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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. 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.

  5. 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

  6. 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.

  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. 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...

  9. Constipation

    Science.gov (United States)

    ... contribute to constipation or other changes in bowel habits. Other causes of constipation may include: Colon cancer Diseases of the bowel, such as irritable bowel syndrome Mental health disorders Nervous system disorders Pregnancy Underactive thyroid Use ...

  10. Epidemiology and management of chronic constipation in elderly patients

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    Vazquez Roque M

    2015-06-01

    Full Text Available Maria Vazquez Roque, Ernest P Bouras Gastroenterology and Hepatology Department, Mayo Clinic, Jacksonville, FL, USA Abstract: Constipation is a common functional gastrointestinal disorder, with prevalence in the general population of approximately 20%. In the elderly population the incidence of constipation is higher compared to the younger population, with elderly females suffering more often from severe constipation. Treatment options for chronic constipation (CC include stool softeners, fiber supplements, osmotic and stimulant laxatives, and the secretagogues lubiprostone and linaclotide. Understanding the underlying etiology of CC is necessary to determine the most appropriate therapeutic option. Therefore, it is important to distinguish from pelvic floor dysfunction (PFD, slow and normal transit constipation. Evaluation of a patient with CC includes basic blood work, rectal examination, and appropriate testing to evaluate for PFD and slow transit constipation when indicated. Pelvic floor rehabilitation or biofeedback is the treatment of choice for PFD, and its efficacy has been proven in clinical trials. Surgery is rarely indicated in CC and can only be considered in cases of slow transit constipation when PFD has been properly excluded. Other treatment options such as sacral nerve stimulation seem to be helpful in patients with urinary dysfunction. Botulinum toxin injection for PFD cannot be recommended at this time with the available evidence. CC in the elderly is common, and it has a significant impact on quality of life and the use of health care resources. In the elderly, it is imperative to identify the etiology of CC, and treatment should be based on the patient’s overall clinical status and capabilities. Keywords: pelvic floor dysfunction, constipation, elderly 

  11. Role of rectal myomectomy in refractory chronic constipation

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    Rajeev G Redkar

    2012-01-01

    Full Text Available Background: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. Materials and Methods: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included in the study. Anorectal myectomy under general anaesthesia was carried out in these selected patients and were followed-up for up to 6 months to 5 years. Clinical improvement was measured by post-operative bowel habits and relief of symptoms. Results: Twenty-two patients improved clinically; partial response in 4 patients, no response in 2 patients. Two patient required further pull through surgery and was found to have transition zone at the recto-sigmoid level. Ten patients had aganglionosis (of which 5 had ganglion cells present in the proximal part of speciment, 7 had normal histology, 7 had hypoganglionosis, 2 had intestinal neuronal dysplasia, one had nerve hypertrophy and one had immature ganglia. Conclusion: Anorectal myectomy is an effective and technically simple procedure in selected patients with chronic refractory constipation, for both diagnostic and therapeutic purpose. Because apart from confirming Hirschsprung′s disease, it also therapeutically relieves symptoms in 93% of patients with chronic refractory constipation.

  12. 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.

  13. 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 ...

  14. 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.

  15. 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.

  16. [Treatment of Chronic Functional Constipation during Pregnancy and Lactation].

    Science.gov (United States)

    Gharehbaghi, K; Gharehbaghi, D R; Wierrani, F; Sliutz, G

    2016-02-01

    Natural fibres (bulk-forming agents), docusate sodium (stool-softener), mineral oils (lubricant laxatives), macrogol (polyethylene glycol, PEG), sugars and sugar alcohols (osmotic laxatives) and anthraquinones and diphenolic laxatives (stimulant laxatives) seem to be safe medicaments regarding teratogenicity and lactation. The US Food and Drug Administration (FDA) risk categories for these substances taken during pregnancy and lactation are often the result of the lack of studies than of evidence-based information. So risk categories do not help in the decision-making for the right laxative. Alternative solutions such as proposals of the American College of Gastroenterology's Committee on FDA related matters, (ACG-FDA) and the Motherisk Programme try to improve decision-making. For newer compounds such as chloride-channel-activators and procinetics no data regarding safe use in pregnancy and during breast-feeding are available as yet. We suggest the use of macrogol and lactulose as the first-line therapy in treating chronic constipation during pregnancy. Macrogol shows some advantages, such as faster onset of bowel action and fewer flatulences. If this treatment does not work or starts but then stops working, we recommend in the second and third trimenon a second-line treatment with diphenolic laxatives such as bisacodyl and and sodium picosulfate. During pregnancy the decision on the application of these laxatives is largely determined by the side-effects of tenesmus associated with preterm births. During lactation we recommend macrogol (preferable to lactulose due to the lack of data), lactulose, bisacodyl and sodium picosulfate, according to the nature of the conditions. PMID:26866689

  17. 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

    stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0......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...

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    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).

  20. Demographics and health care seeking behavior of Singaporean women with chronic constipation: implications for therapeutic management

    OpenAIRE

    Gwee KA; Setia S

    2012-01-01

    Kok Ann Gwee1,2, Sajita Setia31Gleneagles Hospital, 2Yong Loo Lin School of Medicine, National University of Singapore (NUS), 3Janssen, Johnson and Johnson Pte Ltd, SingaporeIntroduction: Chronic constipation is significantly more prevalent in women than men in Singapore. We carried out a survey to study patient demographics, symptom prevalence, healthcare-seeking behavior, and patient satisfaction with available treatment options in women with chronic constipation.Methods: Responses were col...

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

    Science.gov (United States)

    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

  2. The Role of Cow's Milk Allergy in Pediatric Chronic Constipation: A Randomized Clinical Trial

    OpenAIRE

    Seyed-Mohsen Dehghani; Bita Ahmadpour; Mahmood Haghighat; Sara Kashef; Mohammad Hadi Imanieh; Mohammad Soleimani

    2012-01-01

    Objective: Cow's milk allergy has different presentations in children and can cause functional bowel symptoms such as chronic constipation. The aims of this study were to investigate the role of cow’s milk allergy as a cause of chronic constipation and effect of cow’s milk free diet (CMFD) on its treatment in children.Methods: We performed a randomized clinical study comparing CMFD with cow’s milk diet (CMD) in two groups each consisting of 70 patients (age range, 1-13 years) with chronic fun...

  3. The Role of Cow’s Milk Allergy in Pediatric Chronic Constipation: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Seyed-Mohsen Dehghani

    2012-12-01

    Full Text Available Objective: Cow's milk allergy has different presentations in children and can cause functional bowel symptoms such as chronic constipation. The aims of this study were to investigate the role of cow’s milk allergy as a cause of chronic constipation and effect of cow’s milk free diet (CMFD on its treatment in children.Methods: We performed a randomized clinical study comparing CMFD with cow’s milk diet (CMD in two groups each consisting of 70 patients (age range, 1-13 years with chronic functional constipation (defined as Rome III criteria. All subjects had been referred to a pediatric gastroenterology clinic and had previously been treated with laxatives for at least 3 months without success; also all 140 patients performed skin prick test. The case group received CMFD for 4 weeks. After that they received CMD for 2 extra weeks. The control group received CMD for whole 6 weeks. A response was defined as decreased in signs and symptoms that not fulfilled Rome III criteria after 4 weeks of CMFD and came back to Rome III criteria after 2 weeks of CMD challenge.Findings: After 4 weeks 56 (80% patients of the case group responded in comparison to 33 (47.1% patients in the control group (P=0.0001. In the case group after 2 weeks challenge 24 out of 56 (42.8% responders developed constipation according to Rome III criteria. With other words, the frequency of cow’s milk allergy among constipated patients was 80%. Only one patient had positive skin prick test.Conclusion: In children, chronic constipation can be a manifestation of cow’s milk allergy. At present, although several aspects must be further investigated, a therapeutic attempt with elimination diet is advisable in all children with constipation unresponsive to correct laxative treatment.

  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

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    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. 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

  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. 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

  9. 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.

  10. 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.

  11. EMOST: elimination of chronic constipation and diarrhea by low-frequency and intensity electromagnetic fields.

    Science.gov (United States)

    Bókkon, István; Erdőfi-Szabó, Attila; Till, Attila; Lukács, Tünde; Erdőfi-Nagy, Eva

    2014-01-01

    Previously, we reported about the effectiveness of the EMOST (Electro-Magnetic-Own-Signal-Treatment) treatments in reduction of phantom limb pain as well as improvement of the quality of sleep and mood in subjects under clinical circumstances. We also presented the successful application of EMOST for mental stress management of humans under catastrophic conditions. Our some years experience indicated that the efficiency of EMOST is much greater in children than in adult subjects. In addition, in children much less treatment is needed for recovery compared to adult subjects, as well as the duration of the treatment is shorter. It is possible that this particular success is due to the large plasticity of the central and the autonomic nervous system in young patients. Thus, our research pays special attention regarding the EMOST effectiveness in the field of chronic childhood diseases. Here we report about results of routine alternative treatments carried out at Biolabor Biophysics and Laboratory Services Ltd. by EMOST device regarding to the elimination of chronic constipation and persistent diarrhea in the case of two children. We also briefly present two important possible biological mechanisms such as redox processes and the bidirectional communication between skin cells and the nervous system regarding the efficiency of low-frequency and low-intensity electromagnetic fields (LFI-EMF) treatments. PMID:23781990

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

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    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. Effects of Daikenchuto on Abdominal Bloating Accompanied by Chronic Constipation: A Prospective, Single-Center Randomized Open Trial

    Directory of Open Access Journals (Sweden)

    Mika Yuki

    2015-12-01

    Conclusions: DKT treatment improved quality of life for patients with chronic constipation regardless of the presence of SIBO and showed no effects on small intestine bacteria. UMIN Clinical Trial Registry identifier: UMIN000008070.

  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. Primary swenson′s pull-through in children with chronic constipation: A preliminary report

    Directory of Open Access Journals (Sweden)

    Bakare Tajudeen I

    2010-01-01

    Full Text Available Background: The discrepancy in diameters of the resected ends coupled with the heavy faecal loads in the colon of chronically constipated children with Hirschsprung′s disease makes definitive primary pull-through procedure quite difficulty in this group. Patients and Methods: Four consecutive patients (aged 5 months to 11 years who presented with chronic constipation were given warm saline enema along with Castor oil per oram twice daily for 1 week before and 2 weeks after full-thickness biopsies that confirmed Hirschsprung′s disease. All patients had intravenous Cefuroxime or Ceftriaxone plus Metronidazole at induction of anaesthesia. Intra-operatively, the levels of resections were 6-8 cm proximal to the most contractile part of the colon adjacent to the transition zone observed after complete division of mesenteric vessels. Results: There were three males and one female, aged 5 months to 11 years. The levels of aganglionosis were in the rectosigmoid region, except one in the descending colon. There was one case each of anastomotic stenoses, mild enterocolitis and deep peri-anal excoriation. The bowel motions were two to four times daily within 1 month post-operatively. Conclusion: It can be concluded from this preliminary study that with pre-operative saline enema and oral Castor oil for about 3 weeks in chronically constipated children with Hirschsprung′s disease primary pull-through procedures can be performed successfully. However, further prospective work is required with this method.

  18. 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

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

    International Nuclear Information System (INIS)

    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 (ρ = 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%, ρ < 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 rectal

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

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    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

  5. 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

  6. 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

    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 w...

  7. 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.

  8. 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...

  9. Effects of Daikenchuto on Abdominal Bloating Accompanied by Chronic Constipation: A Prospective, Single-Center Randomized Open Trial

    OpenAIRE

    Mika Yuki; Yoshinori Komazawa; Yoshiya Kobayashi; Maho Kusunoki; Yoshiko Takahashi; Sayaka Nakashima; Goichi Uno; Isao Ikuma; Toshihiro Shizuku; Yoshikazu Kinoshita

    2015-01-01

    Background: Daikenchuto (DKT), a traditional Japanese herbal medicine, is widely used for treatment of gastrointestinal disorders. We evaluated the efficacy and safety of DKT for abdominal bloating in patients with chronic constipation. Objective: To evaluate the efficacy and safety of DKT for the treatment of abdominal bloating. Methods: After discontinuing as-needed use of laxatives, 10 patients received oral DKT for 14 days (15 g/d). To evaluate small intestinal bacteria overgrowth (...

  10. LIFELAX – diet and LIFEstyle versus LAXatives in the management of chronic constipation in older people: randomised controlled trial

    OpenAIRE

    Speed, Chris; Heaven, Ben; Adamson, Ashley; Bond, John; Corbett, Sally; Lake, Amelia; May, Carl; Vanoli, Alessandra; McMeekin, Peter; Rubin, Gregory; Steen, Nick; McColl, Elaine

    2010-01-01

    Objectives - To investigate the clinical effectiveness and cost-effectiveness of laxatives versus dietary and lifestyle advice, and standardised versus personalised dietary and lifestyle advice. Design - A prospective, pragmatic, three-armed cluster randomised trial with an economic evaluation. Setting: General practices in England and Scotland, UK. Participants - People aged ? 55 years with chronic constipation, living in private households. Participants were identified as those wh...

  11. 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

  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. 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.

  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. 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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. [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

  1. 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.

  2. 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

  3. 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 ...

  4. Anorectal manometry in children with chronic functional constipation Manometria anorretal em crianças com constipação intestinal crônica funcional

    Directory of Open Access Journals (Sweden)

    Rosa Helena Monteiro Bigélli

    2005-09-01

    Full Text Available BACKGROUND: The anorectal manometry is a very utilized and well recognized examination in children with chronic funcional constipation. The major manometric findings in these children are: anal hypotonia, anal hypertonia, paradoxal contraction of the external anal sphincter, decreased ability of internal anal sphincter to relax during rectal distension and alterations in rectal contractility, sensibility and compliance. AIMS: To evaluate the anal basal pressure and the relaxation reflex before and after standard treatment for a better understanding of the physiopathologic mechanisms involved in pediatric chronic functional constipation. METHODS: Anorectal manometry was performed before treatment on 20 children with chronic functional constipation aged 4 to 12 years and the results were compared to those obtained after standard treatment, with a good outcome. RESULTS: There was a reduction in anal basal pressure after treatment, but no differences were detected between the anorectal manometries performed before and after treatment in terms of amplitude and duration of relaxation, residual pressure, latency time, or descent and ascent angle. CONCLUSIONS: We conclude that the anal basal pressure decreased in children recovering from chronic functional constipation, but the standard treatment did not provide all the conditions necessary for the relaxation reflex of constipated children to return to the values described in normal children.RACIONAL: A manometria é um exame bastante utilizado e bem reconhecido no diagnóstico diferencial da constipação intestinal crônica na criança. Os achados manométricos mais comumente verificados nas crianças com constipação intestinal crônica funcional são: hipotonia e hipertonia anal, contração paradoxal do esfíncter anal externo, habilidade diminuída do esfíncter anal interno para relaxar durante a distensão retal, aumento da complacência e do limiar de sensibilidade retal, além de diminui

  5. 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

  6. Perfil manométrico anorrectal en pacientes con constipación crónica asociada a ciego móvil Anorectal manometric profile in patients presenting with chronic constipation associated with a mobile cecum

    Directory of Open Access Journals (Sweden)

    Daisy Naranjo Hernández

    2011-09-01

    , que se produce como consecuencia del ciego móvil y que conduce a constipación crónica.Introduction: Constipation is a serious health problem affecting to millions of persons at world level. The anorectal manometry makes an objective assessment of the rectoanal segment dynamics for constipation diagnosis, the anal incontinence, etc. From 1989, it was demonstrated that the mobile cecum provoke organic alterations of colon leading to chronic constipation. Objective: To determine by manometry, the existence of a common and reproducible pattern favoring the diagnosis of mobile cecum-associated chronic constipation. Methods: A descriptive research was conducted in 90 patients (40 children, 50 adults between 2006 and 2009 in the Institute of Gastroenterology all of them diagnosed with chronic constipation refractory to conventional m treatment, as well as a barium-meal specific radiologic colon study as Gold Standard to diagnose presence of mobile cecum. A anorectal manometry was carried out using a PC Polygraf HR, by a catheter system of continuous perfusion and registries were assessed in a computer with analysis program. It was found that the rest pressure of internal anal sphincter was of X = 79,6 mm Hg for the group of children with a 65,8 % of relaxation for the inhibitory rectoanal reflex. In adult patients, the pressure of internal anal sphincter was of X= 80,9 mm Hg and a 68,2% of relaxation of internal anal sphincter. The pressure of contraction of external anal sphincter, the anal canal length and the rectal sensitivity were normal in both groups. There was a common and reproducible pattern with hypertonicity of internal anal sphincter and a relaxation deficit due to an incomplete inhibitory rectoanal reflex in the 94% of cases. Conclusion: There was a relation among these findings and the potential decrease in transportation of the inhibitory neurotransmitters produced as consequence of the mobile cecum leading to a chronic constipation.

  7. Is constipation a trivial matter?

    Science.gov (United States)

    Starnes, David Samuel; Lawrence, Hannah; Navaratnam, Ragavan

    2016-01-01

    Constipation is a common symptom of patients presenting to the emergency department. If poorly managed, it can have significant consequences. A 50-year-old man was admitted to the emergency department following cardiac arrest. His medical history included a diagnosis of cerebral palsy and multiple admissions to hospital with constipation. Clinical examination revealed a grossly distended and tense abdomen. Circulatory supply to the lower limbs was acutely impaired. CT scan revealed massive dilation of the large bowel due to faecal loading with compromised circulation to the lower limbs. Despite aggressive attempts at resuscitation, the patient continued to deteriorate and passed away. On reflection, a diagnosis of abdominal compartment syndrome secondary to severe constipation was made. This case highlights the vigilance required when managing what is often felt to be a trivial complaint and the considerable consequences when there is a failure to do so. PMID:26818688

  8. Parkinsonsim due to a Chronic Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Bosuk Park

    2009-05-01

    Full Text Available Subdural hematoma is a rare cause of parkinsonism. We present the case of a 78-year-old man with right-side dominant parkinsonism about 3 months after a minor head injury. MRI reveals a chronic subdural hematoma on the left side with mildly displaced midline structures. The parkinsonian features were almost completely disappeared after neurosurgical evacuation of the hematoma without any anti-parkinson drug.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. Constipation - self-care

    Science.gov (United States)

    ... Most fruits will help ease constipation. Berries, peaches, apricots, plums, raisins, rhubarb, and prunes are just some ... when you are using laxatives. Store your laxative medicine safely in a medicine cabinet, where children cannot ...

