamic MRI; 28 (26.2%) presented anismus; 60 (56.1%) presented cystocele; 59 presented vaginal or cervical prolapse(55.1%); and, 54 (50.5%) presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion: MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic. (authors)

  19. Self-administered acupressure for treating adult psychiatric patients with constipation: a randomized controlled trial

    OpenAIRE

    Wong, Wai Kit; Chien, Wai Tong; Lee, Wai Ming

    2015-01-01

    Background Constipation has a high prevalence rate (>30 %) in psychiatric patients with psychotropic drugs. Common pharmacological and non-pharmacological interventions for constipation might have longer-term negative and adverse effects that would outweigh their short-term efficacy in symptom reduction. This randomized controlled trial aims to investigate the effect of self-administered acupressure for the management of constipation, in hospitalized psychiatric patients. Methods Seventy-eigh...

  20. Effects of Low-frequency Current Sacral Dermatome Stimulation on Idiopathic Slow Transit Constipation

    OpenAIRE

    Kim, Jin-seop; Yi, Seung-Ju

    2014-01-01

    [Purpose] This study aimed to determine whether low-frequency current therapy can be used to reduce the symptoms of idiopathic slow transit constipation (ISTC). [Subjects] Fifteen patients (ten male and five female) with idiopathic slow transit constipation were enrolled in the present study. [Results] Bowel movements per day, bowel movements per week, and constipation assessment scale scores significantly improved after low-frequency current simulation of S2-S3. [Conclusion] Our results show...

  1. Efficacy of Lactic Acid Bacteria (LAB) supplement in management of constipation among nursing home residents

    OpenAIRE

    Kim Jung; Kim Mi; Lee Do; Jang Seok; Baek Eun; An Hyang; Lee Kang; Park Jong; Ha Nam

    2010-01-01

    Abstract Background Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB) are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management o...

  2. Activation of Natural Killer Cells in Patients with Chronic Bone and Joint Infection due to Staphylococci Expressing or Not the Small Colony Variant Phenotype

    Directory of Open Access Journals (Sweden)

    Sébastien Viel

    2014-01-01

    Full Text Available Chronic bone and joint infections (BJI are devastating diseases. Relapses are frequently observed, as some pathogens, especially staphylococci, can persist intracellularly by expressing a particular phenotype called small colony variant (SCV. As natural killer (NK cells are lymphocytes specialized in the killing of host cells infected by intracellular pathogens, we studied NK cells of patients with chronic BJI due to staphylococci expressing or not SCVs (10 patients in both groups. Controls were patients infected with other bacteria without detectable expression of SCVs, and healthy volunteers. NK cell phenotype was evaluated from PBMCs by flow cytometry. Degranulation capacity was evaluated after stimulation with K562 cells in vitro. We found that NK cells were activated in terms of CD69 expression, loss of CD16 and perforin, in all infected patients in comparison with healthy volunteers, independently of the SCV phenotype. Peripheral NK cells in patients with chronic BJI display signs of recent activation and degranulation in vivo in response to CD16-mediated signals, regardless of the type of bacteria involved. This could involve a universal capacity of isolates responsible for chronic BJI to produce undetectable SCVs in vivo, which might be a target of future intervention.

  3. Mycotoxins and Antifungal Drug Interactions: Implications in the Treatment of Illnesses Due to Indoor Chronic Toxigenic Mold Exposures

    Directory of Open Access Journals (Sweden)

    Ebere C. Anyanwu

    2004-01-01

    Full Text Available Chronic exposure to toxigenic molds in water-damaged buildings is an indoor environmental health problem to which escalating health and property insurance costs are raising a statewide concern in recent times. This paper reviews the structural and functional properties of mycotoxins produced by toxigenic molds and their interactive health implications with antifungal drugs. Fundamental bases of pathophysiological, neurodevelopmental, and cellular mechanisms of mycotoxic effects are evaluated. It is most likely that the interactions of mycotoxins with antifungal drugs may, at least in part, contribute to the observable persistent illnesses, antifungal drug resistance, and allergic reactions in patients exposed to chronic toxigenic molds. Safe dose level of mycotoxin in humans is not clear. Hence, the safety regulations in place at the moment remain inconclusive, precautionary, and arbitrary. Since some of the antifungal drugs are derived from molds, and since they have structural and functional groups similar to those of mycotoxins, the knowledge of their interactions are important in enhancing preventive measures.

  4. Lipo-endomorphin-1 derivatives with systemic activity against neuropathic pain without producing constipation.

    Directory of Open Access Journals (Sweden)

    Pegah Varamini

    Full Text Available To enhance the drug-like properties of the endogenous opioid peptide endomorphin-1 (1 = Tyr-Pro-Trp-Phe-NH(2, the N-terminus of the peptide was modified with 2-aminodecanoic acid, resulting in compound 3. Tyr in compound 1 was replaced with 2,6-dimethyltyrosine yielding compound 2. Derivative 2 was also substituted with 2-aminodecanoic acid producing compound, 4. Lipoamino acid-modified derivatives showed improved metabolic stability and membrane permeability while maintaining high μ-opioid (MOP receptor binding affinity and acting as a potent agonist. In vivo studies showed dose-dependent antinociceptive activity following intravenous (i.v. administration of compounds 3 and 4 in a chronic constriction injury (CCI-rat model of neuropathic pain with ED(50 values of 1.22 (± 0.93 and 0.99 (± 0.89 µmol/kg, respectively. Pre-treatment of animals with naloxone hydrochloride significantly attenuated the anti-neuropathic effects of compound 3, confirming the key role of opioid receptors in mediating antinociception. In contrast to morphine, no significant constipation was produced following i.v. administration of compound 3 at 16 µmol/kg. Furthermore, following chronic administration of equi-potent doses of compound 3 and morphine to rats, there was less antinociceptive tolerance for compound 3 compared with morphine.

  5. Chronic pain due to Little Leaguer’s Shoulder in an adolescent baseball pitcher: a case report

    Science.gov (United States)

    Wasylynko, David

    2015-01-01

    Objective: To describe a case of chronic Little Leaguer’s Shoulder in reference to pain presentation, physical capabilities, and recovery time. Clinical Features: A 17-year-old, junior baseball pitcher presented with shoulder pain when performing high velocity pitching. Conservative treatment for an assumed soft tissue injury failed to resolve the pain, which was regularly aggravated by pitching, and which subsequently prompted further evaluation, and eventual confirmation of Little Leaguer’s Shoulder on subsequent computerized tomography (CT) imaging. Intervention and Outcome: Prior to proper diagnosis, conservative treatment had consisted of activity modification, spinal adjusting, laser therapy, shockwave therapy, Active Release Techniques®, Kinesiotape,® and rehabilitation. Later, rehabilitation, consisting of general muscle and core strengthening, continued for a further six months under the supervision of college athletic trainers. The athlete was able to return to normal pitching duties approximately 12 months later. Summary: In this case, a potentially damaging bone injury masquerading as a simple musculo-tendinous injury created a diagnostic challenge. The patient eventually recovered with rest, time, strengthening, and eventual compliance to prescribed activity modification. PMID:26815884

  6. Acute portal vein thrombosis due to chronic relapsing pancreatitis: a fistula between a pancreatic pseudocyst and the splenic vein.

    Science.gov (United States)

    Kikuchi, Masahiro; Nishizaki, Yasuhiro; Tsuruya, Kota; Hamada, Ikuko; Higashi, Toru; Sakuma, Keiko; Shiozawa, Hirokazu; Aoki, Jun; Nagashima, Rena; Koizumi, Jun; Arase, Yoshitaka; Shiraishi, Koichi; Matsushima, Masashi; Mine, Tetsuya

    2014-02-01

    Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but several other causes might play an important role in PVT pathogenesis. We present a case of alcoholic chronic pancreatitis complicated by acute extensive PVT. The patient was managed conservatively with danaparoid sodium at first, but the thrombosis gradually extended. We then tried radiological intervention using the direct transhepatic and transjugular intrahepatic postsystemic shunt approaches. Although we were able to successfully catheterize the percutaneous transhepatic portal vein (PTP), we could not achieve recanalization of the portal vein. Therefore, PTP catheterization and systemic intravenous infusion of urokinase and heparin was performed to prevent further progression of the thrombosis and cavernous transformation was finally achieved. Computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a pancreatic stone which had possibly induced dilatation of the tail duct and formation of a pancreatic pseudocyst and caused intractable pancreatitis. We performed endoscopic retrograde cholangiopancreatography and placed a stent in the pancreatic duct, which completely cured the pancreatitis. Retrospectively, the previous CT with curved multi-planar reconstruction was reviewed and a fistula was detected between the pancreatic pseudocyst and splenic vein. We concluded that the etiology of the PVT was not only inflammatory extension from pancreatitis but also a fistula between the pancreatic duct and the splenic vein. PMID:26183509

  7. Acute portal vein thrombosis due to chronic relapsing pancreatitis: a fistula between a pancreatic pseudocyst and the splenic vein.

    Science.gov (United States)

    Kikuchi, Masahiro; Nishizaki, Yasuhiro; Tsuruya, Kota; Hamada, Ikuko; Higashi, Toru; Sakuma, Keiko; Shiozawa, Hirokazu; Aoki, Jun; Nagashima, Rena; Koizumi, Jun; Arase, Yoshitaka; Shiraishi, Koichi; Matsushima, Masashi; Mine, Tetsuya

    2014-02-01

    Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but several other causes might play an important role in PVT pathogenesis. We present a case of alcoholic chronic pancreatitis complicated by acute extensive PVT. The patient was managed conservatively with danaparoid sodium at first, but the thrombosis gradually extended. We then tried radiological intervention using the direct transhepatic and transjugular intrahepatic postsystemic shunt approaches. Although we were able to successfully catheterize the percutaneous transhepatic portal vein (PTP), we could not achieve recanalization of the portal vein. Therefore, PTP catheterization and systemic intravenous infusion of urokinase and heparin was performed to prevent further progression of the thrombosis and cavernous transformation was finally achieved. Computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a pancreatic stone which had possibly induced dilatation of the tail duct and formation of a pancreatic pseudocyst and caused intractable pancreatitis. We performed endoscopic retrograde cholangiopancreatography and placed a stent in the pancreatic duct, which completely cured the pancreatitis. Retrospectively, the previous CT with curved multi-planar reconstruction was reviewed and a fistula was detected between the pancreatic pseudocyst and splenic vein. We concluded that the etiology of the PVT was not only inflammatory extension from pancreatitis but also a fistula between the pancreatic duct and the splenic vein.

  8. Protocol on the constipation in an oncology palliative care unit

    Directory of Open Access Journals (Sweden)

    Montserrat Cordero Ponce

    2008-07-01

    Full Text Available Constipation is a problem relatively common even in healthy people, mainly in the western world, influenced mainly by the nutritional diets and the diminution of the physical activity. It is a symptom of difficult valuation by its subjective nature and the difficulty to establish a normality pattern.The incidence is high. It is observed in a 70 - 80% of the patients in terminal situation, the 40 - 50% of the patients with disease outpost and in 90% of the patients dealing with opiate.As nurses in of a palliative care unit we detected the high number of patients which they present/display the symptom and the time that takes in its diagnose and treatment, increasing the incidence-appearance of fecal impactación and intestinal obstruction. It is one of the symptoms that worry to our patients more.We take too frequently the “rectal measures,” being more painful and a little shameful for these patients, instead of using preventive measures, precocious oral treatment and continuous evaluation of the symptom. The knowledge that these patients have of the constipation is in many deficient cases. In order to be able to educate and to take care of to the oncology terminal patient in terminal state with constipation it is essential that we know its physiopathology, causes and complications. Also we will deepen in the most suitable treatment according to the consistency, the effort that the patient must make when defecating and the symptoms that presents/displays, trying that the treatment is customized and individual, although starting off of a previous protocol of performance decided by the health professionals who are going to treat the patient.

  9. Once-daily, controlled-release tramadol and sustained-release diclofenac relieve chronic pain due to osteoarthritis: A randomized controlled trial

    OpenAIRE

    Beaulieu, André D.; Peloso, Paul M.; Boulos Haraoui; William Bensen; Glen Thomson; John Wade; Patricia Quigley; John Eisenhoffer; Zoltan Harsanyi; Darke, Andrew C

    2008-01-01

    OBJECTIVE: The present study was a randomized, parallel, double-blind comparison between controlled-release (CR) tramadol and sustained-release (SR) diclofenac in patients with chronic pain due to osteoarthritis of the hips and/or knees.METHODS: Patients with at least moderate pain intensity, and having received analgesics over the past three months, underwent a two-to seven-day washout of current analgesics before initiation of 200 mg CR tramadol or 75 mg SR diclofenac. During the eight-week...

  10. Slow transit constipation: A functional disorder becomes an enteric neuropathy

    Institute of Scientific and Technical Information of China (English)

    Gabrio Bassotti; Vincenzo Villanacci

    2006-01-01

    Slow transit constipation has been traditionally considered and classified as a functional disorder.However, clinical and manometric evidence has been accumulating that suggests how most of the motility alterations in STC might be considered of neuropathic type. In addition, further investigations showed that subtle alterations of the enteric nervous system, not evident to conventional histological examination, may be present in these patients. In the present article we will discuss these evidences, and will try to put them in relation with the abnormal motor function of the large bowel documented in this pathological condition.

  11. Defining DIOS and Constipation in Cystic Fibrosis With a Multicentre Study on the Incidence, Characteristics, and Treatment of DIOS

    NARCIS (Netherlands)

    Houwen, Roderick H.; van der Doef, Hubert P.; Sermet, Isabelle; Munck, Anne; Hauser, Bruno; Walkowiak, Jaroslaw; Robberecht, Eddy; Colombo, Carla; Sinaasappel, Maarten; Wilschanski, Michael

    2010-01-01

    Objectives: Various definitions for distal intestinal obstruction syndrome (DIOS), meconium ileus equivalent, and constipation in patients with Cystic fibrosis (CF) are used. However, an unequivocal definition for DIOS, meconium ileus equivalent, and constipation is preferred. The aims of this study

  12. The impact of laxative use upon symptoms in patients with proven slow transit constipation

    Directory of Open Access Journals (Sweden)

    Dinning Phil G

    2011-11-01

    Full Text Available Abstract Background Constipation severity is often defined by symptoms including feelings of complete evacuation, straining, stool frequency and consistency. These descriptors are mostly obtained in the absence of laxative use. For many constipated patients laxative usage is ubiquitous and long standing. Our aim was to determine the impact of laxative use upon the stereotypic constipation descriptors. Methods Patients with confirmed slow transit constipation completed 3-week stool diaries, detailing stool frequency and form, straining, laxative use and pain and bloating scores. Each diary day was classified as being under laxative affect (laxative affected days or not (laxative unaffected days. Unconditional logistic regression was used to assess the affects of laxatives on constipation symptoms. Results Ninety four patients with scintigraphically confirmed slow transit constipation were enrolled in the study. These patients reported a stool frequency of 5.6 ± 4.3 bowel motions/week, only 21 patients reported P P Conclusions The reporting of frequent and loose stools with abdominal pain and/or bloating is common in patients with slow transit constipation. While laxative use is a significant contributor to altering stool frequency and form, laxatives have no apparent affect on pain or bloating or upon a patients feeling of complete evacuation. These factors need to be taken into account when using constipation symptoms to define this population.

  13. CHRONIC MENINGITIS IN AN IMMUNOCOMPETENT HOST DUE TO CRYPTOCOCCUS NEOFORMANS VAR. GRUBII - FIRST CASE REPORT FROM TRIPURA, NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Tapan

    2015-10-01

    Full Text Available Cryptococcosis, caused by either of two species, C. neoformans, which is characterized by haploid isolates with the A or D capsular serotype, as well as AD hybrids, or C. gattii, traditionally denoted by serotype B or C. However, more than 90% of infections worldwide are due to haploid strains of C. neoformans var. grubii, which possess the serotype A capsular epitope. Cryptococcal meningitis is mainly a disease of immunocompromised and rare in immunocompetent patients. Prognosis in immunocompetent patients is generally considered good. We report first case of cryptococcal meningitis in an immunocompetent female caused by Cryptococcus neoformans var. grubii.

  14. Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

    Directory of Open Access Journals (Sweden)

    Nodari Franco

    2011-08-01

    Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with

  15. Flavored by Liquid Soup Combined with Biofeedback Training Yin Chronic Functional Intestinal Dry Constipation Clinical Observation%加味增液汤结合生物反馈训练治疗阴虚肠燥型慢性功能性便秘的临床观察

    Institute of Scientific and Technical Information of China (English)

    王爱华; 郑凤萍

    2012-01-01

      目的 探讨加味增液汤结合生物反馈训练治疗阴虚肠燥型慢性功能性便秘的临床疗效.方法 2011年1月至2011年10月共收治慢性功能性便秘(chronic functional constipation,CFC)患者42例(男性20例,女性22例),随机分为:加味增液汤结合生物反馈训练治疗组(A组)20例,单纯生物反馈训练治疗组(B组)22例;4周为1个疗程,共1个疗程.试验期间原则上停用其他相关治疗药物.结果 A组对CFC的总有效率为90%,B组对CFC的总有效率为77.27%,A组和B组具有显著性差异(P=0.036<0.05),A组的总有效率优于B组.结论 加味增液汤结合生物反馈训练对阴虚肠燥型慢性功能性便秘疗效更佳.%  Objective To investigate the clinical efficacy of the Treatment of Chronic Functional Constipation by Modified Fluid-Increasing Decoction Combined with Biofeedback Method. Methods 42 patients(20males and females) of chronic functional constipation (CFC) were theated in the January to October 2011. The patients were randomly divided into; Modified Fluid-Increasing Decoction Combined with Biofeedback Method group (A 20 cases) ,a simple biofeedback training group(B 22cases). 4 weeks for a cure, a course of treatment.During the test others therapeutic agents were disabled in principle. Results The total effective rate of A group was 90%, while B group OF the total effective rate was 77.27%.There was a significant difference (P=0.036<0.05) by statistical analysis in the results of A group and B group , A group in the total efficiency is better than that of B group. Conclusion The better clinilcal efficacy war acquired in the treatment

  16. Childhood constipation as an emerging public health problem

    Science.gov (United States)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-01-01

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities. PMID:27570423

  17. Opioid/naloxone prolonged release combinations for opioid induced constipation

    Institute of Scientific and Technical Information of China (English)

    Shailendra Kapoor

    2012-01-01

    I read with great interest the recent article by Chen et a/in a recent issue of your esteemed journal.The article is highly thought provoking.One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations.For instance,naloxone when administered in a 1∶2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract.The advantage of oxycodone/naloxone prolonged release (OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release (OXC),it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent.Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1.Similarly,L(o)wenstein et al in another recent study have reported that following a month of therapy,complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.

  18. Childhood constipation as an emerging public health problem.

    Science.gov (United States)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-08-14

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities. PMID:27570423

  19. Foods with added fiber improve stool frequency in individuals with chronic kidney disease with no impact on appetite or overall quality of life

    OpenAIRE

    Salmean, Younis A.; Zello, Gordon A; Dahl, Wendy J

    2013-01-01

    Background Fiber intake may be low in individuals with chronic kidney disease (CKD) due to diet restriction and/or poor appetite associated with uremic symptoms, contributing to constipation and reduced quality of life. This report describes the effects of foods with added fiber on gastrointestinal function and symptoms, clinical markers, and quality of life in CKD patients. Findings Adults with CKD (n = 15; 9 F, 6 M; 66 ± 15 y) were provided with cereal, cookies and snack bars without added ...

  20. Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Haja Mydin H

    2013-03-01

    Full Text Available Helmy Haja Mydin, Stephen Murphy, Howell Clague, Kishore Sridharan, Ian K TaylorDepartment of Respiratory Medicine, Sunderland Royal Infirmary, Sunderland, United KingdomBackground: In patients with acute hypercapnic respiratory failure (AHRF during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV. For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD.Methods: COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1, World Health Organization performance status (WHO-PS, clinical observations, a composite physiological score (Early Warning Score, routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded.Results: In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ≥ 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ≥ 3, severe acidosis (pH < 7.20, and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ≥ 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%.Conclusion: WHO-PS ≥ 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.Keywords: acute exacerbations of COPD, noninvasive ventilation, emphysema, prognostic markers

  1. Health-related quality of life in dialysis patients with constipation: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Zhang JS

    2013-06-01

    Full Text Available JiSheng Zhang,1,* CongYang Huang,1,* YanLi Li,1 Jun Chen,2 FangYuan Shen,1 Qiang Yao,3 JiaQi Qian,4 BeiYan Bao,1 XuPing Yao51Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People's Republic of China; 2Blood Purification Center, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People's Republic of China; 3Baxter Healthcare Pty Ltd, Shanghai, People's Republic of China; 4Division of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China; 5Division of Urology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People's Republic of China *These authors contributed equally to this workObjectives: To evaluate differences in the health-related quality of life (HRQoL between patients with constipation receiving hemodialysis (HD and those receiving peritoneal dialysis (PD.Methods: In this cross-sectional study, 605 dialysis patients (478 HD cases and 127 PD cases; all patients were older than 18 years from our hospital were included. A questionnaire was used to evaluate their constipation statuses. The effect of constipation on HRQoL was assessed, using the Chinese version of the 12-item short-form (SF-12 general health survey. Karnofsky score, sociodemographic, and clinical data were also collected. We performed multiple logistic regression analysis to define independent risk factors for constipation and impaired HRQoL.Results: A total of 605 participants (326 men [53.9%] and 279 women [46.1%] were surveyed. The incidence of constipation was 71.7% in HD patients and 14.2% in PD patients. Dialysis patients with constipation had significantly lower mean SF-12 Physical Component Summary scale and Mental Component Summary scale scores than the nonconstipation group (P < 0.05, whereas HD patients had better SF-12 Physical Component

  2. Gallotannin-Enriched Extract Isolated from Galla Rhois May Be a Functional Candidate with Laxative Effects for Treatment of Loperamide-Induced Constipation of SD Rats

    Science.gov (United States)

    Kim, Ji Eun; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Sung, Ji Eun; Lee, Hyun Ah; Lee, Young Hee; Hong, Jin Tae; Hwang, Dae Youn

    2016-01-01

    Several natural products containing tannins are used as traditional medicines for treatment of constipation; however, their pharmacological mechanism is not well understood. The laxative effects of gallotannin-enriched extract isolated from Galla Rhois (GEGR) were investigated using a constipation model induced by loperamide (Lop) injection. After analysis for antioxidant activity of GEGR, alterations in the excretion parameters, histological structure, mucin secretion, and related protein levels were measured in the transverse colon of Sprague Dawley (SD) rats with Lop-induced constipation following treatment with 250, 500 and 1,000 mg/ml of GEGR. The number and weight of feces increased significantly by 48–79% and 128–159%, respectively, in the Lop+GEGR treated group relative to the Lop+vehicle treated group, while food intake and water consumption were maintained at a constant level. The thickness of mucosa, muscle and flat luminal surface, as well as the number of goblet cells and crypt of lieberkuhn were enhanced in the Lop+GEGR treated group. Moreover, mucin secretion increased significantly in a dose dependent manner in the Lop+GEGR treated group. Furthermore, the downstream signaling pathway of the muscarinic acetylcholine receptors (mAChR) M2 and M3 was recovered by GEGR treatment, although the expression level varied. The levels of Gα expression and inositol triphosphate (IP3) concentration were also recovered in the Lop+GEGR treated group relative to the Lop+vehicle treated group. The results of the present study provide strong evidence that tannins distributed in various medicinal plants are important candidates for improving chronic constipation induced by Lop treatment in animal models. PMID:27618438

  3. [A case of acute chronic respiratory failure due to fat embolism syndrome after the left femoral neck fracture].

    Science.gov (United States)

    Oda, Keishi; Kawanami, Toshinori; Yatera, Kazuhiro; Ogoshi, Takaaki; Kozaki, Minako; Nagata, Shuya; Nishida, Chinatsu; Yamasaki, Kei; Ishimoto, Hiroshi; Mukae, Hiroshi

    2011-09-01

    A 78 year old Japanese woman was transferred to our hospital for the treatment of a fracture of the left femoral neck in April, 2010. She had been taking oral corticosteroid (prednisolone 5 mg/day) for the treatment of idiopathic interstitial pneumonia since 2003, and had been treated by home oxygen therapy since 2007. She fell in the restroom at home and hurt herself, and was transferred to our hospital for treatment of a left femoral neck fracture in April, 2010. Her respiratory status was stable just after the transfer; however, she was transferred to the intensive care unit and started to receive mechanical ventilation due to rapidly progressive respiratory failure on the fourth day after admission. Chest X-ray and computed tomography revealed rapid progression of bilateral ground-glass attenuations, and acute exacerbation of interstitial pneumonia was clinically suspected. However, the elevation of D-dimer over time and characteristic findings of petechial hemorrhagic lesions on her palpebral conjunctivae and neck with microscopic findings of phagocytized lipid in alveolar macrophages in her endobronchial secretion led to the diagnosis of fat embolism syndrome. She was successfully treated with high-dose corticosteroid and sivelestat sodium, and she was discharged on the 21st day after admission. Although a differential diagnosis of acute exacerbation of interstitial pneumonia and fat embolism syndrome was necessary and difficult in the present case, characteristic findings of petechial hemorrhagic lesions of skin, palpebral conjunctiva and lipid-laden alveolar macrophages in endotracheal aspirate were useful for the accurate and prompt diagnosis of fat embolism syndrome. PMID:21913383

  4. Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

    Science.gov (United States)

    Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

    2016-10-01

    Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.

  5. Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

    Institute of Scientific and Technical Information of China (English)

    Annie OO Chan; Benjamin CY Wong; Cecilia Cheng; Wai Mo Hui; Wayne HC Hu; Nina YH Wong; KF Lam; Wai Man Wong; Kam Chuen Lai; Shiu Kum Lam

    2005-01-01

    AIM: To investigate coping mechanisms, constipation symptoms and anorectal physiology in 80 constipated subjects and 18 controls.METHODS: Constipation was diagnosed by Rome Ⅱ criteria.Coping ability and anxiety/depression were assessed by validated questionnaires. Transit time and balloon distension test were performed.RESULTS: 34.5% patients were classified as slow transit type of constipation. The total colonic transit time (56 h vs 10 h, P<0.0001) and rectal sensation including urge sensation (79 mL vs 63 mL, P = 0.019) and maximum tolerable volume (110 mL vs95 mL, P = 0.03) differed in patients and controls. Constipated subjects had significantly higher anxiety and depression scores and lower SF-36 scores in all categories. They also demonstrated higher scores of'monitoring' coping strategy (14+6 vs9+3, P = 0.001),which correlated with the rectal distension sensation (P = 0.005), urge sensation (P=0.002), and maximum tolerable volume (P = 0.035). The less use of blunting strategy predicted slow transit constipation in both univariate (P = 0.01) and multivariate analysis (P = 0.03).CONCLUSION: Defective or ineffective use of coping strategies may be an important etiology in functional constipation and subsequently reflected in abnormal anorectal physiology.

  6. Efficacy of Adaptive Biofeedback Training in Treating Constipation-Related Symptoms

    Directory of Open Access Journals (Sweden)

    Jing Tang

    2015-01-01

    Full Text Available Biofeedback therapy is a well-known and effective therapeutic treatment for constipation. A previous study suggested that adaptive biofeedback (ABF training was more effective than traditional (fixed training parameters biofeedback training. The aim of this study was to verify the effectiveness of ABF in relieving constipation-related symptoms. We noticed that in traditional biofeedback training, a patient usually receives the training twice per week. The long training sessions usually led to poor compliance. This study proposes an intensive biofeedback therapy and compares intensive therapy with nonintensive therapy in patients with constipation-related symptoms. Methods. 63 patients with constipation-related symptoms were treated with ABF between 2012 and 2013. These patients were further divided into the intensive therapy and nonintensive therapy groups. Results. A total of 63 patients were enrolled in the study, including 24 in the nonintensive therapy group and 39 in the intensive therapy group. 100% (N=21 of constipation patients achieved the primary efficacy endpoint (≥3 bowel movements/week. There was significant improvement in constipation-related symptoms after adaptive biofeedback. The intensive biofeedback therapy did not show better performance compared to nonintensive biofeedback therapy. Conclusions. This investigation provides support for the efficacy of biofeedback for constipation-related symptoms. The efficacy of intensive therapy is similar to nonintensive therapy.

  7. Relationship between serotonin transporter gene polymorphism and constipation in cancer patients

    Science.gov (United States)

    Li, Weiwei; Huang, Luli; Cai, Weimei; Cao, Sue; Yuan, Yan; Lu, Sheng; Zhao, Yanzheng

    2015-01-01

    Introduction To assess the potential association between serotonin transporter gene insertion/deletion polymorphism and the cancer-related constipation phenotype. Material and methods A total of 120 patients diagnosed with malignant solid tumors were subjected to genotyping. For the two groups – patients with constipation and constipation-free patients with non-gastrointestinal cancer, 60 cases in each group – we collected the peripheral venous blood. We extracted genomic DNA, and used polymerase chain reaction (PCR) to analyze the serotonin transporter (5-HT) link polymorphic region (5-HTTLPR) polymorphism of the serotonin transporter gene. Results The frequency of S/S genotype in cancer patients with constipation was 66.67% (40/60), and the frequency of the S allele was 79.17% (95/120); the frequency of S/S genotype in cancer patients without constipation was 48.33% (29/60), and the frequency of the S allele was 65.83% (79/120). There was a significant difference between the two groups (p < 0.05). Conclusions The presence of 5-HTTLPRS/S genotype and the S allele in patients with cancers probably carry an increased risk of constipation. However, its role as a cause of cancer-related constipation needs to be further investigated. PMID:26199565

  8. The effect of biofeedback training on patients with functional constipation.

    Science.gov (United States)

    Ding, Meihong; Lin, Zheng; Lin, Lin; Zhang, Hongjie; Wang, Meihfeng

    2012-01-01

    The aim of this prospective quasi-experimental study was to explore the influence of biofeedback training on patients with functional constipation (FC). Changes in clinical symptoms, psychological status, quality of life, and autonomic nervous function in 21 FC patients before and after biofeedback training were investigated. The psychological status and quality of life were evaluated with the Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and a Chinese version of the MOS 36-Item Short-Form Health Survey. Autonomic nervous function was assessed on the basis of heart rate variability recorded with a HANS-1000 autonomic nervous biofeedback apparatus. After a complete course of training (10 sessions), clinical symptoms were greatly improved (p biofeedback (p .05). We conclude that biofeedback training can improve clinical symptoms, psychological status, and quality of life in FC patients, but further research is needed to determine whether biofeedback training can improve the autonomic nervous function in FC patients. PMID:22472667

  9. Lubiprostone: evaluation of the newest medication for the treatment of adult women with constipation-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Tisha N Lunsford

    2010-10-01

    Full Text Available Tisha N Lunsford, Lucinda A HarrisDepartment of Gastroenterology and Hepatology, Mayo Clinic – School of Medicine, Scottsdale, Arizona, USAAbstract: Irritable bowel syndrome (IBS is a chronic disorder that affects primarily female patients and is thought also to afflict approximately 7%–10% of the population of the Western World. Although bowel habits may change over the course of years, patients with IBS are characterized according to their predominant bowel habit, constipation (IBS-C, diarrhea (IBS-D, or mixed type (IBS-M, and treatments are focused toward the predominant symptom. Current treatments for IBS-C have included fiber, antispasmodics, osmotic and stimulant laxatives, and the now severely limited 5-HT4 agonist tegaserod. No one agent has been universally successful in the treatment of this bothersome syndrome and the search for new agents continues. Lubiprostone (Amitiza®, a novel compound, is a member of a new class of agents called prostones and was approved for the treatment of chronic idiopathic constipation in 2006 at a dose of 24 µg twice daily and then in 2008 for the treatment of IBS-C in women only at a dose of 8 µg twice daily. Its purported mechanism is as a type 2 chloride channel activator, but recent evidence suggests that it may also work at the cystic fibrosis transport receptor. This article will compare the newly proposed mechanism of action of this compound to the purported mechanism and review the structure, pharmacology, safety, efficacy, and tolerability of this new therapeutic option. Clinical trial data leading to the approval of this agent for the treatment of IBS-C and the gender-based understanding of IBS, as well as this agent’s place among existing and emerging therapies, will be examined.Keywords: large intestine, functional bowel disorder, therapy

  10. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    OpenAIRE

    Senay Akbay

    2014-01-01

    The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervos...

  11. A Case of Apoplexy Attack-Like Neuropathy due to Hereditary Neuropathy with Liability to Pressure Palsies in a Patient Diagnosed with Chronic Cerebral Infarction.

    Science.gov (United States)

    Hachisuka, Akiko; Matsushima, Yasuyuki; Hachisuka, Kenji; Saeki, Satoru

    2016-06-01

    Hereditary neuropathy with liability to pressure palsies is an inherited disease associated with the loss of a copy of the PMP22 gene. The condition leads to mononeuropathy due to compression and easy strangulation during daily life activities, resulting in sudden muscle weakness and sensory disturbance, and displaying symptoms similar to cerebrovascular diseases. We report the case of an 80-year-old man with left paralysis due to chronic cerebral infarction. His medical history indicated remarkable recovery from about 4 months after the onset of left hemiplegia with predominant involvement of the fingers. Despite subsequent recurrent monoplegia of the upper or lower limbs, brain magnetic resonance imaging consistently revealed only previous cerebral infarction in the right corona radiata without new lesions. Medical examination showed reduced deep tendon reflexes in his extremities on both the healthy and hemiplegic sides. Nerve conduction studies showed delayed conduction at the bilateral carpal and cubital tunnels and near the right caput fibulae. Genetic analysis revealed loss of a copy of the PMP22 gene. Thus, he was diagnosed with a cerebral infarction complicated by hereditary neuropathy with liability to pressure palsies. Stroke patients develop sudden muscle weakness and sensory disturbance. However, if such patients have no hyperactive deep tendon reflexes and show atypical recovery of paralysis that does not correspond to findings of imaging modalities, nerve conduction studies and genetic analysis may be necessary, considering the complication of hereditary neuropathy with liability to pressure palsies. PMID:27080157

  12. An examination of the effect of castor oil packs on constipation in the elderly.

    Science.gov (United States)

    Arslan, Gülşah Gürol; Eşer, Ismet

    2011-02-01

    This research, conducted at two rest homes in Manisa, Turkey, was undertaken to examine the effect of castor oil pack (COP) administrations on constipation in the elderly. Study participants were monitored for 7 days before, 3 days during, and 4 days after COP administration utilizing the Recall Bias and Visual Scale Analog (RB-VSAQ) as well as the Standard Diary developed by Pamuk et al. Wilcoxon Signed Ranks, Repeated Measures, Bonferroni, and Mann-Whitney U tests were used for data analysis. Eighty percent of study subjects had been constipated for 10 years or longer. COP administration did not have an effect on the number of bowel movements or amount of feces, but decreased the feces consistency score, straining during defecation and feeling of complete evacuation after a bowel movement, thus decreasing symptoms of constipation. We conclude that COP may be used for controlling symptoms of constipation.