  16. Functional Constipation and Constipation-Predominant Irritable Bowel Syndrome in the General Population: Data from the GECCO Study.

    Science.gov (United States)

    Enck, Paul; Leinert, Johannes; Smid, Menno; Köhler, Thorsten; Schwille-Kiuntke, Juliane

    2016-01-01

    Background. The prevalence of constipation in the (German) population has been shown to be 14.9% in a telephone survey, but more detailed data are required to characterize the sociographics and clinical characteristics of persons with different types of functional constipation, either constipation-predominant irritable bowel syndrome (IBS-C) or functional constipation with or without meeting Rome criteria. Methods. Of 2239 constipated individuals identified during the telephone interview, 1037 (46.3%) were willing to provide a postal address for a questionnaire, of which 589 (56.8%) returned the questionnaire, inquiring about sociographic data, clinical symptoms, and health care behavior related to constipation, as well as health-related quality-of-life (SF12). Subgroups of functionally constipated individuals were compared. Results. More than 50% of the respondents reported a somatic comorbid condition and/or regular medication intake that may contribute to constipation. We split the remaining individuals (N = 214) into three groups, matching Rome-criteria for IBS (IBS-C, n = 64) and for functional constipation (FC-R, n = 36) and FC not matching Rome criteria (n = 114). Nearly all sociographic and clinical characteristics were equal among them, and all individuals with constipation had similar and lowered QOL on the SF-12 physical health domain, but in IBS-C the scores were also significantly lower in comparison to FC-R and FC, in both the physical health and the mental health domain. Conclusion. Only a fraction of individuals with chronic constipation match Rome criteria for IBS-C or FC, but subgroups do not differ with respect to most other measures except quality-of-life profiles. PMID:26880887

  17. 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 ...

  18. 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

  19. 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

  20. CONSTIPATION IN RETT SYNDROME

    Science.gov (United States)

    Gastrointestinal problems occur frequently in girls with Rett syndrome. Constipation is a common problem in girls with Rett syndrome because of their neurological abnormalities. Research studies to better understand the abnormalities of large bowel function in our girls with Rett syndrome have not b...

  1. 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 ...

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Overweight and constipation in adolescents

    OpenAIRE

    Morais Mauro B; Tahan Soraia; Oliveira Julyanne N; Costa Mariana L

    2011-01-01

    Abstract Background The association between overweight and gastrointestinal symptoms has been recently studied in the literature; however, few studies have evaluated the association between overweight and constipation in adolescents in a community-based sample. The aim of this study was to analyze the prevalence of constipation and its association with being overweight in a community-based survey with adolescents. Methods This cross-sectional study included 1,077 adolescents who were enrolled...

  12. 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

  13. 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

  14. 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

  15. Life-threatening cardiotoxicity due to chronic oral phenytoin overdose

    Directory of Open Access Journals (Sweden)

    Su Chih-Min

    2009-01-01

    Full Text Available Severe cardiac adverse effects are often related to intravenous phenytoin overdose. However, there is no reported cardiotoxicity resulting from oral overdose of phenytoin. We report a patient with post-traumatic epilepsy who received oral phenytoin for five months and developed life-threatening junctional bradycardia, with his serum phenytoin level reaching up to 91µg/mL. The patient was successfully treated with temporary transvenous pacemaker implantation for his severe bradycardia and hypotension. To our knowledge, our patient had the most serious cardiovascular toxicity ever reported with chronic oral phenytoin overdose. From emergency department (ED physician′s perspective, when a patient with dysrhythmias and cardiovascular collapse is presented to the ED, severe phenytoin overdose should be considered in patients on oral phenytoin with hyperbilirubinemia, hypoalbuminemia, and severe electrolyte imbalance.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. What I Need to Know about Constipation

    Science.gov (United States)

    ... lower incomes 3 Many women get constipated during pregnancy or after giving birth. Constipation is also common after surgery. People taking medicines to treat depression or to relieve pain from things such as ...

  18. Abdominal Massage for the Treatment of Idiopathic Constipation in Children with Profound Learning Disabilities: A Single Case Study Design

    Science.gov (United States)

    Moss, Lucy; Smith, Melanie; Wharton, Sarah; Hames, Annette

    2008-01-01

    Chronic constipation is a common problem in people with learning disabilities. Treatment often involves dietary changes or long-term laxative use. The participants were five children with profound learning disabilities and additional physical difficulties. Their long-standing idiopathic constipation was managed by laxatives. Intervention lasted up…

  19. 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...

  20. 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

  1. 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.

  2. EVALUATION OF DIET, LIFE STYLE AND STRESS IN THE ETIOPATHOGENESIS OF CONSTIPATION IN GERIATRIC PEOPLE

    OpenAIRE

    Lingu Inya; Kulkarni Prasad V; Tanna Ila; Chandola H M

    2012-01-01

    Diet, lifestyle and mental status are known to play pivotal roles in the occurrence of many chronic diseases. Constipation is one amongst them, which is the commonest complain and significant healthcare problem especially in elderly that increases with age and affect ones physical and mental wellbeing. It is the premonitory symptoms of many existing or forthcoming diseases. In the present study, the survey of elderly patients with constipation has been done to evaluate the patterns of dietary...

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. [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

  10. 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

  11. 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

  12. 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...

  13. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients

    Science.gov (United States)

    Chan, Annie On On; Leung, Gigi; Tong, Teresa; Wong, Nina YH

    2007-01-01

    AIM: To investigate if increased dietary fiber, in terms of kiwifruit, is effective in Chinese constipated patients. METHODS: 33 constipated patients and 20 healthy volunteers were recruited for a 4-wk treatment of kiwi fruit twice daily. Response during wk 1-4 was defined as an increase in complete spontaneous bowl, motion (CSBM) ≥ 1/wk. Secondary efficacy included response during wk 1-4, individual symptoms and scores of bowel habits and constipation. Responses were compared with the baseline run-in period. Colonic transit time and anorectal manometry were performed before and after treatment. RESULTS: Responder rate was 54.5% in the constipated group. The mean CSBM increased after treatment (2.2 ± 2.6 vs 4.4 ± 4.6, P = 0.013). There was also improvement in the scores for bothersomeness of constipation (P = 0.02), and satisfaction of bowel habit (P = 0.001), and decreased in days of laxative used (P = 0.003). There was also improvement in transit time (P = 0.003) and rectal sensation (P < 0.05). However, there was no change in the bowel symptoms or anorectal physiology in the healthy subjects. CONCLUSION: Increasing dietary fiber intake is effective in relieving chronic constipation in Chinese population. PMID:17729399

  14. 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 ...

  15. 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​ . ...

  16. 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.

  17. Food allergy-related paediatric constipation: the usefulness of atopy patch test.

    Science.gov (United States)

    Syrigou, Ekaterini I; Pitsios, Constantinos; Panagiotou, Ioanna; Chouliaras, Georgios; Kitsiou, Sofia; Kanariou, Mary; Roma-Giannikou, Eleftheria

    2011-09-01

    The aims of this study were to evaluate the implication of food allergy as a cause of paediatric constipation and to determine the diet period needed to tolerate the constipation-causing foods. Fifty-four children aged 6 months to 14 years (median, 42 months) suffering from chronic constipation (without anatomic abnormalities, cοeliac disease or hypothyroidism), unresponsive to a 3-month laxative therapy, were prospectively evaluated. All participants were evaluated for allergy to cow's milk, egg, wheat, rice, corn, potato, chicken, beef and soy, using skin tests (SPT), serum specific IgE and atopy patch test (APT). A withdrawal of the APT-positive foods was instructed. Thirty-two children had positive APT; 15 were positive to one; six, to two and 11, to three or more food allergens, wheat and egg being the commonest. After withdrawing the APT-positive foods for an 8-week period, constipation had improved in 28/32 children, but a relapse of constipation was noticed after an oral food challenge, so they continued the elimination diet. Tolerance to food allergens was achieved in only 6/28 after 6 months, compared to 25/28 after 12 months and to all after a 2-year-long elimination. Food allergy seems to be a significant etiologic factor for chronic constipation not responding to treatment, in infants and young children. APT was found to be useful in evaluating non-IgE allergy-mediated constipation, and there was no correlation of APT with IgE detection. Tolerance was adequately achieved after 12 months of strict food allergen elimination. PMID:21347849

  18. Urinary Tract Infection due to Paenibacillus alvei in a Chronic Kidney Disease: A Rare Case Report

    OpenAIRE

    Padhi, Sanghamitra; Dash, Muktikesh; Sahu, Rani; Panda, Pritilata

    2013-01-01

    Paenibacilli, the Gram positive, aerobic spore bearing bacilli are found normally in the environment. Though these organisms were not known to cause human disease, until recently; few species of this genus have been reported to cause infections in humans. We report here, a case of urinary tract infection in a 60-year-old chronic kidney disease patient due to this rare bacterium. The patient presented with complains of fever, dysuria, and flank pain. Routine and microscopic examination of urin...

  19. Acute-on-chronic liver failure due to bacterial infection in liver cirrhosis: causes and management

    OpenAIRE

    Han, Tao

    2015-01-01

    Bacterial infection is a common complication in patients with liver cirrhosis, and acute-on-chronic liver failure due to bacterial infection has become a serious clinical problem. There are still many problems in the research on the pathogenesis and management of bacterial infection in liver cirrhosis, such as insidious onset, difficult early diagnosis, and increased multi-drug resistant bacteria. This article reviews the research progress in the causes and management of bacterial infection i...

  20. 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

  1. 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

  2. Stool Soiling and Constipation in Children

    Science.gov (United States)

    ... soiling include: Need for more toilet training Toilet "phobia" (scared of using the bathroom) Irritable bowel syndrome ... a bowel movement when the urge occurs can lead to constipation. Your child could be scared of ...

  3. Constipation - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... Constipation - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Constipation हिन्दी (Hindi) Bilingual PDF ...

  4. EVALUATION OF DIET, LIFE STYLE AND STRESS IN THE ETIOPATHOGENESIS OF CONSTIPATION IN GERIATRIC PEOPLE

    Directory of Open Access Journals (Sweden)

    Lingu Inya

    2012-12-01

    Full Text Available Diet, lifestyle and mental status are known to play pivotal roles in the occurrence of many chronic diseases. Constipation is one amongst them, which is the commonest complain and significant healthcare problem especially in elderly that increases with age and affect ones physical and mental wellbeing. It is the premonitory symptoms of many existing or forthcoming diseases. In the present study, the survey of elderly patients with constipation has been done to evaluate the patterns of dietary habits, life style and mental health along with their relationships with risk factors for constipation in Saurashtra region of Gujarat especially in the Jamnagar city. Data shows that the majority of the patients were male. Of all the respondents, stress, sedentary lifestyle, lack of exercise, and ruksha (dry, sheeta (cold diets , bad eating habits like vishamashana (irregularity in time and quantity of meal, viruddhashana (incompatible diet were found to be linked to constipation. The elders reporting constipation had tension, anxious mood, depressed mood, disturbed sleep and delayed onset of sleep.

  5. 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

  6. 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.

  7. 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. PMID:26022589

  8. 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.

  9. Renal pigmentation due to chronic bismuth administration in a rhesus macaque (Macaca mulatta).

    Science.gov (United States)

    Johnson, A L; Blaine, E T; Lewis, A D

    2015-05-01

    Renal pigmentation due to the administration of exogenous compounds is an uncommon finding in most species. This report describes renal pigmentation and intranuclear inclusions of the proximal convoluted tubules due to chronic bismuth administration in a rhesus macaque. An 11-year-old Indian-origin rhesus macaque with a medical history of chronic intermittent vomiting had been treated with bismuth subsalicylate, famotidine, and omeprazole singly or in combination over the course of 8 years. At necropsy, the renal cortices were diffusely dark green to black. Light and electron microscopy revealed intranuclear inclusions within the majority of renal proximal tubular epithelial cells. These inclusions appeared magenta to brown when stained with hematoxylin and eosin and were negative by the Ziehl-Neelsen acid-fast stain. Elemental analysis performed on frozen kidney measured bismuth levels to be markedly elevated at 110.6 ppm, approximately 500 to 1000 times acceptable limits. To our knowledge, this is the first report of renal bismuth deposition in a rhesus macaque resulting in renal pigmentation and intranuclear inclusions. PMID:24990482

  10. 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.

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

    Science.gov (United States)

    Wang, Jia; Zhai, Yanbing; Wu, Jiani; Zhao, Shitong; Zhou, Jing; Liu, Zhishun

    2016-01-01

    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. PMID:27190542

  12. 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

  13. Analysis of hepatic gene expression during fatty liver change due to chronic ethanol administration in mice

    International Nuclear Information System (INIS)

    Chronic consumption of ethanol can cause cumulative liver damage that can ultimately lead to cirrhosis. To explore the mechanisms of alcoholic steatosis, we investigated the global intrahepatic gene expression profiles of livers from mice administered alcohol. Ethanol was administered by feeding the standard Lieber-DeCarli diet, of which 36% (high dose) and 3.6% (low dose) of the total calories were supplied from ethanol for 1, 2, or 4 weeks. Histopathological evaluation of the liver samples revealed fatty changes and punctate necrosis in the high-dose group and ballooning degeneration in the low-dose group. In total, 292 genes were identified as ethanol responsive, and several of these differed significantly in expression compared to those of control mice (two-way ANOVA; p < 0.05). Specifically, the expression levels of genes involved in hepatic lipid transport and metabolism were examined. An overall net increase in gene expression was observed for genes involved in (i) glucose transport and glycolysis, (ii) fatty acid influx and de novo synthesis, (iii) fatty acid esterification to triglycerides, and (iv) cholesterol transport, de novo cholesterol synthesis, and bile acid synthesis. Collectively, these data provide useful information concerning the global gene expression changes that occur due to alcohol intake and provide important insights into the comprehensive mechanisms of chronic alcoholic steatosis

  14. Imaging of constipation in infants and children

    International Nuclear Information System (INIS)

    The aims of this review article are to present epidemiology, important definitions, clinical considerations, and etiologic and pathogenetic aspects of constipation in infants and children. Anatomy, physiology, and pathophysiology of the the anorectum are described. Special attention is given to the indications for diagnostic imaging, imaging techniques, and imaging findings with different causes of constipation. Other diagnostic modalities, such as anorectal manometry, electromyography, and biopsy techniques are briefly discussed. The central question as to whether diagnostic imaging is needed for the diagnostic workup of infants and children suffering from constipation can be answered affirmatively. Especially the combination of barium enema or defecography and anorectal manometry allows definition of those infants and children who do not need biopsy and surgery for Hirschsprung's disease. The special role of defecography in this context is underlined. (orig.)

  15. Imaging of constipation in infants and children

    Energy Technology Data Exchange (ETDEWEB)

    Fotter, R. [Division of Pediatric Radiology, Department of Radiology, University Hospital Graz (Austria)

    1998-03-01

    The aims of this review article are to present epidemiology, important definitions, clinical considerations, and etiologic and pathogenetic aspects of constipation in infants and children. Anatomy, physiology, and pathophysiology of the the anorectum are described. Special attention is given to the indications for diagnostic imaging, imaging techniques, and imaging findings with different causes of constipation. Other diagnostic modalities, such as anorectal manometry, electromyography, and biopsy techniques are briefly discussed. The central question as to whether diagnostic imaging is needed for the diagnostic workup of infants and children suffering from constipation can be answered affirmatively. Especially the combination of barium enema or defecography and anorectal manometry allows definition of those infants and children who do not need biopsy and surgery for Hirschsprung`s disease. The special role of defecography in this context is underlined. (orig.) With 8 figs., 1 tab., 73 refs.

  16. Follow-up in Childhood Functional Constipation

    DEFF Research Database (Denmark)

    Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard; Hansen, Anne Vinkel; Jakobsen, Marianne Skytte

    2016-01-01

    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......: Improved self-management behavior caused by access to self-motivated web-based information induced faster short-term recovery during treatment of functional constipation. Patient empowerment rather than health care promoted follow-up might be a step towards more effective treatment for childhood...

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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...

  3. 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

  4. Características clínicas de pacientes pediátricos com constipação crônica de acordo com o grupo etário Clinical characteristics of pediatric patients with chronic constipation according to age group

    Directory of Open Access Journals (Sweden)

    Lilian Cristiane da Silva Medeiros

    2007-12-01

    of patients with chronic constipation according to age group. METHODS: This retrospective study evaluated the demographic data and clinical characteristics of pediatric patients with chronic constipation who had been admitted to an outpatient clinic between May 1995 and December 2000. Data was analyzed according to the followings age groups: infants, pre-school, school age and adolescent. RESULTS: Five hundred and sixty one patients were included in the study. The percentage of patients according to age groups were: infants (19.1%, pre-school (42.9%, school age (26.9%, and adolescents (11.0%. There was no statistical gender difference among the four age groups. Less than three bowel movements per week were observed more frequently in pre-school (65.8% and school age (59.6% than in infants (52.4% and adolescents (43.1%. Fecal escape ("soiling" was found in 75.6% of the pre-school patients aged more than 48 months, in 68.2% of the school age and in 76.7% of the adolescents. Soiling was more frequent in boys (80.7% than in girls (50.0% only in school age children. Retentive posture (67.6%, 40.7%, 27.2%, fear for defecation (70.2%, 44.2%, 29.7% and abdominal pain (80.8%, 69.6%, 73.6% were observed, respectively, more frequently in pre-school than in school age and adolescents. CONCLUSION: There were differences in clinical characteristics according to age group. However, prolonged duration of constipation and an elevated number of complications were observed in all age groups, especially fecal soiling and abdominal pain.

  5. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    International Nuclear Information System (INIS)

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

  6. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    Energy Technology Data Exchange (ETDEWEB)

    Kroepelin, T.; Ziupa, J.; Wimmer, B.

    1983-05-01

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to.

  7. 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...

  8. 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.

  9. 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,

  10. 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.

  11. 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.

  12. 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

  13. 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...

  14. Acute hepatitis due to dengue virus in a chronic hepatitis patient

    Directory of Open Access Journals (Sweden)

    L.J Souza

    2008-10-01

    Full Text Available We present a case of acute hepatitis caused by dengue virus, with a significant increase in aspartate transferase and alanine transferase levels in a chronic hepatitis patient attended at the Cane Sugar Planters Hospital of Campos dos Goytacazes, RJ.

  15. Chronic intussuception due to ileocaecal tuberculosis in a young adult with severe anemia: Case report with literature review

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    Mahesh Gupta

    2010-01-01

    Full Text Available Context : Intestinal intussuception in an adult is a rare entity that differs in etiology from its pediatric counterpart owing to underlying pathologic lead points in adults, mostly neoplasms. The main clinical presentation in chronic intussuception in adults remains dull abdominal pain, and acute intussuception is uncommon. Computed tomography (CT remains the diagnostic modality of choice and surgical resection is the optimal treatment. Case Report : We report a case of chronic intussuception in a young adult presenting with severe anemia and chronic abdominal pain in right hypochondrium and lumbar region. Pre operative diagnosis of chronic ileocolocolic intussuception was made on the basis of ultrasound, barium and CT scan findings. Exploratory laparotomy was done and right hemicolectomy with end to end anastomosis was performed. Histopathological examination of resected specimen revealed presence of tuberculosis in the mass along with mesenteric lymph nodes involvement. Postoperative recovery was uneventful and he was put on antitubercular drugs. In follow-up the patient is asymptomatic. Conclusion : Chronic ileocolocolic intussuception due to tuberculosis should be considered as a possible cause of intestinal obstruction in young patients presenting with vague abdominal pain and severe anemia even in the absence of any specific medical history.

  16. 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

  17. Arthritis and Osteomyelitis due to Aspergillus fumigatus: A 17 years old boy with chronic granulomatous disease

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    Tabak Yalcın

    2003-01-01

    Full Text Available Abstract Background Invasive Aspergillus infections are frequently seen in immunocompromised patients but arthritis is a rare complication of Aspergillus infections in the absence of immune suppressive therapy, trauma or surgical intervention. Case presentation A 17 years old male patient with arthritis and patellar osteomyelitis of the left knee whose further investigations revealed chronic granulomatous disease as the underlying disease is followed. Aspergillus fumigatus was isolated from the synovial fluid and the tissue samples cultures. He was treated with Amphotericin B deoxicolate 0.7 mg/kg/day. Also surgical debridement was performed our patient. Amphotericin B nephrotoxicity developed and the therapy switched to itraconazole 400 mg/day. Itraconazole therapy were discontinued at the 6th month. He can perform all the activities of daily living including. Conclusion We think that, chronic granulomatous disease should be investigated in patients who have aspergillar arthritis and osteomyelitis.

  18. 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...

  19. 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.

  20. 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...

  1. 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...

  2. Copy Number Variations Due to Large Genomic Deletion in X-Linked Chronic Granulomatous Disease

    OpenAIRE

    Arai, Takashi; Oh-ishi, Tsutomu; Yamamoto, Hideaki; Nunoi, Hiroyuki; Kamizono, Junji; Uehara, Masahiko; Kubota, Takeo; Sakurai, Takuya; Kizaki, Takako; Ohno, Hideki

    2012-01-01

    Mutations in genes for any of the six subunits of NADPH oxidase cause chronic granulomatous disease (CGD), but almost 2/3 of CGD cases are caused by mutations in the X-linked CYBB gene, also known as NAD (P) H oxidase 2. Approximately 260 patients with CGD have been reported in Japan, of whom 92 were shown to have mutations of the CYBB gene and 16 to have chromosomal deletions. However, there has been very little detailed analysis of the range of the deletion or close understanding of the dis...

  3. 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

  4. 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.

  5. 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.

  6. 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 patients, without 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.......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...

  7. Subcutaneous abscess due to the basidiomycete Phellinus mori in a patient with chronic granulomatous disease.

    Science.gov (United States)

    Shigemura, T; Nakazawa, Y; Amano, Y; Sudo, A; Watanabe, M; Kobayashi, M; Kobayashi, N; Koike, K; Agematsu, K; Nishimura, K

    2015-06-01

    Chronic granulomatous disease (CGD), a primary immunodeficiency caused by impaired phagocyte killing of intracellular pathogens, is characterized by recurrent, life-threatening, bacterial and fungal infections. As a result of improvements in microbiologic culture and identification techniques, a number of unique filamentous fungi have been reported as significant pathogens in patients with CGD. We report a case of subcutaneous basidiomycete Phellinus mori infection in a patient with CGD. To the best of our knowledge, this is the first reported case of human infection by this fungus. The causative fungus was identified on the basis of its morphological characteristics and nucleotide sequence on the internal transcribed spacer region of the ribosomal RNA gene. This is the fifth case report of filamentous basidiomycetes infecting a patient with CGD; all of these cases have been caused by Phellinus species. We highlight the importance of recognizing filamentous basidiomycetes Phellinus species as possible agents of non-Aspergillus fungal infections in patients with CGD. PMID:25600930

  8. Chronic Renal Failure in a Patient Due to Gluteal Compartment Syndrome After a Nephrectomy Operation

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    Özkan ULUTAŞ, , ,

    2013-09-01

    Full Text Available Gluteal compartment syndrome is a rare reason of rhabdomyolysis resulting from atraumatic origin, and leading to renal failure. Beside to other atraumatic causes like drug abuse, alcohol intoxication, and antihyperlipidemic medications prolonged operation duration in a fixed position is an important cause of this syndrome. Male sex, diabetes mellitus, hypertension and obesity are risk factors for gluteal compartment syndrome associated kidney failure. We report a 56 year old obese patient with a medical history of diabetes mellitus, and hypertension who undergo a nephrectomy operation resulting with gluteal compartment syndrome, and chronic kidney disease. We also highlight the importance of preventive cares and early recognition of gluteal compartment syndrome to avoid further morbidity.

  9. 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

  10. 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.

  11. 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.

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

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    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

  13. 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

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Copy number variations due to large genomic deletion in X-linked chronic granulomatous disease.

    Directory of Open Access Journals (Sweden)

    Takashi Arai

    Full Text Available Mutations in genes for any of the six subunits of NADPH oxidase cause chronic granulomatous disease (CGD, but almost 2/3 of CGD cases are caused by mutations in the X-linked CYBB gene, also known as NAD (P H oxidase 2. Approximately 260 patients with CGD have been reported in Japan, of whom 92 were shown to have mutations of the CYBB gene and 16 to have chromosomal deletions. However, there has been very little detailed analysis of the range of the deletion or close understanding of the disease based on this. We therefore analyzed genomic rearrangements in X-linked CGD using array comparative genomic hybridization analysis, revealing the extent and the types of the deletion genes. The subjects were five Japanese X-linked CGD patients estimated to have large base deletions of 1 kb or more in the CYBB gene (four male patients, one female patient and the mothers of four of those patients. The five Japanese patients were found to range from a patient exhibiting deletions only of the CYBB gene to a female patient exhibiting an extensive DNA deletion and the DMD and CGD phenotype manifested. Of the other three patients, two exhibited CYBB, XK, and DYNLT3 gene deletions. The remaining patient exhibited both a deletion encompassing DNA subsequent to the CYBB region following intron 2 and the DYNLT3 gene and a complex copy number variation involving the insertion of an inverted duplication of a region from the centromere side of DYNLT3 into the deleted region.

  18. 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.

  19. 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.

  20. Trends in Pinus ponderosa foliar pigment concentration due to chronic exposure of ozone and acid rain

    International Nuclear Information System (INIS)

    To determine the effects of ozone and acid rain on mature Ponderosa pine trees, Lawrence Livermore National Lab. has collaborated with University of California Berkeley, University of California Davis, California State University Chico, and the US Forest Service at the latter's Chico Tree Improvement Center. Foliar tissue from mature grafted scions of Pinus ponderosa were exposed to two times ambient ozone for ten months and to acid rain (3.0 pH) weekly for 10 weeks using branch exposure chambers. Pigment extracts were analyzed spectrophotometrically for concentrations of chlorophylls a and b, and carotenoid pigments, at 662 nm, 644 nm, and 470 nm, respectively. Pigment concentrations were expressed on a surface area basis. Preliminary results revealed that chlorophyll a showed a downward trend due to the ozone treatment. Acid rain caused no effects on these three pigments, however, chlorophyll b showed an upward trend due to the interaction of ozone and acid rain. The carotenoid pigments showed no changes due to the treatments either singly, or in combination

  1. 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.

  2. 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

  3. 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

  4. [Hereditary deficiency of alpha 1- antitrypsin in rats due to evolving chronic lung pathology].

    Science.gov (United States)

    Soloveva, N A; Grishaeva, O N; Parik, Iu Ia; Kosova, E Iu; Korolenko, T A

    1994-01-01

    W/SSM rats which are characterized by hereditary abnormal changes in the lungs, hepato- and splenomegalia and some other disturbances have also alpha 1-antitrypsin (AAT) deficiency. A study of AAT in these rats by means of isoelectrofocusing and immunoblotting with anti-AAT antibodies labelled with peroxidase has demonstrated that deficiency of the protease inhibitor is not associated with any disturbances of its synthesis or any changes of its electrophoretic properties. A higher activity of lysosomal glycosidases and proteinases was found in the liver and leukocytes of W/SSM rats. It is suggested that AAT deficiency is due to its modification under the influence of lysosomal enzymes. The described biochemical distances seem to be associated with an increased hexose transport into the cells, which is controlled by a mutant gene. PMID:7513577

  5. Can Intestinal Constipation Be Modulated by Prebiotics, Probiotics and Symbiotics?

    OpenAIRE

    Mônica de Souza Lima Sant’Anna; Célia Lúcia de Luces Fortes Ferreira

    2014-01-01

    The importance of maintaining a healthy intestinal microbiota in the health of the host has been increasingly clarified. This microbiota may appear unbalanced in diseases such as colitis, diarrhea, irritable bowel syndrome and constipation. To rebalance the microbiota and improve the symptoms of constipation, it is recommended to intake prebiotics, probiotics and symbiotics, which works in the modulation of a healthy intestinal microbiota and favors the production of ...

  6. 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 ...

  7. 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 ...

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

    Science.gov (United States)

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

    2016-03-01

    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.

  9. Constipation in pediatric patients with lower urinary tract symptoms

    International Nuclear Information System (INIS)

    To determine the frequency of constipation in patients with pediatric age group presenting with Lower Urinary Tract Symptoms (LUTS). Study Design: Descriptive study. Place and Duration of Study: Outpatient Department of Urology in Pakistan Kidney Institute at Shifa International Hospital, Islamabad, from November 2012 to February 2014. Methodology: Two hundred pediatric patients presenting with Lower Urinary Tract Symptoms (LUTS) were studied in terms of age, gender, obstructive and irritative types of LUTS along with any associated symptoms. Constipation was assessed by Bristol stool chart in these patients. Patients with exstrophy of bladder were excluded from the study. Descriptive statistics were measured for both qualitative and quantitative variables. For qualitative variables like gender, presenting symptoms, constipation and stool types, percentages and frequencies were calculated. For quantitative variables like age, percentages / mean ± SD were calculated. Results: Mean age was 6.87 ± 3.64 years with a range of 2 - 14 years. Constipation was found in 37.5% of the pediatric patients with lower urinary tract symptoms. Conclusion: Constipation is frequent and overlooked problem in pediatric patients having urinary symptoms. Irritative lower urinary tract symptoms are more common. Children up to 5 years of age are the most common sufferers. Knowing the burden of constipation in such patients can help physicians in better treatment of such cases. (author)

  10. 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.

  11. [Possible changes in energy-minimizer mechanisms of locomotion due to chronic low back pain - a literature review].

    Science.gov (United States)

    de Carvalho, Alberito Rodrigo; Andrade, Alexandro; Peyré-Tartaruga, Leonardo Alexandre

    2015-01-01

    One goal of the locomotion is to move the body in the space at the most economical way possible. However, little is known about the mechanical and energetic aspects of locomotion that are affected by low back pain. And in case of occurring some damage, little is known about how the mechanical and energetic characteristics of the locomotion are manifested in functional activities, especially with respect to the energy-minimizer mechanisms during locomotion. This study aimed: a) to describe the main energy-minimizer mechanisms of locomotion; b) to check if there are signs of damage on the mechanical and energetic characteristics of the locomotion due to chronic low back pain (CLBP) which may endanger the energy-minimizer mechanisms. This study is characterized as a narrative literature review. The main theory that explains the minimization of energy expenditure during the locomotion is the inverted pendulum mechanism, by which the energy-minimizer mechanism converts kinetic energy into potential energy of the center of mass and vice-versa during the step. This mechanism is strongly influenced by spatio-temporal gait (locomotion) parameters such as step length and preferred walking speed, which, in turn, may be severely altered in patients with chronic low back pain. However, much remains to be understood about the effects of chronic low back pain on the individual's ability to practice an economic locomotion, because functional impairment may compromise the mechanical and energetic characteristics of this type of gait, making it more costly. Thus, there are indications that such changes may compromise the functional energy-minimizer mechanisms. PMID:25440708

  12. 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.

  13. 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.)

  14. 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.

  15. 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 .

  16. Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

    Directory of Open Access Journals (Sweden)

    C. Ciriza de los Ríos

    2010-12-01

    Full Text Available Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL, squeeze maximum pressure (SMP, squeeze pressure duration (SPD, first sensation, urge and maximum tolerated volume (MTV. Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA, presión de máxima contracción voluntaria (PMCV, duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT. Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001, la presión de reposo (p < 0,001, la LCA (p < 0,001 y la PMCV (p < 0,01 en el grupo de IA con

  17. 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.

  18. 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.

  19. 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.)

  20. 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.

  1. 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....

  2. 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.

  3. 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

  4. 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.

  5. 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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    BACKGROUND: Sacral nerve modulation has been reported as a minimally invasive and effective treatment for constipation refractory to conservative treatment. OBJECTIVE: This study aimed to evaluate the efficacy and sustainability of sacral nerve modulation for constipation in the medium term (up to...... 6 years) and to investigate potential predictors of treatment success. DESIGN: We performed a retrospective review of prospectively collected data. SETTINGS: The study was performed at 2 tertiary-care centers in Europe with expertise in pelvic floor disorders and sacral nerve modulation. PATIENTS...

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

    Directory of Open Access Journals (Sweden)

    Hua Cui

    2012-03-01

    Full Text Available 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.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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

  14. [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

  15. 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...

  16. 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

    2014-01-01

    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. PMID:24891478

  17. Pancreas transplantation in a patient after total pancreatectomy due to chronic pancreatitis - the first case in Poland.

    Science.gov (United States)

    Durlik, Marek; Baumgart, Katarzyna

    2016-03-01

    Chronic pancreatitis is an inflammatory disease that may require surgical intervention. In some patients a total pancreatectomy is necessary. Such patients develop diabetes, which in some cases may be difficult to control. When standard insulin treatment is unsuccessful and the patient has frequent blood glucose swings with life-threatening hiper- and hypoglycemic episodes, a pancreas transplant should be considered. PMID:27213257

  18. Pancreas transplantation in a patient after total pancreatectomy due to chronic pancreatitis – the first case in Poland

    Directory of Open Access Journals (Sweden)

    Durlik Marek

    2016-03-01

    Full Text Available Chronic pancreatitis is an inflammatory disease that may require surgical intervention. In some patients a total pancreatectomy is necessary. Such patients develop diabetes, which in some cases may be difficult to control. When standard insulin treatment is unsuccessful and the patient has frequent blood glucose swings with life-threatening hiper- and hypoglycemic episodes, a pancreas transplant should be considered.

  19. Pancreas transplantation in a patient after total pancreatectomy due to chronic pancreatitis – the first case in Poland

    OpenAIRE

    Durlik Marek; Baumgart Katarzyna

    2016-01-01

    Chronic pancreatitis is an inflammatory disease that may require surgical intervention. In some patients a total pancreatectomy is necessary. Such patients develop diabetes, which in some cases may be difficult to control. When standard insulin treatment is unsuccessful and the patient has frequent blood glucose swings with life-threatening hiper- and hypoglycemic episodes, a pancreas transplant should be considered.

  20. 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.

  1. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    Directory of Open Access Journals (Sweden)

    Huikuan Chu

    2014-01-01

    Full Text Available Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population (18.1% and pediatric population (18.8% were significantly higher than that in general population (8.2%. Prevalence of constipation defined by non-Rome criteria was higher than that by Rome criteria in general population. Prevalence rates of constipation were different for different geographical area. People with less education were predisposed to constipation. In pediatric population, prevalence of constipation was the lowest in children aged 2–6 years. Prevalence of constipation in ethnic minorities was higher than that in Han people. People with constipation were predisposed to FD, haemorrhoid, and GERD. Only 22.2% patients seek medical advice in general population. Conclusions. In China, prevalence of constipation was lower compared with most of other countries. The factors including female gender, diagnostic criteria, geographical area, age, educational class, and race seemed to have major effects on prevalence of constipation.

  2. 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

  3. [Constipation in infants and children: How should it be treated?].

    Science.gov (United States)

    Mouterde, O

    2016-06-01

    Functional constipation is a common pediatric problem in general practice and even more so in pediatric gastroenterology clinics. Treatment is often delayed with psychosocial and digestive consequences. However, treatment is well codified and effective. Hyperosmotic mineral water, diet, and endoanal medications are not treatments for established constipation, whatever the age. The lactulose/lactitol-based medications are authorized and effective before 6 months of age and polyethylene-glycol for infants over 6 months. Mineral oil is less prescribed. The rule for treatment is a sufficient dose for a long time. In case of fecal impaction with or without fecal incontinence, the first stage is fecal disimpaction, using a high dose of PEG the first few days, or repeated phosphate enemas. Education regarding the adaptation of toilets and a daily bowel movement should restore colic motility and avoid relapses when the treatment is discontinued. Psychological concerns should be evaluated and treated. PMID:27117998

  4. 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...

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

    OpenAIRE

    Sarel Halachmi; Farhat, Walid A.

    2008-01-01

    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 importanc...