  13. An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial

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    van Mechelen Willem

    2009-11-01

    Full Text Available Abstract Background In the past decade, a considerable amount of research has been carried out to evaluate the effectiveness of innovative low back pain (LBP interventions. Although some interventions proved to be effective, they are not always applied in daily practice. To successfully implement an innovative program it is important to identify barriers and facilitators in order to change practice routine. Because usual care is not directly aimed at return to work (RTW, we evaluated an integrated care program, combining a patient-directed and a workplace-directed intervention provided by a multidisciplinary team, including a clinical occupational physician to reduce occupational disability in chronic LBP patients. The aims of this study were to describe the feasibility of the implementation of the integrated care program, to assess the satisfaction and expectations of the involved stakeholders and to describe the needs for improvement of the program. Methods Eligible for this study were patients who had been on sick leave due to chronic LBP. Data were collected from the patients, their supervisors and the involved health care professionals, by means of questionnaires and structured charts, during 3-month follow-up. Implementation, satisfaction and expectations were investigated. Results Of the 40 patients who were eligible to participate in the integrated care program, 37 patients, their supervisors and the health care professionals actually participated in the intervention. Adherence to the integrated care program was in accordance with the protocol, and the patients, their supervisors and the health care professionals were (very satisfied with the program. The role of the clinical occupational physician was of additional value in the RTW process. Time-investment was the only barrier for implementation reported by the multidisciplinary team. Conclusion The implementation of this program will not be influenced by any flaws in its application

  14. Tegaserod in the treatment of irritable bowel syndrome (IBS) with constipation as the prime symptom

    OpenAIRE

    Layer, Peter; Keller, Jutta; Loeffler, Helena; Kreiss, Andreas

    2007-01-01

    Irritable bowel syndrome with constipation (IBS-C) as the predominant bowel symptom is a prevalent disorder, characterized by recurring abdominal pain/discomfort, bloating, and constipation, and imposes a significant socio-economic burden. Traditional treatments generally address just one of the multiple IBS symptoms. The efficacy and safety profile of tegaserod, a serotonin 5-HT4 receptor agonist, has been demonstrated in several randomized, placebo-controlled, and open-label trials. This re...

  15. Effect and Safety of Deep Needling and Shallow Needling for Functional Constipation

    OpenAIRE

    Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

    2014-01-01

    Abstract Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional ...

  16. Efficacy of Adaptive Biofeedback Training in Treating Constipation-Related Symptoms

    OpenAIRE

    Jing Tang; Zhihui Huang; Yan Tan; Nina Zhang; Anping Tan; Jun Chen; Jianfeng Chen

    2015-01-01

    Biofeedback therapy is a well-known and effective therapeutic treatment for constipation. A previous study suggested that adaptive biofeedback (ABF) training was more effective than traditional (fixed training parameters) biofeedback training. The aim of this study was to verify the effectiveness of ABF in relieving constipation-related symptoms. We noticed that in traditional biofeedback training, a patient usually receives the training twice per week. The long training sessions usually led ...

  17. An evidence-based dietary fiber enrichment programme for relieving constipation in elderly orthopaedic patients

    OpenAIRE

    Tai, Siu-king, Rosetti; 戴筱荊

    2013-01-01

    Constipation is a multifactorial digestive disorder highly prevailing among the hospitalized elderly Orthopaedic patients. Unlike Western countries, laxative therapy is used to be the first line remedy for constipation in many hospitals of Hong Kong although fiber-rich diet has been proven by numerous studies as the best alternative with low cost and less complications. This dissertation is a translational nursing research which aims at formulating a programme of using fiber-rich food pro...

  18. Intestinal Obstruction Syndromes in Cystic Fibrosis: Meconium Ileus, Distal Intestinal Obstruction Syndrome, and Constipation

    OpenAIRE

    van der Doef, Hubert P. J.; Kokke, Freddy T. M.; van der Ent, Cornelis K; Houwen, Roderick H. J.

    2011-01-01

    Meconium ileus at birth, distal intestinal obstruction syndrome (DIOS), and constipation are an interrelated group of intestinal obstruction syndromes with a variable severity of obstruction that occurs in cystic fibrosis patients. Long-term follow-up studies show that today meconium ileus is not a risk factor for impaired nutritional status, pulmonary function, or survival. DIOS and constipation are frequently seen in cystic fibrosis patients, especially later in life; genetic, dietary, and ...

  19. Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases?

    Institute of Scientific and Technical Information of China (English)

    AM; El-Tawil

    2010-01-01

    Constipation is a significant manifestation of a number of psychological disorders.Published papers recommend using self-assessment questionnaires for discriminating psychological from non-psychological constipated patients before operating on them but reports from major surveys revealed that general practitioners failed to diagnose 70%of depressed patients using self-assessment questionnaires.Lower circulating concentrations of progesterone,17-hydroxyprogesterone,cortisol,testosterone,androstenedione,and d...

  20. Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study

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    Tack Jan

    2011-03-01

    Full Text Available Abstract Background Antipsychotic are the cornerstone in the treatment of schizophrenia. They also have a number of side-effects. Constipation is thought to be common, and a potential serious side-effect, which has received little attention in recent literature. Method We performed a retrospective study in consecutively admitted patients, between 2007 and 2009 and treated with antipsychotic medication, linking different electronic patient data to evaluate the prevalence and severity of constipation in patients with schizophrenia under routine treatment conditions. Results Over a period of 22 months 36.3% of patients (99 received at least once a pharmacological treatment for constipation. On average medication for constipation was prescribed for 273 days. Severe cases (N = 50, non-responsive to initial treatment, got a plain x-ray of the abdomen. In 68.4% fecal impaction was found. Conclusion A high prevalence of constipation, often severe and needing medical interventions, was confirmed during the study period. Early detection, monitoring over treatment and early intervention of constipation could prevent serious consequences such as ileus.

  1. Modification of stool's water content in constipated infants: management with an adapted infant formula

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    Alvarez Marina M

    2011-05-01

    Full Text Available Abstract Background Constipation is a common occurrence in formula-fed infants. The aim of this preliminary study was to evaluate the impact of a formula with high levels of lactose and magnesium, in compliance with the official regulations, on stool water content, as well as a parental assessment of constipation. Materials and methods Thirty healthy term-born, formula-fed infants, aged 4-10 weeks, with functional constipation were included. All infants were full-term and fed standard formula. Exclusion criteria were preterm and/or low birth weight, organic constipation, being breast fed or fed a formula specially designed to treat constipation. Stool composition was measured by near-infrared reflectance analysis (NIRA and parents answered questions about crying associated with defecation and stool consistency at baseline and after two weeks of the adapted formula. Results After 2 weeks of the adapted formula, stool water content increased from 71 +/- 8.1% to 84 +/- 5.9%, (p Conclusions This preliminary study suggests that an adapted formula with high levels of lactose and magnesium increases stool water content and improves symptoms of constipation in term-born, formula-fed infants. A larger randomized placebo-controlled trial is indicated.

  2. Prophylactic use of laxative for constipation in critically ill patients

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    Masri Yasser

    2010-01-01

    Full Text Available Background : This study was designed to evaluate the use of laxative prophylaxis for constipation in intensive care unit (ICU and the impact of early versus late bowel movement on patient′s outcome. Methods : The study was a prospective, randomized controlled trial in critically ill ventilated adult patients, who were expected to stay on ventilator for >72 h. Control group did not receive any intervention for bowel movement for the first 72 h, whereas interventional group received prophylactic dose of lactulose 20 cc enterally every 12 h for the first 72 h. The parameters measured during the study were admission diagnosis, age, gender, comorbid conditions, admission Simplified Acute Physiologic Score (SAPS II, sedative and narcotic agents with doses and duration, timing and tolerance of nutrition, daily assessment of bowel movement, total use of prokinetic, doses of suppositories, and enema for first bowel movement, total number of days on ventilator, weaning failures, extubation or tracheostomy, ICU length of stay, and death or discharge. Results : A total of 100 patients were enrolled, 50 patients in each control and interventional group. Mean age was 38.8 years, and both groups had male predominance. Mean SAPS II score for both was 35. Mean dose of Fentanyl (323.8 ± 108.89 mcg/h in control and 345.83 ± 94.43 mcg/h in interventional group and mean dose of Midazolam (11.1 ± 4.04 mg/h in control and 12.4 ± 3.19 mg/h in interventional group. There were only two (4% patients in control, while nine (18% patients in interventional group who had bowel movement in <72 h (P < 0.05. Mean ventilator days were 16.19, and 17.36 days in control and interventional groups, respectively. Subgroup analysis showed that the patients who moved bowel in <5 days in both groups had mean ventilator days of 18.5, whereas it was 15.88 days for the patients who moved bowel after 5 days in both groups (P< 0.05. Mean ICU days for control was 21.15 ± 10.44 and 20

  3. Study design and rationale for investigating phosphodiesterase type 5 inhibition for the treatment of pulmonary hypertension due to chronic obstructive lung disease: the TADA-PHiLD (TADAlafil for Pulmonary Hypertension associated with chronic obstructive Lung Disease) trial.

    Science.gov (United States)

    Maron, Bradley A; Goldstein, Ronald H; Rounds, Sharon I; Shapiro, Shelley; Jankowich, Matthew; Garshick, Eric; Moy, Marilyn L; Gagnon, David; Choudhary, Gaurav

    2013-12-01

    In patients with chronic obstructive pulmonary disease (COPD), moderate or severe pulmonary hypertension (COPD-PH) is associated with increased rates of morbidity and mortality. Despite this, approaches to treatment and the efficacy of phosphodiesterase type 5 inhibition (PDE-5i) in COPD-PH are unresolved. We present the clinical rationale and study design to assess the effect of oral tadalafil on exercise capacity, cardiopulmonary hemodynamics, and clinical outcome measures in COPD-PH patients. Male and female patients 40-85 years old with GOLD stage 2 COPD or higher and pulmonary hypertension diagnosed on the basis of invasive cardiac hemodynamic assessment (mean pulmonary artery pressure [mPAP] >30 mmHg, pulmonary vascular resistance [PVR] >2.5 Wood units, and pulmonary capillary wedge pressure ≤18 mmHg at rest) will be randomized at a 1∶1 ratio to receive placebo or oral PDE-5i with tadalafil (40 mg daily for 12 months). The primary end point is change from baseline in 6-minute walk distance at 12 months. The secondary end points are change from baseline in PVR and mPAP at 6 months and change from baseline in peak volume of oxygen consumption ([Formula: see text]) during exercise at 12 months. Changes in systemic blood pressure and/or oxyhemoglobin saturation (Sao2) at rest and during exercise will function as safety outcome measures. TADA-PHiLD (TADAlafil for Pulmonary Hypertension assocIated with chronic obstructive Lung Disease) is the first sufficiently powered randomized clinical trial testing the effect of PDE-5i on key clinical and drug safety outcome measures in patients with at least moderate PH due to COPD. PMID:25006405

  4. Three-year follow-up study on hepatic fibrosis due to chronic hepatitis Btreated by interferon-α1b and traditional medicine preparation

    Institute of Scientific and Technical Information of China (English)

    Ming Liang Cheng; Yin Ying Lu; Jun Wu; Tian Ying Luo; Ke Fu Huang; Yi Sheng Ding; Ran Cai Liu; Jia Li; Zhong Li

    2000-01-01

    AIM To investigate the short-term and long-term therapeutic effect of traditional medicine preparation andIFN-α1 b on hepatic fibrosis due to chronic hepatitis B.METHODS Fifty-two patients with hepatic fibrosis of hepatitis B were treated by IFN-alb and traditionalmedicine preparation, then observed the change of serum indexes of hepatic fibrosis, liver biopsy,ultrasonography and fibergastroscopy.RESULTS The serum indexes of hepatic fibrosis decreased significantly after 3-month treatment(P<0.05). The improvement of liver fibrosis was confirmed by liver biopsy, ultrasonography andfibergastroscopy. After 3-year continuous follow-up, the conditions of patients were got better. Symptomsand signs were disappeared. The pathohistologic change of liver, serum index of hepatic fibrosis and liverfunction were continuously improved.CONCLUSION The good short-term and long-term effects were obtained by using IFN-α1b to suppressduplication of hepatitis B virus and traditional medicine preparation to reverse hepatic fibrosis.

  5. Influence of air pressure, humidity, solar radiation, temperature, and wind speed on ambulatory visits due to chronic obstructive pulmonary disease in Bavaria, Germany

    Science.gov (United States)

    Ferrari, Uta; Exner, Teresa; Wanka, Eva R.; Bergemann, Christoph; Meyer-Arnek, Julian; Hildenbrand, Beate; Tufman, Amanda; Heumann, Christian; Huber, Rudolf M.; Bittner, Michael; Fischer, Rainald

    2012-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most important causes of morbidity and mortality in the world. The disease is often aggravated by periods of increased symptoms requiring medical attention. Among the possible triggers for these exacerbations, meteorological factors are under consideration. The objective of this study was to assess the influence of various meteorological factors on the health status of patients with COPD. For this purpose, the daily number of ambulatory care visits due to COPD was analysed in Bavaria, Germany, for the years 2006 and 2007. The meteorological factors were provided by the model at the European Centre for Medium Range Weather Forecast (ECMWF). For the multivariate analysis, a generalised linear model was used. In Bavaria, an increase of 1% of daily consultations (about 103 visits per day) was found to be associated with a change of 0.72 K temperature, 209.55 of log air surface pressure in Pa, and a decrease of 1% of daily consultations with 1,453,763 Ws m2 of solar radiation. There also seem to be regional differences between north and south Bavaria; for instance, the effect of wind speed and specific humidity with a lag of 1 day were only significant in the north. This study could contribute to a tool for the prevention of exacerbations. It also serves as a model for the further evaluation of the impact of meteorological factors on health, and could easily be applied to other diseases or other regions.

  6. Endoscopic ultrasonography guided celiac plexus neurolysis and celiac plexus block in the management of pain due to pancreatic cancer and chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Anthony J Michaels; Peter V Draganov

    2007-01-01

    Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approach, recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus block/neurolysis is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior approach. EUS guided CPN should be considered first line therapy in patients with pain due to pancreatic cancer. It provides superior pain control compared to traditional management with narcotics. A trend for improved survival in pancreatic cancer patients treated with CPN has been reported,but larger studies are needed to confirm this finding.At this time, the use of EUS guided CPB cannot be recommended as routine therapy for pain in chronic pancreatitis since only one-half of the patients experience pain reduction and the beneficial effect tends to be short lived. EUS guided CPB and CPN should be used as part of a multidisciplinary team approach for pain management.

  7. Huge bilateral ovarian cysts in adulthood as the presenting feature of Van Wyk Grumbach syndrome due to chronic uncontrolled juvenile hypothyroidism

    Directory of Open Access Journals (Sweden)

    K S Shivaprasad

    2013-01-01

    Full Text Available Juvenile primary hypothyroidism causing cystic ovaries and pseudoprecocious puberty (Van-Wyk Grumbach syndrome (VWGS is well documented in literature. There are only a few reports of primary hypothyroidism presenting as ovarian cysts in adults. Here we present a case of huge bilateral ovarian cysts in adulthood as the presenting feature of VWGS due to chronic uncontrolled juvenile hypothyroidism. Large uniloculor right ovarian cyst (119 × 81 × 90 mm and a multicystic left ovary (55 × 45 × 49 mm were detected in a 24 year lady with secondary amenorrhea, galactorrhea, and palpable abdominal mass with history of neonatal jaundice, delayed milestones, short stature, and precocious menarche at age of 7.5 years age. She had elevated levels of cancer antigen (CA-125 which normalized post levothyroxine supplementation. Elevated CA-125 may lead to misdiagnosis of ovarian carcinoma and inadvertent treatment. Bilateral ovarian cysts in adults are a rare presentation of juvenile hypothyroidism. It is necessary to screen for primary hypothyroidism in patients presenting with bilateral ovarian cysts to prevent unnecessary evaluation and treatment.

  8. STUDY ON GASTROINTESTINAL MOTILITY IN SLOW TRANSIT CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate motor activity of gastrointestinal tract in patients with slow transit constipation(STC). Methods 42 patients with STC and 20 healthy controls were included in the study. Each subject underwent colonic transit test, gastric emptying, orocecal transit time, electromyography and anorectal manometry. Results According to transit index, 42 STC patients were divided into 3 types: ①0.5

  9. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model

    OpenAIRE

    Jordana K Schmier; Miller, Paige E; Levine, Jessica A; Perez, Vanessa; Maki, Kevin C; Rains, Tia M; Devareddy, Latha; Sanders, Lisa M; Alexander, Dominik D.

    2014-01-01

    Background Nearly five percent of Americans suffer from functional constipation, many of whom may benefit from increasing dietary fiber consumption. The annual constipation-related healthcare cost savings associated with increasing intakes may be considerable but have not been examined previously. The objective of the present study was to estimate the economic impact of increased dietary fiber consumption on direct medical costs associated with constipation. Methods Literature searches were c...

  10. Survey of constipation symptom score in post-stroke patients with cerebrocardiac syndrome%卒中后合并脑心综合征患者的便秘症状评分的调查

    Institute of Scientific and Technical Information of China (English)

    李晓瑛; 高连波

    2012-01-01

    Objective: To inquire constipation symptom score in post - stroke patients with cerebrocardiac syndrome (CCS). Methods: A total of 39 post-stroke patients with CCS (stroke + CCS group) received evaluation of "constipation symptom and therapeutic effect evaluation questionnaire", and they were compared with 54 stroke patients without CCS (stroke control group) admitted in the same period. Results: Compared with stroke control group, there were significant increase in incidence rate of chronic idiopathic constipation (CIC, 24. 07% vs. 64.10%) , and total score and score of each item of constipation symptom [total score: (10. 25 ± 3. 17) scores vs. (14. 47 ± 4. 61) scores] in stroke + CCS group, P<0. 01 both. Conclusion: Chronic idiopathic constipation often occurs in post-stroke patients with cerebrocardiac syndrome and it possesses higher constipation symptom score, which may be one of causes of cerebrocardiac syndrome.%目的:调查卒中后合并脑心综合征(CCS)患者的便秘症状评分现况.方法:39例卒中后合并CCS患者(卒中+CCS组)接受了“便秘症状及疗效评估问卷”评估,并与54例同期住院未合并CCS脑卒中患者(卒中对照组)比较.结果:卒中+CCS组住院期间功能性便秘(CIC)发生率明显高于卒中对照组(64.10%比24.07%,P<0.01),同时卒中+CCS组的便秘症状总分及各分项评分均明显高于卒中对照组[总分:(14.47±4.61)分比(10.25±3.17)分,P<0.01)].结论:卒中后合并脑心综合征患者常常患有功能性便秘,且便秘症状评分严重,后者也可能是脑心综合征发病诱因之一.

  11. Serum magnesium concentration in children with functional constipation treated with magnesium oxide

    Institute of Scientific and Technical Information of China (English)

    Maiko Tatsuki; Reiko Miyazawa; Takeshi Tomomasa; Takashi Ishige; Tomoko Nakazawa; Hirokazu Arakawa

    2011-01-01

    AIM: To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS: We enrolled 120 patients (57 male and 63 female) aged 1-14 years old (median: 4.7 years)with functional constipation from 13 hospitals and two private clinics. All patients fulfilled the Rome Ⅲ criteria for functional constipation and were treated with daily oral magnesium oxide for at least 1 mo. The median treatment dose was 600 (500-800) mg/d. Patients were assessed by an interview and laboratory examination to determine possible hypermagnesemia. Serum magnesium concentration was also measured in sex- and agematched control subjects (n = 38).RESULTS: In the constipation group, serum magnesium concentration [2.4 (2.3-2.5) mg/dL, median and interquartile range] was significantly greater than that of the control group [2.2 (2.0-2.2) mg/dL] (P < 0.001).The highest value was 3.2 mg/dL. Renal magnesium clearance was significantly increased in the constipation group. Serum magnesium concentration in the constipation group decreased significantly with age (P < 0.01).There was no significant correlation between the serum level of magnesium and the duration of treatment with magnesium oxide or the daily dose. None of the patients had side effects associated with hypermagnesemia.CONCLUSION: Serum magnesium concentration increased significantly, but not critically, after daily treatment with magnesium oxide in constipated children with normal renal function.

  12. Pediatric functional constipation treatment with Bifidobacterium-containing yogurt: A crossover, double-blind, controlled trial

    Institute of Scientific and Technical Information of China (English)

    Paula VP Guerra; Luiza N Lima; Tassia C Souza; Vanessa Mazochi; Francisco J Penna; Andreia M Silva; Jacques R Nicoli; Elizabet V Guimaraes

    2011-01-01

    AIM: To evaluate the treatment off pediatric ffunctional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. METHODS: A crossover double-blind fformula-con- trolled trial was carried out on 59 students (age range: 5-15 years) off a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma Ⅲ criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 109 colony fforming unit/mL Biffidobacterium longum (B. longum) (probiotic) daily or only the yogurt ffor a period off 5 wk (fformula). Affterwards, the groups were intercrossed another 5 wk. DDeffecation ffrequency, stool consistency and abdominal and deffecation pain were assessed. RESULTS: Both treatment groups demonstrated improvement in deffecation ffrequency compared to baseline. However, the group treated with probiotic showed most significant improvement in the first phase of the study. An inversion was observed affter crossing over, resulting in a reduction in stool when this group was treated by fformula. Probiotic and fformula improved stool consistency in the first phase of treatment, but the improvement obtained with probiotic was signifficantly higher (P = 0.03). In the second phase off treatment, the group initially treated with probiotic showed worseningstool consistency when using fformula. However, the difference was not significant. A significant improvement in abdominal pain and deffecation pain was observed with both probiotic and fformula in the ffirst phase off treatment, but again the improvement was more significant ffor the group treated with B. longum during phase I (P < 0.05). When all data off the crossover study were analyzed, signifficant difffferences were observed between probiotic yogurt and yogurt only ffor deffecation ffrequency (P = 0.012), deffecation pain (P = 0.046) and abdominal pain (P = 0.015). CONCLUSION: An improvement in deffecation ffrequen- cy and abdominal pain was observed using

  13. Causes,Relative Factors and Strategy of Constipation in Stroke Patients%脑卒中后发生便秘的原因、影响因素及护理对策

    Institute of Scientific and Technical Information of China (English)

    张鑫

    2011-01-01

    Objective To analyze the current status,causes and relative factors of constipation in stroke patients,and to explore the strategy to prevent and treat constipation. Methods The medical data of 150 stroke patients in Neurology Department of No. 3 People's Hospital of Liaocheng from June to December 2008 were analyzed retrospectively. Taking the date of onset as the starting point of observation, the stool frequency was observed since the onset of stroke for 4 weeks. Statistical analysis was conducted on the constipation-related factors of stroke patients. Results Of 150 hospitalized patients, constipation occurred in 19(12. 70%) patients before onset. During the 4-week treatment,constipation occurred in 100 patients,in which 85 patients were newly identified, and the total incidence of constipation was 66. 67%. Significant difference was detected in the incidence of stroke before and after the onset of constipation (P = 0. 000). The constipation incidence was higher in female, elderly and patients with hemorrhagic stroke, lesions in the basal ganglia area and severe neurological deficit (NIHSS higher). The multi-factor analysis logistic regressionequation indicated that gender,age, type of stroke were independent factor to constipation. Conclusion The constipation incidence of stroke patients is comparatively higher due to complex and diverse causes. Nurses should take appropriate and effective methods for prevention and treatment of constipation based on the individual status to maintain smooth stool,prevent complications and to promote recovery of the patients.%目的 分析脑卒中患者发生便秘的现状、原因及其相关因素,探讨预防和解决便秘的对策.方法 回顾性分析山东聊城市第三人民医院神经内科2008年6月至2008年12月间住院治疗的150例脑卒中患者的资料,以患者发病之日作为观察起点,观察患者发病4周内的大便次数,分析脑卒中患者便秘发生的相关因素.结果 150例住院

  14. What’s new in the toolbox for constipation and faecal incontinence?

    Directory of Open Access Journals (Sweden)

    Yeong Yeh eLee

    2014-03-01

    Full Text Available Constipation and faecal incontinence are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multifactorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut-brain-microbiota axis. Initial approach to management should always be the exclusion of secondary causes. Mild symptoms can be approached with conservative measures that may include dietary modifications, exercise and medications. New prokinetics (e.g. prucalopride and secretagogues (e.g. lubiprostone and linaclotide are effective and safe in constipation. Biofeedback is the treatment of choice for dyssynergic defecation. Refractory constipation may respond to neuromodulation therapy with colectomy as the last resort especially for slow-transit constipation of neuropathic origin. Likewise, in refractory FI, less invasive approach can be tried first before progressing to more invasive surgical approach. Injectable bulking agents, sacral nerve stimulation and SECCA procedure have modest efficacy but safe and less invasive. Surgery has equivocal efficacy but there are promising new techniques including dynamic graciloplasty, artificial bowel sphincter and magnetic anal sphincter. Despite being challenging, there are no short of alternatives in our toolbox for the management of constipation and FI.

  15. 便秘的词源学探讨%Etymology Exploration of Constipation

    Institute of Scientific and Technical Information of China (English)

    袁萌; 孙增坤; 程羽; 倪红梅

    2012-01-01

    The problem of sub - health has gradually caused attention. Constipation is one of usual symptoms of sub - health. This paper is to analyse and explore constipation by etymology, and make clear of constipation from both traditional Chinese medicine and modern medicine,and intensify the study of sub - health.%亚健康问题越来越引起人们的关注,便秘是亚健康状态中常见的症状之一.对便秘从词源学角度进行分析,明确中西医学对便秘的认识,以深化对亚健康状态的研究.

  16. Evaluation and Treatment of Functional Constipation in Infants and Children : Evidence-Based Recommendations From ESPGHAN and NASPGHAN

    NARCIS (Netherlands)

    Tabbers, M. M.; DiLorenzo, C.; Berger, M. Y.; Faure, C.; Langendam, M. W.; Nurko, S.; Staiano, A.; Vandenplas, Y.; Benninga, M. A.

    2014-01-01

    Background: Constipation is a pediatric problem commonly encountered by many health care workers in primary, secondary, and tertiary care. To assist medical care providers in the evaluation and management of children with functional constipation, the North American Society for Pediatric Gastroentero

  17. Laxative effects of agarwood on low-fiber diet-induced constipation in rats

    Directory of Open Access Journals (Sweden)

    Shimazawa Masamitsu

    2010-11-01

    Full Text Available Abstract Background Agarwood (Aquilaria sinensis, well known as incense in Southeast Asia, has been used as a digestive in traditional medicine. We investigated the laxative effects of an ethanol extract of agarwood leaves (EEA in a rat model of low-fiber diet-induced constipation. Methods A set of rats was bred on a normal diet while another set was placed on a low-fiber diet to induce constipation. The laxative effect of agarwood was then investigated on both sets of rats. Results Pretreatment of normal rats with single dose of EEA (600 mg/kg, p.o. significantly increased frequency and weight of stools. Also, treatments with EEA (300 and 600 mg/kg, p.o. for 14 days caused a significant increase in stool frequency and weight. Feeding of the animals with a low-fiber diet resulted in a decrease in stool weight, frequency, and water content and also delayed carmine egestion. A single treatment with EEA (600 mg/kg or senna (150 and 300 mg/kg significantly increased stool frequency, weight, and water content and also accelerated carmine egestion in the model rats. Once daily administrations of EEA (150 mg/kg, for 14 days, caused a significant increase in water content of stools. The higher doses of EEA (300 and 600 mg/kg significantly increased frequency, weight, and water content of the stools while accelerating carmine egestion in the constipated rats. Senna (150 and 300 mg/kg produced similar effect as the higher doses of EEA but, in addition, induced severe diarrhea. Conclusion These findings indicate that EEA has a laxative effect, without causing diarrhea, in a rat model of low-fiber diet-induced constipation. These findings suggest that EEA may be highly effective on constipation as a complementary medicine in humans suffering from life style-induced constipation.

  18. Effectiveness of the bowel management program in children with constipation secondary to anorectal malformations

    Directory of Open Access Journals (Sweden)

    Santos Jasso Karla A.

    2014-07-01

    Full Text Available Introduction: One thousand children with anorectal malformation (ARM are born in Mexico every year. In spite of surgical correction, these children continue to present functional fecal problems (constipation and fecal incontinence. We conducted an Intestinal Rehabilitation Program (IRP which consists of an initial rectal disimpaction followed by administration of stimulant-type laxative (senna, with favorable results. The objective of this paper is to describe the effectiveness of the Intestinal Rehabilitation Program/bowel management program (IRP/BMP in children with constipation secondary to surgically corrected ARM. Materials and methods: A descriptive, retrospective, cross-sectional study, describing which was the IRP effectiveness in children with constipation secondary to ARM. The effectiveness was measured by means of a construct of three variables (presence of daily bowel movements, absence of fecal staining, and having a plain abdominal radiograph without fecal residue in left colon and rectum after passing stool. All children who had surgically corrected ARM and constipation in two referral centers were included. Results. One hundred and fifty one children with ARM were included: 21.85% had fecal incontinence, and 67.33% had constipation. Of this group 88.1% showed good response to the BMP. The mean dose of sennoside was 8.45 mg/kg, 95% CI: 5.94-11.12 mg/kg (199.5 mg total dose, 95% CI: 139.50-259.50 mg. Colicky abdominal pain occurred in 5.8% of the patients. Discussion. The use of sennoside has had a positive impact on our patients by means of colonic and rectal emptying without fecal soiling. Key words: Constipation, Anorrectal Malformation, Bowel Managment Program, Sennoside.

  19. Cellular mechanisms underlying the laxative effect of flavonol naringenin on rat constipation model.

    Directory of Open Access Journals (Sweden)

    Zi-Huan Yang

    Full Text Available BACKGROUND & AIMS: Symptoms of constipation are extremely common, especially in the elderly. The present study aim to identify an efficacious treatment strategy for constipation by evaluating the secretion-promoting and laxative effect of a herbal compound, naringenin, on intestinal epithelial anion secretion and a rat constipation model, respectively. METHODS/PRINCIPAL FINDINGS: In isolated rat colonic crypts, mucosal addition of naringenin (100 microM elicited a concentration-dependent and sustained increase in the short-circuit current (I(SC, which could be inhibited in Cl- free solution or by bumetanide and DPC (diphenylamine-2-carboxylic acid, but not by DIDS (4, 4'- diisothiocyanatostilbene-2, 2'-disulfonic acid. Naringenin could increase intracellular cAMP content and PKA activity, consisted with that MDL-12330A (N-(Cis-2-phenyl-cyclopentyl azacyclotridecan-2-imine-hydrochloride pretreatment reduced the naringenin-induced I(SC. In addition, significant inhibition of the naringenin-induced I(SC by quinidine indicated that basolateral K+ channels were involved in maintaining this cAMP-dependent Cl- secretion. Naringenin-evoked whole cell current which exhibited a linear I-V relationship and time-and voltage- independent characteristics was inhibited by DPC, indicating that the cAMP activated Cl- conductance most likely CFTR (cystic fibrosis transmembrane conductance regulator was involved. In rat constipation model, administration of naringenin restored the level of fecal output, water content and mucus secretion compared to loperamide-administrated group. CONCLUSIONS: Taken together, our data suggest that naringenin could stimulate Cl- secretion in colonic epithelium via a signaling pathway involving cAMP and PKA, hence provide an osmotic force for subsequent colonic fluid secretion by which the laxative effect observed in the rat constipation model. Naringenin appears to be a novel alternative treatment strategy for constipation.

  20. 功能性便秘和便秘型肠易激综合征相关生活因素上的差异%Differences in lifestyle factors between functional constipation and constipation-predominant irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    罗昶; 吕尚泽; 白涛; 向雪莲; 侯晓华

    2015-01-01

    目的比较功能性便秘(FC)与便秘型 IBS 患者相关生活因素的差异。方法纳入2011年2月至2014年12月的255例慢性便秘患者,其中 FC 170例,便秘型 IBS 85例。另纳入同期1年内无消化道症状的170名健康者作为对照组。收集所有纳入者的人口学基本资料、生活习惯资料等。先行单因素分析,将差异有统计学意义的变量纳入多因素 Logistic 回归分析。再将 FC 和便秘型 IBS 的各因素纳入决策树模型,分析不同分类下影响因素的作用。结果单因素分析显示,FC 组与便秘型 IBS 组各生活因素比较差异均无统计学意义(P 均>0.05)。多因素 Logistic 回归分析显示,与 FC 组比较,便秘型 IBS 组未发现独立保护或危险因素。经过决策树模型分析,最终纳入 BMI、每日饮水量和便秘家族史3个变量,当 BMI<23.56 kg/m2(除外18.74~<19.83 kg/m2)时,患 FC 的概率高(最高达79.75%);当BMI 为18.74~<19.83 kg/m2,每日饮水量少(<1 L)时,患 FC 的概率高(66.67%);当 BMI≥23.56 kg/m2,有便秘家族史时,患便秘型 IBS 的概率最高(70.00%)。该模型的整体预测准确率为64.6%(42/65), AUC 值为0.688。结论FC 和便秘型 IBS 的发生与多种生活因素密切相关,BMI 低和每日饮水量少是FC 的影响因素,BMI 较高和有便秘家族史是便秘型 IBS 的影响因素。%Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle

  1. Information on risk of constipation for Danish users of opioids, and their laxative use

    DEFF Research Database (Denmark)

    Pottegård, Anton; Knudsen, Thomas Bøllingtoft; van Heesch, Kim;

    2014-01-01

    Background While it is well known that use of opioids often cause constipation, little is known about the information given to patients regarding this potential side-effect and their use of laxatives to prevent it. Objective To assess the degree of information provided by the prescriber to users of...... opioids by the time of the first prescription regarding the risk of constipation. Method Interviews with patients filling an opioid at a community pharmacy were performed by the dispensing pharmacist or pharmaconomist at the pharmacy. Information collected concerned the patient, the opioid, information...