  6. Scintigraphic measurement of regional gut transit in idiopathic constipation

    International Nuclear Information System (INIS)

    In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (pancolonic inertia); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. Transit delays in other parts of the gut suggest that, in some patients, the condition may be a more generalized motor dysfunction

  7. 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)

  8. Inhalation errors due to device switch in patients with chronic obstructive pulmonary disease and asthma: critical health and economic issues

    OpenAIRE

    Roggeri A; Micheletto C; Roggeri DP

    2016-01-01

    Alessandro Roggeri,1 Claudio Micheletto,2 Daniela Paola Roggeri1 1ProCure Solutions, Nembro, Bergamo, Italy, 2Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, Italy Background: Different inhalation devices are characterized by different techniques of use. The untrained switching of device in chronic obstructive pulmonary disease (COPD) and asthma patients may be associated with inadequate inhalation technique and, consequently, could lead to a reduction in adherence to treatment a...

  9. 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 ...

  10. 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...

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

    OpenAIRE

    K S Shivaprasad; Deep Dutta; Rajesh Jain; Manoj Kumar; Indira Maisnam; Dibakar Biswas; Sujoy Ghosh; Satinath Mukhopadhyay; Subhankar Chowdhury

    2013-01-01

    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 × ...

  12. 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...

  13. 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...

  14. 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...

  15. 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.

  16. Managing opioid-induced constipation in advanced illness: focus on methylnaltrexone bromide

    Directory of Open Access Journals (Sweden)

    Katri Elina Clemens

    2010-02-01

    Full Text Available Katri Elina Clemens1,2, Eberhard Klaschik11Department of Science and Research, Centre for Palliative Medicine, University of Bonn, Germany; 2Department of Palliative Medicine and Pain Therapy, Malteser Hospital Bonn/Rhein-Sieg, GermanyAbstract: Constipation is a common symptom in palliative care patients which can generate considerable suffering. There is uncertainty about the choice of treatment options from varying recommendations for management of constipation and a varying clinical practice in palliative care settings. The purpose of the review was to evaluate the current recommendations of therapy guidelines for the management of opioid-induced constipation in palliative care patients with a focus on methylnaltrexone bromide. Recent findings in the literature and related information on the opioid-induced gastrointestinal disorders in patients with advanced illness, as well as information on the opioid-antagonist methylnaltrexone, are discussed. Knowledge of the role of definitions, the causes of constipation and the pathophysiology of opioid-induced constipation must be given high priority in the treatment of patients receiving opioids. Diagnosis and therapy of constipation, therefore, should relate to findings in clinical investigation. Opioid-induced constipation and its adequate treatment is an important issue for patients with advanced illness and also poses therapeutic challenge for clinicians in daily routine. Methylnaltrexone bromide may represent an important therapeutic option for palliative care patients who are suffering from opioid-induced constipation with failure of conventional prophylactic oral laxative treatment.Keywords: opioid-induced constipation, palliative care, opioids, methylnaltrexone bromide

  17. 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.

  18. PARA VERTEBRAL ABSCESS AND RIB OSTEOMYELITIS DUE TO ASPERGILLOUS FUMIGATOUS IN A PATIENT WITH CHRONIC GRANULOMATOUS DISEASE

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    A. Farhoiidi

    2003-03-01

    Full Text Available Chronic granulomatous disease is an infrequent primary immunodeficiency characterized by defective intracellular killing of ingested microorganisms thereby making patients highly susceptible to recurrent lite threatening bacterial and fungal infections. In this study, we review the medical course of an 8 yr old girl with AR-CGD. She suffered from recurrent dermal and deep abscesses, retractable salmonellosis, disseminated BCGosis, recurrent aspergillus infection presenting as mandibular osteomyelitis and pulmonary involvement with invasion to rib and vertebral bodies. Despite of longterm IV amphotricin B, itraconazole and IFN-y administration, and surgical interventions (drainage and resection, she died in spite of long term antibiotic anti fungal prophylaxis and interferon-gamma administrations, invasive aspergillosis resistant to current conventional therapies is the cause of 1/2 to 1/3 of CGD deaths.

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

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    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.

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

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    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.

  1. 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.

  2. Case report 495: Oesteochondroma-like femoral lesions due to chronic professional stress in a Swiss cheese-maker

    International Nuclear Information System (INIS)

    The case is presented of a 78-year-old man who was under treatment for carcinoma of the prostate with skeletal metastasis. As an incidental finding, clinically and radiologically, bony proturbances were observed to involve the right femoral shaft, reminescent of solitary cartilaginous exostoses. This was particularly true of the osseous overgrowth arising from the anterior aspect in the middle third of the right femur. A thick apposition of periosteal new bone was observed. However, a true cartilaginous cap was not present in either lesion excluding a solitary cartilagenous exostosis. A diagnosis of chronic stress was made, associated with the patient's occupation for 34 years as a cheese-maker, resulting in the bony alterations in the right femoral shaft. The history of lifting of cheeses with a weight of up to 120 kg from the shelf to the right thigh of the patient and from there to a table for washing, presumably had caused microfractures and subperiosteal hematomas on the surface of the femur. The mechanism of injury was discussed in detail and the subject of stress injuries incurred by such individuals as professional dancers was considered. The literature was reviewed. (orig.)

  3. 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...

  4. 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

  5. The Relation between Psychiatric Diagnoses and Constipation in Hospitalized Patients: A Cross-Sectional Study

    Science.gov (United States)

    van Harten, Peter N.; Egberts, Toine C. G.; Pijl, Ysbrand J.; Wilting, Ingeborg; Tenback, Diederik E.

    2016-01-01

    Objective. Constipation is a prevalent problem in patients with psychiatric disorders; it reduces quality of life and may lead to severe complications. The prevalence distribution of constipation across all psychiatric diagnoses in patients with severe mental illness (SMI) has hardly been studied. The aim of this study is to estimate the association between psychiatric disorders and constipation in SMI inpatients. Methods. The strength of the association between constipation (based on use of laxatives) and DSM-IV psychiatric diagnosis was studied in a cross-sectional study with “adjustment disorders” as the reference group. The association was analyzed using logistic regression. Results. Of the 4728 patients, 20.3% had constipation. In the stratum of patients older than 60 years, all psychiatric categories except for substance related disorders were significantly associated with a higher prevalence of constipation (odds ratios ranging from 3.38 to 6.52), whereas no significant associations were found in the stratum of patients between 18 and 60 years (odds ratios ranging from 1.00 to 2.03). Conclusion. In the elderly, all measured psychiatric diagnoses are strongly associated with an increased prevalence of constipation. Physicians should be extra alert for constipation in SMI patients, independent of specific psychiatric diagnoses. PMID:27034921

  6. 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.

  7. Slow Transit Constipation Associated With Excess Methane Production and Its Improvement Following Rifaximin Therapy: A Case Report

    OpenAIRE

    Ghoshal, Uday C; Srivastava, Deepakshi; Verma, Abhai; Misra, Asha

    2011-01-01

    Constipation, a common problem in gastroenterology practice, may result from slow colonic transit. Therapeutic options for slow transit constipations are limited. Excessive methane production by the methanogenic gut flora, which is more often found in patients with constipation, slows colonic transit. Thus, reduction in methane production with antibiotic treatment directed against methanogenic flora of the gut may accelerate colonic transit resulting in improvement in constipation. However, t...

  8. Frequency of Enuresis, Constipation and Enuresis Association with Constipation in a Group of School Children Aged 5-9 Years in Malatya, Turkey

    OpenAIRE

    Uğuralp, Sema; Karaoğlu, Leyla; Karaman, Abdurrahman

    2003-01-01

    The aim of this study was to determine the frequency of enuresis, constipation and enuresis associated with constipation in school children aged 5-9 years living in Malatya Municipality, Turkey. This is a descriptive cross-sectional study. All elementary schools in Malatya Municipality with kindergarten and preparatory classes took part in the study. All parents of the children aged 5-9 years enrolled in these schools were given a questionnaire. Completion of the questionnaire was voluntary...

  9. 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

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

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    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

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

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    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.

  12. 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 ...

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

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    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

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

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    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

  15. [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

  16. Changes in hospitalizations due to opportunistic infections, chronic conditions and other causes among HIV patients (1989–2011. A study in a HIV unit

    Directory of Open Access Journals (Sweden)

    C Redondo Sanchez

    2012-11-01

    Full Text Available Background: Reduction in mortality and morbidity in HIV patients due to the introduction of HAART have resulted in changes in patterns of hospital admissions. Objective: To examine trends of HIV patients hospital admissions. Design and method: Serial cross-sectional analysis of HIV-hospitalized patients from 1989 to 2011 in an HIV Care Unit. Each hospitalization was classified as major categories: opportunistic infections, other infections, drug-related admissions, chronic hepatopathy, AIDS and non-AIDS-related tumours and chronic medical conditions (COPD, diabetes and as specific diagnosis: tuberculosis, PCP, CMV, bacterial pneumonia and others. We considered 4 periods of time: pre-HAART, 1989–1996; early HAART, 1997–2001; intermediate HAART, 2002–2006; and present HAART, 2007–2011. Results: We evaluated 2588 admissions. 20.7% of patients were unaware of HIV infection before first admission; this proportion did not change along the time (p=0.27. No previous outpatient follow-up was seen in 34.9% of patients. There were differences in diagnosis, mortality, age and mean inpatient stay time (Table 1 between the analyzed periods of time. Conclusions: (i HAART and older age have changed the pattern of hospital admissions with a decrease of OI-related admissions and an increase of chronic diseases and non-AIDS-related tumours and with a decrease in mortality and length of inpatient stay. (ii Proportion of patients with unknown HIV serostatus before admission has not changed along the time. (iii Pneumonia, respiratory tract infection and tuberculosis were the more common causes of admission.

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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...

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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 ...

  5. 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...

  6. 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 ...

  7. 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 ...

  8. The Long-term Clinical Efficacy of Biofeedback Therapy for Patients With Constipation or Fecal Incontinence

    OpenAIRE

    Lee, Byoung Hwan; Kim, Nayoung; Kang, Sung-Bum; Kim, So Yeon; Lee, Kyoung-Ho; Im, Bo Youn; Jee, Jung Hee; Oh, Jane C.; Park, Young Soo; Lee, Dong Ho

    2010-01-01

    Background/Aims There has been a controversy regarding the usefulness of biofeedback therapy for functional constipation or fecal incontinence. This study was performed to investigate the long-term clinical efficacy of biofeedback therapy. Methods Sixty-four patients with constipation or fecal incontinence received biofeedback therapy for 4 weeks. Symptom improvements were evaluated immediately after the completion of biofeedback therapy and during the follow-up period of about 12 to 64 month...

  9. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    OpenAIRE

    2014-01-01

    Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population...

  10. Metabolomics approach to serum biomarker for loperamide-induced constipation in SD rats

    OpenAIRE

    Kim, Ji-Eun; Lee, Young-Ju; Kwak, Moon-Hwa; Jun, Go; Koh, Eun-Kyoung; Song, Sung-Hwa; Seong, Ji-Eun; Kim, Ji Won; Kim, Kyu-Bong; Kim, Suhkmann; Hwang, Dae-Youn

    2014-01-01

    Loperamide has long been known as an opioid-receptor agonist useful as a drug for treatment of diarrhea resulting from gastroenteritis or inflammatory bowel disease as well as to induce constipation. To determine and characterize putative biomarkers that can predict constipation induced by loperamide treatment, alteration of endogenous metabolites was measured in the serum of Sprague Dawley (SD) rats treated with loperamide for 3 days using 1H nuclear magnetic resonance (1H NMR) spectral data...

  11. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. 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

  15. Slow Transit Constipation Associated With Excess Methane Production and Its Improvement Following Rifaximin Therapy: A Case Report

    Science.gov (United States)

    Srivastava, Deepakshi; Verma, Abhai; Misra, Asha

    2011-01-01

    Constipation, a common problem in gastroenterology practice, may result from slow colonic transit. Therapeutic options for slow transit constipations are limited. Excessive methane production by the methanogenic gut flora, which is more often found in patients with constipation, slows colonic transit. Thus, reduction in methane production with antibiotic treatment directed against methanogenic flora of the gut may accelerate colonic transit resulting in improvement in constipation. However, there is not much data to prove this hypothesis. We, therefore, report a patient with slow transit constipation associated with high methane production both in fasting state and after ingestion of glucose, whose constipation improved after treatment with non-absorbable antibiotic, rifaximin, which reduced breath methane values. PMID:21602997

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

    Science.gov (United States)

    Shivaprasad, K S; Dutta, Deep; Jain, Rajesh; Kumar, Manoj; Maisnam, Indira; Biswas, Dibakar; Ghosh, Sujoy; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2013-10-01

    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. PMID:24251145

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. 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

  2. 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.

  3. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  4. 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...... relation between defecation and changes in rectal diameter in both healthy children and constipated children during maintenance treatment.Asking for defecation signals before scanning should be considered a routine question, and a positive answer should cause postponement of the scan......., there were no difference between groups (2 pm (P = 0.103)/5 pm (P = 0.644) ). Only in the constipated group, rectal diameter exceeded 3 cm without the patients feeling the urge to defecate. CONCLUSION: We found no independent daily variation in either group without relation to defecation. There was a...

  5. Managing morphine-induced constipation: a controlled comparison of an Ayurvedic formulation and senna.

    Science.gov (United States)

    Ramesh, P R; Kumar, K S; Rajagopal, M R; Balachandran, P; Warrier, P K

    1998-10-01

    Constipation is a frequent cause of distress in advanced cancer. A palliative care unit in Kerala, a southern state of India, conducted a controlled trial comparing a liquid Ayurvedic (herbal) preparation (Misrakasneham) with a conventional laxative tablet (Sofsena) in the management of opioid-induced constipation in patients with advanced cancer. Although there was no statistically significant difference in the apparent degree of laxative action between the two, the results indicate that the small volume of the drug required for effective laxative action, the tolerable taste, the once-daily dose, the acceptable side effect profile, and the low cost make Misrakasneham a good choice for prophylaxis in opioid-induced constipation. There is a need for further studies of Ayurvedic medicines in palliative care. PMID:9803051

  6. Update on the management of constipation in the elderly: new treatment options

    Directory of Open Access Journals (Sweden)

    Satish SC Rao

    2010-06-01

    Full Text Available Satish SC Rao, Jorge T GoSection of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Iowa City, University of Iowa Carver College of Medicine, Iowa City, IowaAbstract: Constipation disproportionately affects older adults, with a prevalences of 50% in community-dwelling elderly and 74% in nursing-home residents. Loss of mobility, medications, underlying diseases, impaired anorectal sensation, and ignoring calls to defecate are as important as dyssynergic defecation or irritable bowel syndrome in causing constipation. Detailed medical history on medications and co-morbid problems, and meticulous digital rectal examination may help identify causes of constipation. Likewise, blood tests and colonoscopy may identify organic causes such as colon cancer. Physiological tests such as colonic transit study with radio-opaque markers or wireless motility capsule, anorectal manometry, and balloon expulsion tests can identify disorders of colonic and anorectal function. However, in the elderly, there is usually more than one mechanism, requiring an individualized but multifactorial treatment approach. The management of constipation continues to evolve. Although osmotic laxatives such as polyethylene glycol remain mainstay, several new agents that target different mechanisms appear promising such as chloride-channel activator (lubiprostone, guanylate cyclase agonist (linaclotide, 5HT4 agonist (prucalopride, and peripherally acting μ-opioid receptor antagonists (alvimopan and methylnaltrexone for opioid-induced constipation. Biofeedback therapy is efficacious for treating dyssynergic defecation and fecal impaction with soiling. However, data on efficacy and safety of drugs in elderly are limited and urgently needed.Keywords: constipation, elderly, treatment

  7. 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.

  8. 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

  9. 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...

  10. [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

  11. 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.

  12. Modulation of the gut microbiota composition by rifaximin in non-constipated irritable bowel syndrome patients: a molecular approach

    Science.gov (United States)

    Soldi, Sara; Vasileiadis, Sotirios; Uggeri, Francesca; Campanale, Mariachiara; Morelli, Lorenzo; Fogli, Maria Vittoria; Calanni, Fiorella; Grimaldi, Maria; Gasbarrini, Antonio

    2015-01-01

    Rifaximin, with its low systemic absorption, may represent a treatment of choice for irritable bowel syndrome (IBS), mainly due to its ability to act on IBS pathogenesis, through the influence on gut microbiota. The aim of the present study was to assess, by biomolecular tools, the rifaximin active modulation exerted on gut microbiota of non-constipated IBS patients. Fifteen non-constipated IBS subjects were treated with 550 mg rifaximin three times a day for 14 days. Stool samples were collected before starting the treatment, at the end of it, and after a 6-week washout period. Real-time polymerase chain reaction, denaturing gradient gel electrophoresis, and next-generation sequencing were applied to all the samples to verify and quantify possible microbial fluctuations. Rifaximin treatment did not affect the overall composition of the microbiota of the treated subjects, inducing fluctuations in few bacterial groups, balanced by the replacement of homologs or complementary bacterial groups. Rifaximin appeared to influence mainly potentially detrimental bacteria, such as Clostridium, but increasing the presence of some species, such as Faecalibacterium prausnitzii. A decrease in the Firmicutes/Bacteroidetes ratio after 14 days of treatment and bacterial profiles with higher biodiversity were observed during the follow-up compared to baseline. Rifaximin treatment, although effective on IBS symptom relief and normalization of lactulose breath test, did not induce dramatic shifts in the microbiota composition of the subjects, stimulating microbial reorganization in some populations toward a more diverse composition. It was not possible to speculate on differences of fecal microbiota modification between responders vs nonresponders and to correlate the quali-/quantitative modification of upper gastrointestinal microbiota and clinical response. PMID:26673000

  13. 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.

  14. 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.