  2. Conventional treatment of functional constipation has a positive impact on the behavioural difficulties in children with and without faecal incontinence

    DEFF Research Database (Denmark)

    Modin, Line; Jakobsen, Ida Skytte; Jakobsen, Marianne Skytte

    2016-01-01

    AIM: Constipation studies have only evaluated behavioural difficulties in children with faecal incontinence. This study evaluated changes in behavioural difficulties in childhood with functional constipation (FC) with and without faecal incontinence, based on treatment outcomes. METHODS: Children...... treatment of FC had a positive impact on behavioural difficulties in constipated children with and without faecal incontinence. This study highlights the importance of proactive detection and treatment of FC in paediatric patients.......AIM: Constipation studies have only evaluated behavioural difficulties in children with faecal incontinence. This study evaluated changes in behavioural difficulties in childhood with functional constipation (FC) with and without faecal incontinence, based on treatment outcomes. METHODS: Children...... aged five to 16 years who fulfilled the Rome III criteria for FC received conventional treatment. The Strength and Difficulties Questionnaire was completed at inclusion and at the 12-month follow-up. RESULTS: We included 116 children. The behaviour scores decreased in successfully treated boys (10...

  3. What do we know about dietary fiber intake in children and health? The effects of fiber intake on constipation, obesity, and diabetes in children.

    Science.gov (United States)

    Kranz, Sibylle; Brauchla, Mary; Slavin, Joanne L; Miller, Kevin B

    2012-01-01

    The effect of dietary fiber intake on chronic diseases has been explored in adults but is largely unknown in children. This paper summarizes the currently existing evidence on the implications of dietary fiber intake on constipation, obesity, and diabetes in children. Current intake studies suggest that all efforts to increase children's dietary fiber consumption should be encouraged. Available data, predominantly from adult studies, indicate significantly lower risks for obesity, diabetes, and constipation could be expected with higher dietary fiber consumption. However, there is a lack of data from clinical studies in children of various ages consuming different levels of dietary fiber to support such assumptions. The existing fiber recommendations for children are conflicting, a surprising situation, because the health benefits associated with higher dietary fiber intake are well established in adults. Data providing conclusive evidence to either support or refute some, if not all, of the current pediatric fiber intake recommendations are lacking. The opportunity to improve children's health should be a priority, because it also relates to their health later in life. The known health benefits of dietary fiber intake, as summarized in this paper, call for increased awareness of the need to examine the potential benefits to children's health through increased dietary fiber.

  4. Mycotic aneurysm of the femoral artery resulting from mismanagement of a pathological femur fracture due to chronic osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Mwaka Erisa Sabakaki

    2013-01-01

    Full Text Available Abstract Introduction Mycotic aneurysms are rarely listed among the possible complications of osteomyelitis of the long bones. To the best of our knowledge this is the first case of chronic osteomyelitis associated with a pathological fracture of the femur and a mycotic aneurysm of the femoral artery. Case presentation We present the case of a 13-year-old Ugandan boy who was referred to our hospital with chronic osteomyelitis associated with a pathological fracture of the right femur and a mycotic aneurysm of the femoral artery. He underwent a successful above-knee amputation and is currently undergoing rehabilitation. Conclusions Aneurysms associated with chronic osteomyelitis of the long bones are very rare. However, in Africa, where people often still believe in crude traditional remedies, they should be considered among the possible diagnoses especially where acute injuries of the limbs are massaged and manipulated.

  5. [Clinical and economical evaluation of new analgesics for the management of chronic pain].

    Science.gov (United States)

    Coluzzi, Flaminia; Ruggeri, Matteo

    2014-11-01

    The management of chronic pain still represent a challenge for physicians. Opioids are the main stem in the treatment of chronic severe pain, not only for their potency, but as they act as central drugs. The main limit to their utilization in clinical practice is the prevalence of side effects, in particular in the gastrointestinal tract, whose constipation represents the most common. Two new formulations are nowadays available on the market: tapentadol PR (TAP PR) and oxycodone/naloxone (OXN). A recent meta-analysis showed that both drugs have a better tolerability profile than a tradizional opioid, such as oxycodone CR (OXY CR), but TAP PR reduces by 47% (RR=0.53) the percentage of patients discontinuing treatment because of side effects, compared to 24% (RR=0.76) of OXN. A similar advantage has been reported in the reduction of the risk of developing nausea and/or vomiting: TAP PR reduces the risk by 47% (RR=0.53), while OXN reduces the risk by only by 10% (RR=0.90). Both drugs reduced by about 40% the risk of constipation (RR=0.61 for TAP PR and for OXN). These results have been recently confirmed by a direct comparison of the two formulations (TAP PR vs OXN) in patients with chronic low back pain with neuropathic component. Both drugs were reported to be effective in reducing pain intensity and neuropathic symptoms, however TAP PR resulted superior to OXN in terms of analgesic efficacy, quality of life, and tolerability, in particular regarding constipation and adherence to treatment. A pharmacoeconomic analysis can be useful to understand the costs of these clinical advantages, and can be done by using a probabilistic analisys and by populating a Markov model that simulates the transition in time of 100 patients through 4 different possible health states: 1) still on treatment; 2) presence of adverse events; 3) discontinuation; 4) death. Both treatments (TAP PR and OXN) have been shown to have an excellent cost-effectiveness profile. In the case of OXN, in

  6. Comparison of a Chinese Herbal Medicine (CCH1 and Lactulose as First-Line Treatment of Constipation in Long-Term Care: A Randomized, Double-Blind, Double-Dummy, and Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Chien-Hsun Huang

    2012-01-01

    Full Text Available Many institutionalized patients and their healthcare providers are dissatisfied with current laxative therapy. This study compared therapeutic efficacy, safety, and laxative cost of an herbal formula (CCH1 and lactulose for long stay patients with constipation. In this double-blind, double-dummy, and placebo-controlled trial, we randomized 93 residents with chronic constipation from two long-term care facilities in Taiwan to receive either CCH1 with lactulose placebo or CCH1 placebo with lactulose for 8 weeks, then followed up for 4 weeks without study medication. Both treatments were effective and well tolerated for patients, but CCH1 produced more spontaneous bowel movements, less rectal treatments, less amount of rescue laxative, and lower laxative cost than lactulose during treatment. No significant differences were found in stool consistency, stool amount, global assessment, and safety concerns. In conclusion, our results suggest that CCH1 may have better efficacy and could be used as an alternative option to lactulose in the treatment of constipation in long-term care.

  7. Distended bladder presenting with constipation and venous obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Sharma Anu

    2012-01-01

    Full Text Available Abstract Introduction A distended urinary bladder has been known to cause venous obstruction or rarely bowel obstruction. We report the first case in the literature in which urinary bladder distension presented with both venous obstruction and constipation. This is an unusual presentation of urinary bladder distension and serves to broaden our differential diagnoses for a patient with clinical venous obstruction. Case presentation An 83-year-old man of African descent presented with constipation and bilateral lower limb edema. A huge abdominal mass was evident which was a large, distended urinary bladder confirmed by computed tomography. Promptly after urethral catheterization, both constipation and lower limb edema resolved. Conclusions To the best of our knowledge distended urinary bladder causing both constipation and lower limb edema has never previously been reported. Analysis of the literature revealed several factors resulting in the patient's presentation. A high level of suspicion for urinary bladder distension must be maintained for prompt diagnosis and to avoid improper management.

  8. Acute urinary retention in a pre-school girl with constipation

    Directory of Open Access Journals (Sweden)

    Guillermo A. Ariza Traslaviña

    2015-12-01

    Full Text Available Objective: To report a case of a preschool girl who developed acute urinary retention associated with constipation. Case description: A girl aged six years old presented a 24 h history of inability to urinate. She was went twice to the emergency room during this period. In the first admission, 12 h after the onset of the symptoms, she presented abdominal pain and acute urinary retention. After the drainage by urinary catheterization of 300 mL of clear urine, she presented relief of the symptoms and, as urinalysis had no change, the patient was discharged home. Twelve hours after the first visit, she returned to the emergency room complaining about the same symptoms. At physical examination, there was only a palpable and distended bladder up to the umbilicus with no other abnormalities. Again, a urinary catheterization was performed, which drained 450 mL of clear urine, with immediate relief of the symptoms. Urinalysis and urine culture had no abnormalities. During the anamnesis, the diagnosis of constipation was considered and a plain abdominal radiography was performed, which identified large amount of feces throughout the colon (fecal retention. An enema with a 12% glycerin solution was prescribed for three days. During follow-up, the child used laxatives and dietary modifications, this contributed to the resolution of the constipation. There were no other episodes of urinary retention after 6 months of follow-up. Comments: Acute urinary retention in children is a rare phenomenon and constipation should be considered as a cause.

  9. Transabdominal ultrasound measurement of rectal diameter is dependent on time to defecation in constipated children

    DEFF Research Database (Denmark)

    Modin, Line; Dalby, Kasper; Walsted, Anne-Mette;

    2015-01-01

    AIM: To study whether diurnal variations and time in relation to defecation has to be taken into account when measurements of rectal diameter are used to determine faecal impaction in constipated children. METHODS: Repeated ultrasound measures of rectal diameter were performed in 28 children (14...

  10. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable

    Directory of Open Access Journals (Sweden)

    Niv G

    2013-04-01

    Full Text Available Galia Niv,1 Tamar Grinberg,2 Ram Dickman,3 Nir Wasserberg,4 Yaron Niv1,3 1Risk Management and Quality Assurance, 2Emergency Department, 3Department of Gastroenterology, 4Department of Surgery B, Rabin Medical Center, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel Objectives: Constipation is a common complaint, frequently treated with cleansing enema. Enemas can be very effective but may cause serious adverse events, such as perforation or metabolic derangement. Our aim was to evaluate the outcome of the use of cleansing enema for acute constipation and to assess adverse events within 30 days of therapy. Methods: We performed a two-phase study: an initial retrospective and descriptive study in 2010, followed by a prospective study after intervention, in 2011. According to the results of the first phase we established guidelines for the treatment of constipation in the Emergency Department and then used these in the second phase. Results: There were 269 and 286 cases of severe constipation in the first and second periods of the study, respectively. In the first study period, only Fleet® Enema was used, and in the second, this was changed to Easy Go enema (free of sodium phosphate. There was a 19.2% decrease in the total use of enema, in the second period of the study (P < 0.0001. Adverse events and especially, the perforation rate and the 30-day mortality in patients with constipation decreased significantly in the second phase: 3 (1.4% versus 0 (P = 0.0001 and 8 (3.9% versus 2 (0.7% (P = 0.0001, for perforation and death in the first and second period of the study, respectively. Conclusion: Enema for the treatment of acute constipation is not without adverse events, especially in the elderly, and should be applied carefully. Perforation, hyperphosphatemia (after Fleet Enema, and sepsis may cause death in up to 4% of cases. Guidelines for the treatment of acute constipation and for enema administration are urgently needed. Keywords

  11. Early fiberoptic bronchoscopy during non-invasive ventilation in patients with decompensated chronic obstructive pulmonary disease due to community-acquired-pneumonia

    OpenAIRE

    Scala, Raffaele; Naldi, Mario; Maccari, Uberto

    2010-01-01

    Introduction Inefficient clearance of copious respiratory secretion is a cause of non-invasive positive pressure ventilation (NPPV) failure, especially in chronic respiratory patients with community-acquired-pneumonia (CAP) and impaired consciousness. We postulated that in such a clinical scenario, when intubation and conventional mechanical ventilation (CMV) are strongly recommended, the suction of secretions with fiberoptic bronchoscopy (FBO) may increase the chance of NPPV success. The obj...

  12. Segmental Difference of the Hepatic Fibrosis from Chronic Viral Hepatitis due to Hepatitis B versus C Virus Infection: Comparison Using Dual Contrast Material-Enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jae Ho; Yu, Jeong Sik; Chung, Jae Joon; Kim, Joo Hee; Kim, Ki Whang [Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    We wanted to identify the geographic differences in hepatic fibrosis and their associations with the atrophy-hypertrophy complex in patients with chronic viral hepatitis using the dual-contrast material-enhanced MRI (DC-MRI) with gadopentetate dimeglumine and ferucarbotran. Patients with chronic C (n = 22) and B-viral hepatitis (n = 35) were enrolled for determining the subjective grade of fibrosis (the extent and thickness of fibrotic reticulations) in the right lobe (RL), the caudate lobe (CL), the medial segment (MS) and the lateral segment (LS) of the liver, with using a 5-grade scale, on the gradient echo T2-weighted images of DC-MRI. The fibrosis grades of different segments were compared using the Kruskal-Wallis test followed by post-hoc analysis to establish the segment-by-segment differences. The incidences of two pre-established morphologic signs of cirrhosis were also compared with each other between the two groups of patients. There were significant intersegmental differences in fibrosis grades of the C-viral group (p = 0.005), and the CL showed lower fibrosis grades as compared with the grades of the RL and MS, whereas all lobes were similarly affected in the B-viral group (p = 0.221). The presence of a right posterior hepatic notch was significantly higher in the patients with intersegmental differences of fibrosis between the RL and the CL (19 out of 25, 76%) than those without such differences (6 out of 32, 19%) (p < 0.001). An expanded gallbladder fossa showed no significant relationship (p = 0.327) with the segmental difference of the fibrosis grades between the LS and the MS. The relative lack of fibrosis in the CL with more advanced fibrosis in the RL can be a distinguishing feature to differentiate chronic C-viral hepatitis from chronic B-viral hepatitis and this is closely related to the presence of a right posterior hepatic notch.

  13. Acquired chronic hepatocerebral degeneration due to cirrhosis from non-alcoholic steatohepatitis Síndrome hepatocerebral crónico secundario a cirrosis por esteatohepatitis no alcohólica

    OpenAIRE

    Burgos, A.; P. E. Bermejo; J. L. Calleja; Vaquero, A.; L. E. Abreu

    2009-01-01

    Introduction and objective: acquired chronic hepatocerebral degeneration, acquired hepatolenticular degeneration or pseudo-Wilson is an infrequent disorder with a hepatic origin. Cases in the literature are scarce and it is frequently confused with hepatic encephalopathy and Wilson's disease. The aim of this essay is to report a patient suffering from this disorder due to cirrhosis from non-alcoholic steatohepatitis. Case report: we present a 54-year-old man diagnosed from cirrhosis grade B9 ...

  14. Risk Factors for Functional Constipation in Young Children Attending Daycare Centers.

    Science.gov (United States)

    Park, Minkyu; Bang, Yun Gyu; Cho, Ky Young

    2016-08-01

    Our objective was to determine the risk factors associated with the development of functional constipation (FC) in young children attending daycare centers. A cross-sectional survey using a questionnaire based on the Rome III criteria was conducted in children aged 25 to 84 months from 3 randomly selected daycare centers in January 2016. The items in a questionnaire were statistically compared in the constipated and non-constipated groups. A total of 212 children were included and FC was found in 8.5%. Multivariate logistic regression analyses revealed that maternal history of constipation (odds ratio [OR] = 4.1, 95% Confidence Interval [CI] 1.2-13.9), history of painful defecation before age 1 (OR = 10.4, 95% CI 1.1-101.3), history of painful defecation during toilet training (OR = 28.9, 95% CI 1.9-423.8), no or difficult defecation at a daycare center (OR = 5,804.6, 95% CI 134.4-250,718.4), no meat consumption (OR = 10.1, 95% CI 1.2-88.1), and 500 mL or less of water intake per day (OR = 9.9, 95% CI 0.9-99.5) were powerful predictors of FC in young children (P < 0.05). Additionally, the constipated group was significantly associated with 2 hours or less of outdoor play activities per day, entry into daycare centers before 24 months age, 6 hours or more of attendance at a daycare center per day, breastfeeding for less than 6 months, 3 meals or less per day, and 3 or fewer servings of fruits and vegetables per day (P < 0.05). The findings of this study can guide parents, daycare teachers, and clinicians in prevention, early recognition and early intervention for the risk factors associated with FC in young children. PMID:27478337

  15. Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms

    Institute of Scientific and Technical Information of China (English)

    Kok-Sun Ho; Charmaine You Mei Tan; Muhd Ashik Mohd Daud; Francis Seow-Choen

    2012-01-01

    AIM:To investigate the effect of reducing dietary fiber on patients with idiopathic constipation.METHODS:Sixty-three cases of idiopathic constipation presenting between May 2008 and May 2010 were enrolled into the study after colonoscopy excluded an organic cause of the constipation.Patients with previous colon surgery or a medical cause of their constipation were excluded.All patients were given an explanation on the role of fiber in the gastrointestinal tract.They were then asked to go on a no fiber diet for 2 wk.Thereafter,they were asked to reduce the amount of dietary fiber intake to a level that they found acceptable.Dietary fiber intake,symptoms of constipation,difficulty in evacuation of stools,anal bleeding,abdominal bloating or abdominal pain were recorded at 1 and 6 mo.RESULTS:The median age of the patients (16 male,47 female) was 47 years (range,20-80 years).At 6 mo,41 patients remained on a no fiber diet,16 on a reduced fiber diet,and 6 resumed their high fiber diet for religious or personal reasons.Patients who stopped or reduced dietary fiber had significant improvement in their symptoms while those who continued on a high fiber diet had no change.Of those who stopped fiber completely,the bowel frequency increased from one motion in 3.75 d (± 1.59 d) to one motion in 1.0 d (± 0.0 d) (P < 0.001);those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d (± 2.09 d)to one motion per 1.9 d (± 1.21 d) on a reduced fiber diet (P < 0.001); those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d (± 1.03 d) before and after consultation.For no fiber,reduced fiber and high fiber groups,respectively,symptoms of bloating were present in 0%,31.3% and 100% (P < 0.001) and straining to pass stools occurred in 0%,43.8% and 100% (P < 0.001).CONCLUSION:Idiopathic constipation and its associated symptoms can be effectively reduced by stopping or even lowering the intake

  16. Evaluation of a multi-modal grounded theory approach to explore patients’ daily coping with breathlessness due to chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Bastrup, Lene; Dahl, Ronald; Pedersen, Preben Ulrich;

    2013-01-01

    Conventional methods have not yet succeeded in capturing the complexity of how people with chronic obstructive pulmonary disease (COPD) cope with breathlessness during daily living. We used a multi-modal grounded theory (GT) approach to investigate coping. In this paper, we describe and evaluate...... the participants’ ability to remember and narrate how they cope with breathlessness; capture the multidimensional aspects involved in coping with breathlessness; encompass tools for collecting both qualitative and quantitative data, providing the opportunity to generate, synchronize, and combine data......; and be ethically justifiable. The approach should also be consistent with the GT methodology of generating a theory. Striving to develop and perfect the multi-modal GT approach was time-consuming. Apart from this practical challenge, the multimodal GT approach met all evaluation criteria. This approach has...

  17. Extreme gastric dilation caused by chronic lead poisoning: A case report

    Institute of Scientific and Technical Information of China (English)

    Vesna Begovic; Darko Nozic; Srdjan Kupresanin; Dino Tarabar

    2008-01-01

    Lead is a toxic metal that affects many organ systems and functions in humans.In the majority of adults,chronic lead poisoning comes from exposures to work places and can occur in numerous work settings, such as manufacturing, lead smelting and refinement, or due to use of batteries, pigments, solder, ammunitions,paint, car radiators, cable and wires, certain cosmetics.In some countries, lead is added to petrol.We present a rare case of gastric dilation caused by long-term petrol ingestion.A 16-year-old young man was admitted to our hospital due to a 6-mo history of exhaustion, dizziness,nausea, abdominal cramps and constipation.X-ray examination revealed dilated stomach descending into the pelvis and small bowel distension.After a long clinical observation, we found that the reason for the chronic lead poisoning of the patient was due to a 3-year history of petrol ingestion.The patient spontaneously recovered and stomach returned to its normal position and size.Lead poisoning should be taken into consideration in all unexplained cases of gastric dilation.

  18. EFFECT OF THE CONSUMPTION OF A CHEESE ENRICHED WITH PROBIOTIC ORGANISMS (BIFIDOBACTERIUM LACTIS BI-07 IN IMPROVING SYMPTOMS OF CONSTIPATION

    Directory of Open Access Journals (Sweden)

    Diane Cassia FAVRETTO

    2013-09-01

    Full Text Available Context Constipation is a very common symptom in the general population. One way of non-pharmacological treatment of constipation is through the addition of probiotics to food. Obectives The aim of this study was to evaluate de effect of the consumption of a fresh cheese, enriched with Bifidobacterium lactis Bi-07 on the symptoms of constipated women. Methods A randomized controlled trial, carried out in the Basic Health Units of Guaporé's City – RS/Brazil, between january and may 2012, with 30 constipated women. The patients were randomized into two groups whom received, for 30 days, 30 g of fresh cheese enriched with Bifidobacterium lactis Bi-07 (n = 15 or regular fresh cheese (n = 15. Constipation symptoms were evaluated according to ROMA III Consensus, before and after the nutritional intervention. Also, data of clinical and anthropometric characteristics of the individuals were collected. Accepted level of significance 5% (P≤0,05. Results The medium age of the studied population was 37,5±14,4 years in the intervention group and 40,8±12,8 years in the control group. After 30 days we observed that the ingestion of fresh cheese enriched with Bifidobacterium lactis Bi-07 promoted benefic effects on the symptoms of strength to evacuate. Conclusion The consumption of 30g/day of a fresh cheese enriched with Bifidobacterium lactis Bi-07 has beneficial effects on constipation symptoms.

  19. What’s New in the Toolbox for Constipation and Fecal Incontinence?

    OpenAIRE

    Lee, Yeong Yeh

    2014-01-01

    Constipation and fecal incontinence (FI) are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multi-factorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut–brain–microbiota axis. Initial approach to management should always be the exclusion of secondary ...

  20. What’s new in the toolbox for constipation and faecal incontinence?

    OpenAIRE

    Yeong Yeh eLee

    2014-01-01

    Constipation and faecal incontinence are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multifactorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut-brain-microbiota axis. Initial approach to management should always be the exclusion of secondary cause...

  1. An appraisal of clinical practice guidelines for constipation: a right attitude towards to guidelines

    OpenAIRE

    Tian, Hongliang; Ding, Chao; Gong, Jianfeng; Ge, Xiaolong; McFarland, Lynne V; Gu, Lili; Chen, Qiyi; Ma, Chunlian; Zhu, Weiming; Li, Jieshou; Li, Ning

    2016-01-01

    Background Clinical practice guidelines (CPGs) are formally developed statements that assist users to provide proper health care for a kind of disease and play a significant contribution in healthcare system. This study report the methodological quality of CPGs on constipation. Methods The “Appraisal of Guidelines and Research and Evaluation” (AGREEII) instrument was developed to determine the quality of CPGs. A comprehensive search was developed using five databases and three guideline websi...

  2. A novel transgenic mouse model of growth plate dysplasia reveals that decreased chondrocyte proliferation due to chronic ER stress is a key factor in reduced bone growth

    Directory of Open Access Journals (Sweden)

    Benedetta Gualeni

    2013-11-01

    Disease mechanisms leading to different forms of chondrodysplasia include extracellular matrix (ECM alterations and intracellular stress resulting in abnormal changes to chondrocyte proliferation and survival. Delineating the relative contribution of these two disease mechanisms is a major challenge in understanding disease pathophysiology in genetic skeletal diseases and a prerequisite for developing effective therapies. To determine the influence of intracellular stress and changes in chondrocyte phenotype to the development of chondrodysplasia, we targeted the expression of the G2320R mutant form of thyroglobulin to the endoplasmic reticulum (ER of resting and proliferating chondrocytes. Previous studies on this mutant protein have shown that it induces intracellular aggregates and causes cell stress and death in the thyroid gland. The expression and retention of this exogenous mutant protein in resting and proliferating chondrocytes resulted in a chronic cell stress response, growth plate dysplasia and reduced bone growth, without inducing any alterations to the architecture and organization of the cartilage ECM. More significantly, the decreased bone growth seemed to be the direct result of reduced chondrocyte proliferation in the proliferative zone of growth plates in transgenic mice, without transcriptional activation of a classical unfolded protein response (UPR or apoptosis. Overall, these data show that mutant protein retention in the ER of resting and proliferative zone chondrocytes is sufficient to cause disrupted bone growth. The specific disease pathways triggered by mutant protein retention do not necessarily involve a prototypic UPR, but all pathways impact upon chondrocyte proliferation in the cartilage growth plate.

  3. Antiviral efficacy of adefovir dipivoxil versus lamivudine in patients with chronic hepatitis B sequentially treated with lamivudine and adefovir due to lamivudine resistance

    Institute of Scientific and Technical Information of China (English)

    Yeon Seok Seo; Ji Hoon Kim; Jong Eun Yeon; Jong-Jae Park; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Chang Hong Lee

    2007-01-01

    AIM: To compare the antiviral efficacy of adefovir (ADV) in lamivudine (LMV)-resistant patients with LMV treatment in nucleoside-na(i)ve patients, using serum samples collected sequentially during the course of treatment progressing from LMV to ADV.METHODS: Forty-four patients with chronic hepatitis B (CHB) were included. The patients were initially treated with LMV and then switched to ADV when LMV resistance developed. Antiviral efficacy was assessed by measuring the following: reduction in serum HBV DNA from baseline, HBV DNA negative conversion (defined as HBV DNA being undectable by the hybridization assay),and HBV DNA response (either HBV DNA level ≤ 105 copies/mL or a ≥ 2 log10 reduction from baseline HBV DNA level).RESULTS: After two and six months of treatment, HBV DNA reduction was greater with LMV compared to ADV treatment (P = 0.021). HBV DNA negative conversion rates were 64% and 27% after one month of LMV and ADV treatment respectively (P = 0.001). Similarly, HBV DNA response rates were 74% and 51% after two months of LMV and ADV treatment respectively (P = 0.026).The time taken to HBV DNA negative conversion and to HBV DNA response were both delayed in ADV treatment compared with LMV.CONCLUSION: The antiviral efficacy of ADV in LMV-resistant patients is slower and less potent than that with LMV in nucleoside-na(i)ve patients during the early course of treatment.

  4. The Quintessence of Traditional Chinese Medicine: Syndrome and Its Distribution among Advanced Cancer Patients with Constipation

    Directory of Open Access Journals (Sweden)

    Chung-Wah Cheng

    2012-01-01

    Full Text Available Constipation is a common problem in advanced cancer patients; however, specific clinical guidelines on traditional Chinese medicine (TCM syndrome (Zhang are not yet available. In this cross-sectional study, the TCM syndromes distribution and their common symptoms and signs among 225 constipated advanced cancer patients were determined. Results showed that 127 patients (56.4% and 7 patients (3.1% were in deficient and excessive patterns, respectively, while 91 patients (40.4% were in deficiency-excess complex. The distributions of the five syndromes were: Qi deficiency (93.3%, Qi stagnation (40.0%, blood (Yin deficiency (28.9%, Yang deficiency (22.2%, and excess heat (5.8%. Furthermore, age, functional status, and level of blood haemoglobin were factors related to the type of TCM syndrome. A TCM prescription with the functions on replenishing the Deficiency, redirecting the flow of Qi stagnation and moistening the dryness caused by the blood (Yin deficiency can be made for the treatment of advance cancer patients with constipation. Robust trials are urgently needed for further justifying its efficacy and safety in evidence-based approaches.

  5. The Leech method for diagnosing constipation: intra- and interobserver variability and accuracy

    International Nuclear Information System (INIS)

    The data concerning the value of a plain abdominal radiograph in childhood constipation are inconsistent. Recently, positive results have been reported of a new radiographic scoring system, ''the Leech method'', for assessing faecal loading. To assess intra- and interobserver variability and determine diagnostic accuracy of the Leech method in identifying children with functional constipation (FC). A total of 89 children (median age 9.8 years) with functional gastrointestinal disorders were included in the study. Based on clinical parameters, 52 fulfilled the criteria for FC, six fulfilled the criteria for functional abdominal pain (FAP), and 31 for functional non-retentive faecal incontinence (FNRFI); the latter two groups provided the controls. To assess intra- and interobserver variability of the Leech method three scorers scored the same abdominal radiograph twice. A Leech score of 9 or more was considered as suggestive of constipation. ROC analysis was used to determine the diagnostic accuracy of the Leech method in separating patients with FC from control patients. Significant intraobserver variability was found between two scorers (P=0.005 and P<0.0001), whereas there was no systematic difference between the two scores of the other scorer (P=0.89). The scores between scorers differed systematically and displayed large variability. The area under the ROC curve was 0.68 (95% CI 0.58-0.80), indicating poor diagnostic accuracy. The Leech scoring method for assessing faecal loading on a plain abdominal radiograph is of limited value in the diagnosis of FC in children. (orig.)

  6. Colonic necrosis and perforation due to calcium polystyrene sulfonate in a uraemic patient: a case report

    OpenAIRE

    Akagun, Tulin; Yazici, Halil; Gulluoglu, Mine G.; Yegen, Gulcin; Turkmen, Aydin

    2011-01-01

    Sodium or calcium polystyrene sulfonate (Kayexalate or analog) is an ion-exchange resin commonly used to treat hyperkalaemia in patients with chronic kidney disease. It is known to cause digestive complications, such as nausea, vomiting and constipation. Although rare, colonic necrosis and perforation are very severe complications associated with the medication. In this case report, we present a case of calcium polystyrene sulfonate-induced colonic necrosis and perforation to remind clinician...

  7. Changes of the cerebral metabolite patterns in patients undergoing hemodialysis due to chronic renal failure: evaluation with proton magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Hye Won; Yu, Hyeon; Yu, Soo Jeong; Kim, Gi Hyeon [Chung-Ang University Medical Center, College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    We wanted to evaluate the cerebral metabolites in patients with chronic renal failure (CRF) and who were undergoing hemodialysis by performing proton MR spectroscopy and were wanted to evaluate the correlation between the changes in the cerebral metabolite ratios and the duration after starting the initial hemodialysis. Proton MR spectroscopy was performed in 15 patients with CRF and who were undergoing hemodialysis and in ten healthy volunteers. The changes in N-acetylaspartate (NAA), choline-containing compounds (Cho), myo-inositol (Myo), glutamine/glutamate complex (Glx), and creatine (Cr) were analyzed. MR spectroscopy was performed before and after hemodialysis. For the patients with CRF before hemodialysis, the Cho/Cr ratio in the gray matter ({rho} < 0.001) and the Myo/Cr ratio in both the gray and white matter ({rho} < 0.01) were significantly elevated compared with those in the control subjects. For the patients with CRF after hemodialysis, their Cho/Cr ratios were significantly reduced in both the gray and white matter compared with that before hemodialysis ({rho} < 0.05). There was a significant positive correlation between the Cho/Cr ratio and serum Cr in the gray matter of CRF patients after hemodialysis (r = 0.54, {rho} < 0.05). The cerebral metabolite ratios were not significantly correlated with the duration after starting the initial hemodialysis. The cerebral metabolite patterns are significantly different between the patients with CRF and who are undergoing hemodialysis and the normal controls. The cerebral metabolite ratios are not significantly correlated with the duration after starting the initial hemodialysis.

  8. Chronic Endometritis Due to Common Bacteria Is Prevalent in Women With Recurrent Miscarriage as Confirmed by Improved Pregnancy Outcome After Antibiotic Treatment

    Science.gov (United States)

    Matteo, Maria; Tinelli, Raffaele; Pinto, Vincenzo; Marinaccio, Marco; Indraccolo, Ugo; De Ziegler, Dominique; Resta, Leonardo

    2014-01-01

    Recurrent miscarriage (RM) is defined as 3 or more miscarriages before 20 weeks’ pregnancy. In recent years, interest has been focused on chronic endometritis (CE), a subtle inflammation thought to be associated with RM. We aimed to evaluate the relationships between CE and RM. The records of 360 women with unexplained RM were retrospectively analyzed. Data from hysteroscopy, endometrial histology, endometrial culture, and polymerase chain reaction for chlamydia, performed before and after antibiotic treatment for CE, were analyzed. The occurrence of successful pregnancies within 1 year after treatment was also evaluated. Results showed that 208 (57.8%) women with RM showed CE at hysteroscopy; 190 (91.3%), positive at hysteroscopy, were also positive at histology, and 142 (68.3%) had positive cultures. Common bacteria were found in 110 (77.5%) patients. Mycoplasma and Ureaplasma were found in 36 (25.3%) patients and Chlamydia in 18 patients (12.7%). In 102 (71%) women, antibiogram-based antibiotic treatment normalized hysteroscopy, histology, and cultures (group 1); while in 40 (28.2%) patients, CE was still present at hysteroscopy (group 2). In 16 of the 66 patients positive at hysteroscopy, but not at cultures, the hysteroscopy becomes normal (group 3) after a Centers for Disease Control and Prevention-based therapy; while in 50 women, CE was still present (group 4). One year after treatment, group 1 showed a significantly higher number of pregnancies (78.4%) compared to group 2 (17.5%; P < .001) and group 4 (15.3%; P = .005). The CE is frequent in women with RM. Antibiotic treatment seems to be associated with an improved reproductive outcome. PMID:24177713

  9. Redox Imbalance in the Peripheral Mechanism Underlying the Mirror-Image Neuropathic Pain Due to Chronic Compression of Dorsal Root Ganglion.