  15. Metabolomics approach to serum biomarker for loperamide-induced constipation in SD rats.

    Science.gov (United States)

    Kim, Ji-Eun; Lee, Young-Ju; Kwak, Moon-Hwa; Jun, Go; Koh, Eun-Kyoung; Song, Sung-Hwa; Seong, Ji-Eun; Kim, Ji Won; Kim, Kyu-Bong; Kim, Suhkmann; Hwang, Dae-Youn

    2014-03-01

    Loperamide has long been known as an opioid-receptor agonist useful as a drug for treatment of diarrhea resulting from gastroenteritis or inflammatory bowel disease as well as to induce constipation. To determine and characterize putative biomarkers that can predict constipation induced by loperamide treatment, alteration of endogenous metabolites was measured in the serum of Sprague Dawley (SD) rats treated with loperamide for 3 days using (1)H nuclear magnetic resonance ((1)H NMR) spectral data. The amounts and weights of stool and urine excretion were significantly lower in the loperamide-treated group than the No-treated group, while the thickness of the villus, crypt layer, and muscle layer was decreased in the transverse colon of the same group. The concentrations of aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatinine (Cr) were also slightly changed in the loperamide-treated group, although most of the serum components were maintained at a constant level. Furthermore, pattern recognition of endogenous metabolites showed completely separate clustering of the serum analysis parameters between the No-treated group and loperamide-treated group. Among 35 endogenous metabolites, four amino acids (alanine, glutamate, glutamine and glycine) and six endogenous metabolites (acetate, glucose, glycerol, lactate, succinate and taurine) were dramatically decreased in loperamide-treated SD rats. These results provide the first data pertaining to metabolic changes in SD rats with loperamide-induced constipation. Additionally, these findings correlate the changes in 10 metabolites with constipation. PMID:24707303

  16. 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

  17. 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.

  18. 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

    International Nuclear Information System (INIS)

    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.

  19. 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...

  20. 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

  1. Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial

    OpenAIRE

    Beemster, Timo T.; van Velzen, Judith M.; van Bennekom, Coen A. M.; Frings-Dresen, Monique H.W.; Reneman, Michiel F.

    2015-01-01

    Background Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the design of a non-inferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational r...

  2. 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 ...

  3. 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

  4. 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.

  5. Chronic Consptipation and Diet

    Directory of Open Access Journals (Sweden)

    Mehmet Ince

    2011-02-01

    Full Text Available Constipation presented a lof of sign-symptoms is not a single disease and a disorder that affect colonic and anorectal function. Constipation is defined as decreased of defecation number by physicians and all of problems relation with defecation by patients. But a accurate and correct defitinition giving base on patophyslogically by Rome III criteria. As patophyslogically, constipation is improved by decreased material that will be reached cecum, decreased motility of colon and multiple results improving defecation disorders. Constipation can be divided irratable bowel syndrome with constipation (normal transit, slow transit constipation and defecation disorders but there is no accurate border in this classification. Neurotransmitters, stress, medical therapies, sleep and meals are association with etiology of constipation. A high fiber diet can reach easily to cecum and prevent constipation. Therefore aim of this review is to stress effect of fiber diet in the first and second type of constipation. Slow transit constipation in 13-15% patients and irratable bowel sendrom with constipation (normal transit in 59% patients has being diagnosed. Seconder causes of constipation can be found with a good history taking from patients. Accurate diagnosis can be find with colon transit time followed by abdominal and pelvic examinitian. Treatment should be begin after correction of seconder causes. It should be recommendation to patients a high fiber diet, exercise, appropriate fluid with medical therapy. Lubiprostone and Tegaserod are used to begin for treatment of slow transit constipation. Laparoscopic surgery is recommened to patients not recoveried by medical therapy. [TAF Prev Med Bull 2011; 10(1.000: 71-76

  6. Colon Transit Scintigraphy by 67Ga-Citrate for Idiopathic Constipation

    Directory of Open Access Journals (Sweden)

    H. Javadi

    2005-06-01

    Full Text Available Background/Objective: Segmental colonic transit studies are important in patients with severe constipation. This study is the first Iranian preliminary survey of colonic transit scintigraphy using 67Ga-citrate as a new method in constipated patients with normal radiographic and colonoscopic evaluations. Patients and Methods: Thirteen patients with idiopathic constipation underwent colon transit scintigraphy. After oral administration of 6-7 MBq 67Ga-citrates, serial abdominal images were taken up to 72 hours. Pattern classification wa s performed visually according to the distribution of radioactivity. Scintigraphic parameters such as geometric mean center (GMC of segmental retention of tracer, as well as mean ac tivity profiles and colo nic tracer half-clearance time were calculated Results: Three patterns of colonic transit scintigraph y were recognized. Nine patients had the normal pattern, i.e. excellent propagation of ac tivity. Three patients had the colonic inertia pattern with marked retention of activity in th e transverse colon and splenic flexure at 48 hours. One patient had significant retention of activity in the rectosigmoid at 72 hours, defined as functional rectosigmoid obstruction (FRSO. No significant difference was seen in GMC24h between the normal pattern and colonic inertia (P=0.053, but GMC48h and GMC72h markedly differed between the two groups (P=0.0 16 and 0.025 respectively. The mean half clearance time (MCT of the two groups was di fferent (P=0.017. Our results are well compatible with scintigraphic diagnostic criteria in different patterns of colonic transit defined by other studies with different radiotracer. Conclusion: Oral 67Ga-citrate colon transit scintigraphy is a feasible method to evaluate idiopathic constipation and seems to be a suitable surrogate for radio-opaque markers.

  7. 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...

  8. 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 ...

  9. 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...

  10. 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.

  11. 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.)

  12. 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 ...

  13. Modulation of the gut microbiota composition by rifaximin in non-constipated irritable bowel syndrome patients: a molecular approach

    Directory of Open Access Journals (Sweden)

    Soldi S

    2015-12-01

    Full Text Available Sara Soldi,1 Sotirios Vasileiadis,2 Francesca Uggeri,1 Mariachiara Campanale,3 Lorenzo Morelli,4 Maria Vittoria Fogli,5 Fiorella Calanni,5 Maria Grimaldi,5 Antonio Gasbarrini31AAT – Advanced Analytical Technologies Srl, Piacenza, Italy; 2Centre for Environmental Risk Assessment and Remediation, University of South Australia, Mawson Lakes, Australia; 3Internal Medicine and Gastroenterology Division, Catholic University of Rome, Rome, Italy; 4Microbiology Institute, Catholic University of Piacenza, Piacenza, Italy; 5Alfa Wassermann SpA, Bologna, ItalyAbstract: Rifaximin, with its low systemic absorption, may represent a treatment of choice for irritable bowel syndrome (IBS, mainly due to its ability to act on IBS pathogenesis, through the influence on gut microbiota. The aim of the present study was to assess, by biomolecular tools, the rifaximin active modulation exerted on gut microbiota of non-constipated IBS patients. Fifteen non-constipated IBS subjects were treated with 550 mg rifaximin three times a day for 14 days. Stool samples were collected before starting the treatment, at the end of it, and after a 6-week washout period. Real-time polymerase chain reaction, denaturing gradient gel electrophoresis, and next-generation sequencing were applied to all the samples to verify and quantify possible microbial fluctuations. Rifaximin treatment did not affect the overall composition of the microbiota of the treated subjects, inducing fluctuations in few bacterial groups, balanced by the replacement of homologs or complementary bacterial groups. Rifaximin appeared to influence mainly potentially detrimental bacteria, such as Clostridium, but increasing the presence of some species, such as Faecalibacterium prausnitzii. A decrease in the Firmicutes/Bacteroidetes ratio after 14 days of treatment and bacterial profiles with higher biodiversity were observed during the follow-up compared to baseline. Rifaximin treatment, although effective on IBS

  14. 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.

  15. 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

  16. 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...

  17. 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

  18. The effect of Aloe ferox Mill. in the treatment of loperamide-induced constipation in Wistar rats

    Directory of Open Access Journals (Sweden)

    Wintola Olubunmi A

    2010-08-01

    Full Text Available Abstract Background Constipation is the most common gastrointestinal complaint all over the world and it is a risk factor of colorectal cancer. In this study, the efficacy of aqueous leaf extract of Aloe ferox Mill. was studied against loperamide-induced constipation in Wistar rats. Methods Constipation was induced by oral administration of loperamide (3 mg/kg body weight while the control rats received normal saline. The constipated rats were treated with 50, 100 and 200 mg/kg body weight/day of the extract for 7 days during which the feeding characteristics, body weight, fecal properties and gastrointestinal transit ratio were monitored. Results The extract improved intestinal motility, increased fecal volume and normalized body weight in the constipated rats, which are indications of laxative property of the herb with the 200 mg/kg body weight of the extract showing the best efficacy. Conclusion The effect of the extract compares favourably well with senokot, a standard laxative drug. These findings have therefore, lent scientific credence to the folkloric use of the herb as a laxative agent by the people of the Eastern Cape of South Africa.

  19. BOTULINUM TOXIN: FOR SAFE AND EFFECTIVE NON-SURGICAL TREATMENT IN ACUTE AND CHRONIC ANAL FISSURES

    Directory of Open Access Journals (Sweden)

    Rehan Sabir

    2015-12-01

    Full Text Available BACKGROUND Fissure in ano is a common painful anorectal condition with high recurrence rates. It is commonly seen due to sedentary lifestyle, which involves prolonged sitting posture, mental stress, low fiber diet and lack of physical activity which causes chronic constipation. Irrespective to whichever modality of existing therapies that are used, the recurrences are common. The traditional surgical option like lateral internal sphincterotomy, which has been into practice since long time carries risk of incontinence. It is a need of an hour to rely on a treatment modality which should be simple, safe, effective and reversible with no permanent sequelae. In this study chemical sphincterotomy using injection, Botulinum toxin gives an alternative modality and proved to be the most safe and reliable non-operative option for treating both acute and chronic fissure in ano. AIM AND OBJECTIVE This present study clinically assesses the role of injection Botulinum Toxin A in the management of acute and chronic anal fissure. METHODS A total of 50 patients including both acute and chronic fissure-in-ano were treated with injection Botulinum toxin as first line of management. RESULT All patients were found to get symptomatic relief with high rates of fissure healing eventually. The lack of complications and simplicity in its administration makes it a reliable alternative to the currently practiced therapies. CONCLUSION Botulinum toxin offers a simple outpatient procedure for fissure-in-ano, which is safe without any significant complications. It carries the potential of being used as a first line of management in acute and chronic fissure-in-ano.

  20. 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

  1. 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 ...

  2. 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 ...

  3. Severe constipation in a patient with Myhre syndrome: a case report.

    Science.gov (United States)

    Bassett, John K; Douzgou, Sofia; Kerr, Bronwyn

    2016-04-01

    Myhre syndrome is a rare autosomal dominant genetic condition characterized by short stature, distinctive facial dysmorphisms, generalized muscle hypertrophy, skeletal abnormalities, decreased joint motility, developmental delay, deafness and cardiac defects. Myhre syndrome and the allelic laryngeal stenosis, arthropathy, prognathism and short stature syndrome are caused by a missense mutation of SMAD4, resulting in altered expression of transforming growth factor β and bone morphogenic protein, affecting cell growth and differentiation. Here, we report on the case of a 7-year-old girl showing symptoms of Myhre syndrome and with a known SMAD4 mutation presenting with the novel symptom of severe constipation. PMID:26636501

  4. Diagnostic accuracy of the Barr and Blethyn radiological scoring systems for childhood constipation assessed using colonic transit time as the gold standard

    International Nuclear Information System (INIS)

    Constipation is a common childhood symptom and abdominal radiography is advocated in diagnosis and management. To assess the reproducibility and diagnostic accuracy of the Barr and Blethyn systems for quantifying constipation on abdominal radiographs in children. Radiographs were scored by three observers of increasing radiological experience (student, junior doctor, consultant). Abdominal radiographs produced during measurement of colonic transit time (CTT) were classified as constipated or normal based on the value of the transit time, and were scored using both systems by observers blinded to the CTT. Abdominal radiographs obtained in children for reasons other than constipation were classed as normal and similarly scored. Reproducibility was measured using the kappa statistic. Diagnostic accuracy was measured using the area under the curve (AUC) for the receiver operator characteristic (ROC) curve. Using either system, scores were higher for constipated children (P<0.01). The consultant produced higher scores than the other observers (P<0.01). Interobserver reproducibility was moderate with the best kappa value only 0.48. The best correlation between score and CTT was 0.51 (junior doctor scores). Diagnostic accuracy of the scores was only moderate, with the largest AUC for a ROC curve of 0.84 for the consultant using the Barr score. Scoring of abdominal radiographs in the assessment of childhood constipation should be abandoned because it is dependent on the experience of the observer, is poorly reproducible, and does not accurately discriminate between constipated children and children without constipation. (orig.)

  5. 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.

  6. 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

  7. 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

  8. 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…

  9. 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 ...

  10. 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 ...

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. Due diligence

    International Nuclear Information System (INIS)

    The Occupational Health and Safety (OHS) Act requires that every employer shall ensure the health and safety of workers in the workplace. Issues regarding the practices at workplaces and how they should reflect the standards of due diligence were discussed. Due diligence was described as being the need for employers to identify hazards in the workplace and to take active steps to prevent workers from potentially dangerous incidents. The paper discussed various aspects of due diligence including policy, training, procedures, measurement and enforcement. The consequences of contravening the OHS Act were also described

  18. Heredity of chronic bronchitis

    DEFF Research Database (Denmark)

    Meteran, Howraman; Backer, Vibeke; Kyvik, Kirsten Ohm; Skytthe, Axel; Thomsen, Simon Francis

    2014-01-01

    BACKGROUND: Smoking is a major risk factor for lung diseases and lower respiratory symptoms, but since not all smokers develop chronic bronchitis and since chronic bronchitis is also diagnosed in never-smokers, it has been suggested that some individuals are more susceptible to develop chronic...... bronchitis due to genetics. OBJECTIVE: To study the relative influence of genetic and environmental factors on the variation in the susceptibility to chronic bronchitis. METHODS: In a population-based questionnaire study of 13,649 twins, 50-71 years of age, from the Danish Twin Registry, we calculated sex......-specific concordance rates and heritability of chronic bronchitis. The response rate was 75%. RESULTS: The prevalence of chronic bronchitis was 9.3% among men and 8.5% among women. The concordance rate for chronic bronchitis was higher in monozygotic twins than in dizygotic twins among women; 0.30 vs. 0.17, but not...

  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. 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...

  2. 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.

  3. 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.

  4. 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...

  5. 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

  6. Dynamic study of pelvic floor in patients with constipation: dynamic magnetic resonance vs defecography

    International Nuclear Information System (INIS)

    Purpose: to compare the concordance between defecography and magnetic resonance in patients with constipation. Materials and methods: we did a prospective and descriptive assay to determine the concordance of a diagnostic test with 17 patients. The evaluation of the studies was double blind. Results: the 17 patients were females, age range 31 - 77 year the symptoms were present between 3 to 120 months. Anterior rectocele was the most common diagnosis (11 patients) and magnetic resonance had sensibility 100%, specificity 50%, positive predictive value 78, 57% and negative predictive value 100%. 7 patients had pelvic floor descent and magnetic resonance had sensibility 71.4%, specificity 20% positive predictive value 38.46% and negative predictive value 50%. Defecography found patients with enterocele and magnetic resonance had sensibility 0% and specificity 100 anismus was present in 2 patients and magnetic resonance didn't find them. Conclusion defecography is still the gold standard for patients with eonstipation. Magnetic resonance are a promise for those patients but has to improve

  7. 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

  8. The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt

    Directory of Open Access Journals (Sweden)

    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.

  9. Toxicology and safety of the tincture of Operculina alata in patients with functional constipation

    Directory of Open Access Journals (Sweden)

    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

  10. 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

  11. Chronic Bronchitis

    Science.gov (United States)

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Chronic bronchitis is one type ...

  12. Chronic gastritis

    OpenAIRE

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-01-01

    Abstract Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understand...

  13. 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.

  14. 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...

  15. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  16. 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.

  17. [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

  18. Long Term Health Risks Due to Impaired Nutrition in Women with a Past History of Bulimia Nervosa

    OpenAIRE

    Sagar, Ashwini

    2005-01-01

    Bulimia nervosa serves as a disease model for a variety of physiological problems associated with improper nutritional intake. Although there is extensive research on women who are actively bulimic, very little has been done to follow-up on women who have overcome bulimia. Amennorhea, anemia, constipation, severe dehydration, arrhythmias, osteoporosis, and diabetes can all be health risks due to impaired nutrition while a patient is bulimic. Fortunately, some of the health problems caused by ...

  19. 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

  20. 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

  1. 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

  2. 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。

  3. 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。

  4. 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

  5. Switching to low-dose oral prolonged-release oxycodone/naloxone from WHO-Step I drugs in elderly patients with chronic pain at high risk of early opioid discontinuation

    Directory of Open Access Journals (Sweden)

    Lazzari M

    2016-05-01

    Full Text Available Marzia Lazzari,1 Claudio Marcassa,2 Silvia Natoli,1 Roberta Carpenedo,1 Clarissa Caldarulo,1 Maria B Silvi,1 Mario Dauri1 1Department of Emergency and Critical Care Medicine, Pain Medicine and Anaesthesiology, Tor Vergata Polyclinic, University of Rome, Rome, 2Cardiology Division, Fondazione Maugeri IRCCS Veruno, Novara, Italy Purpose: Chronic pain has a high prevalence in the aging population. Strong opioids also should be considered in older people for the treatment of moderate to severe pain or for pain that impairs functioning and the quality of life. This study aimed to assess the efficacy and safety of the direct switch to low-dose strong opioids (World Health Organization-Step III drugs in elderly, opioid-naive patients.Patients and methods: This was a single-center, retrospective, observational study in opioid-naive patients aged ≥75 years, with moderate to severe chronic pain (>6-month duration and constipation, who initiated treatment with prolonged-release oxycodone/naloxone (OXN-PR. Patients were re-evaluated after 15, 30, and 60 days (T60, final observation. Response to treatment was defined as an improvement in pain of ≥30% after 30 days of therapy without worsening of constipation.Results: One-hundred and eighty-six patients (mean ± SD age 80.7±4.7 years; 64.5% women with severe chronic pain (mean average pain intensity 7.1±1.0 on the 11-point numerical rating scale and constipation (mean Bowel Function Index 64.1±24.4; 89.2% of patients on laxatives were initiated treatment with OXN-PR (mean daily dose 11.3±3.5 mg. OXN-PR reduced pain intensity rapidly and was well tolerated; 63.4% of patients responded to treatment with OXN-PR. At T60 (mean daily OXN-PR dose, 21.5±9.7 mg, the pain intensity was reduced by 66.7%. In addition, bowel function improved (mean decrease of Bowel Function Index from baseline to T60, -28.2, P<0.0001 and the use of laxatives decreased. Already after 15 days and throughout treatment, ~70

  6. 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.

  7. Chronic migraine.

    Science.gov (United States)

    Schwedt, Todd J

    2014-01-01

    Chronic migraine is a disabling neurologic condition that affects 2% of the general population. Patients with chronic migraine have headaches on at least 15 days a month, with at least eight days a month on which their headaches and associated symptoms meet diagnostic criteria for migraine. Chronic migraine places an enormous burden on patients owing to frequent headaches; hypersensitivity to visual, auditory, and olfactory stimuli; nausea; and vomiting. It also affects society through direct and indirect medical costs. Chronic migraine typically develops after a slow increase in headache frequency over months to years. Several factors are associated with an increased risk of transforming to chronic migraine. The diagnosis requires a carefully performed patient interview and neurologic examination, sometimes combined with additional diagnostic tests, to differentiate chronic migraine from secondary headache disorders and other primary chronic headaches of long duration. Treatment takes a multifaceted approach that may include risk factor modification, avoidance of migraine triggers, drug and non-drug based prophylaxis, and abortive migraine treatment, the frequency of which is limited to avoid drug overuse. This article provides an overview of current knowledge regarding chronic migraine, including epidemiology, risk factors for its development, pathophysiology, diagnosis, management, and guidelines. The future of chronic migraine treatment and research is also discussed. PMID:24662044

  8. 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,

  9. 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.

  10. EFFECTIVENESS OF HEALTH EDUCATION ON PREVENTION AND MANAGEMENT OF CONSTIPATION IN TERMS OF KNOWLEDGE AMONG GERIATRIC PEOPLE IN A SELECTED OLD AGE HOME KOLKATA

    OpenAIRE

    De, Subrata

    2015-01-01

    AIM: The aim was to evaluate the effectiveness of Health education in terms of knowledge on prevention and management of constipation among geriatric people. SETTING AND DESIGN : A pre experimental research was conducted in a selected old age home in Kolkata using one group pre - test post t est design , 30 geriatric people hav...

  11. 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

  12. Chronic inflammatory polyneuropathy

    Science.gov (United States)

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy ... of the body equally. Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic neuropathy caused by ...

  13. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  14. The clinical effect of a new infant formula in term infants with constipation: a double-blind, randomized cross-over trial

    Directory of Open Access Journals (Sweden)

    Taminiau Jan AJM

    2007-04-01

    Full Text Available Abstract Background Nutrilon Omneo (new formula; NF contains high concentration of sn-2 palmitic acid, a mixture of prebiotic oligosaccharides and partially hydrolyzed whey protein. It is hypothesized that NF positively affects stool characteristics in constipated infants. Methods Thirty-eight constipated infants, aged 3–20 weeks, were included and randomized to NF (n = 20 or a standard formula (SF; n = 18 in period 1 and crossed-over after 3 weeks to treatment period 2. Constipation was defined by at least one of the following symptoms: 1 defecation frequency Results Period 1 was completed by 35 infants. A significant increase in defecation frequency (NF: 3.5 pre versus 5.6/week post treatment; SF 3.6 pre versus 4.9/week post treatment was found in both groups, but was not significantly different between the two formulas (p = 0.36. Improvement of hard stool consistency to soft stool consistency was found more often with NF than SF, but did not reach statistical significance (90% versus 50%; RR, 1.8; 95% CI, 0.9–3.5; p = 0.14. No difference was found in painful defecation or the presence of an abdominal or rectal mass between the two groups. Twenty-four infants completed period 2. Only stool consistency was significantly different between the two formulas (17% had soft stools on NF and hard stools on SF; no infants had soft stools on SF and hard stools on NF, McNemar test p = 0.046. Conclusion The addition of a high concentration sn-2 palmitic acid, prebiotic oligosaccharides and partially hydrolyzed whey protein resulted in a strong tendency of softer stools in constipated infants, but not in a difference in defecation frequency. Formula transition to NF may be considered as treatment in constipated infants with hard stools.

  15. 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.

  16. 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

  17. 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

  18. Constipação intestinal em mulheres na pós-menopausa Constipation in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Simone Caetano Morale de Oliveira

    2005-12-01

    Full Text Available OBJETIVOS: Investigar a prevalência e os fatores associados à constipação intestinal em mulheres na pós-menopausa e avaliar o grau de concordância entre diferentes critérios diagnósticos. MÉTODOS: Estudo de corte transversal com 100 mulheres na pós-menopausa e idade superior a 45 anos. Foram aplicados os critérios de Roma II, freqüência de evacuações por semana e auto-avaliação. Avaliaram-se as características sociodemográficas e clínicas com análise descritiva das mesmas. Posteriormente calculou-se o grau de concordância entre os critérios diagnósticos através do coeficiente Kappa (k. A associação entre constipação intestinal e seus possíveis determinantes foi estudada por análise bivariada e multivariada, utilizando-se a razão de prevalência (RP. O intervalo de confiança foi fixado a 95% (IC 95%. RESULTADOS: A média de idade das participantes foi de 58,9±5,9 anos (variação, 46-76 anos. As prevalências de constipação intestinal foram de 47%, 37% e 26%, segundo os critérios de auto-avaliação, Roma II e freqüência de evacuações menor que três vezes por semana, respectivamente. O melhor grau de concordância foi observado entre auto-avaliação e Roma II (k: 0,63; IC 95%: 0,48-0,78. Após análise multivariada, o antecedente de cirurgia perianal (RP: 2,69; IC 95%: 1,03-7,01 segundo Roma II, e a presença de hemorróidas, segundo os critérios de freqüência (RP: 2,53; IC 95%: 1,16-5,51 e de auto-avaliação (RP: 1,78; IC 95%: 1,01-3,15 associaram-se à constipação. CONCLUSÃO: A prevalência de constipação intestinal em mulheres na pós-menopausa foi elevada. A concordância entre os critérios variou de moderada a boa. O antecedente de cirurgia perianal e a presença de hemorróidas associaram-se à constipação.OBJECTIVES: To investigate the prevalence and factors associated with constipation in postmenopausal women and evaluate the level of agreement between different diagnostic criteria

  19. Rats with minimal hepatic encephalopathy due to portacaval shunt show differential increase of translocator protein (18 kDa) binding in different brain areas, which is not affected by chronic MAP-kinase p38 inhibition

    OpenAIRE

    Agusti, Ana; Dziedzic, Jennifer L.; Hernandez-Rabaza, Vicente; Guilarte, Tomas R.; Felipo, Vicente

    2013-01-01

    Neuroinflammation plays a main role in neurological deficits in rats with minimal hepatic encephalopathy (MHE) due to portacaval shunt (PCS). Treating PCS rats with SB239063, an inhibitor of MAP-kinase-p38, reduces microglial activation and brain inflammatory markers and restores cognitive and motor function. The translocator protein-(18-kDa) (TSPO) is considered a biomarker of neuro-inflammation. TSPO is increased in brain of PCS rats and of cirrhotic patients that died in hepatic coma. Rats...

  20. 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.

  1. 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 ...

  2. Chronic Pain

    Science.gov (United States)

    ... who have chronic pain may also have low self-esteem, depression, and anger. Causes & Risk Factors What causes ... as stretching and strengthening activities) and low-impact exercise (such as walking, swimming, or biking) can help ...

  3. 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 ...

  4. Chronic Pericarditis

    Science.gov (United States)

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... weeks after heart surgery) and is considered subacute. Causes Usually, the cause of chronic effusive pericarditis is ...

  5. 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.

  6. 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.

  7. Opioid-induced constipation reversal in response to placebo in a patient with a history of IBS receiving methadone maintenance therapy.

    Science.gov (United States)

    Samokhvalov, Andriy V; Rehm, Jürgen

    2015-01-01

    Opioid-induced constipation (OIC) is one of the major side effects in patients receiving methadone maintenance treatment (MMT). Quite often, constipation becomes a factor significantly affecting therapeutic options and choices. Currently used approaches are symptomatic and in many cases ineffective. At the same time, it is well known that the gastrointestinal system is a subject for psychosomatic influences. In this case report, we describe an unexpected outcome of placebo administration in a patient suffering from OIC since her participation in MMT. The patient participated in a triple-blind randomised placebo-controlled trial of naloxone for treatment of OIC. As part of the study crossover design, the patient received 1 week of placebo followed by 1 week of naloxone, and had significant improvement in her bowel functioning when receiving placebo, then returned to baseline during the second week of the study. PMID:26567239

  8. Efficacy and tolerability of low-dose oral prolonged-release oxycodone/naloxone for chronic nononcological pain in older patients

    Directory of Open Access Journals (Sweden)

    Guerriero F

    2014-12-01

    . OXN-PR was well tolerated; only one patient (1.9% prematurely withdrew from treatment, due to drowsiness.Conclusion: Findings from this open-label prospective study suggest that low-dose OXN-PR may be effective and well tolerated for treatment of moderate-to-severe chronic pain in older patients. Besides its effectiveness, these data indicate that low-dose OXN-PR may be considered a safe analgesic option in this fragile population and warrants further investigation in randomized controlled studies. Keywords: chronic pain, elderly, opioid, oxycodone, constipation

  9. Rats with minimal hepatic encephalopathy due to portacaval shunt show differential increase of translocator protein (18 kDa) binding in different brain areas, which is not affected by chronic MAP-kinase p38 inhibition

    Science.gov (United States)

    Agusti, Ana; Dziedzic, Jennifer L.; Hernandez-Rabaza, Vicente; Guilarte, Tomas R.; Felipo, Vicente

    2014-01-01

    Neuroinflammation plays a main role in neurological deficits in rats with minimal hepatic encephalopathy (MHE) due to portacaval shunt (PCS). Treating PCS rats with SB239063, an inhibitor of MAP-kinase-p38, reduces microglial activation and brain inflammatory markers and restores cognitive and motor function. The translocator protein-(18-kDa) (TSPO) is considered a biomarker of neuro-inflammation. TSPO is increased in brain of PCS rats and of cirrhotic patients that died in hepatic coma. Rats with MHE show strong microglial activation in cerebellum and milder in other areas when assessed by MHC-II immunohistochemistry. This work aims were assessing: 1) whether binding of TSPO ligands is selectively increased in cerebellum in PCS rats; 2) whether treatment with SB239063 reduces binding of TSPO ligands in PCS rats; 3) which cell type (microglia, astrocytes) increases TSPO expression. Quantitative autoradiography was used to assess TSPO-selective 3H-(R)-PK11195 binding to different brain areas. TSPO expression increased differentially in PCS rats, reaching mild expression in striatum or thalamus and very high levels in cerebellum. TSPO was expressed in astrocytes and microglia. Treatment with SB239063 did not reduces 3[H]-PK11195 binding in PCS rats. SB239063 reduces microglial activation and levels of inflammatory markers, but not binding of TSPO ligands. This indicates that SB239063-induced neuroinflammation reduction in PCS rats is not mediated by effects on TSPO. Also, enhanced TSPO expression is not always associated with cognitive or motor deficits. If enhanced TSPO expression plays a role in mechanisms leading to neurological alterations in MHE, SB239063 would interfere these mechanisms at a later step. PMID:24307181

  10. Rats with minimal hepatic encephalopathy due to portacaval shunt show differential increase of translocator protein (18 kDa) binding in different brain areas, which is not affected by chronic MAP-kinase p38 inhibition.

    Science.gov (United States)

    Agusti, Ana; Dziedzic, Jennifer L; Hernandez-Rabaza, Vicente; Guilarte, Tomas R; Felipo, Vicente

    2014-12-01

    Neuroinflammation plays a main role in neurological deficits in rats with minimal hepatic encephalopathy (MHE) due to portacaval shunt (PCS). Treating PCS rats with SB239063, an inhibitor of MAP-kinase-p38, reduces microglial activation and brain inflammatory markers and restores cognitive and motor function. The translocator protein-(18-kDa) (TSPO) is considered a biomarker of neuroinflammation. TSPO is increased in brain of PCS rats and of cirrhotic patients that died in hepatic coma. Rats with MHE show strong microglial activation in cerebellum and milder in other areas when assessed by MHC-II immunohistochemistry. This work aims were assessing: 1) whether binding of TSPO ligands is selectively increased in cerebellum in PCS rats; 2) whether treatment with SB239063 reduces binding of TSPO ligands in PCS rats; 3) which cell type (microglia, astrocytes) increases TSPO expression. Quantitative autoradiography was used to assess TSPO-selective (3)H-(R)-PK11195 binding to different brain areas. TSPO expression increased differentially in PCS rats, reaching mild expression in striatum or thalamus and very high levels in cerebellum. TSPO was expressed in astrocytes and microglia. Treatment with SB239063 did not reduces (3)[H]-PK11195 binding in PCS rats. SB239063 reduces microglial activation and levels of inflammatory markers, but not binding of TSPO ligands. This indicates that SB239063-induced neuroinflammation reduction in PCS rats is not mediated by effects on TSPO. Also, enhanced TSPO expression is not always associated with cognitive or motor deficits. If enhanced TSPO expression plays a role in mechanisms leading to neurological alterations in MHE, SB239063 would interfere these mechanisms at a later step. PMID:24307181

  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. 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

  13. 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。

  14. 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.

  15. Chronic cough hypersensitivity syndrome

    OpenAIRE

    Morice, Alyn H.

    2013-01-01

    Chronic cough has been suggested to be due to three conditions, asthma, post nasal drip, and reflux disease. A different paradigm has evolved in which cough is viewed as the primary condition characterised by afferent neuronal hypersensitivity and different aspects of this syndrome are manifest in the different phenotypes of cough. There are several advantages to viewing cough hypersensitivity as the unifying diagnosis; Communication with patients is aided, aetiology is not restricted and the...

  16. 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 ...

  17. 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 ...

  18. 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

  19. 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

    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...... 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...

  20. Tumor carcinoide de ovario asociado con estreñimiento severo Ovarian carcinoid tumor associated to severe constipation

    Directory of Open Access Journals (Sweden)

    Mario Arturo González Mariño

    2002-09-01

    Full Text Available Se describe el caso de una paciente con estreñimiento severo, refractario al tratamiento médico, a quien se realizó laparotomía por hallazgo de masa anexial que fue reportada como tumor tipo carcinoide estrumal de ovario. En el posoperatorio hubo mejoría de su cuadro de estreñimiento, lo cual posiblemente esté explicado por la remoción del tumor productor del péptido YY. Se presentan datos clínicos, patológicos y se hace una revisión de la literatura.We present a patient with severe constipation, unresponsive to medical treatment, who was operated because of a pelvic mass which was reported as an ovarian strumal carcinoid on pathology examination. At the postoperative period, stools were more frequent, possibly because of resection of the peptide YY producing tumor. The clinical features and pathologic findings are presented here. A review of the literature is made.

  1. Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN-173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571

    Directory of Open Access Journals (Sweden)

    Perrin Catherine

    2009-03-01

    Full Text Available Abstract Background Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30–50%, these children reported abdominal pain, bloating, flatulence, diarrhoea, nausea and bad taste of the medication. Two recent studies have shown that the fermented dairy product containing Bifidobacterium lactis strain DN-173 010 is effective in increasing stool frequency in constipation-predominant irritable bowel syndrome patients with a defecation frequency Methods/design It is a two nation (The Netherlands and Poland double-blind, placebo-controlled randomised multicentre trial in which 160 constipated children (age 3–16 years with a defecation frequency Bifidobacterium lactis DN-173 010 or a control product, twice a day, for 3 weeks. During the study all children are instructed to try to defecate on the toilet for 5–10 minutes after each meal (3 times a day and daily complete a standardized bowel diary. Primary endpoint is stool frequency. Secondary endpoints are stool consistency, faecal incontinence frequency, pain during defecation, digestive symptoms (abdominal pain, flatulence, adverse effects (nausea, diarrhoea, bad taste and intake of rescue medication (Bisacodyl. Rate of success and rate of responders are also evaluated, with success defined as ≥ 3 bowel movements per week and ≤1 faecal incontinence episode over the last 2 weeks of product consumption and responder defined as a subject reporting a stool frequency ≥ 3 on the last week of product consumption. To demonstrate that the success percentage in the intervention group will be 35% and the success percentage in the control group (acidified milk without ferments, toilet training, bowel diary will be 15%, with alpha 0.05 and power 80%, a total sample size of 160 patients was calculated. Conclusion This

  2. Development of opioid-induced constipation: post hoc analysis of data from a 12-week prospective, open-label, blinded-endpoint streamlined study in low-back pain patients treated with prolonged-release WHO step III opioids

    Directory of Open Access Journals (Sweden)

    Ueberall MA

    2015-08-01

    Full Text Available Michael A Ueberall,1 Gerhard HH Mueller-Schwefe2 1Institute for Neurological Sciences, Nuremberg, Germany; 2Interdisciplinary Center for Pain and Palliative Care Medicine, Göppingen, Germany Background: Opioid-induced constipation is the most prevalent patient complaint associated with longer-term opioid use and interferes with analgesic efficacy, functionality, quality of life, and patient compliance.Objectives: We aimed to compare the effects of prolonged-release (PR oxycodone plus PR naloxone (OXN vs PR oxycodone (OXY vs PR morphine (MOR on bowel function under real-life conditions in chronic low-back pain patients refractory to World Health Organization (WHO step I and/or II analgesics.Research design and methods: This was a post hoc analysis of the complete data set from a prospective, randomized, open-label, blinded endpoint (PROBE streamlined study (German pain study registry: 2012-0012-05; European Union Drug Regulating Authorities Clinical Trials [EudraCT]: 2012-001317-16, carried out in 88 centers in Germany, where a total of 901 patients requiring WHO step III opioids to treat low-back pain were enrolled and prospectively observed for 3 months. Opioid allocation was based on either optional randomization (n=453 or physician decision (n=448. In both groups, treatment doses could be adjusted as per the German prescribing information, and physicians were free to address all side effects and tolerability issues as usual. The primary endpoint was the proportion of patients maintaining normal bowel function throughout the complete treatment period, assessed with the Bowel Function Index (BFI. Secondary analyses addressed absolute and relative BFI changes, complete spontaneous bowel movements, use of laxatives, treatment emergent adverse events, analgesic effects, and differences between randomized vs nonrandomized patient groups.Results: BFI changed significantly with all three WHO step III treatments, however significantly less with OXN

  3. 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 of ...

  4. 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 ...

  5. 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 ...