    Science.gov (United States)

    Lv, H; Chen, H; Xu, J J; Jiang, Y S; Shen, Y J; Zhou, S Z; Xu, H; Xiong, Y C

    2016-05-01

    Reactive oxygen species (ROS) play a critical role in the pathogenesis of neuropathic pain, but few studies have examined the role of oxidative stress in the mirror-image neuropathic pain (MINP). The present study was to investigate the role of ROS in MINP caused by chronic compression of the dorsal root ganglion (DRG) (CCD) in a rat model. SD rats were randomly divided into sham group and CCD group. CCD was conducted to induce MINP. CCD rats were intraperitoneally injected with α-Phenyl-N-tert-butyl-nitrone (PBN) at 7 days after surgery. Paw withdrawal mechanical threshold (PWMT) was measured at -1, 1, 3, 5 and 7 days after surgery in sham group and CCD group, and at 8 time points after PBN injection. Rats were sacrificed at 3 and 7 days after surgery in sham group and CCD group and at 0.5 and 2 h after PBN injection, and the superoxide dismutase (SOD) and catalase activities, as well as hydrogen peroxide (H2O2) and malonaldehyde (MDA) contents were determined in the contralateral DRGs. Results showed bilateral PWMT reduced significantly in sham group and CCD group, but it returned to nearly normal level in sham group. MDA content, H2O2 content and SOD activity increased significantly, while catalase activity remained unchanged in CCD rats. PBN at 100 mg/kg significantly attenuated bilateral mechanical hyperalgesia accompanied by the improvement of oxidative stress in the contralateral DRGs. Our results demonstrate that ROS produced in the contralateral DRG are involved in the pathogenesis of CCD induced MINP, and ROS scavenger may be a promising drug for the therapy of MINP. PMID:26471165

  10. Analysis of TCM syndrome type and multiple factors for patient with constipation after stroke%脑卒中后便秘的中医证型及多因素分析

    Institute of Scientific and Technical Information of China (English)

    吴巧珑; 苏淋

    2015-01-01

    Objective: To investigate the TCM syndrome type in constipation after stroke and the related factors in order to improve the pertinence and effectiveness of prevention. Methods: TCM Syndromes of chronic constipation for 100 cases of post-stroke patients with habitual constipation of after TCM diagnosis and treatment according to the statistics of "consensus" is analyzed and their t their demographic factors (gender, age, nationality, marriage, etc.) before the onset of defecation, diet, stroke type and position, treatment of 35 indicators, univariate odds ratio (OR) is collected and logistic analysis and multi factor regression analysis is done. Results: the TCM syndrome type of lung and spleen deficiency type occupy the highest proportion, the single factor analysis showed that age, female, hemorrhagic stroke, basal ganglia lesions, application of antidepressants in patients with constipation multiple rate is higher, Logistic analysis showed that gender, age, type of stroke, the treatment using antidepressants were independent factors for constipation. Conclusion: Stroke prone to constipation, lung and spleen deficiency of TCM. Application of antidepressant drugs, sex, age, type of stroke treatment were independent factors influencing constipation.%目的:探讨脑卒中后便秘的中医证型及分析相关因素,提高预防的针对性和有效性。方法:对100例脑卒中后患者分为便秘组68例、无便秘组32例,根据《慢性便秘中医诊疗共识意见》进行中医证型统计,采集人口学因素(性别、年龄、民族、婚姻等)、发病前排便情况、饮食方式、脑卒中类型和部位、治疗用药情况等35项指标,进行单因素优势比(OR)分析和多因素Logistic回归分析。结果:中医证型以肺脾气虚型比例最高,单因素分析显示女性、高龄、出血性脑卒中、基底神经节区病变、应用抗抑郁药患者便秘多发率较高,Logistic 分析显示性别、年

  11. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  12. A new type of defecation disorder due to insufficient fixation of the rectum to the sacrum is improved by rectopexy: A report of three cases

    Directory of Open Access Journals (Sweden)

    Wataru Sumida

    2016-07-01

    Full Text Available Chronic constipation is the most common clinical disorder in children. However, some cases of constipation do not meet the criteria defined by Rome III. We encountered such defecation disorders in three patients who presented with constipation as a chief complaint along with excessive strain and bleeding hemorrhoids during defecation despite normal stools. Contrast enema revealed that the rectum was separated from the sacrum in each patient, which may have been caused by insufficient fixation of the rectum. Conservative treatment with laxatives and suppositories failed to achieve improvement. Therefore, all underwent a laparoscopic rectopexy. After surgery, each patient was able to evacuate without strain and the hemorrhoids disappeared. Insufficient fixation of the rectum should be considered as a potential cause of defecation disorders. Rectopexy is effective for this type of defecation disorder.

  13. Therapeutic Effect of Activated Carbon-Induced Constipation Mice with Lactobacillus fermentum Suo on Treatment

    Directory of Open Access Journals (Sweden)

    Huayi Suo

    2014-11-01

    Full Text Available The aim of this study was to investigate the effects of Lactobacillus fermentum Suo (LF-Suo on activated carbon-induced constipation in ICR (Institute of Cancer Research mice. ICR mice were orally administered with lactic acid bacteria for 9 days. Body weight, diet intake, drinking amount, defecation status, gastrointestinal transit and defecation time, and the serum levels of MTL (motilin, Gas (gastrin, ET (endothelin, SS (somatostatin, AChE (acetylcholinesterase, SP (substance P, VIP (vasoactive intestinal peptide were used to evaluate the preventive effects of LF-Suo on constipation. Bisacodyl, a laxative drug, was used as a positive control. The normal, control, 100 mg/kg bisacodyl treatment, LB (Lactobacillus bulgaricus-, LF-Suo (L- and LF-Suo (H-treated mice showed the time to the first black stool defecation at 90, 218, 117, 180, 155 and 137 min, respectively. By the oral administration of LB-, LF-Suo (L, LF-Suo (H or bisacodyl (100 mg/kg, the gastrointestinal transit was reduced to 55.2%, 72.3%, 85.5% and 94.6%, respectively, of the transit in normal mice, respectively. In contrast to the control mice, the serum levels of MTL, Gas, ET, AChE, SP and VIP were significantly increased and the serum levels of SS were reduced in the mice treated with LF-Suo (p < 0.05. By the RT-PCR (reverse transcription–polymerase chain reaction and western blot assays, LF-Suo increased the c-Kit, SCF (stem cell factor, GDNF (glial cell line-derived neurotrophic factor and decreased TRPV1 (transient receptor potential vanilloid 1, NOS (nitric oxide synthase expressions of small intestine tissue in mice. These results demonstrate that lactic acid bacteria has preventive effects on mouse constipation and LF-Suo demonstrated the best functional activity.

  14. Treatment of Abdominal Segmental Hernia, Constipation, and Pain Following Herpes Zoster with Paravertebral Block.

    Science.gov (United States)

    Kim, Saeyoung; Jeon, Younghoon

    2015-01-01

    Herpes zoster (HZ) most commonly occurs in elderly patients and involves sensory neurons resulting in pain and sensory changes. Clinically significant motor deficits and visceral neuropathies are thought to be relatively rare. A 72-year-old man presented with abdominal segmental hernia, constipation, and pain following HZ in the left T9-10 dermatome. Sixteen days before presentation, he had developed a painful herpetic rash in the left upper abdominal quadrant. Approximately 10 days after the onset of the rash, constipation occurred and was managed with daily oral medication with bisacodyl 5 mg. In addition, 14 days after the onset of HZ, the patient noticed a protrusion of the left upper abdominal wall. Abdominal x-ray, ultrasound of the abdomen, and electrolyte analysis showed no abnormalities. General physical examination revealed a reducible bulge in his left upper quadrant and superficial abdominal reflexes were diminished in the affected region. Electromyographic testing revealed denervational changes limited to the left thoracic paraspinal muscles and supraumbilical muscles, corresponding to the affected dermatomes. He was prescribed with 500 mg of famciclovir 3 times a day for 7 days, and pregabalin 75 mg twice a day and acetaminophen 650 mg 3 times a day for 14 days. However, his pain was rated at an intensity of 5 on the numerical analogue scale from 0 (no pain) to 10 (worst pain imaginable). A paravertebral block was performed at T9-10 with a mixture of 0.5% lidocaine 3 mL and triamcinolone 40 mg. One day after the procedure, the abdominal pain disappeared. In addition, 5 days after the intervention, the abdominal protrusion and constipation were resolved. He currently remains symptom free at a 6 month follow-up. PMID:26431148

  15. Systematic review of randomised controlled trials:Probiotics for functional constipation

    Institute of Scientific and Technical Information of China (English)

    Anna; Chmielewska; Hania; Szajewska

    2010-01-01

    AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and ...

  16. Effectiveness of the bowel management program in children with constipation secondary to anorectal malformation

    Directory of Open Access Journals (Sweden)

    Karla A. Santos Jasso

    2014-07-01

    with the condition were included. Results: of 151 children with ARM monitored in outpatient service, only 67.33% had constipation. Of this group, 88.1% showed good response to the BMP. The average dose of sennoside was 8.45 mg/kg, 95% CI: 5.94-11.12 mg/kg (199.5 mg total dose; 95% CI: 139.50-259.50 mg. Abdominal cramp was the primary adverse effect reported (5.8%. Discussion: use of sennosides had a positive impact on our patients’ quality of life by achieving colonic and rectal emptying and preventing daily fecal staining.

  17. Chronic intestinal pseudo-obstruction as an expression of inflammatory enteric neuropathy

    Directory of Open Access Journals (Sweden)

    Rita Pimentel

    2014-11-01

    Full Text Available Chronic intestinal pseudo-obstruction (CIPO is characterised by inadequate digestive tract motility and can lead to severely disordered motility. CIPO manifests as recurrent episodes of intestinal sub-occlusion without an anatomical obstruction. We present the case of a 41-year-old female, with severe chronic constipation and several episodes of intestinal sub-occlusion. Investigation revealed colonic inertia and marked distension of the small bowel and colon with no evidence of stenosis or obstructive lesions, compatible with CIPO. After several treatments were tried (domperidone, erythromycin, cisapride, octreotide, total enteral nutrition, with partial or no response, further work-up was done trying to identify an etiology. Gastrointestinal manometry showed neuropathic type abnormalities, transmural biopsy of the jejunum revealed degenerative enteric neuropathy and anti-HU antineuronal antibody screen was positive, suggesting an autoimmune type neuropathy with diffuse involvement of the digestive tract. Corticosteroids showed partial improvement of short duration and azathioprine was also tried but discontinued due to intolerance. Marked dietary intolerance and malnutrition lead to total parenteral nutrition (TPN at home since October 2011. Since then, symptoms and nutritional status improved, with rare episodes of pseudo-obstruction, not requiring hospitalisation.

  18. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  19. Distinct resting-state brain activity in patients with functional constipation.

    Science.gov (United States)

    Zhu, Qiang; Cai, Weiwei; Zheng, Jianyong; Li, Guanya; Meng, Qianqian; Liu, Qiaoyun; Zhao, Jizheng; von Deneen, Karen M; Wang, Yuanyuan; Cui, Guangbin; Duan, Shijun; Han, Yu; Wang, Huaning; Tian, Jie; Zhang, Yi; Nie, Yongzhan

    2016-10-01

    Functional constipation (FC) is a common functional gastrointestinal disorder (FGID) with a higher prevalence in clinical practice. The primary brain regions involved in emotional arousal regulation, somatic, sensory and motor control processing have been identified with neuroimaging in FGID. It remains unclear how these factors interact to influence the baseline brain activity of patients with FC. In the current study, we combined resting-state fMRI (RS-fMRI) with Granger causality analysis (GCA) to investigate the causal interactions of the brain areas in 14 patients with FC and in 26 healthy controls (HC). Our data showed significant differences in baseline brain activities in a number of major brain regions implicated in emotional process modulation (i.e. dorsal anterior cingulate cortex-dACC, anterior insula-aINS, orbitofrontal cortex-OFC, hippocampus-HIPP), somatic and sensory processing, and motor control (i.e., supplementary motor area-SMA, precentral gyrus-PreCen) (Ppropel limbic regions at the aINS and HIPP to induce abnormal emotional processing regulating visceral responses; and weaker effective connectivity from the SMA and PreCen, which are regions involved with somatic, sensory and motor control, propel the aINS and HIPP, suggesting abnormalities of sensory and behavioral responses. Such information of basal level functional abnormalities expands our current understanding of neural mechanisms underlying functional constipation.

  20. Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child.

    Science.gov (United States)

    Kilway, Denise M

    2016-01-01

    This quality improvement project examined the use of fecal occult blood test in the constipated child in a pediatric gastroenterology outpatient clinic. A retrospective chart review was completed on 100 children seen for an initial visit with the gastroenterology provider. The number of fecal occult blood tests performed and the child's coinciding symptoms were tallied and compared with the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations. An educational intervention was held with the pediatric gastroenterology providers consisting of a PowerPoint presentation summarizing aims of the quality improvement project and reviewing recommendations for use of fecal occult blood test in the constipated child. Pre- and post-intervention chart review data sets were compared. Results showed a 19.6% decrease in the use of fecal occult blood tests performed during the post-intervention timeframe. However, when used in conjunction with North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, the appropriateness of fecal occult blood test use increased by 71.4% in the post-intervention patients. Reviewing the recommendations with gastroenterology providers assisted in optimizing the meaningful use of fecal occult blood test, improving quality and safety of care for children seen in the pediatric gastroenterology outpatient clinic.

  1. Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child.

    Science.gov (United States)

    Kilway, Denise M

    2016-01-01

    This quality improvement project examined the use of fecal occult blood test in the constipated child in a pediatric gastroenterology outpatient clinic. A retrospective chart review was completed on 100 children seen for an initial visit with the gastroenterology provider. The number of fecal occult blood tests performed and the child's coinciding symptoms were tallied and compared with the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations. An educational intervention was held with the pediatric gastroenterology providers consisting of a PowerPoint presentation summarizing aims of the quality improvement project and reviewing recommendations for use of fecal occult blood test in the constipated child. Pre- and post-intervention chart review data sets were compared. Results showed a 19.6% decrease in the use of fecal occult blood tests performed during the post-intervention timeframe. However, when used in conjunction with North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, the appropriateness of fecal occult blood test use increased by 71.4% in the post-intervention patients. Reviewing the recommendations with gastroenterology providers assisted in optimizing the meaningful use of fecal occult blood test, improving quality and safety of care for children seen in the pediatric gastroenterology outpatient clinic. PMID:27070795

  2. Pushing beyond resistors and constipators: implementation considerations for infection prevention best practices.

    Science.gov (United States)

    Bearman, Gonzalo; Stevens, Michael P

    2014-01-01

    Despite increased knowledge in the science of infection prevention, the implementation of evidence-based best practices remains a challenge. The dissemination of infection prevention risk reduction best practices should be approached with flexibility and a collaborative perspective. High-quality evidence and cost assessments to support interventions are important initial considerations. An implementation framework should be contextually appropriate, take into account an organization's culture, and be mindful of an approach that minimizes complexity. Trialing an intervention within a specific unit may later lead to increased uptake organization wide. Highly functional collaborations with effective leaders are needed for successful implementation. Leadership for infection prevention initiatives may include upper level management; however, hospital epidemiologists and infection preventionists often play this role. Although published data fail to identify a single best integrative strategy for infection prevention practice change, success has been associated with education initiatives and seminars, audit and feedback, distribution of educational materials, marketing, mass media, positive deviance, and the employment of champions, facilitators, role models, and opinion leaders. Local personnel, such as organizational resistors and constipators, can be barriers to idea dissemination and implementation. In addition to a thoughtfully conceived implementation strategy, dealing with infection prevention resistors and constipators includes getting their buy-in early in the dissemination process, working around them, or terminating their employment. More data are needed to best define which infection prevention dissemination strategies are most effective. PMID:24407546

  3. Autism Spectrum Disorders May Be Due to Cerebral Toxoplasmosis Associated with Chronic Neuroinflammation Causing Persistent Hypercytokinemia that Resulted in an Increased Lipid Peroxidation, Oxidative Stress, and Depressed Metabolism of Endogenous and Exogenous Substances

    Science.gov (United States)

    Prandota, Joseph

    2010-01-01

    Worldwide, approximately 2 billion people are chronically infected with "Toxoplasma gondii" with largely yet unknown consequences. Patients with autism spectrum disorders (ASD) similarly as mice with chronic toxoplasmosis have persistent neuroinflammation, hypercytokinemia with hypermetabolism associated with enhanced lipid peroxidation, and…

  4. Treating Constipation

    Science.gov (United States)

    ... it costs. Ask if they have a drug discount program that can help you pay less for your medicine. Buy your medicine from the pharmacy that gives you the cheapest price.  Sign up for patient assistance programs: Most companies that make medicines have programs that help people ...

  5. Understanding Constipation

    Science.gov (United States)

    ... pregnancy or whenever abdominal muscles are lax. Bowel habits are also important. Sufficient time should be set aside to allow for undisturbed visits to the bathroom. In addition, the urge to have a bowel ...

  6. Effect of impingement abdomen vibration therapy on COPD patients with constipation%冲击式腹振疗法治疗慢性阻塞性肺疾病便秘患者的效果观察

    Institute of Scientific and Technical Information of China (English)

    蒋洪霞; 李青荷

    2015-01-01

    目的:探讨冲击式腹振疗法治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)便秘患者的效果。方法2013年8月~2014年7月将本院呼吸内科收治的COPD便秘患者83例,按随机数字表法随机分为两组,对照组48例,试验组35例。对照组采用常规治疗方法,试验组在常规治疗基础上给予冲击式腹振疗法治疗。比较两组患者治疗效果及治疗后便秘症状积分情况。结果两组患者治疗效果比较,P<0.05,差异具有统计学意义,试验组治疗总有效率明显高于对照组;两组患者治疗后便秘症状积分比较,P<0.05,差异具有统计学意义,试验组患者便秘症状积分明显低于对照组。结论冲击式腹振疗法能有效治疗COPD患者便秘,从而提高其生活质量,值得临床推广应用。%Objective To investigate the effect of abdominal vibration therapy on chronic obstructive pulmonary disease (COPD) patients with constipation. Methods In the respiratory department from August 2013 to July 2014, eighty-three COPD patients with constipation were divided into the experiment group (n=35) and the control group (n=48) using random digit table. The control group were treated with conventional western medicine and the experiment group received impingement abdomen vibration therapy on the basis of western medicine treatment. The two groups were compared in terms of symptoms of constipation and curative effect. Results The curative effect of the experiment groups was significantly better than that of the control group (P<0.05). The score on constipation in the experiment group was significantly lower than that of the control group (P<0.05). Conclusion The abdominal vibration therapy is effective in the treatment of COPD patients with constipation. It can improve their quality of life and be worthy of clinical application.

  7. Role of dietary patterns, sedentary behaviour and overweight of the longditudinal development of childhood constipation: The generation R Study

    NARCIS (Netherlands)

    Kiefte-de Jong, J.C.; Vries, de J.H.M.; Escher, J.; Jaddoe, V.W.; Hofman, M.K.; Raat, H.; Moll, H.

    2013-01-01

    The influence of childhood nutrition on the development of constipation beyond the period of weaning and breastfeeding is relatively understudied. In addition, eating patterns in childhood can be highly correlated with overweight and sedentary behaviour, which may also have an influence on constipat

  8. Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

    Directory of Open Access Journals (Sweden)

    Thaís Helena Benetti

    2011-03-01

    Full Text Available CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4% with a mean age of 47.5 years old (23-72 were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1 and distal (2 portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007, independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06. The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008, either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides

  9. 儿童功能性便秘生物反馈治疗研究进展%Biofeedback therapy for functional constipation in children

    Institute of Scientific and Technical Information of China (English)

    吴建霞

    2012-01-01

    Functional constipation ( FC ), also known as habitual or simple constipation, is a persistent primary constipation caused by non-systemic or intestinal diseases. It is a common cause of bowel disorders in children and accounts for more than 90% of constipated children. Biofeedback, as a new behavioral therapy, is widely used for FC adults with satisfactory results, but its efficacy in constipated children remains controversial. This article reviews the progress in the biofeedback therapy for functional constipation in children.%功能性便秘(functional constipation,FC)是指非全身疾病或肠道疾病所引起的原发性持续便秘,又称为习惯性便秘或单纯性便秘,是儿童排便障碍的常见原因.FC占儿童便秘的90%以上.生物反馈是一种新兴的行为疗法,被广泛用于成人FC患者的治疗,具有较好的效果.然而,其在治疗儿童便秘患者的疗效还存在一定的争议.文中就儿童FC生物反馈治疗的研究进展作一综述.

  10. Role of Synbiotics in the Treatment of Childhood Constipation: A Double-Blind Randomized Placebo Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mozhgan Sabbaghian

    2010-12-01

    Full Text Available Objective:Constipation is a common problem in children. There is some clinical evidence for the role of probiotics and prebiotics in the treatment of constipated children. This is the first study on the therapeutic effect of synbiotics (combination of probiotics and prebiotic in treatment of childhood constipation. Methods:In a double-blind randomized placebo controlled study 102 children aged 4-12 years with functional constipation were assessed according to Rome III criteria for 4 weeks. They were divided into 3 groups: Group A, received 1.5 ml/kg/day oral liquid paraffin plus placebo, group B, 1 sachet synbiotic per day plus placebo and group C, 1.5 ml/kg/day oral liquid paraffin plus 1 sachet synbiotic per day. Frequency of bowel movements (BMs, stool consistency, number of fecal incontinence episodes, abdominal pain, painful defecation per week, success of treatment and side effects were determined in each group before and after treatment. Findings:The frequency of BMs per week increased in all groups (P<0.001, but it differed between groups and was higher in group C (P=0.03. Stool consistency increased and number of fecal incontinence episodes, abdominal pain and painful defecation per week decreased in all groups similarly and there was statistically no difference between them. No side effects were reported in group B; the main side effect in group A and C was seepage of oil (P<0.001. Treatment success was similar in all groups without any significant difference between them (P=0.6.   Conclusion:This study showed that synbiotics have positive effects on symptoms of childhood constipation without any side effects.

  11. Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis

    Directory of Open Access Journals (Sweden)

    Mohammad M. H. Abdullah

    2015-12-01

    Full Text Available Background: Evidence-based research highlights beneficial impacts of dietary fibre on several aspects of the gut pathophysiology that are accompanied by a considerable financial burden in healthcare services. Recommended intakes of dietary fibre may thus associate with financial benefits at a population level. Objective: We sought to systematically assess the potential annual savings in healthcare costs that would follow the reduction in rates of functional constipation and irregularity with increased dietary fibre intakes among Canadian adults. Design: A cost-of-illness analysis was developed on the basis of current and recommended levels of fibre intake in Canada, constipation reduction per 1 g fibre intake, proportion of adults who are likely to consume fibre-rich diets, and population expected to respond to fibre intake. Sensitivity analyses covering a range of assumptions were further implemented within the economic simulation. Results: Our literature searches assumed a 1.8% reduction in constipation rates with each 1 g/day increase in fibre intake. With intakes corresponding to the Institute of Medicine's adequate levels of 38 g/day for men and 25 g/day for women, among 5 and 100% of the adult populations, anywhere between CAD$1.5 and CAD$31.9 million could be saved on constipation-related healthcare costs annually. Each 1 g/day increase in dietary fibre was estimated to result in total annual healthcare cost savings that ranged between CAD$0.1 and CAD$2.5 million. Conclusions: The present research suggests an economic value of increasing dietary fibre intake beyond its well-known health benefits. Healthy-eating behaviours consistent with the recommended intakes of dietary fibre by the general public should hence be advocated as a practical approach for reducing costs associated with the management of constipation in Canada.

  12. Association of High Dietary Saturated Fat Intake and Uncontrolled Diabetes with Constipation: Evidence from the National Health and Nutrition Examination Survey (NHANES)

    Science.gov (United States)

    Taba Vakili, Sahar Taba; Nezami, Behtash Ghazi; Shetty, Akshay; Chetty, Veerappa. K.; Srinivasan, Shanthi

    2015-01-01

    Background Constipation is highly prevalent in the United States. The association of dietary fat intake with constipation has not been well studied. We recently reported that mice fed a high-fat diet had higher incidence of constipation than regular diet fed mice. The aim of this study was to assess if increased intake of dietary saturated fat in humans is also associated with higher risk of constipation and reduced stool frequency. Methods Analyses were based on data from 6,207 adults (≥20 years) from the 2005–2006 and 2007–2008 cycles of the National Health and Nutrition Examination Surveys (NHANES) who had completed the bowel health questionnaire. Constipation was defined as a stool frequency of less than three times per week. Multivariable logistic regression analysis was used to calculate adjusted prevalence odds ratio estimates. Statistical analyses were performed using R and RStudio softwares. Key Results The prevalence of constipation in this sample was 3.1%. After multivariable adjustment high saturated fat remained associated with constipation. The odds ratio for high saturated fat intake associated with constipation was much higher in diabetics above 65 years, especially in non-Hispanic blacks, females, and those with poor glycemic control, compared to the control group. Conclusions & Inferences To our knowledge, this is the first report to investigate the association of high saturated fat diet, bowel frequency and diabetes. This study demonstrates that a high dietary saturated fat intake is associated with significant increase in the prevalence of constipation, especially in the uncontrolled diabetic, non-Hispanic black, female patients. PMID:26176421

  13. 生物反馈治疗小儿功能性便秘的疗效研究%Efficacy of biofeedback therapy in children with functional constipation

    Institute of Scientific and Technical Information of China (English)

    江米足; 张雁翼; 陈洁; 章许平; 欧弼悠

    2009-01-01

    Objective To evaluate the benefits of biofeedback therapy in children with functional constipation caused by pelvic floor dysfunction (PFD). Method Anorectal manometry (PC Polygraf HR, Medtronic) was performed in children with functional constipation according to the diagnostic criteria of Rome Ⅲ. Among them, 47 cases with PFD were trained with biofeedback therapy (PC Polygraf HR, Medtronic) according to the degree of cooperation. They received the treatment twice every week, and those in whom the therapy was performed at least three times were enrolled to evaluate the efficacy in this study. Result A total of 27 cases (20 male and 7 female) in whom the procedure was performed at least three times were eligible for inclusion into this study. The mean age of them was (6.7±2.2) years (range 4 12 years), and the mean duration of symptoms was (3.0±2.3) years with a range of 6 months to 8 years. Among them, 16 cases received the biofeedback training more than 5 times, while 8 cases more than 7 times. The rectal maximum contraction pressure during defecation was increased significantly with the number of biofeedback training before treatment and after 3, 5, and 7 times of treatment was (36.2± 10.4), (45.1±9.5), (47.6±9.1), and (47.8±8.8) mm Hg (1 mm Hg=0.133 kPa) respectively (P<0.01). The potential of ehctromyography of external anal sphincter decreased progressively, but had not reached significance. Follow-up continued for 3 to 12 months by telephone, the clinical response to biofeedback treatment was evaluated as excellent (complete resolution of constipation), good (improvement of constipation), partial or poor (no improvement of constipation). The response was excellent in 13 cases (48.1%), good in 8(29.6%), partial in 3(11.1%), and 2(7.5%) cases had no improvement, and 1 case was lost to follow-up, and the rate of success was 88.9% (24/27). Conclusion Biofeedback therapy is a safe and effective treatment option for functional constipation due to PFD in

  14. Aquaporins in the Colon as a New Therapeutic Target in Diarrhea and Constipation

    Science.gov (United States)

    Ikarashi, Nobutomo; Kon, Risako; Sugiyama, Kiyoshi

    2016-01-01

    Aquaporins (AQPs) play important roles in the water transport system in the human body. There are currently 13 types of AQP, AQP0 through AQP12, which are expressed in various organs. Many members of the AQP family are expressed in the intestinal tract. AQP3 is predominantly expressed in the colon, ultimately controlling the water transport. Recently, it was clarified that several laxatives exhibit a laxative effect by changing the AQP3 expression level in the colon. In addition, it was revealed that morphine causes severe constipation by increasing the AQP3 expression level in the colon. These findings have shown that AQP3 is one of the most important functional molecules in water transport in the colon. This review will focus on the physiological and pathological roles of AQP3 in the colon, and discuss clinical applications of colon AQP3. PMID:27447626

  15. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women

    Institute of Scientific and Technical Information of China (English)

    Yue-Xin Yang; Mei He; Gang Hu; Jie Wei; Philippe Pages; Xian-Hua Yang; Sophie Bourdu-Naturel

    2008-01-01

    AIM: To investigate the effect of a fermented milk containing Bifidobacterium lactis DN- 173010 and yogurt strains (BIO ) on adult women with constipation in Beijing. METHODS: A total of 135 adult females with constipation were randomly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria (control). Stool frequency, defecation condition scores, stool consistency and food intake were recorded at baseline and after 1 and 2 wk in an intention-to-treat population of 126 subjects. In parallel, safety evaluation parameters were performed. RESULTS: At baseline, no differences were found between groups. Following consumption of test product, stool frequency was significantly increased after 1 wk (3.5±1.5 vs 2.4±0.6, P < 0.01) and 2 wk (4.1±1.7 vs 2.4±0.6, P < 0.01), vs baseline. Similarly, after 1 and 2 wk, of test product consumption, defecation condition (1.1±0.9 vs 1.9±1.2, P < 0.01 and 0.8±1.0 vs 1.9±1.2, P < 0.01, respectively) and stool consistency (1.0±0.8 vs 1.5±1.1, P < 0.01 and 0.6±0.8 vs 1.5±1.1, P < 0.01, respectively) were significantly improved. Compared with the control group, stool frequency was also significantly increased (3.5±1.5 vs 2.5± 0.9, P <0.01 and 4.1±1.7 vs 2.6±1.0, P <0.01, respectively), and defecation condition (1.1±0.9 vs 1.6±1.1, P < 0.01 and 0.8±1.0 vs 1.6±1.1, P < 0.01, respectively) and stool consistency (1.0±0.8 vs 1.4±1.0, P < 0.05 and 0.6±0.8 vs 1.3±1.0, P < 0.01, respectively) significantly decreased after 1 and 2 wk of product consumption. During the same period, food intake did not change between the two groups, and safety parameters of the subjects were within normal ranges. CONCLUSION: This study suggests a beneficial effect of a fermented milk containing B. lactis DN-173010 on stool frequency, defecation condition and stool consistency in adult women with constipation constipated women after 1 and 2 wk of consumption.

  16. [Lead poisoning. A surprising cause of constipation, abdominal pain and anemia].

    Science.gov (United States)

    Hoffmanová, Iva; Kačírková, Petra; Kučerová, Irena; Ševčík, Rudolf; Sánchez, Daniel

    2016-02-01

    This article reports on patient that has been presented with sudden onset of constipation, abdominal pain and normocytic anemia. Gastroscopy and colonoscopy ruled out an organic diseases. In peripheral blood and bone marrow aspirates mears, coarse basophilic stippling of erythrocyte (and erythroblasts) point out a possibility of heavy metal poisoning. The level of plumbemia exceeded 8.4 times the maximal permitted value for common (non-professional) population. A source of poisoning was indentified from a glaze on a ceramic jug, from which the patient had drank tea with lemon for three months. A lead concentration in the tea extract was 227 mg/kg. In developed countries, lead poisoning is a rare diagnosis. As the symptoms are nonspecific, missed diagnoses could occur, especially in sporadic, non-occupational exposure. However, a microscopic evaluation of the peripheral bloods mear with finding of predominantly coarse basophilic stippling of erythrocyte mayle ad to suspicion of lead poisoning. PMID:27172444

  17. Consumo de fibra alimentar e de macronutrientes por crianças com constipação crônica funcional Fiber and nutrients intake in constipated children

    Directory of Open Access Journals (Sweden)

    Rosane C. Gomes

    2003-09-01

    .OBJECTIVES: The aim of this case-control study was to evaluate the intake of fiber alimentary and macronutrients in constipated children. METHODS: Fifty-four children (aged 2-12 yr with diagnosis of chronic functional constipation were investigated at the Pediatric Hospital, "Universidade Federal do Rio Grande do Norte", Natal, RN, Brazil. They were age and sex matched with 50 patients without constipation. A standard questionnaire was applied to both groups and a 3 day dietary record was analyzed by computer software. RESULTS: The mean age at onset of symptoms was 29,0 ± 26,1 months. There was not sex predominance and no difference about nutritional condition between the groups. Constipated children ate less fiber, proteins, lipids, carbohydrates and less caloric and protein adequated percentuals. The proportion of children who ate less dietary fiber than recommended (age + 5 g /day was greater in the constipated group (83,3% than in controls (66,6%; odds ratio 2,6. CONCLUSION: Constipated children ate less fiber and macronutrients than children without constipation. Intake of dietary fiber below the minimum recommendation is a risk factor for chronic functional constipation in children.

  18. 癌痛患者强阿片类药物镇痛治疗继发便秘现况调查分析%Survey of Constipation Induced by Strong Opioid Drugs in Patients with Cancer Pain

    Institute of Scientific and Technical Information of China (English)

    杨丽华; 段培蓓; 侯庆梅; 修闽宁; 陈毓雯

    2013-01-01

      目的探讨癌痛患者采用强阿片类药物镇痛治疗继发便秘的发生率、严重程度及其影响。方法选取2011年10月-2013年2月在江苏省中医院肿瘤内科接受镇痛治疗的107例住院患者,调查强阿片类药物相关性便秘的发生率、严重程度及对生活质量的影响。结果强阿片类药物相关性便秘发生率高达91.6%;在该类便秘各单项评分中,排便费力、排便不尽感位列前2位,积分值远高于其他单项;此类便秘对癌痛患者的生活质量造成严重影响。结论强阿片类药物相关性便秘发生率高、症状严重、持续时间长,是癌痛患者最主要的困扰之一,因此探寻一种有效的特异性针对便秘发生机制、安全简便且患者乐于接受的干预措施迫在眉睫。%Objective To assess the prevalence, severity and impact of opioid-induced constipation (OIC) in cancer patients receiving opioid therapy for chronic pain. Methods Totally 107 cases of patients complaining pain (NRS score for moderate-severe pain), and receiving treatment with strong opioid were surveyed for the occurrence and severity of OIC and its impact on their quality of life. Results The most frequently-seen side effect of strong opioid drugs was constipation (91.6%) and most patients reported that OIC had severely negative impact on their overall quality of life. Conclusion The survey findings confirm that OIC occurs frequently among patients taking opioids for chronic cancer pain, which exerts negative impact on their quality of life. It is necessary to find a safe and acceptable approach specifically targeting the opioid-mediated mechanisms that cause constipation for patients.

  19. Effectiveness and safety of noninvasive positive-pressure ventilation for severe hypercapnic encephalopathy due to acute exacerbation of chronic obstructive pulmonary disease:a prospective case-control study

    Institute of Scientific and Technical Information of China (English)

    ZHU Guang-fa; ZHANG Wei; ZONG Hua; XU Qiu-fen; LIANG Ying

    2007-01-01

    Background Although severe encephalopathy has been proposed as a possible contraindication to the use of noninvasive positive-pressure ventilation(NPPV),increasing clinical reports showed it was effective in patients with impaired consciousness and even coma secondary to acute respiratory failure,especially hypercapnic acute respiratory failure(HARF).To further evaluate the effectiveness and safety of NPPV for severe hypercapnic encephalopathy,a prospective case-control study was conducted at a university respiratory intensive care unit(RICU)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)during the past 3 years.Methods Forty-three of 68 consecutive AECOPD patients requiring ventilatory support for HARF were divided into 2 groups,which were carefully matched for age,sex,COPD course,tobacco use and previous hospitalization history,according to the severity of encephalopathy,22 patients with Glasgow coma scale(GCS)0.05),but group A needed an average of 7 cmH2O higher of maximal pressure support during NPPV,and 4,4 and 7 days longer of NPPV time,RICU stay and hospital stay respectively than group B(P<0.05 or P<0.01).NPPV therapy failed in 12 patients(6 in each group)because of excessive airway secretions(7 patients),hemodynamic instability(2),worsening of dyspnea and deterioration of gas exchange(2),and gastric content aspiration(1).Conclusions Selected patients with severe hypercapnic encephalopathy secondary to HARF can be treated as effectively and safely with NPPV as awake patients with HARF due to AECOPD;a trial of NPPV should be instituted to reduce the need of endotracheal intubation in patients with severe hypercapnic encephalopathy who are otherwise good candidates for NPPV due to AECOPD.