  6. Low chronic radiation doses

    International Nuclear Information System (INIS)

    In the context of the Chernobyl and Fukushima accidents where large territories have been contaminated durably and as consequence where local populations are submitted to chronic low radiation doses, IRSN (French institute for radiation protection and nuclear safety) has led various studies to assess the impact of chronic low doses. Studies about the effects of uranium on marine life show that the impact is strongly dependent on the initial state of the individual (zebra Danio rerio fish). The studies about the impact of chronic low doses due to cesium and strontium contamination show different bio-accumulations: 137Cs is found in the animal's whole body with higher concentrations in muscles and kidneys while 90Sr is found almost exclusively in bones and it accumulates more in female mice than in males. The study dedicated to the sanitary impact of chronic low doses on the workers of the nuclear industry shows a higher risk for developing a leukemia, a pleural cancer or a melanoma but no correlation appears between doses and the appearance of the pleural cancer or the melanoma. (A.C.)

  7. 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。

  8. 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

  9. Lack of exercise is a major cause of chronic diseases.

    Science.gov (United States)

    Booth, Frank W; Roberts, Christian K; Laye, Matthew J

    2012-04-01

    Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life

  10. 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...

  11. 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

  12. 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...

  13. 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

  14. 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.

  15. 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. ...

  16. 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 ...

  17. 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.

  18. 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.

  19. 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...

  20. 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。

  1. Partially hydrolyzed guar gum in the treatment of irritable bowel syndrome with constipation: Effects of gender, age, and body mass index

    Directory of Open Access Journals (Sweden)

    Luigi Russo

    2015-01-01

    Full Text Available Background/Aims: Partially hydrolyzed guar gum (PHGG relieves symptoms in constipation-predominant irritable bowel syndrome (IBS and may have prebiotic properties. However, the correlation between the effectiveness of PHGG and patient characteristics has not been examined. We aimed to investigate the effect of PHGG in symptom relief on constipation-predominant IBS according to gender, age, and body mass index (BMI. Patients and Methods: Sixty-eight patients with IBS entered a 2-week run-in period, followed by a 4-week study period with PHGG. Patients completed a daily questionnaire to assess the presence of abdominal pain/discomfort, swelling, and the sensation of incomplete evacuation. The number of evacuations/day, the daily need for laxatives/enemas and stool consistency-form were also evaluated. All patients also underwent a colonic transit time (CTT evaluation. Results: PHGG administration was associated with a significant improvement in symptom scores, use of laxatives/enemas, stool form/consistency and CTT. At the end of the study period and compared with baseline, the number of evacuations improved in women, patients aged ≥ 45 years and those with BMI ≥ 25 (P < 0.05 for all comparisons; abdominal bloating improved in males (P < 0.05, patients < 45 years (P < 0.01 and those with BMI < 25 (P < 0.05. A decrease in the number of perceived incomplete evacuations/day was reported in patients with a BMI ≥ 25 (P < 0.05. Reductions in laxative/enema use were recorded in females (P < 0.05, patients < 45 years (P < 0.01, and patients with BMI < 25 (P < 0.05. Conclusions: Gender, age, and BMI seem to influence the effect of PHGG supplementation in constipated IBS patients. Further studies are needed to clarify the interaction of such parameters with a fiber-enriched diet.

  2. 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 ...

  3. Living with Chronic Bronchitis

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Chronic Bronchitis If you have chronic bronchitis, you can take steps to control your symptoms. ... and a pneumonia vaccine. If you have chronic bronchitis, you may benefit from pulmonary rehabilitation (PR). PR ...

  4. 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)

  5. Radiolabelled cytokines for imaging chronic inflammation

    Directory of Open Access Journals (Sweden)

    Signore Alberto

    2002-01-01

    Full Text Available 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 pathophysioloy of chronic disorders, combined 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 candidates as radiopharmaceuticals.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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 • ...

  11. 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 ...

  12. 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 ...

  13. Constipation - self-care

    Science.gov (United States)

    ... beans, chickpeas, soybeans, and lentils), peanuts, walnuts, and almonds will also add fiber to your diet. Other ... at bedtime. You can mix powder laxatives with milk or fruit juice to make them taste better. ...

  14. Colectomy for refractory constipation

    DEFF Research Database (Denmark)

    Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth; Knudsen, Lisbet Lomholdt

    2010-01-01

    day after a colectomy with no uncontrolled diarrhoea. The mean CTT was 65.0 h for patients operated, 37.9 h in non-operated patients and 24.75 h in controls (p <0.05). Abdominal bloating and pain and defecation parameters correlated significantly positively with CTT and faecal loading, which were...... reduced bloating and pain and improved defecation patterns significantly. Although patient satisfaction was rather high, there are significant risks of postoperative complications and future operations. The operated patients had a significant increased CTT, faecal load and colon length, compared to non...

  15. 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 ...

  16. 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.

  17. 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.

  18. 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...

  19. 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.

  20. 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

  1. EBV CHRONIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    Delia Racciatti

    2010-02-01

    Full Text Available

    The infection from Epstein-Barr virus (EBV or virus of infectious mononucleosis, together with other herpesviruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and eventually with the “shedding”, it is still not clear if this virus can determine chronic infectious diseases, more or less evolutive. These diseases could include some pathological conditions actually defined as “idiopathic”and characterized by the “viral persistence” as the more credible pathogenetic factor. Among the so-called idiopathic syndromes, the “chronic fatigue syndrome” (CFS aroused a great interest around the eighties of the last century when, just for its relationship with EBV, it was called “chronic mononucleosis” or “chronic EBV infection”.

    Today CFS, as defined in 1994 by the CDC of Atlanta (USA, really represents a multifactorial syndrome characterized by a chronic course, where reactivation and remission phases alternate, and by a good prognosis

  2. Efficacy Observation of Fiberform in the Treatment of Constipation during Pregnancy%非比麸治疗妊娠期便秘的疗效观察

    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。

  3. 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...

  4. 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 ...

  5. 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...

  6. Chronic granulomatous disease

    International Nuclear Information System (INIS)

    Chronic granulomatous disease (CGD) is a rare congenital immunodeficiency characterized by recurrent bacterial and fungal infections as well as granuloma formation. The manifestations of this disease can involve single or multiple organ systems. The lungs are the most commonly affected organ; however, lymphatic, hepatic, skeletal, gastrointestinal, genitourinary, head and neck, and central nervous system involvement have also been described. Most patients present with symptoms in their first few years of life. Due to the nonspecific manner in which patients present, the pediatric radiologist may be among the first to recognize the pattern of infection, inflammation, and granuloma formation leading to a diagnosis of CGD. The purpose of this paper is to review the imaging findings of CGD that can manifest throughout the body. (orig.)

  7. Chronic granulomatous disease

    Energy Technology Data Exchange (ETDEWEB)

    Towbin, Alexander J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Chaves, Ian [Advocate Illinois Masonic Medical Center, Department of Internal Medicine, Chicago, IL (United States)

    2010-05-15

    Chronic granulomatous disease (CGD) is a rare congenital immunodeficiency characterized by recurrent bacterial and fungal infections as well as granuloma formation. The manifestations of this disease can involve single or multiple organ systems. The lungs are the most commonly affected organ; however, lymphatic, hepatic, skeletal, gastrointestinal, genitourinary, head and neck, and central nervous system involvement have also been described. Most patients present with symptoms in their first few years of life. Due to the nonspecific manner in which patients present, the pediatric radiologist may be among the first to recognize the pattern of infection, inflammation, and granuloma formation leading to a diagnosis of CGD. The purpose of this paper is to review the imaging findings of CGD that can manifest throughout the body. (orig.)

  8. 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

  9. 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

  10. 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

  11. Human due diligence.

    Science.gov (United States)

    Harding, David; Rouse, Ted

    2007-04-01

    Most companies do a thorough job of financial due diligence when they acquire other companies. But all too often, deal makers simply ignore or underestimate the significance of people issues in mergers and acquisitions. The consequences are severe. Most obviously, there's a high degree of talent loss after a deal's announcement. To make matters worse, differences in decision-making styles lead to infighting; integration stalls; and productivity declines. The good news is that human due diligence can help companies avoid these problems. Done early enough, it helps acquirers decide whether to embrace or kill a deal and determine the price they are willing to pay. It also lays the groundwork for smooth integration. When acquirers have done their homework, they can uncover capability gaps, points of friction, and differences in decision making. Even more important, they can make the critical "people" decisions-who stays, who goes, who runs the combined business, what to do with the rank and file-at the time the deal is announced or shortly thereafter. Making such decisions within the first 30 days is critical to the success of a deal. Hostile situations clearly make things more difficult, but companies can and must still do a certain amount of human due diligence to reduce the inevitable fallout from the acquisition process and smooth the integration. This article details the steps involved in conducting human due diligence. The approach is structured around answering five basic questions: Who is the cultural acquirer? What kind of organization do you want? Will the two cultures mesh? Who are the people you most want to retain? And how will rank-and-file employees react to the deal? Unless an acquiring company has answered these questions to its satisfaction, the acquisition it is making will be very likely to end badly. PMID:17432159

  12. Chronic granulomatous disease

    Science.gov (United States)

    CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... In chronic granulomatous disease (CGD), immune system cells called ... some types of bacteria and fungi. This disorder leads to long- ...

  13. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Experiencing Chronic Homelessness Share This: People Experiencing Chronic Homelessness We've made significant progress in our national ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  14. Chronic motor tic disorder

    Science.gov (United States)

    Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start at age 5 or 6 and get worse until age 12. They often improve during adulthood.

  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 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 ...

  17. 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.

  18. 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

  19. 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 ...

  20. 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.

  1. 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)....

  2. 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

  3. 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...

  4. Chronic Inflammatory Demyelinating Polyneuropathy

    OpenAIRE

    Dimachkie, Mazen M.; Barohn, Richard J.

    2013-01-01

    Chronic Inflammatory polyneuropathies are an important group of neuromuscular disorders that present chronically and progress over more than 8 weeks, being referred to as chronic inflammatory demyelinating polyneuropathy (CIDP). Despite tremendous progress in elucidating disease pathogenesis, the exact triggering event remains unknown. Our knowledge regarding diagnosis and management of CIDP and its variants continues to expand, resulting in improved opportunities for identification and treat...

  5. Electroacupuncture treatment of chronic insomniacs

    Institute of Scientific and Technical Information of China (English)

    RUAN Jing-wen; WANG Chu-huai; LIAO Xin-xue; YAN Ying-shuo; HU Yue-hua; RAO Zhong-dong; WEN Ming; ZENG Xiao-xiang; LAI Xin-sheng

    2009-01-01

    Background Due to the quick rhythm of life and work pressure, more and more people suffer from sleep quality problems. In this study, we investigated the effect of electroacupuncture on sleep quality of chronic insomniacs and the safety of electroacupuncture therapy.Methods Four courses of electroacupuncture treatment were applied to 47 patients. With pre-treatment and post-treatment self-control statistical method, Pittsburgh sleep quality index (PSQI) scores were used for evaluating sleep quality. Polysomnogram was used for detecting insomniacs' changes in sleep architecture. The safety of electroacupuncture was evaluated by monitoring the self-designed adverse events and side effects during treatment and post-treatment.Results Electroacupuncture considerably improved insomniacs' sleep quality and social function during the daytime.Electroacupuncture had certain repairing effect on the disruption in sleep architecture. At the same time,electroacupuncture prolonged slow wave sleep (SWS) time and relatively rapid eye movement sleep (REM sleep) time.There was no hangover, addiction or decrements in vigilance during the daytime (incidence rate was 0). However,insomnia rebound rate was about 23% within one month.Conclusions These results suggest that electroacupuncture has beneficial effect on sleep quality improvement in the patients with chronic insomnia, which may be associated with repairing sleep architecture, reconstructing sleep continuity,as well as prolonging SWS time and REM sleep time. Electroacupuncture treatment for chronic insomnia is safe.Therefore, electroacupuncture therapy could be a promising avenue of treatment for chronic insomnia.

  6. 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

  7. Risk factors and prediction for functional and chronic inflammatory bowel diseases in infants

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2014-03-01

    Full Text Available Objective — to determine mainly significant risk factors and prediction for development of functional bowel disease and chronic non-ulcerative non-specific colitis in infants. Materials and methods. Retrospective studies were conducted using the method of questioning parents and analysis of medical records of 344 infants in the age from 6 months to 3 years of life, including 134 infants with functional constipation (FC , 64 infants with functional diarrhea (FD and 146 children with chronic non-specific not-ulcerative colitis (CNNC. The control group included 50 healthy children of similar age and gender. In groups of children retrospectively determined the frequency of risk factors. To compare the data between different groups was used analysis of Pearson c2 criteria and relative risks (relative risk, RR with 95% confidence intervals. Prediction for the development of FC, FD and CNNC was applied the method of discriminant function analysis based on the analysis of 51 essential marks. Results. Mathematical analysis of risk factors for bowel diseases allowed to identify the most important of them, in particular, family history of diseases of the digestive system, including bowel disease, complications during pregnancy and at birth disorders, women chronic extragenital diseases, chronic diseases of women characterized by prolonged exposure in the body to opportunistic or pathogenic bacteria, nutritional and feeding disorders, high infection index and history of infectious diseases. Revealed by the discriminant function analysis significant risk factors, represent their important role in the development of functional bowel disorders and chronic non-specific non-ulcerative colitis. Conclusions. Identifying the risk factors for the development and application of prediction algorithm for functional bowel diseases and chronic non-specific non-ulcerative colitis is enable to develop the effective treatment and preventive measures to reduce the

  8. Radiology of chronic diseases of the ankle joint

    International Nuclear Information System (INIS)

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  9. 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...

  10. Chronic Hemodialysis in Small Children.

    Science.gov (United States)

    Novljan, Gregor; Rus, Rina R; Premru, Vladimir; Ponikvar, Rafael; Battelino, Nina

    2016-06-01

    When peritoneal dialysis is inapplicable, chronic hemodialysis (HD) becomes the only available treatment option in small children. Due to small patient size, central venous catheters (CVC) are mainly used for vascular access. Over the past 4 years, four children weighing less than 15 kg received chronic HD in our unit. A total of 848 dialysis sessions were performed. Altogether, 21 catheters were inserted. In all but one occasion, uncuffed catheters were used. Catheter revision was performed 15 times during the study period, either due to infection or catheter malfunction. The median number of catheter revisions and the median line survival was 3.0/patient-year and 53 days (range; 6-373 days), respectively. There were 14 episodes of catheter related infections requiring 11 CVC revisions (78.6%). The median rate of line infections was 2.8/patient-year. Chronic HD in small children is demanding and labor intensive. Issues pertain mainly to CVCs and limit its long-term use. PMID:27312919

  11. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik;

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...

  12. Uso de psyllium para controle de constipação em cães The use of psyllium to control constipation in dogs

    Directory of Open Access Journals (Sweden)

    Letícia Tortola

    2009-12-01

    Full Text Available psyllium (Plantago psyllium é um vegetal comumente utilizado como adjuvante no tratamento de afecções que resultam em constipação. Com o objetivo de melhor compreender os efeitos dessa fibra em cães, foram realizados dois experimentos. O primeiro avaliou, em cães sadios, inclusões de 0%, 2% e 4% de semente integral moída de psyllium à dieta (com base na matéria natural. Para tanto, foram empregados oito cães da raça Beagles adultos, os quais receberam as dietas experimentais por oito dias. Verificou-se aumento linear da umidade das fezes com a adição de teores crescentes de psyllium (R²=0,54 e P=0,0012, sem alteração do escore fecal e número de defecações por dia. O segundo experimento incluiu avaliação da opinião de 24 proprietários cujos cães receberam suplementação de 2% de psyllium como parte do tratamento de afecções que causaram constipação. Dos proprietários incluídos, 19 (79,2% relataram melhora da defecação de seus cães durante a administração da fibra. Quinze (62,5% observaram que as fezes dos animais, antes ressecadas ou endurecidas, tornaram-se normais ou pastosas. Os resultados comprovaram para cães os efeitos laxativos do psyllium já descritos na medicina humana, indicando seu uso no tratamento de suporte de enfermidades que levam à constipação.psyllium (Plantago psyllium is a fiber generally used as a supplement in the treatment of diseases that led to constipation. To understanding of the effects of this fiber in dogs, two experiments were conducted. The first evaluated in healthy dogs a diet supplementation with 0%, 2% and 4% of ground whole psyllium seeds (as-fed basis. Eight adult Beagle dogs were used. They received the experimental diets for eight days. A linear increase of faecal moisture was verified with the addition of psyllium (R²=0.54 and P=0.0012, with no alteration on faecal score or number of defecations per day. The second experiment included 24 dogs with constipation

  13. 不同术式治疗慢传输型便秘的评价%Evaluation of colon slow transit constipation

    Institute of Scientific and Technical Information of China (English)

    龚旭晨; 朱向琥; 王峰; 阿力马斯; 艾克拜尔; 包文; 陈敏; 祝利

    2008-01-01

    Objective To observe the results of three kinds of surgical modality(total colectomy,subtotal colectomy and cecoreetostomy)in the treatment of colonic slow transit constipation(STC)and to discuss the reasonable surgical therapeutic method of STC.Methods The clinical data of 35 patients with intractable colonic slow transit constipation undergoing surgical treatment were retrospectively reviewed from Mar.2000 to Jan.2008,ten of them undergoing total colectomy,12 undergoing subtotal colectomy and 13 sufferins cecorectostomy.Results After surgery,the symptoms of defecation difficulty,stool traits,bearing down,frequency and abdominal distention were improved obviously.The relapse rate in cecorectostomy wassignificantly higher than that of the total colectomy(P<0.01).Condusiom Total colectomy,subtotal colecstomy and cecorectostomy are all satisfactory modalities for the treatment of STC.Patients with total colectomy may cause higher rate of diarrhea.So appropriate surgical modalities were selected in accordance with the different conditions of patients.%目的 观察3种外科术式(即结肠全切除、结肠次全切除和结肠部分切除术)在治疗结肠慢传输型便秘中的治疗效果,并初步探讨慢传输型便秘(colon slowly transit constipation,STC)合理的手术治疗方式.方法 回顾性分析2000年3月~2008年1月实施手术的35例患者的临床资料,其中行结肠全切除术者10例,12例行结肠次全切除术,13例行结肠部分切除术.结果 35例患者经过手术后,其排便困难、大便性状、下坠感、频次及腹胀等症状均较手术前有明显改善,结肠全切除术者术后无复发,结肠部分切除术者术后复发率明显高于结肠全切除术.结论 结肠全切除、结肠次全切除和结肠部分切除这3种外科术式对治疗结肠慢传输型便秘均有满意的疗效,但结肠全切除术后患者腹泻发生率高,应根据患者的具体病情选择相应的术式.

  14. Constipation in the population over 50 years of age in Albacete province Estreñimiento en la población mayor de 50 años de la provincia de Albacete

    OpenAIRE

    M. A. López Cara; P. J. Tárraga López; M. Cerdán Oliver; J. M. Ocaña López; A. Celada Rodríguez; J. Solera Albero; M. A. Palomino Medina

    2006-01-01

    Objective: to determine the incidence of constipation in Albacete province and its relation with diet and lifestyle. Patients and methods: cross-sectional population survey. We studied 414 participants over 50 years of age in Albacete province. 445 persons over 50 years of age were included in the study. All participants were selected by systematic random sampling; 414 participants filled in the questionnaire correctly. Main measures: age, weight and height, marital status, level of education...

  15. Insomnia and chronic heart failure.

    Science.gov (United States)

    Hayes, Don; Anstead, Michael I; Ho, Julia; Phillips, Barbara A

    2009-09-01

    Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. PMID:18758945

  16. 通腑泻实推拿法治疗小儿实证便秘疗效观察%Efficacy Observation on Massage of Dredging and Purging Treating Children with Constipation of Excess Syndrome

    Institute of Scientific and Technical Information of China (English)

    利玉婷; 陈红蕾

    2014-01-01

    目的:观察通腑泻实推拿法治疗小儿实证便秘的临床疗效。方法:55例实秘患儿采取通腑泻实推拿法治疗,每日1次,5次为一疗程,2个疗程后观察疗效。结果:治愈39例,好转14例,无效2例,总有效率达96.5%。结论:通腑泻实推拿法治疗小儿实秘临床疗效确切,值得推广。%To observe the clinical efficacy in massage of dredging and purging treating children with constipation of excess syndrome. Methods:55 cases of sthenia constipation adopted massage of dredging and purging, 1 time per day, 5 times for a course of treatment, the therapeutic effect was observed after 2 courses of treatment. Results:39 cases were cured, 14 cases improved, 2 cases ineffective, the total effective rate was 96.5%. Conclusion:Massage of dredging and purging treating children with constipation of excess syndrome is clinically quite effective, being worth of promoting.

  17. Apyretic gastrointestinal disorders due to giardiasis contracted in Morocco

    OpenAIRE

    Michael K. Hole; Meunier, Yann A.

    2011-01-01

    We present the case of a 32-year-old French man who presented with morning nausea, bloating, frequent flatulence, burping, occasional pyrosis, and alternating diarrhea and constipation two weeks after a trip to Morocco. The diagnosis was established by a parasitological stool exam that revealed cysts of Giardia lamblia. He was successfully treated with tinidazole.

  18. Apyretic gastrointestinal disorders due to giardiasis contracted in Morocco

    Directory of Open Access Journals (Sweden)

    Michael K. Hole

    2011-05-01

    Full Text Available We present the case of a 32-year-old French man who presented with morning nausea, bloating, frequent flatulence, burping, occasional pyrosis, and alternating diarrhea and constipation two weeks after a trip to Morocco. The diagnosis was established by a parasitological stool exam that revealed cysts of Giardia lamblia. He was successfully treated with tinidazole.

  19. Chronic diseases in adolescence

    OpenAIRE

    Rončević Nevenka; Stojadinović Aleksandra; Odri Irena

    2006-01-01

    Introduction. The prevalence of chronic diseases in adolescence is constantly increasing, especially in the last two decades. Adolescence is a period of important changes: body growth and development, sexual development, development of cognitive abilities, change in family relations and between peers, formation of personal identity and personal system of values, making decisions on future occupation etc. Chronic diseases in adolescence. Chronic disorders affect all development issues and repr...

  20. Chronic obstructive pulmonary disease

    OpenAIRE

    NR Anthonisen

    2007-01-01

    The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are...

  1. Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zanetti, Glaucia [University of Rio de Janeiro, Department of Radiology, Rio de Janeiro (Brazil); Marchiori, Edson [University of Rio de Janeiro, Department of Radiology, University Federal Fluminense, Rio de Janeiro (Brazil); Gasparetto, Taisa D. [University Federal Fluminense, Department of Radiology, Rio de Janeiro (Brazil); Escuissato, Dante L. [University of Parana, Department of Radiology, Curitiba (Brazil); Soares Souza, Arthur [School of Medicine of Sao Jose do Rio Preto (ASSJ), Department of Radiology, Sao Jose do Rio Preto (Brazil)

    2007-11-15

    Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs. (orig.)

  2. Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients

    International Nuclear Information System (INIS)

    Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs. (orig.)

  3. Chronic Granulomatous Disease (CGD)

    Science.gov (United States)

    ... Share this: Main Content Area Chronic Granulomatous Disease (CGD) Phagocyte (purple) engulfing Staphylococcus aureus bacteria (yellow). Credit: NIAID CGD is a genetic disorder in which white blood ...

  4. Chronic silent otitis media.

    Science.gov (United States)

    Paparella, Michael M; Schachern, Patricia A; Cureoglu, Sebahattin

    2002-01-01

    Otitis media occurs along a continuum. For example, otitis media with effusion characterized by fluid pathology can lead to chronic otitis media plus chronic mastoiditis, characterized by the presence of intractable tissue pathology such as cholesteatoma, cholesterol granuloma or granulation tissue. The literature defines chronic otitis media as having a tympanic membrane perforation and otorrhea. Amongst many other sequelae, which can result from the continuum, an important common one is chronic silent otitis media. This overlooked entity which includes pathology beneath an intact tympanic membrane is commonly seen in our human temporal bone laboratory and in patients. The clinical pathological correlates of this important disease are discussed herein. PMID:12021496

  5. Effects of standardized water intake direction on constipation for hospitalized psychiatric patients%规范化饮水指导对住院精神病患者便秘的影响

    Institute of Scientific and Technical Information of China (English)

    杨起萍; 沈红霞; 张碧蓉

    2015-01-01

    Objective:To investigate effects of standardized water intake direction on constipation for hospitalized psychiatric patients. Methods:389 patients were selected and randomly divided into observation group (194 cases) and control group (195 ca-ses) . The control group received routine health guidance, while the observation group received standardized water intake direction based on the routine health guidance. The constipation situations of the two groups were compared. Results:There was no significant difference in the constipation situations 2 weeks after admission between the two groups (P>0. 05); however, there were significant differences in the constipation situations 1 and 2 months after admission (P>0. 05). There was no significant difference in the water in-take compliance 2 weeks after admission between the two groups (P>0. 05); however, there were significant differences in the water intake compliance 1 and 2 months after admission (P>0. 05). Conclusions: The daily per capita water above 1500ml, and a small number of times of drinking can reduce the mental patients' incidence of constipation. Standardized nursing guidance can improve the compliance of water intake for these patients.%目的::探讨规范化饮水指导对住院精神病患者便秘的影响。方法:选择389例患者,采用随机法分为观察组194例和对照组195例。对照组患者接受精神科常规健康指导,观察组患者在此基础上接受规范化饮水指导,比较两组患者的便秘情况。结果:两组患者在入院2周便秘发生数比较差异无显著意义(P>0.05);入院1月和入院2个月便秘发生数比较差异有统计学意义(P0.05),入院1月和入院2个月饮水依从性比较差异有统计学意义(P<0.05)。结论:每日每人饮水在1500 ml以上,且少量多次饮用,可以降低住院精神病患者的便秘发生率,规范化指导能促进患者饮水的依从性。

  6. Heart failure after aortic valve substitution due to severe hypothyroidism

    DEFF Research Database (Denmark)

    Munk, Kim; Sørensen, Stine Heidenheim; Andersen, Niels Holmark;

    2008-01-01

    We report a case of a 70-year-old female with considerable co-morbidities (Type 2 diabetes, Leiden factor V mutation, mild to moderate chronic obstructive pulmonary disease) and a recent biological aortic valve substitution, who was admitted due to circulatory collapse caused by severe heart fail...

  7. Urinary tract infection due to Enterobacter sakazakii

    OpenAIRE

    Bhat Gopalkrishna; Anandhi.R; Dhanya V; Shenoy Shalini

    2009-01-01

    Enterobacter sakazakii is a rare but important cause of necrotizing enterocolitis, bloodstream infection and central nervous system infections in humans, with mortality rates of 40-80%. It has not been reported to cause urinary tract infection. We report a case of urinary tract infection due to E. sakazakii in a 63-year-old lady with chronic renal failure.

  8. Chronic gastrointestinal symptoms and quality of life in the Korean population

    Institute of Scientific and Technical Information of China (English)

    Jeong-Jo Jeong; Sok-Won Han; Kyu-Yong Choi; In-Sik Chung; Myung-Gyu Choi; Young-Seok Cho; Seung-Geun Lee; Jung-Hwan Oh; Jae-Myung Park; Yu-Kyung Cho; In-Seok Lee; Sang-Woo Kim

    2008-01-01

    AIM: To evaluate the prevalence of chronic gastroin-testinal symptoms and their impact on health-related quality of life (HRQOL) in the Korean population. METHODS: A cross-sectional survey, using a reliable and valid Rome 1I based questionnaire, was per-formed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey (SF-36). RESULTS: Of the 1807 eligible subjects, 1417 (78.4%: male 762; female 655) were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastro-esophageal reflux disease (GERD), defined as heart-burn and/or acid regurgitation experienced at least weekly, was 3.5% (95% CI, 2.6-4.5). The prevalence of uninvestigated dyspepsia, irritable bowel syndrome (IBS) and chronic constipation based on Rome Ⅱ cri-teria were 11.7% (95% CI, 10.1-13.5), 2.2% (95% CI, 1.5-3.1), and 2.6% (95% CI, 1.8-3.5) respectively. Compared with subjects without chronic gastrointesti-nal symptoms (n = 1153), those with GERD (n = 50), uninvestigated dyspepsia (n = 166) and IBS (n=31) had significantly worse scores on most domains of the SF-36 scales. CONCLUSION: The prevalence of GERD, uninvesti-gated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health-related quality of life was significantly impaired in sub-jects with GFRD, uninvestigated dyspepsia and IBS in this community.

  9. Pericytes in chronic lung disease.

    Science.gov (United States)

    Rowley, Jessica E; Johnson, Jill R

    2014-01-01

    Pericytes are mesenchymal cells embedded within the abluminal surface of the endothelium of microvessels such as capillaries, pre-capillary arterioles, post-capillary and collecting venules, where they maintain microvascular homeostasis and participate in angiogenesis. In addition to their roles in supporting the vasculature and facilitating leukocyte extravasation, pericytes have been recently investigated as a subpopulation of mesenchymal stem cells (MSCs) due to their capacity to differentiate into numerous cell types including the classic MSC triad, i.e. osteocytes, chondrocytes and adipocytes. Other studies in models of fibrotic inflammatory disease of the lung have demonstrated a vital role of pericytes in myofibroblast activation, collagen deposition and microvascular remodelling, which are hallmark features of chronic lung diseases such as asthma, chronic obstructive pulmonary disorder, pulmonary fibrosis and pulmonary hypertension. Further studies into the mechanisms of the pericyte-to-myofibroblast transition and migration to fibrotic foci will hopefully clarify the role of these cells in chronic lung disease and confirm the importance of pericytes in human fibrotic pulmonary disease. PMID:25034005

  10. Managing your chronic pain

    Science.gov (United States)

    ... your chronic back pain To use the sharing features on this page, please enable JavaScript. Managing chronic pain means finding ways to make your back pain tolerable so you can live your life. You may not be able to ...

  11. Chronic diseases in adolescence

    Directory of Open Access Journals (Sweden)

    Rončević Nevenka

    2006-01-01

    Full Text Available Introduction. The prevalence of chronic diseases in adolescence is constantly increasing, especially in the last two decades. Adolescence is a period of important changes: body growth and development, sexual development, development of cognitive abilities, change in family relations and between peers, formation of personal identity and personal system of values, making decisions on future occupation etc. Chronic diseases in adolescence. Chronic disorders affect all development issues and represent an additional burden for adolescents. The interaction between chronic disorders and various development issues is complex and two-way: the disease may affect development, and development may affect the disease. Developmental, psychosocial and family factors are of great importance in the treatment of adolescents with chronic disorders. Chronic disorders affect all aspects of adolescent life, including relations with peers, school, nutrition, learning, traveling, entertainment, choice of occupation, plans for the future. Physicians should keep in mind that chronic diseases and their treatment represent only one aspect of person's life. Adolescents with chronic diseases have other needs as well, personal priorities, social roles and they expect these needs to be recognized and respected. Adolescent health care should be adjusted to the life style of adolescents.

  12. Invasive mucormycosis in chronic granulomatous disease.

    Science.gov (United States)

    Al-Otaibi, Abdulnasir M; Al-Shahrani, Dayel A; Al-Idrissi, Eman M; Al-Abdely, Hail M

    2016-05-01

    Mucormycosis is a rare opportunistic fungal infection that occurs in certain immunocompromised patients. We present 2 cases of invasive mucormycosis due to Rhizopus spp. in patients with chronic granulomatous disease (CGD) and discuss their clinical presentation, management challenges, and outcomes. PMID:27146621

  13. The Chronic Responsibility

    DEFF Research Database (Denmark)

    Ravn, Iben M; Frederiksen, Kirsten; Beedholm, Kirsten

    2016-01-01

    This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough’s three-dimensional framework for analyzing discourse, and using Dean’s concepts...... of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients’ active role, lifestyle......, and health behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who...

  14. [Chronic migraine: treatment].

    Science.gov (United States)

    Pascual, Julio

    2012-04-10

    We define chronic migraine as that clinical situation in which migraine attacks appear 15 or more days per month. Until recently, and in spite of its negative impact, patients with chronic migraine were excluded of the clinical trials. This manuscript revises the current treatment of chronic migraine. The first step should include the avoidance of potential precipitating/aggravating factors for chronic migraine, mainly analgesic overuse and the treatment of comorbid disorders, such as anxiety and depression. The symptomatic treatment should be based on the use of nonsteroidal anti-inflammatory agents and triptans (in this case ergotamine-containing medications. Preventive treatment includes a 'transitional' treatment with nonsteroidal anti-inflammatory agents or steroids, while preventive treatment exerts its actions. Even though those medications efficacious in episodic migraine prevention are used, the only drugs with demonstrated efficacy in the preventive treatment of chronic migraine are topiramate and pericranial infiltrations of Onabotulinumtoxin A. PMID:22532241

  15. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

    Science.gov (United States)

    ... People About NINDS NINDS Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Information Page Table of Contents (click to jump ... en Español What is Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)? Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological ...

  16. Stages of Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Myelogenous Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Myelogenous Leukemia Go to Health Professional Version Key Points Chronic ...

  17. Stages of Chronic Lymphocytic Leukemia

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Lymphocytic Leukemia Go to Health Professional Version Key Points Chronic ...

  18. Extensive colonic stricture due to pelvic actinomycosis.

    Science.gov (United States)

    Kim, J C; Cho, M K; Yook, J W; Choe, G Y; Lee, I C

    1995-04-01

    A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively. PMID:7576294

  19. [Chronic pain and regional anesthesia in children].

    Science.gov (United States)

    Dadure, C; Marec, P; Veyckemans, F; Beloeil, H

    2013-10-01

    Chronic pain is usually underestimated in children, due to lack of knowledge and its specific signs. In addition to suffering, chronic pain causes a physical, psychological, emotional, social, and financial burden for the child and his family. Practitioners may find themselves in a situation of failure with depletion of medical resources. Some types of chronic pain are refractory to conventional systemic treatment and may require the use of regional anesthesia. Cancer pain is common in children and its medical management is sometimes insufficient. It is accessible to neuroaxial or peripheral techniques of regional anesthesia if it is limited to an area accessible to one of these techniques and no contraindications (e.g., thrombopenia) are present. Complex regional pain syndrome 1 is not rare in children and adolescents, but it often goes undiagnosed. Regional anesthesia may contribute to the treatment of complex regional pain syndrome 1, mainly in case of recurrence, because it provides rapid effective analgesia and allows rapid implementation of intensive physiotherapy. These techniques have also shown interest in phantom limb pain after limb amputation, but they remain controversial for erythromelalgia pain or chronic abdominopelvic pain. Finally, the treatment of postdural puncture headache due to cerebrospinal fluid leak can be treated by performing an epidural injection of the patient's blood, called a blood-patch. Finally, the management of children with chronic pain should be multidisciplinary (pediatrician, physiotherapist, psychologist, surgeon, anesthesiologist) to support the child and her problem in its entirety. PMID:23953871

  20. Intrathecal drug administration in chronic pain syndromes.

    Science.gov (United States)

    Ver Donck, Ann; Vranken, Jan H; Puylaert, Martine; Hayek, Salim; Mekhail, Nagy; Van Zundert, Jan

    2014-06-01

    Chronic pain may recur after initial response to strong opioids in both patients with cancer and patients without cancer or therapy may be complicated by intolerable side effects. When minimally invasive interventional pain management techniques also fail to provide satisfactory pain relief, continuous intrathecal analgesic administration may be considered. Only 3 products have been officially approved for long-term intrathecal administration: morphine, baclofen, and ziconotide. The efficacy of intrathecal ziconotide for the management of patients with severe chronic refractory noncancer pain was illustrated in 3 placebo-controlled trials. A randomized study showed this treatment option to be effective over a short follow-up period for patients with pain due to cancer or AIDS. The efficacy of intrathecal opioid administration for the management of chronic noncancer pain is mainly derived from prospective and retrospective noncontrolled trials. The effect of intrathecal morphine administration in patients with pain due to cancer was compared with oral or transdermal treatment in a randomized controlled trial, which found better pain control and fewer side effects with intrathecal opioids. Other evidence is derived from cohort studies. Side effects of chronic intrathecal therapy may either be technical (catheter or pump malfunction) or biological (infection). The most troublesome complication is, however, the possibility of granuloma formation at the catheter tip that may induce neurological damage. Given limited studies, the evidence for intrathecal drug administration in patients suffering from cancer-related pain is more compelling than that of chronic noncancer pain. PMID:24118774