  20. Constipation acupuncture in the treatment of thoracolumbar fractures after abdominal distension constipation curative effect observation%便秘灸治疗胸腰椎骨折后腹胀便秘的疗效观察

    Institute of Scientific and Technical Information of China (English)

    任春霞

    2016-01-01

    目的:观察便秘灸治疗胸腰椎骨折患者腹胀、便秘的疗效。方法:将102例胸腰椎骨折后腹胀便秘的患者随机分成两组,观察组用便秘灸贴敷脐部,对照组给予腹部按摩、热敷、口服缓泻剂等方法。观察两组患者肛门排气、排便、腹胀消除的情况及观察两组病人副作用发生情况。结果:观察组总有效率96.15%,对照组74%。副作用发生情况:观察组9.16%,对照组36%。结论:便秘灸治疗胸腰椎骨折患者腹胀便秘效果优于按摩、热敷、口服缓泻剂等方法。两组比较,差异有统计学意义(P<0.01)。%Objective To observe the constipation main treatment of thoracolumbar fractures in patients with abdominal distension and constipation curative effect.Methods 102 cases of thoracolumbar fractures after abdominal distension constipation patients were randomly divided into two groups, observation group with constipation main navel, the control group given abdominal massage and hot compress, oral sugar-refining, etc. Observe two groups of patients with anal exhaust, defecation, abdominal distension, eliminate.Results Observation group total effectiveness 96.15%, control group 74%.Conclusion Abdominal distension of constipation in patients with constipation acupuncture treatment thoracolumbar fractures is better than massage and hot compress, oral sugar-refining, etc. Comparison of similar between the two groups was statistically significant (P<0.01).

  1. Acquired chronic hepatocerebral degeneration due to cirrhosis from non-alcoholic steatohepatitis Síndrome hepatocerebral crónico secundario a cirrosis por esteatohepatitis no alcohólica

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    A. Burgos

    2009-11-01

    Full Text Available Introduction and objective: acquired chronic hepatocerebral degeneration, acquired hepatolenticular degeneration or pseudo-Wilson is an infrequent disorder with a hepatic origin. Cases in the literature are scarce and it is frequently confused with hepatic encephalopathy and Wilson's disease. The aim of this essay is to report a patient suffering from this disorder due to cirrhosis from non-alcoholic steatohepatitis. Case report: we present a 54-year-old man diagnosed from cirrhosis grade B9 of the Child Pugh classification. He progressively developed a picture with bradylalia, mild postural and action tremor and spatial and temporal disorientation. Further studies demonstrated an increase of the values of hepatic transaminases and a hiperintensity in the basal nuclei in the cerebral magnetic resonance imaging. Clinical and radiological data established the diagnosis of hepatocerebral degeneration. Conclusions: acquired chronic hepatocerebral degeneration is a disorder rarely reported in the literature that it is usually confused with other diseases. We alert about the need of having this diagnosis into account with patients developing neurological symptoms after hepatic disease.Fundamento y objetivo: el síndrome hepatocerebral crónico, también denominado degeneración hepatolenticular crónica adquirida (DHCA o pseudo-Wilson, es un trastorno poco frecuente de origen hepático. Los casos recogidos en la literatura son escasos y frecuentemente es confundido con la encefalopatía hepática y con la enfermedad de Wilson. El objetivo de este artículo es presentar un paciente que sufre este trastorno de forma secundaria a una cirrosis por esteatohepatitis no alcohólica. Caso clínico: se trata de un varón de 54 años diagnosticado de cirrosis en grado funcional de Child-Pugh B9 que presentó un cuadro progresivo de bradilalia, temblor postural y de acción leve y, en ocasiones, desorientación temporoespacial. Los estudios complementarios

  2. Chronic functional bowel syndrome enhances gut-brain axis dysfunction, neuroinflammation, cognitive impairment, and vulnerability to dementia.

    Science.gov (United States)

    Daulatzai, Mak Adam

    2014-04-01

    The irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder world wide that lasts for decades. The human gut harbors a diverse population of microbial organisms which is symbiotic and important for well being. However, studies on conventional, germ-free, and obese animals have shown that alteration in normal commensal gut microbiota and an increase in pathogenic microbiota-termed "dysbiosis", impact gut function, homeostasis, and health. Diarrhea, constipation, visceral hypersensitivity, and abdominal pain arise in IBS from the gut-induced dysfunctional metabolic, immune, and neuro-immune communication. Dysbiosis in IBS is associated with gut inflammation. Gut-related inflammation is pivotal in promoting endotoxemia, systemic inflammation, and neuroinflammation. A significant proportion of IBS patients chronically consume alcohol, non-steroidal anti-inflammatories, and fatty diet; they may also suffer from co-morbid respiratory, neuromuscular, psychological, sleep, and neurological disorders. The above pathophysiological substrate is underpinned by dysbiosis, and dysfunctional bidirectional "Gut-Brain Axis" pathways. Pathogenic gut microbiota-related systemic inflammation (due to increased lipopolysaccharide and pro-inflammatory cytokines, and barrier dysfunction), may trigger neuroinflammation enhancing dysfunctional brain regions including hippocampus and cerebellum. These as well as dysfunctional vago-vagal gut-brain axis may promote cognitive impairment. Indeed, inflammation is characteristic of a broad spectrum of neurodegenerative diseases that manifest demntia. It is argued that an awareness of pathophysiological impact of IBS and implementation of appropriate therapeutic measures may prevent cognitive impairment and minimize vulnerability to dementia. PMID:24590859

  3. Chronic penile strangulation

    OpenAIRE

    Lopes, Roberto I.; Silvia I Lopes; Roberto N. Lopes

    2003-01-01

    Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examin...

  4. Characterization of Changes in Global Genes Expression in the Distal Colon of Loperamide-Induced Constipation SD Rats in Response to the Laxative Effects of Liriope platyphylla.

    Directory of Open Access Journals (Sweden)

    Ji Eun Kim

    Full Text Available To characterize the changes in global gene expression in the distal colon of constipated SD rats in response to the laxative effects of aqueous extracts of Liriope platyphylla (AEtLP, including isoflavone, saponin, oligosaccharide, succinic acid and hydroxyproline, the total RNA extracted from the distal colon of AEtLP-treated constipation rats was hybridized to oligonucleotide microarrays. The AEtLP treated rats showed an increase in the number of stools, mucosa thickness, flat luminal surface thickness, mucin secretion, and crypt number. Overall, compared to the controls, 581 genes were up-regulated and 216 genes were down-regulated by the constipation induced by loperamide in the constipated rats. After the AEtLP treatment, 67 genes were up-regulated and 421 genes were down-regulated. Among the transcripts up-regulated by constipation, 89 were significantly down-regulated and 22 were recovered to the normal levels by the AEtLP treatment. The major genes in the down-regulated categories included Slc9a5, klk10, Fgf15, and Alpi, whereas the major genes in the recovered categories were Cyp2b2, Ace, G6pc, and Setbp1. On the other hand, after the AEtLP treatment, ten of these genes down-regulated by constipation were up-regulated significantly and five were recovered to the normal levels. The major genes in the up-regulated categories included Serpina3n, Lcn2 and Slc5a8, whereas the major genes in the recovered categories were Tmem45a, Rerg and Rgc32. These results indicate that several gene functional groups and individual genes as constipation biomarkers respond to an AEtLP treatment in constipated model rats.

  5. [Food intake, nutritional status and physical activity between elderly with and without chronic constipation. A comparative study].

    Science.gov (United States)

    Vargas-García, Elisa Joan; Vargas-Salado, Enrique

    2013-01-01

    antecedentes: el estreñimiento es uno de los trastornos gastrointestinales más comunes en la población de edad avanzada porque con el paso de los años los factores implicados en su causa se modifican y repercuten en la ingestión de alimentos, el estado de nutrición y la actividad física. Objetivo: evaluar en el adulto mayor el efecto en el estreñimiento crónico del consumo de alimentos con alto contenido de fibra, el estado nutricio, y la actividad física. Material y métodos: estudio comparativo, prospectivo y transversal efectuado en 140 adultos mayores de la consulta externa de la Unidad de Medicina Familiar51 del Instituto Mexicano del Seguro Social en la ciudad de León, Guanajuato, durante el periodo del 4 mayo al 30 de octubre de 2009. Se valoró si padecían o no estreñimiento de acuerdo con los criterios de Roma III. Se valoró: peso,talla, circunferencia del brazo, pliegue cutáneo tricipital; se aplicó un cuestionario de actividad física validado, y se obtuvo el registro dietético de tres días (dos de entre semana y uno de sábado o domingo). Resultados: la ingestión promedio de fibra y agua no esultó estadísticamente diferente entre los grupos estudiados. Los pacientes con estreñimiento tuvieron dietas menos completas y variadas (p fibra no se relacionó con el estreñimiento.

  6. Effect of Reinforcing Qi and Moistening Intestine Oral Liquid on Anorectal Manometry of Asthenia Type Constipation Patients

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the change of anorectal manometry in asthenia type constipation patients and effect of reinforcing Qi and moistening intestine oral liquid (RQMI) on it. Methods: The total of 135 cases were divided into healthy group, RQMI treated group, Maren pill (MRP) treated group and prepulsid (PPS) treated group, their anal maximal voluntary squeez pressure, rectoanal contraction reflex, rectoanal inhibitory reflex, defecation reflex, rectal volume sensory threshold and rectal maximal tolerable volume were observed. Results: The rectal sensory function of patients weakened obviously and anal sphincter reactivity reduced as compared with those of healthy person (P<0.01), and both were improved by RQMI treatment (P<0.05). Conclusion: RQMI is superior to MRP and prepulside in improving anorectal dynamic abnormality in constipation patient of asthenia type.

  7. Improved Health-Related Quality of Life After Surgical Management of Severe Refractory Constipation-Dominant Irritable Bowel Syndrome

    OpenAIRE

    Lam, Jennifer Y.; Kidane, Biniam; Manji, Farouq; Taylor, Brian M.

    2015-01-01

    Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders (FGIDs). Despite its prevalence and health-care costs, there are few effective therapies for patients with severe symptoms. Our objective was to determine whether surgical management would improve health-related quality of life (HRQOL) in severe refractory constipation-dominant FGIDs. From 2003 to 2005, 6 patients underwent total colectomy with end ileostomy or primary anastomosis. They completed Sh...

  8. Determination of gastrointestinal transit time in functional constipation in children%功能性便秘患儿胃肠传输时间的测定

    Institute of Scientific and Technical Information of China (English)

    杨敏; 王宝西; 王茂贵

    2005-01-01

    BACKGROUND: Functional constipation (FC) might exert great influence on children in body and mental health, social-psychological development and long-term life quality. At present, there is not precise definition, clear classification, unite diagnostic standards and practicable systematic treatment project for FC in children. As a non-traumatic diagnostic means for chronic transiting constipation, gastrointestinal transit time (GTT) is considered as one of the objective indexes for dynamically observing gastrointestinal transit function, and has significance in the diagnosis of abnormal gastrointestinal dynamics, etiological investigation and therapeutic effect assessment.OBJECTIVE: To investigate the difference of GTT between constipation children and normal healthy control, so as to elicit its significance in assessing the dynamics of whole gastro-intestine and each segment.DESIGN: Case control comparative study based on FC children and healthy children.SETTING: Department of Pediatrics, Guangdong Provincial General Hospital, Chinese People's Armed Police Forces.PARTICIPANTS: This study was carried out at Pediatric Department of Guangdong Provincial General Hospital, Chinese People' s Armed Police Forces. Totally 28 children with confirmed FC in the General Hospital of Armed Police took part in the experiment, and 68 healthy children from a certain kindergarten and an elementary school in Guangdong province were selected as normal controls.METHODS: Whole gastrointestinal transit time(GTT), mouth-intestine transit time and colon transit time(CTT) were determined with plain abdominal photograph at 12 hours, 24 hours and 48 hours after orally administrated of radio-opaque markers.MAIN OUTCOME MEASURES: Whole GTT, mouth-intestine transit time and CTT, as well as right colonic transit time, left colonic transit time, rectosigmoid transit time.RESULTS: 50% whole gastrointestinal transit time, mouth-intestine transit time and CTT were[(23.6±1.6) vs (80.4±2.1) hours

  9. Observation on Therapeutic Results in Tuina Treatment of 56 Cases of Infantile Constipation

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-mei; SU Chun-lan

    2004-01-01

    将56例小儿便秘患者分为胃肠积热型,气机不畅型和气阴两虚型,取大肠、中脘、八卦、七节骨、承山、足三里和迎香,应用小儿推拿手法治疗.痊愈45例,有效9例,无效2例,总有效率96.5%.%After 56 cases of infantile constipation were divided into the pattern of stagnation of heat in the stomach and intestines, pattern of obstruction of qi activity and pattern of deficiency in both qi and yin, the treatments were given by infantile Tuina techniques on the infantile points of Dachang (Extra),Zhongwan (CV 12), Bagua (Extra), Qijiegu (Extra), Chengshan (BL 57), Zusanli (ST 36) and Yingxiang (LI 20). The results showed cure in 45 cases, effectiveness in 9 cases, failure in 2 cases and the total effective rate was 96.5%.

  10. Effect and safety of deep needling and shallow needling for functional constipation: a multicenter, randomized controlled trial.

    Science.gov (United States)

    Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

    2014-12-01

    Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study.SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (Pabdominal distention during spontaneous defecating, or Cleveland Clinic Scores over week 1 to 4. However, the lactulose group got better effect than other 2 acupuncture groups in improving stool consistency (Pacupuncture groups were both lower than in the lactulose group at each time

  11. The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt

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    Hebatallah Nour-Eldein

    2014-01-01

    Full Text Available Background: Constipation has a significant impact on the quality of life (QOL. Lifestyle modification is widely accepted and recommended by experts as first-line therapy. Aim: This study aimed at using education on lifestyle modification to improve the QOL of the elderly in nursing homes suffering from functional constipation (FC. Materials and Methods: This study was conducted in nursing homes in Ismailia city, Egypt. It involved 23 elderly patients suffering from FC, who were randomly selected according to the sample equation. They fulfilled the inclusion criteria of being ≥60 years age and according to Rome II criteria. Participants completed personal characteristics and lifestyle questionnaire, the Patient Assessment of Constipation Symptom questionnaire (PAC-SYM to assess the severity of symptoms, and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL to assess pre- and post-intervention. The intervention was conducted in three sessions, of 30 min each, 2 weeks apart using group discussions to educate the sample about dietary pattern, fluid intake, regular physical activity, and the use of laxatives. Statistical analysis: Data were analyzed using a statistical package for social sciences (SPSS version 20. Results: The lifestyle modification education on constipation significantly reduced the severity of symptoms as measured by PAC-SYM, including its total score and subscores (P < 0.001. It also improved the QOL of elderly suffering from constipation as measured by PAC-QOL and reduced total scores of dissatisfaction (P = 0.001 with the exception of the psychosocial subscale. It also significantly increased the satisfaction subscale of PAC-SYM (P < 0.001. Conclusion: Education on lifestyle modification leads to an improvement in the severity of the symptoms of constipation and the QOL of the elderly in nursing homes.

  12. Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain : a focus group study

    NARCIS (Netherlands)

    Muijzer, Anna; Geertzen, Jan H.; de Boer, Wout E.; Groothoff, Johan W.; Brouwer, Sandra

    2012-01-01

    Background: Efforts undertaken during the return to work (RTW) process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES) in cases of sick-listed employees with chronic low b

  13. Toxicology and safety of the tincture of Operculina alata in patients with functional constipation

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    Luciana Kelly Ximenes dos Santos

    2012-09-01

    Full Text Available The tincture of Operculina alata, popularly known as "tincture of jalapa", is used in Northeast Brazil to treat constipation and encephalic vascular accident, but it has not yet been adequately tested for safety and efficacy. The aim of this study was to evaluate the toxicology and safety of the tincture of O. alata in patients with functional constipation. This was a double-blind, randomized, placebo-controlled clinical trial. The study consisted of three phases: pre-treatment, treatment and post-treatment, each phase with duration of seven days. Arterial pressure, heart rate, body weight, adverse events, hematological, metabolic, liver and kidney functions were monitored. Forty patients were randomized to receive tincture of O. alata and 43 patients to receive placebo. There were statistical differences in the clinical aspects between groups, but these changes were not considered clinically significant. Adverse events were considered not serious and of mild intensity, especially dizziness, headache, abdominal pain and nausea. This clinical trial confirmed the safety of the tincture of O. alata in the pharmaceutical form and dosage tested, allowing the product to be safely used in a larger population for the assessment of its clinical efficacy.A tintura de Operculina alata, popularmente conhecida como "tintura de jalapa", é usada no Nordeste do Brasil para tratar constipação intestinal e acidente vascular encefálico, mas sua eficácia e segurança ainda não foram confirmadas. O objetivo deste estudo foi avaliar a toxicologia e segurança da tintura de O. alata em pacientes com constipação intestinal funcional. Este foi um ensaio clínico duplo-cego, randomizado e controlado por placebo. O estudo consistiu de três fases: pré-tratamento, tratamento e pós-tratamento, cada fase com duração de sete dias. Foram monitorizados a pressão arterial, frequência cardíaca, peso corporal, eventos adversos e funções hematológica, metab

  14. The Clinical Study on Hyponatremia as Complicated by Respiratory Failure due to Chronic Obstructive Disease%慢性阻塞性肺疾病呼吸衰竭并发低钠血症的临床研究

    Institute of Scientific and Technical Information of China (English)

    童长刚

    2013-01-01

    目的:探讨慢性阻塞性肺疾病合并呼吸衰竭患者并发低钠血症的影响因素,寻找最佳的防治措施。方法:回顾性分析2010-2013年本院收治的106例慢性阻塞性肺疾病呼吸衰竭并发低钠血症患者,通过分析临床资料,找出低钠血症发生的原因及有效的治疗方案。结果:106例患者除原发疾病外,有85例伴随不同程度的精神症状和体征,全部患者的血钠平均水平为(119.77±6.53)mmol/L,伴有代偿性呼吸性酸中毒的患者18例,伴有失代偿性呼吸性酸中毒的患者52例,呼吸性酸中毒合并代谢性碱中毒17例,呼吸性酸中毒合并代谢性酸中毒14例。在综合治疗的基础上补钠,纠正电解质紊乱,治疗后患者痊愈77例,好转26例,病情恶化死亡3例。死亡的3例患者中,2例死于多器官衰竭,1例死于重度低钠血症。结论:慢性阻塞性肺疾病呼吸衰竭的患者并发低钠血症的发生率较高,临床医生需要仔细观察患者表现,做到早期发现、明确诊断、有效干预。%Objective:To investigate the pathogenic causes of chronic obstructive pneumonic disease(COPD)with respiratory failure and hyponatremia,and formulate the best preventive measure. Method:To select clinical data of 106 management of COPD with respiratory failure and hyponatremia patients admitted in our hospital during 2010 to 2013 and retrospectively analyze. The pathogenic causes and effective treatments of hyponatremia were identified. Result:In 106 patients with primary disease,85 cases accompany with different degree of mental symptoms and signs. The serum sodium average of all patients was(119.77±6.53)mmol/L. 106 patients included compensatory respiratory acidosis(18 cases),decompensate respiratory acidosis(52 cases),respiratory acidosis and metabolic alkalosis(17 cases),and respiratory acidosis and metabolic acidosis(14 cases). On the basis of comprehensive therapy,patients were

  15. Opiate-induced constipation related to activation of small intestine opioid μ2-receptors

    Institute of Scientific and Technical Information of China (English)

    Wency Chen; Hsien-Hui Chung; Juei-Tang Cheng

    2012-01-01

    AIM:To investigate the role of opioid μ-receptor subtype in opiate-induced constipation (OIC).METHODS:The effect of loperamide on intestinal transit was investigated in mice.Ileum strips were isolated from 12-wk-old male BALB/c mice for identification of isometric tension.The ileum strips were precontracted with 1 μmol/L acetylcholine (ACh).Then,decrease in muscle tone (relaxation) was characterized after cumulative administration of 0.1-10 μmol/k loperamide into the organ bath,for a concentration-dependent study.Specific blockers or antagonists were used for pretreatment to compare the changes in loperamide-induced relaxation.RESULTS:In addition to the delay in intestinal transit,loperamide produced a marked relaxation in isolated ileum precontracted with ACh,in a dose-dependent manner.This relaxation was abolished by cyprodime,a selective opioid μ-receptor antagonist,but not modified by naloxonazine at a dose sufficient to block opioid μ-1 receptors.Also,treatment with opioid μ-1 receptor agonist failed to modify the muscle tone.Moreover,the relaxation by loperamide was attenuated by glibenclamide at a dose sufficient to block ATP-sensitive K+ (KATP) channels,and by protein kinase A (PKA) inhibitor,but was enhanced by an inhibitor of phosphodiesterase for cyclic adenosine monophosphate (cAMP).CONCLUSION:Loperamide induces intestinal relaxation by activation of opioid μ-2 receptors via the cAMPPKA pathway to open KATP channels,relates to OIC.

  16. Burden of constipation-predominant irritable bowel syndrome (IBS-C) in France, Italy, and the United Kingdom

    OpenAIRE

    DiBonaventura MD; Prior M; Prieto P.; Fortea J

    2012-01-01

    Marco daCosta DiBonaventura,1 Mercedes Prior,2 Pablo Prieto,2 Josep Fortea21Health Outcomes Practice, Kantar Health, New York, NY, USA; 2Global Market Access, Marketing and Medical Affairs, Almirall, Barcelona, SpainBackground: Several studies have examined the effect of irritable bowel syndrome (IBS) on health outcomes in Western Europe, but less research has focused on the constipation subtype (IBS-C). The current study addresses this gap by comparing patients with IBS-C and matched control...

  17. Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study

    Directory of Open Access Journals (Sweden)

    Oriol Cunillera

    2015-07-01

    Full Text Available Introduction: Kiwifruit consumption has shown to improve functional constipation in healthy elderly population, according to studies in New Zealand and China. The aim of this study was to evaluate the effect of kiwifruit intake on functional constipation in a Mediterranean patient population characterized by its distinctive nutritional habits.Material and Methods: An open, non-controlled and non-randomized longitudinal study was conducted in 46 patients with constipation (Rome III criteria. Patients monitored for five weeks: weeks 1 and 2 no kiwifruit and weeks 3-5 three kiwifruit per day (Green kiwifruit, Actinidia deliciosa var Hayward. Bristol Scale, volume of stools, and ease of defecation was self- reported daily. The evolution of the categorical variables was tested using the Bhapkar test; functional data methodology was used for continuous variables, and Generalized Estimating Equation (GEE models were adjusted.Results: The percentage of patients with ≥3 stools per week increased from 82.61% (95% CI: 69–91.2 at week 1 to 97.78% (95% CI: 87.4–99.9 at week 2 of kiwifruit intake, with 76.09% (95% CI: 61.9–86.2 responding during the first week. The reporting of stable ideal stools increased from 17.39% (95% CI: 8.8–31 at week 2 to 33.33% (95% CI: 21.3–48 at week 5. According to GEE models, the number of depositions increased significantly (p-values<0.001 in 0.398 daily units at week 1 the first week of intake, up to 0.593 daily units at week 5; significant improvements on facility in evacuation and volume of evacuation were found from the firstweek of intake (all p-values<0.001.Conclusions: The intake of three kiwifruits per day significantly improves the quality of evacuation (number of depositions, volume, consistency and ease in a Mediterranean patient population suffering from functional constipation.

  18. Discussion on Constipation in Patients With Acute Myocardial Infarction Care%急性心肌梗死患者便秘护理问题的探讨

    Institute of Scientific and Technical Information of China (English)

    范艳华

    2015-01-01

    目的:探讨急性心肌梗死患者便秘的护理措施。方法通过对26例急性心肌梗死患者便秘的护理评估,总结护理方法。结果本组患者中无一例出现排便用力导致死亡。结论个性化护理对缓解急性心肌梗死患者便秘,甚至并发症至关重要。%Objective To investigate constipation in patients with acute myocardial infarction care measures. Methods 26 patients with acute myocardial infarction in patients with constipation nursing assessment, nursing summary. Results None of the patients in this group appear defecation leads to death. Conclusion Personalized care to relieve constipation in patients with acute myocardial infarction, even critical complications.

  19. 老年性便秘中医辨治探讨%Discuss Traditional Chinese Medicine for Constipation in Older Adluts

    Institute of Scientific and Technical Information of China (English)

    吴至久; 代渊; 王飞

    2012-01-01

    This aticle is from the older adults' physical characteristics, diet and daily life, medication, TCM syndrome differentiation and ancient literature to discuss traditional Chinese medicine for constipation in older adluts. It has certain significance to clinical treatment for constipation in older adluts.Older adluts; constipation; traditional Chinese medicine; treatment based on syndrome%文章从老年人的身体素质特点、饮食起居、中医辨证特点及用药注意事项等方面同时结合古代文献详细阐述老年性便秘的中医辨证治疗,对临床有一定指导意义.

  20. [Transition to adult care for children with chronic neurological disorders; which is the best way to make it?].

    Science.gov (United States)

    Moreno Villares, José Manuel

    2014-01-01

    Chronic neurological disorders in children have significant effects on adult medical and social function. Transition from pediatric to adult services is a complex process. No objective data are available to inform physicians about the most effective approach. Nevertheless the most recommended approach is a joint pediatric/adult transition clinic. Malnutrition, either under or overnutrition, is a common condition among neurologically impaired children. Undernutrition is most prevalent, and its causes are diverse: insufficient caloric intake, excessive nutrient losses and abnormal energy metabolism. Malnutrition is associated with significant morbidity, while nutritional rehabilitation improves overall health as well as quality of life. It is not easy to determine which the nutritional needs in these patients are. Besides, they often present difficulties for oral feeding, mainly due to oromotor dysfunction. Gastrointestinal symptoms, gastro esophageal reflux and constipation, as well as spasticity, scoliosis and joint deformities contribute to these difficulties. Because of that, an assessment of nutritional status should be performed periodically, and to assess efficacy and security of oral intake. If modifying oral diet we cannot confirm an adequate support, a nasogastric tube or a gastrostomy need to be considered. Often, a fundoplication is associated to the placement of a gastrostomy. Although the outcomes in a better nutritional status and quality of life are often obtained, it is not an easy decision for families. PMID:25077342

  1. Analysis on Electroencephalogram(EEG) in Patients with Mental Disorder Due to Chronic Alcoholism%慢性酒精中毒性精神障碍患者脑电图分析

    Institute of Scientific and Technical Information of China (English)

    洪美娜; 吴民吉; 庄镇欣; 周佩心; 刘满芬; 李佩宜

    2013-01-01

    Objective To study the relation EEG changes and course of chronic alcoholism. Methods 48 male patients with chronic alcoholism were examined with EEG . Results 60.4%of alcohole patients were found to have abnormal EEG significantly higher than normal control group. The date had statistical meaning. The common abnomality included arrhythmia, increased slow wave. Conclusion Chronic alcoholism can cause extensive cerebral damage as manifestated by the EEG changes. The ef ect on EEG was related to the dosage and time of drinking alcohol.%目的探讨慢性酒精中毒的脑电图改变。方法对48例慢性酒精中毒性精神障碍患者进行脑电图检查。结果显示异常率为60.4%,明显高于对照组10%,差异非常显著(P﹤0.01)。饮酒时间长、饮酒量大,脑电图异常率高。脑电图主要异常可分为慢波型和失律型。结论提示慢性酒精中毒对脑功能的影响及其脑组织的损害是弥漫性的。对脑电图的影响程度与饮酒时间、饮酒量大小有关。

  2. Molecular characterization in patients with chronic granulomatous disease due to p47phox deficiency Caracterización molecular en pacientes con enfermedad granulomatosa crónica por deficiencia en p47 phox

    Directory of Open Access Journals (Sweden)

    Diana García de Olarte

    1998-01-01

    Full Text Available NADPH oxidase system is an enzymatic electron transport complex localized in the membrane of phagocytic cells. Several proteins belong to this system: A flavocytochrome b558, formed by a b chain (gp91.phox and an a chain (p22.phox and, at least, 3 cytosolic proteins (p47.phox, p67.phox and p40 phox. Genetic alteration in any of these proteins causes the syndrome of Chronic Granulomatous Disease (CGD. Characterization of mutations in patients with CGD has been fundamental to elucidate the structure and function of NADPH oxidase system ComponentS. Several findings make p47.phoX an interesting model to study the molecular mechanism involved in regulating the expreSSion and bioChemical function ofthis system. So far, in patients with p47.phoX defect a deletion of dinucleotide GT has been foUnd at the beginning of exon 2; most of them are homocygotic for this deletion which is probably due to recombinant events between normal p47.phoX gen and a recently described pseudogen. Any mutation found when diagnosing non.homocygotic patients (gDNA or cDNA may represent a pseudogen change. Therefore, for precise identification of the genetic defect it is necessary to separate the normal gen from the pseudogen and to analyze individual sequences. Non.homocygotic patients posibly have a second mutation in the wild type allele different fron GT deletion. On the other hand, through site. oriented mutagenesis it is posible to modify some of the aminoacids or domains of p47.phoX, which may be essential for its function and relationship with CGD. With this method010gy it is possible to introduce changes in a gen whoSe sequence is thoroughly known and which is amplified; mutants So generated can give information concerning the structure and function of the analyzed genes, observing their effect on function. In this way the importance of a structural change on the function of a protein can be determined. El sistema NAOPH oxidasa es un complejo enzimático transportador

  3. [Constipation in the hospital. Ethical reflection on its care by the nursing staff].

    Science.gov (United States)

    Berger, Valérie; Durand, Luc; Grocq, Martine

    2010-12-01

    The intestinal elimination of the hospitalized patients is a function insufficiently taken into account by the nursing staff from a preventive point of view. Nevertheless, numerous patients present transit disorders which are mostly translated into a diagnosis of constipation requiring therapeutic prescriptions and sometimes even aggressive and expensive medical examinations. The objective of this work is to lead an ethical reflection on the care of intestinal elimination by the nursing staff. Through a questionnaire, we wish to answer 3 questions: how come the nursing staff have difficulties taking care of the intestinal elimination of the hospitalized patients? What are the determiners which influence the care of the intestinal elimination by the nursing staff? Does training prepare the nursing staff to take care of the intestinal elimination of the hospitalized patients? The questionnaire was distributed to doctors, male and female nurses, nursing auxiliaries and students in care of the sick working in medicine, surgery and intensive care of the same hospital. This survey allowed to question 130 persons among whom 36 doctors, 37 male and female nurses, 30 nursing auxiliaries and 27 students. We were able to confirm that the care of the intestinal elimination is insufficiently taken into account in a preventive way, because 56 % of the people interviewed explain that the problem of intestinal elimination is not approached before the complaint of the patient Several determiners make that the nursing staff are not in a preventive approach. This care does not meet much interest, is experienced as devaluing, taboo and the relation nursing staff-patient is hindered because everyone has difficulties to speak about it. Institutional difficulties are also discussed, such as the lack of coordination of the nursing staff and the lack of time. Another point of this survey shows that work experience is not an element which facilitates this care because the more the nursing

  4. Investigation of attention via the counting Stroop task in patients with functional constipation

    Institute of Scientific and Technical Information of China (English)

    SUN Yi; LI Xiao-yi; YAO Lin-yan; ZHAO Lan; DAI Ning; WU Hao

    2012-01-01

    Background The etiology and pathology of functional constipation (FC) is unclear.Some researches suggest that psychological factors may be related to this common problem.This study aimed to investigate the relationship between attention processing and emotional status in FC patients compared with healthy controls.Methods We investigated selective attention and emotional status in patients with FC using the counting Stroop task.Thirty-five FC patients (FCP group) and 24 healthy controls (HCs) underwent an event-related potential (ERP) study while performing the task.Response time,latency and amplitude of P300 were collected and compared between the two groups.The Hamilton Depression Rating Scale (HAMD-17),Hamilton Anxiety Scale (HAMA),Symptom Checklist-90 (SCL-90) and Eysenck Personality Questionnaire (EPQ) were administered prior to the counting Stroop task.Results Scores for the FCP group differed significantly from those for the HCs on the HAMD-17,HAMA,SCL-90 (Global Severity Index,Positive Symptoms Total,dimensions of somatization,obsessive-compulsive,depression,anxiety,and psychosis),as well as extraversion and neurosis dimensions of the EPQ (P<0.05).There was no significant difference in response time or accuracy rate between the two groups (P>0.05).ERP results showed prolonged latency at F4,additionally found enhanced activation at F3,FC1 and T8,and decreased activation at sites FC6 and P7 in the patients with FC.Statistically,significant differences of P300 latency at site F4 (P <0.05) and P300 amplitude at F3,F4,T8,P7,FC1 and FC6 (P<0.05) between the patients with FC and the HC were revealed.Conclusions The findings suggest that patients with FC are more susceptible to depression and anxiety,as well as somatization,obsessive-compulsive tendencies and other neurotic personality characteristics.Patients may employ psychological defense mechanisms to avoid the pain of depression and anxiety.ERP results imply there may be some brain dysfunction and

  5. Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation

    Institute of Scientific and Technical Information of China (English)

    Giovanni Gasbarrini; Marcello Candelli; RiccardoGiuseppe Graziosetto; Sergio Coccheri; Ferdinando Di Iorio; Giuseppe Nappi

    2006-01-01

    AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome (IBS) accompanying predominant constipation.METHODS: A total of 3 872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres.Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy.A questionnare to collect personal data on social and occupational status, family and pathological case history,life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment.Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis.Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test.RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients.The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients.Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91± 12 (T1/2) and 53 ± 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the

  6. 生物反馈电刺激治疗功能性便秘%Biofeedback Treatment of Functional Constipation

    Institute of Scientific and Technical Information of China (English)

    卞秀华

    2015-01-01

    目的:探讨功能性便秘采用生物反馈电刺激治疗的意义。方法55例患者进行生物反馈电刺激治疗1个月前后的排便情况的对比、直肠肛管测压、24 h结肠传输试验以及直肠和盆底肌电描记进行对比分析。结果生物反馈电刺激治疗对各型的FC均有一定疗效。结论对FC采用生物反馈电刺激治疗后肛管直肠动力异常改善,盆底肌不协调运动消失,每周便次增加,便秘改善。%ObjectiveTo investigate the functional constipation using Biofeedback therapy significance.Methods A comparative analysis of 55 patients were compared Biofeedback therapy defecation a month before and after, anorectal manometry, 24 hours colon and rectum and pelvic transmission test EMG tracings were.Results Biofeedback treatment of various types of FC all have a certain effect.Conclusion FC using Biofeedback treatment of anorectal motility disorders improve, uncoordinated movement of the pelvic floor muscles disappear, it plays increase, constipation improve every week.

  7. Treating 40 cases of diabetes constipation in TCM%中医治疗糖尿病便秘40例

    Institute of Scientific and Technical Information of China (English)

    王澜舸

    2014-01-01

    40 cases of patients with diabetes constipation were treated in TCM medicine, better effects were achieved. The author thought that Ziyin should be paid attention in the treatment of diabetes constipation, the medicine of Kuhan cannot cure the disease totally. Ziyin weizhu, Zhuyang Weifu must be used to improve Living quality.%对40例糖尿病便秘患者行中医治疗,疗效较好。笔者认为治疗糖尿病引起的便秘一定要以滋阴为主,方可达到“治本”的目的;如果仅以苦寒之品泻火、导泻,则只能“治标”。而以“滋阴为主,助阳为辅”,方能“标本兼治”,改善患者生活质量。

  8. Currently available cough suppressants for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan

    2008-01-01

    Chronic cough is a common symptom but only a fraction of patients seek medical attention. Addressing the causes of chronic cough may lead to control of cough; however, this approach is not always successful since there is a certain degree of failure even when the cause(s) of cough are adequately treated; in idiopathic cough, there is no cause to treat. Persistent cough may be associated with deterioration of quality of life, and treatment with cough suppressants is indicated. Currently available cough suppressants include the centrally acting opioids such as morphine, codeine, and dextromethorphan. Peripherally acting antitussives include moguisteine and levodropropizine. Early studies report success in reducing cough in patients with chronic bronchitis or COPD; however, a carefully conducted study showed no effect of codeine on cough of COPD. Success with these cough suppressants can be achieved at high doses that are associated with side effects. Slow-release morphine has been reported to be useful in controlling intractable cough with good tolerance to constipation and drowsiness. There have been case reports of the success of centrally acting drugs such as amitryptiline, paroxetine, gabapentin, and carbamezepine in chronic cough. New opioids such as nociceptin or antagonists of TRPV1 may turn out to be more effective. Efficacy of cough suppressants must be tested in double-blind randomised trials using validated measures of cough in patients with chronic cough not responding to specific treatments. Patients with chronic cough are in desperate need of effective antitussives that can be used either on demand or on a long-term basis.

  9. Currently available cough suppressants for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan

    2008-01-01

    Chronic cough is a common symptom but only a fraction of patients seek medical attention. Addressing the causes of chronic cough may lead to control of cough; however, this approach is not always successful since there is a certain degree of failure even when the cause(s) of cough are adequately treated; in idiopathic cough, there is no cause to treat. Persistent cough may be associated with deterioration of quality of life, and treatment with cough suppressants is indicated. Currently available cough suppressants include the centrally acting opioids such as morphine, codeine, and dextromethorphan. Peripherally acting antitussives include moguisteine and levodropropizine. Early studies report success in reducing cough in patients with chronic bronchitis or COPD; however, a carefully conducted study showed no effect of codeine on cough of COPD. Success with these cough suppressants can be achieved at high doses that are associated with side effects. Slow-release morphine has been reported to be useful in controlling intractable cough with good tolerance to constipation and drowsiness. There have been case reports of the success of centrally acting drugs such as amitryptiline, paroxetine, gabapentin, and carbamezepine in chronic cough. New opioids such as nociceptin or antagonists of TRPV1 may turn out to be more effective. Efficacy of cough suppressants must be tested in double-blind randomised trials using validated measures of cough in patients with chronic cough not responding to specific treatments. Patients with chronic cough are in desperate need of effective antitussives that can be used either on demand or on a long-term basis. PMID:17909897

  10. Bone marrow mesenchymal stem cell transplantation improves airway inflammation due to chronic asthma%骨髓间充质干细胞移植改善慢性哮喘气道炎症

    Institute of Scientific and Technical Information of China (English)

    张起; 郭蕊蕊; 胡江平

    2016-01-01

    BACKGROUND:Studies have shown that bone marrow mesenchymal stem cel transplantation can improve disease conditions by reducing inflammation. OBJECTIVE:To explore the therapeutic efficacy of bone marrow mesenchymal stem cels on chronic asthma rats. METHODS: A rat model of chronic asthma was established by intraperitonealy injected and aerosolized ovalbumin. After modeling, rats were given 4×105 and 8×105 bone marrow mesenchymal stem celsvia the tail vein, respectively. Thirty days later, the lung tissues were observed pathologicaly using hematoxylin-eosin staining; RT-qPCR and ELISA methods were employed to test the changes in interleukin-10, tumor necrosis factor-α and interferon-γ levels in lung tissue and peripheral blood, respectively. RESULTS AND CONCLUSION:Rat models of chronic asthma were successfuly established after intraperitoneal injection of ovalbumin combined with aerosolized ovalbumin. After 30 days of cel treatment, the structure of lung tissues were obviously recovered, and the levels of interleukin-10, tumor necrosis factor-α and interferon-γ showed some improvement in lung tissue and peripheral blood, but there were no differences between the two groups. In conclusion, bone marrow mesenchymal stem cels show some potential role in the treatment of chronic asthma.%背景:以往研究提示骨髓间充质干细胞移植能够通过减轻炎症程度来改善病情。  目的:探讨骨髓间充质干细胞对慢性哮喘大鼠的治疗效果。  方法:通过卵白蛋白腹腔注射加雾化刺激的方式制备大鼠慢性哮喘模型,待模型稳定后,尾静脉注射4×105及8×105个骨髓间充质干细胞。治疗30 d后,苏木精-伊红染色观察肺组织病理变化,RT-qPCR、ELISA法检测肺组织和外周血中白细胞介素10、肿瘤坏死因子α、γ-干扰素水平。  结果与结论:①卵白蛋白腹腔注射配合雾化刺激的方法可以制备稳定的慢性哮喘模型。②治疗后30 d,

  11. Nursing Care for Senile Patients with Parkinson's Disease and Constipation%老年帕金森病患者便秘护理

    Institute of Scientific and Technical Information of China (English)

    贾春梅

    2012-01-01

    目的:探讨老年帕金森病患者便秘的个体化护理措施及其效果.方法:对50例老年帕金森病便秘患者分组,分别给予常规护理和个体化综合护理,2个月后观察两者便秘症状的改善情况.结果:观察组的老年帕金森病患者的便秘症状有明显改善.结论:长期综合性的个体化护理可以缓解老年帕金森病患者的便秘症状.%Objective: To explore the individual nursing care for the senile patients with Parkinson's disease(PD) and constipation. Methods: 50 senile patients with Parkinson's disease and constipation were divided into two groups, one group received individual nursing care, the other group received routine nursing care. The effect of individual nursing group was compared with routine nursing group. Results: The individual nursing group of Parkinson's patients with constipation symptoms were obviously improved. Conclusions : Individual nursing care is effective for the senile Parkinson's patients with constipation symptoms.

  12. Characteristics of Constipation Prescriptions and Medicines in Medical Secrets of an Official%《外台秘要》便秘方药特色探析

    Institute of Scientific and Technical Information of China (English)

    姚佳音; 叶进

    2011-01-01

    选取治疗便秘方68首,从常用药物、方药特色、组方义解等方面分析其特点.%This paper selected 68 constipation prescriptions form Medical Secrets of an Official and analyzed the characteristics of common herbs and prescriptions composition.

  13. Synergistic Effect of Fermented Rice Extracts on the Probiotic and Laxative Properties of Yoghurt in Rats with Loperamide-Induced Constipation

    Directory of Open Access Journals (Sweden)

    Jae-Suk Choi

    2014-01-01

    Full Text Available Aim. The objective was to evaluate the synergistic effects of fermented rice extracts (FRe on the laxative and probiotic properties of yoghurt in rats with loperamide-induced constipation. Methods. After constipation induction, yoghurt containing FRe (BFRe; 0.05%, 0.1%, or 1% was administered orally once per day for 6 days. Results. Loperamide treatment caused marked decreases in fecal pellet numbers and water content discharged, as well as in the surface mucosal thickness of the colonic lumen, intestinal charcoal transit ratio, thickness, and number of mucous-producing goblet cells in the colonic mucosa, whereas it increased the remnant fecal pellet number and the mean diameter of the colonic lumen. However, this loperamide-induced constipation was ameliorated by treatment with FRe, yoghurt single formula, or 0.05%, 0.1%, or 1% BFRe (10 mL/kg. Additionally, the viable numbers of Lactobacillus in the cecal contents and feces were markedly higher than those in constipated rats. Moreover, greater probiotic and laxative effects were detected in BFRe-treated rats than in rats treated with equivalent doses of yoghurt or FRe single formula. Conclusion. The results suggest that addition of FRe to liquid yoghurt will enhance the probiotic and beneficial laxative effects of yoghurt in the digestive tract, without causing side effects.

  14. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Lopes Roberto I

    2003-01-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  15. Burden of constipation-predominant irritable bowel syndrome (IBS-C in France, Italy, and the United Kingdom

    Directory of Open Access Journals (Sweden)

    DiBonaventura MD

    2012-11-01

    Full Text Available Marco daCosta DiBonaventura,1 Mercedes Prior,2 Pablo Prieto,2 Josep Fortea21Health Outcomes Practice, Kantar Health, New York, NY, USA; 2Global Market Access, Marketing and Medical Affairs, Almirall, Barcelona, SpainBackground: Several studies have examined the effect of irritable bowel syndrome (IBS on health outcomes in Western Europe, but less research has focused on the constipation subtype (IBS-C. The current study addresses this gap by comparing patients with IBS-C and matched controls for health status, work productivity, and resource utilization.Methods: Data were obtained from the 2010 5EU National Health and Wellness Survey (NHWS, which includes respondents from France, Germany, Italy, Spain, and the UK. Only participants from France (n = 15,051, Italy (n = 7580, and the UK (n = 15,065 were included in the analyses. Respondents who reported a physician diagnosis of IBS and reported only constipation symptoms were compared with respondents who did not report being diagnosed with IBS using a propensity score-matching methodology (matching on sociodemographics, health behaviors, and comorbidities. Differences between patients with IBS-C and matched controls were examined on health status (Short Form Survey Instrument version 2, work productivity (Work Productivity and Activity Impairment questionnaire, and health care resource use in the past 6 months.Results: A total of 83 (0.55%, 109 (1.44%, and 204 (1.35% respondents reported a diagnosis of IBS with only constipation symptoms in France, Italy, and the UK, respectively. Within each country, patients with IBS-C reported significantly worse health status compared with matched controls (all P < 0.05 and significantly more physician visits (all P < 0.05. More hospitalizations were also observed in the UK (P < 0.05. Among those who were employed, patients with IBS-C in France and the UK also reported significantly more presenteeism than matched controls (all P < 0.05.Conclusion: These

  16. Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study

    Directory of Open Access Journals (Sweden)

    Muijzer Anna

    2012-01-01

    Full Text Available Abstract Background Efforts undertaken during the return to work (RTW process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES in cases of sick-listed employees with chronic low back pain (CLBP. Methods Using focus groups consisting of Labor Experts (LE's working at the Dutch Social Insurance Institute, arguments and underlying grounds relevant to the assessment of RTW-ES were investigated. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model. Results Two focus groups yielded 19 factors, of which 12 are categorized in the ICF model under activities (e.g. functional capacity and in the personal (e.g. age, tenure and environmental domain (e.g. employer-employee relationship. The remaining 7 factors are categorized under intervention, job accommodation and measures. Conclusions This focus group study shows that 19 factors may be relevant to RTW-ES in sick-listed employees with CLBP. Providing these results to professionals assessing RTW-ES might contribute to a more transparent and systematic approach. Considering the importance of the quality of the RTW process, optimizing the RTW-ES assessment is essential.

  17. Clinical Research of Treating Senile Functional Constipation by TCM Drugs and Non-Drug Therapy%中药配合非药物疗法治疗老年功能性便秘临床观察

    Institute of Scientific and Technical Information of China (English)

    李俊; 李亚玲

    2012-01-01

    Objective : To observe the value and efficacy of treating senile functional constipation ( syndrome of Yin deficiency of qi and blood) by TCM drugs and colon hydrotherapy. Methods: 110 cases with the same type of patients were randomly divided into two groups by research methods of a single-blind,randomized,parallel-controlled. TCM drugs and non-drug therapy were used in treatment group; polyethylene glycol-electrolyte powder in control group, both groups were treated and observed in 4 weeks, follow-up in 3 months, 1 year and 3 years after the treatment. Two groups total effective, the short term efficacy and long-term curative effect were compared. Results: The differences of each date between the two sets of cases were statistically significant ( P < 0.05) , treated groups were significantly better than control groups. Conclusion: TCM drugs and non-drug therapy in elderly patients with chronic functional constipation have the exact effect,and long-term curative effect is good and fewer side effects. This technique is worthy of clinical application.%目的:观察并探讨中药辨证治疗+非药物疗法(结肠水疗)治疗老年功能性便秘(气血阴虚证)的临床价值和疗效.方法:采用单盲、随机、平行、对照试验研究方法,依据纳入、排除标准选择患者110例,随机分为治疗组和对照组;治疗组采用中药辨证治疗+非药物疗法治疗;对照组采用聚乙二醇电解质散剂治疗,两组均治疗、观察4周,于治疗后3月、1年、3年各随访一次;对两组总有效率,短、长期疗效等指标进行比较.结果:两组病例的各项指标比较,差异均有统计学意义(P<0.05),治疗组明显优于对照组.结论:实验所采用疗法为中、西疗法结合,药物与非药物疗法结合,标本兼治,疗效确切、稳定,长期疗效好,副作用少,值得临床推广应用.

  18. Value of 24-hour Delayed Film of Barium Enema for Evaluation of Colon Transit Function in Young Children with Constipation

    Science.gov (United States)

    Yoo, Ha Yeong; Son, Jae Sung; Park, Hye Won; Kwak, Byung Ok; Kim, Hyeong Su; Bae, Sun Hwan

    2016-01-01

    Background/Aims A colon transit time test using radio-opaque markers (CTTRM) is considered the gold standard for evaluating colon transit function. A 24-hour delayed film of barium enema (BE) has been used as a supplementary method in structural evaluations. The aim of this study was to evaluate the utility of a 24-hour delayed BE film for assessing colon transit function in young children with constipation. Methods In total, 93 children with constipation who performed both single-contrast BE and CTTRM were enrolled in this study. Of these, the data from 70 children were analyzed (males 33, females 37; mean age [range], 5.63 ± 2.94 [2–14] years). The basic principle of the study is “velocity = distance/time”. Time values were identified in both studies, and the colon length and distance of barium movement were measured on the 24-hour delayed BE film. Thus, colon transit velocity values could be calculated using both methods. The correlation between colon transit velocity using a 24-hour delayed BE film versus CTTRM was analyzed statistically. Results Median value (interquartile range) of colon transit velocity using CTTRM was 1.57 (1.07–2.89) cm/hr, and that using BE of that was 1.58 (0.94–2.07) cm/hr. The Spearman correlation coefficient was 0.438 (P children younger than 4 years (r = 0.537, P = 0.032). Conclusions Although the correlation between BE and CTTRM was not very strong, the 24-hour delayed BE film could provide broad information about colon transit function in young children, especially those under 4 years who usually cannot undergo CTTRM. PMID:26979249

  19. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease.

    Science.gov (United States)

    Quimby, Jessica M

    2016-11-01

    Dysregulation of normal kidney functions in chronic kidney disease (CKD) leads to several pathophysiologic abnormalities that have the potential to significantly clinically affect the CKD patient. This article discusses the clinical impact of hypertension, hypokalemia, anemia, dysrexia, nausea/vomiting, and constipation in the CKD patient and therapies for these conditions. These clinical manifestations of disease may not occur in every patient and may also develop later during the progression of disease. Therefore, monitoring for, identifying, and addressing these factors is considered an important part of the medical management of CKD.

  20. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease.

    Science.gov (United States)

    Quimby, Jessica M

    2016-11-01

    Dysregulation of normal kidney functions in chronic kidney disease (CKD) leads to several pathophysiologic abnormalities that have the potential to significantly clinically affect the CKD patient. This article discusses the clinical impact of hypertension, hypokalemia, anemia, dysrexia, nausea/vomiting, and constipation in the CKD patient and therapies for these conditions. These clinical manifestations of disease may not occur in every patient and may also develop later during the progression of disease. Therefore, monitoring for, identifying, and addressing these factors is considered an important part of the medical management of CKD. PMID:27593576

  1. [Chronicity, chronicization, systematization of delusions].

    Science.gov (United States)

    Trapet, P; Fernandez, C; Galtier, M C; Gisselmann, A

    1984-05-01

    Chronicity in psychopathology is indicative of a term, a decay. Chronicization only leads the way to this term. Here, chronicization is taken literally as an inscription in the time course of delusions. The mechanism of systematization seems to be a central mark in the approach to chronic delusions. It is not an alienation or an irreversible closing but an attempted accommodation with reality in the life of psychotic subjects, irrespective of the delusional structure. The role of therapy and drug treatment as a follow-up may in that case assume another meaning.

  2. Vaginal discharge due to primary varicella

    OpenAIRE

    Ajith C; Gupta Somesh; Ratho Radha; Narang Tarun

    2008-01-01

    Cervicitis is an important cause of abnormal vaginal discharge. We describe a case of vaginal discharge due to cervicitis caused by primary varicella zoster infection in a patient with chronic immunosuppression. Though a few reports of genital infection due to chicken pox are available, to the best of our knowledge, there are no reports of abnormal vaginal discharge due to cervicitis caused by chicken pox.

  3. Vaginal discharge due to primary varicella

    Directory of Open Access Journals (Sweden)

    Ajith C

    2008-01-01

    Full Text Available Cervicitis is an important cause of abnormal vaginal discharge. We describe a case of vaginal discharge due to cervicitis caused by primary varicella zoster infection in a patient with chronic immunosuppression. Though a few reports of genital infection due to chicken pox are available, to the best of our knowledge, there are no reports of abnormal vaginal discharge due to cervicitis caused by chicken pox.

  4. Chronic lead poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Hess, K.; Straub, P.W.

    1974-02-19

    A detailed description is given of the complex pathological picture observed in the case of a worker with 30 years' occupational exposure to lead in an accumulator factory (evolution of the disease, clinical findings, autopsy). In spite of a typical clinical picture, lead is not held responsible for the terminal encephalopathy, in view of the fact that Alzheimer's syndrome was discovered at autopsy. However, the neurovegetative asthenia and progressive kidney disease without hypertonia, but with uraemia, which preceded the encephalopathy are in all probability due to chronic lead poisoning. The article discusses the diagnosis and symptomatology of chronic lead poisoning, encephalopathy and kidney disease.

  5. Chronic cholecystitis

    Science.gov (United States)

    ... foods may relieve symptoms in people. However, the benefit of a low-fat diet has not been proven. Alternative Names Cholecystitis - chronic Images Cholecystitis, CT scan Cholecystitis, cholangiogram Cholecystolithiasis Gallstones, cholangiogram Cholecystogram References Wang ...

  6. Chronic Meningitis

    Science.gov (United States)

    ... School Lunch Lines FDA Cracks Down on Antibacterial Soaps Health Tip: Schedule a Back-to-School Dental ... the Professional Version Meningitis Introduction to Meningitis Acute Bacterial Meningitis Viral Meningitis Noninfectious Meningitis Recurrent Meningitis Chronic ...

  7. 采用DUR和DUE法评价78例慢性乙型肝炎患者的用药情况%Evaluation of Drug Utilization in 78 Patients with Chronic Hepatitis B by DUR and DUE Methods

    Institute of Scientific and Technical Information of China (English)

    魏润新; 江璇

    2009-01-01

    目的:评价我院慢性乙型肝炎患者的用药情况及合理性.方法:采用药物利用评价(DUR)和药物利用评估(DUE)法,对我院2007年4月~2008年4月78例慢性乙型肝炎患者的用药情况、诊断、治疗过程监测及治疗结果进行分析.结果:78例患者中,单一用药2例,其余均为联合用药;有6例患者作了病理学分期;均进行了治疗过程监测.11种药物的药物利用指数(DUI)>1,2种药物的DUI<1,12种药物的DUI=1.结论:联用DUR和DUE法可更全面地评价慢性乙型肝炎患者的用药情况,慢性乙型肝炎应根据相关指南进行规范治疗.

  8. Effects of electroacupuncture at Zusanli (ST 36) on neurons in the colonic myenteric plexus in rats with irritable bowel syndrome with constipation

    Institute of Scientific and Technical Information of China (English)

    Liting Zhu; Zhonghan Li; Bin Xu; Chen Xia; Jie Cheng; Xiaoren Xiang; Yi Zhu

    2011-01-01

    We studied the effects of electroacupuncture at Zusanli (ST 36) on neurons in the colonic myenteric plexus and on defecation in rats with irritable bowel syndrome with constipation (IBS-C). We also used intragastric administration of pinaverium bromide as a positive control treatment to reveal the pathway mediating the onset of IBS-C. Both electroacupuncture and pinaverium bromide greatly improved defecation in rats with IBS-C. Immunohistochemical staining of the enteric nervous system neuronal marker protein gene product 9.5 in the colonic myenteric plexus showed that electroacupuncture by itself, or in combination with pinaverium bromide, increased the number of neurons and the staining intensity of protein gene product 9.5 in the colonic myenteric plexus. We conclude that visceral hypersensitivity is likely to be a primary cause of constipation in IBS-C rats.

  9. Lead Toxicity Resulting from Chronic Ingestion of Opium

    Directory of Open Access Journals (Sweden)

    Jalili, Mohammad

    2009-11-01

    Full Text Available A 32-year-old man presented to the emergency department (ED with lower abdominal pain and constipation. He related chronic ingestion of large amounts of opium. Physical examination showed mild abdominal tenderness and gingival discoloration. Diagnostic studies showed a mild hypochromic, microcytic anemia with basophilic stippling of the red blood cells. Abdominal imaging showed no intra-abdominal pathology. A diagnosis of lead toxicity was confirmed through serum lead levels. The patient was put on chelation therapy and his signs and symptoms started to resolve. As a comprehensive search for other sources of lead was unsuccessful, opium adulterants were considered as the culprit. Chemical analysis of the opium confirmed this. Contaminated drugs have been reported as a source of exposure to toxins such as arsenic or lead. While other reports deal with patients from clinics, this report illustrates lead toxicity from ingestion of contaminated opium in the ED.[West J Emerg Med. 2009;10(4:244-246.

  10. Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment.

    Science.gov (United States)

    Andromanakos, Nikolaos P; Kouraklis, Grigorios; Alkiviadis, Kostakis

    2011-01-01

    Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. A variety of neuromuscular disorders of the pelvic floor lead to the different pathological conditions such as anorectal incontinence, urinary incontinence and constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles, accompanied by perineal pain are levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia. In the diagnosis of these syndromes, contributing to a thorough history, physical examination, selected specialized investigations and the exclusion of organic disease with proctalgia is carried out. Accurate diagnosis of the syndromes helps in choosing an appropriate treatment and in avoiding unnecessary and ineffective surgical procedures, which often are performed in an attempt to alleviate the patient's symptoms.

  11. Biofeedback Therapy Combined with Traditional Chinese Medicine Prescription Improves the Symptoms, Surface Myoelectricity, and Anal Canal Pressure of the Patients with Spleen Deficiency Constipation

    OpenAIRE

    Jin-Gen Lu; Chen Wang; Hong-Tao Liang; Jin Yi; Xiu-Tian Guo; Yong-Qing Cao; Yi-Bo Yao

    2013-01-01

    In order to observe the clinical therapeutic effects of Yiqi Kaimi Prescription and biofeedback therapy on treating constipation with deficiency of spleen qi, the 30 cases in the control group were given oral administration of Yiqi Kaimi Prescription, in combination with anus-lifting exercise; the 30 cases in the treatment group were given biofeedback therapy on the basis of the afore mentioned methods for the control group. The TCM symptom scores and anorectal pressures before and after trea...

  12. Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis%腹针配合中药治疗气滞血瘀型慢性盆腔痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

    Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.%目的:观察腹针配合中药治疗盆腔炎性疾病后气滞血瘀型慢性盆腔痛的临床疗效。方法将60例盆腔炎性疾病后气滞血瘀型慢性盆腔痛患者随机分为治疗组和对照组,每组30例。治疗组采用腹针配合中药治疗,对照组采用单纯中药治疗。治疗3个月经周期后,观察两组治疗前后腹痛VAS评分及McCormack量表评分变化。结果两组治疗后腹痛VAS评分及McCormack量表评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后腹痛VAS评分及McCormack量表评分与对照组比较,差异均具有统计学意义(P<0.01)。结论腹针配合中药能够减轻盆腔炎性疾病后气滞血瘀型慢性盆腔痛。

  13. Treatment patterns, symptom reduction, quality of life, and resource use associated with lubiprostone in irritable bowel syndrome constipation subtype.

    Science.gov (United States)

    Solem, Caitlyn T; Patel, Haridarshan; Mehta, Sonam; Mody, Reema; Macahilig, Cynthia; Gao, Xin

    2016-05-01

    Objectives Real-world patient outcomes data is scarce concerning the high disease burden of IBS-C. The aim of this study was to compare patient-reported symptom control, health-related quality of life (HRQoL), resource utilization, and treatment satisfaction of lubiprostone vs non-lubiprostone treatment for irritable bowel syndrome-constipation (IBS-C). Research design and methods An observational, retrospective US chart review and computer-assisted telephone patient survey was conducted March to August 2013 recruiting women over 18 years old with physician-confirmed IBS-C who had initiated new treatment from inadequate relief of previous treatments and who had been on the new treatment ≥3 months. Multiple IBS-C treatments were permitted. IBS-C severity, time since diagnosis, age, and race were controlled using inverse probability of treatment weighting. Weighted outcomes were compared using t-tests (continuous outcomes) and chi-squared tests (categorical outcomes). Main outcomes measures Instruments included Patient Assessment of Constipation Symptoms (PAC-SYM) and IBS quality of life (IBS-QoL). A single item assessed current treatment satisfaction. Results Of 162 patients (mean age 45.9 [SD 15.3] years old, 71% white, 61.1% with moderate IBS-C), 76 switched to lubiprostone and 86 to non-lubiprostone. Groups were similar in clinical and demographic characteristics and previous 30 day IBS-C treatment. After weighting, all PAC-SYM scores were lower for lubiprostone (P < 0.05). All IBS-QoL subscales were higher for lubiprostone including overall, dysphoria, social reaction, sexual, and relationship scores (P < 0.05.) More lubiprostone patients reported positive treatment satisfaction (92.3% vs 71.0%, P < 0.001). Conclusions In IBS-C patients with inadequate response to previous therapies, lubiprostone improved patient-reported symptom control, treatment satisfaction, and HRQoL. Key limitations include lack of measurement of patient-reported outcomes

  14. Biofeedback therapy combined with traditional chinese medicine prescription improves the symptoms, surface myoelectricity, and anal canal pressure of the patients with spleen deficiency constipation.

    Science.gov (United States)

    Yao, Yi-Bo; Cao, Yong-Qing; Guo, Xiu-Tian; Yi, Jin; Liang, Hong-Tao; Wang, Chen; Lu, Jin-Gen

    2013-01-01

    In order to observe the clinical therapeutic effects of Yiqi Kaimi Prescription and biofeedback therapy on treating constipation with deficiency of spleen qi, the 30 cases in the control group were given oral administration of Yiqi Kaimi Prescription, in combination with anus-lifting exercise; the 30 cases in the treatment group were given biofeedback therapy on the basis of the afore mentioned methods for the control group. The TCM symptom scores and anorectal pressures before and after treatment were observed and evaluated. There were significant differences in TCM symptom scores, anorectal pressure, and clinical recovery rate before and after treatment. In the treatment group, the total recovery rate was 86.66%, while in the control group it was 50%; there were significant differences between the two groups (P < 0.01). Yiqi Kaimi Prescription coupled with biofeedback therapy is clinically effective for treating constipation with deficiency of spleen qi, and thus this method is applicable for functional constipation with deficiency of spleen qi.

  15. Biofeedback Therapy Combined with Traditional Chinese Medicine Prescription Improves the Symptoms, Surface Myoelectricity, and Anal Canal Pressure of the Patients with Spleen Deficiency Constipation

    Directory of Open Access Journals (Sweden)

    Yi-Bo Yao

    2013-01-01

    Full Text Available In order to observe the clinical therapeutic effects of Yiqi Kaimi Prescription and biofeedback therapy on treating constipation with deficiency of spleen qi, the 30 cases in the control group were given oral administration of Yiqi Kaimi Prescription, in combination with anus-lifting exercise; the 30 cases in the treatment group were given biofeedback therapy on the basis of the afore mentioned methods for the control group. The TCM symptom scores and anorectal pressures before and after treatment were observed and evaluated. There were significant differences in TCM symptom scores, anorectal pressure, and clinical recovery rate before and after treatment. In the treatment group, the total recovery rate was 86.66%, while in the control group it was 50%; there were significant differences between the two groups (P<0.01. Yiqi Kaimi Prescription coupled with biofeedback therapy is clinically effective for treating constipation with deficiency of spleen qi, and thus this method is applicable for functional constipation with deficiency of spleen qi.

  16. Advances in the clinical research on functional constipation%功能性便秘的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    姜明明

    2011-01-01

    功能性便秘是一种常见消化道疾病,严重影响人们生活质量.功能性便秘的发病与精神心理因素、激素、排便动力学异常等多因素有关.影像学、肛门直肠测压等多种方法可诊断该病,药物、生物反馈、心理等多途径治疗有一定疗效.本文就功能性便秘的病因、诊断、治疗等临床研究新进展作一综述.%Functional constipation is a common digestive disease, seriously affecting the quality of life. The incidence of functional constipation is related to multiple factors such as psychological factors,hormones, abnormal bowel movements, and so on. This disease can be diagnosed by iconography, anorectal manometry, etc. Combined therapy with drug, biofeedback and psychology shows certain curative effect for functional constipation.

  17. Developments in managing severe chronic pain: role of oxycodone–naloxone extended release

    Directory of Open Access Journals (Sweden)

    Fanelli G

    2015-07-01

    Full Text Available Guido Fanelli,1 Andrea Fanelli2 1Anesthesia and Intensive Care Unit, University of Parma, Parma, 2Anesthesia and Intensive Care Unit, Policlinico S Orsola-Malpighi, Bologna, Italy Abstract: Chronic pain is a highly disabling condition, which can significantly reduce patients’ quality of life. Prevalence of moderate and severe chronic pain is high in the general population, and it increases significantly in patients with advanced cancer and older than 65 years. Guidelines for the management of chronic pain recommend opioids for the treatment of moderate-to-severe pain in patients whose pain is not responsive to initial therapies with paracetamol and/or nonsteroidal anti-inflammatory drugs. Despite their analgesic efficacy being well recognized, adverse events can affect daily functioning and patient quality of life. Opioid-induced constipation (OIC occurs in 40% of opioid-treated patients. Laxatives are the most common drugs used to prevent and treat OIC. Laxatives do not address the underlying mechanisms of OIC; for this reason, they are not really effective in OIC treatment. Naloxone is an opioid receptor antagonist with low systemic bioavailability. When administered orally, naloxone antagonizes the opioid receptors in the gut wall, while its extensive first-pass hepatic metabolism ensures the lack of antagonist influence on the central-mediated analgesic effect of the opioids. A prolonged-release formulation consisting of oxycodone and naloxone in a 2:1 ratio was developed trying to reduce the incidence of OIC maintaining the analgesic effect compared with use of the sole oxycodone. This review includes evidence related to use of oxycodone and naloxone in the long-term management of chronic non-cancer pain and OIC. Keywords: chronic pain, opioid-induced constipation, opioids, oxycodone–naloxone

  18. Postoperative Issues of Sacral Nerve Stimulation for Fecal Incontinence and Constipation: A Systematic Literature Review and Treatment Guideline

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Matzel, Klaus; Lundby, Lilli;

    2011-01-01

    on a wider literature using the keywords “complication,” “adverse effect,” “treatment failure,” “equipment failure,” “infection,” “foreign-body migration,” “reoperation,” “pain,” and “algorithm.” STUDY SELECTION: Four hundred sixty-one titles were identified, and after a title and abstract review, 135 were......BACKGROUND: There is a lack of knowledge on the incidence and management of suboptimal therapeutic effect and the complications associated with sacral nerve stimulation for fecal incontinence and constipation. OBJECTIVE: This study aimed to review current literature on postoperative issues...... and to propose a treatment algorithm. DATA SOURCE: PubMed, MEDLINE, and EMBASE were searched using the keywords “sacral nerve stimulation,” “sacral neuromodulation,” “fecal incontinence,” and “constipation” for English-language articles published from January 1980 to August 2010. A further search was conducted...

  19. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... nuclear disaster. It takes many years to develop leukemia from radiation exposure. Most people treated for cancer ...

  20. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are: Exposure to ...

  1. The Effect of Community Nursing on Constipation of Patients With Cerebral Hemorrhage During Convalescence%社区护理对脑出血康复期患者便秘的影响

    Institute of Scientific and Technical Information of China (English)

    马艳萍

    2015-01-01

    Objective To discuss the effect of community nursing on constipation of patients with cerebral hemorrhage during convalescence. Methods To take targeted nursing measures on 154 cases of patients, including sports, dietary and drug guidance. Results In 154 patients, the stool unobstructed in 78 cases, defecation smoothly in 59 cases, to dig out for 15 cases, due to defecation and forced bleeding in 2 cases. Conclusion The comprehensive application of various nursing measures can help patients establish normal defecation behavior and improve the quality of life.%目的:探讨社区护理对脑出血康复期患者便秘的影响。方法对154例患者采取包括运动指导,饮食指导和用药指导等有针对性的护理措施。结果154例患者中,大便通畅自行排便1次/d有78例,排便变顺利59例,需人工掏便15例,因排便用力引起再出血2例。结论各种护理措施的综合应用可以帮助患者建立正常的排便行为,提高生存质量。

  2. BRAIN GRAY MATTER VOLUME CHANGES ASSOCIATED WITH CHRONIC PAIN IN PATIENTS WITH PAIN DUE TO BRACHIAL PLEXUS AVULSION%臂丛神经撕脱伤后疼痛患者脑区灰质容积变化的研究

    Institute of Scientific and Technical Information of China (English)

    陈富勇; 陶蔚; 秦文; 于春水; 胡永生; 李勇杰

    2011-01-01

    Objective: To investigate brain structural changes involved in chronic pain in patients with pain due to brachial plexus avulsion, voxel-based morphometry was used to determine the brain gray matter changes . Methods: Ten right-handed patients with chronic pain due to left brachial plexus avulsion, whose pain reduced more than 75% after DREZotomy, and ten right-handed age- and sex-matched healthy control subjects participated inparticipated in the study. VAS, HADD and HADA were recorded before and 6 months after DREZotomy, respectively. Statistical parametric mapping 5 was applied for data analysis. Results: Compared with healthy subjects, the patients had gray matter decreases in the periaoueductal gray matter (PAG) and ipsilateral hippocampus, and significant gray matter increases in the ipsilateral anterior cingulate cortex (ACC) (BA24), the contralateral inferior frontal cortex (BA47). Comparing with patients during pain before DREZotomy, VBM analysis after DREZotomy showed there were no, significant gray matters changes.Conclusion: These findings suggest that chronic pain is associated with cortical and subcortical reorganization on a structural level, which may play an important role in the process of the chronication of pain in patients with pain due to brachial plexus avulsion.%目的:应用基于体素的形态学分析技术探讨臂丛神经撕脱伤后疼痛患者与慢性疼痛相关的脑结构改变.方法:选择左侧臂丛神经撕脱伤后慢性疼痛,行脊髓背根入髓区切开术后疼痛减轻>75%的患者,共10例,以及10例性别和年龄匹配的健康志愿者纳入研究.疼痛患者分别在术前和术后半年采集MRI数据,同时行视觉模拟评分(VAS),汉密尔顿抑郁(HADD)和焦虑评分(HADA).用统计参数图5( SPM5)软件分析数据.结果:与健康志愿者相比,在臂丛神经撕脱伤后慢性疼痛患者中,灰质容积减低的脑区为中央导水管周围灰质和患肢同侧的海马;灰质容积增高

  3. Chronic breast abscess due to Mycobacterium fortuitum: a case report

    Directory of Open Access Journals (Sweden)

    MacNeill Fiona A

    2011-05-01

    Full Text Available Abstract Introduction Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery. Case presentation We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with Mycobacterium fortuitum and treated with antibiotic therapy and surgical debridement. Conclusion This is a rare case of a spontaneous breast abscess secondary to Mycobacterium fortuitum infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.

  4. [Chronic hypocalcemia due to anti-calcium sensing receptor antibodies].

    Science.gov (United States)

    Marques, Pedro; Santos, Rita; Cavaco, Branca; Leite, Valeriano

    2014-01-01

    Introdução: O hipoparatiroidismo cursa com hipocalcemia e é mais frequentemente registado após cirurgia cervical. A etiologia autoimune é mais rara e difícil de diagnosticar. Caso clínico: Mulher, 52 anos, sem antecedentes pessoais, medicamentosos ou familiares relevantes, referenciada por hipocalcemia e calcificação dos núcleos da base, detetados no decurso de investigação de quadro de mialgias. Além de hipocalcemia (4,6 mg/dL), foi verificada hiperfosfatemia (8,7 mg/dL), hormona paratiroideia indetetável, calciúria, fosfatúria e magnesúria baixas. A análise molecular do gene CaSR excluiu mutações germinais. A pesquisa de anticorpos anti-receptor sensível do cálcio (anti-CaSR) foi positiva. Atualmente está assintomática e normocalcémica sob terapêutica com cálcio e vitamina D. Discussão: Embora rara, a hipocalcemia por hipoparatiroidismo autoimune deve ponderar-se em adultos sem antecedentes de cirurgia cervical, medicação hipocalcemiante, história familiar ou fenótipo sugestivo de doença genética. Hormona paratiroideia diminuída ou indetetável exclui pseudohipoparatiroidismo e a positividade para anti-CaSR confirma o diagnóstico.

  5. Risk of death due to chronic chagasic cardiopathy

    Directory of Open Access Journals (Sweden)

    Enrique C Manzullo

    1999-09-01

    Full Text Available In this longitudinal study 5,710 people were included. The inclusion criteria were two positive serological results for Trypanosoma cruzi infection, 15 and 50 years old and no other demostrable diesease at the time of study. In the five year follow up 1,117 patients were lost. The follow up involved yearly evaluation of serology, clinical examination, X-ray of torax, and ECG, for 4,593 patients and 263 were contacted at home because they did not assist for their clinical consultant. Time average of follow up was 5.3 years. Eighty nine (1.5% of the 4,593 patients died during the follow-up period, 63 (71% by cardiac insufiency (CI and 26 (29% by severe ventricular arrithmias. Diagnosis of cardiomegaly was present in all the patients with diagnosis of CI and in 15 (5% of the patients with diagnosis of arrithmias.The ECG alterations of these pacients show 61 right bundle brunch block (RBBB, associated or not with left anterior hemiblock (LAHB, 47 pathological Q wave and 70 primary repolarization alterations; 61 had polyfocal ventricular arrithmia. The death rate was similar in the sexes and was more frequent between 40 and 50 years of age. Information on 1,380 recuperated patients shows that 15 died with no previous symptoms and without medical assistance and were interpretate as sudden death. The latest ECG in three follow-up of these pacients indicates (before death that only one had normal study and 14 presented 12 RBBB; 9 LAHB; 7 isolated ventricular arrithmia; 10 repolariz alterations; 2 patological Q wave, 10 patients of them with RBBB and repolariz alterations. In all the cases we had people between 35 and 43 years old, 9 men and 6 women. This study shows that in Chagas disease is possible to differenciate two risk groups. A low risk death group that have normal ECG and clinical evaluation during the follow up, and a high risk group associate ECG with RBBB and primary alterations of repolarization and/or inactivation zones with not anual clinical evaluation.

  6. A Chronic Disseminated Dermatophytosis Due to Trichophyton violaceum

    NARCIS (Netherlands)

    Zhan, Ping; Li, Zhi-Hua; Geng, Chengfang; Jiang, Qing; Jin, Yun; Dolatabadi, S.; Liu, Weida; de Hoog, G Sybren

    2015-01-01

    A 48-year-old female had presented dandruff and breakable hair for more than 40 years, dry scaly erythema on bilateral palms and feet accompanying with nail destruction for 20 years, and scaling papules on the buttock for 5 years. Direct microscopic examination showed endothrix anthroconidia within

  7. Chronic Ulceration and Sinus Formation due to Foreign Body

    DEFF Research Database (Denmark)

    Hansen, Karin Birgitte; Gottrup, Finn

    2015-01-01

    Foreign bodies like residues of suture or mesh may lead to a foreign body reaction, cavity formation and continuous secretion and perhaps ulceration. We present a more than 9 years long medical record of a 49 year old man after a simple surgical procedure. The background was a sinus formation gen...... in these cases. The knowledge of the foreign body reaction in tissue continuously needs to be reestablished in the health care system especially in areas, where implantation of foreign material is used....

  8. Dosis efectiva de hidromorfona en pacientes con dolor crónico oncológico: experiencia de 4 años en el Centro Médico Nacional "20 de Noviembre" ISSSTE Effective dose of hydromorphone in patients with chronic oncologic pain: a four-year experience in the Centro Médico Nacional 20 de Noviembre, a public hospital in Mexico

    Directory of Open Access Journals (Sweden)

    E. Rionda

    2009-07-01

    hydromorphone treatment were also noted. Results: The mean dose used was 22 mg ± 16 mg in 24 hours. Of the 72 patients, seven did not achieve adequate pain control and one discontinued the treatment due to adverse effects. The most common adverse effects were constipation, nausea, vomiting and drowsiness. Constipation was significantly more frequent than the remaining adverse effects. Constipation is an adverse effect that is highly tolerable when controlled by medication. Conclusions: The mean effective hydromorphone dose is a relatively low dose at which the adverse effects are still tolerable. The most common adverse effect was constipation, which is fairly tolerable with medication. Hydromorphone is a safe and effective drug even for prolonged periods.

  9. Chronic pain - resources

    Science.gov (United States)

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association -- www.theacpa.org National Fibromyalgia and Chronic Pain Association -- www.fmcpaware.org ...

  10. Low back pain - chronic

    Science.gov (United States)

    Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... Low back pain is common. Almost everyone has back pain at some time in their life. Often, the exact cause ...

  11. Chronic motor tic disorder

    Science.gov (United States)

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  12. Chronic Pelvic Pain

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  13. Employees with Chronic Pain

    Science.gov (United States)

    ... Home | Accommodation and Compliance Series: Employees with Chronic Pain By Beth Loy, Ph.D. Preface Introduction Information ... at http://AskJAN.org/soar. Information about Chronic Pain How prevalent is chronic pain? Chronic pain has ...

  14. 口服橄榄油治疗脑卒中后便秘52例疗效观察%Constipation after oral administration of olive oil and 52 cases of stroke treatment efficacy

    Institute of Scientific and Technical Information of China (English)

    安莉; 甄景; 王杏微; 王钧

    2011-01-01

    Objective: To observe the olive oil for the treatment of constipation in patients with stroke. Methods: 52 cases of stroke in patients with constipation after oral administration of olive oil and constipation treatment of stroke, observed in patients with defecation. Results: 52 cases of stroke in patients with constipation after oral administration of olive oil, a marked improvement in bowel movements, the effective rate of 90. T%. Conclusion: After oral administration of olive oil for constipation have a better stroke treatment.%目的:观察橄榄油对脑卒中患者便秘的治疗效果.方法:对52例脑卒中便秘患者采用口服橄榄油治疗卒中后便秘,观察患者的排使情况.结果:52例脑卒中便秘患者经口服橄榄油后,排使情况明显改善,有效率为90.4%.结论:口服橄榄油对脑卒中后便秘有较好的治疗作用.

  15. Nursing Care of Patients with Constipation After Stroke by Oral Administration of Olive Oil%脑卒中便秘患者口服橄榄油后的治疗护理观察

    Institute of Scientific and Technical Information of China (English)

    杜媛媛

    2016-01-01

    Objective: To observe the olive oil for the treatment of constipation in patients with stroke. Methods: 52 cases of stroke in patients with constipation after oral administration of olive oil and constipation treatment of stroke, observed in patients with defecation. Results: 52 cases of stroke in patients with constipation after oral administration of olive oil, a marked improve-ment in bowel movements, the effective rate of 90.4%. Conclusion: After oral administration of olive oil for constipation have a better stroke treatment.%目的:观察脑卒中患者便秘口服橄榄油的治疗护理效果。方法:对200例脑卒中便秘患者采用口服橄榄油治疗卒中后便秘,观察患者的排便情况。结果:200例脑卒中便秘患者经口服橄榄油后,排便情况明显改善,有效率为95%。结论:脑卒中患者便秘口服橄榄油后有较好的治疗护理作用,在临床上值得推广。

  16. The effection of fiberfon to anorectal pressure in children with functional constipation%小麦纤维素颗粒对功能性便秘患儿肛门直肠压力的影响

    Institute of Scientific and Technical Information of China (English)

    田娟; 江逊; 张薇; 仝海霞; 王春晖; 王宝西

    2012-01-01

    Objective To observe the clinical curative effect of Fiberform (wheat fiber) on functional constipation in school-age children. Methods A total of 48 school-age children with functional constipation admitted to pediatric department from September 2009 to February 2011 were selected. Fiberform was administered orally for 3 weeks and anorectal pressure was detected before and after treatment. Another 10 healthy normal children were chosen as control. Results After taken Fiberform orally, the remission or improvement of constipation symptoms was shown in children with functional constipation, and total effective rate was 90.6%. Rectal visceral sensation thresholds and rectal maximum volume threshold were higher in children with constipation than those in normal children before treatment of Fiberform and the differences were significant (all P0.05). However,rectal visceral sensation thresholds and rectal maximum volume threshold were obviously lower after treatment than those before treatment and the differences between before and after treatment were significant (all P0.05);治疗后的直肠感知阈值较治疗前降低,直肠最大容量阈值也较治疗前明显降低,差异均有统计学意义 (P <0.05).结论 小麦纤维素颗粒可降低肛门直肠压力,可用于学龄期儿童功能性便秘的治疗.

  17. Chronic coughing

    International Nuclear Information System (INIS)

    Chronic coughing was acknowledged to result from pathological state of the respiratory organs. Cardiac diseases could be accompanied by coughing as well. It was recommended to perform x-ray examinations, including biomedical radiography of the chest, computerized tomography, scintiscanning with 67Ga-citrate, bronchi examination in order to exclude heart disease. The complex examination permitted to detect localization and type of the changes in the lungs and mediastinum, to distinguish benign tumor from malignant one

  18. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  19. Heterogeneity of glucagonomas due to differential processing of proglucagon-derived peptides

    DEFF Research Database (Denmark)

    Challis, Benjamin G; Albrechtsen, Nicolai J Wewer; Bansiya, Vishakha;

    2015-01-01

    UNLABELLED: Pancreatic neuroendocrine tumours (pNETs) secreting proglucagon are associated with phenotypic heterogeneity. Here, we describe two patients with pNETs and varied clinical phenotypes due to differential processing and secretion of proglucagon-derived peptides (PGDPs). Case 1, a 57-year......-old woman presented with necrolytic migratory erythema, anorexia, constipation and hyperinsulinaemic hypoglycaemia. She was found to have a grade 1 pNET, small bowel mucosal thickening and hyperglucagonaemia. Somatostatin analogue (SSA) therapy improved appetite, abolished hypoglycaemia and improved...... the rash. Case 2, a 48-year-old male presented with diabetes mellitus, diarrhoea, weight loss, nausea, vomiting and perineal rash due to a grade 1 metastatic pNET and hyperglucagonaemia. In both cases, plasma levels of all measured PGDPs were elevated and attenuated following SSA therapy. In case 1...

  20. Why chronic constipation may be harmful to your lungs: a case report and review of lipoid pneumonia and mycobacterium fortuitum leading to acute respiratory failure and septic shock

    Directory of Open Access Journals (Sweden)

    Till S

    2015-10-01

    Full Text Available No abstract available. Article truncated at 150 words. A 43 year-old female with a past medical history of right-sided hemiparesis secondary to motor vehicle accident 17 years prior presented a two week history of cough, fever and right-sided pleuritic chest pain. Her baseline status included using a wheelchair, living alone at home and working as a teacher. On admission she had a temperature of 39.6º C, was tachycardia and hypotensive requiring vasopressors. Labs were remarkable for a white count of 25,000 cells/mcL. Chest x-ray showed right-sided infiltrate and pleural effusion (Figure 1. Bronchoscopy and thoracentesis was performed upon admission. The pleural fluid was exudative with a glucose of 78 and no suggestion of loculations on chest x-ray or ultrasound. The patient was started on therapy for community-acquired pneumonia. On day 4 after admission, the patient had increasing sinus tachycardia, hypotension and was worsening despite being on antimicrobial therapy. A CT angiogram of the chest was performed (Figure 2. ...

  1. Why chronic constipation may be harmful to your lungs: a case report and review of lipoid pneumonia and mycobacterium fortuitum leading to acute respiratory failure and septic shock

    OpenAIRE

    Till S; Mathew M; Liao D-W; Ramirez C

    2015-01-01

    No abstract available. Article truncated at 150 words. A 43 year-old female with a past medical history of right-sided hemiparesis secondary to motor vehicle accident 17 years prior presented a two week history of cough, fever and right-sided pleuritic chest pain. Her baseline status included using a wheelchair, living alone at home and working as a teacher. On admission she had a temperature of 39.6º C, was tachycardia and hypotensive requiring vasopressors. Labs were remarkable for a white ...

  2. 老年特发性便秘患者结肠动力学变化%Changes of Colonic Dynamics in Elderly Patients with Chronic Idiopathic Constipation

    Institute of Scientific and Technical Information of China (English)

    高利利; 吴本俨; 邵勇; 李园

    2001-01-01

    为探讨老年慢性特发性便秘(CIC)患者结肠运动功能变化,应用不透X线标记物法对59例老年CIC患者及36例对照者进行结肠通过时间检查.结果显示:(1)CIC组全结肠及分段结肠通过时间较对照组明显延长(P<0.05),其中老年CIC患者全结肠通过时间正常者32例,有16例(50%)存在局部结肠通过时间延长;(2)老年CIC患者中排便次数≤3次/周者与排便次数>3次/周者之间全结肠通过时间无显著性差异(P>0.05);(3)长期服用泻药的老年CIC患者其全结肠及分段结肠通过时间较间断服药和不服药者明显延长(P<0.05);(4)直乙部位通过时间明显延长的老年CIC患者其运输指数(TI)明显高于左半结肠和右半结肠通过时间延长者(P<0.05).结果提示:(1)老年CIC患者存在结肠动力学异常,其中长期服用泻药者结肠动力学异常更严重;(2)结肠通过时间检查可以较好地反映结肠运动功能变化.

  3. Chronic complicated osteomyelitis

    International Nuclear Information System (INIS)

    Fourteen patients with prior trauma and/or surgery of the lower extremity and suspected active chronic osteomyelitis underwent MR imaging. Eleven patients also underwent In-111 scanning. All patients had surgical confirmation, MR imaging could assess the extent of abnormal marrow and distinguish abnormal marrow due to granulation tissue from active osteomyelitis. The presence and extent of soft-tissue infection could be determined and distinguished from bone involvement in spite of tissue distortion. The course and origin of sinus tracts could be followed. MR imaging was more sensitive to active infection than In-111 scanning. All 11 cases of active osteomyelitis were correctly diagnosed with MR imaging. In-111 scans were positive in only five of the eight cases of active infection in which scans were obtained. MR imaging is useful in chronic complicated osteomyelitis

  4. 儿童功能性便秘的危险因素分析%The risk factors of childhood functional constipation

    Institute of Scientific and Technical Information of China (English)

    胡会; 肖咏梅; 张婷

    2015-01-01

    ObjectiveTo study the risk factors of childhood functional constipation.MethodsA cross-sectional analysis of risk factors associated with 182 cases of functional constipation in children was conducted from March 2013 to February 2014. ResultsThe male patients were more than females, mainly in preschool children. The risk factors were did not like fruits and vegetables (52.2%), drank less water (44.0%), did not develop the habit of daily bowel movement (39.5%), defecation fear (36.3%), inadequate food intake (25.8%). There were different risk factors in different age stages.ConclusionsFunctional constipation is related to gender, age, diet habits and mental psychology.%目的:了解儿童功能性便秘的危险因素。方法采用横断面调查方法,调查2013年3月至2014年2月期间消化专科门诊确诊的182例功能性便秘患儿的便秘相关危险因素。结果功能性便秘以男性患儿多见,并以学龄前期为主;患儿主要存在不喜食蔬菜水果(52.2%),饮水少(44.0%),未养成每天排便习惯(39.5%),存在排便恐惧(36.3%),食物摄取不足(25.8%)等危险因素;不同年龄阶段的危险因素有所不同。结论功能性便秘与性别、年龄、饮食生活习惯和精神心理相关。

  5. Chronic Insomnia

    OpenAIRE

    Buysse, Daniel J.

    2008-01-01

    Ms. F, a 42-year-old divorced woman, presents for evaluation of chronic insomnia. She complains of difficulty falling asleep, often 30 minutes or longer, and difficulty maintaining sleep during the night, with frequent awakenings that often last 30 minutes or longer. These symptoms occur nearly every night, with only one or two “good” nights per month. She typically goes to bed around 10:00 p.m. to give herself adequate time for sleep, and she gets out of bed around 7:00 a.m. on work days and...

  6. Acute chylous peritonitis due to acute pancreatitis

    OpenAIRE

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of “chyle” occurs rapidly, the patient may present with signs of peritonitis. Preoperative...

  7. Comprehensive management of chronic pain in haemophilia.

    Science.gov (United States)

    Young, G; Tachdjian, R; Baumann, K; Panopoulos, G

    2014-03-01

    Chronic pain, most often due to haemophilic arthropathy, is a pervasive problem in persons with haemophilia (PWH) that adversely impacts function and quality of life. PWH with inhibitors and older PWH may be especially vulnerable to progressive arthropathy and resulting chronic pain. The development of chronic pain from acute pain involves a complex interplay of biological and psychosocial factors that may all contribute to the perpetuation of chronic pain and the outcome of therapy. In the absence of evidence-based guidelines, an individualized, multimodal approach to chronic pain management is proposed, as it is in individuals without haemophilia who have chronic pain. Pharmacological treatment is central to the management of chronic pain and must be modified based on pain intensity, ongoing response to therapy and the risk for adverse events. Non-pharmacological interventions, including physiotherapy, complementary treatments and surgical (e.g. orthopaedic) or other invasive procedures, may be integral to chronic pain management in this population. Ongoing psychosocial assessment is critical to identify those factors that may be contributing to the perpetuation of chronic pain or acting as barriers to effective management. Additional study is needed to identify optimal pharmacological treatments for chronic pain in PWH based on the unique pathophysiology of haemophilic arthropathy and on risk profile. Systematic determination of the particular psychosocial factors impacting the experience and management of chronic pain in PWH would likewise add value to the treatment of this pervasive problem.

  8. Chronic kidney disease

    Science.gov (United States)

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... 2012_CKD_GL.pdf . McCullough PA. Interface between renal disease ... patients with kidney failure. N Engl J Med . 2010;362(14):1312- ...

  9. 血吸虫病疾病负担研究Ⅱ慢性血吸虫病健康不公平性的测量%Burden of disease in schistosomiasis japonica Ⅱ Measurement of health inequalities due to chronic schistosomiasis

    Institute of Scientific and Technical Information of China (English)

    贾铁武; 孙乐平; 洪青标; 邓瑶; 张功华; 汪昊; 易平; 郭家钢; 周晓农

    2011-01-01

    目的 对慢性血吸虫病所致的健康不公平性进行测量与评价.方法 以湖区两县慢性血吸虫病的健康寿命损失年为基础数据,采用集中指数(曲线)和基尼系数(洛伦兹曲线)对慢性血吸虫病疾病负担在年龄和地区间的分布差异进行定量分析.结果 女性和男性年龄集中指数分别为0.395和0.380,男女间无明显差异;仅占人口总数30%的45岁以上各人群疾病负担均约占各自总体的近60%.当涂县和汉寿县基尼指数分别为0.666和0.451,一类村和二类村的疾病负担占各县总量的60%以上.结论 集中指数和基尼系数及相关曲线直观量化了慢性血吸虫病所致的健康不公平性,45岁以上人群和二类以上流行村是病情控制的重点.%Objective To measure and evaluate the health inequalities due to chronic schistosomiasis japonica. Methods Based on years lived with disability (YLD) caused by chronic schistosomiasis, a concentration index and Cini index, along with a concentration curve and Lorenz curve, the health inequalities between sexes, age groups or endemicities were identified and quantified. Results The age concentration index was 0.395 of females and 0.380 of males, with no significant difference between them. More than 60% of YLD was contributed by those aged ≥45 years old who accounted for about a third of total population in both sexes. Gini index was 0.666 of Dangtu County and 0.451 of Hanshou County, and 60% of YLD was contributed by the highly endemic villages. Conclusions The concentration index and Cini index could quantify the magnitude of health inequalities well. The priority of morbidity control should be given to those aged ≥45 years old and living in highly endemic villages.

  10. 帕金森病患者便秘临床特点及相关因素分析%Clinical characteristics and correlative factors of constipation in patients with Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    李雪莲; 陈先文; 王尚培; 蒋曼丽; 冯爱君; 杨倩; 胡盼盼

    2016-01-01

    1.322,P<0.05).早发便秘组(运动症状前发生)和晚发便秘组(运动症状后发生)便秘严重程度均与帕金森病运动症状严重程度、抗帕金森病药物日剂量及抑郁程度相关.不同抗帕金森病药物调整前后便秘严重程度变化存在个体差异.结论 便秘患者的年龄、病程、运动症状严重程度、抗帕金森病药物剂量、抑郁症状严重程度及排尿障碍程度均高于非便秘患者,日饮水量及蔬菜日摄入量低于非便秘患者.帕金森病患者便秘的严重程度与帕金森病的运动症状严重程度、抑郁症状及抗帕金森病药物剂量呈正相关.早发便秘与晚发便秘在严重程度和相关因素上差异无统计学意义.不同抗帕金森病药物对便秘的影响存在个体差异.对帕金森病患者便秘应针对不同危险因素进行个性化处理.%Objective To investigate the characteristics and the correlative factors of constipation in Parkinson's disease (PD) patients.Methods The demographic information,clinical features and history of medications of 193 patients with idiopathic PD consulting in the outpatient department of the First Affiliated Hospital,Anhui Medical University were collected.Patients were evaluated using following scales:Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ),Hoehn-Yahr stage,Bristol Scoring Scale,Cleveland Constipation Scoring Scale (CCS),Scale for Outcomes in PD-autonomic for Autonomic Symptoms,Simple Food Frequency Questionnaire,Hamilton Depression Scale (HAMD),Mini Mental State Examination.The patients were divided into constipation group and non-constipation group based on Rome Ⅲ Criteria for Diagnosis of Functional Constipation,and the correlative factors of constipation were compared and analyzed between the two groups.The severity of constipation and influencing factors were also compared between patients with early onset constipation (occurred before present of motor symptoms) and patients with

  11. 金陵术治疗顽固性便秘的围手术期处理%Perioperative treatment of Jinling procedure for refractory constipation

    Institute of Scientific and Technical Information of China (English)

    刘建磊; 姜军; 丁威威; 冯啸波; 倪玲; 姚安龙; 倪小红; 李宁

    2013-01-01

    目的 顽固性便秘药物治疗效果差,既往手术方式远期疗效有争议,南京军区南京总医院普通外科研究所创新的金陵术式治疗顽固性便秘疗效显著.文中主要研究金陵术治疗顽固性便秘的围手术期处理.方法 回顾性分析金陵术治疗的148例便秘患者的临床资料,分析术前、术中、术后治疗措施,总结其中易发问题、常见术后不适及并发症,为临床治疗提供借鉴.结果 148例患者术后出现肠梗阻13例,吻合口出血8例,吻合口瘘4例,其中5例肠梗阻需手术治疗,其他患者均经保守治疗治愈,未出现手术相关性死亡病例.结论 金陵术治疗顽固性便秘,术前应明确诊断、完善评估,术中减少应激、微创操作,术后积极处理各种不适,做好并发症的防治,提高手术的安全性.%Objective Intractable constipation responds poorly to drug therapy, and the long-term effectiveness of surgery for it remained controversial before the Jinling Procedure ( subtotal colectomy and side-to-side cecorectal anastomosis ) came into being, a surgical innovation of our department, which has proved to be significantly effective for intractable constipation. This study aims to investigate the perioperative treatment of the Jinling Procedure for intractable constipation. Methods We reviewed the pre-, intra-and post-operative treatment measures for f48 cases of intractable constipation treated by Jinling Procedure. We also analyzed the postoperative discomfort and complications. Results All the 148 patients were cured, without surgery-related deaths. Postoperative intestinal obstruction occurred in f 3 cases, anastomotic stoma bleeding in 8, and anastomotic stoma fistula in 4, which were all cured by surgery or conservative treatment. Conclusion Definite diagnosis and assessment of intractable constipation are required before Jinling procedure; stress reduction and minimally invasive technology are necessitated during the surgery

  12. Clinical research of noninvasive mechanical ventilation in patients with conscious disturbance due to acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure%无创机械通气治疗伴意识障碍AECOPD呼吸衰竭患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    徐丽娜; 孙开宇; 曹洁; 陈宝元

    2013-01-01

    目的 探讨无创机械通气救治伴有意识障碍慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者成功的相关因素.方法 AECOPD伴有意识障碍的重症呼吸衰竭患者54例,接受BiPAP呼吸机治疗.按照治疗效果分为成功组和失败组,比较两组患者各项指标及变化,进行Logistic回归分析,寻找无创通气成功的相关因素.结果 NIPPV失败组患者稳定期FEV1%pred较高,PaCO2值较低,治疗后GCS评分较低,pH值较低,PaCO2较高,均较NIPPV成功组明显.Logistic回归分析提示,治疗后GCS评分NIPPV后期失败有显著影响.结论 治疗后GCS评分是NIPPV治疗伴有意识障碍AECOPD呼吸衰竭患者成功的相关因素.%Objective To investigate the factors related to the success of noninvasive ventilation in the treatment of conscious disturbance due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure.Methods Fifty-four patients with conscious disturbance due to AECOPD complicated with respiratory failure were selected in the study,that treated by BiPAP ventilation.They were divided into effective group and failure group according to the curative effect,clinical and physiological parameters were analyzed comparatively between two groups,multi-variable logistic regression analysis was used to find the predictive factors of the success in noninvasive ventilation.Results In stable phase,FEV1 % predicted was higher,PaCO2 values was lower significantly in patients in NIPPV failure group who also had a lower GCS compared with NIPPV success group.Multi-variable logistic analysis suggests statistical significance in GCS after 2 h ventilation.Conclusions The failure of NIPPV in patients with conscious disturbance due to AECOPD complicated with respiratory failure was influenced by GCS after 2 h ventilation.

  13. Radiolabelled cytokines for imaging chronic inflammation

    International Nuclear Information System (INIS)

    Diagnosis and particularly follow-up of chronic inflammatory disorders could be often difficult in clinical practice. Indeed, traditional radiological techniques reveal only structural tissue alterations and are not able to monitor functional changes occurring in tissues affected by chronic inflammation. The continuous advances in the knowledge of the pathophysiology of chronic disorders, combine with the progress of radiochemistry, led to the development of new specific radiolabelled agents for the imaging of chronic diseases. In this scenario, cytokines, due to their pivotal role in such diseases, represent good candidate as radiopharmaceuticals. (author)

  14. Atypical Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... myeloproliferative neoplasms, leukemia , and other conditions . Chronic Myelomonocytic Leukemia Key Points Chronic myelomonocytic leukemia is a disease ... chance of recovery) and treatment options. Chronic myelomonocytic leukemia is a disease in which too many myelocytes ...

  15. Voice in chronic hemodialyzed individuals

    Directory of Open Access Journals (Sweden)

    Radish Kumar Balasubramanium

    2010-01-01

    Full Text Available Objective: Chronic hemodialysis affects various body systems, one of which is the respiratory system. Since respiration is the prime source for speech, vocal dysfunctions are expected to be present in patients with chronic hemodialysis. The present study attempts to shed light on the changes in acoustic and aerodynamic characteristics of voice, if any, in patients with chronic hemodialysis. Materials and Methods: Phonation of sustained vowel/a/sample was subjected to acoustic analysis using VAGHMI software. Sustained duration of/a/,/s/, and/z/ was recorded for the purpose of aerodynamic analysis. The independent t test was employed to find the significant difference between the two groups. Results: Chronic hemodialyzed subjects showed significant deviation in frequency, perturbation, and aerodynamic measures when compared to normal subjects. These results are discussed with respect to the underlying pathophysiology. Conclusion: The results of the present study revealed that subjects with chronic hemodialysis exhibit clinical evidence of voice disorders. Vocal deviations in chronic hemodialyzed subjects are explained due to the influence of the renal system on the respiratory and the phonatory system and the negative fluid balance effect of hemodialysis.

  16. Doença celíaca e constipação: uma manifestação clínica atípica e pouco frequente Enfermedad celíaca y constipación: una manifestación clínica atípica y poco frecuente Celiac disease and constipation: an uncommon atypical clinical manifestation

    Directory of Open Access Journals (Sweden)

    Cristiane Boé

    2012-06-01

    chronic constipation. CASE DESCRIPTION: Two girls, aged 18 and 30 months, had chronic constipation refractory to standard treatment. Both patients concomitantly evidenced low weight gain and short stature. The investigation of the digestive-absorptive function was positive for IgA antibodies against tissue transglutaminase. The diagnosis of CD was confirmed by a small bowel biopsy that showed moderate/severe villous atrophy and increased intraepithelial lymphocytic infiltration. One month after starting the dietary treatment with a gluten-free diet, both patients recovered from constipation, with the passage of soft stools daily. COMMENTS: CD may be presented in the classical, asymptomatic or atypical forms. In the latter form, isolated manifestations, surch as constipation, delay the diagnosis of the disease.

  17. Eldercare at Home: Constipation

    Science.gov (United States)

    ... cold/flu/allergy tablets? Diuretics or water pills Anti-hypertensives (medications for blood pressure) Some medicines can ... dealing with common caregiving problems. © 2016 Health in Aging. All rights reserved. Feedback • Site Map • Privacy Policy • ...

  18. Constipation - self-care

    Science.gov (United States)

    ... fast foods, such as white breads, pastries, doughnuts, sausage, fast-food burgers, potato chips, and French fries. ... before talking with your provider. This includes mineral oil. Some people get a rash, nausea, or a ...

  19. Constipation (For Kids)

    Science.gov (United States)

    ... they don't poop every day, but everybody's bathroom habits are different. One kid might go three times ... Maybe they don't want to use the bathroom at school or maybe they just don't want to stop what they're doing right then. But if you make a habit of ignoring your body's signals that it's time ...

  20. Diagnosis of Constipation

    Science.gov (United States)

    ... diarrhea , so you should stay close to a bathroom during the bowel prep. For the procedure, you’ ... La Información de la Salud en Español Health Statistics Healthy Moments Radio Broadcast Clinical Trials For Health ...

  1. Treatment for Constipation

    Science.gov (United States)

    ... a bowel movement. You should also use the bathroom as soon as you feel the urge to ... La Información de la Salud en Español Health Statistics Healthy Moments Radio Broadcast Clinical Trials For Health ...

  2. Colectomy for refractory constipation

    DEFF Research Database (Denmark)

    Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth;

    2010-01-01

    between operated and non-operated patients. MATERIAL AND METHODS: Out of 281 patients, 30 women and 5 men underwent surgery. All patients were evaluated by clinical and physiological investigations. Forty-four randomly selected healthy persons constituted the control group. RESULTS: Twenty-one patients...

  3. Onycholysis due to trauma

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-04-01

    Full Text Available Female patient, 35 years old who came to the private office due to discoloration of her left thumbnail and little pain since 1 month ago. Clinical examination shows nail disease on her left thumbnail with onycholysis and dyschromia, dermatoscopy showed white-yellowish discoloration (Fig. 1A, B. The rest of the clinical examination was normal. Patient use to using acrylic nails since 2 years ago and denied some trauma at the nail. The diagnosis of onycholysis due to trauma was done and recommended her not to use acrylic nail, maintain the nail short and avoid wetness.

  4. Effect of INHP on brain white matter lesion and cognitive impairment due to chronic cerebral hypoperfusion in rats%间断性常压低氧后适应对慢性脑血流低灌注大鼠脑白质损伤和认知功能障碍的影响

    Institute of Scientific and Technical Information of China (English)

    李国青; 孟然; 任长虹; 冯兴中; 曹金强; 李宁; 马林; 吉训明

    2013-01-01

    Objective To study the effect of intermittent normobaric hypoxia postconditioning (INHP) on brain white matter lesion and cognitive impairment due to chronic cerebral hypoperfu -sion in rats .Methods Thirty-two SD rats were divided into sham group ,model group,INHP1 group and INHP2 group (8 in each group) .Cognitive function of rats was assessed by Morris water maze test and severity of brain white matter lesion was assessed with Klüver-Barrera staining . Astroglia and microglia in brain white matter were marked with GFAP and Iba-1 antibodies .Results The cognitive impairment ,axonal loss and vacuolization in brain white matter with activated astrocytes and microglias occurred earlier in model group than in sham group .The reference anamness was poorer ,the brain white matter lesion was severer ,and the number of GFAP-posi-tive astrocytes and Iba-1-positive microglias was greater in INHP1 group than in model group , whereas the reference anamness was better ,the brain white matter lesion was milder ,and the number of GFAP-positive astrocytes and Iba-1-positive microglias was smaller in INHP2 group than in model group (P<0 .05) .Conclusion Delayed INHP but not early INHP can improve cognitive impairment and brain white matter lesion due to chronic cerebral hypoperfusion .%目的 探讨间断性常压低氧后适应(intermittent normobaric hypoxia postconditionning,INHP)对慢性脑血流低灌注大鼠脑白质损伤和认知功能障碍的影响.方法 选择健康成年雄性SD大鼠32只,随机分为假手术组、模型组、INHP1组和INHP2组,每组8只.Morris水迷宫用于评价大鼠的认知功能,Klüver-Barrera 染色用于评价脑白质损伤的严重程度,胶质纤维酸性蛋白(GFAP)抗体、Iba-1抗体分别用于免疫标记脑白质中星形胶质细胞和小胶质细胞.结果 与假手术组比较,模型组大鼠出现认知功能障碍、脑白质中髓鞘脱失、空泡形成,并有星形胶质细胞、小胶质细

  5. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Harmsen, L; Thomsen, S F; Sylvan Ingebrigtsen, Truls;

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  6. [Lung disorders due to metals].

    Science.gov (United States)

    Rüegger, M

    1995-03-11

    Though metals represent the largest group of elements they rather rarely cause respiratory diseases. This article will therefore review the most important ones caused by inhaled dusts of metals and some of their inorganic compounds, but leaving aside silicosis and silicatosis as well as iatrogenically induced metal pneumopathies. Among toxic inflammatory diseases metal fume fever, an influenza-like condition caused by zinc oxide, ranks as the commonest. Activities such as oxi-acetylene cutting and welding of zinc covered metal pieces account for about 90% of all cases compensated in Switzerland. Due to the non-recurrent character of this type of work, the typical waning of symptoms while exposure is going on has become seldom. Toxic pneumonia caused by inhaled metal fumes occurs rather seldom. However, serious cases have been reported where soldiers were exposed to zinc chloride from smoke bombs. The existence and extent of chronic airflow limitation due to occupational exposure to metallic dusts have not been widely examined but are to be assumed when there is poor occupational hygiene. Concerning asthma, there are at least four metals and several of their compounds which have been proven to cause variable airway narrowing, namely chromium, nickel, platinum and cobalt (the latter as hardmetal). Platinum complex salts (chloro-compounds) are very potent sensitizers leading to a notable prevalence of asthma among exposed workforces. Nevertheless, there have been no such cases in Switzerland for more than ten years. Hard-metal not only causes asthma but also an alveolitis-like interstitial lung disease progressing to fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Skin manifestations and comorbidities of chronic arsenicosis due to contaminated drinking water and their risk factors%慢性饮水型砷中毒患者皮肤表现和合并疾病及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    韩建文; 狄震; 张巧丽; 刘佳; 乌日嘎; 智艳平; 乌日娜

    2016-01-01

    目的:分析慢性饮水型砷中毒患者的皮肤表现、合并疾病以及可能的影响因素。方法对内蒙古95例慢性饮水型砷中毒患者的人口学特征、皮肤表现、合并疾病进行流行病学调查和分析。建立logistic回归模型,分析性别、年龄、开始饮用高砷水年龄、水砷浓度及饮用高砷水时间年龄与皮肤表现、合并疾病间的相关性。结果95例患者中共有77例患者发生色素沉着,75例发生色素减退,93例发生掌跖部皮肤角化,27例患者发生皮肤癌,其中多发性皮肤癌8例。合并结核5例、高血压15例、类风湿性关节炎2例、脑梗死4例、冠心病7例、内脏恶性肿瘤3例、肝硬化6例、贫血2例。回归分析发现色素沉着与水砷浓度相关(OR=0.32,95%CI=0.10~0.98);校正OR=0.27,95%CI=0.08~0.90)。冠心病的发生与饮用高砷水时间具有相关性(OR=6.41,95%CI=1.09~37.88;校正OR=8.55,95%CI=1.212~60.41)。肝硬化的发生与水砷浓度具有相关性(OR=24.67,95%CI=2.69~226.57;校正OR=22.51,95%CI=2.38~213.11)。结论慢性砷中毒患者色素代谢异常、掌跖部皮肤角化、皮肤癌发生率高。水砷浓度、饮用高砷水时间不同对人体可能产生不同的影响。%Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta⁃minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic⁃contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had

  8. A P300 study of cognition in patients with functional constipation%功能性便秘患者认知功能P300研究

    Institute of Scientific and Technical Information of China (English)

    吴皓; 孙毅; 冯锐; 赵岚; 戴宁

    2013-01-01

    目的 探讨功能性便秘患者的认知功能和情绪状态及其关联性.方法 选取35例功能性便秘患者及24例健康志愿者,在执行听觉Oddball序列任务时,采集事件相关电位(ERP)行为学及脑电数据.ERP检测前进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、症状自评量表(SCL-90)及艾森克人格量表(EPQ)评估,并将各评分结果进行统计学分析比较.结果 功能性便秘组患者汉密尔顿抑郁、焦虑总分和SCL-90中躯体化、强迫、抑郁、焦虑、精神病性及EPQ中内外向和神经质因子与健康对照组对比,差异均有统计学意义(P<0.05).功能性便秘组和健康对照组的ERP-P300反应时分别为(474.28 ±128.29)ms和(424.28±94.95) ms,准确率分别为(97.16±4.17)%和(98.02±2.65)%,组间比较,差异无统计学意义(P>0.05).功能性便秘组在F3和F7位点上的P300波幅均较健康对照组增高(P<0.05),但其相应的P300潜伏期比较,差异无统计学意义(P>0.05).结论 功能性便秘患者有焦虑抑郁情绪,可能存在躯体化、强迫等方式应对焦虑抑郁的痛苦体验;其听觉通道信息加工中涉及内隐加工的认知功能可能存在异常.%Objective To investigate the relationship between cognitive function and emotional status in functional constipation patients.Methods Thirty-five functional constipation patients (the functional constipation group) and 24 healthy controls (the HCs) were enrolled in an event-related potential (ERP),behavior and electroeneephalogram study while performing an oddball auditory task.Response time,accuracy,latency and P300 amplitude were compared between the two groups.The Hamilton depression rating scale (HAMD-17),Hamilton anxiety scale (HAMA),symptom check list-90 (SCL-90) and Eysenck personality questionnaire (EPQ) were administered prior to the oddball task.Results The average HAMD-17,HAM A and SCL-90 (the somatization,obsessive-compulsive disorder

  9. Curative ef ect observation of 37 functional constipation patients treated with biofeedback therapy%生物反馈治疗功能性便秘37例疗效观察

    Institute of Scientific and Technical Information of China (English)

    金学林

    2014-01-01

    目的:探讨生物反馈治疗功能性便秘的临床疗效。方法对我院2012年11月-2014年5月进行生物反馈治疗的37例功能性便秘病人回顾分析。结果生物反馈治疗后患者便秘症状评分显著降低,有效率为81.08%。结论生物反馈治疗对功能性便秘治疗安全有效。%Objective We aim to study the clinical curative ef ect of biofeedback therapy for functional constipation.Methods Clinic data of 37 functional constipation patients were evalua-ted.They were treated with biofeedback therapy in our hospital during November 2012 to May 2014.Results After biofeedback therapy,functional constipation symptom scores of patients de-creased significantly,with ef ective rate of 81.08%.Conclusions Biofeedback therapy for the treatment of functional constipation is safe and ef ective.

  10. Chronic urticaria

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2011-01-01

    Full Text Available Chronic urticaria (CU is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

  11. Influencing Factors of Constipation in Patients with Diabetes%62例糖尿病患者便秘发生情况及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王振宇; 李晓静; 童奥; 唐红; 马小艳; 朱慧娟; 吴丽丽; 王颖; 曹蕊; 王书瑶

    2012-01-01

    Objective To understand the prevalence of constipation in patients with diabetes and its risk factors and to provide specific nursing intervention. Methods A self-designed questionnaire about the influencing factors and degree of constipation was applied in the survey of 62 patients with diabetes. Results The incidence of constipation reached 48% among diabetic patients, who mainly suffered from slight constipation. Food intake, laxative drugs and calcium supplementation exerted influence on constipation (P<0.01 or P<0.05). Conclusion There is high incidence of constipation in patients with diabetes. Health education, such as reasonable diet, correct choice of laxative drugs and appropriate calcium supplementation to prevent constipation should be promoted.%目的 探讨糖尿病患者便秘发生情况及其相关因素,以便有针对性地实施护理干预,预防糖尿病患者便秘的发生.方法 采用自行设计的调查表,对62例糖尿病患者进行调查,评估其便秘发生情况及程度,对导致便秘的因素进行多因素Logistic回归分析.结果 糖尿病患者便秘发生率为48%,以轻度便秘为主;Logistic回归分析显示,便秘与严格限制饮食、自服通便药、补充钙剂有关(P<0.01或P<0.05).结论 糖尿病患者便秘发生率高,且与饮食、用药等情况相关.护理中应做好健康教育,教会患者合理安排进食,正确选择通便药物,在补充钙剂时需注重便秘的预防.

  12. Biofeedback therapy of pelvic floor functional constipation%盆底功能失调型便秘的生物反馈治疗

    Institute of Scientific and Technical Information of China (English)

    黄忠诚; 刘祺; 罗维珍; 苏冀; 唐佳新; 王爱民; 刘清安

    2009-01-01

    Objective To study the effect of biofeedback therapy on pelvic floor functional constipation. Methods An analysis of the clinical data of 46 cases of biofeedback therapy of pelvic floor functional constipation was made retrosoectively. Results Among 44 cases who completed the course, anorectic manometer detection results of 35 cases indicated that the rectum sensitivity threshold and the maximum tolerance capacity and recto-anal inhibitory reflex decreased, compared with those before treatment. Paradoxical contraction of pelvic floor disappeared and normal bowel movement was regained; in 6 cases the symptoms were improved,including times of bowel movement, sense of incomplete defecation and anorectic distention. The effective rate of biofeedback trestment was 93.2 %. Only 3 cases were ineffective and 2 cases lost follow-up after treatment. Conclusions The short-term effect of biofeedback therapy for pelvic floor functional constipation is satisfactory,and has advantages of non-traumatic, low cost and unhospitalization.%目的 探讨盆底功能失调型便秘的生物反馈治疗的效果.方法 回顾性分析46例盆底功能失调型便秘行生物反馈治疗患者的资料.结果 44例坚持完成治疗的患者中,35例肛管直肠压力测定示直肠感觉阈值、最大耐受容量、直肠肛门抑制反射较治疗前降低,盆底肌的反常收缩消失,恢复正常排便;6例排便次数、排便不尽感、肛门坠胀感较治疗前有所改善;3例无效;2例终止治疗后失访,总有效率为93.2%.结论 盆底功能失调型便秘生物反馈治疗近期疗效满意,具有无创、费用低、无需住院等特点.

  13. 非比麸治疗妊娠期便秘的疗效观察%Efficacy Observation of Fiberform in the Treatment of Constipation during Pregnancy

    Institute of Scientific and Technical Information of China (English)

    杨金英; 刘磊; 张国正

    2014-01-01

    Objective:To explore the effects of Fiberform in the treatment of constipation during pregnancy.Method:A total of 92 pregnant women diagnosis of functional constipation from July 2013 to September 2013 were admitted to Guangzhou women and children medical center,these women were divided into control group with 48 cases and study group with 44 cases.The control group received basic therapy which included diet habit change,defecate method training,moderate water and moderate exercise,the study group received basic treatment plus oral intake of Fiberform 3.5 g/time 2 weeks.The defecation symptoms improvement and stool quality were compared between the two groups.Result:The total efficacy rate of study group was 93.1%,was significantly higher than that of control group with 54.1%,there was statistically different(P<0.05).There were no severe adverse effects during the treatments.Conclusion:The Fiberform is effective in treating constipation during pregnancy,is worth clinical promotion.%目的:研究非比麸治疗妊娠期便秘的有效性。方法:选择2013年7-9月在广州市妇女儿童医疗中心诊断为功能性便秘的92例患者,分别按照是否接受非比麸治疗分为研究组44例和对照组48例。对照组给予基础治疗,包括调整饮食、训练排便方法、适量饮水、适量活动;研究组在此治疗基础上口服小麦纤维素颗粒3.5 g/次,治疗2周,比较两组孕妇排便症状和大便性状。结果:研究组总有效率为93.1%,显著高于对照组的54.1%,两组比较差异有统计学意义(P<0.05)。治疗期间未发现明显不良反应。结论:非比麸治疗妊娠期便秘效果明确,值得临床推广应用。

  14. TCM diagnosis thoughts and methods on constipation caused by 5-HT3 receptor antagonist%5-HT3受体拮抗剂所致便秘中医诊治思路与方法

    Institute of Scientific and Technical Information of China (English)

    冷启宁; 盛军章; 任志兵

    2013-01-01

      目的:研究中医治疗5-HT3受体拮抗剂所致便秘的思路与方法。方法:通过对肿瘤化疗病人因应用5-HT3受体拮抗剂而出现的不良反应-便秘的症状、舌象、脉象进行辨证分析,得出辨证结论,分析治疗方法。结果:5-HT3受体拮抗剂所致便秘中医辨证为阴虚燥结,治以滋阴通腑泻热,方药选用增液承气汤。结论:增液承气汤是治疗5-HT3受体拮抗剂所致便秘的有效方剂,而且能提高5-HT3受体拮抗剂的止吐效果。%Objective:To investigate the TCM therapy thoughts and methods of constipation caused by 5-HT3 receptor antagonist. Methods:The adverse reactions caused by application of 5-HT3 receptor antagonist, including constipation, tongue manifestation and pulse manifestation were analyzed based on different symptoms and signs. Results:The constipation caused by 5-HT3 receptor antagonist was diagnosed as yin asthenia and fluid-consuming constipation. Zengye Chengqi decoction was used to Ziyin Tongfu and Xieye. Conclusion:Zengye Chengqi decoction was effective on treating constipation caused by 5-HT3 receptor antagonist, and it could also improve the vomit-stopping effect of 5-HT3 receptor antagonist.

  15. 中西医结合治疗肝胃郁热型慢性胃炎临床研究%Clinical Study on Integrated Traditional Chinese and Western Medicine in the Treatment of Chronic Gastritis due to Accumulation of Heat in the Liver and Stomach

    Institute of Scientific and Technical Information of China (English)

    晋相林

    2011-01-01

    Objective: To observe the clinical effects of Sanshen Weiyan Decoction integrated with Western Medicine in treating chronic erosive gastritis due to accumulation of heat in the liver and stomach. Methods: 100 patients of chronic erosive gastritis in accordance with inclusive criteria were randomly divided into two groups, each of 50 cases, according to the orders of their treatment. Patients in control group were treated by Omeprazole Capsules, 20mg each time and twice a day before meals, and Amoxycillin Capsules were taken by 1.0g each time and twice a day; after meals, Clarithromycin Tablets 0. 5g were taken each time and twice a day. Seven days later, Omeprazole Capsules were taken 20mg each time and once a day, for another 14days. Patients in treatment group were treated by Sanshen Weiyan Decoction besides the drugs taken by the control group, one formula each day, after fried with water, and the decoction should be taken twice, once in the morning and once in the evening. Both groups took 21days as a course of treatment, during which patients were forbidden to have cool, cold, bitter and feast foods. Results: ① Total effect comparisons between the two groups showed that the mean rank of the control group was 43.54, while the treatment group was 57.46. The Mann-Whitney U statistics were 902. 00; Wilcoxon were 2177. 00; the Z test statistics Z=2. 594, p =0. 009 (double -sided), and the effects of the two groups had significant difference, which showed that the treatment group was better than the control group. ② The total effective rates of the two groups showed that the treatment group was 88.00% while the control group was 72. 00%. After being compared, x2 = 4. 000 v = 1 and p = O. 046, which showed that the difference between both groups was significant and the treatment group was better than the control group. ③ The total effective rates of the two groups on fighting high pressure (HP): the treatment group was 86. 00% while the control group was

  16. Neuromodulation of chronic headaches

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Jensen, Rigmor H; Antal, Andrea;

    2013-01-01

    The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even...

  17. Lubiprostone: evaluation of the newest medication for the treatment of adult women with constipation-predominant irritable bowel syndrome

    OpenAIRE

    Lunsford, Tisha N; Harris, Lucinda A

    2010-01-01

    Tisha N Lunsford, Lucinda A HarrisDepartment of Gastroenterology and Hepatology, Mayo Clinic – School of Medicine, Scottsdale, Arizona, USAAbstract: Irritable bowel syndrome (IBS) is a chronic disorder that affects primarily female patients and is thought also to afflict approximately 7%–10% of the population of the Western World. Although bowel habits may change over the course of years, patients with IBS are characterized according to their predominant bowel habit, const...

  18. Untying chronic pain

    OpenAIRE

    Häuser, Winfried; Wolfe, Frederik; Henningsen, Peter; Schmutzer, Gabriele; Brähler, Elmar; Hinz, Andreas

    2014-01-01

    Background: Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods: A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic ...

  19. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  20. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  1. Comparison of low-versus high-intensity focused ultrasound in treating pain due to chronic soft tissue injury%低强度和高强度聚焦超声治疗慢性软组织损伤性疼痛效果的比较

    Institute of Scientific and Technical Information of China (English)

    徐城; 刘丹彦

    2015-01-01

    目的 比较低强度和高强度聚焦超声治疗慢性软组织损伤性疼痛的效果.方法 慢性软组织损伤性疼痛病人93例,性别不限,年龄18~ 80岁,BMI 18~31 kg/m2,病程3个月~ 10年,数字评估量表评分4~8分,采用随机数字表法,将病人分为2组:低强度组(LI组,n=49)和高强度组(HI组,n=44).LI组以能感受到(酸、麻、胀、痛)的最小聚焦超声强度持续治疗10 min;HI组以不能耐受的聚焦超声强度治疗1 min,停止1 min,共治疗10 min;1次/d,2组疗程均为5d.治疗期间当数字评估量表评分仍>4分时肌肉注射帕瑞昔布钠40 mg;根据疗效指数和活动功能改善情况评估疗效,并进行生活质量评分和抑郁评分,记录治疗有关不良事件的发生情况.结果 LI组和HI组治疗总有效率分别为98%和84%;与HI组比较,LI组治疗总有效率升高,生活质量评分升高(P<0.05),抑郁评分差异无统计学意义(P>0.05).LI组无一例病人使用帕瑞昔布钠,未见治疗有关不良事件发生,HI组有1例病人(2%)使用帕瑞昔布钠,皮肤灼伤、神经损伤和异常疼痛的发生率分别为4%、2%和2%,未见组织肿胀发生.结论 与高强度聚焦超声比较,低强度聚焦超声治疗慢性软组织损伤性疼痛的疗效高,且安全性良好.%Objective To compare the low-intensity focused ultrasound (LIFU) and high-intensity focused ultrasound (HIFU) in treating pain due to chronic soft tissue injury.Methods Ninety-three patients with pain due to chronic soft tissue injury, aged 18-80 yr, with body mass index of 18-31 kg/m2,course of the disease 3 months-10 yr, and pain intensity of 4-8 in a numeric rating scale, were randomly divided into 2 groups using a random number table: low intensity group (group LI, n =49) and high intensity group (group HI, n =44).In group LI, the patients received LIFU with the minimum ultrasonic intensity causing senses (acid, hemp, swelling, pain) , and the treatment was continued

  2. Analysis of the Effect of Non-invasive Positive Pressure Ventilation in the Treatment of Acute StrokeComplicated with Respiratory Failure Due to Chronic Obstructive Pulmonary Disease%无创正压通气治疗急性脑卒中合并慢性阻塞性肺疾病呼吸衰竭的疗效

    Institute of Scientific and Technical Information of China (English)

    刘梅; 蔡振林; 邓星奇; 李响; 凌美蓉; 周健

    2012-01-01

    Aim: To study the effect of non-invasive positive pressure ventilation (NIPPV) in the treatment of acute stroke complicated with respiratory failure due to chronic obstructive pulmonary disease(COPD). Methods: Analysis of 67 patients with acute stroke complicated with respiratory failure due to chronic obstructive pulmonary disease(COPD) (acute stroke+COPDRF group), 59 patients with acute stroke complicated with central respiratory failure(acute stroke+CRF group), 65 patients with COPD complicated with respiratory failure (control group) were treated by BiPAP. During six hours before and after the treatment, the changes of vital signs and arterial blood gas, mortality rate, average effective ventilation time, and average mechanical ventilation time of dead or survivor in the three groups were analyzed statistically. Results: The therapeutic efficiency of acute stroke+COPDRF group, acute stroke+CRF group and the control group was 71.64%, 30.50%, 72.30%, respectively. There was no statistical significance between the acute stroke+COPDRF group and the control group (P>0.05). There were statistical significances between the acute stroke+CRF group and the other two groups(F0.05). There were statistical significances between the acute stroke+CRF group and the other two groups(p<0.01). There were statistical significances between the acute stroke+COPDRF group and the control group in average effective ventilation time, and between the acute stroke +CRF group and the other two groups(p<0.05). There were statistical significances between the average mechanical ventilation time of dead or survivor with acute stroke+COPDRF group and the control group and the other two groups(p<0.05). Conclusion: It was confirmed that non-invasive positive pressure ventilation on acute stroke complicated with respiratory failure due to COPD had clinical effect.%目的:观察无创正压通气(NIPPV)治疗急性脑卒中合并慢性阻塞性肺疾病(COPD)呼吸衰

  3. 影响严重功能性便秘的相关因素分析%Related Factors in Patients with Functional Constipation

    Institute of Scientific and Technical Information of China (English)

    马红英; 赵永娇; 何颖华

    2015-01-01

    [Objective] To explore the related factors of functional constipation .[Methods] A total of 86 cases diagnosed as functional constipation as case group .According to severity ,they were divided into severe ( n=23) and non‐severe ( n=63) groups .And another 100 randomly selected healthy persons without a histo‐ry of constipation were selected as control group .The related factors of severe functional constipation were screened and logistic regression analyses performed .[Results]Univariate analyses showed that a history of se‐vere disease ,body mass index (BMI) ,smoking ,long‐term abuse of volumetric laxatives ,self‐rating depres‐sion score (SDS) ,self‐rating anxiety score (SAS) ,anal squeeze pressure and anal defecation pressure were higher than non‐severe patients and controls .And the differences were statistically significant ( P <0 .05) . BMI in non‐severe patients ,long‐term abuse of volumetric laxatives ,SDS score ,SAS score ,anal squeeze pressure and anal defecation pressure were higher than controls .And the differences were statistically signifi‐cant ( P <0 .05) .Further multivariate analyses indicated that long‐term abuse of volumetric laxatives ,SDS score ,SAS score ,anal squeeze pressure and anal defecation pressure were independent risk factors for the oc‐currence of severe functional constipation .[Conclusion] Severe functional constipation are closely correlated with long‐term abuse of volumetric laxatives ,anxiety ,depression ,other negative emotions and abnormal ano‐rectal dynamics .%【目的】探讨严重功能性便秘的相关危险因素。【方法】回顾性分析2009年12月至2014年1月86例本院诊断为功能性便秘患者的临床资料,根据其严重程度分为重度组与非重度组,同时随机选取本院同期体检健康的100例无便秘病史的健康人群作为对照组,筛选出影响严重功能性便秘的相关因素,应用lo‐gistic回归进行多因素回归分析

  4. Infecção crônica por Toxoplasma gondii induzindo hipertrofia de neurônios do plexo mientérico do cólon descendente de Rattus norvegicus Chronic infection due to Toxoplasma gondii inducing neuron hypertrophy of the myenteric plexus of Rattus norvegicus descending colon

    Directory of Open Access Journals (Sweden)

    Janaína Soares

    2009-06-01

    Full Text Available Neste estudo, foram avaliados os efeitos da infecção crônica por taquizoítos de Toxoplasma gondii sobre os neurônios mientéricos do cólon descendente de ratos adultos. Utilizaram-se 10 ratos Wistar machos, com 60 dias de idade, divididos em grupo controle e experimental, que foram inoculados por via oral com 10(5 taquizoítos do genótipo I de T. gondii. Após 30 dias, os animais foram anestesiados e submetidos à laparatomia. O cólon descendente foi retirado, mensurado, dissecado e seus preparados de membrana submetidos à técnica de Giemsa, para coloração dos neurônios do plexo mientérico, seguido por análise morfométrica e quantitativa. Verificou-se que a infecção não causou alterações nas dimensões do órgão ou na população neuronal, porém houve um aumento significativo da área do pericário e citoplasma.The effects of the chronic infection due to Toxoplasma gondii tachyzoites on the myenteric neurons of the adult rat descending colon were assessed in this study. Ten male, 60-day-old, Wistar rats, divided into control and experimental group were orally inoculated with 10(5 tachyzoites from Toxoplasma gondii genotype I strain. After 30 days, the animals were anesthetized and submitted to laparotomy. The descending colon was removed, dissected, and the whole-mounts were staining by Giemsa, in order to observe neurons of the myenteric plexus, followed by quantitative and morphometric analysis. It was verified that the infection caused alterations neither with respect to the dimensions of the organ nor the neuronal population; however, there was a significant increase of the perikarion area and the cytoplasm.

  5. Technical Due Diligence

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Varano, Mattia

    2011-01-01

    Technical Due Diligence (TDD) as an evaluation of the performance of constructed facilities has become an important new field of practice for consultants. Before the financial crisis started in autumn 2008 it represented the fastest growing activity in some consulting companies. TDD is mostly...... carried out for buyers or sellers involved in real estate transactions. It can also be part of mergers including real estate and other assets or part of facilities management outsourcing. This paper is based on a case study and an interview survey of companies involved in TDD consulting in Denmark......, the investigation of current practice also identifies examples of value adding practices, which can give the companies in question competitive advantages by differentiation and/or give input to improvements of the recommended practice guidelines....

  6. Gabapentin for Chronic Refractory Cancer Cough.

    Science.gov (United States)

    Atreya, Shrikant; Kumar, Gaurav; Datta, Soumitra Shankar

    2016-01-01

    Vagal sensory neuropathy or vagal hypersensitivity has been implicated in the pathophysiology of chronic cough. Earlier reports have shown gabapentin to be effective in sensory laryngeal neuropathy and symptom conditions that have a proven neural origin. We present a case report of a patient with chronic refractory cough due to a soft tissue mass in the lung that caused compression of the mediastinal structures. The patient was successfully treated with gabapentin with reduction in the cough intensity, duration, and frequency. PMID:26962287

  7. Gabapentin for Chronic Refractory Cancer Cough

    OpenAIRE

    Shrikant Atreya; Gaurav Kumar; Soumitra Shankar Datta

    2016-01-01

    Vagal sensory neuropathy or vagal hypersensitivity has been implicated in the pathophysiology of chronic cough. Earlier reports have shown gabapentin to be effective in sensory laryngeal neuropathy and symptom conditions that have a proven neural origin. We present a case report of a patient with chronic refractory cough due to a soft tissue mass in the lung that caused compression of the mediastinal structures. The patient was successfully treated with gabapentin with reduction in the cough ...

  8. Gabapentin for chronic refractory cancer cough

    Directory of Open Access Journals (Sweden)

    Shrikant Atreya

    2016-01-01

    Full Text Available Vagal sensory neuropathy or vagal hypersensitivity has been implicated in the pathophysiology of chronic cough. Earlier reports have shown gabapentin to be effective in sensory laryngeal neuropathy and symptom conditions that have a proven neural origin. We present a case report of a patient with chronic refractory cough due to a soft tissue mass in the lung that caused compression of the mediastinal structures. The patient was successfully treated with gabapentin with reduction in the cough intensity, duration, and frequency.

  9. Urea synthesis in patients with chronic pancreatitis

    DEFF Research Database (Denmark)

    Hamberg, Ole; Sonne, J; Larsen, S;

    2001-01-01

    Up-regulation of urea synthesis by amino acids and dietary protein intake may be impaired in patients with chronic pancreatitis (CP) due to the reduced glucagon secretion. Conversely, urea synthesis may be increased as a result of the chronic inflammation. The aims of the study were to determine...... urea synthesis kinetics in CP patients in relation to glucagon secretion (study I) and during an increase in protein intake (study II)....

  10. Gabapentin for Chronic Refractory Cancer Cough

    Science.gov (United States)

    Atreya, Shrikant; Kumar, Gaurav; Datta, Soumitra Shankar

    2016-01-01

    Vagal sensory neuropathy or vagal hypersensitivity has been implicated in the pathophysiology of chronic cough. Earlier reports have shown gabapentin to be effective in sensory laryngeal neuropathy and symptom conditions that have a proven neural origin. We present a case report of a patient with chronic refractory cough due to a soft tissue mass in the lung that caused compression of the mediastinal structures. The patient was successfully treated with gabapentin with reduction in the cough intensity, duration, and frequency. PMID:26962287

  11. Resolution of chronic hepatitis C following parasitosis

    Institute of Scientific and Technical Information of China (English)

    Valerie Byrnes; Sanjiv Chopra; Margaret J Koziel

    2007-01-01

    An inefficient cellular immune response likely leads to chronic hepatitis C virus (HCV) infection. Resolution of chronic HCV infection in the absence of treatment is a rare occurrence. We report the case of a 39-year old white male with a 17-year history of chronic HCV infection, who eradicated HCV following a serious illness due to co-infection with Babesia (babesiosis), Borriela Borgdorferi (Lyme disease) and Ehrlichia (human granulocytic ehrlichiosis). We hypothesize that the cellular immune response mounted by this patient in response to his infection with all three agents but in particular Babesia was sufficient to eradicate HCV.

  12. Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Fahad Saeed

    2011-01-01

    Full Text Available Gastrointestinal (GI bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI in chronic kidney disease (CKD and end-stage renal disease (ESRD patients. We suggest an approach to diagnosis and management of this problem.

  13. Microbiota benefits after inulin and partially hydrolized guar gum supplementation: a randomized clinical trial in constipated women Beneficios en la microbiota intestinal después de la suplementación con inulina y la goma guar parcialmente hidrolizada: un ensayo clínico aleatorizado en mujeres con estreñimiento

    OpenAIRE

    D. Linetzky Waitzberg; C. C. Alves Pereira; L. Logullo; T. Manzoni Jacintho; Almeida, D.; Mª L. Teixeira da Silva; R. S. Matos de Miranda Torrinhas

    2012-01-01

    Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. Methods: Our study enrolled 60 constipat...

  14. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; von Linstow, Marie-Louise; Nepper-Christensen, Steen;

    2005-01-01

    To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults.......To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults....

  15. Chronic Diarrhea in Children

    Science.gov (United States)

    ... can include cramping abdominal pain nausea or vomiting fever chills bloody stools Children with chronic diarrhea who have ... can include cramping, abdominal pain, nausea or vomiting, fever, chills, or bloody stools. Children with chronic diarrhea who ...

  16. Chronic inflammatory demyelinating polyneuropathy

    Science.gov (United States)

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory polyneuropathy; Guillain-Barré - CIDP ... CIDP is one cause of damage to nerves outside the brain or spinal cord ( peripheral neuropathy ). Polyneuropathy ...

  17. Chronic fatigue syndrome

    Science.gov (United States)

    Bennett RM. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274. Engleberg NC. Chronic ...

  18. "Chronic Lyme Disease"

    Science.gov (United States)

    ... Content Marketing Share this: Main Content Area "Chronic Lyme Disease" What is "chronic Lyme disease?" Lyme disease is an infection caused by ... J Med 357:1422-30, 2008). How is Lyme disease treated? For early Lyme disease, a short ...

  19. Prostaglandins and chronic inflammation

    OpenAIRE

    Aoki, Tomohiro; Narumiya, Shuh

    2012-01-01

    Chronic inflammation is the basis of various chronic illnesses including cancer and vascular diseases. However, much has yet to be learned how inflammation becomes chronic. Prostaglandins (PGs) are well established as mediators of acute inflammation, and recent studies in experimental animals have provided evidence that they also function in transition to and maintenance of chronic inflammation. One role PGs play in such processes is amplification of cytokine signaling. As such, PGs can facil...

  20. Complementary and Alternative Medicine Methods in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Zeynep Erdogan

    2014-08-01

    Full Text Available Despite its long history, use of complementary and alternative medicine (CAM methods has increased dramatically only after 1990s. Up to 57% of patients with chronic renal use CAM methods.These patienys use CAM methods to overcome hypertension, fatigue, constipation, leg edema, pain, cramps, anxiety, depression, sleep disorders, to cope with symptoms such as itching, to stop the progression of kidney disease and to improve their quality of life. Methods used are herbal products and food supplements, acupressure, acupuncture, homeopathy, exercise, aromatherapy, yoga and reflexology. Nephrotoxic effect of several CAM therapies used in patients with renal impairment could disturb hemodynamics by reducing the glomerular filtration rate. For this reason, health care providers should question patients about used of CAM, methods. Communication with patients should be clear and should not act judgmental. Health care personnel should learn more about CAM methods in order to avoid unwanted situations that could develop after the application of CAM methods. Patients should be informed correctly and scientifically about these methods to avoid harmful and unnecessary uses. [Archives Medical Review Journal 2014; 23(4.000: 770-786